Autistic burnout

Autistic burnout is a prolonged state of intense fatigue, decreased executive functioning or life skills, and increased sensory processing sensitivity experienced by autistic people. Autistic burnout is thought to be caused by stress arising from masking or living in a neurotypical environment that does not accommodate needs of autistic people. While not formally recognized as a medical condition in the DSM-5, autistic burnout has become increasingly recognized within the autistic community and gained attention among researchers, clinicians, and autistic individuals themselves as a significant aspect of the autistic experience.

Definition

Autistic burnout is defined as a syndrome of exhaustion, skill loss/regression, and sensory hypersensitivity or intensification of other autistic features that endures for at least 3 months. Autistic individuals commonly describe autistic burnout to be caused by prolonged overexertion of one's abilities to cope with life stressors, including lack of accommodations for one's support needs, which tax an autistic person's mental, emotional, physical, and/or social resources.

To explain the behavior of autistic burnout from a proximate approach, emphasis is placed on the immediate social, psychological, and environmental factors that contribute to the formation of autistic burnout. In the contemporary context, environmental factors such as social expectations play a huge role in causing autistic individuals to mask themselves in order to be accepted in an unaccommodating world designed for neurotypical individuals. Raymaker et al., the first academic research into autistic burnout, developed a conceptual model to explain the different causes contributing to autistic burnout. The different triggers of autistic burnout are categorized into two main factors: life stressors and the barriers to support encountered by autistic individuals (Raymaker et al., 2020).

Life stressors such as autistic masking or camouflaging has been proposed to be the most prominent factors contributing to autistic burnout. Masking is a strategy used by autistic individuals, either consciously or unconsciously, where they suppress autistic traits and attempt to behave like a neurotypical person in order to be accepted by the society (Hull, 2021). The need of masking for autistic individuals often derives from the social pressures and expectations autistic individuals face regarding academic achievement, social connections, and financial independence. Masking serves as a survival mechanism for autistic individuals to meet social expectations and to be treated better due to the lack of empathy from society. As the process of camouflaging and pretending to be someone else other than one’s true self requires an extensive amount of cognitive efforts, research demonstrated that autistic masking is significantly detrimental to the mental health of autistic individuals. This is because masking creates a discrepancy between societal expectations and the actual capabilities of oneself which results in a situation where expectations outweighs ability (Raymakers et al., 2020). This creates a sense of inadequacy which lowers one’s self-esteem, leads to an identity crisis, and results in an overwhelm of emotions, leading to autistic burnout episodes.

Another environmental factor that contributes to autistic burnout is the barriers to support as many autistic individuals find neurotypical people hard to communicate to. One crucial element that hinders autistic individuals to seek help when experiencing burnout is the response of gaslighting and dismissal that they experience. Gaslighting is the act of making someone question their own sense of reality and dismissal refers to neglecting the feelings autistic individuals experience during burnout episodes by telling them “that happens to everyone” . In Raymaker's research, participants reported feeling invalidated and unsupported when expressing their struggles as they were often being told that their difficulties were their own fault (Raymaker et al., 2020). The lack of acceptance and understanding by the people who autistic individuals seek out to, who might be friends or family, when experiencing burnout can exacerbate their feelings of isolation and frustration as the responses were not supportive. Thus, this further hinders their ability to seek and access necessary support needed to relieve stress and recover from autistic burnout.

Symptoms and impacts

To identify whether someone is experiencing autistic burnout, Raymaker et al. has identified some key symptoms which includes chronic exhaustion, loss in life skills, and reduced tolerance to stimulus (Raymaker et al., 2020). Chronic exhaustion refers to the depletion of internal reserves both mentally and physically. This pervasive fatigue can negatively impact different aspects of life for autistic individuals as it results in loss of interests to engage in activities, difficulties to maintain social relationships with low social battery, and challenges in completing the simplest tasks such as brushing teeth due to fatigue (Neff, 2023). Consequently, persistent exhaustion leads to the loss of life skills in managing different aspects of their lives, such as taking care of oneself, managing effective social relationships, and decision-making in everyday life. When cognitive abilities are depleted due to chronic exhaustion, this hinders language disability challenges which many autistic individuals already face while managing effective communication to maintain different social relationships. Lastly, autistic individuals experiencing burnout often experience sensory hypersensitivity which reduces their tolerance to environmental stimulus by decreasing the sensitivity threshold. This means that when they experience autistic burnout, they can be easily triggered by the simplest stimulus which can contribute to emotional impulsivity such as excessive crying.

Autistic burnout may be chronic and/or recurrent. Extended periods of autistic burnout can significantly impair an individual's ability to maintain employment, schooling, independent living, and general quality of life. It may also contribute to increased prevalence of comorbid depression, anxiety, and suicidality among autistic people. Autistic burnout shares some features with occupational burnout and clinical depression such as fatigue and limited functioning in work or social contexts. However, autistic burnout can occur independently of employment and is distinct from occupational burnout occurring in an autistic employee, which can also occur. Depressive symptoms such as anhedonia or sleep disturbances are observed less frequently in autistic burnout.

Potential solutions

Raymaker’s research suggests some prevention tools to prevent autistic burnout and help autistic individuals recover from emotional overload which includes 3 main categories: acceptance & support network, being autistic, and formal support. From the qualitative analysis of 19 interviews with autistic individuals, results suggest that having a support network where you are accepted by who you are and not being shamed or judged upon is critical to recover from autistic burnout as the stress is being relieved by autistic individuals verbally expressed (Raymaker et al., 2020). Secondly, building self-acceptance as being autistic through unmasking and recognizing the strengths one has by being autistic are essential to reduce autistic burnout (Raymaker, 2022). Lastly, seeking professional mental health support for advice without feeling ashamed of being autistic and in need for support is important for autistic individuals to recover from burnout.

History of #AutisticBurnout

The term "autistic burnout" is believed to have emerged by the late 2000s among autistic communities such as Wrong Planet and has continued to grow among social media users of the #ActuallyAutistic or #AutisticBurnout hashtags on platforms such as Twitter. Throughout the 2010s, autistic burnout gained traction among autism researchers as a construct with ecological validity alongside concepts like neurodiversity proposed by the autism rights movement. It is often discussed in conjunction with autistic masking/camouflage, compensation, or "passing." The phenomenonology of autistic burnout may be related to that of autistic meltdowns. Ongoing research is largely qualitative in nature.

See also

• Autistic masking
• Occupational Burnout
• Autism Spectrum Disorder

References

Feng, J., Pratt, J., & Spence, I. (2012). Attention and Visuospatial Working Memory Share the Same Processing Resources. Frontiers in Psychology, 3. https://doi.org/10.3389/fpsyg.2012.00103

Hull, L., Levy, L., Lai, M.-C., Petrides, K. V., Baron-Cohen, S., Allison, C., Smith, P., & Mandy, W. (2021). Is social camouflaging associated with anxiety and depression in autistic adults? Molecular Autism, 12 (1). https://doi.org/10.1186/s13229-021-00421-1

Neff, M. A. (2023). Autistic Burnout Symptoms. Insights of a Neurodivergent Clinician. https://neurodivergentinsights.com/blog/autistic-burnout-symptoms

Raymaker, D. (2022). Understanding Autistic Burnout. www.autism.org.uk. https://www.autism.org.uk/advice-and-guidance/professional-practice/autistic-burnout

Raymaker, D. M., Teo, A. R., Steckler, N. A., Lentz, B., Scharer, M., Delos Santos, A., Kapp, S. K., Hunter, M., Joyce, 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. https://doi.org/10.1089/aut.2019.0079