iiinova — where your digital self keeps evolving

Alia Breon, MD @aliabreonmd.bsky.social · 23h

Starr! It’s so confusing and sorry my article didn’t land for you. It has to do with prediction error: when sensory information doesn’t match what the brain expects from prior experience. Autistic thinkers build highly-specific prediction models. So there is more mismatch. (And that is high spend)

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Alia Breon, MD @aliabreonmd.bsky.social · 10/10/2026

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...

aliabreonmd.substack.com

The Biochemistry of Autistic Burnout

And why I am finally grateful for all the energy I spent memorizing the Krebs cycle

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Alia Breon, MD @aliabreonmd.bsky.social · 10/10/2026

Prediction error, I think. Deep and narrow processing builds deep and narrow (highly specific) predicitons. Highly specific predicitons -> more prediction error -> more signals for cells to respond/prepare. Respond = use ATP run their cellular machinery. Results in less ATP left for clean up.

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Alia Breon, MD @aliabreonmd.bsky.social · 09/10/2026

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-...

substack.com

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

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Alia Breon, MD @aliabreonmd.bsky.social · 04/10/2026

Great article! Empathy is 'tasting' another's emotional experience. People who think alike construct emotions alike, and so overlap more. Empathy tests don't measure a deficit - they measure similarity between constructed experiences. Mismatch, not deficit. That's Milton's double empathy problem.

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Alia Breon, MD @aliabreonmd.bsky.social · 01/10/2026

Your note made me tear up a bit. Because I have been trying to write that book for three years -- about how I as an MD had to completely change how I understood autism and neurodiversity. How the person who needed to change was me.

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Alia Breon, MD @aliabreonmd.bsky.social · 01/10/2026

This is fascinating: "the endothelial cells [around blood vessels in the brain] had half the normal level of a molecule called ATP." ATP = the energy unit used by all cells in the body. Potentially more support for the idea that Autism is a difference processing resource distribution. #Monotropism

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Alia Breon, MD @aliabreonmd.bsky.social · 01/10/2026

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...

nytimes.com

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.

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Alia Breon, MD @aliabreonmd.bsky.social · 25/09/2026

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?

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Alia Breon, MD @aliabreonmd.bsky.social · 28/06/2026

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...

aliabreonmd.substack.com

Meet the Mast Cell

A Link Between Stress, Inflammation, and Burnout

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Alia Breon, MD @aliabreonmd.bsky.social · 23/02/2026

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...

aliabreonmd.substack.com

The Neuroscience of Overwhelm

Deciphering the biological signal of too much, too fast

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Alia Breon, MD @aliabreonmd.bsky.social · 21/02/2026

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...

open.substack.com

The Neuroscience of Overwhelm

Deciphering the biological signal of too much, too fast

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Alia Breon, MD @aliabreonmd.bsky.social · 11/12/2025

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.

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Alia Breon, MD @aliabreonmd.bsky.social · 08/12/2025

Hi Helen! Thank you and I am so happy this piqued your interest. I have been quietly reading your work for the last couple years and so it is wonderful to get to connect with you.

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Alia Breon, MD @aliabreonmd.bsky.social · 08/12/2025

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.

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Alia Breon, MD @aliabreonmd.bsky.social · 07/12/2025

It is heartbreaking to see how medical science and autistic lived experience has been pushed aside and made way for fear-based messaging. There is a complex interplay between the immune system, stress biology and sensory procesing but vaccines are not the problem.

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Alia Breon, MD @aliabreonmd.bsky.social · 07/12/2025

Yes!! Autism is fundamentally a difference in how salient (important and interesting) information engages with the attentional networks and interests systems.

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Alia Breon, MD @aliabreonmd.bsky.social · 07/12/2025

Yes! It is a difference in how processing resources are distributed. The autistic mind naturally attributes more resources to important and interesting experiences. This deepens processing in some areas, but leaves less resources for others. The theory of monotropism.

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Alia Breon, MD @aliabreonmd.bsky.social · 07/12/2025

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.

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Alia Breon, MD @aliabreonmd.bsky.social · 07/12/2025

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 ⬇️

aliabreonmd.substack.com

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.

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Alia Breon, MD @aliabreonmd.bsky.social · 01/12/2025

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...

aliabreonmd.substack.com

I needed a new lens

How lived experience reshaped what I thought I knew

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