# 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, 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.
It is similar to occupational burnout, exhaustion disorder and other conceptions of burnout.

## Definition

Autistic burnout is defined as a syndrome of exhaustion, skill loss/regression, and sensory hypersensitivity or intensification of other autistic features. 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 of what 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.
The Autistic Burnout construct (ABO) screening test for autistic burnout was released in May 2023. It was developed by American psychologist Jared Richards and twelve others.

## 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 themselves, 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.$^{:245}$ Depressive symptoms such as anhedonia or sleep disturbances are observed less frequently in autistic burnout.

## Mitigating and minimising strategies

Dr Raymaker has suggested tools to prevent and minimise autistic burnout and to help autistic individuals recover from emotional overload;
* 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.
* building self-acceptance as being autistic through unmasking
* recognizing the strengths one has by being autistic.
* 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.
* being autistic (e.g. pursuing particular interests)
* acting on early signs of autistic burnout (e.g. by cancelling social plans).
Dr. Botha's research agrees with Raymaker's findings. She finds that a feeling of connection to autistic community can bring relief from minority stress, which is a pervasive contributor to autistic burnout. Dr. Botha makes the distinction that autistic community connectedness can only be a partial solution; she refers to it as a buffer against minority stress, with the implication that autistic community connectedness cannot completely eliminate the harmful effects of victimization. However, having a buffer against these harmful effects can increase an autistic person's psychological resilience in response to victimizations.
Social connectedness and belongingness help the effects of victimization, discrimination, or rejection, but connectedness and belongingness can also contribute to internalized stigma. However, feeling connected to the autistic community via advocating politically predicted lower internalized stigma and minority stress.$^{:235-236}$

## Possible lateral impacts

Autistic people appear to have a higher than average incidence of fibromyalgia. This may be due to burnout factors.

## History

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.