Pacing systems are helpful for anyone who is managing a chronic illness or a disability. I first learned about pacing systems when working in health psychology and working with oncology and chronic pain patients. I have since learned about how pacing systems are invaluable for me in managing my Autistic burnout and chronic pain. Pacing systems can be a helpful resource for neurodivergent people, particularly because we are so prone to the boom-or-bust cycle! This article will provide an overview of Autistic and ADHD burnout, and the boom-or-bust cycle and discuss how pacing systems can help us to cultivate a more sustainable life rhythm. 

ADHD, Autism, and Chronic Fatigue

Chronic fatigue and burnout are less commonly discussed among ADHD and Autistic experiences. Many people with ADHD and Autism deal with chronic fatigue, burnout, and chronic pain. Several factors contribute to Autistic burnout and ADHD burnout (sensory overload, over-exerting ourselves, navigating a world not designed for us, and more). One of the things that perpetuate these patterns is something called the "Boom-or-Bust" Cycle. Many Autistic and ADHD people fall into the "Boom-or-Bust Cycle," which exacerbates the burnout cycle. But before we get into the Boom-or Bust Cycle, first let's clarify what Autistic Burnout and ADHD burnout entail. 

Autistic and ADHD Burnout

Autistic and ADHD burnout is characterized by extreme exhaustion and a sense of being overwhelmed caused by prolonged periods of intense stress and overstimulation. When we experience burnout, it can result in increased difficulties with managing daily life tasks, our cognitive functioning declines, and our emotional well-being and mental health can take a deep dive!  Symptoms of autistic and ADHD burnout may include:

• Fatigue: A pervasive experience of fatigue. This includes Feeling constantly tired, even after getting enough rest or sleep.

• Physical symptoms: Headaches, muscle tension, and digestive problems.

• Worsened executive functioning and cognitive difficulties: Executive functioning struggles likely become more amplified, and we'll notice even more difficulty with concentrating, decision-making, problem-solving and memory difficulties. 

• Emotional dysregulation: Increased irritability, mood swings, anxiety, and depression.

• Increased sensory sensitivities: Heightened sensitivity to lights, sounds, textures, or smells.

• Increased difficulty with managing social interactions and communication.

Autistic and ADHD burnout occurs when our internal resources are exhausted beyond measure. It happens more often to individuals who mask their neurodivergence and do not have adequate support, accommodations, or breaks to manage their stress and sensory inputs.

Autistic and ADHD burnout can be triggered by various factors, such as:

• Extended periods of masking (trying to suppress autistic or ADHD traits to fit in)

• Chronic stress

• Sensory overlay

• Navigating demanding environments

Recovery from autistic and ADHD burnout often requires a combination of self-care, therapy, and support from loved ones and professionals. This may include creating a structured routine, practicing stress management techniques, implementing sensory breaks, and seeking therapy or counseling to address emotional well-being.

Learning assertive communication so that we can more effectively communicate our needs and boundaries to those around us, including employers, teachers, and healthcare providers, to prevent burnout and ensure adequate support is another key aspect of recovery. Building a support network and participating in neurodivergent communities of people with similar experiences can also provide validation, understanding, and support while managing burnout. 

Finally, cultivating a sustainable life rhythm that helps us get out of the neurodivergent boom-or-bust cycle is a key component of healing from burnout. Let's now turn to unpack what the neurodivergent boom-or-bust cycle entails. 

The Neurodivergent Boom-or-Bust Cycle

The Neurodivergent Boom-or-Bust Cycle refers to a pattern often observed among neurodivergent individuals. This cycle is characterized by alternating periods of high productivity and engagement, followed by periods of exhaustion and burnout.

What is the Boom-or-Bust Cycle?

First, it is helpful to note that everyone falls into the boom-or-bust cycle to some degree. The boom-or-bust cycle happens when we over-extend ourselves on good days and then need to recover the following day. This isn't a big deal for healthy people as they can easily bounce back.

The boom-or-bust cycle is a common experience for people living with a chronic health condition, fatigue, pain, or disability. On good energy days, it feels so good to accomplish things, we may feel as if we are trying to make up for lost time. So we may over-extend ourselves while overriding our body's signals and push our bodies beyond its limits. This is then inevitably followed by a "crash." Many ADHDers and Autistic people often overextend ourselves--failing to honor their limits in our effort to "push through." This is what is known as the "boom phase." 

During the "boom" phase, we may experience heightened focus, creativity, and productivity. We may be able to hyperfocus on a specific task or project, resulting in increased output and achievement. This phase is often accompanied by a sense of passion, enthusiasm, and motivation. This is particularly common when we have found a new special interest or novel project that we are excited about.

However, we eventually enter the "bust" phase after prolonged periods of intense focus and effort. In this phase, we may experience fatigue, sensory overload, mental exhaustion, and difficulties with executive functioning. This can lead to a decline in productivity, decreased motivation, and an overall feeling of being overwhelmed. Various factors, such as external demands, stressors, changes in routine, or sensory overload, can trigger the boom-and-bust cycle. Additionally, the cycle can vary in duration and intensity from person to person.

What’s Wrong with the Boom-or-Bust Cycle?

This pattern becomes problematic when it becomes a lifestyle that leads to burnout. Below are a few of the problems associated with this cycle:

1) When we perpetually push ourselves beyond our body's limit, it takes longer to recover each time we go through the cycle, and the burnout deepens.

2) It tends to send our mood on a rollercoaster. We tend to feel upbeat, positive, and accomplished on our "good" days, followed by a collapsing depression, disappointment, and melancholy on our "recovery days."

3) Each time we go through the cycle, it takes us longer to get back to our baseline, which is how we end up in positions of chronic pain, fatigue, and burnout.

Boom-or-Bust Graphic

The above graph illustrates The boom-or-bust cycle. You'll notice that the rest time between each cycle extends, and it takes a person longer and longer to return to their baseline. The red line illustrates the downward fatigue spiral that occurs.

The green line represents a steady energy expenditure that is more sustainable and enduring. Pacing systems are one of the things that helps a person get out of the boom-or-bust cycle and to move toward a more sustainable energy rhythm.

Neurodivergent Contributors to the Boom-or-Bust Cycle

Several things make the neurodivergent person more vulnerable to the boom-or-bust cycle. Below are a few neurodivergent tendencies that make us more vulnerable to this pattern:

Hyper-focus + Hyper-fixation

ADHDers and Autistic people often ping-pong between hyper-focus accomplishment and collapse. When hyper-focused, time goes out the window. It likely feels so good to be in the flow state that we forget to drink, eat and go to bed! One night of hyper-focus can throw off the sleep schedule for the week!

ADHD and Autistic People-Pleasing

Particularly among people with ADHD and Autistic people who mask, many adapt to our social differences by becoming perpetual people-pleasers. This can make it hard to set boundaries and say no to others. A person may choose to over-exert themselves vs. risk disappointing someone.

ADHD, Autism, and Internalized Ableism

We often hold ourselves to neurotypical standards when we haven't addressed our internalized ableism. As such, we end up in a pattern of shaming ourselves for failing to meet unrealistic expectations. This results in pushing ourselves to exertion, often followed by burnout.

Interoception Issue

Due to underlying difficulties picking up body cues, we may not receive the early signs of stress or fatigue, leading us to override our body’s instincts. This makes us more vulnerable to over-exert ourselves as we may not realize we are fatigued or stressed until we are near a crash.

Managing the Boom-Or-Bust Cycle

Managing the Neurodivergent Boom-or-Bust Cycle requires self-awareness, self-care, and support systems. Autistic people and ADHDers can benefit from recognizing our patterns and limits, learning to pace ourselves, and implementing strategies to prevent burnout. This may include taking breaks, practicing sensory regulation techniques, setting realistic expectations, and seeking social support. 

How to Get Out of The Boom-or-Bust Cycle?

First, some acceptance of the boom-or-bust cycle is necessary for neurodivergent people. Given our distinctive interest-driven nervous systems, a tendency toward all-or-nothing responses, and intense hyper-focus, it's inevitable that we'll encounter varying degrees of boom-or-bust patterns. For instance, in my case, recognizing this as a facet of my natural energy rhythm—where high productivity days are succeeded by periods of reduced creativity—has allowed me to befriend this cycle rather than combat it. I've become attuned to which tasks suit my high-creative days versus my lower-energy days, crafting a lifestyle that accommodates this ebb and flow. Alongside harmonizing with my inherent energy patterns, there are numerous practices to mitigate the stress and temper the intensity of the boom-or-bust cycle.

Several approaches aid in disengaging from the boom-or-bust rollercoaster, encompassing actions such as countering internalized ableism, honing effective boundaries, prioritizing restorative sleep routines, and more. At a practical level, pacing systems serve as a valuable instrument for disrupting the boom-or-bust cycle. By implementing pacing systems, we intervene in this cycle, orchestrating a more even allocation of energy throughout our activities, which in turn mitigates the extremity of energy crashes.

Pacing Systems for ADHD and Autism

I first learned about pacing systems when working as a therapist in an oncology clinic and with patients undergoing treatment. Pacing their activities was vital for their energy, pain, and more.

What is A Pacing System?

Pacing systems are used widely used in medical systems for people experiencing chronic pain, chronic fatigue, and other challenges related to a disability or chronic health issue. A pacing system is essentially any system that helps you sustainably monitor and manage energy. A pacing system helps you to find balanced energy management as you navigate life with a chronic illness or disability. 

Why Pacing is Important? 

Pacing energy helps to even out our energy expenditure so we don't get stuck in the boom-or-bust cycle (think the green dotted line from the graph above). Pacing systems help create a lifestyle that balances energy expenditure. Various pacing systems are available (Spoon Theory, Energy Accounting, Traffic Light System). 

The goal is to create a more sustainable life where you can feel more empowered--so you experience more agency over your everyday activities (versus feeling as if you are at the mercy of your body).

How Does Pacing Work? 

When addressing the boom-and-bust energy cycle, pacing systems offer an effective way to achieve a more even distribution of energy expenditure. There are several different kinds of pacing systems available. There is no one right pacing system; the best one is the one that resonates with you!  You're likely to resonate with one more than the others. Let's explore three common pacing systems. 

1. Energy Accounting System: Originally developed by Autistic advocate Maja Toudal during her teenage years, the energy accounting system serves as a tool to communicate her experience of being autistic and managing limited energy resources. This approach is akin to balancing a checkbook. Each activity is assigned an energy cost (deposit and input), and you "balance your checkbook" accordingly. Detailed instructions and an example of the energy accounting system can be found in the course materials.

2. Green Light-Yellow Light-Red Light System: If you find yourself becoming fixated on numbers, the color pacing system might be more suitable. Consider trying the Green Light-Yellow Light-Red Light system.

• Red Light Activities: High-energy expenditure tasks

• Yellow Light: Medium to neutral activities

• Green Light: Restorative and recharging activities

With this system, you identify your red light activities and ensure you A) space them out, B) intersperse yellow and green light activities, and C) carefully monitor the number of red light activities you engage in within a given day or week.

3. Spoons Theory: Developed by Christine Miserandino while explaining the impact of lupus on her energy and daily tasks, the Spoon Theory offers an analogy for individuals with chronic illnesses or invisible disabilities. In this concept, you start your day with a limited number of "spoons," representing your energy units. Activities deplete these units, so you must consider how many "spoons" you have each day and allocate them wisely. To learn more about how to adapt spoon theory for neurodivergent people you can check out this article.

Top 3 Reasons Pacing Systems Work for ADHDers and Autistic People

1) They turn something abstract, like "energy," into something concrete and visual. Many pacing systems rely on visual metaphors, which work well for the neurodivergent mind. Talking about "spoons" or "energy units" provides a concrete concept to anchor the conversation.

2) It provides language to talk with other people about our needs. Saying, "I am tired," is vague. Creating language around energy accounting or energy units helps us communicate our needs to others, which is a foundational step in self-advocacy.

3) It increases self-compassion: A pacing system encourages mindful check-ins. Having a pacing system in our life encourages us to check in with ourselves gently ("How am I doing right now? How much energy do I have? How much energy is this activity going to take? What do I need at this moment right now"). This sort of gentle, compassionate check fosters self-compassion.

How to Incorporate a Pacing System into Your Life?

Here are some basic steps for getting started with implementing a pacing system into your life:

1. Select a pacing system that resonates with your preferences and needs. Among the commonly used pacing systems, such as Spoon Theory, Energy Accounting, and the Traffic Light System, choose the one that aligns with your personal style and approach.

   • Opt for the Energy Accounting system if you lean towards a numerical approach and prefer to quantify your energy expenditure.

   • If you’re color oriented and want something broad and basic to capture your activities, you will likely enjoy the Traffic Light System

   • If you’re already familiar with Spoon Theory, you will likely enjoy learning about Spoon Theory, adapted for Neurodivergent people. I have created fillable workbooks for all three, which you can find available here.

2. Do an inventory to understand how much energy you're actually expenditure. During your inventory phase, you want to focus both on what takes energy and what restores energy. 

3. Spend a few days to a week monitoring your energy input and output so that you get a solid idea of your baseline.

4. Set Clear Goals: Define your goals and intentions for implementing a pacing system. Are you looking to reduce burnout, manage chronic conditions, manage chronic pain, be more value-driven in your energy expenditure or enhance your overall well-being?

5. Create a Daily or Weekly Schedule: Based on your energy inventory and baseline, design a daily schedule that includes a balance of activities with varying energy demands. Allocate time for red light, yellow light, and green light activities, ensuring you have opportunities for rest and rejuvenation.

6. Prioritize Self-Care: Incorporate self-care practices into your daily routine. Include activities that recharge you mentally, emotionally, and physically. Self-care is an essential aspect of effective energy management.

7. Practice Mindful Check-ins: Develop mindfulness around your energy levels. This is particularly important for neurodivergent people, as many of us struggle with interoception. So practicing regular check-ins with yourself throughout the day will help you to learn to gauge your energy reserves better. This can help you make informed decisions about when to engage in certain activities and when to rest.

8. Adjust and Fine-Tune: Be open to adjusting and fine-tuning your pacing system as you gather more data and experience. Your energy levels may vary due to factors like stress, changes in routine, or health fluctuations. Flexibility and adaptability are key.

9. Track and Reflect: Keep a journal or record of your pacing journey. Note what activities align well with your pacing system and which ones may require adjustments. Regularly reflecting on your progress can help you refine your approach over time.

10. Seek Support: If needed, seek guidance from professionals, support groups, or mentors with experience with pacing systems or energy management. They can offer additional insights, advice, and encouragement on your journey.

Conclusion

In conclusion, neurodivergent people often have different ways of processing information, managing energy, and engaging with the world around them. The current societal norms of productivity and efficiency do not consider these individual differences, leading to a cycle of overexertion and burnout followed by low energy and disengagement periods. This cycle leaves neurodivergent individuals vulnerable to burnout and can significantly harm their mental and physical well-being.

It is crucial to recognize our energy limits and learn how to work with our natural energy rhythms to break this cycle. Pacing systems can help us better conceptualize energy units in and energy units out.  This approach can offer a tangible avenue to discuss our energy levels and limitations, which ultimately helps us assert ourselves. 

By acknowledging our energy limits and learning to work with our innate rhythms and patterns, we can recover from burnout and build a more sustainable life for ourselves.