Published on 12, July, 2020
Hello my 15 year old son became hugely anxious and stopped attending school about 5 months ago. He’s since had an autism diagnosis and we’ve come to realise that he has been masking and struggling for years and that the pressure of GCSEs finally pushed him to a point where he couldn’t continue. I feel horribly guilty that we didn’t spot it before now and he has been struggling for so long - we had a big bereavement in our family when he was 4 and I think everyone assumed his behaviour was trauma related.
Other than the autism assessment he’s been unable to attend any medical/therapy appts in recent months - he gets to the door and then has a melt down. So we’ve decided to take all pressure off and just give him time to recover and only do things he feels able to do. So no school (and accepting GCSES prob wont happen this year) and focussing on his love of music and films.
However, I am worried about his mental health - anxiety is still high (although not as intense as it was) and he has body image issues. He is not self harming and doesn’t seem to have suicidal ideation. We had our first meeting with CAMHS last week and I really don’t feel like they are taking his mental health issues seriously and are only focusing on signposting autism support. He’s found art therapy helpful in the past (for trauma) but that therapist feels he needs more help than she can offer eg cbt.
I’d love to hear from anyone who’s been in this situation, am I doing the right thing by allowing time for him to recover with the hope that he’ll manage more therapy in the future?
thank you!
Hi! You are doing the right thing! It’s so important to rest and retreat when burnt out. I was diagnosed at age 25 and I am struggling with very severe burnout again as I spent years and years pushing through. I wish I had known earlier on that I am autistic so that I could have been more mindful of how much energy certain things take and could have learnt to better manage everything to avoid burnout.
It can take a really long time to recover from burnout so it’s good you are giving your son the time he needs. Engaging with his special interests is also a good sign! In terms of support, sadly I’ve also not had good experiences with mental health services- they often don’t really understand about autism and burnout can get mistaken for depression- I’ve been advised on countless occasions to ‘socialise more’ when burntout which was the last thing I needed. What I haven’t figured out yet is how to live life in a way that doesn’t lead to endless cycles of burnout- rest and time off is essential but if after the time off you return to the same environnent that caused burnout in the first place and handle things as before you’ll probably just burnout again. I think it is important to think about burnout prevention before returning- i haven’t figured out yet what that means for me but I am sure with your support you and your son can come up with ideas- it might mean thinking about adjustments at school or whether some study from home would be suited. Coming up with ways to ensure rest eg. Maybe somehow setting aside time for music and film. And thinking about other stress factors and if any can be avoided. I am sure there are also techniques to help with anxiety but I’ve also not figured that out yet. I think the key is probably to figure out what works for your son. It’s very good you are being so supportive and are allowing him to properly take time off. It will be very helpful down the line and hopefully it will avoid sleeping into endless cycle of burnout.
In terms of therapy, CBT is what the NHS tends to offer (at least for adults) however this is not always the best suited for autistic people. The NICE guidelines actually state that any therapy should be adapted in case of autistic patients. I have had some CBT on NHS - it wasn’t particularly helpful for me but that doesn’t mean it won’t be for someone else ( the adult CBT course I was on was very structured and not individualised)Ideally you would probably have a specialist therapist that understands about autism and burnout- this is at least what the autism advisor at my university has recommended for me. My university might help me with funding to put this into place now as they feel the standard NHS CBT is not specialised enough in my case. Unfortunately the specialist therapist would only be available privately. I hope with the help of uni I may be able to access this- will know more in a few months. I don’t have very high expectations though for therapy in general but maybe this would actually be helpful
Thanks. I can relate to putting yourself under pressure to go back to studying/work or even just to be productive. I think this is quite common. Taking time off for me is really hard even when burnt out- I don’t like not having something to do or not being productive and have high standards etc. feel guilty about not coping etc. In the past I actually only managed to stop and take time off after a GP told me I had to (I ended up severely underweight as I was just not taking care of myself and stress worsened IBS). I think people sometimes assume that when you are burnt out it feels good to take time off but it actually can be really hard to deal with even when a break is essential. There is usually the initial relief but then it gets harder. I think it is really good that you are supporting your son in taking the time he needs to recover and letting him know it is okay and a good and necessary thing to do. I think being unable to tell when you need some rest or a break and also finding it hard to allow yourself to do so is probably a factor that contributes to burnout in first place.
I really hope you find the support you need for your son. I had quite a few different counsellors over years (mostly before my autism diagnosis) and I think if it doesn’t feel right with a certain counsellor it is best to stop. Because therapy can actually be harmful and counterproductive- people don’t often talk about this but I would listen to your instincts- I think some increase in anxiety after a session is probably something that can happen but if it doesn’t feel right, it might be better to find another counsellor or try another type of therapy. I’m probably biased on this matter though as I have some issues that were actually exacerbated through therapy.
wishing you and your son all the best!!
Ann thanks so much for taking the time to reply and I’m sorry you’re experiencing burnout at the moment. It’s good to hear you think we are probably taking the right approach! It’s hard cause there is a lot of pressure to get him back to school (he puts it on himself too). As a mum there is a strong urge to try and fix and do something so doing nothing except supporting and being there feels quite hard!Im fortunate in that I can pay for some therapy for him but he found the few sessions of cbt he had really confronting and the thought of each session just escalated anxiety to an uncontrollable level so it felt sensible to stop pushing. I think you’re right some of this is finding the right therapist. I do hope you manage to access the support you need too.