Autistic Burnout: When the Autistic brain overloads
Autistic burnout has been a subject of discussion in Autistic circles for many years. One could imagine that there is little left to be discussed, and yet understanding of what burnout actually looks like is still not up to scratch. It would seem that we need to have a discussion about what forms burnout can take, and how it’s innumerable forms can impact on Autistic people.
What is Autistic burnout?
“Autistic burnout” is often used by autistic adults to describe a state of incapacitation, exhaustion, and distress in every area of life.1 Informally, autistic adults describe how burnout has cost them jobs, friends, activities, independence, mental and physical health, and pushed them to suicidal behavior
Raymaker et al (2020)
At the surface level, burnout is understood as absolute exhaustion. Unfortunately this has resulted in observational models largely presenting something that is often mistaken for depression (more on this later). For me, the key word in the above quote is “distress”. As we will explore further, this distress can take many forms. However for the purposes of defining here, Autistic burnout can look like the following
Autistic adults reported that “Autistic burnout is when I no longer have the energy reserves
Arnold et al (2022)
necessary to act Neurotypical”. The impact of autistic burnout cannot be understated, with some
even describing suicidal ideation or suicide attempts.
Of note is the findings of Raymaker et al (2020) that found chronic exhaustion, loss of skills, and decreased tolerance to stimulus to be regular features of burnout.
Does burnout always look like depression?
It’s important to note that research is still in it’s infancy here and limited literature exists. A simple answer to this question is that overlap exists. Some features of Autistic burnout are shared with depression, and a person can certainly experience both simultaneously. However, one key take away is that burnout can not be treated with medication. Instead it is necessary to curate one’s environment and make alteration to how we engage with demands (read as; change our boundaries).
In simple terms, burnout is unique to the individual. It will vary based on the demands of one’s life, further neurodivergence, and the environment and culture we exist within. Broadly speaking, burnout is less about withdrawing, and more about overloading. As such, burnout is influenced by the way that we manage our emotions and psychological resources.
Atypical Burnout
Atypical burnout is somewhat misleadingly named, because it is not all that atypical. It can be conceptualised as a form of Autistic burnout that does not match with common observational models of what burnout is understood to be (Adkin & Gray-Hammond, 2023). Such forms of burnout (anecdotally) can appear as paranoia, mania, or even episodes of psychosis.
These forms of psychosis are reported by Autistic people to be closely tied to experiences of parenting or work where they are unable to simply stop and recover. Members of the Autistic community have also connected it with interoceptive differences that result in alexithymia. Also to consider is the intersection with ADHD of which Rong et al (2021) found in 40.2% of cases. Co-occurring ADHD may prevent a person from being able to rest and re-regulate themselves.
Autistic burnout and psychosis
To date there is no academic research into the link between Autistic burnout and psychosis. However, the previously published article on the burnout to psychosis cycle proved popular enough to suggest that there is a need for research into this phenomenon of burnout (Gray-Hammond & Adkin, 2023).
This cycle is particularly relevant to AuDHD (Autistic + ADHD) people. Professionally, I have witnessed this particular cycle, and would again highlight the need to conduct further research in this area. Ribolsi et al (2023) found a prevalence rate for psychosis of 34.8% in Autistic populations. Similarly, ADHD traits have been observed in up to 57% of Schizophrenic cohorts (Arican et al, 2019).
Meerkat Mode
Meerkat mode presents a state of chronic hypervigilance secondary to atypical burnout. Conceptualised by Tanya Adkin, this is yet another professional observation that warrants further research (Adkin, 2023). It is common in cases of monotropic split (Adkin, 2022). Yet again we see the AuDHD intersection, demonstrating again how features of burnout can be impacted by further neurodivergence. This is particularly interesting for those observing mania in Autistic people. This particular intersection is significantly under researched. Underwood et al (2023) did find that Bipolar Disorder is of increased prevalence in autistic people at 2.5%.
Autistic burnout is complex and diverse
It is clear from literature and the experiences of Autistic people that burnout is not as simple as needing to stop and rest. Autistic burnout presents a matter of clinical significance for those supporting the mental health of Autistic people, up to 79% of whom may experience a mental health problem (Curnow et al, 2023). It is of the utmost urgency that burnout and it’s intersection with mental health is investigated. Lets not forget that Autistic people represent up to 41% of suicide deaths (Cassidy et al, 2022). Understanding Autistic burnout might just save lives.
References
Adkin, T. (2022) Guest Post: What is monotropic split? https://emergentdivergence.com/2022/07/14/guest-post-what-is-monotropic-split/
Adkin, T. (2023) What is meerkat mode and how does it relate to AuDHD? https://emergentdivergence.com/2023/06/06/what-is-meerkat-mode-and-how-does-it-relate-to-audhd/
Adkin, T., & Gray-Hammond, D. (2023) Creating Autistic Suffering: What is Atypical Burnout? https://emergentdivergence.com/2023/05/12/creating-autistic-suffering-what-is-atypical-burnout/
Arican, I., Bass, N., Neelam, K., Wolfe, K., McQuillin, A., & Giaroli, G. (2019). Prevalence of attention deficit hyperactivity disorder symptoms in patients with schizophrenia. Acta Psychiatrica Scandinavica, 139(1), 89-96.
Arnold, S., Higgins, J., Weise, J., Desai, A., Pellicano, L., & Trollor, T. (2022) Investigating Autistic burnout (#AutBurnout). https://www.autismcrc.com.au/sites/default/files/reports/3-076RI_Autistic-Burnout_Final-report.pdf
Cassidy, S., Au-Yeung, S., Robertson, A., Cogger-Ward, H., Richards, G., Allison, C., … & Baron-Cohen, S. (2022). Autism and autistic traits in those who died by suicide in England. The British Journal of Psychiatry, 221(5), 683-691.
Curnow, E., Rutherford, M., Maciver, D., Johnston, L., Prior, S., Boilson, M., … & Meff, T. (2023). Mental health in autistic adults: A rapid review of prevalence of psychiatric disorders and umbrella review of the effectiveness of interventions within a neurodiversity informed perspective. Plos one, 18(7), e0288275.
Gray-Hammond, D., & Adkin, T. (2023) Creating Autistic Suffering: The AuDHD Burnout to Psychosis Cycle- A deeper look. https://emergentdivergence.com/2023/06/05/creating-autistic-suffering-the-audhd-burnout-to-psychosis-cycle-a-deeper-look/
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.
Ribolsi, M., Fiori Nastro, F., Sacchetto, S., Riccioni, A., Siracusano, M., Mazzone, L., & Di Lorenzo, G. (2022). Recognizing psychosis in autism spectrum disorder. Frontiers in Psychiatry, 13, 768586.
Rong, Y., Yang, C. J., Jin, Y., & Wang, Y. (2021). Prevalence of attention-deficit/hyperactivity disorder in individuals with autism spectrum disorder: A meta-analysis. Research in Autism Spectrum Disorders, 83, 101759.
Underwood, J. F., DelPozo-Banos, M., Frizzati, A., Rai, D., John, A., & Hall, J. (2023). Neurological and psychiatric disorders among autistic adults: a population healthcare record study. Psychological Medicine, 53(12), 5663-5673.
You must be logged in to post a comment.