
Though little studied, exhaustion among people with autism has become its own pandemic.
Eric Garcia, a political reporter, struggles with intense bouts of burnout.Credit...Greg Kahn for The New York Times
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By Beth Winegarner
Tyla Grant, 24, holds down a full-time advertising job, is trying to get a nonprofit off the ground and creates regular content for her podcast, YouTube channel and Instagram. Occasionally, she winds up so fried she can’t speak or get out of bed for days.
Ms. Grant is also autistic. While most people undergo periods of burnout — physical, cognitive and emotional depletion caused by intense, prolonged stress — autistic people, at some point in their lives, experience it on a whole different level. Autistic traits can amplify the conditions that lead to burnout, and burnout can cause these traits to worsen. They may become unable to speak or care for themselves, and struggle with short-term memory. This harms their ability to perform well at jobs, in school or at home.
“It’s the point at which there’s no more of you left to give. The battery’s dead. Tyla’s left the chat,” she said. “Whatever you want from me, you’re not going to get.”
The U.S. Centers for Disease Control estimates that, as of 2017, 2.2 percent of adults in the United States — nearly 5.5 million people — are autistic. That’s almost certainly an undercount; many in the autistic and research communities believe that women and people of color are underdiagnosed.
Autistic burnout is a concept already widely accepted in neurodivergent communities, but it hasn’t been formally studied much. Research does show that autistic people have a harder time keeping their heads above water in ways that are similar to burnout, and some experts offer advice on how to deal with it.
Autism and mental health.
A wide range of life stressors contribute to autistic burnout, according to a small 2020 study led by Portland State University researcher Dora M. Raymaker. Those include being forced to hide their autistic traits (often called “masking”), managing the disabling aspects of autism and coping with a world that expects autistic people to perform at the same level as their non-autistic peers.
Participants of the survey described barriers to support, such as having their experiences and differences dismissed by others, a lack of external support and an inability to take breaks.
Beyond this study, there are few published papers about autistic burnout, but similar conditions can help fill out the picture. For instance, in one 2020 study, 20 percent of autistic adults had been diagnosed with an anxiety disorder, compared to just under 9 percent of non-autistic adults.
Some of that anxiety stems from peer rejection or from being ostracized for autistic traits, such as a deep interest in a specific topic, researchers found. Autistic people are also simply more vulnerable to anxiety; they’re more sensitive to sensory input and their nervous systems are more likely to react strongly to stress, according to the study.
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Autistic adults are also more likely to feel suicidal; a 2018 study published in Molecular Autism found that 72 percent of autistic adults scored highly for suicide risk, compared to 33 percent of the general population. Numerous studies have found a connection between burnout and suicidal thinking in non-autistic adults in a wide range of professions, including medicine and policing.
For autistic people, a number of factors contributed to their suicidal thoughts, including self-harm and masking, as well as not having their support needs met, according to the study.
Burnout can erode independence.
Political reporter Eric Michael Garcia agreed that rest is a key remedy for autistic burnout, and he’s noticed, as he gets older, that it takes him longer to recharge. Mr. Garcia, 30, experienced his first extended period of autistic burnout while covering the 2016 elections. At first he thought he was just working too much, but a debilitating fatigue hung over him for a month.
Soon after, he started noticing autistic people writing about burnout. Many of his peers, he said, spend all their energy trying to perform well at work and come home too exhausted to tend to other needs, such as cooking healthy meals, taking out the trash or sustaining friendships and relationships.
In his book “We’re Not Broken: Changing the Autism Conversation,” Mr. Garcia wrote that when non-autistic people experience burnout, no one doubts their ability to live independently. But for autistic adults, a burnout state can lead loved ones and medical professionals to question their self-sufficiency, and even suggest they move home with family. Many can remain independent by having a live-in or occasional support person who can help with shopping, cooking and bills, he wrote.
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Sleep is challenging — but crucial.
Autistic burnout isn’t a permanent state, however. One of the best ways for anyone to recover from burnout is rest, particularly sleep, according to Amelia Nagoski, the co-author of the best-selling 2019 book “Burnout: The Secret to Unlocking the Stress Response Cycle.” But autistic people have a harder time sleeping because of their neurological differences, according to a 2019 study.
Autistic people are more likely to sleep for shorter periods of time and experience lower-quality sleep, and they’re more likely to be night owls, the study found. Research on non-autistic adults shows that insomnia is a strong predictor of burnout, suggesting a similar link among autistic people with sleep disorders.
Ms. Nagoski, 44, addressed autistic people’s sleep woes in a recent YouTube video. “This essential thing that is fundamental to wellness is harder for autistic people,” she said. She was diagnosed with autism in 2020, and launched her channel, Autistic Burnout, to offer advice and resources to people experiencing the condition.
All the usual sleep-hygiene tips apply to autistic people, including avoiding screens near bedtime, making sure the room is sufficiently dark and cool, and taking a shower to make your temperature drop afterward, which tells your body it’s time to sleep. But autistic people have to follow this advice more diligently, and even then, she said, it’s “more effort for less result.”
Find social connection that works.
Rest isn’t the only remedy for autistic burnout. Connecting with others is a significant way to alleviate burnout for non-autistic adults, Ms. Nagoski said, and may be helpful. But many autistic people misread social cues, take statements literally and are uncomfortable with touch.
Ms. Nagoski (with her twin sister and co-author, Emily Nagoski) recommends 20-second hugs and six-second kisses for neurotypical adults because they release the hormone oxytocin, but “those never worked for me,” she said. Instead, she recommends finding community through social media, where the #actuallyautistic and #autisticburnout hashtags help people find one another on most large social media platforms.
Ms. Grant finds herself making trade-offs when it comes to friendships. When people ask to spend time with her, she often declines, in order to protect her energy. But her autism already strains her friendships. “Just saying ‘no’ isn’t that easy, especially when you’re used to saying ‘yes’ just to keep your friends,” she said.
Ultimately, one of the best ways to keep autistic people from burning out will be to increase accommodations in workplaces, schools, hospitals — anywhere they might spend time, Mr. Garcia said. Each autistic person may need different supports, such as quiet spaces to work, longer lunch breaks, alternative lighting, predictable schedules or the ability to have a support person with them. But there needs to be adequate motivation for those spaces to change, or autistic adults will continue to burn out more intensely than their peers, he said.
Autism is still largely considered a childhood condition, as though those children don’t grow up and continue to be autistic. As more and more people are diagnosed, “there are going to be more autistic people graduating college and in the work force,” Mr. Garcia said. Because autistic people have such differing needs, “it may be impossible to determine a uniform policy,” he said. “But it does need to be addressed.”
Beth Winegarner is a journalist, essayist and author, most recently of “A Riff Of One’s Own.”
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FAQs
What does an autistic burnout feel like? ›
Physical Symptoms
Autistic people in burnout describe feeling exhausted and depleted. As if all of their internal reserves have been used up. These symptoms are not better explained by being physically unwell, malnourished, or having engaged in excessive exercise.
You can recover from burnout by understanding your own personal stress triggers, ways of lowering your stress levels and adapting your life so that your needs are met. Sometimes you might need help to get other people and/ or organisations to make reasonable adjustments for you.
What does an autistic shutdown look like in adults? ›They may not respond to communication anymore, retreat to their room or lie down on the floor. They may also no longer be able to move from the situation they are in, no matter what it is (for example, a shopping centre or a classroom). Shutdowns tend to be more discreet than meltdowns, and may sometimes go unnoticed.
What is the difference between autistic burnout and depression? ›During a depressive episode, a person may feel stuck in their sadness or feel numb and lose interest in their hobbies. When a person is experiencing autistic burnout, however, they may not feel sadness at all and may lose abilities that they once had (e.g. may lose the ability to speak).
How do you fight autism burnout? ›- Remove obligations. It's time to get a little ruthless with your schedule and commitments. ...
- Participate in soothing activities. ...
- Sensory interventions. ...
- If you can't sleep, rest. ...
- Practice self-compassion.
So far, researchers have learned that periods of autistic burnout can last a long time (weeks, months, or years) and that some people never fully recover.
Do autistic adults grieve? ›All people, including children and adults on the autism spectrum, grieve in their own unique ways. Grief can be complex for any of us. It is important to acknowledge that any loss can cause grief. Loss of a favorite toy or routine as well as the loss of a house, school, or family member can be very significant.
Can autistic burnout make you sick? ›Autistic people have described various ways that autistic fatigue and burnout have affected them. Autistic fatigue has often been described as exhaustion with additional difficulties such as: increased meltdowns and sensory sensitivity. physical pain and headaches.
Why do autistic people get fired? ›Autistic people are often fired for being autistic. A manager may not realize that's why they are letting an employee go, but autistic people can be fired due to a fundamental lack of understanding of our natural traits.
What is the final stage of autism? ›ASD Level 3 – On the most severe end of the spectrum is Level 3 which requires very substantial support. Signs associated with both Level 1 and Level 2 are still present but are far more severe and accompanied by other complications as well.
What to do when an autistic person shuts down? ›
The best remedy for a shutdown is giving the person the space to rest, recuperate and recover without placing additional demands on them. A shutdown can be like a reset for an autistic person.
What does severe autism look like in adults? ›finding it hard to understand what others are thinking or feeling. getting very anxious about social situations. finding it hard to make friends or preferring to be on your own. seeming blunt, rude or not interested in others without meaning to.
Does stress make autism worse? ›Anxiety was also strongly correlated with behavior and learning disabilities in children with ASD. ASD patients are prone to stress,24 and considerable evidence indicates that patients with ASD have eggagerated responses to threatening images. Prenatal stress was linked to increased risk of a child developing ASD.
What is an autistic breakdown? ›It happens when someone becomes completely overwhelmed by their current situation and temporarily loses control of their behaviour. This loss of control can be expressed verbally (eg shouting, screaming, crying), physically (eg kicking, lashing out, biting) or in both ways.
Does autistic burnout feel like depression? ›Some autistic people experience it as an overwhelming sense of physical exhaustion. They may have more difficulty managing their emotions than usual and be prone to outbursts of sadness or anger. Burnout may manifest as intense anxiety or contribute to depression or suicidal behavior.
How do you stop autism rage? ›- Communicate clearly. ...
- Provide structure. ...
- Help to identify emotions. ...
- Offer a safe space or 'time out' ...
- Offer an alternative. ...
- Find out if the person is being bullied. ...
- Useful resources.
People with autism sometimes may have physical symptoms, including digestive problems such as constipation and sleep problems. Children may have poor coordination of the large muscles used for running and climbing, or the smaller muscles of the hand. About a third of people with autism also have seizures.
How long does burnout last? ›How Long Does Burnout Last? It takes an average time of three months to a year to recover from burnout. How long your burnout lasts will depend on your level of emotional exhaustion and physical fatigue, as well as if you experience any relapses or periods of stagnant recovery.
What happens after an autistic shutdown? ›This is similar to what some people with autism experience when they get overwhelmed—a shutdown. Shutdowns are related to meltdowns. In both situations, an autistic person's brain becomes so stressed that he/she can't control his/her reaction. In the case of a meltdown, he/she may cry, scream, hit, and kick.
How do you relax someone with autism? ›- Remember the rule of one. Use the rule of one when a child is deeply stressed, anxious or in the middle of a meltdown. ...
- Deep Breathing. ...
- Isometric Exercise. ...
- Deep Pressure. ...
- Massage. ...
- Provide a Box of Tactile Items. ...
- Create a Calming Area. ...
- Communication.
Why do autism symptoms get worse with age? ›
Amaral: The percentage of kids who increased in severity between ages 6-11 was higher than that of other ages. We theorize that could be due to the many increased social demands that may lead people to withdraw, as well as the development of anxiety, which can increase at that age.
Are autistic adults lonely? ›Research suggests that autistic people are more likely to experience feelings of loneliness compared to non-autistic people. This can be due to a lack of acceptance and understanding by society, making them feel excluded.
Do autistics lack empathy? ›Research from 2018 has shown that autistic people may have difficulties with cognitive empathy (recognizing another person's emotional state) but not affective empathy (the ability to feel another's emotional state and a drive to respond to it).
Do autistic adults understand feelings? ›There is a persistent stereotype that people with autism are individuals who lack empathy and cannot understand emotion. It's true that many people with autism don't show emotion in ways that people without the condition would recognize.
What triggers sensory overload in autism? ›Sensory overload happens when an intense sensory stimulus overwhelms your ability to cope. This can be triggered by a single event, like an unexpected loud noise, or it can build up over time due to the effort it takes to cope with sensory sensitivities in daily life.
Can trauma make autism symptoms worse? ›There is a strong correlation between autism and trauma. In fact, research indicates that trauma can actually make ASD symptoms more challenging to live with.
Is it hard to keep a job with autism? ›While those with milder forms of autism can sometimes find suitable work if their special needs are addressed, many others can't. People with classic autism or more severe forms of autistic spectrum disorders cannot generally handle jobs which require any significant degree of interaction with others.
Does Target hire people with autism? ›Target, a well-known retail company, is one of the top companies that hire autistic adults. Target believes in the importance of diversity and inclusion when it comes to employees, making a point of smoothing out the hiring process for anyone who wants to apply, regardless of disability.
Why is it hard for autistic people to find a job? ›Job Options Depend on Abilities and Challenges
Other issues that can be serious obstacles to employment for autistic adults include: Social anxiety. Severe sensory challenges.
ASD begins before the age of 3 years and can last throughout a person's life, although symptoms may improve over time. Some children show ASD symptoms within the first 12 months of life. In others, symptoms may not show up until 24 months of age or later.
Are you born with autism? ›
Autism is not an illness
It means your brain works in a different way from other people. It's something you're born with. Signs of autism might be noticed when you're very young, or not until you're older. If you're autistic, you're autistic your whole life.
A new study found that around 30 percent of young children with autism have less severe autism symptoms at age 6 than they did at age 3, with some children losing their autism diagnoses entirely.
How do you tell a autistic person about death? ›- Don't avoid talking about it. Explain it as fully as possible. ...
- Use social stories to describe the viewing or funeral. Ask your child's speech therapist or teacher to help write a social story. ...
- Teaching before loss occurs. ...
- Look for everyday examples.
DSM-5 defines catatonia as being characterized by the presence of at least three of the following symptoms: catalepsy, waxy flexibility, stupor, mutism, negativism, agitation, posturing, stereotypes, mannerisms, grimacing, echolalia, and echopraxia [1] (Supplementary Table S1).
What is the average life span of autistic adults? ›The study found that the average death of an autistic person was age 54, while their matched controls had an average death age of 70 (Bazian 2016). That means, on average, autistic people are dying 16 years earlier than the general population.
What can mimic high functioning autism in adults? ›- Obsessive-compulsive disorder (OCD) The symptoms of OCD, such as compulsive hand washing, cleaning or touching items like doorknobs, can resemble the repetitive motions of autism. ...
- Antisocial personality disorder. ...
- Schizophrenia. ...
- Learning disorders. ...
- Attention Deficit Hyperactive Disorder (ADHD)
The global increase in autism prevalence reflects major improvements in public awareness and public health response to autism. Children are now more likely to be diagnosed earlier, and even underrepresented regions like Africa and the Middle East have been advancing their ability to measure autism prevalence.
Why do people with autism worry so much? ›Difficult social situations and sensory environments can increase stress and increase anxiety for autistic people. Another significant cause of anxiety is a sense of being misunderstood and/or not accepted by non-autistic people. To 'fit in' and not be seen as different, autistic people might mask or camouflage.
Does Zoloft help with autism? ›This open-label study suggests that short-term sertraline treatment may reduce the behavioral reactions seen in association with situational transitions or environmental changes in children with autistic disorder, though the beneficial effect may be only temporary in some children.
Do autistic people worry a lot? ›Anxiety is a mental health problem that is common in autistic adults and children. Anxiety can have a big impact on daily life, for example coping at school or at work.
What does stimming mean? ›
Stimming – or self-stimulatory behaviour – is repetitive or unusual body movement or noises. Stimming might include: hand and finger mannerisms – for example, finger-flicking and hand-flapping. unusual body movements – for example, rocking back and forth while sitting or standing.
Can PTSD mimic autism? ›Can complex PTSD be misdiagnosed as autism? Yes, the two conditions have many overlapping symptoms and may occasionally confuse each other. A clinician could misinterpret why the child isn't communicating well and connecting with others. It's certainly possible that a child with autism could also develop PTSD.
What does autistic catatonia feel like? ›Catatonia affects a person's ability to move in a normal way. People with catatonia can experience a variety of symptoms. The most common symptom is stupor, which means that the person can't move, speak, or respond to stimuli. However, some people with catatonia may exhibit excessive movement and agitated behaviour.
What happens when an autistic person is overwhelmed? ›Meltdowns are not the only way an autistic person may express feeling overwhelmed. They may also refuse to interact, withdrawing from situations they find challenging or avoiding them altogether.
What do autism meltdowns look like? ›What does an 'autism meltdown' look like? Some signs that a loved one is having or nearing a meltdown may include: being irritable, which can include shouting or physical aggression. fidgeting or stimming more (repetitive movements or noises)