Episode 2: Autistic Burnout

Show Notes:

Do you ever find yourself in a state of paralyzing burnout that can happen even when you're doing activities that you enjoy?

Have you ever taken a vacation to fight the fatigue of life only to find that your post-vacation burnout-recovery state is reversed sooner and more severely than others?

Do you wonder how you can reduce your burnout in a way that works and actually lasts?

Then this episode is for you.

Top 3 reasons to listen to this episode:

1. Understand what autistic burnout looks like and how it differs from the burnout that might be experienced from things like work.
2. Identify ways to provide self-care when you are experiencing autistic burnout, as well as how to incorporate sensory soothers.
3. Learn how autistic burnout and ADHD can affect each other.

Autistic burnout can be a very tiring and frustrating experience. It can have a significant impact on your productivity, relationships, and overall quality of life. Therefore, it is important to understand what it is, how it affects you, and how to deal with it effectively. By doing so, you can preserve your energy and improve your quality of life.

To cope with autistic burnout, it is crucial to identify the activities or practices that help you recharge and calm your senses. By incorporating these practices into your daily routine, you can manage your energy levels and reduce the likelihood of burnout.

Additional Resources:

• Check out Dora M. Raymaker's study on autistic burnout: “Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew: Defining Autistic Burnout." 

Megan's Resources for Autism and Burnout: 

• How to Spot Autistic Burnout: https://neurodivergentinsights.com/blog/autistic-burnout-symptoms
• What Causes Autistic Burnout: https://neurodivergentinsights.com/blog/what-causes-autistic-burnout
• Autistic Burnout Recovery: https://neurodivergentinsights.com/blog/autistic-burnout-recovery
• Autistic Burnout Workbook:  https://neurodivergentinsights.com/neurodivergentstore/p/autistic-burnout-guide-and-worksheets

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Transcript

PATRICK CASALE: Hey everyone, you are listening to another episode of Divergent Conversations podcast. I'm your co-host, Patrick Casale.

MEGAN NEFF: And I'm Dr. Neff.

PATRICK CASALE: And we are going to talk about autistic burnout today, because Megan and I are both in it

MEGAN NEFF: This will make for an interesting conversation [CROSSTALK 00:00:22].

PATRICK CASALE: All these conversations are and we're going to look at each other and say, "Did that feel too fucking dark again?" But in reality, I think, that's the purpose here. So, I'm in it for sure. And, you know, Megan, I'm always going to defer to you when we're talking clinically, because I think you're by far the expert when it comes to all the research that you do and all the effort that you put in. So, what is autistic burnout for all of our listeners who may not really have a good grasp of that?

MEGAN NEFF: Yeah, no, that's a great question. And we should definitely add a link to this in the notes. I think her first name is Dana Ashlie? So, I think, I actually don't know her pronouns. So, I shouldn't assume her. But Dana Raymaker. They did a fantastic article that is the first to clinically define and research autistic burnout. It's a qualitative study. For people who don't know what that is, I really like qualitative studies, because it stays with people's stories. 

So, they interviewed like 19 autistic people. 10 of them were women, which is rare for an autistic study, foreword genderqueer or gender, not in the binary, which is, again, fantastic for a study on autism. And then, I think there were like six or seven men. 

So, first of all, I love a study that's representing autism from a more diverse lens, gender-speaking. And they found some themes, I realize I'm doing the very autistic, like, [INDISCERNIBLE 00:02:07] like, here's the design of the study, here's the people versus just like, what is autistic burnout? Okay, I'm zooming back out.

PATRICK CASALE: It's cool, you're fun.

MEGAN NEFF: So, okay, fantastic study, people should read it and there's a lot of kind of versions of it that I think it's a more accessible read than some peer-reviewed studies. So, they interviewed folks and listened for themes. That's how you do qualitative study, you listen for themes and you pull those out.

Their definition of autistic burnout is, it's defined by three features, chronic exhaustion, this is emotional, this is physical, this is all the domains of exhaustion that are possible. It is a loss of skills. So, particularly, executive functioning skills, speaking skills. I know for me that is a big one, my ability to speak coherently or speak at all is really impacted by burnout. And then sensory sensitivities increase during burnout. 

So, those are the three core features. They define it as three months or longer. Honestly, I think just when you're defining anything clinically you have to kind of put a timeframe around it. But I'm curious about that three months mark, why that's there. And they show how it really is distinct from like, you know, culture talks a lot about occupational burnout, that this really is distinct from that. It's also distinct from depression. Now, it often leads to depression, but it is distinct from depression. 

I think this is such an important thing for mental health therapists to understand, because this is one of the leading pathways to suicidality for autistic people. And mental health therapists often don't understand burnout. They think it's depression, they treat it like depression, but it needs a different support, different treatment. 

It's also more common among high maskers. They identified that masking was one of the huge factors contributing, which makes so much sense to me. So, I think this really sets people up to be misunderstood by their therapist, if their therapist not aware of high masking autism, not aware of suicidality. Okay, I'll stop there, because I've done a bit of a little info. But yeah, that's the clinical definition of autistic burnout.

PATRICK CASALE: I love this, because this is Megan and my process where we're obviously processing information very differently, and then, relaying it very differently, too. 

And I think it's important to have your info dumps and your perspectives, because people need to know that component too, right? Like, this is the definition, this is, clinically speaking, what this looks like. And I think so often we're you using the term burnout in society in general, right? And you mentioned it was more related, workforce-related. Like, hey, yeah, we get it, work is stressful, and it's hard, and you're overworked and underpaid, and all the things that come with it, and then that leads to burnout. But this is different. And I think main component that you mentioned really set that apart. 

And, I mean, we can go layer upon layer here, where it's like, what about autistic people in the workplace experiencing both like workplace burnout, autism burnout, etc. But in reality, like, it gets missed a lot. And clinically speaking, for sure, but also in friend groups and society in general. Like, the general advice around burnout is like, take a break, and like, go on vacation, or like, take a week off from work, and you'll be okay. And that is not what we're talking about here. I mean, even in that situation, a week off doesn't do it justice, but like…

MEGAN NEFF: Right, right? Because then we're returning to the life that's burning us out. And that's what's different about, you know, allistic person, or neurotypical person who's experiencing burnout. They often can go through a recovery period, and then, like, bounce back. But for the autistic person, like, what I see a lot, what I've experienced a lot into the last two years when I deeply restructured my life it's like burnout, go back to my normal, but then I burnout again, because it was the normal life that was burning me out. 

And so, that kind of bounced back and forth between burnout, like somewhat functional burnout, functional burnout, functional… And so, there isn't that idea of like bouncing back to some idea of normal. Often, it's not the case when we're talking about autistic burnout.

PATRICK CASALE: I love that you made that distinction, because that's an important one here. And for the autistic person who's experiencing autistic burnout, when you said a minimum of three months, right? I know we're talking clinically speaking, this could be going on for years, this could be going on for-

MEGAN NEFF: Oh, yeah.

PATRICK CASALE: …lifetimes. 

MEGAN NEFF: Totally, totally. 

PATRICK CASALE: You and I DM each other on Instagram a lot, like, and I did it before we started recording and I wish we were recording. I'm glad you kind of pointed that out. I asked you like, "Hey, how are you doing today?" And that's such a like conditioned question. You know, like, I'm supposed to introduce that way. And you were like, "I don't know. Like, I'm kind of here." Right? Like…

MEGAN NEFF: Yeah, I do wish we were recording that moment of… And then, I think I told you. "No, that's a terrible question." Which is funny. That's actually how I respond to that question now. I mean, with you, I'm obviously really comfortable and will be like, "Yoh, that's a terrible question. Why you're asking me that neurotypical…."

But with people who maybe aren't as an autistic culture, I will ask them to clarify like, what part of my life are you asking about? Because it's such a complex, like, what bucket in my life are we talking about when you ask me that?

PATRICK CASALE: One, I love that. We are comfortable enough to just name it in our interaction. And two, I think that's such a good fucking point. 

And I was talking to a caller yesterday about like, fluffing up emails of like, I kind of get straight to the point, you know, ask you what I need to ask you, or give you the information that you need, or whatever, and just be done with it. But then I always find myself, like, inserting a smiley face, or a lol, or like punctuation mark to emphasize my point, or like going back and copying and pasting, like, "Hey, how are you today, I hope all is well." Then jumping into the point that I actually want to make, and even operating from that neurotypical lens and expectation of communication leads to burnout, because that [CROSSTALK 00:09:09]-

MEGAN NEFF: Oh, yeah.

PATRICK CASALE: …energy to constantly think about how you are responding to things and how you're being received.

MEGAN NEFF: Yep, yep, it takes that extra step of, I do the same thing. I read an email, and then I go back, and I like I warm it up. It's like, okay, I need to, like, have some sort of intro. And, oh, I shouldn't just say the thing. So, yeah, that whole extra step. And it is, it's prefrontal cortex work every time we're doing that. We do it in email, we do in conversation. So, all of these things that are happening on a more intuitive level for other people that we do when we mask, you know, that's all that prefrontal cortex, which is part of why it makes so much sense to me that masking is such a significant factor when it comes to burnout.

PATRICK CASALE: Yeah, just think about how much energy is being spent all the time. And then, how much is being absorbed all the time? And the differentiation there between like, once you start to get into that burnout place where you mentioned, a lot of it is sensory and overstimulation. 

I'll give you an example. I was hosting a retreat that I was running a couple of weeks ago in New Orleans, and you know, I'm recovering from surgery, my energy is low, my capacity is low, my distress tolerance is already low. It hit me in a moment where I was sitting in the room with 20 people, they're all socializing, they're all having fun, but I'm picking up on like every word that everyone is saying. It's starting to get louder. And then, every noise is starting to like become more and more irritating. And the temperature is getting really hot. And I'm starting to find myself like stemming and like, needing the need to just regulate myself. 

And I just realized in that moment, like, you're burnt out already, and you haven't even started what you're embarking upon this year. And combined surgery recovery with, you know, the autistic burnout piece of just the realization of when you're in that moment your distress tolerance skills kind of dissipate. Like, your executive functioning, like you mentioned, just starts to crumble. 

And that was the first time for me, and I'm going to be really vulnerable here and honest, for our listeners, like, where I realized, I am so much closer to feeling that I am disabled or unable to function. And that world that sees me does not see it, because of how much energy and effort goes into doing whatever I'm doing. 

And I had this major fucking grief moment and that moment where I was like, not only am I recognizing this, but I also realized like, I've created this thing in my business that am I really not capable of actually doing? That was really hard to try to process in that moment.

MEGAN NEFF: It sounds like such a claustrophobic moment when you describe, like being in that moment, seeing what you had to do in front of you. And then, like the limits you are encountering in your body?

PATRICK CASALE: Yeah, yeah, it was hard. And you were one of the first people I thought about messaging that to, because I was like, "I need to talk to someone about this who kind of understands what I'm talking about."

MEGAN NEFF: Yeah.

PATRICK CASALE: It's just such a challenge in that moment. And all you want to do is like retreat, and turn off the world, and disappear from it. And I know that that is a way to sensory soothe, too, but when you're expected to be participating, or involved, or hosting, or coaching, or whatever the responsibility is, it becomes too much.

MEGAN NEFF: I know for me in those moments there's a narrative that kicks in, I should be able to push through, what is wrong with me that I can't push through? Was that part of it, too?

PATRICK CASALE: Oh, absolutely. It was like, that was coming up, "You're letting your co-host and business partner down, because you're not pulling your weight. Why can't you just do the thing that you've done before? Clearly, something is wrong with you." And, "You're not able to do this thing." I like having fucking limitations placed upon what I can do.

MEGAN NEFF: Oh, my gosh, right? Yeah, yeah. I mean, that's something I've thought so much about the last two or three years, is the limits and how that is for me, claustrophobic, that is the word for it. I feel claustrophobic when I encounter the limits in my body. 

And they feel like they shouldn't be there. Like, even when I am, like my head knows, right? Like, the social disability model. And autism is a disability, and, like, I know these things, but in those moments, like, my felt experience is still, there's something wrong with you that you can't push through. And I'm not attributing it to being disabled. I'm not attributing it to being autistic, because it's been so baked into me my whole life that you should be able to do what others can do, you should be able to push through. Why are you making this so hard? It's in your head. Like, all those narratives are still baked into my body.

PATRICK CASALE: Yeah. When that's coming up for you, I mean, how are you managing that? How are you kind of getting through those moments, because they can be so painful too and so debilitating?

MEGAN NEFF: Yeah, yeah. I mean, so I'll answer two ways. On one level, I think I've restructured my life to reduce those moments, right? It's interesting sometimes when I disclose this to people, people seem surprised. And I realize like, "Oh yeah, if you encountered me digitally you might not realize this." Like, I rarely leave my house. I mean, I'll go on walks. But I rarely see people, I rarely interact with people in body form, I rarely commit to things where I know I might encounter that claustrophobic, like, I've got a pretty fierce-like autonomy demand avoidance streak going on. 

So, one, I've structured my life, I think, to avoid those moments. Last year, I was adjunct teaching at a university leading like a clinical team once a week. And it was three hours, eight students, but I'd come home exhausted, and be so exhausted the next day. And I stopped doing that this year. So, that'd be an example of I have restructured my life to avoid those painful moments. 

And then, what do I do when I am encountering those moments? Like, I'm very meta in how I talk to myself. So, I'll talk myself through it of like, I'll identify the scripts that are playing, and I'll remind myself of the scripts I know that are true, but that I don't yet, like they're not living in my body yet. So, I'll do a lot of that kind of mindful naming of scripts in the way I talk to myself and remind myself. And then, I'll check in of like, what do I need? And I'm typically able to get myself some version of what I need.

PATRICK CASALE: Yeah, I love that answer. And, you know, I think the ability to restructure is wonderful. And I also think that for us, we've talked about this before, it's also a privilege that we have [CROSSTALK 00:16:57].

MEGAN NEFF: Absolutely, absolutely, yeah. 

PATRICK CASALE: And I start thinking about, like, what if you don't have the ability to restructure and really be mindful of how your days are laid out and who you're interacting with, and when, and having control and autonomy over your situation like that?

MEGAN NEFF: I'm so glad you brought the privilege piece up, because I think this is such an integral part of the autistic burnout pieces, is I'm very aware, I've been able to restructure my life because of all of my privileges. 

When I started my business, at that point, we were dependent on my spouse's income. So, there's economic privilege. I have a doctorate. So, there's a lot of education that gives me a lot of mobility in the professional space. 

So, I feel that when I work with clients in burnout, you know, whether they're in middle of graduate school, or due to socio-economic barriers, or name any of the barriers, cannot restructure their life, I think that's when I as a therapist feel the most stuck of like, there are systemic issues here, there are like neurobiological vulnerabilities here, there's very little I can say. Like, yes, we can talk about their sensory profile and we can talk about how to recover. But at the end of the day, there's these very real systemic blocks that we're running into that I have no control of and that feels claustrophobic. That's like my word of the day, apparently. I feel very stuck when I'm in that place with clients.

PATRICK CASALE: Yeah, yeah. That's a great point, because there's nothing as the therapist that you can do to change that situation or their experiences, or responsibilities, even. And it's so challenging, because the system is not designed for folks who can't fit into that neurotypical model, especially, in the workforce. It's just, 99% of it just doesn't feel well-suited or set up with our needs in mind.

MEGAN NEFF: And then, also, thinking about kind of supports for disabled people of like, when someone… when they're functioning, there's issues with that word, but it… Okay, when they're functioning [CROSSTALK 00:19:34]. Yeah, when their function ebbs and flows, like, we don't really have societal support for people like that. I think, individually, we don't know what to do with ourselves when we're someone who's, you know, I can go from, like, speaking on a stage to be non-speaking and laying flat on the couch the next day. Like, there's not really a template for folks of us who have such a range, because there's so many spikes, and there's so many valleys, and yeah, there's not great supports built-in, we have to kind of figure them out ourselves. Which again, if you have privilege, you're able to do that.

PATRICK CASALE: Yeah, yeah. And I think that's the paradox here, right? Is like, but even with that being said, to share from our own experiences of recognizing our privilege, but also recognizing that we are currently stuck or feeling like we're in our own versions of our own autistic burnout of, we still have responsibilities to take care of, right? Like, I know, you have your kiddos, I have two businesses to run, those responsibilities don't go away. And that means that I have to get really laser-focused, and really intentional about what I'm saying yes to, and what I'm not responding to. 

And for the people pleasers and us, like myself, who I feel like I'm a recovering people pleaser, I feel like shutting off the world, there's this almost push pole guilt feeling of like not responding to people. And it feels good to have people in your life where you can just tell them very honestly, like, "I can't do this right now, this is all I'm capable of doing."

And for me, that typically looks like turning all the lights off and laying in bed, watching something that's mindless over, and over, and over again, and not able to do anything else. But there's a cost there too, with like, partnerships, and communication, and just connection. But that's really all I can do. And coming back from New Orleans, I laid in bed for almost a week and a half. Like, if I wasn't doing one or two things a day that I had built in, that was all I could do.

MEGAN NEFF: So, I'm having a new thought listening to you talk and like the picture of you in a room, lights off, week and a half, and knowing you, knowing that like, yes, Game of Thrones like is enlivening for you, but also knowing that you do thrive on relationship and connection. 

Okay, so here's the thought I'm having. What if the recovery from autistic burnout is depressing, like in the sense of like, isolation, darkness? Like, what a brutal Catch-22 if what we need for our bodies to recover are also things that disconnect us and like, slow our bodies down to a degree that we're then losing connection with the things that give our life meaning and joy. And yeah, I don't know. Yeah, like, can I ask how are you faring after a week and a half of like dark room recovery?

PATRICK CASALE: Yeah, one, I think that's a wonderful point that you just pointed out, like, you're spot on. The things that we need may also be the things that do lead to that depressive state. So, it is that Catch-22. 

And you and I are both ADHD. The ADHD parts of me are like, "This is fucking terrible. Like, laying here, doing nothing, not creating, not feeling energized, like not feeling like there's a spark or something to get excited about." And the autistic part wins every time, because it's like, waving the white flag, right? Of like, I can't. Like, I can't do more than I can do right now. 

But to answer your question, how am I doing now? I still feel it and I can't connect the dots between what is still recovery from surgery and what is also this autistic burnout piece. I think that they're both kind of intensifying the other. Does that make sense? Like-

MEGAN NEFF: Oh, absolutely.

PATRICK CASALE: I just feel like if I'm typically running on like at 100% right now I feel like I'm at like 20%. So, it's pretty depleted. And then, the question becomes like, how do you replenish that to even get to a place where you can at least get through the day and the tasks that you've created for yourself? I think that's a Catch-22 of being an autistic entrepreneur, because, in New Orleans, I was saying thinking, "Okay, you're going to Costa Rica to speak at a conference." Which I actually backed out of today and I feel very proud of myself for doing, "And then you're hosting a retreat in Ireland." And I just kept thinking, "I can't do this stuff. Like, this is my world right now."

And that's why I think the next month going into February, you know, I don't know when we're going to publish this episode, just for frame of reference, like, I'm going to be doing very little until I leave to go to Ireland in March because I want to conserve and like, regenerate, and replenish as much energy as I can. But here's the Catch-22 to that Megan, Ireland will then take all of it and more. So, you're playing this catch up game all the fucking time of like, how do I replenish? How do I recharge if I'm constantly depleting?

MEGAN NEFF: I wonder if, not necessarily better, but an alternative term for demand avoidance would be like energy scarcity mindset of, like demand avoidance is so logical, based on what you're just describing of you have to store up energy for six weeks to go do a 10-day thing and then you have to recover from it. Yeah, energy scarcity mode. Can we make that a thing?

PATRICK CASALE: Yeah, I think we could definitely make that a thing. I think we can do an episode on that. I mean, I think you're so right, because the demand avoidance, like you said, is very logical. When you lay it all out [INDISCERNIBLE 00:26:31]. Of course, I'm going to avoid doing this. But in reality, it's like, I'm just so aware of how much energy it is going to take and how much I'm going to be depleted, that you have to go into that scarcity mode of like, I can't give it anywhere else, because there's nowhere else to give it or to receive it.

MEGAN NEFF: Yeah, yeah. I'm thinking of, like, when I get an alert on my, you know, iPhone, or like, Apple Watch of like, you have low battery, would you like to go into low power mode? Where it's like, okay, all of the things that are draining power, we're going to turn it off. It's kind of like living in low-power mode. And then when that becomes your life, I think it's hard to not be depressed.

PATRICK CASALE: Yep, because that's really when you're in that mode, where, okay, you turn it all off, right? And you recognize that you're there or you're very aware of what's going on. But then you can't say yes to the things that do bring you satisfaction and joy, because you're depressed, and you feel rundown, and you feel antisocial. Like, I feel like I don't want to interact with people. And that's a good indicator for someone like myself to acknowledge like, this is where I'm at, because I thrive on the connection that I have. And for me to want to avoid that at all costs is usually a very good indication of like, okay, we've arrived here, and this is where we're at.

MEGAN NEFF: I love that you have a litmus test of like, this is my gauge of I know kind of where my power mode's at. For you, it's kind of how you respond to connections. For me, it's how I respond to ideas or books. And this was before I realized I was autistic. I've always been an avid reader. I love philosophy. I love kind of existential deep books and reading, and playing with ideas. When I can't pick up a book it's like, "Oh, my goodness, what is wrong with me?" And partly because I've had so much chronic fatigue, I could pretty much always sit on the couch and read a book. 

But those moments in my life where I couldn't pick up a book, I couldn't listen to a podcast that had ideas, I couldn't take in any new ideas, that was my litmus test. Pronunciation is a hard thing for me. You'll realize that by doing a podcast with me. I'm speaking make up words all the time. But yeah, so I think it's really helpful for people when they know what their litmus test, however you say that word is of, oh, this is a sign, I'm entering low power mode, I'm entering burnout.

PATRICK CASALE: I love that you just named that. Are you in that mode right now where books and new ideas are just [INDISCERNIBLE 00:29:21].

MEGAN NEFF: So, I actually can't tell. I was thinking about that as we started like, okay, am I in autistic burnout, or is this like winter chronic fatigue? And I think I've had chronic fatigue, essentially, since I had kids. So, it's hard for me to tease out what is burnout, what is chronic fatigue. 

You know, I make a workbook a month, which is a lot of work, but I've been able, right now I'm working on one about just how we relate to our thoughts and cognitions, and I've been able to really enjoy learning about some of these concepts and reworking them to the fact that I'm able to enjoy parts of it. To me, I'm like, okay, I'm not at completely, like, burnout mode. But other areas of my life are definitely, I can tell I'm in burnout mode. So, I would say, I'm like, yeah, 50%. If you're at 20%, I would say I'm at 50%, because I still have things that can spark my curiosity. When I'm in deep burnout nothing sparks my curiosity.

PATRICK CASALE: And I think that's the exact point right there, that's it. You just nailed it. Something can spark your curiosity, but if it can't that is a great indication that that is where you are, that you are in autistic burnout. 

And I want all of you listening to think about what are the things that spark your curiosity? What are the things that you feel really, like, energized by and passionate about, interested in? If nothing is coming to mind right now, if you're feeling any of the things that Megan and I are talking about, could be a very good indication that that's where you're at, as well. 

And I think one thing that we're not touching on and that's important to name too, is I think, when you are in autistic burnout substance use is going to ramp up, drastically. 

MEGAN NEFF: Absolutely, absolutely.

PATRICK CASALE: And I noticed that for me that I was out of a fucking retreat in New Orleans, which is a city of debauchery and surrounded by 20 people that I had to be on for the entire time, so alcohol is my best friend at that moment, because I was messaging you about that of like, the socializing piece, the dropping into the, "Socially [CROSSTALK 00:31:37]" Right? Of being able to interact with people, to be able. To have some semblance of small talk alcohol has to be the lubricant for me. And acknowledging that is the realization of like, you have to pay attention to that for yourselves, for any of you who are listening, like, whatever the substance of choice or process of choice is, because it can get dangerous very quickly, and it can get out of hand very, very quickly, too.

MEGAN NEFF: Yeah, yeah, yeah. So, this is interesting. This isn't something I've talked too much about. I hope to talk more about, because I think it's a really important part of being neurodivergent, of burnout. But I have struggled with disordered relationship to alcohol in the past, and particularly, around burnout. 

So, it's interesting. I'm curious about… there's something I've noticed. So, my spouse and I respond really different to alcohol. For me, it energizes me. For them, he's like ready to go to sleep after a glass or two of wine, or beer, or whatever it is. I noticed among autistic people and this is totally anecdotal, I noticed that it tends to be more energizing for them, which I'm really curious about. 

So, for me, I often used it to energize and as like liquid dopamine. So, if I had papers to grade or some tedious task, and I was in burnout, then I'd be like, "Oh, well, I'll pair it with some wine tonight." And that became… like, because I could not mobilize. And it was before I knew about ADHD and autism, so I had no like medication support around dopamine and stimulants. 

So, I think whether it's socializing, because it takes a sensory edge off, and it makes socializing easier, or whether it's to try and motivate us, or because it gives us this kind of faux sense of regulation and energy, I think there's so many reasons we're really vulnerable to, particularly, I would say alcohol during burn out.

PATRICK CASALE: I agree 100% and with everything you just said, including the energizing component. And you know, there's such a cost to it too, because you don't sleep well, and then you throw in alcohol into the mix. And I mean, it's just so challenging. 

So, really trying to, you know, figure out, for our listeners, too, you do a great job, Megan, I want to highlight this of like, really posting valuable, tangible content where you can put it into motion immediately and start putting it into place. And you talk about sensory soothing a lot, and you talk about skills and techniques to kind of manage burnout when you're in it. And I'm just curious about things that our listeners who may not be mental health professionals and have access to the things that we do, that they can do when they're experiencing some of this stuff.

MEGAN NEFF: Yeah, yeah. I've got cascading thoughts happening. So, on one, I think, identifying those self-soothers that are like faux self-soothers. Like, they're self-soothing in the moment, but they're actually making your burnout worse. So, things like alcohol use or other substance use. I would think identifying those and really targeting those things, because those create a cycle, a loop that then perpetuate the burnout. 

And I think for a lot of people working with a medical provider or mental health therapist when they're targeting those self-soothers that are actually in the long run causing more harm, it can be really helpful to work with someone around those things. 

And then, yeah, I talk about sensory detox a lot, sensory soothing. You have to have some interoceptive awareness to be able to identify when you're sensory overloaded and then soothe yourself. So, sometimes you have to actually go back a few steps and kind of work on interoceptive awareness, which there's some kind of simple mindfulness. That sounds like a big thing, work on interoceptive awareness, but there's simple mindfulness things. Like, I have a smoothie right here, I can grab my smoothie, I can focus on the sensation of the coldness on my hand and what that feels like, I can do that for 10 seconds while I drink my morning smoothie. And by mindfully attending to the sensory experience, putting my smoothie down, noticing the difference in my hand, that's interoceptive awareness builder right there. And it's not an extra I have to do in my day, it's when I'm grabbing my coffee or my smoothie. 

Wow, I'm like diverging all over the place, so interceptive awareness, sensory soothers, like using all the kinds of sensory accommodations that can be helpful, and it often, I think, takes a lot of experimenting, especially, for later in life diagnosed people and high maskers who maybe are so disassociated from the body by the time they get to diagnosis or identification. It takes a lot of experimenting to figure out what is soothing for my body? What does my body, like? What doesn't it like? 

So, giving yourself a lot of kind of play space to figure that out. Rest, there's lots and lots of rest, dropping demands, and those can be small. Like, sometimes we think, "Well, I can't leave my job." Or "I can't, you know, walk away from my business." 

For our family, there's some demands that can always be dropped, for example, family dinner. If someone is having an overloading day they can eat in their room, they can eat in a quiet space. That's an example of a more simple demand drop or maybe not showering that day. Like, there can be these more simple demand drops. But I think thinking through where can I drop demands. 

And spending less time masking. So, figuring out who are the safe people to be around who I don't have to mask as much. Are there things I can say no to? To say no is huge, just like working on boundaries. And then that gets into people pleasing. 

And, again, working with a therapist, I think around why I say no hard can be really helpful. I just spewed off a random list. There's more and I think I have a few blog posts that talk about recovery tips, we can link to that. You're going to get a more linear version of me when I write versus when I talk.

PATRICK CASALE: I like to get both versions because both are unbelievably helpful. And I just learned a new word today from you. So, interoceptive, I did not know that term. So, here we are. 

But these are great tips. And I think you're so spot on when it's like different things are going to work for different people. And it's so easy to say like, here's a list of 10 things to try things out. You know, for me, I always need to take hot showers, and like I've always been obsessed with them.

MEGAN NEFF: Me too.

PATRICK CASALE: And I never realized why I take two showers a day. But now I have a very good understanding and just doing those types of things have been really helpful. And, again, hitting home on having a neurodivergent affirmative therapist really important. If you're, you know, struggling and you're autistic, if you're ADHD, if you have any form of neurodiversity. Like, having good therapy is so crucial. 

And yeah, being able to unmask, like Megan said, so when you go on a podcast with your friend, and you know each other you don't start with the conversation with, "Hey, how are you doing today?" Knowing that Megan is going to say, "Oh, that's a really bad question." But those are the things, right? That we were talking about, the little things that build up. So, if you can remove these little things from your day-to-day, like the energy it takes to revisit your emails, the energy it takes to communicate with your friends or your loved ones, it's really helpful, because it's just that one extra fucking thing that you don't have to do, or you don't have to worry about, or you don't have to put your energy into. And I think it's so hard when everything takes that extra little bit of energy,

MEGAN NEFF: Yeah, absolutely.

PATRICK CASALE: Well, this has been a really great conversation about a topic that I think is, obviously, near and dear to our hearts and that we know a lot of you are experiencing in the moment or have experienced. And I hope that this has been helpful. And we're going to continue to have conversations about these topics that a lot of people are just not having. And I think that getting this perspective is really great. 

So yeah, I don't have anything else to add today. I think I'm hitting my limit. So, I'm going to be honest about that on air. And, yeah, I think that's where I'm at.

MEGAN NEFF: I love that. And that's perhaps the best you asked about, like, what can people do to help with burnout? I think that's actually probably one of the best things is to recognize when we're at our limit and honor it.

PATRICK CASALE: Yeah. I've gotten used to now post-surgery two things a day. And my schedule is my limit. And that used to be really hard. And it's getting to be a welcomed part of my week where I can say like, all right, I get to talk with Megan for my second thing of the day, and then I'm done. 

But yeah, I think for any of you listening, all this information will be in the show notes, too. All the links to the blogs Megan's talking about, and the articles. And I just hope that this has been helpful for everyone, too. We still don't know how to close this podcast out, so…

MEGAN NEFF: Didn't we come up with like an awkward…?

PATRICK CASALE: Yeah, we're just going to say goodbye and then turn it off.

MEGAN NEFF: Yeah, but we had some kind of tagline. I'm trying to remember at the moment, like the place where we do awkward goodbyes, goodbye.

PATRICK CASALE: The place where we do awkward goodbyes on the Divergent Conversations podcast coming out every single week. Goodbye. 

MEGAN NEFF: Perfect.