I have a roommate I’m reasonably certain is autistic. He hates any kind of change (the migration to windows 11 is killing his soul since he can’t bring his ancient Dell along for the ride). He doesn’t remember what you talked to him about yesterday, instead remembering a completely different outcome to any conversation. He doesn’t clean up after himself, and cannot be convinced to do so.
The problem the brings me here is when he moved in I told him the common areas must be kept clean. You can make any mess you clean up after. If it has to stay a mess, do it in your room. As long as it doesn’t violate fire code or decay or cause lasting damage, I could give a damn.
So he makes his room a mess, then says he finds the mess depressing and overwhelming and migrates to a different room and makes a nest there. He forms little piles around the nest, always keeps things near him to instantly deal with. But it eventually becomes too much and he migrates elsewhere and starts again.
I cannot get him to clean up. When I talk to him about it, it doesn’t matter what tone or delivery I use. He gets anxious, has some sort of fear response, gets visibly agitated but in more of a scared way than an angry way, and will not talk. He can’t form sentences. Then it suddenly evaporates and he bluescreens. He reboots. He doesn’t recall the conversation. He doesn’t realize one was still taking place. He just walks off and does something else. Not like is an asshole dismissive way but in an incredibly frightening Alzheimer’s way.
When I do get him to talk, he says he doesn’t want to stayed coooped up in his room when working on anything because it’s messy and depressing. (Then fucking open your blinds to let in sun and clean damnit!) But it’s a change in his environment he cannot bring to action.
He also has issues with time management. Like he says he’ll do his dishes and he starts in playing Skinner box games on his phone or trying to pirate porn off YouTube (don’t ask. I’ve not been successful convincing him that is dumb) and he looses track of time. He intends to do the dishes but he ends up going down some rabbit hole and by the time he frees himself he is already late for something else and has to leave.
But he will go back to his parents and mow their lawn and at work he will skip lunches because “there are carts in the parking lot that nobody is putting away”. He can do things, even when they are someone else’s priorities or problems. But he absolutely cannot help himself. He’s just spinning his wheels.
I’m not effective here. I feel pressing any harder is just abusive. He’s clearly got some flavor of neurospicy going on but he’s an adult and aware of the issue. He needs to deal with that and he’s just not.
He is oblivious to social cues and even when I’m being verbose he doesn’t pay attention and do the fucking thing. I’m constantly moving his little hoarder piles back to his room to clean my home. He’s not improving and some of his issues, like the bluescreens, sound funny but are deeply disturbing to witness. He has other issues too, like his diet is nothing but ice cream, cookies, and fiber supplements. He’s in his 20s but turned my home into a Metamucil commercial. I’ve never seen him eat anything else. He can sit on the couch watching TV and then suddenly jolt and flail as if being electrocuted for a second then fall back into reality. “Sorry. That happens sometimes.”
Just, dude.

He’s on meds for that and depression and they do fuck all.
You have no idea how much worse it could be without the meds. Trust me.
I’ve seen him with and without. Some days he misses doses or takes them so late he stays up all night long. Aside from removing any semblance of a sleep schedule they don’t do anything for him.
We’ve talked about sleep hygiene. He dismisses it.
Please be mindful of dismissive judgements from your liminal perspective on their disability that may in fact stem from your lack of integral, clinical details. 🙇🏼♂️
Normally I would agree with you, but OP is living in the environment created by the roommate’s symptoms. This is obviously uncontrolled or, at best, extremely poorly managed mental illness and it is not reasonable to expect OP (who is this person’s roommate, not explicitly a friend, certainly not a family member, and definitely not a partner) to sacrifice their own wellbeing in deference to this person’s dysfunction.
OP obviously has empathy for this person, but is clearly at the end of their rope, and your pontificating and language policing from the outside doesn’t actually help OP or the roommate in any way. I work in medicine, I deal with a LOT of mental health patients, and your comment here doesn’t read as any kind of advocacy for people suffering from mental illnesses, it just reads as virtue signalling or sanctimonious tone policing.