I didn’t appreciate the cumulative effects of stress at first and definitely had no clue about managing burnout. Maybe it’s because I’ve always pushed myself to extreme levels in pursuit of achievement. I had become used to the self-imposed pressure and when one goal was attained, I’d go searching for the next.
In high school I ran at international track and field meets for disabled athletes. In college I started racing Ironmans. Then, in medical school I took up ultrarunning, working my way up to 100-mile races. “Why?” one might ask. “Because I could. Because 50 miles doesn’t seem like much when everyone else is running 100.”
to reality TV...
When my dad was killed in the Haiti earthquake in 2000, instead of taking time off of medical school, I sequestered myself for 7 weeks with complete strangers to be on the reality TV show, Survivor.
and medical training...
This pattern didn’t change as I finished medical school and then went on to complete a 4-year residency in anesthesiology and a 2-year clinical-research fellowship in Pain Medicine. Believe me, nobody does a 2-year fellowship in Pain Medicine, but I wanted that extra edge.
When I finally finished my medical training, I was so excited to start my first real job as a Pain Doctor. I had done it! This is what I had been working towards for the last 10 years.
to a full-time job...
It wasn’t long before I started questioning my job. At the time, it wasn’t the job itself. I had a light schedule with plenty of time to meet with and care for my patients. It was the bureaucracy of the system I worked in. The limited treatments I could offer. The long wait times for patients to receive care. As well as the frustration they felt that was directed at me.
and a divorce...
A few months later, my husband and I decided on an amicable separation. We had grown apart and it had plagued our marriage for years. I would later come to realize the significant emotional toll that relationship had had on me and all of the feelings I had held in and never processed.
and the death of my dog...
A few months later, when I put down my dog of 12 years, who had been by my side since the day I started medical school, all of the emotions started to surface. Years and years of unprocessed emotion that I had easily suppressed. It wasn’t any one thing. It was the cumulation of it all.
It would take many more months for me to realize that I was suffering from burnout, the experience of physical, mental, and emotional exhaustion that results from chronic, unresolved stress. While it’s often tied to the workplace, it can result from the accumulation of many stressful factors like I described above.
What is Burnout?
Burnout syndrome, also known as “vital exhaustion” is different from being tired or overworked. We’ve all had days when we just want to crawl into bed after an especially long day at work or maybe after spending time at a family gathering. That’s normal. You’ll rebound after a good night’s sleep.
Burnout, on the other hand, is a severe stress condition that can cause long-term physical damage if not recognized and treated. Unfortunately, it can be hard to recognize because the symptoms of burnout can be vague and easily attributed to other ailments.
The Symptoms and Negative Effects of Burnout
Burnout can affect you on a physically, mentally, and emotionally. Physically, you may feel depleted or notice symptoms like abdominal pain, nausea, loss of appetite, headaches or trouble sleeping. In extreme circumstances it can cause tachycardia or palpitations or lower the immune system, making you more susceptible to colds or the flu.
You may also notice difficulty concentrating, forgetfulness, changes in mood, irritability, increased negativity and decreased pleasure in previously pleasurable activities. It’s natural to distance yourself from friends and family because of feelings of overwhelm, discontent or sense of dread or failure.
The first thing I noticed was a quickness to dismiss social engagements. I had excellent justifications, but the end result was the same – social isolation. I also started having headaches, insomnia, tiredness, difficulty concentrating, and I would procrastinate on the simplest tasks. But interestingly, I could deal with those. I dismissed them initially.
I didn’t start really appreciating the physical toll until I stopped recovering from workouts. The one thing I enjoyed most, running solo along single-track trails, felt overwhelmingly exhausting. I also started to notice my baseline HR gradually increase and sometimes it would feel like my heart would flutter in my chest. These would symptoms I could no longer dismiss.
If not recognized and addressed, burnout can have long-term consequences. A recent study found that burnout can increase your risk of heart attack, ischemic heart disease, stroke and sudden cardiac death as much as well-known risk factors like obesity, elevated cholesterol, and smoking. That was enough to scare me into action.
Who is at Risk for Burnout?
Burnout is becoming increasingly common, affecting 42% of physicians according to a recent survey. But it can affect anyone, from physicians and business executives to students, athletes, and even moms and dads. Google searches for ‘signs of burnout’ were up 24% in 2020 compared to the previous year.
Risk factors for burnout can be tied to personality characteristics, lifestyle, and environmental influences. The constant barrage of information from social media, news feeds, emails, and text messages create another layer of stress that keeps our minds in overdrive. One of the steps I’ve taken was to silence notifications from apps on my phone to reduce the “noise” in my daily life.
Typical characteristics of individuals at risk include:
- having a Type A personality,
- needing to be in control,
- being a workaholic,
- being a perfectionist,
- having poor self-esteem, and/or
- having poor coping mechanisms.
Other factors that increase risk include:
- having a demanding job,
- being a caregiver,
- experiencing a major life change like divorce or the death of a loved one,
- having a stressful homelife,
- living with a chronic illness, and/or
- financial stress.
The Steps to Recovery
The first, and in my opinion the most important, step of any recovery process is awareness. You HAVE to be aware that you are headed down this path (or may already be far along it) in order to start making changes to reverse the damage and take back your life.
It’s easy to remain in denial like I did for months (maybe it was years), but that will only keep you stuck where you currently are. You should probably go back to the beginning of this article if you’re not sure why that’s a problem!
The next step is to evaluate your current life, in its entirety, to identify the main factors that are keeping you stuck. There may be one primary stressor like a demanding work or home life, or it may be an accumulation of smaller stressors that have taken a toll.
Either way, the only way to heal from burnout is to identify and address these areas of stress. This is like taking stock of your life. It can be hugely rewarding if you allow yourself to enjoy the process.
Specific areas to review:
- Work life
- Home life and relationships
- Emotional wellbeing
- Big life changes like divorce, a breakup, death of a loved one, etc
- Physical health like an acute or chronic illness or injuries
- Financial security
Once you’ve identified the factors that are contributing to the cycle of chronic stress, you need to be willing to address them. Coming up with solutions can seem intimidating, but any problem can be solved by breaking it down.
Allow yourself the time and space you need to work through each of the stressors you identified in Step 2. This may also be a good time to reach out to a loved one, seek professional advice, or join a community of like-minded people for support. You are not alone in this. And you will get through this.
Give yourself the best chance for success by creating a healthy environment to work through these issues. Eat a healthy, well-balanced, whole-food diet. Get plenty of exercise but limit the intensity as your body recovers from the physical stress of burnout.
Start a daily mindset practice like mindfulness, meditation, breathwork, journaling, or gratitude practice. Make sure to get plenty of sleep. Do things that make you happy. Doing these steps alone aren’t enough to cure burnout but will help with recovery and maintaining health and wellness in the future.
Once you’ve taken the time to address the main stressors in your life, take some time to congratulate yourself. You’ve done so much to get to this point. Maintain the healthy habits that have helped you get to this point. Be sure to reassess your life regularly to avoid falling into old patterns that put you at risk of burnout again.