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 has 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. 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.

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 that autistic people encounter.

Life stressors such as autistic masking or camouflaging have been proposed to be the most prominent factors in autistic burnout. Masking is a strategy autistic people use, consciously or unconsciously, to suppress autistic traits and attempt to behave like neurotypical people for social acceptance. The need autistic people feel 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 much cognitive effort. Research shows that autistic masking is significantly detrimental to an autistic person's mental health, because it creates a situation where societal expectations outweigh their abilities. 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. In Raymaker's research, participants reported feeling invalidated and unsupported when expressing their struggles as they were told their difficulties were their own fault. Lack of acceptance and understanding from people to whom autistic people reach out when experiencing burnout, people who might be friends or family, 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 have identified some key symptoms, which include chronic exhaustion, loss in life skills, and reduced tolerance to stimulus. 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 interest to engage in activities, difficulty maintaining social relationships with low social battery, and challenges in completing the simplest tasks such as brushing teeth due to fatigue. Persistent exhaustion consequently leads to the loss of skills to manage various aspects of their life, such as taking care of themself, managing effective social relationships, and decision-making in everyday life. When cognitive abilities are depleted due to chronic exhaustion, language disability challenges, which many autistic individuals already face, are exacerbated, affecting the management of effective communication required to maintain different social relationships. Lastly, autistic individuals experiencing burnout often experience sensory hypersensitivity which reduces their tolerance of 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 tools to prevent autistic burnout and to help autistic individuals recover from emotional overload. From the qualitative analysis of 19 interviews with autistic individuals, results suggest that having a support network where a person is accepted for who they are and is not being shamed or judged are critical to recovery from autistic burnout. Secondly, building self-acceptance as being autistic through unmasking, and recognizing the strengths one has by being autistic, are essential to reduce autistic burnout. Lastly, seeking professional mental health support for advice without feeling ashamed of being autistic and in need of support is important for autistic individuals to recover from burnout.

History of #AutisticBurnout
The term "autistic burnout" is believed to have emerged in 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, and "passing". The phenomenonology of autistic burnout may be related to that of autistic meltdown. Ongoing research is largely qualitative in nature.