At some point in their life, many adults with Autism Spectrum Disorder (ASD) experience intense physical, emotional, or mental exhaustion, a state known as autistic burnout. Often, this is accompanied by a loss of previously developed skills, a phenomenon called autistic regression. In order to clarify what these terms mean, here are descriptions of these two conditions, as told to me by patients of mine and from the literature on ASD.
Autistic burnout often permeates every area of the person’s life. It happens because of the expectation to look neurotypical, to avoid stimming, to be social, and to look as non-autistic as possible.
Burnout happens as a result of having to learn skills and behaviors that are not natural to the person but are adopted because of the expectation to fit into a society that values looking neurotypical.
The more high functioning one is, the more expectations there are to continue maintaining the appearance of being typical. This requires specific fluid adaptability. One figures out how to fit into social norms and expectations, develop coping strategies, adapt to the “normal” world, understand rules of proper conduct, and test out what works in society. But there is a price to be paid, that being the discovery that coping successfully only raises the bar to be even more normal. The cycle can be debilitating.
Basically, the higher functioning one is the more pressure is put to bear on hiding one’s true nature, to behave like everyone else, and disappear into normality. It’s no wonder that anxiety, depression, and other mental health concerns are greater in high-functioning adults on the spectrum, given the constant pressure to appear normal in ever-increasing ways.
It takes a long time to recover from burnout. After trying on a daily basis to live in a way that is not natural, one’s coping strategy falls apart at the seams, each time taking longer and longer to recover. Even after recovering, burnout can happen quicker and require less to activate it.
The process of recovering from burnout is even harder for those who are undiagnosed. Imagine trying harder and harder to be normal without knowing why you are doing so in the first place. This is typically overwhelming. Many undiagnosed adults who felt different throughout their life but didn’t know why try even harder than before to hide their differences. It is no wonder that burnout is more acute, more disorienting, and less manageable for these people.
Autistic regression is both a reaction to, and the cause of, burnout. Imagine being faced with the daily demand to be someone you are not. At some point, things just don’t work anymore. Executive functioning deteriorates, memory is compromised, the ability to tolerate sensory or social overload is reduced, social skills fade, and one’s general ability to cope is greatly reduced or lost. One regresses, and for those adults whose coping skills were minimal to begin with, the process can kindle severe reactions.
The good news is that autistic burnout and regression are reversible. While both phenomena are often mentally and emotionally taxing, they are not necessarily debilitating nor permanent. Early intervention, that is, addressing the root problem before it becomes overwhelming, makes all the difference in the world. Help from friends, a therapist, other adults with ASD, and whoever else may be ready and willing to assist often is all it takes to reverse course and lead one back to living a satisfying, productive, and fulfilling life.
Dr. Kenneth Roberson is an ASD psychologist in San Francisco with over 30 years of experience. To ask a question or schedule an appointment, please call 415-922-1122.