Is it Depression or Autistic Burnout? Why CBT Fails

Text Dr. Lenz any feedback or questions Dr. Megan Anna Neff on Late-Identified Autism, Autistic Burnout, and Self-Care Clinical psychologist Dr. Megan Anna Neff discusses how discovering her child was autistic near the end of her doctorate led her to research autism in girls, recognize her own autism, and create Neurodivergent Insights to translate peer-reviewed research into visuals. She and the host describe gaps in clinical training, frequent missed or misdiagnosed autism and ADHD in adults, limited access to adult assessment, and the value and risks of formal diagnosis. Neff explains autistic burnout as nervous-system burnout marked by chronic exhaustion, increased sensory sensitivity and meltdowns, and loss of skills, and notes masking, life transitions, and alexithymia as contributors while cautioning to rule out medical causes. They address overlaps with chronic pain, suicidality risk, and poor response to CBT when neurotype is unsupported. Neff outlines her book "Self-Care for Autistic People" (sensory, physical, emotional, mental, social, and professional self-care) and shares where to find her work and community. 00:00 Meet Dr Megan Neff 01:32 The Zigzag Into Autism 04:16 Health Psychology Roots 05:14 Training Gaps In Adults 08:32 Self Diagnosis And Screening 13:01 What Is Autistic Burnout 17:07 Misdiagnosis And Function 21:38 Burnout Versus Medical Causes 24:30 Triggers And Risk Factors 27:21 Why Burnout Builds 28:57 Sensory Safety First 31:37 Quick Fix Coping Traps 34:15 Screening and Misdiagnosis 38:03 Liberation Then Grief 40:39 Autistic Self Care Basics 44:20 Book Chapters and Tips 48:47 Advice for Three Groups 52:59 Resources and Farewell Click here for the YouTube Channel Click here for the YouTube channel International Conference on ADHD in November 2025 where Dr. Lenz will be one of the speakers. Joy Lenz Fibromyalgia 101. A list of fibromyalgia podcast episodes that are great if you are new and don't know where to start. Support the show When I started this podcast and YouTube Channel—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 29+ years as an MD. Please remember to talk with your doctor about your symptoms and care. This content doesn’t replace per...