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 is not autism-friendly (does not accommodate autistic people's needs). 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 people 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 three months.^[1] Autistic people commonly say it is 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.^[2][3]

To explain the behavior of autistic burnout from a proximate approach, emphasis is placed on immediate social, psychological, and environmental factors. In the contemporary context, environmental factors such as social expectations play a big role in causing autistic people to mask themselves in order to be accepted in a world designed for neurotypical people. The first academic research into autistic burnout was developed by Dora Raymaker in 2020 as a conceptual model to explain the different causes contributing to autistic burnout. The triggers of autistic burnout are in two main categories: life stressors and the barriers to support autistic people encounter.^[1]

Life stressors such as autistic masking or camouflaging have been proposed to be the most prominent factors in autistic burnout.^[4] Masking is a strategy autistic people use, consciously or unconsciously, whereby they suppress autistic traits and attempt to behave like a neurotypical people for social acceptance.^[5] Autistic people's need to mask often derives from the social pressures and expectations they face regarding academic achievement, social connections, and financial independence. Masking is a survival mechanism for them to meet social expectations and be treated better. Camouflaging and pretending to be different than one is requires an extensive cognitive effort. Research shows that autistic masking is significantly detrimental to autistic people's mental health, because it creates a situation where societal expectations outweigh their abilities.^[1] This can lower their self-esteem, lead to an identity crisis, and result in overwhelming emotions, leading to burnout episodes.

Many autistic people find neurotypical people hard to communicate with. One element that keeps autistic people from seeking help when experiencing burnout is the gaslighting and dismissal they experience. Gaslighting is the act of making someone question their own sense of reality, and dismissal refers to neglecting autistic people's feelings during burnout episodes by telling them it "happens to everyone". In Raymaker's research, participants reported feeling invalidated and unsupported when expressing their struggles as they were told their difficulties were their own fault.^[1] Lack of acceptance and understanding from people whom autistic people reach out to, who might be friends or family, when experiencing burnout can exacerbate their feelings of isolation and frustration, further hindering their ability to get the support they need to relieve stress and recover from 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.^[1] 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.^{[6][unreliable source?]} 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.^[1][5] Autistic burnout shares some features with occupational burnout and clinical depression such as fatigue and limited functioning in work or social contexts.^[3] However, autistic burnout can occur independently of employment and is distinct from occupational burnout occurring in an autistic employee,^[7] which can also occur.^[8]: 245 Depressive symptoms such as anhedonia or sleep disturbances are observed less frequently in autistic burnout.^[1]

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.^[1] Secondly, building self-acceptance as being autistic through unmasking and recognizing the strengths one has by being autistic are essential to reduce autistic burnout.^[9] 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.^[10] Throughout the 2010s, autistic burnout gained traction among autism researchers as a construct with ecological validity^[11] alongside concepts like neurodiversity proposed by the autism rights movement.^[7] It is often discussed in conjunction with autistic masking/camouflage, compensation, or "passing."^[11] The phenomenonology of autistic burnout may be related to that of autistic meltdowns.^[2] Ongoing research is largely qualitative in nature.^[12][13]

See also

• Autistic masking
• Occupational Burnout
• Autism Spectrum Disorder

References

1. Raymaker, Dora M.; Teo, Alan R.; Steckler, Nicole A.; Lentz, Brandy; Scharer, Mirah; Delos Santos, Austin; Kapp, Steven K.; Hunter, Morrigan; Joyce, Andee; Nicolaidis, Christina (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. doi:10.1089/aut.2019.0079. PMC 7313636. PMID 32851204.
2. Deweerdt, Sarah (2020-03-30). "Autistic burnout, explained". Spectrum. Simons Foundation. doi:10.53053/bpzp2355. S2CID 251634477. Retrieved 2023-05-09.
3. Winegarner, Beth (2021-09-03). "'The Battery's Dead': Burnout Looks Different in Autistic Adults". The New York Times. ISSN 0362-4331.
4. Pearson A, Rose K (2021). "A Conceptual Analysis of Autistic Masking: Understanding the Narrative of Stigma and the Illusion of Choice". Autism Adulthood. 3 (1): 52–60. doi:10.1089/aut.2020.0043. PMC 8992880. PMID 36601266.
5. Hull L, Levy L, Lai MC, Petrides KV, Baron-Cohen S, Allison C; et al. (2021). "Is social camouflaging associated with anxiety and depression in autistic adults?". Mol Autism. 12 (1): 13. doi:10.1186/s13229-021-00421-1. hdl:1983/be77a5f4-7c6c-4194-91b0-36633306a80c. PMID 33593423.{{cite journal}}: CS1 maint: multiple names: authors list (link)
6. Neff, M. A. (2023). Autistic Burnout Symptoms. Insights of a Neurodivergent Clinician. https://neurodivergentinsights.com/blog/autistic-burnout-symptoms
7. Tomczak MT, Kulikowski K (2023). "Toward an understanding of occupational burnout among employees with autism - the Job Demands-Resources theory perspective". Curr Psychol: 1–13. doi:10.1007/s12144-023-04428-0. PMC 9958323. PMID 37359683.
8. Bury SM, Spoor JR, Hayward SM, Hedley D (2022-06-30). "Supporting the mental health and well-being of autistic and other neurodivergent employees in the work environment". In Bruyere SM, Colella A (ed.). Neurodiversity in the workplace: Interests, issues, and opportunities. Routledge. pp. 241–266. doi:10.4324/9781003023616. ISBN 9781003023616.{{cite book}}: CS1 maint: multiple names: authors list (link)
9. Raymaker, D. (2022). Understanding Autistic Burnout. www.autism.org.uk. https://www.autism.org.uk/advice-and-guidance/professional-practice/autistic-burnout
10. Mantzalas, Jane; Richdale, Amanda L.; Adikari, Achini; Lowe, Jennifer; Dissanayake, Cheryl (2022). "What Is Autistic Burnout? A Thematic Analysis of Posts on Two Online Platforms". Autism in Adulthood. 4 (1): 52–65. doi:10.1089/aut.2021.0021. PMC 8992925. PMID 36605565.
11. Libsack EJ, Keenan EG, Freden CE, Mirmina J, Iskhakov N, Krishnathasan D; et al. (2021). "A Systematic Review of Passing as Non-autistic in Autism Spectrum Disorder". Clin Child Fam Psychol Rev. 24 (4): 783–812. doi:10.1007/s10567-021-00365-1. PMC 10613328. PMID 34505231.{{cite journal}}: CS1 maint: multiple names: authors list (link)
12. Øverland E, Hauge ÅL, Orm S, Pellicano E, Øie MG, Skogli EW; et al. (2022). "Exploring life with autism: Quality of Life, daily functioning and compensatory strategies from childhood to emerging adulthood: A qualitative study protocol". Front Psychiatry. 13: 1058601. doi:10.3389/fpsyt.2022.1058601. PMC 9732257. PMID 36506426.{{cite journal}}: CS1 maint: multiple names: authors list (link)
13. Mantzalas J, Richdale AL, Dissanayake C (2023). "Examining subjective understandings of autistic burnout using Q methodology: A study protocol". PLOS ONE. 18 (5): e0285578. Bibcode:2023PLoSO..1885578M. doi:10.1371/journal.pone.0285578. PMC 10198508. PMID 37205659.{{cite journal}}: CS1 maint: multiple names: authors list (link)