Divergent Conversations Episode 121 (Season 3): Burnout City: Burnout Symptoms at a Cellular Level [featuring Dr. Mel Houser]
Cells Driving Chronic Exhaustion
- Mitochondrial dysfunction means cells make less energy and spend it inefficiently.
- This explains why everyday tasks like standing or talking can feel exhausting for many autistic people.
Identify And Avoid PEM
- Learn what post-exertional malaise (PEM) looks like for you and avoid triggers.
- Staying out of PEM speeds recovery and prevents prolonged worsening of symptoms.
Pace Using A Sustainable Baseline
- Use pacing: find a sustainable baseline (often half what you expect) and set stopping thresholds.
- Radical, consistent pacing for days can increase capacity over time.
Understanding the root causes behind Autistic burnout symptoms can feel confusing, especially when physical symptoms are present but dismissed or misunderstood. Many in the neurodivergent community face not only emotional exhaustion but a web of hidden medical conditions that often go undiagnosed, leaving them searching for seemingly elusive answers and support.
In this episode, Patrick Casale and Dr. Megan Anna Neff, two AuDHD mental health professionals, are joined by Dr. Mel Houser, an Autistic physician and founder of All Brains Belong, as they discuss the intricate connections between Autistic burnout and underlying health issues like mitochondrial dysfunction, post-exertional malaise (PEM), dysautonomia, postural orthostatic tachycardia syndrome (POTS), and mast cell activation. This discussion covers what happens on a cellular level during burnout, the importance of pacing and sensory adjustments, and why diagnostic overshadowing can be such a serious barrier to effective care. Dr. Houser also shares practical strategies, resources, and hopeful ways forward for those struggling with chronic fatigue, energy regulation, and co-occurring medical concerns.
Top 3 reasons to listen to the entire episode:
- Gain a deeper understanding of why Autistic burnout isn’t "just in your head"—this episode breaks down the science behind energy production, chronic illness, and how they intersect with neurodivergent experiences.
- Discover pacing techniques, environmental adaptations, and supplements that may support recovery and energy management—plus get direct links to free resources designed specifically for neurodivergent adults.
- Hear honest, validating conversation about grief, privilege, and agency while exploring what it really takes to honor energy access needs and navigate medical systems as an Autistic or ADHD adult.
If you or someone you care for battles constant exhaustion, brain fog, or unexplained physical symptoms, don’t miss this compassionate and practical conversation, and learn how Autistic burnout and chronic illness connect—and discover steps you can take to better support your body, brain, and well-being.
DISCLAIMER: This episode is not intended as medical advice.
More about Mel:
Dr. Mel Houser (she/they) is an Autistic family physician with a clinical focus on providing primary care for neurodivergent patients across the lifespan. She is the Founder and Executive Director of All Brains Belong VT, a nonprofit 501(c)(3) organization in Montpelier, Vermont that uses universal design principles to provide neurodiversity-affirming medical care, social connection opportunities for all ages, and neurodiversity-related educational training. At age 37, Dr. Houser was diagnosed as autistic, ADHD, dyspraxic, dyslexic, and dyscalculic. She is also the parent of an autistic 6-year-old, who is her guru of so many keys to the universe.
- Website: allbrainsbelong.org
- Instagram: instagram.com/allbrainsbelongvt
- What the bleep can I eat?!: whatthebleepcanieat.com
All Brains Belong Resources:
- Everything is Connected to Everything: Improving the Healthcare of Autistic & ADHD Adults: allbrainsbelong.org/all-the-things
- Exploring ENERGY Equilibrium Strategies for Individuals who Experience Post Exertional Malaise (PEM) - allbrainsbelong.org/pem collab with Autism Level UP!
- Brain Club® Digital Resource Library - Healthcare (Check back in mid-September for more topics): allbrainsbelong.org/brain-club
Other Resources:
- Bateman Horne Center's ME/CFS Crash Survival Guide: batemanhornecenter.org/wp-content/uploads/filebase/crash_care/Dark_Blue_Survival_Guide_Complete.pdf
- Neurodivergent Insights Resource on Autistic Burnout: neurodivergentinsights.com/burnout-resources
- The Autistic Burnout Workbook by Dr. Megan Anna Neff: simonandschuster.com/books/The-Autistic-Burnout-Workbook/Megan-Anna-Neff/9781507223062
- Check out Neurodivergent Insights’ Library of Boundary Scripts (free resource)
Divergent Conversations Podcast Episodes:
- Episode 2: Autistic Burnout (divergentpod.com/2)
- Episode 47: Autistic Burnout (Part 2): A Deep Dive Into The Diversity of Burnout (divergentpod.com/47)
- Episode 73: Chronic Health (Part 4): All Brains Belong [featuring Dr. Mel Houser] (divergentpod.com/73)
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Thanks to Our Sponsor: Landmark College & Jane
Landmark College is the world's first accredited college designed exclusively for students who learn differently. Landmark, located in Putney, Vermont, offers courses in person and online, awarding associate and bachelor's degrees, and offering pre-college, gap year, and professional development programs for educators who work with neurodivergent students. With a student-to-faculty ratio of just 7 to 1, and the renowned Landmark College Institute for Research and Training, Landmark offers personalized and research-informed support for neurodivergent students that is not available at traditional colleges. Enrollment is still open for Fall 2025. Learn more about this opportunity at landmark.edu.
✨ Jane:
Jane is a clinic management software and EMR designed to be an extra set of helping hands in your health and wellness business. Available online and on any device, Jane has branded online booking, scheduling, insurance billing, customizable documentation templates and online forms, integrated payments, telehealth, and more — wrapped up in one beautiful package that even your patients/clients will love. Backed by our unlimited human support available by phone, email, and chat (even on Saturdays!), Jane is here to help you get back to the work you love. Get 2 months off new Jane subscriptions when you use code DCPOD at signup. Visit: janesoftware.partnerlinks.io/divergentconversations
✨ Neurodivergent Insights Autistic Burnout Resources
If you’d like to supplement your learning on burnout, you can check out Neurodivergent Insights' resources on burnout. We have articles, an Autistic Burnout course, workbooks, and print books! Visit: neurodivergentinsights.com/burnout-resources
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💬 Join Divergent Conversations Underground
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Mentioned in this episode:
Landmark College
Landmark College is the world's first accredited college designed exclusively for students who learn differently. Landmark, located in Putney, Vermont, offers courses in person and online, awarding associate and bachelor's degrees, and offering pre-college, gap year, and professional development programs for educators who work with neurodivergent students. With a student-to-faculty ratio of just 7 to 1, and the renowned Landmark College Institute for Research and Training, Landmark offers personalized and research-informed support for neurodivergent students that is not available at traditional colleges. Enrollment is still open for Fall 2025. Learn more about this opportunity at landmark.edu.
Learn More About Landmark College
Jane
Jane is a clinic management software and EMR designed to be an extra set of helping hands in your health and wellness business. Available online and on any device, Jane has branded online booking, scheduling, insurance billing, customizable documentation templates and online forms, integrated payments, telehealth, and more — wrapped up in one beautiful package that even your patients/clients will love. Backed by our unlimited human support available by phone, email, and chat (even on Saturdays!), Jane is here to help you get back to the work you love. Get 2 months off new Jane subscriptions when you use code DCPOD at signup. Visit: https://janesoftware.partnerlinks.io/divergentconversations
Neurodivergent Insights' Autistic Burnout Resources
If you’d like to supplement your learning on burnout, you can check out Neurodivergent Insights' resources on burnout. We have articles, an Autistic Burnout course, workbooks, and print books! Visit: https://neurodivergentinsights.com/burnout-resources