This the first part of our two-part conversation with Dr. Megan Neff, a clinical psychologist, neurodivergent advocate, and a mother of two, who shares insights on autistic burnout—a phenomenon deeply intertwined with chronic pain and invisible illnesses like fibromyalgia.
Before we dive into the conversation with Dr. Neff, I’d like to share a heartfelt message from a listener in California:
"Dr. Lenz, I am a parent of a trans, autistic, and disabled teen with POTS and debilitating chronic pain. While there's no formal fibromyalgia diagnosis, there is one for dysautonomia. Managing the nervous system needs for autism, gender dysphoria, and chronic pain feels overwhelming. No real question, just that a lot of the usual ways of approaching things do not apply."
This message resonates deeply with the challenges many face when navigating overlapping conditions like autism and chronic pain. It underscores the importance of self-awareness and understanding, especially in the context of autistic burnout—a topic we'll explore today with Dr. Neff.
Meet Dr. Megan Neff
Dr. Megan Neff is a multifaceted professional: a clinical psychologist, neurodivergent advocate, mother, therapist, researcher, and speaker. She describes herself as an "existential misfit," constantly questioning the big things in life and never settling for simple answers. Based in Portland, Oregon, where she lives with her spouse and two children, Dr. Neff's professional journey has been marked by zigzags and existential curiosities, leading her to become an advocate for the neurodivergent community.
Her practice, NeuroDivergent Insights, is dedicated to increasing awareness about autism and ADHD, particularly among those who have been historically overlooked or misunderstood in medical and therapeutic settings. Her work is fueled by a personal journey that began when her child was diagnosed with autism—a revelation that led her to realize her own neurodivergence.
The Zigzag Journey into Autism Awareness
Dr. Neff’s path was anything but linear. Initially, she envisioned herself pursuing academia, diving into philosophical waters. But life took a turn when her child was diagnosed with autism during the final stages of her doctorate. This diagnosis prompted a deep dive into research about autism, particularly in girls, leading Dr. Neff to a startling realization: she, too, is autistic.
This epiphany ignited a passion in Dr. Neff to raise awareness about the vast number of undiagnosed autistic adults, particularly women and genderqueer individuals. She recognized a significant gap in her own training and the broader psychological field, which often fails to adequately identify and support neurodivergent individuals, especially those with non-stereotypical presentations.
A Lack of Training in Autism Diagnosis
One of the most striking aspects of Dr. Neff's journey is her candid acknowledgment of the gaps in her formal training. Despite earning a doctorate in clinical psychology with a focus on health psychology, she received minimal education on autism, particularly in adults. This oversight is not uncommon, as many mental health professionals are still trained to view autism as a childhood condition, often overlooking its manifestations in adults.
Dr. Neff’s experiences highlight a significant issue in the healthcare system: many autistic adults, especially those without co-occurring intellectual disabilities, remain undiagnosed and misunderstood. This lack of recognition can lead to misdiagnoses, such as bipolar disorder or borderline personality disorder, due to the emotional reactivity that often accompanies autistic burnout.
Understanding Autistic Burnout
So, what exactly is autistic burnout? Unlike occupational burnout, which many are familiar with, autistic burnout is a different beast altogether. It’s not recognized in the DSM, but it’s a very real and debilitating condition that affects many autistic individuals.
Dr. Neff explains that autistic burnout is best understood as a burnout of the nervous system. Autistic individuals typically have more sensitive nervous systems, making them more prone to burnout. This condition is characterized by:
1. Chronic Exhaustion: This is not just physical tiredness but a pervasive exhaustion that affects every aspect of a person’s life—emotional, cognitive, and physical. It can feel like hitting a wall that one simply cannot get past.
2. Increased Sensory Sensitivity: Individuals in burnout often experience heightened sensitivity to sensory inputs, leading to more frequent sensory meltdowns or shutdowns. Everyday transitions, like moving from a shower to the cooler air outside, can become overwhelming and trigger significant emotional reactions.
3. Loss of Skills: Perhaps the most confusing aspect of autistic burnout is the loss of previously acquired skills. A person who was once capable of handling daily tasks may suddenly find themselves unable to perform basic activities of daily living. This can be disorienting and distressing, not only for the individual but also for those around them.
Misdiagnosis and Functional Assessment
Dr. Neff also addresses the issue of misdiagnosis. Emotional meltdowns, a common feature of autistic burnout, are often misinterpreted as symptoms of bipolar disorder or borderline personality disorder. This is particularly true for women and girls, who are more likely to be misdiagnosed due to their emotional reactivity.
In terms of assessing burnout, Dr. Neff advocates for using functional assessments like the Fibromyalgia Impact Questionnaire (FIQ), which can track improvements over time. This approach helps individuals recognize progress in managing their condition, even when it feels like there is none.
Moving Forward
As our conversation with Dr. Neff illustrates, understanding and addressing autistic burnout requires a nuanced and informed approach. It’s about more than just recognizing the symptoms; it’s about understanding the underlying nervous system sensitivities and the profound impact burnout can have on an individual’s life.
In the next part of this interview, we will delve deeper into the intersection of autistic burnout and chronic pain, exploring strategies for management and support. Stay tuned for more insights from Dr. Megan Neff.
Remember, while we discuss these topics, it’s important to consult with your own healthcare provider for personalized advice and treatment.
Conclusion
Dr. Megan Neff’s journey from academic aspirations to becoming a leading advocate for neurodivergent individuals is a testament to the power of self-discovery and the importance of filling the gaps in our understanding of autism, particularly in adults. Her insights into autistic burnout offer a valuable perspective on a condition that affects many, yet remains poorly understood in both medical and psychological fields.
If you’d like to learn more about Dr. Neff’s work, you can visit her website, NeuroDivergent Insights.
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