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Battling Autistic Burnout's Side Kicks: Skill Regression and Cognitive Decline

Updated: Aug 27, 2023

Continuing the discussion from last week – or the week before because let’s be honest, I have no concept of time these days – let’s talk about ways to address the devastating skill regression many of us face due to Autistic burnout. And to be clear in prefacing, I’m not suggesting any of these methods should “cure” anything or progress us further than where we started; please look at these as management or recovery, not “healing” because I think that can get sticky when we’re talking Autism mixed with chronic stress. There is a lot we can to do manage and reduce chronic stress, which is in and of itself healing, but it stops at Autism and other neurodevelopmental differences, and I need that to be clear.


Okay.



Since I’m primarily focused on tracing things back to a point of origin to be as preventative as possible, it was undeniable to see the link between Autistic burnout and chronic stress. Once I knew more about the neurology of the autistic brain, it was even clearer that autistic burnout has very similar physiological impacts to chronic stress because, well, that’s essentially what it is: an accumulation of chronic stress that has eventually broken us down to the point of affecting our brains with things like a reduction in the size of the hippocampus and gray matter, including areas like the cerebellum. The hippocampus is responsible for a host of functions like long and short-term memory, and helps with emotional processing. The cerebellum is connected to our proprioception which contributes to things like motor skills. As an aside, gray matter is a particularly relevant theme so let’s quickly define it: “The grey matter throughout the central nervous system allows enables individuals to control movement, memory, and emotions. Different areas of the brain are responsible for various functions, and grey matter plays a significant role in all aspects of human life.” You can see how the combined deterioration of these things can lead to very real and noticeable physical consequences.


Can burnout and skill regression happen to anyone, Autistic or not? Absolutely. So why does this seem to be a bigger issue for Autistics and often at such an early age? I would argue that because Autistics naturally have hyper-aroused limbic systems, we begin accumulating stress earlier and at greater levels even in the most perfect and accommodating of circumstances; then you factor in trauma from growing up Autistic - undiagnosed or not; and on top, factor in the often cited inability to stim freely and as needed - which is essentially our ability to regulate our nervous systems; all of this compounded by intersectionality - and it’s anything but difficult to see how this accumulation occurs so quickly and intensely.


Diving into my own burnout, I had to ask myself why this accumulated stress finally came to a head in 2021/2022 and hindsight, she’s a tricky one… the one thing that kept me from completely succumbing to burnout was so glaringly obvious to my pattern recognition, and research backs the theory up. It was movement - exercise.


When I had a mole removed from my stomach in October 2021, I had to stop all exercise for 2 weeks afterward and was told I could “begin slowly” after that. Due to where my incision was located, I was unable to do anything without irritating it for months. Each time I’d try, the incision was very sore, and I’d pay for it for days. At this point, I’d been moving regularly for over 5 years and sure, I’d take breaks, but I never just …. Stopped for months – until then. So unbeknownst to me at the time, movement was the very sheer thread barely holding me together and when it fell through, so did I.


And now I get it… as a certified health coach and trainer, I logically knew most of these benefits of exercise, but it’s an entirely different experience to feel those benefits being siphoned from you.


So like a recipe that makes you read the life story before getting to the point, let’s get to the part everyone is waiting for - the top 3 ways to improve memory, cognitive functioning, and motor skills because you know I’m not going to leave it at “exercise”.


1. Learning something new

2. Mindfulness (whoa, stick with me)

3. Exercise (double whoa - don't go!)


Cute, but… these things aren’t easy when you’re in burnout SO, let’s go over the benefits of each in a way that can be realistically applied in burnout and/or if we have existing interoception/proprioception issues… I’m nothing if not the number one proponent of nuance.


Learning something new

Before you immediately write this off, hear me out. I’m not talking about reading and studying a book; I’m talking about learning something you enjoy that is hands-on. A great example is learning to play an instrument. Now again, I know you’re thinking “that crap is expensive” and I hear you, but even a portable keyboard can provide immense benefits. In fact, studies have shown that playing an instrument provides mental stimulation similar to exercise.


Another option would be games or activities that require some degree of physicality with reasoning – including video games because yes, hand-eye coordination definitely counts. The most important thing to note is that it’s okay to get creative and think about getting your special interests involved – or perhaps this is a road leading to the discovery of a new special interest.


Rather than trying to summarize what has already been summarized nicely, I’m going to pull out exerpts of the most pertinent information from various sources to better illustrate how these activities can help with cognitive functioning and motor skills.


Some more information about the benefits of playing musical instruments:

  • “Playing an instrument may be one of the best ways to help keep the brain healthy. “It engages every major part of the central nervous system,” said John Dani, PhD, chair of Neuroscience at Penn’s Perelman School of Medicine, tapping into both the right and left sides of the brain. For example, playing the violin – which, like many instruments, requires the right hand to do something different than the left-- uses the peripheral nervous system, which controls movement of your fingers, as well as gross and fine motor skills. The brain’s executive function – which plans and makes decisions – comes into play as a musician plays one part but keeps focus on what’s coming next. Couple that with the total sensory input – visual, auditory, emotional and all at the same time – and it becomes a total “workout” for the brain. “Recent studies suggest that music may be a uniquely good form of exercising your brain,” he said. “Fun can also be good for you.”

  • Results from a study of people who started to play piano between the ages of 60 and 85 noted that “after six months, those who had received piano lessons showed more robust gains in memory, verbal fluency, the speed at which they processed information, planning ability, and other cognitive functions, as compared with those who had not received lessons.” So it’s never too late.”

Additional information comparing the neurology of older and younger musicians:

  • “Cross-sectional behavioral studies have shown that older instrumental musicians have higher levels of non-verbal visual memory, naming, executive function, and auditory attention compared to non-musicians

  • Previous studies on musicians’ brains have focused on young musicians. These studies have found larger gray matter volume (GMV) in the auditory cortex, motor cortex, cerebellum, and putamen in young musicians compared to non-musicians. Among the various brain regions where young musicians show gray matter enlargement, the cerebellum seems to be particularly relevant to behavioral functions. For example, reported that compared to non-musicians, young keyboard players had a larger cerebellar volume, and there was a correlation between the cerebellar volume and the daily practice intensity.

  • For the first time, we found neural advantages in older musicians compared to age-matched non-musicians. The musicians showed lower levels of age-related cognitive decline and brain atrophy in the cerebellum. Behaviorally, cerebellum-related skillful tapping was associated with the maintenance of executive function in musicians.

Mindfulness

I can hear the collective groan but again, hear me out please. I am not suggesting everyone “go meditate” or aimlessly journal because if you are a person who is painfully self-aware but lacks interoception and/or has alexithymia, this is not helpful. In this case, my suggestion when you hear “mindful practice” or “meditation” is to reframe what that means for you. As someone who also struggles with these things, here’s what it means for me: mindful movement. What the fork does that mean? Moving with my breath; that’s it. We spend enough time in our brains, so this is a way to connect with our bodies using diaphragm breathing, also getting all of those stress-relieving benefits to aid in “psychological wellbeing”. Sometimes I’ll add tapping or music to get the additional benefits those provide in helping to distract the mind and calm the nervous system, but I find those are more useful for triage regulation whereas this is more… daily maintenance type stuff. Now of course, if you enjoy things like guided meditations, DO IT! That’s great. My point is that “mindful” isn’t one thing and whatever gets you into this space is your mindfulness practice.


Information about “Mindfulness” and changes in brainstem gray matter (where PWB = psychological wellbeing)

  • “One region with enhanced gray matter concentration following the MBSR course was in the cerebellar vermis, reaching into a region of the brain stem that included the locus coeruleus, nucleus raphe pontis, pontine tegmentum, and the sensory trigeminal nucleus. The locus coeruleus, a site of synthesis of norepinephrine, has been implicated in conditions such as depression and anxiety. Furthermore, this region may play a role in modulating serotonin release. The modulation of levels of serotonin, which is synthesized in the raphe nuclei, has been shown to be one of the most effective treatments for mood and anxiety disorders. The pontine tegmentum, part of the cholinergic system, is implicated in regulating selective attention, wakefulness, learning, reward, and sleep.

  • Given that these regions are well-known to modulate several systems, including the serotonin, dopamine, and norepinephrine systems, as well as play central roles in processes such as mood, arousal, sleep, and, we reasoned that gray matter changes in these regions might contribute to enhanced well-being following mindfulness practice. A subset of individuals in our previous study had completed a questionnaire to assess PWB. Therefore, in order to test this hypothesis, we re-analyzed this subgroup of the previous data set and investigated correlations between changes in gray matter concentration and changes in self-report measures of PWB.”

Exercise

The grand finale is the one that I know most people really don’t want to hear, but it’s physical exercise. To preface, I know this isn’t fair and feels ableist because the physical ability to exercise is not universally available to everyone, which is why I wanted to find and offer alternatives and, of course, nuance to make sure as many people can seek the mental benefits of exercise to help battle deteriorating cognitive functioning that is inherent with autistic burnout.


I also realize that when you’re in the throes of burnout, movement is hard af for even the most physically-able bodied. This is part of why I’ve been posting so much of what I’ve been doing in terms of physical exercise – along with alternatives and options – to help illustrate the level of time and intensity that has been effective in hopes it can eliminate some intimidation and misunderstanding about what exercise can be.


Breath-connected movement and somatics can be a good way to grease the wheels, so to speak. Sure, it’s a great way to get the body used to more movement before diving into something we aren’t even motivated to do, but I’ve found it to be pivotal in terms of helping me heal my relationship with my body, which helps me feel more “motivated” to exercise – for the benefits and how it makes me feel, not as punishment, etc.


And ultimately, these are many of the reasons I’m so passionate about body-neutral movement and making it as accessible to as many as possible.


Let’s dive into some details.


Information about the Effects of Physical Exercise on Cognitive Functioning and Wellbeing: Biological and Psychological Benefits (where PE = physical exercise)

  • “In fact, experimental and clinical studies have reported that PE induces structural and functional changes in the brain, determining enormous biological, and psychological benefits.

  • These effects are reflected on cognitive functioning. In fact, the results of cross-sectional and epidemiological studies showed that PE enhances cognitive functions in young and older adults, improving memory abilities, efficiency of attentional processes and executive-control processes.

  • It was now well-accepted that is the interaction between biological and psychological mechanisms linked to PE enhances the wellbeing. Biological mechanisms of beneficial effects of PE are mainly related to increasing in cerebral blood flow and in maximal oxygen consumption, to delivery of oxygen to cerebral tissue, to reduction in muscle tension and to increased serum concentrations of endocannabinoid receptors. Moreover, neuroplasticity phenomena such as changes in neurotransmitters are recognized to affect wellbeing. For example, PE increases the levels of serotonin and the levels of beta-endorphins, such as anandamide.

  • Evidences of PE increasing brain functioning

    • Increased gray matter volume in frontal and hippocampal regions [7]

    • Increased levels of neurotrophic factors (e.g., peripheral BDNF) [8]

    • Increased blood flow [9] Increasing in academic achievement (especially children) [10]

    • Improvements in cognitive abilities (learning and memory, attentional processes and executive processes) [11]

    • Prevention of cognitive decline and reduced risk of developing dementia (especially in the elderly) [12]

    • Modified network topology [13]

  • Psychological Benefits:

    • PE decreases:

      • anxiety, depression, dysfunctional and psychotic behaviors, hostility, tension, phobias, headaches [3]

    • PE increases:

      • assertiveness, confidence, emotional stability, cognitive functioning, internal locus of control, positive body image, self-control, sexual satisfaction [4]”

Also, why do I really really believe this? Because exercise is one of the few things we can do for free. This stuff isn’t telling us to buy anything or take anything – not that legitimate medication may not also be necessary – but I think it’s important to point this out in a world that’s looking to capitalize on our fear, discomfort, and/or pain to make a few dollars.


All right, that’s a soapbox I’m not going to get further on right now…


I hope this has been helpful. I’ve included a few other links from research below.


And hey, if you’re interested in more information about body-neutral health and fitness, well… stay tuned.


And stay regulated,

Shauna


…..


I’ve removed references from all quote excerpts for brevity, but they can be located in the original sources linked.


Additional resources:

fatigue & stress - gray matter

cerebellum and trauma

stress & brain shrinking

cerebellum under stress



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