the point at which there’s no more of you left to give

September 9, 2021 11:22 AM

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. Though little studied, burnout among people with autism has become its own pandemic.
posted by sciatrix (17 comments total)

Link paywalled for me, but I can read it at this Google amp link.
posted by Dysk at 11:44 AM on September 9, 2021 [1 favorite]

Yeah definitely a thing for me, I had some very bad work-triggered burnout about 5 years ago. Historically there has been very little academic research into adult autism in general, but that is very rapidly changing. Raymaker et al from last year looks like a good summary study of the issue with links to other relevant studies
posted by JZig at 11:51 AM on September 9, 2021 [5 favorites]

I didn't see anything in the article about burnout being caused by being stuck in situations that I don't know how to exit from, because the inputs I've been given are ambiguous and my coworkers don't understand why I need more information about things they probably didn't think about. My brain will break itself in half when you ask me to do something with blockers that can't be resolved. It's debilitating.
posted by bleep at 11:55 AM on September 9, 2021 [23 favorites]

Ambiguity + unresolvable blockers makes me very uncomfortable but doesn't cause a full breakdown or burnout. Ambiguity + unresolvable blockers + time/performance pressure is what triggers it for me because it feels unescapable. I've gotten better at reminding myself that a lot of the time/performance pressure I feel is self-inflicted and 99% of the time it's totally fine to finish something late or to a subpar quality level. I can often escape by consciously deciding to not do the thing I thought I needed to do. But then for social reasons I sometimes need to say I'll do the thing anyway, which is VERY uncomfortable and I try very hard to not have to say that.
posted by JZig at 12:00 PM on September 9, 2021 [8 favorites]

I didn't finish my comment (as usual) I feel that this is a huge, ongoing source of stress more or less every day depending on how shitty the work culture is, that doesn't seem to bother anyone else. Stress adds up until my whole brain crashes.
posted by bleep at 12:01 PM on September 9, 2021 [5 favorites]

Mirror link
posted by snuffleupagus at 1:41 PM on September 9, 2021 [2 favorites]

I definitely get this whenever I have too many interactions with people in a day. One of the (multiple) reasons several therapists have independently told me that they think I'm probably on the spectrum. Not the biggest reasons for thinking that, but wow, does this sound familiar.
posted by sir jective at 3:02 PM on September 9, 2021

My current bout of autistic burnout has come from spending applying for jobs for the past year, which is the absolute worst.
posted by Jon_Evil at 4:07 PM on September 9, 2021 [5 favorites]

I’m only formally diagnosed with ADHD, anxiety, depression, and PTSD. But I was a late adhd diagnosis, and I’m strongly beginning to suspect I am on the spectrum. (Restricted interests, trouble understanding social cues, “weird”, spent way too long hiding who I am because I don’t get people) I know ptsd can look like autism but I think back to so much of my life, and there were signs so long ago. A couple friends have been encouraging me to pursue an evaluation because of family I remind them of. Another friend, when I asked him what he thought as he’s finishing his phD in psych, said “uh yes, I knew that you were on the spectrum from the moment I met you.” Which was funny but also left me wondering if everyone could see it but me.

Autistic burnout was the concept that hammered home the idea that I could be on the spectrum. Sometimes I seem competent and functional, hyper competent even, and then I just can’t. It’s been a pattern that has ebbed and flowed throughout my life. It’s not like what others had described with burnout- usually I loved my job and work, I just needed to shut down for a while. And that can be confusing and isolating, especially not having the tools to explain. The isolation is especially confusing because I can go long times without thinking of someone or even noticing I’ve been alone too long, until it reaches a breaking point. It’s like my social time thermostat is off.

We’ll see. I am dragging my feet on the process of looking for a new therapist after a bad experience, but I need to, for other reasons as well. When I do find someone, I’m absolutely going to seek an evaluation because if that is what is going on with me, it explains a lot and all I can say is that autistic burnout is no joke.
posted by [insert clever name here] at 8:49 PM on September 9, 2021 [15 favorites]

Coming from the other side, a so called "NeuroTypical" living with an autistic partner for 36 years, the only reason we've lasted through the shitty bosses that wouldn't renew his medical training contract (residency) or couldn't understand why he wouldn't partake in locker-room talk (one incident stands out, a beautiful female surgical trainee started , he's an anesthesiologist, and in the anaesthetic breakroom, whole department male which in itself should have been a red card here in the UK, they were talking trash about her. He would not take part. Boss said, what's up and he simply said, I can't talk shit, it just doesn't feel right to talk that way about a colleague, his next perf review had him severely marked down for colleague interaction and communication. )

So after three countries and training programmes, 4 times re-inventing myself and taking jobs outside my professional training, and a lot of scripting interactions and debriefing, the breakdown when it happened was me. I was suicidal at how unfair this was when he had never in his entire career had a significant patient safety issue. If you want a good anaesthetist ask for an autist! I was really really lucky my GP spotted the signs. My OH has managed his need to be "away" by disappearing down various rabbit holes or special interests evenings and weekends and luckily our children really get it, with one of them definitely on the spectrum and the other possibly. You could not meet more honest, straightforward, intellectually curious engaged people. I am lucky to have them and the rest of society needs to be educated about the skills, benefits and contentment that simple accepting other in all its forms and making space for that brings.

He's recently joined Autistic Doctors international and sadly he's the only male on the board. The female autistic doctors have managed to mask more and have reached further in their careers than male autistic doctors it appears to me observing their group. But the cost is clearly horrendous.
posted by Wilder at 1:21 AM on September 10, 2021 [8 favorites]

I know ptsd can look like autism

I am, very gently, going to point out two things before I step out again.

1) the biggest risk factor for stressful experiences becoming traumas that people continue to struggle with is the presence of feeling judged to be responsible or at fault for the experience by trusted people in your social group... which describes a whole lot of the reaction that an overloaded autistic, especially an undiagnosed or undisclosed autistic, experiences from allistic counterparts.

2) many of the diagnostic criteria of autism specifically pertain to a traumatized autistic person because complex trauma is that fucking common among autistic people.

Just so's you know, there's a lot of overlap between autism and PTSD because we only barely understand what an autistic person without some level of PTSD looks like in practice.

So if you're trying to work out whether autistic identity might be useful to helping you understand yourself but are struggling because you know you have symptoms of PTSD and what if it's just PTSD overlap... keep those things in mind.
posted by sciatrix at 5:56 AM on September 10, 2021 [23 favorites]

If you want a good anaesthetist ask for an autist!

If I were under the knife or intubated with Covid, I would hope one of my kindred spirits were assigned to apply his or her hyper focus on my vitals.
posted by ocschwar at 7:54 AM on September 10, 2021 [2 favorites]

Just so's you know, there's a lot of overlap between autism and PTSD because we only barely understand what an autistic person without some level of PTSD looks like in practice.

This is very helpful to know! I've been struggling with this question... I have ADHD and complex PTSD. I also have hypermobile Ehlers Danlos syndrome, and I read a few studies that seemed to link autism/EDS.

I brought up autism at one point to my psychiatrist, and he immediately just brushed it aside. I mean, I get it, I seem to function pretty well but I also have a lot of sensory processing issues (Iike I refused to wear jeans as a kid because I couldn't stand how the material felt, food stuff, etc)

But things like alexithymia (not being able to feel emotions) could be autism or PTSD.

I remember very consciously having to teach myself a lot of social scripts. I do better in structured environments like interacting with students vs just free form no guidelines. I still dread when people ask "how are you" because when I answer them it's awkward because some people use it as a greeting (so fucking weird! Just say "hi") but if you just sort of say "hi" and don't answer the question that goes badly too. How are you supposed to know?? I find it very stressful but I think I pass well enough most of the time.

I definitely have incredibly obsessive interests. I always have. As a kid, it was horses. Oh my god was I a walking encyclopedia about everything remotely having to do with horses. Want to know every breed of horse in alphabetical order? A history of horse racing in the US? Etc

Also eye contact. the crazy thing is I spent most of my life not even noticing the not making eye contact thing I do until I did notice it and then I tried to make eye contact and like I can sort of do it when I'm not talking but like it's almost impossible to talk and look someone in the eye at the same time.

But reading about autistic burnout and autistic meltdowns was what first got me thinking about this. because when my health - thanks to EDS and some other comorbid issues - completely fell apart a few years ago, suddenly I was just so exhausted all the time, and I started having these meltdowns. It's like, my brain just could not even anymore, and suddenly everything feels so overwhelming and I just explode and it's horrible and I hate it but like I can't stop it until it just burns itself out.

At the same time, there's some autonomic nervous dysfunction inherent in both EDS and to some extent PTSD. So maybe it's just that?

I don't know. I just know that 2 yrs ago after an incredibly stressful period of work - like working 12 to 14 hour days, 7 days a week - I just broke. But it feels different than regular burnout, because I didn't stop caring. I didn't even feel depressed. In fact, I kept making it worse because I did still care a lot about my job and I wanted to keep doing it but then it was like I was so exhausted and broken that I kept having these meltdowns.

I spent a long time looking for answers, trying to figure out what caused these meltdowns. They're not panic attacks. It's not even really anxiety. It just feels like something short circuits and suddenly I'm so overwhelmed and stressed and I can't take it anymore.

I've finally cut significantly back so that I'm barely working and can focus on PT and resting and trying to get back to being roughly functional.

And you know, this is the first time I really wrote it all out and it's like, huh, maybe I wasn't completely crazy for thinking about I might be on the spectrum. In fact, I kind of can't believe my psychiatrist who worked with me for a decade thought it was that weird an idea.

I honestly have no idea why I wrote all of that out. I just think it's been swirling around in my brain too long.

Thanks for sharing this article.
posted by litera scripta manet at 5:49 PM on September 10, 2021 [11 favorites]

sciatrix’s (1) and (2) here became yet another MeFi comment about autism that I ended up reading to my therapist. That thing of “feeling judged to be responsible or at fault” is especially So Very True.
posted by bixfrankonis at 9:57 PM on September 10, 2021 [2 favorites]

but if you just sort of say "hi" and don't answer the question that goes badly too. How are you supposed to know??

ugh yeah

in a pinch go with "oh, pretty good" or "oh, not bad" or even "oh, you know..." (bemused shrug).

They just need permission to say their next thing.
posted by snuffleupagus at 10:04 PM on September 10, 2021 [3 favorites]

They just need permission to say their next thing.

You're not talking about eye contact here, but interestingly (since eye contact also has come up), I just read a thing about (presumably neurotypical) eye contact that suggests that contact is made not to establish connection but "to signal when we have achieved shared understanding and need to contribute our independent voice". I'd really be curious for someone to run this same study with autistic people, and between autistic and allistic people.
posted by bixfrankonis at 10:14 PM on September 10, 2021 [2 favorites]

I also want to say thanks for the article, and also for the comments. I'm not diagnosed, but this feels very familiar. There were a few months in the pandemic - after the food supply chain stabilized, and before the grand march back to "normalcy" - where I had plenty of bandwidth and got important life things done. That was a very strange feeling. I had routines! that didn't fall apart in a stiff breeze! But we're back to the grind, and I spent Labor Day weekend being a lump. The Nagoskis' book on burnout is sitting in my to-read pile, and I really should get on that.
posted by mersen at 5:06 AM on September 11, 2021 [3 favorites]