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Component 5. Reviewing Culprit Medication

Somehow I missed posting this information originally, so I'm adding it after the fact. Here are my notes on Component 5.  Here again, the advice in Dr. Shah's book about meds is really for doctors, and you should give your doctors the book, but there are some basic take-aways. Ativan, under close supervision, is often really helpful for catatonia, and as a matter of fact, it can even help doctors diagnose catatonia, because it tends to work differently on catatonic and non-catatonic people. (If your Ativan is all of a sudden making you feel more lucid and awake and capable of fluid movement/normal speech, whereas it used to make you feel sleepy...that's one possible sign that your severe burnout might actually be catatonic.) On the other hand, anti-psychotics can be really counterproductive for catatonia; they are usually a Bad Idea. (Tl;dr: if you think you might have/likely have autistic catatonia or severe burnout, don't let your doctor put you on something like Abil...
Dr. Raymaker's work on autistic burnout contains an invaluable table of suggestions for surviving or avoiding burnout, which they have grouped under the following categories: being autistic; formal supports; strategy; individual support; community support; peer support; attending to autistic needs; unmasking; using autistic strengths; reasonable accommodations; instrumental support; mental health support; time off/breaks; social withdrawal; reduced activity. It bears noting that, elsewhere, Dr. Raymaker has explicitly distinguished between autistic burnout and catatonia, suggesting that catatonia may be feature in burnout but that burnout itself is a distinct, and generally broader, phenomenon. Yet these suggestions (found on pp. 138-139 of her 2020 article) may help those suffering from catatonia as well as those who have identified their experience as "burnout."  Many people suggest finding communities and social connections where masking is unnecessary, or otherwise fi...
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From 2018 to 2023, I experienced a series of episodes that I came to understand as autistic burnout, of varying degrees of intensity and persistence. Until 2022, I was self-diagnosed with autism but had not received a professional diagnosis, and neither I nor anyone else connected my symptoms of autistic burnout with autism. After a year of profound exhaustion, I began to undergo episodes of "brain fog" or semi-consciousness, which I eventually came to call dissociation, as a kind of personal shorthand. A friend of mine eventually called 911 for me (with my permission) and I was admitted to the hospital for a week, where they ruled out absent seizures, and then a wide range of mental health conditions, before sending me home without an answer. It was clear to the hospital's psychiatrists that I had PTSD, but for what reason no one could say. During the course of these five years, I strove to keep a demanding full-time job, with mixed success at best. I was often on leave ...
Many of Dr. Amitta Shah's recommendations, in Catatonia, Shutdown and Breakdown in Autism , were not found anywhere else in my reading. Shah is very transparent that the book is designed for clinicians and caretakers; it is definitely not a DIY guide to recovering from autistic catatonia. Some autistic people may even find its language (including use of terms like "high-functioning") to be a bit off-putting. Nonetheless, I found it to be an invaluable read Shah is very direct about the challenges of living alone for those who might be recovering from catatonia; one of the strongest recommendations of this book might be for the person in burnout to find a way to get as much direct support as possible. She suggests that a great deal of support may be necessary for recovery, and that even one-on-one support might be necessary in the early stages of healing. Many of Shah's recommendations for managing catatonia echo those provided by autistic people for managing autistic ...

Conclusions and Take-Aways

Recognizing that the phenomenon of autistic burnout and the phenomenon of autistic catatonia are one and the same could have many benefits for autistic people. Here are a few that come to mind.  * The first is simple safety. Catatonia is a very dangerous condition, and autistic catatonia is progressive if unchecked, often moving from mild to severe. Autistic people experiencing burnout should understand the signs of autistic catatonia so that they can self-monitor. They should know when to request medical supervision or even go to a hospital for care. * Another benefit has to do with disability rights and disability advocacy. People with autistic catatonia frequently have a hard time seeking or explaining their need for accommodations, which may differ from the accommodations needed by other autistic people in the same workplace, or from the accommodations needed by the same person before the onset of catatonia. Recognizing autistic catatonia as a disorder with its own prognosis, s...

Autistic Catatonia and "Autistic Burnout": Some Possible Overlaps (Part 4 of 5)

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In what follows here I will describe some of what I see as the similarities between "autistic burnout," as autistic people often use the term, and the development of autistic catatonia, as outlined by the clinicians cited in the prior post.  Among the most common shared features might be loss of speech, either partial or total: at times this might take the form of difficulty finding the right word (anomia), of slowed speech or of partial speech. The anonymous author of the blog "Musings of an Aspie" offers a compelling record of their own experience of partial speech loss, in "Uncooperative Words and Where Do I Go From Here." Others lose speech entirely for some period of time, from minutes to months of years. Some discussion of speech loss is found in a very large number of accounts of burnout and is, of course, a major feature of mild catatonia.  Other shared features might be more subtle. As an example, I've included a simple graphic made by @actual...

Amitta Shaw, et al. Autistic Catatonia (also called Catatonic Breakdown)

Research into autistic catatonia is well-established; early work in the field had been published by the year 2000, and study of the topic has continued since. As recently as 2022, a major overview of the topic was published in the journal Nature --which, as many know, is one of the most prestigious scientific journals in the world, with a readership of three million unique readers per month. (The article is titled "Catatonia in autism and other neurodevelopmental disabilities: a state-of-the-art review.") As a result, it is easy to find descriptions of autistic catatonia online.  Here are a few basic facts about autistic catatonia: * Somewhere between 5% and 20% of autistic people are said to present with catatonic features at any given time. * Autistic catatonia may apparently be triggered by stress or trauma, but its onset does not always have an obvious cause.  * Autistic catatonia is often hard to recognize, even for clinicians, because its presentation is quite gradu...