chronicdivergent

[chronicdivergent]

As a cancer survivor, I’m BEGGING you to wear a mask at the hospital. My immune system is shit. I wear a mask, and it helps. But it helps even more if others are also masking.

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The data does not support the assumption that all burned out people can “recover.” And when we fully appreciate what burnout signals in the body, and where it comes from on a social, economic, and psychological level, it should become clear to us that there’s nothing beneficial in returning to an unsustainable status quo. 

The term “burned out” is sometimes used to simply mean “stressed” or “tired,” and many organizations benefit from framing the condition in such light terms. Short-term, casual burnout (like you might get after one particularly stressful work deadline, or following final exams) has a positive prognosis: within three months of enjoying a reduced workload and increased time for rest and leisure, 80% of mildly burned-out workers are able to make a full return to their jobs. 

But there’s a lot of unanswered questions lurking behind this happy statistic. For instance, how many workers in this economy actually have the ability to take three months off work to focus on burnout recovery? What happens if a mildly burnt-out person does not get that rest, and has to keep toiling away as more deadlines pile up? And what is the point of returning to work if the job is going to remain as grueling and uncontrollable as it was when it first burned the worker out? 

Burnout that is not treated swiftly can become far more severe. Clinical psychologist and burnout expert Arno van Dam writes that when left unattended (or forcibly pushed through), mild burnout can metastasize into clinical burnout, which the International Classification of Diseases defines as feelings of energy depletion, increased mental distance, and a reduced sense of personal agency. Clinically burned-out people are not only tired, they also feel detached from other people and no longer in control of their lives, in other words.

Unfortunately, clinical burnout has quite a dismal trajectory. Multiple studies by van Dam and others have found that clinical burnout sufferers may require a year or more of rest following treatment before they can feel better, and that some of burnout’s lingering effects don’t go away easily, if at all. 

In one study conducted by Anita Eskildsen, for example, burnout sufferers continued to show memory and processing speed declines one year after burnout. Their cognitive processing skills improved slightly since seeking treatment, but the experience of having been burnt out had still left them operating significantly below their non-burned-out peers or their prior self, with no signs of bouncing back. 

It took two years for subjects in one of van Dam’s studies to return to “normal” levels of involvement and competence at work. following an incident of clinical burnout. However, even after a multi-year recovery period they still performed worse than the non-burned-out control group on a cognitive task designed to test their planning and preparation abilities. Though they no longer qualified as clinically burned out, former burnout sufferers still reported greater exhaustion, fatigue, depression, and distress than controls.

In his review of the scientific literature, van Dam reports that anywhere from 25% to 50% of clinical burnout sufferers do not make a full recovery even four years after their illness. Studies generally find that burnout sufferers make most of their mental and physical health gains in the first year after treatment, but continue to underperform on neuropsychological tests for many years afterward, compared to control subjects who were never burned out. 

People who have experienced burnout report worse memories, slower reaction times, less attentiveness, lower motivation, greater exhaustion, reduced work capability, and more negative health symptoms, long after their period of overwork has stopped. It’s as if burnout sufferers have fallen off their previous life trajectory, and cannot ever climb fully back up. 

And that’s just among the people who receive some kind of treatment for their burnout and have the opportunity to rest. I found one study that followed burned-out teachers for seven years and reported over 14% of them remained highly burnt-out the entire time. These teachers continued feeling depersonalized, emotionally drained, ineffective, dizzy, sick to their stomachs, and desperate to leave their jobs for the better part of a decade. But they kept working in spite of it (or more likely, from a lack of other options), lowering their odds of ever healing all the while. 

Van Dam observes that clinical burnout patients tend to suffer from an excess of perseverance, rather than the opposite: “Patients with clinical burnout…report that they ignored stress symptoms for several years,” he writes. “Living a stressful life was a normal condition for them. Some were not even aware of the stressfulness of their lives, until they collapsed.”

Instead of seeking help for workplace problems or reducing their workload, as most people do, clinical burnout sufferers typically push themselves through unpleasant circumstances and avoid asking for help. They’re also less likely to give up when placed under frustrating circumstances, instead throttling the gas in hopes that their problems can be fixed with extra effort. They become hyperactive, unable to rest or enjoy holidays, their bodies wired to treat work as the solution to every problem. It is only after living at this unrelenting pace for years that they tumble into severe burnout. 

Among both masked Autistics and overworked employees, the people most likely to reach catastrophic, body-breaking levels of burnout are the people most primed to ignore their own physical boundaries for as long as possible. Clinical burnout sufferers work far past the point that virtually anyone else would ask for help, take a break, or stop caring about their work.

And when viewed from this perspective, we can see burnout as the saving grace of the compulsive workaholic — and the path to liberation for the masked disabled person who has nearly killed themselves trying to pass as a diligent worker bee. 

I wrote about the latest data on burnout "recovery," and the similarities and differences between Autistic burnout and conventional clinical burnout. The full piece is free to read or have narrated to you in the Substack app at drdevonprice.substack.com

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TW for depressing thoughts around fatigue, energy, chronic illness, depression, loss/grief

Sometimes, I’m more active than normal, I get more done, and it feels really nice.

But sometimes, my fatigue flares and leaves me laying in bed, exhausted, indescribably thankful for my kitty laying next to me and keeping me grounded despite the swirl of anxious and depressing thoughts.

Because I remember how, in high school, I would so often “sleep in” until noon on the weekends to catch up on rest. How a few years ago, I would sleep until 1 or 2pm. How now, I find myself still in bed, aching and tired, even past 4.

I find my thoughts turning to my grandfather’s concerned remarks about my grandma—“she’s sleeping more these days.” The weight and sadness and concern in his voice. The unspoken fear and knowledge that both of my grandparents are past the midpoint of their lives. The thought that sleeping more is indicative of a decline, in health and in life and in year’s remaining. And I think again of how much I sleep.

And I feel shame. Shame for the rest that my body needs and craves. Shame for the time that I spend away from the waking world—away from responsibilities and from family, equally. Shame for the understanding that no amount of rest will ever fully restore me. Shame for waking with the weight of exhaustion still hanging over me, and the sense that the time I spent could have been used better, or at least more efficiently.

I feel shame, and grief, for the knowledge that those close to me have long since been out of bed. Doing productive things with their time. Building experience and forming new memories and, most of all, living.

I want to live, and to enjoy life to the fullest. And sometimes that does feel attainable. But sometimes, when I find myself in bed well past noon, I stare at the ceiling and I grieve.

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a mystery

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I’ve been working on getting into shape lately.

And by that, I don’t mean I’m getting “in shape” fitness wise.

I mean I’m getting my body. to make shapes.

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I was thinking about this a lot yesterday, but one of the things I really struggle with post almost dying in 2019, was how almost every medical provider focused on the effects of the trauma and not the actual physical fallout.

Like, yes. It was immensely traumatic and trauma profoundly affects the brain, but with hindsight (and by hindsight I mean I’ve been grinding my gears over this for the last four years) I can’t help but feel the ball got lobbed over the “mental health” fence a little too quickly.

I had fucking hypoxia, for God’s sake.

Why was no one more concerned that I can’t remember things or that my skill level as a writer and editor dropped substantially in the aftermath. (I’ve gradually regained most of it, but there are still things I have to pause and look up that were once second nature to me. I hate it. It’s traumatic every time it happens because there’s just a blank hole where Knowledge used to be and God dammit I worked hard for that and now it’s tumbleweed.)

And I know the answer is Covid. I know the world shut down just as I started getting answers and I’m one of the lucky ones because I’m still here. But fuck me. I don’t know how they expected me to CBT and mindfulness my way out of that one.

[chronicdivergent]

I was thinking about this a lot yesterday, but one of the things I really struggle with post almost dying in 2019, was how almost every medical provider focused on the effects of the trauma and not the actual physical fallout.

Like, yes. It was immensely traumatic and trauma profoundly affects the brain, but with hindsight (and by hindsight I mean I’ve been grinding my gears over this for the last four years) I can’t help but feel the ball got lobbed over the “mental health” fence a little too quickly.

I had fucking hypoxia, for God’s sake.

Why was no one more concerned that I can’t remember things or that my skill level as a writer and editor dropped substantially in the aftermath. (I’ve gradually regained most of it, but there are still things I have to pause and look up that were once second nature to me. I hate it. It’s traumatic every time it happens because there’s just a blank hole where Knowledge used to be and God dammit I worked hard for that and now it’s tumbleweed.)

And I know the answer is Covid. I know the world shut down just as I started getting answers and I’m one of the lucky ones because I’m still here. But fuck me. I don’t know how they expected me to CBT and mindfulness my way out of that one.

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Dudes healthcare is so fake. My ADHD meds are $940 without insurance. But they gave me a website of "coupons" which straight up looks like a scam website, and I got it today for $60! Just a coupon from a random website and it was $900 cheaper. America, I am confusion!! America explain!!

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The original post I saw seems no longer rebloggable, but here. Current as of October 18, 2024.

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comorbid disorders are either like "yeah ok, makes sense" or "what the fuck"

adhd and autism having a high comorbidity rate? yeah checks out

adhd and autism both having high rates of comorbidity with hypermobility and GI issues? thats an evil curse

[chronicdivergent]

Just something I really want to share on here because it’s important.

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I would like to see more people talk about how jobs treat disabled employees.

I used to prep, wash dishes, and cook at mellow mushroom. I had chronic pain that wasn't NEARLY as bad as it is today, but it was still very debilitating. I told my employer "i cannot stand more than 4 to 6 hours. I CANNOT do shifts longer than this due to my illness." And even though i made my boundaries VERY clear, everyday i worked it was 8 hours at the least and 10 or 12 at the most. I would go up to my manager and say "look i really need to leave, my shift is over, my chronic pain is killing me." And he'd say "we really need to here, you HAVE to push through." And so i did, and after one, ONE month of that job my crps got incredibly worse to the point where i could no longer walk my dog around the block which was .5 miles. I quit, and that was FOUR years ago, and ever since that day I HAVE BEEN BEDRIDDEN AND HAVE TO USE A WHEELCHAIR. It is my biggest regret in life.

My best friend who has seen my whole journey has recently developed undiagnosed chronic pain, and she is in the EXACT same scenario i was 4 years ago. Busting her ass at a pizza place with extreme pain that hurts her so much she tells me "im in so much pain i don't even feel like a person." She doesn't feel LUCID. And her manager and coworkers are saying the same thing "if you don't help us you will let us down, we'll be in the shit."

That job thats hurting you isn't fucking worth it. I promise you no money is worth losing all your physical abilities and never getting them back. Your coworkers and boss do not give a shit about you, so don't you dare suffer for them. They will never understand your struggle and they will never try. They truly think being understaffed is worse than whatever pain you experience. They would rather you permanently damage yourself than inconvenience them. FUCK THEM. DON'T FUCKING DO IT!

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Oh same. My one time of fully dislocating my right shoulder happened while I was sleeping.

Currently practicing a starter version of "came back wrong," and it's called "woke up wrong": basically, you go to sleep, something incomprehensible to the human mind happens to your body position, and when you wake up you are injured in some undiagnosable but persistent way.

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A type of flu virus that used to sicken people every year hasn't been spotted anywhere on Earth since March 2020. As such, experts have advised that the apparently extinct viruses be removed from next year's flu vaccines. The now-extinct viruses were a branch of the influenza B family tree known as the Yamagata lineage. Scientists first reported the apparent disappearance of Yamagata viruses in 2021. At that time, experts speculated that precautions taken to stop the spread of COVID-19 — such as masking and social distancing — had not only driven the overall number of flu cases to historic lows but may have completely snuffed out this type of flu virus. 

Continue Reading.

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This is from 2020, but it definitely still applies.

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My theory of adhd management is that in order to focus there are 4 things that need to be sufficiently occupied:

Eyes

Ears

Hands (or body)

Brain

And if you aren’t occupying them enough or there’s too many things demanding the use of one, it’ll start to wreck havoc on your ability to do things.

So for example, listening to a podcast. This occupies your ears and brain as you focus on both listening and processing what you hear, but it leaves your hands and eyes completely without anything to do. If you tried to sit down and just listen to a podcast by itself you’d probably get unbearably bored and stop doing it.

But if you pair that activity with something that uses your hands and eyes, like a craft, household chore, or commute, suddenly you’re fully plugged in and can in fact focus better on both tasks than you could if you tried doing them separately.

It’s also why you can’t listen to a podcast while doing homework; you’re trying to use your brain for two different tasks. To occupy your ears while doing homework (which is already using eyes, brain, and hands) you need something for your ears that doesn’t require your brain: music. Specifically music that doesn’t use too much brain power, which is why some people prefer instrumentals or songs in other languages.

Hyperfixation and sensory overload change this by moving the threshold for how much sensory input you need to be able to function. If I’m extremely focused on a craft project (eyes, hands, brain) I might not even need something for my ears; my interest in the project makes up for it. If i’ve had a very overwhelming day, trying to listen to an audiobook while I do some stretches could be too much to process. My brain needs a break.

Video games, which pretty much universally occupy all 4 areas, are basically instant, easy focus wrapped up in a neat little bow. No wonder adhd-havers tend to love them.

If you’re struggling with a task, try looking at which areas it occupies and which are left unattended. Then try to find something enjoyable to fill those gaps, and see if that helps.