What I Thought Was AuDHD Burnout Wasn't the Whole Story

Two weeks ago, I woke up from surgery with a surprise diagnosis—and more energy than I'd had in years.

Which is a truly ridiculous thing to realize immediately after someone has cut into your abdomen.

I went into surgery expecting a fibroid removal. Fibroids are incredibly common, and most women will develop them at some point in their lives. Based on my previous experiences with surgery, I thought I knew exactly what recovery would look like. Last year, a finger surgery knocked me out for weeks, so I was mentally preparing myself to spend days in bed, exhausted, uncomfortable, and unable to focus on much of anything. As a restless, overachieving AuDHDer whose favorite coping mechanism is often "doing too much," recovery sounded like a special kind of torture.

Instead, my surgeons found and excised endometriosis.

When they told me, my immediate response was, "Holy fuck."

The bigger surprise came the next day. Despite actively recovering from surgery and having literal holes in my abdomen, I had more energy than I'd had in years. Not because I was suddenly cured, because my burnout had magically disappeared, or because all of my health issues were solved overnight. I simply felt different enough that I couldn't stop thinking about it.

For years, my exhaustion made perfect sense. I'm a chronically ill AuDHDer who runs multiple businesses, tiptoeing the line of burnout. Just existing under capitalism as a disabled person. If you had asked me why I was exhausted, I could have given you a dozen reasonable explanations without even pausing to think about it. The reality is that many of those explanations were completely accurate. The burnout and stress were real. The demands of entrepreneurship and emotional labor of being in the helping professions was real. I was navigating a world not built for my brain and body, and I had drastically lowered expectations of myself over time.

What I didn't realize was that those explanations weren't the whole story.

Over time, debilitating periods, pelvic pain, brain fog, fatigue, and other symptoms had quietly become part of my baseline. They crept in gradually enough that I adapted to them. I planned around them. I lowered expectations even more during certain times of the month. I built coping strategies. Eventually, I stopped questioning them altogether.

The photo from my recent social media post on this topic is a perfect example. That's me on one of what I jokingly called my "death days"—days during my period when I felt so awful that functioning seemed nearly impossible. I was sandwiched between two heating pads because the pain was that intense. Looking back, it seems absurd that I accepted that as normal. At the time, though, it was simply part of my life. I expected it and planned around it. I assumed that was just how my body worked.

One of the strangest things about chronic illness is how quickly humans adapt. Give us enough time and we'll start accommodating almost anything. We reorganize our schedules, lower our expectations, and build workarounds. Eventually, we become so familiar with our symptoms that we stop recognizing them as symptoms at all. They become part of our identity instead.

I think Autistic and ADHD people may be especially vulnerable to this. Many of us spend our entire lives adapting. We adapt to sensory overload, social expectations, inaccessible environments, executive functioning challenges, and systems that weren't designed with us in mind. We become incredibly skilled at pushing through discomfort because, frankly, we've often had to.

The downside is that eventually we can become so good at pushing through that we stop asking whether what we're pushing through is actually normal.

Endometriosis affects approximately 1 in 10 women and people assigned female at birth, though many experts believe the true prevalence is likely higher. Diagnostic delays are common, with many people spending seven to ten years—or even longer (especially in BIPOC folks) —searching for answers. Symptoms can include severe menstrual pain, pelvic pain, gastrointestinal symptoms, fatigue, painful sex, infertility, and a variety of other experiences that often overlap with different medical conditions. Despite affecting millions of people, it remains surprisingly misunderstood and under-researched.

As I learned more about endometriosis after surgery, I found myself thinking about the overlap between neurodivergence and chronic illness. Research consistently shows that autistic and ADHD individuals experience higher rates of many chronic health conditions. Emerging research also suggests higher rates of endometriosis among neurodivergent individuals. At the same time, many of us face significant barriers to receiving appropriate healthcare.

Medical trauma is common. Many neurodivergent people have had experiences of being dismissed, misunderstood, or told that their symptoms are simply anxiety, stress, or burnout. The double and triple empathy problem can make communication between patients and providers more difficult. Financial barriers make accessing healthcare challenging even when good care exists. For disabled people in particular, navigating healthcare systems often requires enormous amounts of time, energy, money, and self-advocacy.

When you combine those barriers with a lifetime of pushing through discomfort, it's easy to see how symptoms become normalized.

One of the biggest lessons from this experience has been realizing that multiple things can be true at the same time. I'm still AuDHD. I'm still recovering from burnout. I'm still chronically ill. I still need rest, accommodations, and support. This is not a magical cure story, and I have no interest in pretending it is.

What it is, however, is a reminder that burnout wasn't the whole story.

More importantly, it's a reminder that the explanations we have for our struggles don't always capture the entire picture. Sometimes we're burned out and chronically ill. Sometimes we're stressed and dealing with untreated medical conditions. Sometimes we're carrying multiple burdens at once and blaming ourselves for all of them.

The question I keep coming back to is this: What have I normalized?

Because the day after surgery, I realized I wasn't entirely sure what my baseline was anymore.

So here's my PSA to the neurodivergent community: If something feels off, keep asking questions. If you've normalized pain, fatigue, brain fog, or symptoms because they've always been there, get curious. And if you've convinced yourself that suffering is simply the price of being productive, successful, neurodivergent, or human, maybe question that too.

Because sometimes...maybe what you've been blaming on yourself isn't the whole story.