She appeared in singer Courtney Love's backing band on her 2004 America's Sweetheart tour and returned to the United States. After having an abortion, Autumn attempted suicide and was kept on suicide watch in a Los Angeles mental institution. After her release, she later had her cell block number tattooed on her arm as a way of remembering what had happened to her. She released the 2006 album Opheliac with the German label Trisol Music Group. In 2007, she released Laced/Unlaced; the re-release of On a Day... appeared as Laced with songs on the electric violin as Unlaced. She later left Trisol to join New York-based The End Records in 2009 and release Opheliac in the United States, where previously it had only been available as an import. Currently she is working on an album entitled Fight Like A Girl.
Autumn draws influence for her music—the style of which she has alternatively labeled as "Victoriandustrial" and glam rock—from plays, novels, and history, particularly the Victorian era, with her musical inspiration being the English violinist Nigel Kennedy. Her live performances, which she calls dinner theatre because of her practice of throwing tea and tea-time snacks offstage, make use of burlesque to counterbalance the morbid topics; Autumn incorporates theatrics with an all-female backing band called The Bloody Crumpets. Outspoken about bipolar disorder and her experience in a modern-day mental institution, she has written an autobiographical novel, 2010's The Asylum for Wayward Victorian Girls.