Neurodivergent Doctor explains Autism problems with interoception. Do you notice what is happening?

Are you running hot? Can't seem to warm up? Do you have a high pain tolerance? Do you not feel emotions until they are extreme? These and other phenomenon may be linked to problems with your eighth sense: Interoception. As a neurodivergent myself, this is something I struggle with and have experience dealing with. This video explains what it is and what to do about it. Disclaimer - This is my personal opinion and is for informational purposes only. This is not therapy and no therapeutic relationship between me and any viewer is asserted or implied. If you have questions, please seek a qualified professional. Photos and videos are licensed to me and any other photos are used for educational purposes under common use laws. If you would like references, please research this subject as there are a multitude of references easily accessible online.

[catsandcrafts]

It's scary, as a middle age woman, to be suddenly discovering all this information that totally explains all the things in my whole life that caused me problems, made me somewhat 'unlikeable' and basically made everything in life 10 times harder than it seemed to be for everyone else around me! Now I know I have a massive problem with 'interoception'. How interesting!

[sarahselch]

I’m very sensitive to temperature. I’m either freezing, or sweating. I’m never comfortable.

[ComedorDelrico]

After watching this, so many things suddenly make sense.

I've always found it strange when people eat small portions. For example, they say they're hungry but then they just eat half a sandwich or something. I never understood how people could get full off of such a small amount. If I'm hungry, I want a big plateful of food. Or maybe two.

Eventually, I realized that I just don't feel hunger until I'm absolutely ravenous. I go from no hunger to "I want to eat all the things" in a matter of minutes. There is no in-between.

The reason other people are able to get "full" from a small portion is that they actually start to feel it when they're just a little bit hungry, and then just a little food makes them full. I've never felt just a little hungry. It just doesn't register for me until it's overwhelming.

[nanadeneanu]

I am a 66yo, recently diagnosed ASD. I am also a retired M.D. due to a complete undiagnosed ASD breakdown 20 years ago. I have been healing and managing myself my entire life with NO information! To have information now is like a blessed miracle. I feel like someone has turned on the light, given me a map, and eased my suffering. Thank you!

[paulmryglod]

I can relate to so much of this. I actually put in cameras on our house after a string of neighborhood car break-ins. I was standing in the driveway explaining something important to my fiancée and she said, "Why are you angry? You're angry so often!"
I was not angry at all, but i felt like i was being attacked by a made up issue.
I reviewed the video, and sure enough, my emphasis and energetic feelings came across as being angry. It looked on the recording like i was argumentative and holding back rage. My internal feelings were no where near that.
I stopped arguing with anyone about this and just take them at their word when im told im a certain way, because my internal feelings and external expressions do not align.

[ShadoeLandman]

Feeling hungry feels like nausea to me. My mom is the same.

I’m hot all the time, except when I’m freezing, which seems like a relief if I’m home and can curl up in a big blanket or afghan. But there’s no middle comfortable ground, and it’s too hot 90% of the time. I would probably really benefit from a weighted blanket if only it didn’t make me hotter. I often lose sleep from getting too hot.

I’m extremely physically sensitive to smells, textures, things that should be tiny discomforts like insect bites, etc. A mosquito bite will drive me nuts and stick around for like a week even if not scratched, and I can’t put anything on it to reduce the itch because my skin is so sensitive hydrocortisone cream gives me a chemical burn.

Strong or even moderate scents make my nose run, and my eyes itch from the slightest breeze. And then there are actual allergies and foods that my body simply rejects like they’re poison. I can’t do body mindfulness and such because if I pay attention, everything seems uncomfortable to painful. Pain in my head is often impossible to pinpoint, so I can’t tell irritated gums from a toothache, earache, oncoming acne blemish, bruise, etc.

And I’m always bruised because I run into objects every day that I 100% know are there.

I’m not very noise sensitive for an Autistic, but can’t stand people singing out of tune, the squeak of fingers sliding across guitar strings, or solid ringing from cymbals or a triangle. But I also can’t stand silence because I have two kinds of tinnitus.

My period (menstruation) is just a big pile of awfulness, both emotionally and physically. And wearing a bra makes me feel like I’m in a vice. And don’t get me started on clothing tags.

[neuroticnation]

I am autistic, have ADHD, and fibromyalgia. Those three have such deeply overlapping symptoms it’s almost like it’s three aspects of the same disorder. People with fibromyalgia are more likely to be autistic, but not the other way around. I wonder how many actually ARE autistic. More than we know, I think.

[r.w.bottorff]

This helps me clarify why in risky situations, instead of flying or fighting or freezing or fawning...I often am deep in thought trying to figure out what I am disturbed by instead of taking action.

[sherryseeton]

This is the first discussion I've encountered on the topic of messed up body temp control being related to neurodivergence. I've been plagued for many years with feeling too warm and SWEATING. 🥵 It's gross! Earlier this year I was diagnosed with ADHD + anxiety, but lately I suspect that I may have other neurodivergent things going on as well. I have to say that although it was initially a relief to have a specific diagnosis for things that have troubled and frustrated most of my life, at this point I'm feeling overwhelmed, confused and exhausted with the struggle to understand my own brain.😢 And that's in addition to a lifetime of feeling rejected by the rest of my species. Thank goodness for animals, who seem to have no problems with me and are my only reliable source of positive interaction. 😕

[TIPPYtoeup]

I have cold sweaty hands, feet and armpits and am freezing at the same time. I was also born deaf. And delt with bullying as a child throughout my entire childhood. I loose control of my facial features and other motor skills in just about every social interaction. My anxiety has and depression have been so bad throughout my life. I’ve literally lived my life alone. I’m 37 and have no friends, haven’t for many many years. It’s been a hard life. But I’ve always known it isn’t just because of the bullying or deafness. Those things just made it incredibly difficult in addition to my probably undiagnosed autism.

Thanks for this. I will subscribe;)

[rkillik]

More and more I find that the "weird" things in my childhood were ADHD symptoms. I wet the bed until 11 and that was absolutely humiliating.

[damescholar]

Oh yes! That’s me to a tee. Always feeling cold, forgetting to drink and eat, bumping into doors and other people and having always bruises because of this, being drained for no reason at all, having unexplained panic attacks… yes yes yes!

[rottweilerdriver]

I have been a fan of yours for about a year now. Normally I don't comment on many of videos, even ones I like or dislike. But this one chilled me to the core. I am diagnosed ASD (and ADHD) and I have all of the things you talked about. Including my brain NOT correctly doing shivering! I actually do into seizures. This did NOT happen as a child, but as a child, pain and thirst were near NON-EXISTENT to me, unless a parent gave me fluids or forced me to "rest and go easy" (I was chasing snakes and lizards EVERYWHERE!)... And yes, even as a child I was told I have the "If looks could KILL" face or the "Thousand Yard Stare" (That is because I was NOT looking at them, but INTERNALLY in my memory palace or somewhere ELSE in the universe.)...Anyway, this talk is to VERY TRUE. our internal controller is so "messed up" or out of whack. I would LOVE to chat with you more on a professional level some time, if you are ever studying OLDER people with autism. (I am 60). Thanks for the great videos and content, Doctor! When I die, I am donating my body and brain to science in the hope we can UNDERSTAND neurodiversity more. Much love and kindness to all my neurodiverse friends.

[amesonward]

I have the opposite bladder issue. I get cues to go way too early and close together. It happens when my body is at rest. It’s so frustrating.

[marshallsweatherhiking]

Does anyone else have sensations that neurotypical people simply have no good words for? To me overstimulation feels very different from anxiety, yet neurotypical people lump it all together. To me anxiety is fear-based. Its a deep gut feeling. What I deal with is not so much anxiety but kind of sensory stress and its really not the same at all. I also struggled to explain that antidepressants that are supposed to treat anxiety will cause this “stress” feeling to become much worse even though there is nothing “stressful” going on to cause it.

I would describe it as closest to a restless leg sensation but not in my legs but rather the entire left (non-dominate) side of my body. It’s not anxiety as it isn’t fear based and its not really a gut sensation. Any description I give is pretty useless for neurotypicals as it seems they don’t have this sensation. Also, when its really bad it can feel as if I’m being tickled from the inside and it can be so uncomfortable I need to clench my fists and curl up.

When I did some research later on in my life, I learned of a thing called akathisia. This is supposed to be a medication side effect, but I had it as a child due to stress or overstimulation, even when not taking any medications at all. I don’t know if its the same as akathisia, as there is no “desire to move”. The common subjective description of akathisia as feeling a tickle in your bones is pretty close though.

[hanaholmgren]

This explains SO MUCH! I’m as yet undiagnosed (for now) but I’m certain I’m on the spectrum. I have always had trouble with temperature regulation, and people who know me joke that I always have “corpse hands” or feet, freezing to the touch. I’ve always struggled with dehydration, body cues like using the bathroom, frequent generalized anxiety, etc. Now I have a word for it!

[neuroticnation]

I tend to be dehydrated, always forgetting to drink and not realizing I’m thirsty. But what about breathing? I’m always breathing really shallow and stop breathing for a few seconds constantly. I don’t realize I’m doing it until I suddenly need to take a deep breath. Everything has gotten worse since I moved from sea level, where I lived the first 50yrs of my life, to the high desert. It’s so dry and the oxygen is lower. I’ve been here for 3 years and still can’t get used to it.

[gillb]

It's fascinating to know there is a link to bedwetting. Both of my Autistic sons wet the bed until they were in their teens and no-one ever mentioned that to us

[drfill]

I have realised i have HUGE pain tolerance. Consequences are bad. I'm not very risk averse and have been known to carry on with sometimes deeply grevious injuries.

Like you i forget to eat. I call it "forgetorexic".

One thing you didn't mention which is probably the worst of the lot is.. TIME BLINDNESS!! If i get involved in a task, goodbye day... and i have serious adulting to do!

That said, i make these quirks work for me. And i try to show up on time!

[leekestner]

I learned recently that I confuse being thirsty with being hungry. My stomach will dry out and begin to pinch and feel like hunger but I may have only eaten an hour before. I find if I drink the feeling of pinching goes away and I am fine. This was eye opening and such a help as I have struggled my whole life to keep my weight under control. Dry mouth doesn't work as a signal because I have had to take allergy medicines since childhood so learned just to ignore dry mouth. Carrying a water bottle also helps as I will automatically reach for and drink from it but not be aware enough to go get me a glass of water from the kitchen.