Burnout vs. autistic burnout

Did you know that autistic burnout is not just burnout as experienced by autistics, but a distinct condition with different causes and symptoms as classical burnout? In this article, I will explain the differences.

Burnout

In the 1970s, Dr. Herbert Freudenberger, a German-born American psychologist, coined the term burnout, describing it as a “state of physical and mental exhaustion caused by one’s professional life.”^[1]Staff Burnout (Freudenberger, 1974)

Dr. Freudenberger would work for 10 hours a day in his private psychologist practice, after which he would do a second full shift at St. Mark’s Free Clinic dealing with youth with addiction and other health concerns—he was very attached to the underprivileged and said that their problems became his own. Once the clinic closed for the day he and the volunteer staff would hold meetings far into the morning hours, after which he would go home and sleep for a few hours and get up and do it all again the next day. A year into this schedule his daughter found him unable to get out of bed. Hence his personal experience prompted him to define a condition which he was aware that others who were working more than was healthy for themselves experienced.

In 2015, the WHO included burnout in ICD-10 (the 10th revision of the International Classification of Diseases), and it became a clinical disorder. In 2022, the ICD-11 refined the term describing it as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.” It is characterized by three dimensions:

• Feelings of energy depletion or exhaustion
• Increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job
• Reduced professional efficacy

Burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.^[2]Burn-out an “occupational phenomenon”: International Classification of Diseases, (WHO, 2019)

Causes

Six main causes of burnout have been described, with workload being the main cause. All six causes of burnout are:^[3]The Burnout Epidemic: The Rise of Chronic Stress and How We Can Fix It, (Moss, 2021)

• An excessive workload
• A perceived lack of autonomy (being micro-managed)
• A lack of being recognized or rewarded
• Bad relationships at work
• Being treated unfairly
• When your values and the company’s values do not match

There are also other forms of non-official types of burnout. For instance, caregiver burnout is a feeling of deep exhaustion and stress after caring for another person/animal. Like all burnout, the main symptom is exhaustion which does not abate.

Autistic burnout

Autistic burnout differs from classic burnout. Dora M. Raymaker et al. (2020) defined autistic burnout as:^[4]“Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining Autistic Burnout (Raymaker, 2020)

Autistic burnout is a syndrome conceptualized as resulting from chronic life stress and a mismatch of expectations and abilities without adequate supports. It is characterized by pervasive, long-term (typically 3+ months) exhaustion, loss of function, and reduced tolerance to stimulus.

Symptoms

According to Raymaker et al., the symptoms of autistic burnout are:^[5]“Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining Autistic Burnout (Raymaker, 2020)

• Chronic exhaustion
• Loss of skills
• Reduced tolerance to stimulus

Causes

Raymaker et al. described the cause of autistic burnout as:^[6]“Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining Autistic Burnout (Raymaker, 2020)

• Life stressors that add to the cumulative load experienced
• Barriers to support that creates an inability to obtain relief from the load

Based on these causes, it is easy to see why autistics would suffer from burnout—potentially both autistic burnout and classic burnout. But whereas classical burnout typically stems from work, autistic burnout occurs due to social demands, masking, and living in an unaccommodating society.

Classical vs. autistic burnout

Different conditions with different causes will result in different symptoms and treatment requirements. So it is important to know if we are in classical burnout or autistic burnout.

Burnout usually occurs when the resources to meet life’s demands fall short of the ability to meet those needs. Being autistic adds a whole extra layer of orders of which non-autistics do not have any awareness. These include sensory, social, and communication demands.^[7]The effect of ambient sounds on decision-making and heart rate variability in autism (Bellamy et al. 2021) It is a cumulative load. Raymaker (2020) describes that autistic burnout occurs due to chronic life stress and a mismatch between expectations and abilities.^[8]“Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining Autistic Burnout (Raymaker, 2020)

Like the more regular forms of burnout—common among individuals in high-stress jobs or toxic work environments, and even among those in various caregiving roles—that result from chronic stress and consistent overexertion, autistic burnouts can equally follow periods of intense stress or prolonged exposure to challenging environments. But the stressors and challenging environments that trigger autistic burnout often include sensory overload, social demands, and changes in routine, too.

• Autistic burnout is a social phenomenon, and has 3 main causes causes:
  • Social demands
  • Masking
  • Living in an unaccommodating society
• Autistics are prone to both classical and autistic burnout

Symptoms

Below is a table showing the different symptoms of classical and autistic burnout.

Causes

Below is a table showing the different causes of classical and autistic burnout.

Treatment

And finally, below is a table showing the different treatments for classical and autistic burnout.

5 autistics share their experience of burnout

Question: What caused your autistic burnout?

Natalie’s experience

Autism, alexithymia, anxiety; cis-female; age 54; diagnosed at 46

I am passionate about autism advocacy, which involves various activities such as public speaking, teaching, writing advising, and assessing individuals with autism. In addition to this I am a mother to my young adult ADHDer who I help gain independence and navigate his world. I am also a full-time caregiver to Pluto, my 21-year-old dog (the world’s 5th oldest dog living), who requires much of my time to maintain his health. I am also a wife and a friend, and I study competitive chess. So occasionally, I wind up so exhausted, all I can do is work and sleep. I have recently been in a state of burnout, as well as caregiver burnout and also autistic burnout. The main symptom I have is chronic exhaustion. I do not remember the last time I felt like I was not tired. I also have some somatic pain.

I have had both autistic burnout and burnout. With autistic burnout masking and social demands exceeded my available energy. In the case of burnout, I just work too much and leave no headroom. I had no break from constant self-imposed demands and the demands of my life. The first time I had autistic burnout was when I was nineteen. I was coping with managing university courses and familial problems, which made living with my parents impossible and thus, I was also working to support myself. There was way too much socializing between school and work as a waitress. It was simply too much. Something had to give, and I recall thinking I had chronic fatigue syndrome—I wanted to sleep all the time, and I found it impossible to manage going to all my classes. Looking back now, it is obvious I had autistic burnout.

The demands I put on myself, my anxiety, social demands, pet demands, house demands, self-care demands, masking, and just dealing with an overwhelming sensory and social world.

Eva’s experience

Autism, ADHD, alexithymia; trans; age 35; diagnosed at 25

My burnout was caused by working on projects without a definite deadline, being in a management position while navigating my PTSD around human contact (in particular emails), perpetual challenges with organization and other executive challenges as someone with ADHD, feeling alone in all of this rather than part of a team where everyone has equal responsibilities, and feeling insignificant.

I think being on HRT might also have contributed, as what I got validation and a sense of self-worth from shifted, and I needed time to adapt to that change in my cognition. Having overworked myself for years and having a cannabis use disorder (I have now been sober for over a year though!) to help me cope with it all—including managing sensory stimulation and self-regulation—were probably contributors as well. Basically, I coped for many years, but at some point the demands, responsibility, capacity, self-esteem, and motivation just became incongruent; it took me about two years to find that balance again and get the mental health to sustain it.

I realize now that I experienced a combination of classical and autistic burnout.

Debra’s experience

Autism, ADHD; biracial cis woman; age 31; diagnosed at 28

For me, burnout is a result of being in an environment that requires me to mask my neurodivergent needs constantly. Most of the time I am in environments where I need to mask for short periods with breaks in between. In these environments, I am still stressed and often overwhelmed, but I have time to recover.

In contrast, I experience burnout in environments where I am stuck masking all/most of the time and don’t have enough recovery time. Thankfully, because my jobs have all been pretty flexible, I have been able to take time to myself and recover from the early signs of burnout. It usually takes me several weeks of “withdrawing from society” to return to baseline. There has only been one time in my life when I was so burned out that it took me multiple months to recover, but I know that this is a common experience for many autistics.

Shreddy’s experience

Autism, ADHD; cis-male; age 63; diagnosed at 58

I have had several burnouts, some worse than others. A recent and long-lasting one ended in divorce. I simply couldn’t cope with the never-ending, overlapping demands involving children, school, activities, household maintenance, and problem-solving. I thought I was prepared but was mistaken and barely made 3 years. I’ve had several burnouts involving work, primarily self-inflicted, by pursuing what I wanted to learn and achieve in a non-sustainable way. In every case, things were not the same afterward, and in many ways, I felt like I never fully recovered.

Hailey’s experience

Autism, alexithymia, anxiety; cis-female; age 24; diagnosed at 22

As I have tailored my life in such a way that it is sustainable based on my needs, my burnout is usually caused by excessive changes and not honouring my needs.

For example, this might mean taking on too many engagements, socializing excessively, or otherwise not leaving myself with enough alone time. My most severe encounter with burnout occurred when I was 17—I had moved out for the first time, was attending my first year of college, started a new job, and was living with a romantic partner for the first time. There was a level of distress inherently caused by such a dramatic change in my daily life, but more than that, the grueling schedule I had made for myself left me with no time to recuperate. At that age, I had yet to learn how to recognize my needs and had no idea that I was autistic. That experience resulted in me being unable to work for several months and unable to make basic daily decisions, such as what to eat for dinner or how to problem-solve when I needed to move.