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Key points
- Autistic burnout is a term for the effects of overwhelm over a longer period for neurodivergent people.
- Loss of interests in special interests, executive functioning problems, and low mood are signs of burnout.
- In the short-term, physical self-care, rest and re-focus can assist with autistic burnout.
- In the long-term, more permanent accommodations may be necessary.
As a therapist specializing in the intersection of neurodivergence and mental health, I have met several autistics sharing, at points, a kind of lifelessness. During this experience, speech is slow, the mood is low, disorganization flourishes, and typical intense interests turn blunted. I see this most often in clients at the end of a semester, after a particularly nasty bureaucratic work dance, or during times of family discord. There are some elements of depression, but seemingly something more. When I learned about autistic burnout, it all made sense.
Autistic Burnout
Autistic burnout is not a medical term that you might find in the DSM-5. Rather, it is a phrase coined by those with lived experience to describe particular phenomena that many autistic people encounter while attempting to interact in a world that is often non-affirming (Raymaker et al., 2020). It's an accumulation of several factors: masking, pressures to adapt to neurotypical social expectations, sensory overload, changes to routine, unkindness from others, and more. It's what happens when so much electricity hits the circuit box that it blows.
On the outside, it can look like withdrawal, fatalistic thinking, exhaustion, frustration, and disorganization. Inside, it can feel like a confusing mix of depression, anxiety, numbness, and/or an inability to keep up. Executive functioning takes a big hit. It's a real problem.
Common comorbidities, such as ADHD, major depression, and generalized anxiety disorder, can further complicate things.
Circuit Overload
Autistic people are constantly adapting to meet the demands of a neurotypical-dominated society. In the process, neurodivergent people are often misunderstood, excluded, and rejected by others. This can cause immense stress. Autism is associated with a bottom-up processing style, sometimes making one both a master of patterns and challenged at filtering through what might not be relevant in the given moment. Information of all kinds, especially sensory and social pieces, more easily becomes overwhelming.
With support, many can accommodate and even thrive with this processing style. Yet, when accommodations and understanding are denied, as often happens in settings where autism is not understood, repeated overwhelm and the unrelenting social expectations take a toll. Autistic burnout is the extinguishing of that final spark.
Autistic burnout in youth can be easily misunderstood as a behavioral issue. Children and adolescents might start saying "no" more frequently without explanation or engaging in other behaviors meant for self-preservation in the face of being overwhelmed, such as no longer making eye contact, the overuse of electronics, putting their heads down more often, giving one-word answers, or using a prompt like a phone to avoid interaction. The teen likely won't be able to explain what is going on, and adults around them might give unhelpful explanations, such as seeing the youth as being lazy or having a bad attitude, judgments that only add to the adolescent's burden and lead to a worsening of the burnout.
Autistic burnout is not a permanent condition, yet recovery often requires some adjustments. It's important to recognize that while autistic burnout looks quite similar to depression, the two are approached much differently. In typical depression, for example, behavioral activation or encouraging someone to become active as a way to fight off the inactivity of depression is often utilized within the cognitive behavior traditions. Research on the effects of behavioral activation on autistic burnout is lacking, however, on its face, one could understand how, when feeling overwhelmed, adding more activity (particularly if it is added arbitrarily) could further that depletion. In addition, while behavioral activation often involves engagement with social activity, managing social demands is often a chief contributor to autistic burnout.
Strategies
So, what do we do for autistic burnout? Initial periods of rest and restorative practices would seem logical short-term interventions. Effective approaches to autistic burnout in the immediate can include:
1. Physical Self-Care: When burnout hits, the first things to suffer are typically those we deem 'non-essential.' Someone might skip a shower here or the gym there. In time, more and more things are added to the list until even the critical things slide. Unfortunately, this can include tasks involved in personal hygiene, getting enough to eat, sleep, and other vital forms of self-care. It's impossible to feel better when we aren't even having our basic needs met. These are sometimes the first targets for burnout recovery.
2. A Decrease in Demand: It's key to highlight here that what people find stressful varies greatly from person to person. One person might find their work to be energizing while finding frequent social gatherings exhausting. For another, the workplace could be a central force in their burnout. Taking a tally of those tasks that are most taxing and getting rest wherever possible is necessary for working through burnout.
3. A Renewed Focus on a Special Interest: We discussed how traditional behavioral activation might not be ideal for autistic burnout. This said, many autistic people find a single focus, particularly of a specialized interest, refreshing. While most neurotypical people tend to lose interest when focusing on one thing too long, a monotropic focus can be soothing for many autistics. They may find passion in singular interests like beekeeping, Star Trek, electronics, dogs, or any number of specific interests. Backing away from these interests is indicative of significant burnout. For example, if an autistic person who had previously spent several hours a week reading and talking about storms no longer seems to have mental space for this, they are likely very overloaded. Reintroducing a special interest slowly can help in the recovery.
If the underlying stresses are not addressed, circuits are likely to overload again.
Longer-term management of autistic burnout may require an assessment of contributing factors and accommodation within one's community. The goal should not be to get better and return to life as normal. Rather, if possible, an end goal of recovery from autistic burnout will be to create changes toward circumstances that do not burn us out if at all possible. For example, many autistic people utilize routines to stay grounded. Having a variable schedule of work shifts is likely to be demanding. An accommodation of a more consistent schedule could help.
A common contributing stressor is "masking," a strategy an autistic person uses to blend in and adapt. If masking is a significant weight, a question might be asked of what this mask looks like and if there can be more safe places to take it off. In real life, this might look like a decision to disclose one's neurodivergence to more people or allowing oneself the neurodivergent coping skills, such as fidgeting or stimming, that one had been suppressing.
Research has found that many autistic adults find stimming behaviors such as twirling hair, repeating a favorite phrase, or spinning as a source of happiness, energy maintenance, and self-regulation (Kapp et al., 2019). Yet, not all neurotypical people 'get' stimming. They may misinterpret the repetitive behaviors as 'weird' or otherwise problematic. For this reason, many autistic people hide these regulation strategies. If someone can feel free to unmask and engage, these can serve as natural resilience factors. Understanding from people of other neurotypes can mean a lot.
A plan for addressing and accommodating these more persistent stresses will look different for everyone. What might be ideal in managing burnout may or may not be realistic in any given person's environment. Not everyone feels comfortable disclosing their neurodivergence, and regrettably, not all spaces are affirming. Still, gaining support through work accommodations, accessibility agencies, psychotherapy, and connecting with other neurodivergent people can help.
References
Kapp, S. K., Steward, R., Crane, L., Elliott, D., Elphick, C., Pellicano, E., & Russell, G. (2019). ‘People should be allowed to do what they like’: Autistic adults’ views and experiences of stimming. Autism, 23(7), 1782-1792.
Raymaker, D. M., Teo, A. R., Steckler, N. A., Lentz, B., Scharer, M., Delos Santos, A., . & Nicolaidis, C. (2020). “Having all of your internal resources exhausted beyond measure and being left with no clean-up crew”: Defining autistic burnout. Autism in adulthood, 2(2), 132-143.
