Autistic Burnout and
Extreme Burnout Crisis

To understand Extreme Burnout Crisis, you first need to understand Autistic Burnout. Autistic Burnout is a common experience in the neurodivergent community and has been known and talked about for many years now.  There is still however a great deal of ignorance among professionals working with Autistic people and this too often leads to misdiagnosis and the wrong support being given to the individual. There are crossovers between Autism and certain Personality Disorders and Autistic Burnout can present as Depression. But as the quote from the Royal College of Psychiatrists says, it is vital professionals consider burnout before jumping to conclusions about a mental health condition/diagnosis, especially if they know or suspect the individual is Autistic or if the individual self-identifies as Autistic.

50-70% of Autistic people are also ADHD (AuDHD) and this plays a part in why I believe many experience a more extreme burnout. I am particularly concerned about this as an AuDHD person myself, but also because members of my family and friends of mine have experienced this level of crisis. Extreme Burnout Crisis is rarely understood by many professionals working with Autistic people; Autistic Burnout is barely understood, let alone when it manifests in a more extreme way.

To find out information about Autistic Burnout, there are resources for autistic adults and parents of Autistic children in my shop.

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According to Judy Endow autistic burnout “is a state of physical and mental fatigue, heightened stress and diminished capacity to manage life skills, sensory input and social interactions, which comes from years of being severely overtaxed by the strain of trying to live up to demands that are out of sync with your needs”. The Royal College of Psychiatrists describes autistic burnout as "a state of exhaustion, associated with functional and cognitive deterioration and an increase in autism symptomatology, as a consequence of coping with social interaction (including masking) and the sensory environment. It may be a short-lived state (as at the end of a working day), relieved by a relatively brief withdrawal from the stress. However, longer and more severe stress can produce a more sustained state (which entails some form of innate change) which has to wait on its natural remission. It overlaps symptomatically with anxiety and depression, and there may be a heightened risk of suicide.

Its anecdotal basis and the lack of systematic research mean that burnout does not have the status of a formal syndrome or disorder. Nevertheless, the concept captures the need to consider the effect of adjusting somebody’s setting, support, and style of life before assuming their malaise to be a recognised psychiatric disorder." (Royal College of Psychiatrists, The psychiatric management of autism in adults).

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Extreme Burnout Crisis is an experience of burnout that seems to be predominantly experienced by AuDHD (Autistic and ADHD) people.  Below I will explain some of the signs of burnout crisis and the crossovers with mental health conditions such as EUPD and BiPolar etc. Autistic people are often misdiagnosed with Personality Disorders and other mental health conditions before they eventually discover that they are actually autistic https://help4psychology.co.uk/team/dr-judy-eaton/

Autistic people, particularly girls, women and people raised as female, are often identified as having personality disorders when they present in a level of crisis. This is because of the crossovers there are and the lack of understanding there is about what it means to be autistic and AuDHD. There is so much misinformation and lack of autistic led training around autism, especially around issues like autistic burnout, which means a professional/clinician etc, working with an autistic person, can often miss the fact that the individual is autistic rather than that they have a personality disorder such as EUPD.  Many Autistic people of course can have co-occuring mental health conditions but note these can develop because of environments and the specific needs of an autistic person not being met.

In ADHD and AuDHD people, disinhibition is associated with having lower levels of the neurotransmitters Dopamine, GABA and Noradrenaline. *Intrusive stuck thoughts are also related to cognitive disinhibition - the person is not able to stop, or filter out these intrusive thoughts” (Neuroclastic 'Not All Behavior Is Communication - Disinhibition Part 4, Types of Intrusive Thoughts And Compulsions' https://neuroclastic.com/infographics/). This is also related to an Autistic brain being monotropic and therefore finding it hard to switch focus from overwhelming thoughts and also possibly in some cases false memories.