Autistic and AuDHD Support Through Burnout and Beyond

It’s Autism Awareness Month, so I’m writing about a pretty widespread autistic experience that is poorly understood by the mental health world: the relationship between the late-identification/self-realization process and autistic burnout. 

The Realization Process

Many late-identified neurodivergent individuals discover their authentic neurotype only after years of navigating life without understanding why certain aspects of life feel so challenging. For autistic, ADHD, and AuDHD adults—particularly women, femmes, and gender-diverse people who were overlooked in childhood. This realization often comes through experiencing burnout. Autistic Burnout and AuDHD Burnout are fundamentally different from neurotypical exhaustion (and even ADHD burnout), with unique recovery needs and manifestations.

The discovery of one's neurotype typically necessitates a radical reassessment of self-expectations and accommodations. Many newly-identified autistic and ADHD individuals find themselves needing to rest differently, recognize sensory needs, implement supportive routines, and ask for appropriate help—often for the first time. 

It can be confusing, frustrating, even hopeless-feeling. This journey involves developing genuine self-compassion and a willingness to experiment with new ways of honoring one's differences. Often we’ve survived by pushing through, unable to even recognize our limits. Maybe we’ve also internalized the voice of people in our life - parents, teachers, coaches, even therapists, who told us to try harder, “just do it” (but not like that), or be quiet about our struggles. These voices can override our ability to listen to our own internal cues.

Learning to live life differently in a neuronormative society is no easy feat. 

With support from neurodivergent community, neurodivergent-affirming (and identified!) therapists, and educators, it is possible to discover radical self-acceptance for yourself just as you are. As an AuDHD somatic, parts-work, and relational therapist who understands these journeys both professionally and personally, I've witnessed how self-knowledge and compassion transforms lives and creates pathways for authentic thriving.

Two individuals holding hands in front of a rainbow flag, by Kateryna Hliznitsova, via Unsplash (“a couple of people holding hands in front of a rainbow flag”).

What’s the difference between the Pathology Paradigm and the Neurodiversity Paradigm?

Part of this acceptance and awareness journey for many of us includes unlearning what’s called “the pathology paradigm”. The pathology paradigm (PP) says neurodivergences like Autism and ADHD are disorders in need of fixing. The PP says Autism is “Autism Spectrum Disorder” or ASD and the levels within (1,2, or 3) are severity levels based on how close or far from neurotypical performance one can manage. The PP is concerned with how “high” or “low functioning" a person is.

The neurodiversity paradigm (NP) instead asks, “what are your support needs?”, moving the onus from the individual to conform to neurotypical expectations, to institutions, communities, and support networks to meet the needs of everyone. The NP builds off of the concept of biodiversity — the idea that all living organisms are needed and enhance the quality of life of all other living organisms. There’s value in difference. 

The Neurodivergent Umbrella extends beyond autism, ADHD, and AuDHD. It includes other experiences that have been classified as “neurodevelopmental conditions” like learning differences, dyspraxia, dyscalculia, dyslexia, to movement differences like Tourettes and other tics, to what have been classified as "mental health conditions", like depression, bipolar, “personality disorders”, and so on. 

My Personal Journey as a Neurodivergent Therapist in New York

When I learned that I'm autistic after knowing about my ADHD for several years, a whole new world opened up to me. It was freeing, but it was A LOT. This revelation came the way it does for many late-identified autistics, especially women and femmes—through burnout. Not just any burnout, but Autistic Burnout, which is fundamentally different from allistic (aka not autistic) burnout. 

What is Autistic Burnout?

Autistic burnout is a profound change in one’s nervous system and bodymind. It goes well beyond exhaustion and dread, although it often includes those experiences as well. 

According to Dora Raymaker, et al. (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.”

Some common signs of autistic and AuDHD burnout include: 

• Chronic fatigue

• Overwhelm

• Increased sensory aversions

• More metldowns

• More shutdowns 

• Less stimulus required to be pushed into a meltdown or shutdown

• Less cognitive capacity, indicated by things such as reduced verbal and reading comprehension, less working memory available (maybe you understood one moment and then it’s gone the next)

• Less ability to perform self-care tasks and follow previous established routines

• Less verbal capacity

• Increased pain, tension, digestive upset, more susceptibility to illness

• Can increase experiences of anxiety or depression

• Feeling the need to isolate and withdraw from others or more difficulty communicating 

• Difficulty accessing joy and pleasure

• Challenges performing to previous capacity in work and school settings

• Suicidal ideation

These changes are not mere “mindset” issues (as so much of the self-development and mental health spheres would have you believe). If some or most of these feel familiar, know this: you are not deficient, you are not broken, your bodymind is saying something in a really powerful way: what we’ve been doing has not been sustainable, and now we’ve got to pull back and recalibrate how we do things. We have to build a life that works for us. An enormous part of that is getting support. 

A person making a heart with two hands outdoors, by Arif Mills via Unsplash (“person hands doing heart sign”)

Therapy Services for Neurodivergent Clients in New York

As a local New York AuDHD therapist, I welcome:

• Individual neurodivergent clients (including but not limited to autistic, ADHD, and AuDHD individuals)

• Neurodivergent couples

• Polycules with one or more neurodivergent members

  
  

Sessions are available weekly or every other week through secure virtual therapy for anyone in New York State. I offer my clients superbills for out-of-network reimbursement.

Sign up for a free consult today: individual therapy and couples/polycule therapy.

Specialized Group Therapy for Trauma and Chronic Pain

A graphic made by me in Canva!

Did you know about the high correlation of chronic pain and complex (childhood and early adulthood) trauma for neurodivergent folks? I'm now recruiting for my Fall/Winter therapy group focused on the intersection of complex trauma and chronic pain.

This group combines:

1. Psychoeducation about complex trauma, its connection to chronic pain, and medical advocacy

2. Experiential exercises from somatic and parts-work therapies to address triggers, pain, and nervous system regulation

3. Community-building and resource sharing among participants

   
   

If this sounds like a good fit for you, please fill out this interest form.

Useful Resources for Autistic and Neurodivergent Individuals

Through my personal journey and professional development, I've compiled these valuable resources for neurodivergent individuals:

Expert Voices in Autism, ADHD, and AuDHD

• Dr. Megan Anna Neff: Psychologist and author of Self-Care for Autistic People and The Autistic Burnout Workbook, and owner of the blog Neurodivergent Insights which is a huge wealth of information

• Nyck Walsh: Psychotherapist and creator of the Neurodivergent Somatics modality

• Dr. Alice Nicholls: Psychologist specializing in Autistic Burnout recovery strategies, with an excellent blog on the topic

• Dr. Amy Marschall: Author of A Clinician's Guide to Supporting Autistic Clients who also has several worksheets available for free on her website

Helpful Podcasts for Autistic and AuDHD Individuals

• Autistic Culture

• AuDHD Flourishing

• Connected Divergents: Apple and Spotify

• Divergent Conversations

Supportive Apps for Neurodivergent Life

• Routinery - guides you through routines you set up and adjust

• Goblin Tools - made by and for neurodivergent folks, this AI app has several tools including a ‘break this down into smaller steps’ function, a ‘formalizer’ to turn your emails/messages into something more formal and a function that does the opposite, and several other tools 

• Insight Timer - an app of guided meditations, mindfulness courses, my favorite meditations for IFS and quieting my brain before sleep live here!

• Arc Browser - an anti-data tracking internet browser that helps clear the myriad tabs that can accumulate during hyperfocus/research/rabbit hole mode 

• brain.fm - music designed to help you focus

• Finch - a very adorable gamified self-care habits app

• Tick Tick - a simple task management and calendar tool that many of my autistic and ADHD clients like

• Tiimo - another task management tool made with neurodivergent folks in mind, their visual planning function and persistent reminder notifications with countdowns on mobile can be so helpful for those “what should I be doing now?” moments

• Notion and (Obsidian if you like to get in the weeds of coding) - note-taking systems that can do more if you buy/make templates. You can set up endless nested folders and sections so there are definitely some people this won’t be right for. 

• Amazing Marvin - a very customizable and gamified task and time management app (approach gradually as the level of customization available can lead to overwhelm)

• Not an app, but this list would not be complete without the Embrace Autism website and their free, well-vetted assessments for autism and beyond (made accessible by an autistic psychologist). You don’t have to wait for an expensive evaluation to learn more about yourself. 

Remember, these are supports for our neurotype, not ways of changing it. Using these tools with self-compassion is essential to prevent burnout. It’s important to not skip the self-awareness part of burnout recovery, so we don’t use these tools to override our true capacity. If there are other tools you like, tell me in the comments!

Recommended Reading on Neurodiversity (and unlearning the Pathology Paradigm)

• Neuroqueer Heresies by Dr. Nick Walker

• The Empire of Normality by Robert Chapman

• Unmasking Autism by Dr. Devon Price

These books are important resources for unlearning the pathology paradigm, understanding the historical context of neurodiversity, and embracing our inherent goodness.

Neuroqueer Joy: Music for Autistic, AuDHD, and Neurodivergent Folks

For fellow auditory stimmers and music lovers, I've created Neuroqueer: An AuDHD Playlist featuring autistic and AuDHD anthems and artists. Music can be a powerful source of resonance, and many of these tracks are catchy as hell.

A graphic I made in Canva for my playlist!

Connect With a Queer, Neurodivergent Therapist in NYC and New York state

If you're seeking a neurodivergent-affirmative therapist who understands the unique experiences of autistic and ADHD individuals through both personal and professional knowledge, I'd love to connect.

A person with the autism acceptance symbol, a rainbow infinity sign drawn on their hand. Credit: Alexander Grey via Pexels (“Person Wearing Pink Spaghetti Strap Top”). 

Notes about this post:

I am practicing from unceded Lenape & Canarsie land (aka New York City). 

The book links in this post are affiliate links, and I have read each and fully believe in the usefulness of each book I shared. 

Full image descriptions in the alt text.

Resources cited:

Raymaker, D. M., Teo, A. R., Steckler, N. A., Lentz, B., Scharer, M., Delos Santos, A., Kapp, S.

K., Hunter, M., Joyce, A., & Nicolaidis, C. (2020). "Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew": Defining Autistic Burnout. Autism in adulthood : challenges and management, 2(2), 132–143. https://doi.org/10.1089/aut.2019.0079