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.
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).
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 training around autism, especially issues like autistic burnout, which means a professional/clinician 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 the specific needs as 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 the brain being monotropic and therefore finding it hard to switch focus from overwhelming thoughts and also possibly false memories.
Links to research regarding
Free Download of Signs Of
Autistic Burnout Tracker
Crossovers Between Autistic Burnout And Depression
There are differences but also a lot of crossovers between Autistic, ADHD and AuDHD Burnout. This venn diagram gives an idea of the differences for some autistic and AuDHD people (these are not all set in stone and may vary from person to person).
Extreme Burnout Spin (a term I have coined)
For some people, especially those who are AuDHD, their experience of burnout can be very extreme and may mean the individual's life spins significantly out of control. There are various theories as to why this happens, including ideas linked to autistic people and Monotropism. It is also clear that Alexithymia and ADHD play a large part. 50% of Autistic people have Alexithymia which literally means the person "has no words for emotions". This affects their ability to understand how exhausted and anxious they are and makes it much harder to self regulate (especially if you add in the executive functioning differences in an ADHD brain). Difficulties with 'stopping' to rest means they push themselves harder. They might self medicate with drugs and alcohol, or relapse if they have been in recovery. This can mean, among many other things, that they experience extreme paranoia and can contribute to experiences of mania. In this manic state of mind the person might also have very intrusive racing thoughts, that can get louder and louder (sensory overload can also lead to hallucinations). It can be very hard when you are AuDHD and stuck in a kind of wormhole with stuck, dark intrusive thoughts that you cannot shift.
For those who do experience this extreme burnout crisis, there can be very serious consequences. It is vital to understand that the individual is in the midst of a crisis and needs support. If they are diagnosed with ADHD their medication (If they are prescribed ADHD medication) may need to be looked at. Ultimately this person may need significant help and support to stay safe.
I have worked with many ND (neurodivergent) people in the criminal justice system. They too often end up in the system because their needs as an Autistic, ADHD or AuDHD person (for example) have been missed and/or ignored. I have worked with individuals whose autistic meltdowns were not recognised or supported by first responders and it led to a criminal conviction. In some cases the individual's experience of Extreme Burnout Crisis even led to a prison sentence. It is possible according to Sarah Templeton that our prison population in the UK is as much as 85% ADHD; many of these people will also be Autistic. This is a shocking statistic. Of course it does not mean that every ND person who experiences burnout or extreme burnout will end up in Extreme Burnout Spin and in a crisis that leads to consequences such as psychiatric detention or even a prison sentence, but too many do. Too many Autistic and AuDHD individuals are being detained and their needs as a vulnerable person (Autistic people are considered vulnerable under the law) are not understood or being met.
A free version to download of the Guide for First Responders that looks at meltdowns and Autistic Burnout inc a few pages on Extreme Burnout Crisis. The full version is available on Amazon
Free leaflet explaining Autistic Burnout and Extreme Burnout Crisis
If you are in crisis, experiencing suicidal thoughts, there are people you can talk to:
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