What is burnout? Is it the same as stress? And, how do you protect against it?

I was very anxious before going to work in the morning. I’d been unwell with postnatal depression before and that was coming back, so I had to increase my medication. It was the constant feeling like a rabbit in the headlights in work; the fear of making a mistake, which adds to your anxiety.”

These are the words that Dr Stephanie de Giorgio, a locum GP, so kindly shared with The Independent.

Burnout is what happens when you are emotionally exhausted. It was a word first coined in 1974 by Herbert Freudenberger who observed the loss of will in staff looking after people who were addicted to drugs.

There are many different words you can use to describe burnout. Fatigue, depletion and drain go some way to summing up the experience of burnout. But what causes burnout?

The seven causes of burnout

Burnout comes from being chronically stressed and it is caused by several problems in your work environment.

Christina Maslach is a psychology professor at Berkeley in California. Since 1980s, she has been researching this thing called ‘burnout’, and she has found seven specific causes:

1. Work overload
2. Lack of job control
3. Insufficient reward
4. Unfairness
5. Breakdown of community
6. Value Conflict
7. Job-person Incongruity

Here are a few examples.

Work Overload

GPs, nurses, therapists and teachers often work extremely long hours. Early starts and late finishes take their toll. But with work pressures on the rise, the urge to take work home in the evening and at weekends can take over.

Lack of Control

Targets set by government policies can cause major disruption. Instead of focusing on what you think is important, the powers above make demands of you to complete unnecessary paperwork.

Insufficient Reward

Pay depends on your stage of career and for many the opportunity to earn more is missing. Caring professionals work hard and they provide an essential service to society. Pay freezes and low wages frustrate and anger professionals who merely want appropriate financial recognition for what they do.

Breakdown of Community

Conflicts at work are a breeding ground for worry and rumination. When people p*** you off, it can stir up negative feelings. You think about it when you are at home and it can get inside you when you’d rather be thinking about something else.

Changing aspects of your environment are not easy, so what do you do?

How well your work environment takes care of you is significant when it comes to preventing burnout. Some of the solutions are obvious. You just replace the cause with a more helpful goal. For example, you replace:

• Work Overload with a Sustainable Workload
• Lack of Job Control with Feelings of Choice and Control
• Insufficient Reward with Recognition and Reward
• Breakdown of Community with Sense of Community

“But…”, I hear you say. “How do we do that?” The trouble with these solutions is that they aren’t something you can make happen. Even if you could, they take time. And, they take a concerted effort from the group to see it through. They aren’t quick-wins!

So, does this mean it’s hopeless to find ways to make your work environment less stressful? In short, no! There are other ways.

Are you just stressed or nearing burnout?

Stress and burnout are not the same thing. Stress is what you feel when you get up in the morning. It isn’t necessarily a bad thing. Stress can energise you, make you want to get involved and help you feel like you are doing a good job.

But when you feel burned out, the opposite happens. You feel exhausted, you become more cynical and you feel ineffective in what you are doing.

Burnout is what happens when the stress goes on for too long. Recent research carried out by Paul Flaxman with school teachers, found that a restful Christmas holiday was essential to their recovery between the winter and spring terms.

Does burnout come from caring too much?

Burnout and caring are intimately linked. If you didn’t care, then you wouldn’t work so hard. But we also should be careful, because this is a trap. Whilst caring and wanting to make a difference is what drives you, it can become an unrelenting standard.

When you feel like anything you do, you could do better, it is an unrelenting standard. When you feel that everything you do needs to be perfect, then it is an unrelenting standard. And, whilst reaching for the stars is admirable, you can easily overlook something important.

When your focus is on doing as much as you can and to the best of your ability, you might forget to look out for what you need. You might put off taking breaks and resting in the evenings and at weekends. And this is a recipe for burnout.

When you care so much about other people, it doesn’t work to put off what you need. And this is a challenge for many helping professionals. You can neglect what you need to stay fresh and recharge, because you are overwhelmed by the demands of the communities you serve.

Three nails you’ll need to keep hammering over the course of your working life

To stay in-check and to protect yourself against burnout, you need to be hammering three kinds of nails. These nails represent three areas that require your attention if you to remain engaged, involved and effective.  They are:

1. Relationships
2. Professional Development
3. Looking after your Personal Self

Relationships

Caring professionals literally meet, help and say farewell to thousands of people over the course of their careers. Some days, you might just see a handful. Other days, you might see many more.

And to help you manage your relationships, it pays to know about how you successfully start and end them. More than that, how you effectively connect and disconnect with the people that come through your door.

The Cycle of Caring

The cycle of caring talks about four stages. A lot like the seasons of the year, they are all different and equally important. The first stage in this cycle is Attachment. No matter what you do or who you are caring for, people love an emotional connection. This is what helps you through difficult experiences when you are concerned about your health. And, it helps you when you are learning stuff that takes you way outside your comfort zones.

The second stage is Active Involvement. This is when you get down to the work. You get busy doing what you do to look after or teach the person you are with. But, you need the energy and the enthusiasm to do it effectively.

The third stage is Separation. This is the opposite to attachment and involves letting go. Just like you need to let go of children as they grow and get older so that they can develop into independent adults.

The fourth stage is Re-Creation where you rest, play and have fun. You recharge your batteries so that you are ready for stage one again.

So, the challenge and the task is to attend to this cycle through micro-behaviours. You don’t have lots of time between people, so you need to focus on what you can to connect, help them out, separate and re-focus on yourself. That is how you care effectively for both your patients or students and yourself.

Developing Professionally

I bet that one of the reasons you chose your career was because you like to be intellectually stimulated. Whilst you’re training that is easy, because you’re learning so many new things. But once you get into your job, your time gets filled up with seeing people.

The solution is to identify how you want to develop professionally at different stages. Some people are always studying and that can cause problems. On the other hand, you might have stopped learning new things or stretching yourself.

Although taking on new challenges can seem scary when you are stressed, it protects you against burnout. New challenges help you learn and expand your knowledge and your skill. It stimulates parts of your brain that help to level out your stress hormones. And your growth builds your confidence in what you do.

Investing in your Personal ‘Self’

This can be the most challenging commitment. But, as you discovered earlier it is an important stage of being an effective carer. You need to look after yourself so that you can reconnect and help them.

How you take care of yourself can be just small measures. It might involve asking for help at work. It might look like having a laugh with someone. Or, it might mean ensuring you do some exercise even when you don’t feel like it.

Let’s re-cap

In this article, you have learned about burnout and how to begin protecting yourself against it. You saw how the work environment can be a source of stress or play a supportive role. You considered the differences between stress and burnout and understood that unrelenting standards can make you try too hard and forget to look after yourself.

You learned that to protect yourself against stress and burnout, you need to pay attention to three areas of your life: relationships, professional development and your personal life or self.

There is more to come

This is the first in a series of articles aimed at helping you protect yourself against burnout. In this series, you’ll get to work through the issues we’ve covered in more detail. And, in next week’s article, we shall be looking at how to navigate professional uncertainty during the early stages of your career.

You can read other articles in the Burnout Protection Series:

1. Navigating the Choppy Waters of Professional Uncertainty
2. Why celebrating your Professional Successes can save you from burnout
3. Why Columbo won’t save you from the crime of being too busy
   

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