Autistic, ADHD or AuDHD burnout differ from depression and non-autistic burnout. Treating without recognizing it, makes it worse. Learn why rest isn't enough, and what recovery looks like.
Show Notes
Episode Details
Season (Thread): 3
Episode number: 1
Release date: 2026-07-02
Hosts:
Natasha Stavros, PhD — author of The Unmasking Diary and Burning Inside Out (coming to a bookstore near you in December 2026)
Sarah Liebman — licensed marriage and family therapist, ADHD-diagnosed, special interests all things neurodiverse
Audio Engineer and Composer: Noah Smith
Director: Linda Highfield
Duration: 00:27:47
Audience and tone: Educational, conversational, supportive; stigma-free exploration of neurodivergence, diagnosis, and self-understanding using personal experience as a case study
Summary: Autistic burnout isn’t depression, and treating it like depression can make it worse — that’s the central insight of this episode of Following the Threads, as Natasha Stavros shares that she is currently on long-term disability in the depths of autistic burnout following her workplace disclosure. Natasha and Sarah Liebman break down three forms of burnout — depression, occupational burnout, and autistic burnout — and why the distinctions matter clinically: where depression responds to activation and occupational burnout responds to restored autonomy, autistic burnout requires something more fundamental: a complete renegotiation of how you exist in the world. They introduce the concept of the window of tolerance, explore why rest alone is a Band-Aid on a gushing wound, and reframe recovery as a shift from delegation to attunement and tracking your own needs. The episode closes with a raw diary excerpt from After the Masquerade describing, in precise and unflinching detail, what autistic burnout and skill regression actually feel like from the inside.
Key takeaways about autistic, ADHD, and AuDHD burnout and skill regression
Depression differs from burnout in that interventions are primarily about activation, but this can exacerbate symptoms in burnout. The difference between autistic burnout and non-autistic (occupational or personal) burnout relates to the person’s ability to return to the previous functional state when conditions change.
Recognizing autistic burnout involves self-study in what happens to you when you exceed your window of tolerance. There is also research that is adapting the Coppenhagen burnout scale for autistic burnout.
Recovery ultimately requires more than rest, it requires renegotiating your life to reduce chronic stress associated with high load. Load can be physical, cognitive, social, communal, spiritual, etc. It’s not all on you to reduce those loads. But, many high-masking adults with a late-diagnosis survived through hyper-independence and it may not feel comfortable asking for help. Furthermore, “asking for help” assumes delegation—handing tasks off until you resume prior functioning. But autistic burnout requires shifting from delegation to attunement and tracking: tuning into your internal state, noting patterns, and making decisions from that information.
Resources and References
Embrace Autism offers great overview descriptions on this topic: What is autistic burnout?, Signs of autistic burnout, why rest isn’t enough even if you consider the many different kinds of rest you can do (hint there are 12!).
There are several great articles on the differences between depression and neurodivergent burnout by the Autism Doctor, Neurodivergent Insights, and Resilient Mind Counseling, PLLC.
If you want to learn more about where you are in burnout, there are several free quizzes through Adult Autism Assessment and one through Embrace Autism.
Finally, if you are experiencing autistic burnout, research shows that there are three core components: chronic exhaustion, increased sensory sensitivities, and social withdrawal. That there are common strategies used to recover include autonomy is your choices to reduce/stop social obligations, reduce sensory inputs, and time spent alone to reset and recharge.
The Unmasking Autism Diary: Autism, ADHD or AuDHD Burnout and Skill Regression
I am beyond tired. I do not remember being this tired in my entire life except for when I was in my third trimester, maintaining an extra organ and entire human being while working full time with insomnia.
I am not depressed. Unlike other times in my life when I have fantasized about a world without me. That the burden of my existence for myself and others would be casually alleviated if I could just fall in front of a bus on my bike and die. It’s not suicide if it’s an accident. I do not feel this now. I do not wish for an end to my existence, just that I can no longer operate in the world as I once did.
I am sleeping 9 hours a night, uninterrupted with deep sleep and REM. I wake up, I do the morning chores to feed and walk our pets and get our daughter to school. Then I come home, and all I want to do is melt into the couch. Watching TV tires me. I watch and by the end of the episode, I have no idea what I just watched. Listening to audiobooks tires me. I have started the same chapter every night for the last seven days. I can’t tell you who the main characters are.
Thinking about feeding myself tires me. I don’t even like the idea of most food, even my favorites, let alone the idea that I have to prepare anything. It is honestly just easier to not eat unless someone puts food down in front of me.
I look at my phone. I see the calendar. Two thirty minute meetings and the weight of exhaustion sits on my chest. After, I had to lay on my bed with black out curtains drawn, with only my dog to lay on my chest, reducing all sensory input. I closed my eyes, but I did not sleep.
I had to drive fifteen minutes on the freeway and anxiety filled my body. I moved to the slowest lane. I hate having to leave my five mile loop around town, or drive faster than 40 miles per hour.
I cannot keep track of time. My calendar and organization of time was a super skill I had developed to manage my poor working memory and time management. If everything was in the calendar, with notifications, then I didn’t have to remember something or drop the ball.
Now, time escapes me. I can keep time to make it to at most four activities a day: my morning walk with the dogs, my daughter to school, picking my daughter up, getting into bed. Those are the only times I can seem to keep in my mind. I look at the calendar. Then the clock. Then back at the calendar, an empty memory of when I am supposed to do anything.
In my relationships, I am not engaging in conversation. It is easier to listen than to participate. I can talk to the clerk in passing, but only because it is empty.
I cannot find the words to express what is inside of me, nor do I know how to even begin to share it with another person.
All of this is of course exacerbated by the fact that I am not only autistic, but I have complex Post-Traumatic Stress Disorder (cPTSD), which has led me to be hyper-independent. I’ve learned to survive by not relying on anyone else to care for my needs; because until recently – my reality wasn’t acknowledged.
I’ve been reading about autistic burnout and skill regression. I do identify with autistic burnout. I am now eight weeks into my twelve week leave from work. The idea of going back seems an impossibility.
I do not, however, identify with the word regression. In particular, it’s not that I do not cognitively understand how to do something – for example, to eat food, you first make a choice on what to eat, prepare it, put it in your mouth, chew, and swallow.
I cognitively understand how to do all this, it’s just that I can’t actually get myself to eat on my own. I stand there – staring at the fridge. There are too many choices and too much work between making that choice and actually eating. I know what I’m supposed to do, I just can’t seem to act, and that feels like a regression in my ability to cope with demand and load, not the ability to do the thing.
AI-generated Show Transcript
Disclaimer
This podcast is for educational, informational, and entertainment purposes only and does not constitute counseling, psychotherapy, or mental health services. Listening to this podcast or communicating with the host and guests does not form a therapist-client relationship. The information here is not a substitute for professional advice, diagnosis, or treatment. Always seek the advice of your own mental health professional with any questions you may have regarding a mental health condition.*
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Introduction: We’re Back — and Natasha Is in Autistic Burnout
**Natasha Stavros** `[00:01:25]`
Welcome to Following the Threads. I’m Natasha Stavros.
**Sarah Liebman** `[00:01:29]`
And I’m Sarah Liebman.
**Natasha Stavros** `[00:01:31]`
Today’s episode is about neurodivergent burnout and skill regression. And also — we’re back. I am currently on long-term disability. I originally took family medical leave to address a complex PTSD flare-up after I disclosed my diagnosis to my employer and requested accommodations. We will certainly have episodes around that. But for today, I wanted to talk about something common that happens to people — including myself, right now — after they receive a diagnosis. That is autistic burnout and skill regression. Importantly, this can happen at any time, not just after a diagnosis. It just so happens that it is common after one, because the diagnosis frames what may have happened many times before in the context of autism. This episode explores what autistic burnout is, how you recognize it, how you recover, and what the antidote is to a more resilient life.
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Autistic Burnout vs. Depression: How to Tell the Difference
*One of the most common — and consequential — mistakes in treating autistic burnout is misidentifying it as depression. The interventions are not just different; they can be opposite.*
**Natasha Stavros** `[00:03:03]`
Before we start, let’s talk about autistic burnout versus depression. It can be confused with depression, and it can also be confused with non-autistic occupational burnout. So — how do I know I’m not in a depressed state right now? What makes this different?
**Sarah Liebman** `[00:03:20]`
What makes it different is that instead of being a loss of pleasure in doing things, or not having much energy, autistic burnout is more like: your ability to speak decreases. Not “I don’t want to think about this” — more like “I can’t think.” In depression, there can be a diminishing of energy and the ability to handle things, but it doesn’t take you all the way back to a place where you genuinely don’t know how to do things you used to do automatically. Autistic burnout strips you from being a person who seems to be living in the world to a person who’s wondering: how did I ever do that? And there’s an important clinical cue here — if you have a patient with treatment-resistant depression, consider an autism evaluation. Antidepressants and activation strategies work to some degree, but they don’t touch the core of the problem: that prior functioning was already a load that was unsustainable. People who live with that kind of chronic, untreatable depression — the question worth asking is: is that actually depression? Or is it chronic burnout that sometimes dips deep?
**Natasha Stavros** `[00:04:29]`
And one of the things you said to me that was really crystal clear: interventions for depression are activation-based. Whereas in burnout — autistic or otherwise — activation actually increases the load and further exacerbates symptoms. So if you’re trying depression interventions and noticing the opposite effect, that’s probably not just depression.
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Autistic Burnout vs. Occupational Burnout: A Fundamental Distinction
**Sarah Liebman** `[00:06:23]`
With non-autistic or occupational burnout, strategies are more likely to be effective and produce long-term change. We’ve been working a long time to measure occupational burnout — there’s the Copenhagen Burnout Scale, which is often used in healthcare settings. What’s usually recognized there is that burnout looks like: I don’t really care about my job, I don’t have motivation, I can’t see what the future holds. It can be heavily influenced by institutional setup — a department that was functioning reasonably gets a new manager who impedes autonomy and agency, and suddenly people across the department are burning out. Or in healthcare, it’s being presented over and over with the same level of distress with no escape. The fundamental difference is: if you have occupational burnout and you are able to — either within the organization or by leaving — recapture autonomy and agency, the burnout often lifts. The core of recovery from occupational burnout is renegotiating who you are, what you do, and what your purpose is in your workplace.
**Natasha Stavros** `[00:09:02]`
And the words you used for me when we talked about this were: with non-autistic burnout, it’s possible to resume functioning after a period of rest because the self existed before. Whereas with autistic burnout, your entire sense of self is no longer what it was. And this is actually developmental — which is partly where the skill regression comes from.
**Sarah Liebman** `[00:09:36]`
Right. And I want to be precise about what “sense of self” means here. Parts of the self develop — or don’t. When someone has an autism diagnosis that involves the social communication domain, they’ve created a lot of ways to get by: masking, camouflaging, withdrawing to hide burnout. But they haven’t built something based on who they really are and what they really need. That’s why it’s going to be so interesting to see what happens for the generations getting diagnosed earlier — actually getting accommodations so they can build those parts of themselves closer to the developmental timeline.
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How to Recognize Autistic Burnout: The Window of Tolerance
**Natasha Stavros** `[00:10:35]`
That’s a great lead-in to the second point: how do you begin to recognize autistic burnout? A big thing for me is that I don’t even know who I am. So much of everything I’ve ever done has been because I knew it was expected of me — and I never allowed myself to see what I actually wanted, because what I wanted didn’t matter. It was more important to conform. With my therapist, I’ve been talking about understanding my window of tolerance. You and I talked about this as containers: your window of tolerance is a smaller container inside the bigger container that is the life you live within. Part of where I am right now is that I have no idea who I am until I’m pushing past that window. What’s happening are extreme meltdowns and shutdowns — which we’ll have a whole series on — and I’m still just trying to discover: am I being pushed over the edge by something internal, or something external? All of it is new.
**Sarah Liebman** `[00:12:31]`
All you know is you find yourself in a moment and you realize: that’s not what I used to think it was. And what Natasha said about “I don’t even know who I am” is so important. I used to say that to people too — I need to go find out who I really am — and many people would respond: what do you mean? You’ve been you the whole time. But there’s a primal level to this that doesn’t even have words. Is my body sending me a signal? What do I do with this? And if I listen to it, what’s going to happen? A lot of times you’re finding yourself washing up on a beach wondering: how did I get here? It’s like the movie *The Hangover* — you’re backwards mapping the last 39 years of your life.
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Why Rest Alone Is Not Enough: The Overloaded Circuit Board
**Natasha Stavros** `[00:15:04]`
Rest isn’t enough when you’re in autistic burnout. I am sleeping quite well right now, and I am exhausted 24/7. Autistic burnout is like being an overloaded circuit board. You turn it off for days, weeks, or even months — and then you turn it on again, expecting it not to overload, when clearly there is too much signal powering through at any given time. You don’t just need a break. You need a different circuit board. Rest is a Band-Aid on a gushing wound. In my experience over the last five years, returning to the status quo — full-time job, breadwinner, doing all the things — without actually changing the underlying environmental mismatch leads to repeat incidents. It’s like being a hamster in a wheel I can’t get off.
**Sarah Liebman** `[00:16:03]`
Right. Or you need to adjust the power. It’s a fundamental rewiring.
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Autistic Burnout Recovery: From Delegation to Attunement and Tracking
**Natasha Stavros** `[00:16:24]`
When I was talking with my therapist about this, we talked about the load. I said I could talk to my friends, my husband, my daughter — see if they can help. And she recognized immediately how uncomfortable I was with that. And I think that’s not just perceptive — that’s extremely astute. Many high-masking adults with a late diagnosis survived through hyper-independence. So how do you actually shift your thinking enough to begin asking for help?
**Sarah Liebman** `[00:17:24]`
And what even is asking for help? A lot of times when someone finds themselves overloaded, the instinct is delegation: maybe your husband could pick up the slack, maybe you get a cleaning person, maybe you take a nap on the weekend. That’s saying: offload for a little while and then take it all back on. But it doesn’t address that the reason you’re overloaded is because decisions were made for reasons nobody ever thought about — and maybe life just can’t be the way it ever was, because that way was always built on a foundation that was unsustainable. And delegating is itself a load. I have to think about all the things I need. I’d rather be exhausted and do it myself than delegate. So what is attunement and tracking instead? It’s a lot like what we do with an infant: we notice the small signs, we start to create patterns — but we do it for ourselves. We tune in. We start to recognize: if I have to handle bedtime alone at the end of the day when my entire sensory battery is depleted, I can’t do it. This is what I can do, and this is the part that needs to change.
**Natasha Stavros** `[00:18:57]`
Which is actually something we started doing before the diagnosis — tuning in, seeing things differently. That self-study is what takes you to the place of recognizing burnout at all. And so a real cornerstone of recovery is this extremely long process of renegotiating how you exist in the world.
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Closing: What We Covered and What’s Coming Next
**Natasha Stavros** `[00:19:57]`
So for today: we talked about autistic burnout and how it differs from non-autistic burnout and depression. We talked about the research that tries to categorize levels of burnout — including an adaptation of the Copenhagen Burnout Scale for autistic people, which we have linked below. And we talked about how recovery is a renegotiation process, not a rest-and-return. Subscribe to the podcast to hear next week’s episode. And our next season brings our very first ever guest — someone we love and whose work we love — on what happens when you receive a late neurodivergent diagnosis as a parent. Please like, share, or comment. We look forward to getting to know you.
**Sarah Liebman** `[00:20:59]`
All right. See you next time.