autistic burnout?

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aMny of us have heard of burnout, that grinding exhaustion and loss of motivation driven by pressures from work, but for those suffering from autistic burnout it stems from the demands of everyday life.

“It’s a very new field of research, something autistic communities have talked about on social media for quite some time, but empirically we don’t know much about it,” says Francesca Happé, a professor of cognitive neuroscience at King’s College London.

“We know anecdotally that autistic burnout is a state of exhaustion, when the demands of the environment outstrip capacity, and there’s insufficient support. For autistic people the sensory world can be overwhelming”, says Prof Happé, as can everyday social demands.

What exactly is autistic burnout?
Autistic adults describe the primary characteristics as:

Chronic exhaustion
Loss of skills
Reduced tolerance to stimulus
A study on autistic burnout conducted by the Academic Autism Spectrum Partnership in Research and Education described it as “having all of your internal resources exhausted beyond measure and being left with no clean-up crew’’.

Autistic people tend to work incredibly hard to manage and compensate for their differences by “masking” – attempting to blend in. “That in itself can be exhausting because your brain’s having to do an extra load,” says Dr Sarah Lister Brook, a clinical director at the National Autistic Society.

Unlike neurotypical people going into a social situation, for whom conversation flows and feels comfortable, “for some autistic people, they will be monitoring and rehearsing in their mind what to say, micro-analysing facial expressions and trying to assimilate social information at a micro level,” says Dr Lister Brook. Overthinking every detail is exhausting. “If you do that over a period of time, and in lots of different situations at work and in your social life, and you’ve got no opportunity to recharge and re-energise – the risk is burnout.”

How autistic burnout differs from normal burnout
Both result in chronic stress, but the cause of occupational burnout is pressures of work, while autistic burnout is due to the pressures of living and working in a “neurotypical” world and coping with social and sensory stressors.

“While burnout isn’t defined diagnostically, it’s a descriptive term for people who, for whatever reason, have reached a point of exhaustion and burnout of their energy,” says Dr Lister Brook.

What are the symptoms?
The symptoms of autistic burnout can vary, but include:

Exhaustion
Difficulty speaking or moving
Withdrawing from work or social contact
Increased slowness in movements
“There’s exhaustion and also sometimes a sort of inertia or difficulty speaking, moving or initiating when you’re in that very burnt-out state,” says Prof Happé.

For some it can mean exhaustion to the point of being in bed for a few days or even weeks. “In the state of complete exhaustion autistic people will withdraw. For some it will mean giving up their job, even if they liked it, because of the sensory and social demands of the workplace. They may withdraw from social contact even with people they enjoy spending time with just because it’s so exhausting,” Prof Happé adds.

“But it can get to the point where an individual [with autistic burnout] has real challenges just moving. That might start off with increased slowness in movements. It may manifest itself as freezing and getting stuck mid-movement. There may be jerky movements, blinking, grimacing, or postural abnormalities such as twisting into postures that are unusual,” says Dr Lister Brook.

Causes of autistic burnout
Overwhelming of the senses, external and internal
Too much competing noise, bright lights and crowds can compound the problem
Dr Lister Brook says every autistic person she’s worked with in a clinical context has had sensory differences. “For some individuals, they may have certain sensory inputs that are overwhelming for them, and they have to avoid certain situations.”

The most common overwhelming sensory experience is one in which you have competing sounds in a busy environment, like a supermarket or a tube station.

“With lots of different voices talking at once, for most of us, our brains will just adapt to that and focus in on the voice we need to attend to, screening out the rest. Whereas a lot of autistic people have described how in that situation every sound has equal value and it’s all coming at them at the same level,” adds Dr Lister Brook. This excess of information can be overwhelming, and if you add the sensory challenges of bright lights, sights and sensations of crowds brushing past, the whole outing becomes too much.

Interoception is an internal sensory system in which the physical and emotional states of the person are consciously or unconsciously noticed, recognised and responded to, and it’s something autistic people can struggle with.

“It’s internal awareness, the signals you get that you need to go to the toilet or feel thirsty, but also that you’re starting to feel irritated or angry. If you have difficulty picking up on those cues and recognising what they are, it can add to the overwhelm that leads to emotional dysregulation and losing control,” says Dr Lister Brook. This is sometimes referred to as a meltdown, and the cumulative effect of all the sensory and emotional factors can be burnout.

Coping strategies
Calming activities
Build some sensory activities into the day that are calming and energising in a positive way.

“This could be an activity that provides sensory feedback [like swinging or bouncing] that helps the autistic person rebalance and feel better. With children, think about reducing the social demands and ensuring they have the opportunity for recovery time, because kids won’t necessarily know they need that. Autistic adults can be very insightful and aware of their need to opt out of social situations in order to recover, perhaps needing a whole day at the weekend without social contact,” says Dr Lister Brook.

Energy accounting
Make a list of the things that deplete your energy and a list of the things you enjoy doing that restore your energy, such as listening to music or being in nature. It helps to plan the day ahead, considering how depleted your energy stocks are and how you can restore them. “Some people find that helps them keep their energy stocks about right, so that they’re not perpetually exhausting their energy and heading towards burnout,” says Prof Happé.

Self-soothing activities
Known as stimming, most autistic people say that the sensation of rocking, finger flicking or flapping their hands is soothing, although for other autistic people it can be a sign that they’re in distress.

“If you work with somebody who’s autistic, ask them: ‘Is that a sign that you’re overloaded? Should I step back and leave you in peace?’ Autistic people are very honest and if you ask respectfully, that’s how you’ll learn more about autism,” says Prof Happé.

How to prevent autistic burnout
The first port of call is getting professional support to understand what is causing the burnout. “It will be an individual constellation of things. It’s not just one thing for everyone,” says Dr Lister Brook. For information on getting help and support go to NAS.