ADHD & Burnout
Recently I was asked 'how do you manage to do EVERYTHING?!' by someone who also has ADHD. I know they genuinely meant this in a 'please help' kind of way, as they too have ADHD, and from the outside looking in it can seem like I'm really productive, or that I manage to contribute equally in all areas of my life... Work, marriage, fatherhood, hobbies, exercising, family, socialising etc. But the truth of the matter is that it comes in bursts & I often run the risk of burn out.
Burnout is incredibly common in those of us who are neurodivergent. Often our minds are going at a hundred miles per hour, despite what we look like from the outside, which means that many people feel (and evidence suggests) that ADHDers more easily reach burnout when compared to those without ADHD. Burnout also looks very different for everyone, for some of us it means going about our days as usual but doing the bare minimum. For others, it's crippling to the point of being unable to leave their bed.
Burnout & Me
One of the most impactful periods of burnout for me in recent years was during lockdown. I was performing well in my job, had all my hobbies going at full steam, and everything was going relatively well. Suddenly, lockdown happened and all of my structures and coping mechanisms fell apart. I went from speaking to around 90~ people a day as a lecturer to a single person in real life and blank grey avatars online. I couldn’t think straight and it got to the point where I became anxious the moment a new email pinged into my inbox.
Being unable to access support, interact with others, and the feelings of isolation during that period triggered my burnout, yet I had no real way of preventing it because the whole of the world was shut down. After a period of rest to rejuvenate and build back up, I was able to get back to my standard operating without too much impact on my life. These days, I’m pleased to say I can usually feel it approaching, and I have my own ways of preventing it as best I can, mainly in the form of careful diary planning & utilising annual leave strategically.
There’s also a lot of power in saying “No”. Whether that be “Not right now”, or “No I don’t think I’d be able to take that on”.
Burnout & Neurodiversity
The ADHD brain has impaired activity in four functional regions, meaning that someone with ADHD often has to work harder to focus on certain tasks. Sleep and anxiety disorders are also common in those with ADHD & Autism, so when combining mental exhaustion with irregular sleep patterns or a lack of sleep, it can lead to burnout and many health complications that manifest both mentally and physically.
According to a Swedish study (Högstedt et al, 2022), more than a third of ADHD/Autistic adults in Sweden received sickness compensation, compared with 2.4% of the population overall. 70% of ADHD & ASD adults in the study also rated their ability to work as reduced. ADHD & ASD is often associated with poor long-term health, coupled with bouts of burnout it can severely affect a person's ability to work effectively. Yet due to a lack of effective understanding, support & systemic infrastructure many neurodivergent people who are able to work are often excluded from employment.
Evidence suggests that burnout impacts cognitive processes such as planning, organising, memory and regulation of attention… All things that someone with ADHD likely already struggles with due to the executive functioning impairments and core symptoms of ADHD. Therefore, burnout makes ADHD symptoms worse, and can often become more debilitating more rapidly and/or severely for someone with ADHD than for someone who is neurotypical.
What does burnout look like?
Exhaustion (emotional & physical)
Feeling tired all day, yet struggling to sleep at night is a red flag when it comes to burnout. The effects of mental burnout often manifest in a person feeling physically exhausted as the burnout seeps through the entire body. This can make previously simply every-day tasks incredibly difficult. This can also manifest as muscular and bodily aches for no discernible reason, as increased inflammation from the physical stress impacts on the immune system.
One of the non-diagnostic but common symptoms of ADHD is a difficulty in regulating emotions. As a person is born with ADHD (i.e. it doesn’t develop with age, you either have it or you don’t), they are likely to have developed coping mechanisms throughout their lives in order to regulate their emotions to the best of their ability, or they may be taking medication to help with this. But when burnout strikes, despite their best efforts and resources, that emotional capacity is greatly decreased.
Cynicism/detachment
Activities and events that they may have previously enjoyed now become a chore and they struggle to find pleasure in things that once delighted them. Relationships, friendships and personal connections can become strained as they struggle to engage with those around them. People experiencing burnout at work begin to feel that their job is no longer important. Many state that they no longer care about their job or their daily tasks at work. This cynicism may lead some to start looking elsewhere for work, relationships, hobbies, and other activities. This can often lead to a toxic cycle in which the person burning out is constantly complaining about aspects of their job/life that were once not an issue, which in turn fuels the detachment due to the negative focus on the topic.
Inefficacy / decreased sense of accomplishment
This typically plays out in one of two ways:
1 - The Imposter Syndrome kicks in at full speed and they may become incredibly self-critical and withdrawn, doubting themselves, their abilities, their relationships and their work. This often makes a person question their career & responsibilities, feeling like they have no impact or their job doesn’t matter. They may question their abilities when it comes to hobbies, and lack the passion & creativity they once had.
2 - The person burning out may not feel that they personally are inefficient, but that the impact that you actually have is limited and decreased due to problems outside of their control (such as systemic failures, bureaucracy, and other people). This leads people to feel like they are not making a difference at work, and that they likely never will. This decreased sense of accomplishment then begins to justify the belief that your work is pointless and you don’t matter to those around you (building onto the cynicism previously discussed). In some careers, this can be particularly damaging. Healthcare professionals and teachers for instance, may stop believing that they are helping people or are able to help people, which can lead to compassion fatigue, disengagement, and ultimately a self-fulfilling prophecy where you stop being as effective as a professional. Burnout then begins to impact not only yourself and those around you, but also your patients/students.
Burnout & Depression/Anxiety
Many of these feelings appear on a scale for depression or anxiety, and someone neurodivergent is more likely to experience depression and/or anxiety by rates of almost 7-8x average. However, typically burnout is temporary, which means it should only last a short period of time. If it persists, or occurs frequently, it’s important to speak to your GP and/or access additional professional support.
How do we prevent it?
When it comes to work (a frequently reported cause of burnout), it’s actually been found that someone with ADHD may find symptoms lessen when their job is appropriately stressful and challenging, because their attention is forced and boredom is reduced, keeping their ADHD mind busy. Although on the other side of the coin, becoming a ‘workaholic’ may increase the risk of burnout, so it can be a fine line to tread (especially given evidence that suggests workaholism risk is increased for ADHDers).
Other things that can help in terms of work:
Reducing your workload expectations with regard to tasks that you may find mundane (such as admin)
Having a task list/job description that is clearly defined, with accessible instructions
Flexibility in when, where and how you work
Feeling seen and understood at work
Support around sensory sensitivities (another upcoming blog!)
Reducing the accumulated stress of battling with the system and juggling an unsustainable work situation
Often in the case of someone who is neurodivergent it can help to assess your career as a whole, if you’re frequently experiencing burnout. If you have a special interest, it may work for you to find a career within that industry. Someone with ADHD is significantly more likely to be self-employed, because in a more ‘creative’ career no two days are usually the same. So have a think about being a little more non-conformist when it comes to your approach to work. Again, I’ve got more on this coming soon in a different blog!
Whatever burnout looks like for you, prevention is better than cure. Take some time to learn your own triggers, plan your time, assess your work & home situations, and allow yourself time and grace to recover from difficult situations. I can’t stress enough the importance of prioritising your mental health, and I hope you’ve found this blog helpful & informative.
~ Dr Tom
References:
Andreassen et al (2016) The Relationships between Workaholism and Symptoms of
Psychiatric Disorders: A Large-Scale Cross-Sectional Study. PLoS ONE.
Högstedt, E., Igelström, K., Korhonen, L., Käcker, P., Marteinsdottir, I., & Björk, M. (2022).
‘It’s like it is designed to keep me stressed’—Working sustainably with ADHD or autism.
Scandinavian Journal of Occupational Therapy, 30(8), 1280–1291.
Lasky et al (2016) ADHD in context: Young adults’ reports of the impact of occupational
environment on the manifestation of ADHD. Soc Sci Med
Turjeman-Levi et al (2024) ‘Executive function deficits mediate the relationship between
employees’ ADHD and Job Burnout’ AIMS Public Health. 11(1). Pp.394-314.