September 11, 2023 • 27 mins
Autistic burnout is very different from the work-related burnout that non-autistics experience. In this episode, I cover the official definition of autistic burnout, how autistic burnout differs from non-autistic burnout, the latest research on this topic, how burnout relates to shutdown and social hangover, and more. I also discuss my own experiences with burnout and some strategies for avoiding it.
Watch this episode on YouTube.
If you'd like to know more about topics discussed in this episode, check out:
"Risk Markers for Suicidality in Autistic Adults" by Sarah Cassidy et al.
"Autistic Burnout Explained" by Sarah Deweerdt
"Defining Autistic Burnout Through Experts by Lived Experience: Grounded Delphi Method Investigating Autistic Burnout" by Julianne M. Higgins et al.
"'Having All of Your Internal Resources Exhausted Beyond Measure and Being Left With No Clean-Up Crew': Defining Autistic Burnout" by Dora M. Raymaker et al.
Episode outro music: "This Time Around" by oomiee
Theme music: "Everything Feels New" by Evgeny Bardyuzha.
All episodes written and produced by Kristen Hovet.
Send in your questions or thoughts via audio or video recording for a chance to be featured on the show! Email your audio or video clips to otherautism@gmail.com through WeTransfer.
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The views, opinions, and experiences shared by guests on this podcast are their own and do not necessarily reflect those of the host or production team. The content is intended for informational purposes only and should not be taken as medical or professional advice. Please consult with a qualified healthcare provider before making any decisions related to your health, fitness, or wellness.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Kristen Hovet (00:00):
Today we're talking about a kind of burnout
that many autistic individualsexperience and that's different
than non-autistic burnout.
But before I get into it, I'dlike to thank Kashmiri for your
generous one-time show ofsupport to The Other Autism
podcast.
Kashmiri used the Buy Me aCoffee link to send in a
(00:22):
donation.
If you find this podcastinformative and helpful in any
way and would like to do thesame to help keep this podcast
going and growing, please checkout the link in the show notes
that says Buy Me a Coffee.
To start with this topic, Iwill say that, anecdotally,
burnout tends to decrease afteridentification of autism, as
(00:47):
once we know about our neurotype, the majority of us become a
bit gentler with ourselves andtake steps to reduce factors
that can lead to burnout.
Given the amount of burnoutI've experienced and the amount
of pretty dramatic traumas in mylife ever since childhood, I
think I've developed a prettystrict approach to reducing
(01:09):
factors leading to burnout.
I can't wait to tell you whatthis looks like for me.
But I'd like to start with aformal definition of autistic
burnout.
While the formal definition isstill getting ironed out in
autism scholarship, here are acouple from two recent research
papers, all about autisticburnout, which I will link to in
(01:30):
the show notes.
Autistic burnout is defined byDora M Raymaker and their team
as, quote, a syndromeconceptualized as resulting from
chronic life stress and amismatch of expectations and
abilities, without adequatesupports.
It's characterized by pervasive, long-term (typically three or
(01:55):
more months) exhaustion, loss offunction and reduced tolerance
to stimulus.
End quote.
And that part about reducedtolerance to stimulus has to do
with any environmental stimulior information coming in from
one's surroundings.
The researchers went on to saythat autistic burnout can have
(02:15):
serious detrimental impacts onhealth, daily living, employment
, relationships and pretty muchevery area of life.
I know I've had burnout inuniversity that interrupted my
university career, that wasexacerbated by the suicide of
someone I was getting to know atthe time and just different
(02:39):
life stresses happening.
I've also had burnout as aresult of medical trauma, most
recently that included cancer,but I've also had burnout
related to chronic conditionsthat I live with, that I've
spoken of in previous episodes,if you want to give those a
listen.
Severity of autistic burnout canvary from person to person,
(03:01):
depending on their circumstances, but each case of autistic
burnout is challenging and leadsto significant suffering.
These researchers, led byRaymaker, note that autistic
burnout is caused by lifestressors and barriers to
support.
Life stressors in this contextcan include masking, unrealistic
(03:22):
expectations from family,society, school or work, and
major life transitions, such asmoving, someone in the family
passing away, starting school,leaving school, starting a new
job, having a child, gettingmarried, getting divorced, and
so on.
Barriers to support can includegaslighting or dismissal from
(03:45):
others, having poor boundariesand lack of external resources
or supports.
Julianne M Higgins and theirresearch team define autistic
burnout as, quote.
.
.
Sorry, there was just like abug that flew, flew up.
Oh, they like my lights.
(04:07):
Julianne M Higgins and theirresearch team define autistic
burnout as, quote, a highlydebilitating condition.
Sorry.
Condition characterized by.
.
.
this is no laughing matter.
.
.
A highly debilitating conditioncharacterized by exhaustion,
withdrawal, executive functionproblems and generally reduced
(04:29):
functioning, with increasedmanifestation of autistic traits
and distinct from depressionand non-autistic burnout.
End quote.
Anecdotal accounts of autisticburnout often describe worsening
of medical conditions, suicideideation and suicide attempts as
part of the experience of thephenomenon.
(04:52):
Autistic burnout, theresearchers also state, is
almost always linked with havingto mask or camouflage autistic
traits.
In an article for Spectrum,Sarah Deweerdt writes that
autistic burnout appears toprimarily impact autistic adults
who have strong cognitive andlanguage abilities and who work
(05:12):
or go to school.
Specifically, their work and orschool environments, Deweerdt
writes, include having tointeract with neurotypical
people.
I think Deweerdt's use oflanguage here indicates that
they're referring to autisticindividuals commonly diagnosed
as level one autistics.
I'm not sure if that'sultimately correct, but it does
(05:33):
appear to be what the researchhas suggested thus far and, to
be honest, there isn't muchresearch on autistic burnout, so
that's not saying much.
It's a fairly recent topic inthe realm of academia.
However, we know from thedefinitions of autistic burnout
given earlier that a majorcontributing factor to the
(05:53):
condition is masking orcamouflaging, which are sets of
behaviors typically associatedwith what's been called level
one or high masking autism.
I want to point out that noteveryone diagnosed as level one
autistic is high masking,especially if they've grown up
in particularly supportive andenriched environments, largely
(06:15):
free from bullying, mocking,abuse and other interpersonal
toxicity.
Sadly, however, very few of ushave had the privilege of
experiencing such a world andsuch an upbringing.
I love how the study by Higginsand their team starts with a
description and brief history ofnon-autistic burnout, so we can
(06:35):
see a real difference betweenthe two conditions.
Non-autistic burnout was firstdescribed by Freudenberger in
1974 as, quote, becomingexhausted by making excessive
demands on energy, strength orresources in the workplace.
End quote.
Since then, there's been agreat deal of research on this
(06:56):
form of non-autistic ormainstream burnout.
While non-autistic burnout doesnot appear in the DSM-5, it is
in the ICD-10 and the ICD-11 asan occupational phenomenon, and
ICD here is short forInternational Classification of
Diseases.
(07:17):
The ICD-11 describes burnout asbeing the result of unmanaged
work-related stress leading toexhaustion or fatigue, cynicism
or increased suspicion of othersand reduced professional or
work capacity.
Interestingly, there's actuallyan ongoing debate in the
(07:38):
medical literature and medicalcommunity about whether
non-autistic burnout isn'tactually just a specific
presentation of depression.
For example, a couple of largestudies published in 2020 found
that there's no distinctionbetween depression and
non-autistic burnout, with onestudy by Verkuilen and team
(08:00):
finding that, quote, burnoutlacked discriminant validity and
recommended clinicians assessfor depression when individuals
present with a complaint aboutburnout.
End quote.
The Higgins-led research makessome interesting distinctions
between autistic andnon-autistic burnout.
For one, non-autistic burnoutdoes not come with an increase
(08:23):
in autistic traits such assensory overwhelm or challenges
with speech, sometimes referredto as loss of speech, going
nonverbal or becoming nonverbal.
Additionally, protectivefactors are very different for
autistics and non-autistics, inthe context of burnout.
For example, increased socialinteraction is deemed as both a
(08:47):
protective factor and arequirement for faster recovery
in non-autistic burnout.
But in autistics, probablyunsurprisingly, increased social
interaction can itself lead toburnout or greatly exacerbate it
and definitely get in the wayof recovery, I would say.
(09:09):
The Higgins-led team alsobrought up a potentially
confusing discrepancy.
You may have noted it.
Many study participantsexplained that one main sign of
burnout for them was increasedsocial withdrawal or isolation,
but then many participants alsonoted that social withdrawal or
(09:29):
isolation was actually neededfor recovery from burnout.
I actually think this makestotal sense and is all about the
type of socializing and thecontext.
Social withdrawal can benegative if we're not following
our normal social routines orspending time with supportive
loved ones in our life.
(09:51):
This can definitely be a signof negatively impacted mental
health, for example.
But social withdrawal can bepositive if we're keeping away
from unsupportive people orsocial environments or if we're
only limiting socializing tothose who are loving and
supportive and people we don'tneed to mask around constantly.
(10:12):
Additionally, it's really aboutchoice.
When you're in autistic burnout, you don't have choice.
You start isolating or sociallywithdrawing out of necessity.
On the other hand, when not inautistic burnout, isolating or
socially withdrawing is a choice.
There's a huge distinction ordifference there.
Unfortunately, tellingnon-autistic people that you're
(10:34):
experiencing burnout is oftenmet with misunderstanding,
dismissal or total apathy.
And actually, if you thinkabout it, they'll probably
compare what you're talkingabout to run-of-the-mill or
non-autistic burnout, which isusually associated with work and
is usually something I wouldsay not as debilitating.
(10:55):
If you read about standardburnout, suicide does not come
up as often as it does whenyou're reading about autistic
burnout.
Autistic burnout seems to bemore debilitating, and that's
not dismissing the seriousnessof mainstream or non-autistic
burnout.
It's still definitely somethingyou want to avoid.
It's definitely somethingthat's not healthy.
(11:16):
It's definitely something thatyou want to have prevented in
the workplace, but there's ahuge difference.
So back to what I was saying,when you're talking to
non-autistic people about this,often it's not taken seriously,
mostly because it's just notwell understood yet at the
collective or societal level.
As mentioned, work on autisticburnout is still new in the
(11:38):
world of research, and so it'lltake a long while for awareness
about this topic to spread.
Hence we need to be talkingabout it when and where we can
and, more importantly, when andwhere it's safe to do so.
For me, the way I've describedautistic burnout is that it
feels a bit like the worst caseof shutdown you can possibly
(12:01):
imagine, but lasts much, muchlonger.
Whereas shutdown can last a fewhours to a few days for me,
I've experienced burnout that'sgone on for many weeks or months
.
And really shutdown's marked byso many of the same features of
autistic burnout, but it'stemporally much shorter and much
(12:24):
less severe.
I've also experienceddepression not accompanied by
burnout, so I know that thefeeling of depression is quite
different than burnout.
The reason I mention this isbecause a lot of autistic study
participants have talked aboutthe strong overlap between their
(12:45):
experience of burnout anddepression, but they also, like
me, note a distinct differencebetween the two.
There are some overlaps, ofcourse, as there are with many
mental health-related phenomena,but they're definitely more
different than they are similar.
I've experienced burnout withdepression and burnout without
(13:07):
depression.
Burnout with depression is, inmy opinion, particularly
dangerous and marks some of thelowest periods in my life, of
the suicide ideation variety.
This is just a hunch, but I'mgoing to share it.
So we already know, and havediscussed in previous episodes,
that autistic people have aparticularly high risk for
(13:29):
suicide, and this risk increaseswhen we have co-occurring
mental health conditions such asdepression or anxiety.
It's my hunch that manyautistic adults who are
diagnosed with depression,anxiety and or other conditions
are also, or maybe even only,suffering from burnout, but it's
(13:53):
being caught by differentassessment instruments as these
other conditions, so it's kindof like burnout masquerading as
a variety of mental healthconditions.
I also think that autisticburnout makes any current or
existing mental health conditionmore severe and potentially
(14:14):
more deadly.
This is why I think autisticburnout needs to rise to the top
of research priorities when itcomes to autistic mental health
and mental health supports.
I'll add that this hunch isn'tcoming out of nowhere.
I'm thinking of research bySarah Cassidy and their team,
where chronic masking orcamouflaging and having unmet
(14:36):
support needs predicted risk ofsuicide.
These are some of the top riskfactors for the construct that
we're calling autistic burnout.
So it definitely needs moreattention, as work to prevent
and treat autistic burnout couldprevent a great deal of suicide
ideation and suicide attemptsin the autistic population.
(14:58):
That's just my opinion.
I want to make that very clear.
So what are some solutions orstrategies for recovery in the
context of autistic burnout?
Raymaker and their team statethat the following may help:
Meaningful support from othersand from the community, sensory
breaks, unmasking,accommodations, therapy,
(15:21):
spiritual retreats, time off,reduced social interaction,
setting boundaries, asking forhelp, regular exercise,
meditation, learning torecognize early signs of
burnout, and working onincreased self-advocacy and
self-knowledge.
Higgins and their team make animportant note when it comes to
(15:42):
psychological or mental healthinterventions for autistic
burnout, stating, quote, routinetreatments for depression, such
as cognitive behavior therapyand behavioral activation, may
be contraindicated withinautistic burnout, even though
these conditions may coexist.
Our experts described the needfor withdrawal and downtime for
(16:03):
recovery, somewhat antithetic tobehavioral activation.
With cognitive overload beingdescribed as a key precursor of
autistic burnout, cognitive-focused therapies could be
counterproductive.
End quote.
And it should be noted thatthis research team referred to
their autistic participants asexperts, short for experts by
(16:26):
way of lived experience.
I'd also like to point out that,while some study participants
in the research I spoke of saidthat they had experienced
burnout that lasted only a fewhours or a few days, I
personally would not classifythose cases as burnout.
I don't want to deny theseparticipants' experience of
burnout, and most autisticpeople have had multiple
(16:49):
experiences with burnout, so Iabsolutely think these people
knew what they were describingwhen they added their feedback
about the construct of autisticburnout.
But when it's only a few hoursor a few days, I define that, as
I've mentioned earlier, asshutdown.
I think prolonged shutdown iswhat precedes burnout, in the
(17:10):
same way that acute stressdisorder precedes post-traumatic
stress disorder.
This is just a hypothesis, butI think that if a shutdown can
be reversed in a matter of aweek or less, burnout could
potentially be avoided in thatparticular situation.
I think saying that burnoutlasts for only a few hours or
days doesn't do the phenomenonjustice.
(17:32):
Burnout is intense, it'sserious and, to my understanding
, marked exactly by theinability to move away from or
pull oneself out of that stateof burnout.
If it can resolve in a fewhours, it's not really that
serious.
That's a passing state.
(17:53):
I would really like to seefuture research on autistic
burnout be more careful indefining it and more careful in
their interview and surveyquestions to make that
distinction.
I think this will help moreprecisely differentiate between
contributing factors and themain serious condition or mental
health phenomenon that isautistic burnout.
(18:16):
Another phenomenon that is againsimilar, in my mind, to
shutdown is what's been calledautistic social hangover.
This is not at all a clinicalor official term and I don't
think there's been any researchthat looked solely at this
construct, but it's used a lotin the autistic community.
While a shutdown can accompanya social hangover, a shutdown
(18:39):
isn't always caused by socialinteraction, but a social
hangover, in line with its name,is always the result of some
kind of social interaction.
Descriptions of socialhangovers are all over the
internet and all over theautistic community and can
include feeling particularlytired, more tired than usual,
(19:00):
mentally drained, foggy brained,even physically in pain.
Social hangovers for me usuallyinclude some amount of fatigue
or low energy, increased lightsensitivity, lower mood than
normal, irritability and justfeeling not like myself.
When I'm feeling sociallyhungover, I'll do everything in
(19:21):
my power to avoid seeing anyoneelse.
I'll need to be in a room bymyself, ideally with the lights
off or very low, I'll need tonot have many distractions in
order to work through socialhangover.
Lastly, I promised I would talkabout my relatively new strict
approach when it comes toreducing factors that lead to
burnout for me.
(19:42):
I advocated for myself to beable to work almost entirely
from home.
That was kind of step numberone.
Aside from going into workevery couple months, I have the
ability to do most of my workfrom home.
This has been a real gamechanger when it comes to the
severity of burnout and theincidence of burnout in my life.
In other words, I have way lessburnout these days, and when I
(20:05):
do have it, I tend to recovermore quickly.
This doesn't mean my life issuddenly easy- peasy or free of
the risk of burnout.
I still have to deal with theeffects of masking, I still have
to deal with the effects ofliving in a neurotypical world,
socializing.
.
.
I want to make it clear that Ilove socializing and so do many
autistic people, but we oftenrequire a long recovery period
(20:29):
after socializing.
Actually, I'd change often tonearly all the time.
This, of course, looksdifferent from one autistic to
another, but we all need someamount of time where we can
decompress and process aftersocial interactions.
Some other strategies I haveinclude working out quite often,
(20:49):
I would say minimum three timesa week, sometimes more.
It just helps my body to move.
It helps my brain.
Another big one is when there'sa toxic person in my life that I
recognize as toxic, I don'tstick around, I just leave the
(21:10):
situation.
I don't have any tolerance.
It's not fair to my health.
I've already struggled enoughwith the results of crappy
people doing crappy things.
And so I've just like, you know, one time you mess up,
depending on what it is, okay,I'll give you a second chance.
(21:31):
Second time?
You're out, you're gone, like Ican't.
And that's just what I've hadto do to protect myself.
It might sound harsh, it mightsound unreasonable, but I don't
think it is.
I think we're worth taking careof, we're worth protecting
ourselves.
So there it is.
(21:52):
That's a huge one.
What are some other ones?
I pursue as much as I canbecause obviously I have to make
a living, I have to work, butas much as I can I pursue the
things I want to do, the thingsthat make me happy, that give me
joy.
And to others that can lookpretty intense.
I have a lot of variedinterests and I pursue them
(22:16):
shamelessly, with greatenthusiasm, and I love the
things I'm working on and Idon't care what anyone else
thinks.
I used to care quite a bit.
I think a lot of high-maskingautistics do.
We grow up caring because whenwe don't fit in, that's when we
(22:37):
get the most crap, that's whenwe get mistreated the most.
But I don't know.
I don't know if it's justgetting older, getting wiser, I
don't know.
Influence of others, readingbooks, I don't know, but I just
don't care anymore.
So if someone's going to go like, oh my gosh, you're doing this
and also this, aren't you sobusy, aren't you?
(22:59):
I don't care, I don't care.
It can maybe look like that toyou, but to me I'm just doing my
life, I'm doing the things Ilike to do, and that's.
.
.
It reduces my anxiety, itreduces and prevents burnout and
symptoms of those things.
So you know what?
(23:19):
I'm just going to keep on doingwhat I do.
And I hope this inspires youall to do the same, as much as
you can, as much as you havecapacity to do so, like do the
things.
Do the things you love,whatever that may be, and who
gives a crap what anyone elsethinks?
As long as you're not hurtinganyone, as long as you're not
(23:40):
hurting yourself, do the things.
So I'd love to hear your storiesabout autistic burnout and I'm
particularly interested inhearing your strategies that
helped you recover from burnoutbecause I think that's really
gonna be of interest tolisteners.
They might be in burnout rightnow, so many people are coming
out of burnout or workingthrough burnout.
(24:01):
What are some strategies thatyou've used to recover and
prevent going back into burnout?
Would you like to be a guest onThe Other Autism podcast to
talk about this?
If so, please reach out.
My email address is, as always,in the show notes.
Well, that's all I have for youtoday.
(24:22):
Thank you so much for beinghere.
Until next time, bye.
Today we're talking about a kind of burnout
that many autistic individualsexperience and that's different
than non-autistic burnout.
But before I get into it, I'dlike to thank Kashmiri for your
generous one-time show ofsupport to The Other Autism
podcast.
Kashmiri used the Buy Me aCoffee link to send in a
(00:22):
donation.
If you find this podcastinformative and helpful in any
way and would like to do thesame to help keep this podcast
going and growing, please checkout the link in the show notes
that says Buy Me a Coffee.
To start with this topic, Iwill say that, anecdotally,
burnout tends to decrease afteridentification of autism, as
(00:47):
once we know about our neurotype, the majority of us become a
bit gentler with ourselves andtake steps to reduce factors
that can lead to burnout.
Given the amount of burnoutI've experienced and the amount
of pretty dramatic traumas in mylife ever since childhood, I
think I've developed a prettystrict approach to reducing
(01:09):
factors leading to burnout.
I can't wait to tell you whatthis looks like for me.
But I'd like to start with aformal definition of autistic
burnout.
While the formal definition isstill getting ironed out in
autism scholarship, here are acouple from two recent research
papers, all about autisticburnout, which I will link to in
(01:30):
the show notes.
Autistic burnout is defined byDora M Raymaker and their team
as, quote, a syndromeconceptualized as resulting from
chronic life stress and amismatch of expectations and
abilities, without adequatesupports.
It's characterized by pervasive, long-term (typically three or
(01:55):
more months) exhaustion, loss offunction and reduced tolerance
to stimulus.
End quote.
And that part about reducedtolerance to stimulus has to do
with any environmental stimulior information coming in from
one's surroundings.
The researchers went on to saythat autistic burnout can have
(02:15):
serious detrimental impacts onhealth, daily living, employment
, relationships and pretty muchevery area of life.
I know I've had burnout inuniversity that interrupted my
university career, that wasexacerbated by the suicide of
someone I was getting to know atthe time and just different
(02:39):
life stresses happening.
I've also had burnout as aresult of medical trauma, most
recently that included cancer,but I've also had burnout
related to chronic conditionsthat I live with, that I've
spoken of in previous episodes,if you want to give those a
listen.
Severity of autistic burnout canvary from person to person,
(03:01):
depending on their circumstances, but each case of autistic
burnout is challenging and leadsto significant suffering.
These researchers, led byRaymaker, note that autistic
burnout is caused by lifestressors and barriers to
support.
Life stressors in this contextcan include masking, unrealistic
(03:22):
expectations from family,society, school or work, and
major life transitions, such asmoving, someone in the family
passing away, starting school,leaving school, starting a new
job, having a child, gettingmarried, getting divorced, and
so on.
Barriers to support can includegaslighting or dismissal from
(03:45):
others, having poor boundariesand lack of external resources
or supports.
Julianne M Higgins and theirresearch team define autistic
burnout as, quote.
.
.
Sorry, there was just like abug that flew, flew up.
Oh, they like my lights.
(04:07):
Julianne M Higgins and theirresearch team define autistic
burnout as, quote, a highlydebilitating condition.
Sorry.
Condition characterized by.
.
.
this is no laughing matter.
.
.
A highly debilitating conditioncharacterized by exhaustion,
withdrawal, executive functionproblems and generally reduced
(04:29):
functioning, with increasedmanifestation of autistic traits
and distinct from depressionand non-autistic burnout.
End quote.
Anecdotal accounts of autisticburnout often describe worsening
of medical conditions, suicideideation and suicide attempts as
part of the experience of thephenomenon.
(04:52):
Autistic burnout, theresearchers also state, is
almost always linked with havingto mask or camouflage autistic
traits.
In an article for Spectrum,Sarah Deweerdt writes that
autistic burnout appears toprimarily impact autistic adults
who have strong cognitive andlanguage abilities and who work
(05:12):
or go to school.
Specifically, their work and orschool environments, Deweerdt
writes, include having tointeract with neurotypical
people.
I think Deweerdt's use oflanguage here indicates that
they're referring to autisticindividuals commonly diagnosed
as level one autistics.
I'm not sure if that'sultimately correct, but it does
(05:33):
appear to be what the researchhas suggested thus far and, to
be honest, there isn't muchresearch on autistic burnout, so
that's not saying much.
It's a fairly recent topic inthe realm of academia.
However, we know from thedefinitions of autistic burnout
given earlier that a majorcontributing factor to the
(05:53):
condition is masking orcamouflaging, which are sets of
behaviors typically associatedwith what's been called level
one or high masking autism.
I want to point out that noteveryone diagnosed as level one
autistic is high masking,especially if they've grown up
in particularly supportive andenriched environments, largely
(06:15):
free from bullying, mocking,abuse and other interpersonal
toxicity.
Sadly, however, very few of ushave had the privilege of
experiencing such a world andsuch an upbringing.
I love how the study by Higginsand their team starts with a
description and brief history ofnon-autistic burnout, so we can
(06:35):
see a real difference betweenthe two conditions.
Non-autistic burnout was firstdescribed by Freudenberger in
1974 as, quote, becomingexhausted by making excessive
demands on energy, strength orresources in the workplace.
End quote.
Since then, there's been agreat deal of research on this
(06:56):
form of non-autistic ormainstream burnout.
While non-autistic burnout doesnot appear in the DSM-5, it is
in the ICD-10 and the ICD-11 asan occupational phenomenon, and
ICD here is short forInternational Classification of
Diseases.
(07:17):
The ICD-11 describes burnout asbeing the result of unmanaged
work-related stress leading toexhaustion or fatigue, cynicism
or increased suspicion of othersand reduced professional or
work capacity.
Interestingly, there's actuallyan ongoing debate in the
(07:38):
medical literature and medicalcommunity about whether
non-autistic burnout isn'tactually just a specific
presentation of depression.
For example, a couple of largestudies published in 2020 found
that there's no distinctionbetween depression and
non-autistic burnout, with onestudy by Verkuilen and team
(08:00):
finding that, quote, burnoutlacked discriminant validity and
recommended clinicians assessfor depression when individuals
present with a complaint aboutburnout.
End quote.
The Higgins-led research makessome interesting distinctions
between autistic andnon-autistic burnout.
For one, non-autistic burnoutdoes not come with an increase
(08:23):
in autistic traits such assensory overwhelm or challenges
with speech, sometimes referredto as loss of speech, going
nonverbal or becoming nonverbal.
Additionally, protectivefactors are very different for
autistics and non-autistics, inthe context of burnout.
For example, increased socialinteraction is deemed as both a
(08:47):
protective factor and arequirement for faster recovery
in non-autistic burnout.
But in autistics, probablyunsurprisingly, increased social
interaction can itself lead toburnout or greatly exacerbate it
and definitely get in the wayof recovery, I would say.
(09:09):
The Higgins-led team alsobrought up a potentially
confusing discrepancy.
You may have noted it.
Many study participantsexplained that one main sign of
burnout for them was increasedsocial withdrawal or isolation,
but then many participants alsonoted that social withdrawal or
(09:29):
isolation was actually neededfor recovery from burnout.
I actually think this makestotal sense and is all about the
type of socializing and thecontext.
Social withdrawal can benegative if we're not following
our normal social routines orspending time with supportive
loved ones in our life.
(09:51):
This can definitely be a signof negatively impacted mental
health, for example.
But social withdrawal can bepositive if we're keeping away
from unsupportive people orsocial environments or if we're
only limiting socializing tothose who are loving and
supportive and people we don'tneed to mask around constantly.
(10:12):
Additionally, it's really aboutchoice.
When you're in autistic burnout, you don't have choice.
You start isolating or sociallywithdrawing out of necessity.
On the other hand, when not inautistic burnout, isolating or
socially withdrawing is a choice.
There's a huge distinction ordifference there.
Unfortunately, tellingnon-autistic people that you're
(10:34):
experiencing burnout is oftenmet with misunderstanding,
dismissal or total apathy.
And actually, if you thinkabout it, they'll probably
compare what you're talkingabout to run-of-the-mill or
non-autistic burnout, which isusually associated with work and
is usually something I wouldsay not as debilitating.
(10:55):
If you read about standardburnout, suicide does not come
up as often as it does whenyou're reading about autistic
burnout.
Autistic burnout seems to bemore debilitating, and that's
not dismissing the seriousnessof mainstream or non-autistic
burnout.
It's still definitely somethingyou want to avoid.
It's definitely somethingthat's not healthy.
(11:16):
It's definitely something thatyou want to have prevented in
the workplace, but there's ahuge difference.
So back to what I was saying,when you're talking to
non-autistic people about this,often it's not taken seriously,
mostly because it's just notwell understood yet at the
collective or societal level.
As mentioned, work on autisticburnout is still new in the
(11:38):
world of research, and so it'lltake a long while for awareness
about this topic to spread.
Hence we need to be talkingabout it when and where we can
and, more importantly, when andwhere it's safe to do so.
For me, the way I've describedautistic burnout is that it
feels a bit like the worst caseof shutdown you can possibly
(12:01):
imagine, but lasts much, muchlonger.
Whereas shutdown can last a fewhours to a few days for me,
I've experienced burnout that'sgone on for many weeks or months
.
And really shutdown's marked byso many of the same features of
autistic burnout, but it'stemporally much shorter and much
(12:24):
less severe.
I've also experienceddepression not accompanied by
burnout, so I know that thefeeling of depression is quite
different than burnout.
The reason I mention this isbecause a lot of autistic study
participants have talked aboutthe strong overlap between their
(12:45):
experience of burnout anddepression, but they also, like
me, note a distinct differencebetween the two.
There are some overlaps, ofcourse, as there are with many
mental health-related phenomena,but they're definitely more
different than they are similar.
I've experienced burnout withdepression and burnout without
(13:07):
depression.
Burnout with depression is, inmy opinion, particularly
dangerous and marks some of thelowest periods in my life, of
the suicide ideation variety.
This is just a hunch, but I'mgoing to share it.
So we already know, and havediscussed in previous episodes,
that autistic people have aparticularly high risk for
(13:29):
suicide, and this risk increaseswhen we have co-occurring
mental health conditions such asdepression or anxiety.
It's my hunch that manyautistic adults who are
diagnosed with depression,anxiety and or other conditions
are also, or maybe even only,suffering from burnout, but it's
(13:53):
being caught by differentassessment instruments as these
other conditions, so it's kindof like burnout masquerading as
a variety of mental healthconditions.
I also think that autisticburnout makes any current or
existing mental health conditionmore severe and potentially
(14:14):
more deadly.
This is why I think autisticburnout needs to rise to the top
of research priorities when itcomes to autistic mental health
and mental health supports.
I'll add that this hunch isn'tcoming out of nowhere.
I'm thinking of research bySarah Cassidy and their team,
where chronic masking orcamouflaging and having unmet
(14:36):
support needs predicted risk ofsuicide.
These are some of the top riskfactors for the construct that
we're calling autistic burnout.
So it definitely needs moreattention, as work to prevent
and treat autistic burnout couldprevent a great deal of suicide
ideation and suicide attemptsin the autistic population.
(14:58):
That's just my opinion.
I want to make that very clear.
So what are some solutions orstrategies for recovery in the
context of autistic burnout?
Raymaker and their team statethat the following may help:
Meaningful support from othersand from the community, sensory
breaks, unmasking,accommodations, therapy,
(15:21):
spiritual retreats, time off,reduced social interaction,
setting boundaries, asking forhelp, regular exercise,
meditation, learning torecognize early signs of
burnout, and working onincreased self-advocacy and
self-knowledge.
Higgins and their team make animportant note when it comes to
(15:42):
psychological or mental healthinterventions for autistic
burnout, stating, quote, routinetreatments for depression, such
as cognitive behavior therapyand behavioral activation, may
be contraindicated withinautistic burnout, even though
these conditions may coexist.
Our experts described the needfor withdrawal and downtime for
(16:03):
recovery, somewhat antithetic tobehavioral activation.
With cognitive overload beingdescribed as a key precursor of
autistic burnout, cognitive-focused therapies could be
counterproductive.
End quote.
And it should be noted thatthis research team referred to
their autistic participants asexperts, short for experts by
(16:26):
way of lived experience.
I'd also like to point out that,while some study participants
in the research I spoke of saidthat they had experienced
burnout that lasted only a fewhours or a few days, I
personally would not classifythose cases as burnout.
I don't want to deny theseparticipants' experience of
burnout, and most autisticpeople have had multiple
(16:49):
experiences with burnout, so Iabsolutely think these people
knew what they were describingwhen they added their feedback
about the construct of autisticburnout.
But when it's only a few hoursor a few days, I define that, as
I've mentioned earlier, asshutdown.
I think prolonged shutdown iswhat precedes burnout, in the
(17:10):
same way that acute stressdisorder precedes post-traumatic
stress disorder.
This is just a hypothesis, butI think that if a shutdown can
be reversed in a matter of aweek or less, burnout could
potentially be avoided in thatparticular situation.
I think saying that burnoutlasts for only a few hours or
days doesn't do the phenomenonjustice.
(17:32):
Burnout is intense, it'sserious and, to my understanding
, marked exactly by theinability to move away from or
pull oneself out of that stateof burnout.
If it can resolve in a fewhours, it's not really that
serious.
That's a passing state.
(17:53):
I would really like to seefuture research on autistic
burnout be more careful indefining it and more careful in
their interview and surveyquestions to make that
distinction.
I think this will help moreprecisely differentiate between
contributing factors and themain serious condition or mental
health phenomenon that isautistic burnout.
(18:16):
Another phenomenon that is againsimilar, in my mind, to
shutdown is what's been calledautistic social hangover.
This is not at all a clinicalor official term and I don't
think there's been any researchthat looked solely at this
construct, but it's used a lotin the autistic community.
While a shutdown can accompanya social hangover, a shutdown
(18:39):
isn't always caused by socialinteraction, but a social
hangover, in line with its name,is always the result of some
kind of social interaction.
Descriptions of socialhangovers are all over the
internet and all over theautistic community and can
include feeling particularlytired, more tired than usual,
(19:00):
mentally drained, foggy brained,even physically in pain.
Social hangovers for me usuallyinclude some amount of fatigue
or low energy, increased lightsensitivity, lower mood than
normal, irritability and justfeeling not like myself.
When I'm feeling sociallyhungover, I'll do everything in
(19:21):
my power to avoid seeing anyoneelse.
I'll need to be in a room bymyself, ideally with the lights
off or very low, I'll need tonot have many distractions in
order to work through socialhangover.
Lastly, I promised I would talkabout my relatively new strict
approach when it comes toreducing factors that lead to
burnout for me.
(19:42):
I advocated for myself to beable to work almost entirely
from home.
That was kind of step numberone.
Aside from going into workevery couple months, I have the
ability to do most of my workfrom home.
This has been a real gamechanger when it comes to the
severity of burnout and theincidence of burnout in my life.
In other words, I have way lessburnout these days, and when I
(20:05):
do have it, I tend to recovermore quickly.
This doesn't mean my life issuddenly easy- peasy or free of
the risk of burnout.
I still have to deal with theeffects of masking, I still have
to deal with the effects ofliving in a neurotypical world,
socializing.
.
.
I want to make it clear that Ilove socializing and so do many
autistic people, but we oftenrequire a long recovery period
(20:29):
after socializing.
Actually, I'd change often tonearly all the time.
This, of course, looksdifferent from one autistic to
another, but we all need someamount of time where we can
decompress and process aftersocial interactions.
Some other strategies I haveinclude working out quite often,
(20:49):
I would say minimum three timesa week, sometimes more.
It just helps my body to move.
It helps my brain.
Another big one is when there'sa toxic person in my life that I
recognize as toxic, I don'tstick around, I just leave the
(21:10):
situation.
I don't have any tolerance.
It's not fair to my health.
I've already struggled enoughwith the results of crappy
people doing crappy things.
And so I've just like, you know, one time you mess up,
depending on what it is, okay,I'll give you a second chance.
(21:31):
Second time?
You're out, you're gone, like Ican't.
And that's just what I've hadto do to protect myself.
It might sound harsh, it mightsound unreasonable, but I don't
think it is.
I think we're worth taking careof, we're worth protecting
ourselves.
So there it is.
(21:52):
That's a huge one.
What are some other ones?
I pursue as much as I canbecause obviously I have to make
a living, I have to work, butas much as I can I pursue the
things I want to do, the thingsthat make me happy, that give me
joy.
And to others that can lookpretty intense.
I have a lot of variedinterests and I pursue them
(22:16):
shamelessly, with greatenthusiasm, and I love the
things I'm working on and Idon't care what anyone else
thinks.
I used to care quite a bit.
I think a lot of high-maskingautistics do.
We grow up caring because whenwe don't fit in, that's when we
(22:37):
get the most crap, that's whenwe get mistreated the most.
But I don't know.
I don't know if it's justgetting older, getting wiser, I
don't know.
Influence of others, readingbooks, I don't know, but I just
don't care anymore.
So if someone's going to go like, oh my gosh, you're doing this
and also this, aren't you sobusy, aren't you?
(22:59):
I don't care, I don't care.
It can maybe look like that toyou, but to me I'm just doing my
life, I'm doing the things Ilike to do, and that's.
.
.
It reduces my anxiety, itreduces and prevents burnout and
symptoms of those things.
So you know what?
(23:19):
I'm just going to keep on doingwhat I do.
And I hope this inspires youall to do the same, as much as
you can, as much as you havecapacity to do so, like do the
things.
Do the things you love,whatever that may be, and who
gives a crap what anyone elsethinks?
As long as you're not hurtinganyone, as long as you're not
(23:40):
hurting yourself, do the things.
So I'd love to hear your storiesabout autistic burnout and I'm
particularly interested inhearing your strategies that
helped you recover from burnoutbecause I think that's really
gonna be of interest tolisteners.
They might be in burnout rightnow, so many people are coming
out of burnout or workingthrough burnout.
(24:01):
What are some strategies thatyou've used to recover and
prevent going back into burnout?
Would you like to be a guest onThe Other Autism podcast to
talk about this?
If so, please reach out.
My email address is, as always,in the show notes.
Well, that's all I have for youtoday.
(24:22):
Thank you so much for beinghere.
Until next time, bye.
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