Stress - Burn Out
Burnout is a psychological condition in which a person routinely feels physically and emotionally exhausted, is cynical and critical of him or herself and others, and works less efficiently than usual. This condition is usually brought on by long-term stress, overwork, and a lack of support or acknowledgement.
Though burnout is often confused with stress, it is not the same thing. Stress is characterized by urgency and anxiety, but burnout is characterized by a loss of interest and a feeling of "giving up" or failure. It is a recognized disorder in the International Statistical Classification of Diseases and Related Health Problems (ICD-10), a standard for classifying mental disorders endorsed by the World Health Organization (WHO); but as of 2011 it is not in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the standard guide for classifying mental disorders in the US. If left untreated, this condition can have long-term physical, mental, and emotional effects.
Signs and Symptoms
Burnout has both physical and emotional signs. Though it affects people differently, those with this condition generally have at least a few of the following symptoms:
- Insomnia or sleeping much longer than usual.
- Lowered immunity — constantly having colds or stomach problems.
- Back and shoulder pain, or muscle pain generally.
- Low energy.
- Inability to relax without medication, drugs, or alcohol.
- Significant weight gain or weight loss in a short amount of time.
- Lowered sex drive.
- Not showering, grooming, or dressing appropriately for the workplace.
- A sense of disengagement, or a feeling of "just going through the motions."
- Feeling critical both of the self and of others.
- Becoming irritated more easily than usual.
- A decreased sense of accomplishment.
- A lack of motivation.
- Feeling like a failure.
- Dulled emotions and a lack of empathy or compassion.
In response to these symptoms, people tend to isolate themselves and withdraw from others. They may suddenly drop responsibilities, take a long time to do things that they can usually do quickly, or procrastinate even over simple tasks. Since they can't relax naturally, they often self-medicate to create artificial relaxation with drugs, alcohol, or sleeping pills.
Internal and External Causes
The overarching cause of burnout is long-term stress. This stress can come from overwork, working on things that are incompatible with one's beliefs or interests, or working without recognition or support.
Many burned out work in high-stress jobs, like medicine, pre-college education, law, law enforcement, and social work. It can also be caused by a stressful home life too though. For instance, a stay-at-home mom who is solely responsible for running the house and caring for her children can be just as at-risk as someone in the workplace if she does not get appropriate breaks, have support from her spouse or family, or have the resources to do what is expected of her.
Burnout happens because of a combination of internal and external factors. External factors are often more apparent, but internal factors are just as important.
- A job that requires extremes of activity: constant busyness or long stretches of non-activity, or both.
- A situation that is at odds with one's values. For instance, a social worker having to comply with regulations that he feels is unethical could be at risk, as could or a mom staying at home to raise children when she gets a great sense of satisfaction and accomplishment from working outside the home.
- Not receiving recognition for work either in the workplace or at home.
- Unclear or unrealistic expectations in the workplace or at home.
- A situation that is boring, monotonous, or too easy.
- A lack of control or autonomy in the workplace. Being micro-managed or constantly monitored can lead to this feeling.
- Being unable to meet one's physical, mental, or emotional needs. Being constantly unable to provide for oneself in any one of these areas is a big factor in many cases. Physical needs include things like good nutrition, sleep, and exercise. Mental and emotional needs vary from person to person, but include mental stimulation, having fun or laughing, having time alone or spending time with others, or having one's feelings acknowledged.
- Certain personalities are thought to be more prone to burnout than others, particularly those who tend to be perfectionists or have "type-A" personalities.
- An inability to set boundaries. This is often related to self-esteem, and leads people to take on more than they can realistically handle.
- Placing unclear or unrealistic expectations on oneself in terms of personal life. This can be just as damaging as unclear or unrealistic expectations in the workplace.
- Being unaware of or suppressing personal needs, whether that is a need to be alone sometimes, proper nutrition, or the need to create.
The best way to prevent burnout is to recognize when risk factors like those listed above occur and work to change them or avoid them. Though it's not always possible to avoid triggers entirely — people sometimes have to stay in jobs that they aren't suited for because they need the money, or may be unable to stop doing a certain project, like raising a child — there usually are some ways to modify the situation.
For instance, an at risk stay-at-home mom or dad could try setting more boundaries, like having the spouse help with certain parts of the housework; or she or he might seek out a support network among people in a similar situation. A person who's stressed at work could discuss changing projects with the boss, or could ask for clarification about the expectations for his or her position.
Making sure that physical, mental, and emotional needs are being met is another big part of preventing this condition. Ways to do this include:
- Incorporating activity into the day. Even a ten minute walk can help matters.
- Eating appropriately and getting enough nutrition.
- Sleeping enough — this varies from person to person, so it's important to experiment to find out what is needed. It's also important to recognize things that interrupt sleep, like watching TV before bed or keeping a cellphone on at night.
- Incorporating periods of relaxation into the day. This could be a few minutes of meditation in the morning, a nap after lunch, or an hour of reading before bed.
As with many conditions, burnout is easier to overcome the earlier is it recognized. Having a network of people who care for one's well-being is an important aspect of this, since burned out people may not be able to notice the symptoms in themselves until they become severe.
Though serious, burnout is definitely a treatable condition. There are both medication-based and alternative treatments, one of which may be more or less appropriate depending on the cause, and which can be used together as well. In some cases, a person may need a complete change of job or lifestyle to recover.
The most important part to treating burnout is recognizing it and speaking with someone about it. It's important to schedule a visit with a doctor, since he or she may be able to shed light on problems that could be contributing to the condition, but burned out people may also want to consider talking with a counselor, a religious adviser, or even just someone who can empathize.
A doctor may prescribe medication to treat the symptoms of burnout, including:
- Sedatives or sleeping pills.
- Medication to help with any digestive problems.
- Other medications to deal with associated physical problems.
There are also many non-medication-based treatments, including:
- Counseling or therapy.
- Journaling — this can help people better understand their needs and spark ideas about how to meet them.
- Stress management techniques — some people find it helpful to do a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of their situation and goals.
Though these types of treatments can help with the symptoms of burnout, it's usually impossible to truly treat it if the situation or internal factors remain unchanged. Some people find that they need to quit their jobs entirely, take a long-term leave of absence, or negotiate with their boss to change things about their workplace or schedule.
If burnout is left untreated or unaddressed, it tends to get more and more severe, and can cause long-term physical, mental, and emotional damage. Physically, it can up a person's chances of heart problems, strokes, digestive disorders, fertility problems, diabetes, weight gain, tooth grinding, and problems with the bones and muscles, among other things.
Mentally and emotionally, long-term burnout can lead to depression and anxiety, forgetfulness, nightmares, mental breakdowns, and a risk of suicide. In some cases, this condition has actually led to people dying from overwork or killing themselves. This is particularly notable in Japan, where the phenomenon of karoshi, or death from overwork, is considered a social problem and is addressed by various government and corporate programs.
This condition also has an indirect effect on others, and can be dangerous in those working in jobs where others rely on them, like medicine. A burned out employee is much more likely to make mistakes and careless errors than one who is focused on his or her job, which can be extremely dangerous in medical, social work, and educational settings. For instance, a doctor who is burned out may be much more likely to miss a symptom or make a mistake in a prescription, or a teacher who is burned out might not notice when a child demonstrates signs of abuse.