Trigger Warning: This article discusses burnout and psychosis
While it is evident to myself and my colleagues that Autistic people have a predisposition towards psychotic phenomenon, it seems to be a relatively new discovery to many of the mental health professionals I have talked to. Research that is non pathological in this area is sparse.
Despite this, acute psychosis and psychotic conditions seem to be emerging in the Autistic community (anecdotal, based on experiences of myself and colleagues). Some might suggest this is due to the increased stress that we have faced since 2020.
I feel at this point it is important to discuss a phenomenon I have been witness to in both myself and others. I refer to this as the Burnout-Psychosis Cycle.
To begin with, we will look at the infographic I recently posted to the social media page I run.
Once something places us into a state of burnout, Autistic minds seek to return to their natural state of monotropic attention tunnels. We hyperfocus.
We then get caught in an attention tunnel regarding something that is traumatic to think about, unable to shift our focus from that attention tunnel. This causes distress. Tanya Adkin refers to this as a monotropic spiral.
As we become dysregulated, our sensory experiences also become dysregulated. This is where we may start to have hallucinations, and experience emotional dysregulation such as paranoia or mania. This is the psychosis part of the cycle.
Unfortunately, psychosis leaves the person burnout, starting the cycle again.
In order to break this cycle, we need to ensure that the burntout person has the time and space to engage their attention tunnels within their special interests. Things that will bring them joy and recover their spoons.
It is possible to break the cycle through the treatment of the psychosis, but medication doesn’t generally help burnout.
More research is needed in this area as this is based on anecdotal evidence, rather than peer-reviewed research. Autistic people need to speak loudly about this where and when it is safe for them to do so.
The ramifications of becoming psychotic can be serious. People experiencing psychosis may put themselves in danger, or rarely, endanger others. It may be necessary to detain the individual and have them admitted to an inpatient facility.
While these facilities have their place, it is not a positive experience for many Autistic people, and can add to the burden of trauma that led to the cycle starting in the first place.
When working with Autistic individuals, we need to be holistic in our approach and consider all the factors co tri using to burnout.
Until we do this, we will not be meeting their needs.