“I walked across the lawn my knees and legs trembling. I finally had the night off from duty as a surgical resident. The adrenaline had stopped flowing and the realisation that there would be no calls tonight was almost a soothing bliss as I made my way home. There were no thoughts or even a desire to think about anything but sleep. Food, dinner or snacks were not on my mind despite the late afternoon. I was burned out.

 

Years of being on high alert with work, patients and studying; all I needed was rest; I felt I had nothing more to give. Over a decade later, I do not recall much after that moment walking across the lawn, but I do recall that the next morning I awoke having slept 14 hours straight. No midnight bathroom run, no dinner, no shower, just sleep, and I’m almost certain that I woke up in the same position I fell asleep in. Never before and never again have I slept so soundly for so long.”

This was Lacretia’s first recollection of experiencing burnout. The second and last one, she told me, was a few years ago, but she did not recognise it in herself. A friend, who was a registered nurse, recognised the symptoms during a conversation one day, and told Lucretia that she sounded exhausted, and was at times, overly critical of her colleagues at work. “I thought it was part and parcel by nature of the job to be tired and to be under a lot of stress all the time. I did not enjoy or make time for many activities outside the job” Lacretia recalls.

 

What Is Burnout?

The Mayo Clinic online defines job related burnout as “a special type of work-related stress — a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity”. The World Health Organization (WHO) classifies burnout as it relates to an occupation context only. It is not related to other areas of life, and neither is it a classified as a medical condition.

According to the WHO and the journal, World Psychiatry, the three main criteria for burnout are:

• overwhelming exhaustion;
• detachment, cynicism, irritability and negativity towards the job or responsibility; and lastly
• a decline in work quality and becoming less efficient.

It is interesting to note that the number of articles, research papers, and other online publications on burnout have increased, particularly as it related to the health sector since the COVID pandemic started. However, burnout has also increased across a wide cross-section of the population, thanks to the longer hours many of us have been working and the loss of a work-life balance, all family members being at home all of the time, parents needing to also monitor their children whilst they engage in online learning, which are just a few of the stressors that have emerged due to the pandemic.

 

Key Signs And Symptoms Of Burnout

Lacretia recalls that her episodes, as with most other individuals who experience burnout, had a slow insidious onset, gradually worsening over time. Burnout may start initially by taking on too much at a new job for instance, or working very hard, or for long hours over an extended period of time. Eventually, you may neglect yourself and family and friends, and thanks to physical, mental and emotional fatigue, become highly irritable and critical of others.

Further, and like Lacretia, you may not have time for non-work-related activities, or for socializing. Gradually, you may become withdrawn, develop inner sense of emptiness and eventually experience burnout. “I was not aware of the red flags, and either ignored or consciously and unconsciously rationalized them” she admitted in hindsight.

The occasional feelings of being overwhelmed, helpless, having a hard day at work, or just feeling that getting out of bed requires a Herculean effort, is not burnout. Persistence of these feeling though may be an indication of burnout.

The physical signs and symptoms include feeling exhausted and drained, often with disruption of health sleep patterns. Frequent physical ailments such as headaches, muscle aches and other illnesses may also occur.

The emotional symptoms include frequent self-doubt, feeling helpless, hopeless, unaccomplished, and you may be highly critical and cynical. This may lead to behavioural signs and symptoms including self-isolation, avoiding responsibilities and procrastination.

Having said this, there is a difference between stress and burnout. The latter may result from prolonged stress, but they are different. In stress, there is a sense of having ‘too much’, for example, too much to do and not enough time, but in burnout, the individual has feelings of ‘not enough’, such as not enough energy, motivation, passion or care. However, while most people can recognize stress or stressful situations, they may not equate their lack of passion, motivation, etc., as possible signs of burnout.

 

Recovering From Burnout

As with most things, recognition is key to managing or preventing burnout. Family and friends are invaluable resources who may not only recognize what is happening to you, but may also provide the necessary support, as occurred in Lacretia’s case. Once you accept that you might be experiencing burnout, it will need to be addressed, as it is unlikely to go away or resolve itself on its own – especially you are still in the situation that has triggered your burnout.

In the first instance, you ought to try to identify the likely source(s) of your burnout. Is it your job, and the fact that you have been working long hours, and have not taken any vacation in over a year? Is it because you are taking care of an elderly relative alone, with little or no help support? It is also important to note that your burnout may be the result of a combination of factors, and so may take time to be fully resolved, but it you can start with the most glaring issue and work your way through.

Then once you have identified the likely source(s) of your burnout, it is recommended that you remove yourself – if only temporarily – from these source(s). Frequently, the most prevalent symptom of burnout is fatigue, and so sleep or rest is in order. However, it is emphasized that just getting a few more hours of sleep just one night is unlikely to be enough to eliminate that sense of burnout. Burnout is builds over time, and so it is likely to also take some time to fully recover from it. Further, and perhaps more importantly, properly resolving burnout is about bringing more balance back into your life.

So, in addition to getting proper sleep, adopting a healthy lifestyle consisting of a balanced diet, exercise and time for play or relaxation ought to be a priority, and something that we ought to try to maintain going forward. In order to start to take better care of yourself, you may need to take some much-needed vacation time, or request the help of family or friends, or hire the services of a caregiver, to provide respite care on your behalf.

Finally, it must be highlighted that professional help may be required to properly manage and treat burnout. In this day and age, and in the pressure-filled environments in which so many of exist, burnout is almost inevitable; so it is nothing to be ashamed of. Moreover, any effort to make YOU a priority – and being proactive in restoring your physical, mental and emotional health – is worthy of praise.

If on the other hand you recognise the signs and symptoms of burnout in a family member or a friend, you may be able to help by listening to them, showing support, offering individualised help for their particular needs, and being supportive if professional help is needed.

 

 

Image: Nataliya Vaitkevich (Pexels)