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, separate from the autism itself, may help sufferers of catatonia to articulate their needs better and to get better supports at school or at work. 

*Likewise, understanding the link between autistic burnout and autistic catatonia might help autistic people to seek better medical care. Autistic people are used to being turned down, minimized, and even gaslit when they bring their concerns about autistic burnout to doctors. The term "burnout," which is commonly used to refer to a depressive lack of interest in work or to a period of normal strain and fatigue, may obscure the seriousness of the medical problems that autistic catatonia actually entails. It is possible that, if autistic people were to inform their doctors or psychologists about medical catatonia/catatonic deterioration, and to use the language of catatonia/catatonic deterioration, they might be able to have an easier time communicating their medical concerns, and thus to have more helpful conversations with their doctors. The risk of further deterioration might thereby be avoided. 

* Recognizing the overlaps between autistic burnout and autistic catatonia may help us to "pool" our knowledge about these disorder(s), in order to better understand how to prevent their onset. While clinicians writing about catatonia generally claim little knowledge of how and why catatonia might emerge, autistic people often have a very well articulated sense about what things might bring on autistic burnout. If in fact burnout and catatonia overlap, then it falls to reason that the autistic community has a well developed collaborative understanding of the natural causes and precursors of mild catatonia. These causes include major life changes, illness, and other well recognized stressors, just as clinicians have speculated, but they also include features that clinicians might be less prone to spot themselves. Autistic people, for example, are much more likely to focus on the demands of masking as a major source of autistic burnout. They are likewise much more likely to focus on unmasking as a source of recovery. 

* Just as significantly: recognizing this overlap may help us to pool our knowledge in such a way as to treat these disorders more effectively. Autistic people have produced a wealth of treatment advice internal to their community, which often focuses on rest, on unmasking, and on taking leaves from work, school, and play wherever possible--sometimes much longer leaves than would seem normally advisable. Clinical psychology offers environmental and psycho-ecological approaches to catatonia, which underscore the wisdom of conventional autistic treatments for burnout, while simultaneously emphasizing the risks of letting burnout go unchecked. It also offers potential pharmaceutical treatments, as clinical studies have shown that lorezapam is very commonly effective among people with catatonia. A person suffering from extreme autistic burnout might inquire with a physician about trying a course of Ativan in order to help treat or to help rule out catatonia (although of course not all catatonia responds to lorezapam). Patients suffering from burnout might benefit from reading Dr. Shah's Catatonia in Autism. Patients suffering from mild to moderate catatonia might benefit from reading Dr. Raymaker's "Defining Autistic Burnout," and in particular the wonderful and moving recommendations on pp. 138-139, as to how to recover from burnout. A full discussion of how all these partial solutions and perspectives might be synthesized lies beyond the cope of this series of posts, although I may report back as I read these texts more deeply myself. For now, I will have to stop with this outline of possibilities. Speaking for myself, at least, the greatest benefit of this synthesis would simply be that it offers greater hope for recovery than either approach taken by itself.