“You can’t really recover”: what autistic and ADHD teenagers say school is doing to their mental health

She holds it together from Monday to Friday. By the end of term there is nothing left, and the holidays go on getting her back to where she started before September comes round and it all begins again. School says she’s fine, and her grades seem to back that up, but at home you can see she isn’t.

If that’s your house, a new study has put it into words, and the words come from autistic and ADHD young people themselves.

What the researchers did

A team from King’s College London and UCL, working on a programme called RE-STAR, interviewed 22 autistic and ADHD young people aged 11 to 16, six of whom were both. All of them were in, or had recently been in, a mainstream secondary school in the UK, and all had experienced low mood, depression, anxiety or burnout linked to school. Twelve of them identified as female.

What sets this study apart is who ran it. A panel of neurodivergent young adults helped design the study and co-led every interview alongside an academic researcher, then worked on the analysis too. Before the interviews, young people made photos or drawings at home to show what school and burnout felt like. One chose a picture of a flat tyre. Another chose a photo of a chipped wall.

The paper is a preprint, which means it hasn’t yet been through peer review. It’s still worth reading closely, because it says in young people’s own words what families in our community have been telling us for years.

School is where the distress comes from

The young people described schools that put attendance and behaviour points ahead of how they were actually coping. They talked about isolation rooms where you can’t speak and behaviour policies with too many rules to remember, which left them in constant fear of getting something wrong. Attendance rewards landed as one more reminder that they didn’t fit:

Someone like me is never going to have 100% attendance, so I can’t ever be recognised as deserving a reward.

Young person with ADHD

For families facing Barriers to Attendance, one finding stands out. Pressure to attend made the struggle harder:

I struggle to come into school and I’m also being pressured to come into school and get my attendance up… If they’re pressuring me, it makes it even harder.

Young person with ADHD

Distress was often misread. Shutdown was taken for laziness, and walking away to calm down was taken for rudeness. One young person explained that walking away was “the only way I know how to deescalate.” And the ones who kept their grades up were overlooked altogether:

Teachers seem to think that if you get good grades, then you’re fine. But it’s not really how it works.

Autistic young person with ADHD

That line will be painfully familiar to any parent of a child who masks. It’s the same pattern that keeps autistic girls unidentified for years.

Masking isn’t coping

Young people across the study described hiding themselves to get through the school day. They talked about it as survival, in a place where being themselves meant being bullied or punished.

There is nowhere that feels like a comfortable and safe place to unmask because you are always surrounded by people, so you have to mask all day, which is very tiring.

Autistic young person with ADHD

Underneath the mask sat a constant watchfulness, which the researchers call hypervigilance. Young people described dread that started on Sunday night and didn’t lift until Friday:

I get anxious on a Sunday night, and that doesn’t really feel like it goes away until Friday evening.

Autistic young person

Over time, that adds up to burnout: physical exhaustion and brain fog, until tasks that were once manageable become impossible. And because school keeps going, recovery never finishes. One young person described burnout as a chipped wall:

Even if you, say, have a weekend off or, in the bricks case, you like, repaint it or whatever, it’s still chipped. You can’t really recover. They just sort of stay chipped.

Autistic young person with ADHD

Burnout and depression are different, and the difference matters

The young people described low mood in stark terms: emptiness, numbness, feeling useless, not wanting to get out of bed. Some described urges to hurt themselves. They also made clear that burnout and depression overlap without being the same thing.

The researchers draw out something every parent working with CAMHS or a therapist should know. A common treatment for depression, behavioural activation, works by encouraging someone to do more activities to lift their mood. The authors warn it “may risk exacerbating exhaustion when burnout is present.” If your child is burnt out and the plan is to get them doing more, it is reasonable to ask whether burnout has been considered first.

School counselling didn’t always fit either. As one autistic young person put it, “School is unhelpful when you only get eight sessions, because there are still things that can’t be resolved in eight sessions.”

If you or someone you know is struggling right now, please reach out. Young people can call Childline free on 0800 1111, and anyone can call Samaritans on 116 123, day or night. Our community is here too:

What this gives you as a parent

The authors are clear that support focused only on a young person’s symptoms or behaviour “may overlook broader environmental contributors to burnout, anxiety, and low mood.” They call on schools to “prioritise flexibility, sensory accessibility, relational safety, and collaborative support rather than compliance-based systems.”

That is useful language to take into a meeting with school or a CAMHS appointment. It’s a university research team saying what you have been saying: your child’s distress is a response to an environment that doesn’t fit, and the environment is what needs to change. Masking and cumulative burnout are the words for what is happening.

The young people this study couldn’t reach

The researchers are honest about who is missing. Their findings, they say, “may not represent experiences within specialist provisions, alternative educational settings, or among young people absent from education.”

Those are the young people we meet every week. Many have been out of school for months or years by the time they reach The Haven, our specialist online school, and some haven’t left the house in a long time. At The Haven the camera can stay off and almost every educator is neurodivergent themselves. Back to Balance is a 12-week, gentle reintroduction to learning, with no attendance targets to fail. Young people who couldn’t speak out loud begin to talk, and young people who had given up on learning start to re-engage.

The young people in this study described a system that asked them to adapt until there was nothing left. It doesn’t have to work that way.

Where to start

If this sounds like your family, you don’t have to work it out alone. Join our free Facebook support community, where 35,000 parents and carers who get it are ready to help. Or come along to one of our free monthly family workshops.

If your young person is already out of school, you can find out more about Back to Balance at The Haven.