Preventing Autistic Burnout and ADHD Burnout

ADHD burnout is a consequence of chronic stress, causing disturbance to physical (autonomic nervous system) and mental functioning. It is caused by overextending and leads to fatigue. Autistic burnout, similarly, "is a state of physical and mental fatigue, heightened stress, and diminished capacity to manage life skills, sensory input, and/or social interactions, which comes from years of being severely overtaxed by the strain of trying to live up to demands that are out of sync with our needs" (Raymaker, M.D. Autistic Women's Network).

In order to support future generations of neurodiverse children from experiencing the adverse impact of ADHD or autistic burnout, it is important that we move towards a neuro-affirming and neuro-biologically informed approach that accommodates to the level of the child's individual needs.

What Autistic and/or ADHD Burnout Looks Like

If a child is experiencing symptoms of autistic and/or ADHD burnout, they may appear to regress—becoming less flexible in their thinking and reaching meltdown more easily—and will present with increased reactivity (e.g., behavioral concerns). An analogy I often use to explain this to adults is that the child's cup is full; the addition of any further stimuli leads to a dysregulated state.

When the social demands outweigh the child's ability to cope, meltdowns present as the autonomic state of a dysregulated dorsal vagal state (shutdown, numbing, disconnection, or dissociation), or a sympathetic state (mobilization of fight or flight, or survival mode thinking). This may have resulted from the combination of a lack of accommodations, sensory and/or emotional overload, insufficient opportunity to feel diverse thinking skills are of value, and/or suppressing autistic or ADHD traits.

How to Manage ADHD and/or Autistic Burnout

While self-care is a particularly important approach for treating symptoms of burnout (a balanced diet, sleeping, creating opportunities for being vs. doing, etc.), what is essential for treating autistic and ADHD burnout is increasing the level of accommodations to ensure the environment is more in sync with the child's needs. Activities that are regulatory, rhythmic, and/or involve movement are beneficial for completing stress cycles (to help the body move out of survival mode thinking). Neurodivergent minds need to rest and recharge. There are many different types of rest, including sensory rest, creative rest, emotional rest, and social rest.

When a child has faced a distressing situation that they could not resolve, repeated exposures without intervention may do them more harm than good. You must address the symptoms of autism spectrum disorder and/or attention deficit hyperactivity disorder. Wait to find more workable options and provide coping skills at a later date.

Change is a process that requires preparation (considering developmental and therapeutic gains) and support (accommodations). The child will likely need intervention before they can feel calm and comfortable to engage in an activity that led them to feel flooded with an emotion in the past.

Co-regulation is dependent upon how the child is seen, heard, and offered a neuroception of safety—i.e., a reduction of cues of danger and the experience of cues of safety via connection (Porges, 2009). Demonstrating emotional attunement (a desire to understand and an ability to respect the child's inner world) influences social and emotional development (self-regulation, attachment, and a sense of self). In her book Beyond Behaviors, Dr. Mona Delahooke discusses the implementation of neuro-biologically informed (i.e., understanding the brain/body connection has implications for supporting behavioral differences in autistic children) treatment models that are respective and inclusive.

The Value of Acceptance

Many neurodiverse children learn to mask their behaviors to fit in and be accepted by their peers and/or due to an unhealthy assumption that neurotypical social skills are the only way to succeed in life. Masking is not only physically and emotionally exhausting, but it is also particularly adverse for mental health (anxiety, depression), self-perception, and self-esteem, and it may trigger burnout.

Time spent without masking and a passage of time to recover may be needed. An important first step in removing the mask is acceptance. By offering, respect, support, and flexibility (accommodations in the workplace and education system), we will encourage self-determination, empowerment, and innovations for the good of all. A diagnosis of autism spectrum disorder or ADHD can allow neurodiverse individuals to stand with pride and connect to their tribe.

Burnout Essential Reads

Understanding Burnout Among South Asian American Physicians

Why Are Teachers at Greater Risk of Burnout?

It is important, too, to value the contribution of diverse thinking skills. For example, hyperfocus, a common trait of neurodiverse individuals, allows them to focus on one thing for a long period of time. Surrendering is the strength of detaching from what life must look like (fixed outcomes, convergent ways of thinking), and the science of finding something thanks to an observant mind.

Neurodiverse minds are often powerful and creative. There is a natural love of learning, fascination with facts, ability to listen without judgment or assumption, and a heightened awareness of details that can lead to insights. There is often a pure intention to be one's best self. Connections (as distinct from socializing, which is internalizing social norms) provide meaning in relationships—whether with people, objects, or stimuli.