Insights of a Neurodivergent Clinician

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Autism and ADHD Burnout Recovery

What Causes Autistic and ADHD Burnout?

Autistic and ADHD burnout are both characterized by pervasive, long-term exhaustion, loss of function, and increased difficulties with managing daily tasks. While there is considerable overlap in the features of both types of burnout, it is important to note that the Raymaker et al. (2021) study specifically addresses Autistic burnout. However, ADHD burnout shares many similar characteristics due to the overlapping demands on cognitive and emotional resources.

Primary Characteristics of Neurodivergent Burnout

  • Chronic Exhaustion: Persistent, deep fatigue that doesn’t improve with rest.

  • Reduced Tolerance to Stimuli: Heightened sensitivity to sensory inputs, such as light, sound, and touch.

  • Increased Executive Functioning Challenges: Greater difficulties in planning, organizing, remembering, and managing daily tasks.

  • Loss of Skills: Deterioration in executive functioning, which includes difficulties in thinking, remembering, planning, performing basic self-care, and managing daily activities.

Additional Symptoms

In addition to intense emotional, physical, and mental exhaustion, neurodivergent burnout can lead to:

  • Emotional Dysregulation: Increased difficulty managing emotions, leading to outbursts or intense anxiety.

  • Enhanced Neurodivergent Traits: Increase in repetitive behaviors, sensory sensitivities, and more difficulties adapting to change.

  • Cognitive Impairments: Increased difficulties with memory and focus, making it hard to perform everyday tasks.

  • Increased Executive Functioning Challenges: Greater difficulties in planning, organizing, remembering, and managing daily tasks.

  • Inability to Mask: People often loose or decline in their ability to mask, which is one of the reasons that burnout is a common time for neurodivergent adults to be identified.

  • Time Perception Challenges: Greater difficulty in perceiving the passage of time, leading to procrastination or last-minute stress.

  • Increased Impulsivity: Heightened impulsivity that may lead to risky decisions.

Common Contributors to Neurodivergent Burnout

Research highlights several common contributors to neurodivergent burnout, including:

  1. Masking:

    • Constantly suppressing Autistic or ADHD traits to appear "neurotypical" demands significant cognitive and emotional effort, leading to exhaustion.

    • Masking creates a disconnect between one's internal state and external presentation, increasing stress and anxiety.

  2. Minimized Needs:

    • Having social and sensory needs dismissed by others because they appear "fine" due to masking.

    • Lack of understanding and support from those around them can exacerbate feelings of isolation and frustration.

  3. Lack of Appropriate Supports and Accommodations:

    • Not having access to necessary accommodations, whether in the workplace, school, or social settings.

    • Inadequate support structures can leave individuals struggling to cope with everyday demands, contributing to burnout.

  4. Executive Functioning Fatigue:

    • Frequent transitions and managing multiple stressors can lead to executive functioning fatigue.

    • The mental effort required to organize, plan, and execute daily tasks becomes overwhelming, leading to decreased functionality.

  5. Overall Load Exceeding Abilities and Supports:

    • When the cumulative demands of life exceed an individual's capacity and available supports, burnout is the likely outcome.

    • Balancing work, social, and personal responsibilities without adequate support creates a high-risk environment for burnout.

  6. Hyperfocus:

    • Intense focus on a single activity to the exclusion of everything else can lead to neglect of basic self-care and rest.

    • While hyperfocus can be productive, it can also drain energy reserves, contributing to burnout.

Burnout Recovery

Recovery depends on the person and the specific causes. For a more prolonged season of burnout, a person may need to significantly restructure their lifestyle and remove themselves from the causes of their burnout. It may become more difficult to recover the older a person is. Following are some of my go-to tips for recovering from burnout:

  • Attend to the sensory! Moving in ways that feel natural and good, reducing sensory load, engaging in sensory activities that are restorative⁠

  • Spend time unmasked (again, masking is consistently one of the highest predictors of burnout). ⁠

  • Ensure appropriate accommodations are in place (at school, work, etc.). ⁠

  • Practicing good boundaries in relationships (we have fewer spoons). ⁠

  • Engage in activities that are enlivening (special interests, passions, time alone, or with those whom you can safely unmask). ⁠

  • Support healthy rhythms by prioritizing healthy sleep hygiene, routines, & practices. ⁠

Be Cautious of Depression Treatments for Undiagnosed Neurodivergent Burnout

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Mental health providers will often prescribe "behavioral activation" for depression (assigning activities that help a person gain a sense of accomplishment, and achievement & helps them get back out in the world). This may make burnout worse unless it is adapted for the Autistic or ADHD person. Behavioral activation, if used, should focus on implementing sensory activities, special interests, rest, and must avoid activities designed to increase time spent socializing in neurotypical spaces.

Similarly, “cognitive reframing” is a common technique used for treating depression. Attempts made to "cognitively reframe" the experience may intensify shame around burnout (particularly if the therapist or person does not understand it is an Autistic/ADHD burnout).

References:

“Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining Autistic Burnout”