Preventing AuDHD burnout

Burnout varies greatly from person to person. Moreover, burnout often looks different for neurodivergent folks compared to neurotypicals. We previously wrote an article about autistic burnout.

Here, I share some strategies for how those of us who are AuDHD (both autistic and ADHD) can prevent burnout.

AuDHD burnout

When we think about neurotypical burnout, we commonly think of burnout due to workplace environments or occupational demands. However, for AuDHD, we can experience burnout due to many other factors. Burnout for autistic (and likely also for AuDHD) individuals is thought to be caused by a long-term mismatch between expectations and capabilities.^[1]“Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining Autistic Burnout (Raymaker et al., 2020) For example, the accumulation of pressure to conform to social norms, not having sufficient accommodations, and a lack of empathy surrounding our needs.^[2]“Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining Autistic Burnout (Raymaker et al., 2020)^[3]A conceptual model of risk and protective factors for autistic burnout (Mantzalas et al., 2022)^[4]Exploring life with autism: Quality of Life, daily functioning and compensatory strategies from childhood to emerging adulthood: A qualitative study protocol (Øverland et al., 2022)

Unfortunately, there hasn’t been a lot of research on ADHD/autism and burnout yet. In fact, one recent study even found that most of the research about neurodivergent and/or disability burnout actually focuses on how we are the cause of the burnout experienced by others!^[5]Burnout through the Lenses of Equity/Equality, Diversity and Inclusion and Disabled People: A Scoping Review (Wolbring & Lillywhite, 2023) (Ouch…) We are hopeful that as burnout becomes more well-known in neurodivergent circles, there will be more research conducted about how it is caused and how it can be managed. In the meantime, this article combines findings from recent studies and my own personal experience about ways that AuDHDers can anticipate and prevent AuDHD burnout.

Anticipating burnout

We can reduce the likelihood of experiencing AuDHD burnout if we can figure out situations where we are at high risk of developing burnout. Since we know that burnout is caused by a long-term accumulation of unfavourable situations,^[6]“Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining Autistic Burnout (Raymaker et al., 2020) recognizing when we find ourselves in these situations early on is helpful in the long run.

Identifying high-risk situations

To identify situations where we are likely to develop burnout, we can look out for the following things:

• Transitions: AuDHDers tend to struggle with transitions. Our autistic traits mean that we usually prefer routine and predictability, and our ADHD traits mean that we often struggle with planning. Both of these make transitions difficult to manage. If we find ourselves in a transitional period, this may be a sign that we are at increased risk of developing burnout.
• Stressful life events: Similar to neurotypicals, this increased level of stress uses up a lot of internal resources, making day-to-day functioning more difficult. Even if we are normally thriving in our current day-to-day, a sudden stressful life event may mean that we are no longer able to manage as well.
• Ambiguous situations: When we find ourselves in environments that have no set routine, we can feel out of control. Similar to experiencing transitions, being in an ambiguous or unpredictable workplace, home, or school, can increase distress, leading to an increased risk of developing burnout.^[7]Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout (Higgins et al., 2020)^[8]Toward an understanding of occupational burnout among employees with autism – the Job Demands-Resources theory perspective (Tomczak & Kulikowski, 2023) For instance, if our workplace does not have regular schedules or clear deadlines and instructions.
• Being constantly misunderstood: It is extremely taxing to constantly have to explain and justify ourselves. For example, in a workplace, we may be seen as “lazy” or “demanding” instead of being met with accessibility accommodations. This constant lack of empathy has been shown to relate to burnout.^[9]Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout (Higgins et al., 2020)
• High levels of masking: Similarly, if we are often in situations where we need to mask/camouflage, this can lead to burnout.^[10]Burnout: The Cost of Masking Neurodiversity in Graduate STEM Programs (Syharat et al., 2023)^[11]Looking good but feeling bad: “Camouflaging” behaviors and mental health in women with autistic traits (Beck et al., 2020)^[12]Experiences of neurodivergent students in graduate STEM programs (Syharat et al., 2023) It takes a lot of energy to act in ways that are opposite to our authentic selves!
• People-pleasing: This behaviour is common among neurodivergent folks and ADHD in particular. We may be engaging in people pleasing to avoid being judged negatively. Especially when we want to be seen as “competent” and “not lazy”. Just like masking, this is a sign that we are unable to be authentic in our current situations, and we may be at increased risk of burnout in the long term. This is especially relevant when these situations cause us to constantly agree to things that are outside our capacity. For example, we may agree to work in a distracting environment just so we don’t have to “annoy” our boss by asking for accommodations.
• Highly social situations (with neurotypicals): This also relates to being in situations where we are required to socialize inauthentically, and constantly.^[13]Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout (Higgins et al., 2020))(A cross-sectional study of psychological distress, burnout, and the associated risk factors in hospital pharmacists in Japan (Higuchi et al., 2016) I know that for me, having a weekly workplace social event where the expectations are to stand around and perform small-talk, leads to burnout due to the constant dread and energy demands of masking.
• Sensory stimuli: Being in situations where there is a lot of sensory stimulation going on around us is another “recipe” for AuDHD burnout.^[14]“Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining Autistic Burnout (Raymaker et al., 2020) It can cause us to experience long-term sensory overload and frequent meltdowns. It can also cause us to be easily distracted, and prevent us from engaging in our tasks. It can even cause physical pain, which can further put us at risk of experiencing burnout.

One difficulty with preventing burnout is that these situations cannot always be avoided. Sometimes, they can even be desirable for short periods of time, like when we want to attend an event even though it is loud and crowded. Thus, it is helpful to be aware of these external high-risk situations and how often we find ourselves in them, while also developing an awareness of internal signs that burnout may be approaching.

Practicing self-awareness

Monitoring for internal signs of burnout can be difficult for AuDHDers. Particularly those of us who also have alexithymia. I’ve created a list of self-reflection questions that you can use to practice becoming more self-aware about when burnout may be occurring. Each question asks us to reflect on a change in behaviour that is commonly associated with burnout in autism and ADHD. Integrating these questions into a weekly routine can help us learn to identify signs that we are not coping well. This practice can ultimately help us feel more in control of our situation.

• Am I unable to do things that I usually find doable? For example, has it been more challenging for me to speak? Manage daily tasks such as showering, eating, and brushing teeth?^[15]“Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining Autistic Burnout (Raymaker et al., 2020)^[16]“Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions (Hull et al., 2017)
• Has my tolerance for sensory stimuli gone down? For example, do I find myself getting more easily overwhelmed and distracted by loud noises, bright lights, strong smells, and lots of information?^[17]“Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining Autistic Burnout (Raymaker et al., 2020)
• Have I been feeling more exhausted or depressed/anxious than usual? For example, do I feel tired all the time, emotionally numb, emotionally dysregulated, or suicidal?^[18]Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout (Higgins et al., 2020)
• Is my executive functioning different? For example, is my memory worse than usual? Or my concentration?^[19]Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout (Higgins et al., 2020))(Towards the measurement of autistic burnout (Arnold et al., 2023)
• Am I overcommitting to things? For example, am I agreeing to take on more tasks than I can handle at work? Am I scheduling too many social engagements? Something to keep in mind when reflecting on this question is that this is a common occurrence in ADHD when our situations are boring or without enough novelty and stimulation. This may not always be a big deal for neurotypicals, but in AuDHD, it is a sign of burnout when it happens often. It is important for those of use with ADHD to ensure that we are getting enough novelty and stimulation in a way that isn’t also harming our mental health.
• Am I procrastinating a lot? Likewise, this is a sign that the tasks we are “supposed” to be doing are requiring too much of our energy. For example, they may be too hard or too boring. While this is normal for some tasks, if all of our tasks cause us to procrastinate, this may be a sign that we are in burnout or getting close to burnout.

Something to keep in mind is that meltdowns and shutdowns can happen regardless of burnout. These reactions are typically associated with specific moments, but we can recover from them. When we are monitoring for signs of burnout, we want to monitor for long-term or extended periods of behavioural change where there is little/no relief. In particular, we want to monitor for long-term changes in energy (e.g., more fatigue), mood (e.g., feeling depressed), and functioning (e.g., inability to do things we usually do). 

Preventing burnout

Being able to catch signs of burnout early based on identifying high-risk situations and practicing self-awareness is the first step to preventing burnout. In addition, we also need to make sure we change our situation and/or make our situations more sustainable so that we don’t actually end up with burnout. Here are my top two tips for preventing burnout:

Self-care

Engaging in self-care is a way for us to take care of ourselves. Research shows that regularly practicing self-care can reduce our chances of experiencing burnout.^[20]Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout (Higgins et al., 2020) However, for AuDHD, what constitutes self-care can be different than what is often advertised as self-care in the media and for neurotypicals. In particular, self-care for AuDHD can involve managing sometimes opposing ADHD and autistic needs like needing both routine and spontaneity.

Here are some examples of self-care activities that can be deliberately and regularly implemented into your weekly schedules to help to prevent AuDHD burnout:

• Stimming
• Engaging in special interests
• Withdrawing from social and sensory situations that are overwhelming
• Also ensuring that we are getting enough nourishing sensory stimulation
• Managing hyperfocus so that it isn’t at the expense of things that we need (like meals and sleep!)
• Schedule those things that we need, like meals and sleep

In general, engaging in self-care activities aims to restore energy levels, make sure that we are getting our needs met, and provide an outlet for dealing with stressful situations.

Seeking support

This can be considered a form of self-care, but I felt that it deserved its own recognition. Since our burnout is often the result of not having our needs met or experiencing limited empathy, preventing burnout often necessitates seeking out support. This can be in the form of:

• Social support:  Surrounding ourselves with people who value us for who we are, who don’t judge us based on our neurodivergent traits, and who respect that we may have different needs. This includes cultivating relationships with other community members who can understand our experiences and can offer the support that we need.
• Accommodations: Typically related to our school or workplace, these accommodations can help us with planning, sticking to a routine, and setting boundaries at work.^[21]Toward an understanding of occupational burnout among employees with autism – the Job Demands-Resources theory perspective (Tomczak & Kulikowski, 2023)^[22]How can the work environment be redesigned to enhance the well-being of individuals with autism? (Tomczak, 2022)^[23]Occupational issues of adults with ADHD (Adamou et al., 2013)  For example, these types of accommodations can help us manage the combination of time blindness and hyperfocus by helping us get into a sustainable routine. For accommodation ideas, you can check out my work and school accommodations article.
• Taking up more time and space: These forms of support may be all that some individuals need to prevent burnout!^[24]Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout (Higgins et al., 2020) For example, asking for more time to work on something or asking to work from home instead of in a crowded office.

Regardless of what supports you seek out, the goal is to ensure that your needs are being met.

In this article, we discussed ways to identify when we may be at risk of experiencing AuDHD burnout, and ways to help prevent burnout from developing. Nonetheless, burnout isn’t always avoidable. In the next article, I explore ways to manage and cope if we find ourselves in the middle of burnout. Read it here:

Preventing AuDHD burnout