Autistic burnout

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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.

Contents

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. [1] 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. [2] [3]

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. [1]

Life stressors such as autistic masking or camouflaging have been proposed to be the most prominent factors in autistic burnout. [4] Masking is a strategy autistic people use, consciously or unconsciously, to suppress autistic traits and attempt to behave like neurotypical people for social acceptance. [5] 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. [1] 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. Gaslighting is the act of making someone question their own sense of reality. Dismissal refers to neglecting an autistic person's feelings during burnout episodes by telling them it "happens to everyone". In Raymaker's research, participants reported feeling invalidated and unsupported when expressing their struggles as they were told their difficulties were their own fault. [1] 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. [1] 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. [6] [ unreliable source? ] 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. [1] [5] Autistic burnout shares some features with occupational burnout and clinical depression such as fatigue and limited functioning in work or social contexts. [3] However, autistic burnout can occur independently of employment and is distinct from occupational burnout occurring in an autistic employee, [7] which can also occur. [8] : 245  Depressive symptoms such as anhedonia or sleep disturbances are observed less frequently in autistic burnout. [1]

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 you are accepted by who you are and not being shamed or judged upon is critical to recover from autistic burnout as the stress is being relieved by autistic individuals verbally expressed. [1] Secondly, building self-acceptance as being autistic through unmasking and recognizing the strengths one has by being autistic are essential to reduce autistic burnout. [9] Lastly, seeking professional mental health support for advice without feeling ashamed of being autistic and in need for 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. [10] Throughout the 2010s, autistic burnout gained traction among autism researchers as a construct with ecological validity [11] alongside concepts like neurodiversity proposed by the autism rights movement. [7] It is often discussed in conjunction with autistic masking/camouflage, compensation, and "passing". [11] The phenomenonology of autistic burnout may be related to that of autistic meltdown. [2] Ongoing research is largely qualitative in nature. [12] [13]

Related Research Articles

<span class="mw-page-title-main">Asperger syndrome</span> Neurodevelopmental diagnosis now categorized under autism spectrum disorder

Asperger syndrome (AS), also known as Asperger's syndrome or Asperger's, formerly described as a neurodevelopmental disorder characterized by significant difficulties in social interaction and nonverbal communication, along with restricted, repetitive patterns of behavior and interests. Asperger syndrome has been merged with other disorders into autism spectrum disorder (ASD) and is no longer considered a stand-alone diagnosis. It was considered milder than other diagnoses which were merged into ASD due to relatively unimpaired spoken language and intelligence.

<span class="mw-page-title-main">Neurodiversity</span> Non-pathological explanation of variations in mental functions

Neurodiversity is a framework for understanding human brain function that recognizes the diversity of human cognition as a biological fact. The neurodiversity paradigm argues that diversity in human cognition is normal and that some conditions classified as mental disorders are differences and disabilities that are not necessarily pathological.

The following outline is provided as an overview of and topical guide to autism:

Mind-blindness, mindblindness or mind blindness is a theory initially proposed in 1990 that claims that all autistic people have a lack or developmental delay of theory of mind (ToM), meaning they are unable to attribute mental states to others. According to the theory, a lack of ToM is considered equivalent to a lack of both cognitive and affective empathy. In the context of the theory, mind-blindness implies being unable to predict behavior and attribute mental states including beliefs, desires, emotions, or intentions of other people. The mind-blindness theory asserts that children who delay in this development will often develop autism.

Sensory overload occurs when one or more of the body's senses experiences over-stimulation from the environment.

<span class="mw-page-title-main">Masking (personality)</span> Social process

In psychology and sociology, masking is the process in which an individual camouflages their natural personality or behavior to conform to social pressures, abuse, or harassment. Masking can be strongly influenced by environmental factors such as authoritarian parents, rejection, and emotional, physical, or sexual abuse. Masking can be a behavior individuals adopt subconsciously as coping mechanisms or a trauma response, or it can be a conscious behavior an individual adopts to fit in within perceived societal norms. Masking is interconnected with maintaining performative behavior within social structures and cultures.

<span class="mw-page-title-main">Autism therapies</span> Therapy aimed at autistic people

Autism therapies include a wide variety of therapies that help people with autism, or their families. Such methods of therapy seek to aid autistic people in dealing with difficulties and increase their functional independence.

<span class="mw-page-title-main">Stimming</span> Repetitive self-stimulatory behaviour common in neurodevelopmental disorders

Self-stimulatory behavior, also known as "stimming" and self-stimulation, is the repetition of physical movements, sounds, words, moving objects, or other behaviors. Such behaviors are found to some degree in all people, especially those with developmental disabilities such as ADHD, as well as autistic people. People diagnosed with sensory processing disorder are also known to potentially exhibit stimming behaviors.

Compassion fatigue is an evolving concept in the field of traumatology. The term has been used interchangeably with secondary traumatic stress (STS), which is sometimes simply described as the negative cost of caring. Secondary traumatic stress is the term commonly employed in academic literature, although recent assessments have identified certain distinctions between compassion fatigue and secondary traumatic stress (STS).

<span class="mw-page-title-main">Societal and cultural aspects of autism</span>

Societal and cultural aspects of autism or sociology of autism come into play with recognition of autism, approaches to its support services and therapies, and how autism affects the definition of personhood. The autistic community is divided primarily into two camps; the autism rights movement and the pathology paradigm. The pathology paradigm advocates for supporting research into therapies, treatments, and/or a cure to help minimize or remove autistic traits, seeing treatment as vital to help individuals with autism, while the neurodiversity movement believes autism should be seen as a different way of being and advocates against a cure and interventions that focus on normalization, seeing it as trying to exterminate autistic people and their individuality. Both are controversial in autism communities and advocacy which has led to significant infighting between these two camps. While the dominant paradigm is the pathology paradigm and is followed largely by autism research and scientific communities, the neurodiversity movement is highly popular among most autistic people, within autism advocacy, autism rights organizations, and related neurodiversity approaches have been rapidly growing and applied in the autism research field in the last few years.

<span class="mw-page-title-main">Occupational burnout</span> Type of occupational stress

The ICD-11 of the World Health Organization (WHO) describes occupational burnout as an occupational phenomenon resulting from chronic workplace stress that hasn't been successfully managed, with symptoms characterized by "feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy." It is classified as a mismatch between the challenges of work and a person's mental and physical resources, but is not recognized by the WHO as a medical condition.

Asociality refers to the lack of motivation to engage in social interaction, or a preference for solitary activities. Asociality may be associated with avolition, but it can, moreover, be a manifestation of limited opportunities for social relationships. Developmental psychologists use the synonyms nonsocial, unsocial, and social uninterest. Asociality is distinct from, but not mutually exclusive to, anti-social behavior. A degree of asociality is routinely observed in introverts, while extreme asociality is observed in people with a variety of clinical conditions.

Autism, formally called autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental disorder marked by deficits in reciprocal social communication, and the presence of restricted and repetitive patterns of behavior. Other common signs include difficulties with social interaction, verbal and nonverbal communication, perseverative interests, stereotypic body movements (stimming), rigid routines, and hyper- or hyporeactivity to sensory input. Autism is clinically regarded as a spectrum disorder, meaning that it can manifest very differently in each person. For example, some are nonspeaking, while others have proficient spoken language. Because of this, there is wide variation in the support needs of people across the autism spectrum.

Sex and gender differences in autism exist regarding prevalence, presentation, and diagnosis.

Discrimination against autistic people is the discrimination, persecution, and oppression that autistic people have been subjected to. Discrimination against autistic people is a form of ableism.

Compassion fatigue (CF) is an evolving concept in the field of traumatology. The term has been used interchangeably with secondary traumatic stress (STS)s. Secondary traumatic stress is the term commonly employed in academic literature, although recent assessments have identified certain distinctions between compassion fatigue and secondary traumatic stress (STS).

Autistic masking, also referred to as camouflaging or neurodivergent masking, is the conscious or subconscious suppression of autistic behaviors and compensation of difficulties in social interaction by autistic people with the goal of being perceived as neurotypical. Masking is a learned coping strategy that can be successful from the perspective of autistic people, but can also lead to adverse mental health outcomes.

<span class="mw-page-title-main">Autism and LGBT identities</span>

Current research indicates that autistic people have higher rates of LGBT identities and feelings than the general population. A variety of explanations for this have been proposed, such as prenatal hormonal exposure, which has been linked with sexual orientation, gender dysphoria and autism. Alternatively, autistic people may be less reliant on social norms and thus are more open about their orientation or gender identity. A narrative review published in 2016 stated that while various hypotheses have been proposed for an association between autism and gender dysphoria, they lack strong evidence.

<span class="mw-page-title-main">Double empathy problem</span> Psychological theory regarding individuals on the autism spectrum

The theory of the double empathy problem is a psychological and sociological theory first coined in 2012 by Damian Milton, an autistic autism researcher. This theory proposes that many of the difficulties autistic individuals face when socializing with non-autistic individuals are due, in part, to a lack of mutual understanding between the two groups, meaning that most autistic people struggle to understand and empathize with non-autistic people, whereas most non-autistic people also struggle to understand and empathize with autistic people. This lack of understanding may stem from bidirectional differences in communication style, social-cognitive characteristics, and experiences between autistic and non-autistic individuals, but not necessarily an inherent deficiency. Recent studies have shown that most autistic individuals are able to socialize, communicate effectively, empathize well, and display social reciprocity with most other autistic individuals. This theory and subsequent findings challenge the commonly held belief that the social skills of autistic individuals are inherently impaired, as well as the theory of "mind-blindness" proposed by prominent autism researcher Simon Baron-Cohen in the mid-1980s, which suggested that empathy and theory of mind are universally impaired in autistic individuals.

Special interests are highly focused interests common in autistic people.

References

  1. 1 2 3 4 5 6 7 8 Raymaker, Dora M.; Teo, Alan R.; Steckler, Nicole A.; Lentz, Brandy; Scharer, Mirah; Delos Santos, Austin; Kapp, Steven K.; Hunter, Morrigan; Joyce, Andee; Nicolaidis, Christina (2020). ""Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew": Defining Autistic Burnout". Autism in Adulthood . 2 (2): 132–143. doi:10.1089/aut.2019.0079. PMC   7313636 . PMID   32851204.
  2. 1 2 Deweerdt, Sarah (2020-03-30). "Autistic burnout, explained". Spectrum. Simons Foundation. doi: 10.53053/bpzp2355 . S2CID   251634477 . Retrieved 2023-05-09.
  3. 1 2 Winegarner, Beth (2021-09-03). "'The Battery's Dead': Burnout Looks Different in Autistic Adults". The New York Times . ISSN   0362-4331.
  4. ↑ Pearson, A; Rose, K (2021). "A Conceptual Analysis of Autistic Masking: Understanding the Narrative of Stigma and the Illusion of Choice". Autism Adulthood. 3 (1): 52–60. doi:10.1089/aut.2020.0043. PMC   8992880 . PMID   36601266.
  5. 1 2 Hull, Laura; Levy, Lily; Lai, Meng-Chuan; Petrides, K. V.; Baron-Cohen, Simon; Allison, Carrie; et al. (2021). "Is social camouflaging associated with anxiety and depression in autistic adults?". Mol Autism. 12 (1): 13. doi: 10.1186/s13229-021-00421-1 . hdl: 1983/be77a5f4-7c6c-4194-91b0-36633306a80c . PMC   7885456 . PMID   33593423.
  6. ↑ Neff, M. A. (2023). Autistic Burnout Symptoms. Insights of a Neurodivergent Clinician.
  7. 1 2 Tomczak, MT; Kulikowski, K (2023). "Toward an understanding of occupational burnout among employees with autism - the Job Demands-Resources theory perspective". Curr Psychol. 43 (2): 1582–1594. doi: 10.1007/s12144-023-04428-0 . PMC   9958323 . PMID   37359683.
  8. ↑ Bury, SM; Spoor, JR; Hayward, SM; Hedley, D (2022-06-30). "Supporting the mental health and well-being of autistic and other neurodivergent employees in the work environment". In Bruyere, SM; Colella, A (eds.). Neurodiversity in the workplace: Interests, issues, and opportunities. Routledge. pp. 241–266. doi: 10.4324/9781003023616 . ISBN   9781003023616.
  9. ↑ Raymaker, D. (2022). Understanding Autistic Burnout. www.autism.org.uk.
  10. ↑ Mantzalas, Jane; Richdale, Amanda L.; Adikari, Achini; Lowe, Jennifer; Dissanayake, Cheryl (2022). "What Is Autistic Burnout? A Thematic Analysis of Posts on Two Online Platforms". Autism in Adulthood . 4 (1): 52–65. doi:10.1089/aut.2021.0021. PMC   8992925 . PMID   36605565.
  11. 1 2 Libsack, Erin J.; Keenan, Elliot Gavin; Freden, Caroline E.; Mirmina, Julianne; Iskhakov, Nathaniel; Krishnathasan, Darsiya; et al. (2021). "A Systematic Review of Passing as Non-autistic in Autism Spectrum Disorder". Clin Child Fam Psychol Rev. 24 (4): 783–812. doi: 10.1007/s10567-021-00365-1 . PMC   10613328 . PMID   34505231.
  12. ↑ Øverland, Elisabeth; Hauge, Åshild Lappegard; Orm, Stian; Pellicano, Elizabeth; Øie, Merete Glenne; Skogli, Erik Winther; et al. (2022). "Exploring life with autism: Quality of Life, daily functioning and compensatory strategies from childhood to emerging adulthood: A qualitative study protocol". Front Psychiatry. 13: 1058601. doi: 10.3389/fpsyt.2022.1058601 . PMC   9732257 . PMID   36506426.
  13. ↑ Mantzalas, Jane; Richdale, Amanda L.; Dissanayake, Cheryl (19 May 2023). "Examining subjective understandings of autistic burnout using Q methodology: A study protocol". PLOS ONE. 18 (5): e0285578. Bibcode:2023PLoSO..1885578M. doi: 10.1371/journal.pone.0285578 . PMC   10198508 . PMID   37205659.
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