In my younger days, I struggled with constant lethargy and low motivation. Repetitive thoughts and worries sometimes kept me awake for hours, while the way my household operated made it difficult to get both the quiet I wanted and the sleep I needed. I no longer experience these difficulties.
Those experiences taught me to ask what was using up my energy, what helped me recover and what needed to change. For someone facing exhaustion now, the answer may involve a habit, the environment, the demands on them or their health.
The aim is to find a way of living that leaves enough energy for our responsibilities and for things that make life worthwhile.
First, notice what has changed
It helps to describe the problem more precisely than “I am tired”. Are we struggling to stay awake, finding ordinary physical activity unusually difficult, losing the ability to concentrate or feeling overwhelmed by demands we could previously manage? When did it start, and what was happening around that time?
Persistent exhaustion deserves attention even when being tired has become familiar. The NHS advises seeing a doctor if tiredness has lasted a few weeks without a clear explanation or is affecting daily life. Sleep problems, medicines, mental health difficulties and physical conditions can contribute. Depending on the circumstances, a doctor may investigate causes such as anaemia, diabetes or thyroid problems. Tell them about medicines and supplements you take, as well as changes in sleep and everyday functioning.
Being autistic is useful context for that conversation. It should not prevent a new or worsening problem from being investigated.
Look at the whole day
A calendar records activities, but rarely records what they cost us. A short appointment might involve preparing to leave, travelling through a noisy place, waiting without knowing when we will be seen and trying to explain something important under pressure. Looking only at the appointment’s duration misses much of the experience.
For a few ordinary days, make a brief note of:
- What happened: the main activities and the environments in which they took place.
- What was demanding: for example, noise, uncertainty, sustained concentration, conversation or repeated interruptions.
- What allowed recovery: sleep, quiet time, practical help or a break from a particular kind of demand.
- What happened afterwards: how you felt later that day and the following day.
Keep this light enough to be useful. A few words about one difficult part of the day may reveal more than an elaborate tracking system that we soon abandon.
Look for a repeated pressure that can be reduced. Could an appointment happen at a quieter time? Could two demanding activities be separated? Could a recurring instruction be written down so that it does not require another conversation? My approach to Pragmatic Planning considers the full cost of commitments, including recovery, when deciding what is sustainable.
Make quiet available before bedtime
My family liked to keep the television on at high volume. I stayed up late because the night offered relief from daytime noise and distractions. I then napped in the afternoon and evening to catch up on lost sleep, which made it harder to sleep at night.
The late hours gave me something I needed, but the resulting pattern was difficult to sustain. Advice to go to bed earlier would have left the reason for staying awake unresolved.
If this pattern sounds familiar, ask how to make some quiet time available earlier. At home, this might mean agreeing when the television is turned down, when its user wears headphones or which room is kept quieter. At work, it might mean a protected period without conversation or a quieter place for a break. Make the arrangement specific enough that the people sharing the space know what to do.
The Sensory Environment Checklist can help identify the source of a recurring problem and agree a practical change.
Sleep habits still matter. The NHS guidance on insomnia suggests a regular waking time, time to relax before bed and a sleeping environment that is dark, quiet and comfortable. Start with the part you can change. If sleep remains difficult despite changes, or is making daily life hard to cope with, discuss it with a doctor rather than endlessly adjusting the routine alone.
Give worries somewhere to wait
My bedtime worries could include remote hypothetical events, such as meeting a lion that had escaped from the zoo. An unlikely problem could still occupy my attention for hours.
I used two simple techniques. I wrote down my worries and the things I needed to remember, then told myself to return to them after waking. I also reminded myself that worrying in bed was not solving the problem.
A note can include one action for tomorrow if there is something useful to do. It does not need to become a complete investigation at bedtime. For a concern that cannot be resolved immediately, recording it can at least remove the additional job of trying to remember it all night.
I also used yoga, meditation and breathing exercises, including brief moments of meditation during otherwise idle times. Other options to try at bedtime include counting breaths, visualising a calm place and guided relaxation. Choose according to what helps you settle. There is no need to turn winding down into another demanding project.
Take a wider loss of capacity seriously
Autistic people have described periods of prolonged exhaustion, reduced ability to manage everyday activities and lower tolerance of sensory input. An early study of autistic burnout documented these experiences. More recent research continues to examine how autistic burnout relates to depression and other forms of burnout.
If a loss of capacity is spreading across daily life, it is worth asking what support and assessment are needed. Explaining which activities have become difficult, how long the change has lasted and what happens after a demanding day gives someone helping us more to work with than the label alone.
Practical support might include reducing non-essential demands, making responsibilities more predictable or getting help with an unavoidable task. A period away from work may still contain appointments, household work, messages and social obligations. Notice which demands are continuing during the time that is supposed to allow recovery.
Choose movement according to your response
For a period, I walked briskly to and from work for about twenty minutes each way. I liked making exercise serve a practical purpose, and it also saved transport costs. Movement was easier to include in my day when it was part of going somewhere I already needed to go.
The amount and kind of activity we can manage depend on our health and how we respond. If ordinary physical or mental activity repeatedly leaves you markedly worse afterwards, including hours later or the following day, discuss this pattern with a doctor before trying to push your fitness. For people with ME/CFS, the CDC’s guidance on post-exertional malaise emphasises keeping activity within individual limits to avoid worsening symptoms.
Leave room for a worthwhile life
The sense that life was good, beautiful and meaningful mattered to me, too. Living with continual uncertainty, anxiety, fear or anger can make daily life feel like a burden. Changes in perspective were an important part of my own experience.
That sense of meaning mattered alongside attention to sleep, health and the practical conditions of life. Even a project we care deeply about uses time and energy. There is value in protecting a manageable amount of enjoyable activity while reconsidering commitments that repeatedly leave us depleted.
Choose one recurring pressure to reduce and one opportunity for recovery to protect. Make the change concrete: who needs to agree, what will happen differently and when will you review whether it helped?
I wanted a routine in which I could meet my responsibilities, take part in worthwhile activities and still have enough capacity for ordinary life afterwards. That was the standard I used to judge a coping strategy.