Episode 113 (Season 3): Autistic Burnout City: Perpetual Sensory Hell
Jul 03, 2025
Show Notes
Living with perpetual Autistic burnout can feel like navigating a world that’s always just a little too overwhelming, exhausting, or out of sync. For neurodivergent people, teasing apart burnout from depression and understanding how chronic sensory and emotional overload shapes daily life is not just challenging but key for self-advocacy and well-being.
In this episode, Patrick Casale and Dr. Megan Anna Neff, two AuDHD mental health professionals, discuss the lived experience of Autistic burnout. They share personal stories about perpetual exhaustion, reflect on the nuances that differentiate Autistic burnout from depression, and illustrate how life stressors, health challenges, and environmental demands converge to create what they jokingly call “perpetual sensory hell.” With humor and candor, they explore how burnout can signal deeper misalignment and the importance of understanding personal triggers, as well as highlight why these conversations matter so much for late-identified Autistic adults.
Top 3 reasons to listen to the entire episode:
- Gain clarity on the difference between Autistic burnout and depression through real-life examples and practical markers—vital for anyone navigating neurodivergent mental health.
- Hear validating stories about sensory struggles, task exhaustion, and the havoc that chronic burnout can wreak, along with the role of major life changes, masking, and health conditions.
- Pick up concrete advice for recognizing your own burnout triggers, interpreting external and internal signals, and beginning to build a more resilient, neurodivergent-affirming life.
If you’re navigating burnout or are curious about what “Autistic burnout” really means, this episode offers honest validation, practical wisdom, and a sense of solidarity. Discover how being seen and understood can be the first step out of perpetual burnout.
Resources
- Neurodivergent Insights Resource on Autistic Burnout: neurodivergentinsights.com/burnout-resources
Divergent Conversations Podcast Episodes:
- Episode 2: Autistic Burnout (divergentpod.com/2)
- Episode 47: Autistic Burnout (Part 2): A Deep Dive Into The Diversity of Burnout (divergentpod.com/47)
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Transcript
PATRICK CASALE: Hey, everyone. You are listening to the Divergent Conversations podcast. We are two neurodivergent mental health professionals in a neurotypical world. I'm Patrick Casale.
MEGAN NEFF: And I'm Dr. Neff.
PATRICK CASALE: And during these episodes, we do talk about sensitive subjects, mental health. And there are some conversations that can certainly feel a bit overwhelming. So, we do just want to use that disclosure and disclaimer before jumping in. And thanks for listening.
Hey, everyone. Welcome back to Divergent Conversations. We are getting ready to release a new collection that we are going to do, an entire autistic burnout collection, and pretty exciting, because we just did a collection on Not Your Typical Wellness. And I feel like I am already in burnout. So, this is a really fascinating time to start this series.
MEGAN NEFF: Patrick, have you ever left burnout?
PATRICK CASALE: I don't think so. I mean, I-
MEGAN NEFF: [CROSSTALK 00:03:39] just a perpetual.
PATRICK CASALE: Yeah. I mean, my life does feel like perpetual burnout. Yeah, it really does.
MEGAN NEFF: And I realize I'm just diving right into the deep end, and this is not how we talked about sketching out, which is just how we do. But like in our last series, and I appreciated your honesty around this, and correct me if I'm wrong, but I feel like you talked about also being depressed.
PATRICK CASALE: Mm-hmm (affirmative).
MEGAN NEFF: How do you tease out when you're depressed? First, when you're in burnout? Or does that distinction even matter to you?
PATRICK CASALE: We are diving really right away. Love it. I think we were like, “We're going to give a little quick synopsis definition of what autistic burnout is.” But, you know, let's circumnavigate that. We do have episodes, full episodes number two and number 47, where we have done deep, extensive dives on what autistic burnout is. And we are going to link those in the show notes for every single episode of the series. Okay, anyway, [CROSSTALK 00:04:50]-
MEGAN NEFF: Wow, look at that social ligamenting that you just did. Like, burnt out to be like-
PATRICK CASALE: I'm so tired right now [CROSSTALK 00:04:55] did that.
MEGAN NEFF: Yeah, I'm impressed.
PATRICK CASALE: Which is probably why I'm always in burnout, if I'm being honest, is like, how naturally that stuff comes to me in a lot of senses. And I think that keeps me stuck here. Okay.
MEGAN NEFF: Because you had an itchy thought. Like, no, we've got to define autistic burnout before we dive into kind of emotional conversation, yeah.
PATRICK CASALE: Yeah.
MEGAN NEFF: So, yeah, that's part of the hypervigilance load that you carry, yeah.
PATRICK CASALE: Which feels pretty consistent. Okay, how am I differentiating between whether I know that I'm in burnout or that I'm depressed? As someone who really resonates with like a major depressive disorder diagnosis, or maybe at least cyclothymia, can never say that word correctly. Like, chronic underlying depression at all times, it's hard to tease out. It is really hard to tease out at times.
But I think for me, when I'm thinking more about autistic burnout, I'm thinking about how impacted all parts of me are, not just my mental state. And I think a lot of that can feel like unbelievable, sensory overwhelm, irritability, frustration tolerance, lack of special interests or participation in them, my desire to socialize and desire to withdraw. But that can feel like, “ooh, which one is this?” in that situation. I’ve really start to think about the sensory component. Like, I’ve really start to think about how I feel, like, I've talked about this before, that exposed nerve ending moving through the world, being shocked all the time, that feels constant, and it's just like every little thing becomes bigger and bigger and bigger.
And I was noticing this yesterday when I was laying on my couch. I wasn't feeling well. I had like a sore throat, low-grade, feverish. And of course, I’m like, “Of course, I'm sick again, right?” And I was like, answering an email. And I was like, “Oh, that is really irritating me right now.” The having to respond to this thing, having to open that extra tab, having to do that, like, open my computer again, I'm like, noticing the frustration building, and it's always a good indication for me that I'm like, well, either on the way or I'm like, already firmly there and just never realized it until it hits you like a ton of bricks.
MEGAN NEFF: Yeah, yeah. So, your experience of it is like there's the kind of gradual build, the frustration, which I, definitely, relate to. Like, tasks just start feeling like molasses, and then, it hits like a ton of bricks. Is that when it's like collapse on the couch for you type thing?
PATRICK CASALE: Yeah, yeah. And that's almost where I want to take my phone and, like, throw it across the room, because I'm so overwhelmed, and I start to have, like, more sensory meltdowns and shutdowns. And they start to intensify. And things that would not typically, you know, lead to, one, everything starts to lead to sensory meltdown, and then, therefore, sensory shutdown. And then, I'm just in it and I can't get out of it.
MEGAN NEFF: Like, yeah, perpetual sensory hell.
PATRICK CASALE: Yeah, perpetual sensory hell, yeah.
MEGAN NEFF: Burnout. Like, I'm thinking of, like, if burnout was a city and it's like, Welcome to Burnout, Welcome to Perpetual Sensory Hell. Oh my gosh, that would be a fun activity. Like, burnout the city, and then, to like, design it. [CROSSTALK 00:08:34]-
PATRICK CASALE: Oh my God. You know, also, of like, man, we really need our merch lineup because that is such a good t-shirt. Like, it's such a good, I would wear it. Welcome to Burnout Perpetual Sensory Hell.
MEGAN NEFF: We need a clever name for our burnout city too. Like, burnout something. And then, like, yeah, that would be the tagline. And then, what would the restaurants be in our burnout city?
PATRICK CASALE: Oh my God. [INDISCERNIBLE 00:09:01] Applebee's. It would just be Applebee's. Like, you would have no other options, and people would be coming through singing. Have you ever stepped foot in one when they're like singing happy birthday? Yeah, it would just be that on like a loop when all you can eat is, like, those sizzling, disgusting steak platters that come out scalding hot, and they're like smoking in your face, and you set it down in front of you, and it just burns you immediately, but then, the smoke is hitting you in the face, and it just tastes horrible. Like [CROSSTALK 00:09:33].
MEGAN NEFF: All the clothes are made of wool, scratchy wool.
PATRICK CASALE: Yep, yep.
MEGAN NEFF: Yeah, and you [CROSSTALK 00:09:37]-
PATRICK CASALE: [CROSSTALK 00:09:38]. Like, your socks are, like, irritating your toes the entire time. The temperature is never right.
MEGAN NEFF: And all of the houses are doing laundry, and they'll like, exhaust from you. And they're all using, like, fragrant, the dryer sheets, and like the fragrant… You know when you walk by a house doing laundry and the exhaust, it just smells so chemically? So, all the houses are always doing laundry with a terrible fragrant.
PATRICK CASALE: The only vehicles that exist are ambulances and fire trucks with their sirens on, and they just drive up and down the street casually, but it's like the ice cream man, but that thing is just blaring all the time.
MEGAN NEFF: So, one needs to, like, take this transcription, okay, I'm not actually saying people should do this because controversial, but like, and turn it into an AI video. You know how they can, like, make videos now and turn this into a city, except I wouldn't want to watch that video, because it'd be too overstimulating.
PATRICK CASALE: Right, yeah, yeah. And you're like, either under stimulated all the time, and you're just, like, wanting to crawl out of your skin. Or you're so overstimulated that you're just curled up in a ball, and you just can't get out of it.
MEGAN NEFF: So, the under stimulation that is, yeah, because I will feel under stimulated and burnout, because I lose access to my curiosity when I'm in burnout, which is, for me, my cure. Like, I said this, I think, oh, I don't know if I said it on the podcast or if I wrote it in relation to my OCD. I talked about how this was a new insight recently. I fill my mind with ideas in order to escape my thoughts and curiosity is how I do that. So, when I lose access to curiosity, that, to me, becomes a trigger for depression, partly, so for me, burnout often will lead to depression. But it's that under stimulation of I'm under stimulated, but nothing sounds good, like reading a book, like doing a creative project, because I don't have energy for it.
So, it's also different than… because this becomes an important distinction, anhedonia, I'm probably mispronouncing it, but like the loss of pleasure, which is part of depression, there's that. But then, in burnout, for me, it's, I just don't have energy. And that feels different.
PATRICK CASALE: It does feel different, and because you and I are both AuDHD, I feel like I'm always in that space where the the ADHD side is so under stimulated in these moments where it's like I need something to feel creative, or to feel stimulated, but I don't have the energy. I don't have capacity. So, you're almost wrestling with yourself in that way.
MEGAN NEFF: And in my past life, when I struggled more in my relationship to alcohol, that's when I was most vulnerable to go to alcohol. Because it's like, well, this is going to be like kind of some passive dopamine while I'm doing this other thing. And obviously, filling our systems with alcohol is not going to support burnout recovery. But I think it makes sense that I think a lot of us do that for that stimulation, especially, if we're AuDHD.
PATRICK CASALE: Yeah, 100%. Yeah. So, it's so fitting that we go from wellness to burnout, and I'm in it. Like, I can feel it intensely, and I realize, like, it's only June 12th right now, and I have so much left to do this year.
MEGAN NEFF: And I don't know if you're like me, but like, in my head I'm like, “It's June. This is supposed to be the best energetic months, because it's summer and it's sunny.” And I know, for me, I'm very sensitive to that. Is that true for you? Or is summer usually actually your better months?
PATRICK CASALE: Yeah. I mean energetically for sure, I always feel myself like slowing and shutting down once, like, middle of October comes into like March-ish. But you know, I was having this thought and association the other day about how it is June, how it's like “nicer weather outside”, there's more sun, and because I'm so sensitive to temperature and heat, it's so hard for me to be, like, excited about that, while a lot of other people around me are, like, gearing up for spending significantly more time outside, and I'm like, constantly trying to seek shade or ventilation or, like, how can I regulate my temperature at all times in order to, like, participate in this part of life?
MEGAN NEFF: Yeah, yeah. I mean, and I've heard a lot of other folks talk about that too. Because I think I might be making this up, but I don't think I am, but I don't know the academic [INDISCERNIBLE 00:14:29], I think one thing I've read about ADHD is that we can be more sensitive to kind of like circadian rhythm shifts, and so the sun. So, I think for a lot of us, sometimes we do feel more energy with the sun.
But then there's, again, especially, if we're AuDHD, there's regulating our environment if we're outside, there's bugs, there's the brightness of the sun, there's the temperature regulation. So, even if we are in bodies that perhaps benefit from more sunlight, then that's also something that we have to navigate of like, and how do we do that in a way that feels okay?
PATRICK CASALE: And also, we're both wearing black right now too.
MEGAN NEFF: Well, I'm always wearing black [CROSSTALK 00:15:08]-
PATRICK CASALE: You're always wearing black [CROSSTALK 00:15:09]-
MEGAN NEFF: You're just copying me.
PATRICK CASALE: Yeah, yeah. I just [CROSSTALK 00:15:11]-
MEGAN NEFF: Welcome to the club.
PATRICK CASALE: It’s really dark in my office, because it's, like, later in the day here. But yeah, I think that's a part of it too, right? Like, how much cognitive energy has to go into that constant hypervigilance of, like, everything has to be just right at all times for our sensory systems, and how often I can feel so depleted from having to navigate that in, like, most areas of my life at all times.
MEGAN NEFF: Yeah, yeah, yeah, yeah.
PATRICK CASALE: So, I want to flip the script a little bit. You asked me about this. You just got back from a trip. I imagine, for you, you're also feeling worn down to some degree. Are you feeling like you're in burnout at the moment, or do you feel like, “I feel like I'm kind of at a good place.”
MEGAN NEFF: So, my reference point was, like, forever shifted after last fall. So, I mean, yeah, I've talked about this on the podcast. I got COVID in 2020. I was, like, quite sick for nine months, developed asthma as part of it. And then, every time I've gotten COVID it, like, just takes me out for four to six months. And then, it's also like, well, what do I call that? Do I call that autistic burnout? Do I call that long COVID? Do I call it chronic fatigue syndrome? Like, and it's helpful to have names for things. And then, also, it's like, these cluster together in ways that are complex.
So, my reference point being the fall, which was when I was really struggling to do what I'm doing now, which is sitting up right. Like, I was on the couch being… I always confuse horizontal and vertical. I was doing horizontal, like, pretty much all day. On a good day, I could get myself to work three hours.
Compared to that I feel much, much better. I'm back to being able to work full days. And that's probably because of some health things, I still mostly do it vertically, but I'm able to, like, go outside in the sun and do it. So, that's my reference point. So, compared to that reference point, I'm feeling much better than I was.
And also, I’m very much aware. And we've also talked about this a bit on the podcast. But, you know, this year started with that website migration that went terribly, horribly wrong, and I've been in fight/flight energy, that tipped into pretty intense energy in the spring. And so, I'm also very aware that my nervous system has been in a stress state for many months. And so, I'm kind of terrified of the fall, or I'm terrified about when I get sick again, because I don't want to, like, make it a self-fulfilling prophecy, but I'm imagining a pretty intense crash might be coming.
PATRICK CASALE: Yeah, and you kind of talked about that in the wellness series of like, this fear of when is this energy going to go away? Or when am I going to really struggle again? And scary that is.
MEGAN NEFF: And the intensity of that, because when we were recording, I was in the intensity of that, like that has shifted down, which is really good, because I was struggling to sleep. It was so intense. And that has shifted. And it didn't shift into a depression, which I was a bit worried on. And so, it has shifted back into, like, I don't think I have a baseline, but to what feels like would be a healthy baseline if I had one.
And I'm still, like, dealing with business stress, and I'm curious as that wraps up, like, what my body will do? But right now, I'm appreciating the sun, I'm appreciating that my body is managing to get a little bit of sleep, and I'm feeling, for me, pretty resilient. But again, that's a huge caveat of like what, for me, is resilient.
PATRICK CASALE: Yeah, for sure, that makes a lot of sense. And, I mean, I'm glad for you for that reason, for sure, because I remember recording last year in the fall, when you were like, “I'm just going to lay down on my couch and turn my video off, because I can't, like, do this right now.” And you were really struggling, for sure, and physically and mentally in that time.
MEGAN NEFF: And I couldn't put words. Like, words into sentences were so hard for me. And yeah, yeah. So, we have a family gathering. So, once a year, we gather with my spouse's family. And as far as I can tell, that's where I got COVID last year. So, like, I'm, actually, going into next week, like, really scared. And again, I have traveled. I traveled to Belize, I'm so scared of getting COVID, because that's the thing that, for me, takes me completely out. And I do what I can to be cautious, and you only have so much control.
PATRICK CASALE: For sure, yeah, absolutely. Thinking about-
MEGAN NEFF: Just-
PATRICK CASALE: …the last time I felt good for, like, any stretch of time, so much has happened, you know, over the last couple years, but like, well, I was, like, looking at the hurricane here ever since then, because I was already in burnout going into that. So, coming out of it has been so challenging, because life doesn't stop, you know? Like, I've done a better job, like we talked about in some of our episodes, of setting better boundaries in my life, and all of the things, and, like, even announcing a big pivot in my career a couple weeks ago. But like, I haven't been able to get out of it. I haven't been able to, like, dig myself out of it. And sometimes I do think I need, like, a month of just complete solitude and isolation from all things. And that also is horrifying to me.
MEGAN NEFF: You've talked about that. You've talked about kind of wanting to, like, go underground for a period, which I actually really love for you, Patrick. And you've talked about that, how it's so hard to not respond to notifications, and it's so hard to, like, fully get off.
So, what one thing that's been in the back of my head as we're talking about our levels of burnout is we are both writing a book in this next year, which is a really freaking heavy lift. And I'm also feeling that as I'm, like, anticipating this year. I'm like, “Oh my gosh, have I budgeted enough time for this?”
And where was I going with this? Oh, I think the thing about, like, yeah, we were texting about this off of, well, not recording about how important it is to hold on to your mind when you're writing a book, and to have access to your mind, and how hard that can be when we're like in the pings and the pongs, and how you're, in addition to writing a book, thinking about career shifts. And I am so excited for you, if you actually make this happen, for you to have a season of going dormant and like, the image that keeps coming into my head is like roots, and soil, and ground, and then, like coming back from that with something that feels really deeply rooted, that feels new, that feels so aligned for you.
Because the tension I've felt as we've been recording, there's something that hasn't felt aligned for you. And would you say that's part of your burnout even, is like friction around that of the way your work, I don't know? Alignment, work, burnout, these words associated in my head, do they make any connection for you?
PATRICK CASALE: Yeah, for sure. I think since the day we met, you know, I've been doing work that I haven't always truly loved. And I think that that has intensified over time. You know, like, just the career that I've had over the last couple of years has required a lot of me to be like a presence, and a face, and like a person who's involved in a lot of things, and it just doesn't feel aligned to me.
And then, once the passion went away, it feel very misaligned. And then, like, obviously, continuing to show up in those spaces or in that environment, because capitalism and needing to make money, and it's just like that just almost amplifies everything, too, of like being in a space where you just don't feel content, or passion filled, or excited, and then that becomes a situation where you start to try to, like, split hairs. Of like, is this burnout? Is this depression? Is this burnout? Is this depression? And that kind of vacillates, like, back and forth.
MEGAN NEFF: Or is it misalignment? Right? Is it value misalignment? And there's something in my life that, like, would benefit from adjusting? And that goes back to the idea of like emotions are signals, right? Emotions aren't good or bad. They're signals. And sometimes burnout can be signals of like, is this signaling a need for some sort of life trajectory shift?
PATRICK CASALE: Yep, which is horrifying in a lot of ways, but, you know-
MEGAN NEFF: Because that's change.
PATRICK CASALE: Yeah, which…
MEGAN NEFF: Is our favorite.
PATRICK CASALE: Change, routine disruption, like all of the things that we really love, sarcasm. And I think I said to you offline, like, I feel like there's a part of me that has placed myself in this situation purposefully. Like, I have run myself down by doing all of these things over the last four or five years so that I can take a step back and, like, actually rest, and actually, breathe, and like, I don't have to work so hard right now because I have set myself up in that space from the retreats, and the podcasts, and some other stuff that I've done.
MEGAN NEFF: So, yeah, I'm curious what you mean by that, because my brain goes to two places. One is, like, you've done that to financially set yourself up so that you could take a break, which would make sense, or do you mean it… Because I also relate to this, where it's like you are so burned out you literally can't, so you have no other option but to take a step back.
PATRICK CASALE: That part.
MEGAN NEFF: The second one?
PATRICK CASALE: They're both true.
MEGAN NEFF: Yeah, yeah, yeah, yeah.
PATRICK CASALE: This is a both and. Again, like [CROSSTALK 00:25:37]-
MEGAN NEFF: No, but I'm the same way. I need my body to say hell no for me to, actually, take a step back, which is what happened last fall for me.
PATRICK CASALE: Yeah. And, you know, since we've known each other, both of us get sick fairly often. And I've just noticed like, the increasing likelihood that I'm getting sick more and more and more and more. I'm more and more fatigued all the time. And like you said, it could be chronic fatigue syndrome, it could be this, it could be this, but in reality, it's a culmination. And I think for me, that culmination has led to such an intense period of autistic burnout that my body is like, hell no. Like, there's no gas in the tank whatsoever. Like, we're beyond empty. It's like, when you're driving, when you're a teenager, and your gas tank is definitely empty, but you're like, “I can go 30 more miles.” And I'm way beyond that. Like, that barometer is gone. So, yeah.
MEGAN NEFF: That's part of our city is, every time you go to a gas station to fill up, it's like it gives you an inch, just enough so that you're like your gas tank still is registered as empty, but it's at like, the top of empty, and that's all you can ever get at a gas station when you go to a gas station in our burnout city.
PATRICK CASALE: Or you show up to the gas station and you're on empty, and the gas tank says, or the gas thing says, “Out of service.” And then, you have to drive down the road, you know?
MEGAN NEFF: No, no, no. You have to push your car down the road.
PATRICK CASALE: But it's up a hill. And like…
MEGAN NEFF: Do you want to come to a retreat in our burnout city? We are selling tickets for 2027.
PATRICK CASALE: Oh, God, yeah. You know, laughing about this and joking about this is so helpful, because I know so many of you are probably listening and relating so hard to this too, of like, yeah.
And oh, okay, one more thing for the city, because I just watch my dog walk out of my peripheral, like walking down the street, is the only animals that exist in this city are my Shih Tzu named Hudson, and he just barks incessantly, nonstop, doesn't matter how often you try to get him to be quiet and like, it just doesn't ever, never, ever, ever stops.
MEGAN NEFF: None of the cute, fluffy animals are there.
PATRICK CASALE: No, no. So, that's it.
MEGAN NEFF: Just the barky ones.
PATRICK CASALE: Yep.
MEGAN NEFF: And the cats that throw up.
PATRICK CASALE: Yeah, or, you know, like, you're finally sleeping and like, your dog decides that he needs to go outside to go to the bathroom at three in the morning. So, you have to, like, wake up from sleeping for the first time in like a week, and let your animal out to go to the bathroom. Sometimes [CROSSTALK 00:28:23]-
MEGAN NEFF: What are the beds made of?
PATRICK CASALE: Oh, people will laugh at this if you've come to my Ireland retreat, but some of you have said that you would rather sleep on the ground than sleep in the beds at the cottages that existed there. So, maybe something like that feels like plywood, basically, I don't know, no mattress, no box spring. But it's like one of those pillows that you get at a hotel that is way too soft, and it's like lumpy, and like, you keep trying to, like, put it behind your head somehow, and like, you're squeezing it in half to give yourself support, and you just cannot get comfortable.
MEGAN NEFF: And then, in the middle of the city is like an accommodation center. But to get accommodations, you have to wait in line for six hours in the sun and listen to like, loud music and parades going by you. And then, by the time you finally get to the accommodation desk, they give you like earbuds, like sleeping earbuds.
PATRICK CASALE: Yeah, and they're like-
MEGAN NEFF: And they’re like, “You're welcome.”
PATRICK CASALE: But they only have one, so you have to choose which ear it goes into, or it's like the DMV, where they just put the sign on the desk, and they're like, going to lunch, and you just have to stand there for 30 more minutes. Oh, man.
MEGAN NEFF: This could be a fun movie.
PATRICK CASALE: I think you could come up with some cool visuals for this so, you know, we'll see where that goes. Yeah, and in all seriousness, like, I think this is a hard place to be. And, you know, the differentiation, you do such a wonderful job with, like, the Misdiagnosis Monday posts, and the Venn diagrams that are so useful visually for people to kind of make sense of. And the burnout component of like, is it depression? Is it autistic burnout? Is it A, B, C, D, E, F, G. And I think everything we're talking about wrapped up into, like, this experience, you know, is what it is for me, and that's how I know when I'm there.
MEGAN NEFF: Yeah, yeah. And like, you said something a moment ago, I like that. It's like, this constellation of experiences. And I think that when I think about and when I talk about burnout recovery, that becomes a really important part of the conversation, like, I think sometimes partly the autistic mind, we want to be like, well, is it this, or is it that? And then, what's the treatment?
And with autistic burnout, it's multi-systemic. And so, it's not like, there's this one treatment, it's like, well, okay, your nervous system's probably been dysregulated for a long time. You know, is your sensory system regulated? How's your sleep? How's your health? This is a hard one, and we talked about wanting to do a series on food, which I do, but also, like, you know, are you eating things that's causing inflammation in your body? So, it's also, like a there's a lifestyle factor to it. There's just-
PATRICK CASALE: For sure.
MEGAN NEFF: …because our systems are so vulnerable and we're moving through this world, it's a multiple system thing. And then, of course, if we're having any mental health condition on top of that, or medical condition on top of that, those are also some of those drivers for burnout.
PATRICK CASALE: Yep, absolutely [CROSSTALK 00:31:28]-
MEGAN NEFF: So, yeah.
PATRICK CASALE: That intensifies too when that's happening, right? Like, and I noticed that too. I should have mentioned that, like, my chronic pain has gone up pretty drastically over the last month or two, and I can tell, like, that's all tied in as well. So, when I'm starting to experience more and more acuity and intensity, I'm like, “I'm probably there.”
MEGAN NEFF: And that is, well, first of all, I'm sorry, as someone who also lives with chronic pain. Like, chronic pain flares are often the first domino for so many things for me. And I know for a lot of us. Knowing, like, what the triggering event is, I think that's part of… So, I talk a bit about, you know, burnout recovery, and like, building a life more resilient to burnout. I think knowing what our triggers are is a big, important piece of that. For me too, the chronic pain becomes a trigger. Because when my pain is flaring, I'm moving less, my sleep is also worse. I'm more prone to seek comfort through foods that I know cause inflammation in my body, that cause stomach pain in my body.
And so, those triggering events, and then knowing what they are, because it's like, okay, and I see you. I see your chronic pain, and I see the behaviors that want to follow when I'm in that cycle. And then, I see what it creates. And it takes me, like, walking through that cycle 20 times, right? Before I'm like, okay, maybe I'll try something different here.
PATRICK CASALE: Yeah, exactly. Yeah, spot on, spot on. And, you know, it's interesting, you know, if you make a post or two about burnout on social media, for example, and you'll get comments about like, isn't that just everyone's experience of life? Like, doesn't everyone just experience burnout? Because we live in capitalism and the world is on fire, and like all of the things.
MEGAN NEFF: We do. Like, all humans, probably in modern society, are experiencing some level of burnout, and it's not the same. It's not the same as autistic burnout.
PATRICK CASALE: And that's the big differentiating factor of like, it's not the same.
MEGAN NEFF: Yeah, yeah. And I think about it more like, kind of socially, like, when an autistic person says, “I'm in burnout.” What they mean tends to be really different. Like, I'm struggling to feed myself. I'm struggling to put words into sentences. Like, something that for someone else when they're in burnout doesn't seem like a heavy lift for us does.
PATRICK CASALE: Yeah, and I’m glad you named that. That's kind of what I wanted to get at, is that it's very different. I mean, I think we're all probably in some stage of burnout in this world right now.
MEGAN NEFF: We live in a dehumanizing world that's like, not supportive of our systems, or our minds, or our connections. Like, everything we talked about in the wellness series. You know, we live in anti-nourishing systems, and worlds, and so all humans are struggling, which is, again, that's where, with any conversation, it can be like us versus them, like autistic burnout, and we're struggling, but neurotypicals are fine. It's like, no, all humans are struggling. We're like the whole canaries in the coal mine thing. Like, I think we have a more exaggerated response often, but…
PATRICK CASALE: Yeah, thank you for breaking that down, because I think that's just an important point to make. You know, like everyone's struggling. I can't imagine I know a single human who's not experiencing some semblance of burnout, and it's just really not the same, and the longevity of it too is so different, and it's hard to differentiate, though, y'all. Like, I mean, life is hard. Life is really freaking hard.
MEGAN NEFF: There's another tagline, life is really freaking hard.
PATRICK CASALE: I'm glad this has been an uplifting episode, and those are always our favorite.
MEGAN NEFF: And with your voice, those are always our favorite.
PATRICK CASALE: Yeah, I'm not in, like, ER mode though, like last time, you know? Like, in the grief episode situation, I was super depressed. I'm not in that mode right now. Yeah, I think my [CROSSTALK 00:35:38].
MEGAN NEFF: Burnt out.
PATRICK CASALE: …right now. I'm burnt out.
MEGAN NEFF: Yeah, which, which makes sense. I mean, you've had a lot happening, and you've been traveling a lot, and you've been absorbing a lot of negative energy in the world, and are pretty impacted by that. So, I think of you as like a pretty hypervigilant person, at baseline. And then, high 2025.
PATRICK CASALE: Yep, yep.
MEGAN NEFF: Okay, yeah. Oh, I did have a thought, it was when you were talking about being on the couch and wanting to throw your phone. Okay, this is a totally divergent thought. I thought about how you've talked about OCD a bit, and some of your compulsions show up is like you can't have any notifications on your phone. And I was thinking about the OCD burnout connection, because some of the compulsions we do can be really energy exhausting. And then, burnout, like we're exhausted. What is some of the OCD stuff look like for you and burnout? Like, because also when I'm not sleeping, my OCD gets worse. But then, yeah, it was one of the first times my brain went to think about the OCD burnout connection. Does that…
PATRICK CASALE: No, I mean, it definitely relates. And yeah, I'm just trying to think of examples. Compulsions-
MEGAN NEFF: Because you are so like, okay, my inbox has to be zero, notifications have to be zero. Do you let any of that go when you're in burnout or does it… You do?
PATRICK CASALE: Yeah, I am so much less responsive, and that's another indication for me of like, because there is still that compulsive need to check, respond, delete, clear all the things, but I'm just like, I don't have the energy or the capacity to even care about how much agony this is causing me mentally by not being able to do these things right now.
MEGAN NEFF: But then, I would assume it's causing stress to see that [INDISCERNIBLE 00:37:34] yeah, yeah. And what about like, showers, like, I know you often will do like three showers a day, or [CROSSTALK 00:37:40].
PATRICK CASALE: Yeah. I mean that never changes. Like, I am a baseline to shower a day human, so, you know, I definitely have a compulsive need to constantly be washing my hands and, like, I probably put way too much hand sanitizer on at all times. But like, I haven't noticed an increase in any of that. Yeah. I mean, I don't know. I haven't noticed, and maybe I'll start paying attention more to that side of things for myself.
MEGAN NEFF: Yeah, I'll get pulled into more checking loops, checking this kind of [CROSSTALK 00:38:15]-
PATRICK CASALE: Like the whole checking situation. Like, did I leave the stove on type of thing?
MEGAN NEFF: Yeah, yeah. And it'll get worse where it's like, like, you know, I'll be driving down the road, and I'll be like, yeah, I know I turned off my hair thing or the stove, but I'll be like, “I just have to go back and check.” And I think it's partly because of that irritability is so much more it's like, I just can't handle the distress of this. So, even though I have a memory of turning it off, I need to go back and check.
So, like, it's almost like I have less control over my checking behavior. Like, whereas sometimes I can self-soothe myself when I'm leaving. I'll be like, “No, I do remember unplugging that. I know I want to go back and check what, but not going to. I don't have the same amount of patience to walk myself through that.
PATRICK CASALE: That makes sense. Yeah, I do notice, actually, now that you say that, like, the compulsive need to check and clear things intensifies, but I don't actually do it. So, the action actually decreases, which is interesting, but the need to, like, constantly, like, I'll check my inbox. I'll check my Spruce Health like group practice account. I'll check all of the things constantly, like, compulsively on loop over and over and over and over again. But I don't do anything about it. Like, I can't.
MEGAN NEFF: Yeah, I do that too. Like, because the only kind of work I really have access to is passive work. So, I'm checking, but then I'm not actively working on anything, so I'm just sitting there stressing myself out.
PATRICK CASALE: Yep, yep.
MEGAN NEFF: We're really smart, Patrick.
PATRICK CASALE: I like to think so too, yeah.
MEGAN NEFF: This is a recommended burnout strategy, just like passively checking on all the accumulating work, stressing yourself out.
PATRICK CASALE: Yeah, it's a blast, yeah. I don't know, I'm feeling that weird energy right now of like shifting.
MEGAN NEFF: Yeah, I can tell. I was like, okay, you're starting to get like antsy, like you're ready to wrap this episode up. Let’s do it.
PATRICK CASALE: Yeah. How do we wrap this up? Because I know we want to, you are doing burnout in your world, in NDI right now?
MEGAN NEFF: Yes. So, our summer theme is Burnout Everything. So, we're doing a burnout course in The Nook, and we're doing a burnout series on social media. So, we had talked about kind of loosely structuring this, yeah, my workbook, partly, because then we just don't have to think about it. So, our goal today for this episode was to talk about, like, what burnout is, what our kind of signs or triggers are, internal signs, external signs.
I guess if we do want to zoom out and offer some concrete things as we wrap this up, one thing I'll say, something else I also talk about a bit is, one of the vulnerabilities is because of interoceptive awareness challenges or alexithymia. A lot of us don't know where we're at in the stress cycle or the burnout cycle till we've hit what you call that, like, the bricks, which means we don't have as much space to intervene at a point where it's like, okay, I could pull back here. I could implement some restorative practices. And then, by the time we do know we're in burnout, we don't have much capacity to support ourselves. So, I think that's part of the vulnerability for a lot of us.
So, one of the exercises that can be helpful when we're thinking about burnout is to spend some time thinking about, what are my external markers? What are my internal markers? What are my triggers? So, like for you, you know chronic pain is a known trigger. For me, when I get pulled into an insomnia loop, I know that's a trigger. Or when something really stressful happens in my life, I know I get a spike of cortisol energy, typically, followed by a crash, so I know that's a trigger.
But for those who have interoceptive awareness challenges, really focusing on the external triggers. So, maybe it is something like we've been talking about, of like, I'll start doing more passive work, but not active work where I'm just, like, checking things. Or maybe it's relying on safe foods more. I know for me when I'm in burnout, like, give me three Amy's gluten-free vegetarian burritos a day, and I will just eat that, and that'll be the only food I eat. Like, it will look more autistic. And by autistic, I mean the like diagnostic criteria, like those traits that often tend to elevate during stress, like need for sameness, need for routine, socializing is going to get harder, communication is going to get harder. So, we will look more autistic when we're starting to track toward burnout. So, people knowing what their external signs are, I think, can be really helpful, especially, if you have less access to your kind of internal signals.
PATRICK CASALE: Yeah, yeah, yeah, I love that. Yep. The reason we're following your lead this month or this season is like path of least resistance y'all. We know it's an important topic. We know so many of you are dealing with this, including ourselves. So, path of least resistance in terms of, like, what collection are we going to do this series?
MEGAN NEFF: Because we're literally like, what are we going to talk about?
PATRICK CASALE: Well, because that's how we plan this podcast is, what are we going to talk about? We go back and forth about it for a while. But we hope this series collection is going to be helpful for everyone and hopefully, helpful for ourselves as we move along it as well.
One thing I want to also add is like, this is when we start to see a lot of people who are discovering that they're autistic later in life is when you have hit such intense periods of autistic burnout that something has to give. Like, something becomes acutely aware that, like, all the things I've tried, not exactly working, all the ideas that I had, potential diagnoses, et cetera, they're not lining up. Like, this is when we're seeing a lot of intensification.
MEGAN NEFF: Absolutely, absolutely. I would say, for a lot of adults, this is when they get identified as autistic, when they're burned out. And that's something, when I'm doing clinical trainings, I like to teach people that, because it means the moment that they're, like, catching a person or interacting with them, it's not just about the autism, it's about the burnout. And that's a really vulnerable time for a lot of us, but yeah, because also the masking. Like, we aren't able to mask in the same way when we're in burnout. So, for a lot of autistic adults, it's like they're wrapping their mind around an autistic identity, and they're grappling with burnout at the same time. And that's a lot for a person.
PATRICK CASALE: It's really heavy. It's really heavy. So, y'all are not alone in this, okay? If you're in this space, just know that. And we're going to link a ton of resources in the show notes.
And like I mentioned before, we started talking really, episodes two and 47 where we kind of deep dive, like, more clinical definition of autistic burnout. So, reference those as well. We're not going to deep dive that in this collection. There's no need to reinvent the wheel. So, anything else?
MEGAN NEFF: Okay, no, I think that's a good summary. And then, I think we're going to, next episode talk about kind of how to think through building a burnout recovery plan.
PATRICK CASALE: Yep, yeah. So, we'll give you some more tangible stuff in the next episode too, and hopefully, you can incorporate that into your day-to-day.
MEGAN NEFF: Oh, what if our city gets a makeover as we go through this series?
PATRICK CASALE: Okay, okay, we are going to continue this burnout city. What was the tagline? I already forgot. It was like something [CROSSTALK 00:45:40].
MEGAN NEFF: Oh, goodness, like the place for sensory hell, or chronic sensory hell. I'll have to re-listen to it. It's a good, tight one.
PATRICK CASALE: Yeah, we already forgot 45 minutes later. But yeah, we're going to continue talking about this, and you know, that's just going to help us really build this world, and hopefully, create a more neuro-affirming one as we go. So, episodes are out on Fridays on all major platforms and YouTube. And you can like, download, subscribe, and share. And goodbye.
