Masking, Burnout and Identity

Not normal tired

Autistic people have described a specific kind of exhaustion for years. Researchers only began defining it in 2020, working with autistic adults to do so.

They called it autistic burnout. Its three main features are chronic exhaustion, loss of skills and a reduced tolerance for things like noise and light.

The definition the National Autistic Society uses comes from that work:

Autistic burnout is a syndrome conceptualised as resulting from chronic life stress and a mismatch of expectations and abilities without adequate supports. It is characterised by pervasive, long-term (typically 3+ months) exhaustion, loss of function, and reduced tolerance to stimulus.

If you have been lying in the dark some evenings because there is nothing left, that is the picture.

Sources: Raymaker et al. 2020, NAS: autistic burnout

Where masking comes in

The 2020 study found burnout happens when life stressors pile up and there is no way to get relief. Expectations outweigh abilities. Masking was named directly, and the authors warned against teaching autistic people to hide their traits.

A separate Australian team asked 23 autistic adults with lived experience to define it. Their definition adds withdrawal, problems with thinking and reduced daily living skills. They also describe masking as a cause, alongside living in a world that does not accommodate you.

When 141 autistic adults were later asked, they strongly agreed with that definition. Many had first been told they had depression, anxiety or another condition instead.

Burnout also builds from load that has nothing to do with masking. Our autistic burnout page covers that side.

Sources: Raymaker et al. 2020, Higgins et al. 2021, Arnold et al. 2023

Why burnout is not depression

The two can look alike from outside, and they are often confused. The 2021 definition warns that treatment designed for depression could make autistic burnout worse.

That is one reason the professional you see matters. A professional who does not know the difference may push for more effort. The problem is too much effort already.

We are not saying which one you have. We are saying the question needs a professional who knows both exist.

Source: Higgins et al. 2021

The link with anxiety and low mood

Burnout is not the only cost. A 2021 UK study of 305 autistic adults found that more masking went with more anxiety, depression and social anxiety.

The effect held after age and autistic traits were accounted for, and it was small at that point. We will not overstate it. The authors still concluded that masking is a risk factor for mental health problems in autistic adults.

Source: Hull et al. 2021

Who you are when you are not on

Not knowing is one of the oldest findings in this research. In 2017, autistic adults described a threat to their sense of self as a long-term cost of masking. In 2021, 277 autistic adults named loss of identity among the dangers.

The same 2021 study found people needed to mask less once they were diagnosed and accepted for who they were. Acceptance, not effort, is what reduced it.

A 2017 study of 272 autistic adults points the same way. Feeling positively part of an autistic identity went with higher self-esteem, and through that with less anxiety and depression. Knowing who you are protects you.

Sources: Hull et al. 2017, Bradley et al. 2021, Cooper et al. 2017

What recovery looks like

The people who defined burnout also described what helped them recover.

• Acceptance and social support from people who understand
• Time off, and expectations lowered for a while
• Doing things in your own way, including unmasking where it is safe

The National Autistic Society adds formal support, reasonable adjustments and learning your own early warning signs. None of this is a treatment plan. It is what people who have been there say worked.

Sources: Raymaker et al. 2020, NAS: autistic burnout

Support that is not therapy

If a professional feels like too much right now, these are lighter places to start.

The Brain Charity

Any neurological condition

Information and counselling for autistic people anywhere in the UK, from a centre in Liverpool.

Supports neurological conditions, which includes autism, but not a mental health condition on its own.

Weekdays 9am to 5pm

Call Email

Mind Infoline

Adults England Wales

Information on mental health support and where to find it, including support for autistic people.

Standard call rates Weekdays 9am to 6pmclosed on bank holidays

Call

If things are bad right now

Autistic adults who defined burnout described suicidal behaviour among its impacts. If that is where tonight is, please do not wait for a therapy appointment.

Our crisis page lists free confidential helplines you can contact now. You do not need to be in danger to use them. You do not need to use us at all.

Source: Raymaker et al. 2020