Understanding Autistic Burnout

Language note: Although individual preferences exist, surveys of the autistic community consistently show that autistic people prefer identity-first language rather than person-first language (i.e., “autistic person” rather than “person with autism”). This article reflects that community language preference.

Although not listed in the Diagnostic and Statistical Manual of Mental Disorders, autistic burnout is a condition that has recently gotten the attention of providers, researchers, and the autistic community. 

Baden Gaeke Franze, 2017 president of the Autistic Self-Advocacy Network of Winnipeg, has written, “On the most basic level, autistic burnout means being exhausted. Our brains and bodies get tired out, and we don’t have the energy to do the things that used to come easily to us.” Essentially, autistic burnout is what happens when an autistic person is no longer able to function as they previously could in the past.

So far, there has been limited research on how autistic burnout is triggered, manifests, and responds to treatment, but members of the autistic community have shared their experiences with burnout.

Signs and Indications

Research centering autistic voices and experiences has defined autistic burnout as “a highly debilitating condition characterized by exhaustion, withdrawal, executive function problems and generally reduced functioning.” Because burnout makes it more difficult for an autistic person to hide their autistic behaviors, burnout was previously thought of as a form of regression, but the autistic person still has their skills and abilities; burnout just prevents them from using these skills.

Each individual’s experience of burnout will vary, but some hallmark signs reported by autistic people include:

• Fatigue or exhaustion: Autistic burnout often manifests as extremely low energy.
• Withdrawal: Autistic people in burnout may pull away from loved ones or stop engaging in things they previously enjoyed.
• Increased autistic behaviors: This symptom of burnout is not problematic on its own, but if an autistic person notices they are less able to mask autistic behaviors, this can be a sign of burnout.
• Reduced functioning or coping: Due to exhaustion, an autistic person in burnout might be unable to complete basic functional tasks they were previously able to do.
• Increased sensory meltdowns: Because burnout interferes with the autistic person’s ability to use regulation skills, those in burnout might exhibit higher sensory sensitivity and increased risk for meltdowns.
• Suicidal ideation: Autistic people going through burnout are at increased risk for suicidal ideation and may require hospitalization.

Identifying Autistic Burnout

While other mental health conditions can cause an onset of functional impairment, including Major Depressive Disorder, autistic burnout is distinct from any other mental health diagnosis. It is important for providers working with autistic clients to understand and recognize the difference, as preliminary research on autistic burnout has shown that evidence-based treatment for depressive episodes can exacerbate burnout symptoms rather than alleviating them.

If you have a history of mental health issues that manifest as periods of decreased functioning due to exhaustion, executive dysfunction, and withdrawal, and these symptoms have not responded to other treatment approaches, it may be possible that you are experiencing burnout from unidentified or misdiagnosed autism.

Since autistic burnout is not an official diagnosis, it is not something that the provider tests for through a psychological evaluation. However, a provider might notice burnout symptoms developing and talk to you about treatment options.

If you are autistic and notice decreased ability to cope, increased executive dysfunction, exhaustion, or withdrawal from people and activities you once enjoyed, you may be experiencing burnout.

Causes

Although existing research on autistic burnout is minimal, the few existing studies and feedback from the autistic community indicate that burnout is caused by the stress caused from long-term efforts by autistic people to conform with neurotypical expectations and standards of behavior.

Many autistic people, especially those labeled as “high-functioning,” learn from an early age that they might be ostracized or punished for autistic behaviors. In an effort to fit in and be accepted, they mask these behaviors and may present as neurotypical. This is exhausting and wears the person down over time until they can no longer force themselves to mask, leading to burnout.

Autistic children in particular are often referred for Applied Behavioral Analysis (ABA), a treatment that involves behavior modification. If a client’s treatment goals in ABA involve making them behave in ways that are not authentic and natural to them as an autistic person, this treatment can lead to burnout. This is why many autistic people describe their experience in ABA as traumatic or abusive.

Essentially, what we know about autistic burnout so far is that it is a response to chronic, ongoing stress. In particular, it is linked to the stress of existing in a world that is not designed for you.

Prevention

Because burnout is caused by neurotypical expectations, it can be prevented by allowing autistic people to live authentically and embrace neurodiversity-affirming environments. For example, if an autistic person is stimming by flapping their hands, they are often told to stop the behavior. They might be told the behavior is distracting or annoying. Since the behavior is not harming anyone or damaging anything, a neurodiversity-affirming environment would mean the autistic person is allowed to engage in this behavior, and if someone else finds the behavior distracting, they can go to another space.

Allowing autistic people to take space to regulate when needed, create schedules that do not overwork them, and meet their sensory needs also protects against burnout. In addition, providing autistic people with autistic-led education about burnout and meeting sensory needs can allow them to take steps to mitigate burnout symptoms.

Additionally, centering autistic voices in research will lead to developing treatment and supportive services that meet autistic people’s needs rather than forcing them to present as neurotypical. In the long-term, this will prevent burnout in the community as a whole.

Treatment for Autistic Burnout

Because limited research exists about autistic burnout, there are not presently evidence-based protocols for alleviating burnout. Some treatments for mental health issues in the neurotypical population can exacerbate burnout, so it is important for providers to accurately identify autistic clients and create a neurodiversity-affirming treatment environment.

Surveys of the autistic community suggest effective treatment for burnout can include education about burnout, support from other autistic people who have previously recovered from burnout, and reduced demands that allow the autistic person to recover and preserve their energy.

As future research progresses, evidence-based and neurodiverse-affirming treatments for autistic burnout will hopefully emerge, allowing autistic people to receive support, manage burnout when it arises, and prevent future bouts of burnout.