I have been noticing a pattern lately (hello, Whitney's Autism), both in terms of things I'm seeing in the online spaces I'm in and also in the therapy room, and it's a tough one. So it looks like we need to have a proper discussion about Autistic burnout.
Burnout is a well-known state, especially for folks who are working in people-centered jobs. In the undergraduate psychology classes I teach, the topic tends to come up without my intentionally being the one to bring it up. In graduate school, it was a purposeful part of learning how to be a therapist. In the traditional sense, burnout is a state of exhaustion caused by one's work, leading to a mixed-bag of possible feelings, from frustration, sadness, and sometimes outright apathy. In certain workplaces, burnout can have some major impacts - I always think about folks waiting tables when I talk about this. Serving table after table of people (not all of whom have great manners), difficult managers and coworkers, the physical impact of being on your feet for an extended amount of time, and the fact that people are generally not good tippers...it's a recipe for burnout! In these situations, it makes total sense to me that people might be eager to jump ship and find new work, finding that they just don't have it in them to do the work and put on the happy face as a means of trying to earn their living. This classic burnout can definitely be exacerbated by outside stressors (e.g., relationship difficulties, inflation, car trouble, family and/or roommate stress, etc.), but it's very driven by and tends to be relieved by work-specific factors. Get a new job! Set some boundaries! Take a weekend off to recharge!
In the mental health world, we talk with therapists and soon-to-be-therapists about doing what they can to prevent burnout from the start. This is especially important for clinicians as we ask our clients to trust us with their most vulnerable beings. They deserve for us to be as attuned to and allied with them in a way that is not possible when we are burnt out. I have seen incredible clinicians become so burnt out (sometimes even by their very first job out of grad school) that they leave the field for a short period of time and sometimes for good.
I don't want to belittle the experience of classic burnout in any way. This is a real challenge with real consequences. People are looking at changing jobs and even careers in some cases, careers for which they have spend years in school and accumulated thousands of dollars in student loan debt. Classic burnout is also deserving of attention and blogs on its own (hint, hint to some of my colleagues).
Autistic burnout is differentiated from classic burnout in a number of ways:
There's a lot there, so let's go through each of those in more detail so we can talk through the whole concept.
This first concept differentiating Autistic burnout from classic burnout is related to several of the other concepts, so I'll try to talk about this one only without going too much into the others. When talking about classic burnout earlier, we discussed that its primary cause was work. Autistic burnout is caused by the mental, emotional, and physical efforts involved in masking in all areas of life. As we grow and pass through the milestones that are expected of us, even if those milestones are exciting and what we want out of life, the increasing responsibilities and demands on us also increase. Going to college, graduating from college, getting a job, going to grad school, starting a family, taking care of a home, cooking every meal every day, doing your daily work...all of these very "normal" and usually very wanted things build up. Autistic burnout is cumulative.
My own experience with Autistic burnout mirrors that which I hear about from my clients and friends (and what I read and hear about in online spaces) - while I used to be exceptional at doing all of the things that I needed and wanted to do, that excellence had a cost. And as my life became more full and more demands were added to my plate, I continued with the same level of excellence as I had always so easily achieved, leaving me drained not just at the end of the day, but also at the end of the week, the end of the semester, the end of the year, and pretty soon all of the time. I reached a point where it became impossible, without exaggeration, to continue to do all of the things I had been doing for so long. I found myself incapable of functioning at all.
It's at this point where people tend to either reach out for help or are forced into receiving help. I have known people who have dropped out of school, quit jobs, ended relationships, and gone inpatient. It looks drastic and unexpected from the outside, and it is drastic.
When someone reaches Autistic burnout, I find that they and their loved ones are equally confused and scared when they find just how pervasive it is. People who were once highly successful and reliable find that they can't bring themselves to bathe, let alone keep up at work. They can't bring themselves to make a meal, sometimes being incapable of even deciding on something from the pantry to just eat for the sake of getting something into their bellies. Getting out of bed becomes a monstrous feat. It looks like a sudden bout of extreme depression, even sometimes including suicidality. For those who seek help or find themselves in an inpatient setting, it can lead to a diagnosis of major depressive disorder (or one of the main misdiagnoses of Autism, Bipolar). While time away and medication can help in some small way, medication and a break from responsibilities will not cure Autistic burnout. It's also worth mentioning that for many Autistic people who end up going inpatient, this increases their stress and demands, leading to their burnout deepening, not improving.
In the depths of my own Autistic burnout, I remember feeling intense feelings of wanting to run away that felt both scary and also really hopeful at the same time. I seriously considered buying a plane ticket to...somewhere and just leaving. When I had the energy to get thoughts out to my very worried husband, I remember telling him that I didn't want to leave him (this wasn't about him or us), but that I wanted to leave. It makes perfect sense to me how this could feel very much like a desire to just not exist anymore.
Because Autistic burnout is more pervasive and less understood by the mental and medical health community, I frequently see Autistic people in the throes of burnout feeling as if they are crazy and really being hard on themselves for not being able to get themselves together and functioning back at the level they expect from themselves (especially when they have been so high-achieving for so much or all of their lives up until this point). Some Autistic people feel suspicious of my reframing of their difficulties from less of some moral failing into a distinct result of their neurotype (and thus, their nervous system) being chronically overloaded. In the world of Acceptance and Commitment Therapy, getting to this point of the therapeutic relationship is what we call "creative hopelessness." It's a place where we, for the first time, realize and then fully embrace the idea that there's no working our way out of this. There isn't a medication, checklist, routine, or meditation that is going to get us back to where we were. Because where we were wasn't working to begin with. This relates heavily to the last two of our concepts differentiating Autistic burnout from classic burnout.
While the research is limited (in so many ways - don't get me started), the overwhelming majority of literature reports that anywhere between only 5-15% of Autistic adults hold full time employment (there are seriously so many articles, people, and organizations focused on helping to improving career prospects for Autistic people that I couldn't even begin to cite my sources for this one, so you'll have to do a little bit of googling on your own this time). It is notoriously difficult for many Autistic people to find full time employment in the first place, due to job interview processes being distinctly not neurodiversity-affirming, so much so that there are also organizations devoted to helping with this part of the process specifically (which is another blog for another day). For those of us who have been lucky enough that our Autism doesn't interfere with finding full time employment, many work environments are not suited to Autistic people, even when the jobs are especially fulfilling. The daily efforts involved in masking, organization, planning, implementation, etc. can deplete our energy stores, leaving little to nothing left for any kind of life outside of work.
In my own history, I remember joking that I knew I would get sick immediately after turning in my last final of a semester. It was at that point that my nervous system knew that I had finished the last deadline for at least a few weeks, and all of its efforts to keep me up and functioning (and doing very well!) would fall all at once, like clockwork. I remember more than once during undergrad where we would have finished the final performance of a play, and as we would be striking the set (taking the set down and cleaning the space up in preparation for a new show for those of you who aren't theatre nerds), I would feel myself coming down with a sinus infection. Looking back at that now, I wish I had known that this was the beginning signs of Autistic burnout. As soon as I had demands outside of classes and theatre waiting for me at home, I didn't get the recovery time I needed and so easily found as a student.
What has been helpful in my work life in trying to avoid reaching Autistic burnout again is in the flexibility of working in academia. I am thankful each day that I have the ability to take time when I need it, regularly, so I can maintain a full time work schedule on top of parenting, being a partner, my friendships, house hold demands, etc. There are very few careers that allow for this basic need for Autistic people, and that is something myself and my clients talk about frequently in session.
Lately, this has been the component of understanding Autistic burnout that has been most salient for me, and the one where I find many of my clients and friends struggling. Disability is one of those concepts that most people don't consider until it affects our own life. Disability is also something that, if you are not currently experiencing, you will eventually experience. All of us, should we be lucky enough to live a long life, will become disabled.
For many Autistic people, especially those who are more obviously Autistic (don't get me started on this concept either...), it is clear how the world is not built with their neurotype in mind. From small things like expecting eye contact (just enough eye contact, though - not too much, and not too little) in social interaction to larger things like having more effortful thinking, and as such, needing more time in order to process information, there are many ways in which our fast-paced world is not accommodating for Autistic people. It's harder to see this mismatch of expectation and neurotype in high-masking Autistic people, though. Even for ourselves!
The fact is that for most of my life up until my mid-thirties, I have been able to meet my own needs enough that I could avoid burnout. But the costs were too heavy. Once I began to struggle, it was too late. Autistic burnout hit me in the spring of 2023. I could list all of the things that built up to this moment (the major ones being having my second baby in March of 2020, leading to a very difficult postpartum experience during a global pandemic wherein for some reason I thought it was a good idea for us to sell our house and move), but the fact is, each of those things could have been different and I still would have probably reached burnout. This wasn't caused by one event (as stressful and terrible as 2020 was for all of us). Autistic burnout was caused ultimately by my working too hard to function as if I were neurotypical when, in fact, I have never been neurotypical.
This part of the blog could and maybe should be its own blog (or series of blogs), because it really is the whole point of understanding Autistic burnout in the first place. Recovery is possible - I have lived it and I have seen it. But it likely doesn't look or feel the way that you would expect or even want in a lot of ways.
There is nothing you did to deserve this, let alone to cause this. This is not your fault. You are not broken. Because Autistic burnout is not the doing or not-doing of yourself, it also means that you can't work your way out of it. Recovery looks like allowing your nervous system and your body the rest and recovery that it has needed all these years, in whatever time you have available.
In an ideal world, I recommend folks allowing themselves to become as non-functioning as possible. Stay in bed for long periods of time. Allow other people to pick up the slack. Ask for help, and allow help when it shows up. Lower your expectations for yourself and for others. I don't know many people for whom this full escape from demands is possible, especially because so many people find themselves in burnout at a point in their lives when they do have demands that are not possible to offload or ignore. As much as you might roll your eyes at the mention of it, capitalism ensures this type of recovery is really not at the fingertips of anyone in our country.
In reality, recovery from Autistic burnout looks similar, but definitely at a smaller scale. I recommend people incorporate regular naps into their schedule - the more the better (and usually, for my high-achieving friends, this means more than you think you should). It means saying no to more things, even if the things are really, really wanted. It might mean wondering about what it would look like to not be the best employee for a while. Not the best parent. Not the best partner. It usually means having tough conversations with partners and family about what you are capable of doing and no longer capable of doing. It might mean quitting a job, even if its one you love for one reason or another, and seeing out a job where it feels more possible to not be the best employee. It might mean deciding that the bare minimum is actually okay. There are a million ways to imagine what this type of life can look like (see, that's the creative part of creative hopelessness).
Because most of us can't disappear from our lives for a long period of time without consequence, this semi-recovery state that myself and my clients plan for is going to take even more time. Autistic burnout takes much longer to recover from than classic burnout does, so keeping everyone's expectations realistic is important at this phase of the process.
It can be scary to get to the point where you are willing to admit that where you are (or where you are headed) is to Autistic burnout. Believe me when I say that I have been there. It can also feel so incredibly wrong to cut back on life to the degree that you need in order to recover. Not wrong as in "this doesn't feel good," but wrong as in "this is bad and I am bad and surely this means I will die." Having the support of a therapist who understands is really the bare minimum of what you should be able to ask for, but I will tell you that many therapists are not attuned to the differences between classic and Autistic burnout.
If you are finding yourself in a position where you would benefit from a therapist who gets it, please don't hesitate to reach out. Even if I'm not the therapist for you, I'd be happy to help guide you in your search in whatever way that looks.
Recovery is possible, and you deserve it.