Autistic burnout: Exploring autistic perspectives on treatment availability and effectiveness

Autistic burnout, characterised by chronic exhaustion, reduced tolerance to stimuli, and loss of executive function skills (Raymaker, et al., 2020) has severe consequences, including heightened mental and physical health problems, reduced capacity for independent living, decreased quality of life, and suicide attempts (Arnold et al., 2023a; Higgins et al., 2021; Mantzalas, Richdale, Adikari, et al., 2022b; Raymaker et al., 2020). Although autistic burnout has been validated as a syndrome that is distinct from depression and occupational burnout (Higgins et al., 2021; Raymaker et al., 2020), it is unclear if mental health treatment providers are able to distinguish depression from autistic burnout (Rose, 2018). Yet, some treatments such as Cognitive Behavioural Therapy (CBT) and Behaviour Activation (BA) may be ineffective or contra-indicated (Higgins et al., 2021). Considering the limited literature on autistic burnout, the complexity of treating it, and the possible harm involved in providing a treatment that may be contraindicated, it is critical to gain a deeper understanding of this syndrome. This study aimed to explore Autistic experiences accessing treatment for autistic burnout and their perspectives on the effectiveness of the treatments that were offered to them. Eleven participants completed semi-structured interviews. Qualitative analysis was informed by an interpretive phenomenological analysis (IPA) framework using a hybrid inductive-deductive approach at a semantic level. Participants reported that clinicians often failed to identify autistic burnout and generally lacked knowledge of the condition. Misdiagnoses were common, leading to treatments that delayed recovery and exacerbated symptoms of autistic burnout. Participants described negative experiences accessing support, including lack of support services, which eroded their faith in the healthcare system. Potential effective treatments and supports were identified, primarily the need for rest and practical support. These findings highlight the need to raise awareness among clinicians about the nature of autistic burnout, the importance of collaborating with the Autistic client to develop a treatment plan, and the general need for more services for Autistic adults.