Prosper Health's Autism Resource Center

When I was growing up in the 90s and early 2000s, autism spectrum disorder was heavily stigmatized and misunderstood. Since I did exceptionally well in school, no one in my family even considered I might be autistic. Throughout my life, I struggled a lot with focus, sensory sensitivities and interacting with other people. When I was diagnosed with Ehlers-Danlos Syndrome (EDS)  in 2019, I learned how common it is to have ASD or ADHD with EDS. I was diagnosed with ADHD in 2021, but it still felt like I was missing a piece of the picture.

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Until recently, most adults were not diagnosed with autism in their youth. There are likely several reasons for this, including a variety of issues within the diagnostic process. People of color, nonbinary people, transgender individuals and women have been historically underdiagnosed. This is due to discrimination, stigma or misconceptions. The diagnostic process started to improve in the early 2000s, with new diagnostic criteria that more accurately represents how autism shows up in the world.

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For those of us who weren’t diagnosed earlier in life, though, getting an accurate diagnosis can be hard. Some of us have learned how to mask or camouflage so efficiently that we blend into a neurotypical world really well, making it difficult to find a provider who will take our request for an autism assessment seriously.

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This is one of the many reasons why working with a neurodivergent-affirming clinician is critical when seeking a formal diagnosis. Regardless of the outcome, the diagnostic assessment process can play a helpful role in better understanding yourself. 

According to Very Well Mind, burnout is “a type of exhaustion that can happen when you face prolonged stress that eventually results in severe physical, mental, and emotional fatigue.” For a neurotypical person, this might result in feeling exhausted, being more irritable, and struggling with work- or school-related tasks.

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However, autistic burnout feels much more intense. 

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Autistic people deal with a large amount of stress just by trying to navigate the neurotypical world. Conversations with other people, dealing with sensory overload or masking can all take a toll on us. That means we experience high levels of chronic stress every day. Research shows that these kinds of stress levels have negative effects on our physical and mental health, including a higher risk of developing post-traumatic stress disorder (PTSD).

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In 2021, autistic researcher Dora Raymaker and their team worked to define autistic burnout as “a syndrome conceptualized as resulting from chronic life stress and a mismatch of expectations and abilities without adequate support. It is characterized by pervasive, long-term (typically 3+ months) exhaustion, loss of function, and reduced tolerance to stimulus.”

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Let’s break down what autistic burnout can look like in daily life.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder. This means it’s a developmental disability involving an individual's neurological system. It is not a mental disorder or mental illness. ASD affects how people communicate, behave and process sensory information.

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Some people believe that the term "spectrum" means everyone falls somewhere on the spectrum of autism. This is because autistic traits are human traits. Many people do have some features of autism, but this does not mean they have enough features of autism, at a high enough level, to be clinically diagnosed as autistic. In actuality, the term “spectrum” helps to highlight that there are many ways that autism can affect people differently. There’s a wide range of how autism presents in someone’s life. For example, there are some autistic people who need significant support, while others can live more independently.

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The diagnosis “autistic disorder” was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R)––a reference manual for mental health providers—in the late 1980s.

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However, the DSM-5, released in 2013, resulted in a major change in language surrounding autism. Autism spectrum disorder (ASD) is now an overarching diagnosis, encompassing the older diagnoses of Asperger’s syndrome, pervasive developmental disorder-not otherwise specified (PDD-NOS), and autistic disorder.

Increasing awareness and understanding autism

People used to think autism spectrum disorder was rare, but many people are realizing it’s more common than they thought.

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The Cleveland Clinic estimates that 1 in 36 children in the U.S. is autistic, and the CDC estimates that 2.21% of U.S. adults are autistic.

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However, these percentages may actually be higher due to factors like misdiagnosis, underdiagnosis or late diagnoses. These occurrences are particularly common among certain groups, such as girls and women, people of color and those from marginalized communities.

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This doesn’t mean autism is more common now than it used to be. Rather, autism awareness among healthcare providers is higher, especially now that there’s better access to tools and resources for continued learning. The general public knows more about autism, too. These advances help foster better understanding for autistic people as well as their families, friends and communities.

In 2017, the CDC released findings where they estimated that 2.21% of adults in the US were autistic. This data is imperfect. First, it’s from 2017. And, secondly, it’s mostly based on childhood diagnoses of autism. But, it gives us a number to start from, showing that adult autism is not absent from most workplaces.

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Research also shows that people with autism spectrum disorder are more likely to be underemployed or unemployed than their neurotypical peers. That number may be as high as 85%. This can be due to burnout, inaccessibility, or not having appropriate support and accommodations at work.

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Being autistic can make working difficult. Many jobs are incompatible with autism, like working at the customer service desk of a department store. There can be a lot of unpredictability, challenging social interactions, and stress. 

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Plus, stimming and fidgeting may not be easy to do at work. These coping mechanisms might draw negative attention and are sometimes seen as unprofessional. It is vital for us to be able to engage in these activities, because they can quickly and drastically improve our health and well-being.

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But, often, workplaces don’t see the benefits of hiring and working to retain autistic individuals. They don’t know that we’re often more productive than our neurotypical counterparts—or that, many times, a combination of a severe lack of resources and some intolerance lead to us leaving for another position.

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Thankfully, employees can take steps to get our needs met by seeking out reasonable accommodations.

The term AuDHD has come into increasingly popular use in recent years. Rates of new autism and ADHD diagnoses have grown since the turn of the century, likely in response to growing awareness around ADHD and autism, as well as changes to diagnostic criteria for both. As these rates have risen, an increasing proportion of people have received both diagnoses. AuDHD, the term coined to describe this dual diagnosis, represents a unique set of experiences, strengths and challenges. Understanding these nuances is key to supporting neurodivergent people in our lives, and making truly holistic, neurodiversity-affirming mental health care more widely available.

Transitioning to college is a significant life change for all students, but for autistic folks, this transition often presents additional challenges. College life, with its complex academic demands, new social interactions and often overwhelming environments, can be a difficult adjustment for autistic people. 

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Autistic students may face barriers not only in academics but also in navigating the social, emotional and environmental aspects of campus life. Understanding these challenges and implementing appropriate support is essential to ensure that students can thrive in higher education settings.