Alia Breon, MD
@aliabreonmd.bsky.social
ER physician and neurodivergent mom to a PDA Autistic teen and an ADHD preteen. Writing where neuroscience meets lived experience: autism, monotropism, attention, burnout. Come think out loud with me. aliabreonmd.substack.com
Ive been writing on the science of autistic burnout and monotropism. This one goes deep. Krebs cycle, electron transport chain, how we make ATP. And why the panic of running out of air and the panic of overwhelm are the same alarm. aliabreonmd.substack.com/p/the-bioche...
The Biochemistry of Autistic Burnout
And why I am finally grateful for all the energy I spent memorizing the Krebs cycle
aliabreonmd.substack.com
What does ATP—our cellular energy made in the mitochondria—have to do with autism? Maybe everything. How we spend that currency is where autistic lived experience (the Theory of Monotropism) and the emerging neuroscience of predictive processing converge. substack.com/home/post/p-...
How might prediction mismatch contribute to overwhelm and burnout in monotropic thinkers?
A consideration of how prediction mismatch might contribute to bioenergetic overwhelm and burnout in minds wired for deep processing
substack.com
What do ADHD and autism actually have to do with attention? The question won't make sense until we stop defining attention as the conscious focus of our mind, and consider it instead as how the whole mindbody notices and responds to the world. www.nytimes.com/2026/09/29/s...
What if A.D.H.D. Isn’t About Attention at All?
Evidence suggests that it really affects what psychiatrists like me call sustained engagement — an important difference in understanding how to think about the condition.
nytimes.com
#autres At just 6 weeks old, babies with an autistic older sibling already showed differences on fMRI in the salience network (the brain network that helps direct attention) Could attention be distributed differently from the very start? www.nature.com/articles/s42...
Salience network connectivity is altered in 6-week-old infants at heightened likelihood for developing autism - Communications Biology
Infants with heightened vs. lower likelihood of developing autism spectrum disorder exhibit different functional connectivity patterns in the salience network. These patterns predict sensory and socia...
nature.com
SSRIs can flatten emotion. Burnout recovery may depend on feeling things again. Has anyone tapered off an SSRI (gently, carefully, with support) during autistic burnout? How did it change your recovery? What did you notice?
Like many physicians, I thought of mast cells only as "allergy cells." I had no idea they live in the brain, driving neuroinflammation from stress. Witnessing my autistic son's burnout forced me to look deeper—and it changed everything. aliabreonmd.substack.com/p/meet-the-m...
Meet the Mast Cell
A Link Between Stress, Inflammation, and Burnout
aliabreonmd.substack.com
Your nervous system runs on a budget. Overwhelm is what happens when the withdrawals have been outpacing the deposits — and the body finally calls it in. aliabreonmd.substack.com/p/the-neuros...
The Neuroscience of Overwhelm
Deciphering the biological signal of too much, too fast
aliabreonmd.substack.com
As my 13-year-old PDAer recovers from burnout, I thought the timing was right to write on the neuroscience of overwhelm. open.substack.com/pub/aliabreo...
The Neuroscience of Overwhelm
Deciphering the biological signal of too much, too fast
open.substack.com
A great paper on double empathy theory: autistic social challenges aren’t deficits, but a mismatch between autistic and non-autistic communication and experience. The DSM’s deficit-based framing of autism obscures that reality.
Sue Fletcher-Watson@suereviews.bsky.social · 10mo agoLovely article from my friend and colleague @cjcrompton.bsky.social exploring the intersection of the double empathy problem and autism diagnostic criteria: www.cambridge.org/core/journal...
Ezra Klein recently wrote: "Attention is sometimes an act. But first it is an instinct." We think we choose what we notice. But the initial decision was made before conscious awareness arrived. Pulling attention from its natural direction? That takes effort.
We tell autistic kids to stop spinning, stop flapping—stop expressing joy so visibly. When did you last let happiness move through your whole body? Laugh without checking yourself, or swing just for the rush? My autistic son is teaching me to remember.
Autism studies say the autistic brain is over-connected. Others say under-connected. Others: both. Monotropism makes sense of it. Is the Salience Network the neurobiology beneath it? I explore that idea here ⬇️
Could the Salience Network Be the Neurobiological Basis for Monotropism?
A speculative synthesis from a physician steeped in autism, sensory science, and the neuroscience of attention.
aliabreonmd.substack.com
I’ve been holding these reflections quietly for a long time. I’m finally ready to begin writing about autism, monotropism, attention, and what I’ve learned along the way. Excited to share my first post! aliabreonmd.substack.com/p/why-im-wri...
I needed a new lens
How lived experience reshaped what I thought I knew
aliabreonmd.substack.com
