Defining Burnout
Breaking down Burnout
We all reach this point at some time in our lives–personal or professional. I think I can speak on behalf of most healthcare workers —the rate of burnout immensely skyrocketed with the COVID pandemic. So how do we address this? I promise to ignore it and keep on keeping on will catch up to you.
Let’s start with the basics. So, what exactly is burnout?
Burnout is a psychological syndrome due to a prolonged response to chronic interpersonal stressors. It is specifically a concern for those in “people-focused” professions such as health care, education, and human services. Providers for human services develop an “intense level of personal-emotional contact. . .such relationships can be rewarding and engaging, they can also be stressful”(Maslach, Leiter).
Burnout has three main components: overwhelming exhaustion, feelings of detachment, and a sense of ineffectiveness/lack of accomplishment.
The 5 Stages of Burnout
A 5 stage model for the development of burnout was initially adapted from psychologist Herbert Freudenberger’s 12-stage model addresses the development of this syndrome. It starts with the honeymoon phase (as anything does) which is enthusiasm toward the work you are doing or your place of employment. During this phase, we feel job satisfaction, energetic, optimistic, productive, and creative. The next stage is the onset of stress. This stage is crucial in determining which path is then proceeded down next. If no positive coping mechanisms are implemented here to handle workplace stress then we proceed down the burnout pathway. It is common that in this stage we see work responsibilities take an extensive priority and family, friends, hobbies, working out, etc take a back seat. Symptoms of the second phase are irritability, poor sleep, decreased productivity, and anxiety.
A chronic state of stress occurs in the third stage —this is where a sense of powerlessness starts to creep in. We may start to feel persistent exhaustion, a cynical attitude, and social withdrawal. It is here where we can see turning to the daily glass of wine after work habit develops or other numbing mechanisms. The stage of apathy, stage four, is where we become indifferent because we see no way out of the current situation. Common signs here are self-doubt, pessimism, and chronic health issues develop such as headaches, GI issues, and behavioral problems. The last and final stage is “habitual burnout” which is essentially where we have found no way out and it has led to the development of chronic physical symptoms as well as a large toll on mental health such as the development of depression.
Based on these five stages it becomes clearly evident that early recognition is absolutely essential to prevent worsening symptoms of burnout and progression to a worse state of being. Burnout is a multifactorial process that snowballs quickly.
Am I the Problem?
Is this an “It’s not you , it’s me” situation? Well, that depends. As discussed, burnout is multifactorial. Yes, if you have conditions such as baseline anxiety/depression, and poor coping practices for stress already in place then I would say you are at higher risk for the development of burnout.
One proposed model for the development of burnout is the Job demand-control model that was created by Robert Karasek. This model describes the relationship between job demands and the employee’s freedom to manage the work. In a passive job, we run the risk of being bored due to lack of challenge, but in a high-strain job there are a ton of demands we then become limited in our decisions/control ability—this is where we are at risk of stress.
Karasek RA. Job demands, job decision latitude, and mental strain. Implications for job redesign. Adm Sci Q. 1979;24:285–308. doi: 10.2307/2392498
While challenges are important in the workplace, just like goals, demands need to be measurable and attainable so we feel a sense of accomplishment and confidence boost. When we are under a great number of demands with limited flexibility and power to accomplish goals and meet project deadlines feelings of inadequacy and self-doubt start rolling in.
What to do Next
After reading this if you are questioning whether or not you are experiencing burnout in your current situation ask :
Is my physical health / self-care suffering due to work?
Am I dragging myself to work each morning?
Am I constantly needing to take naps?
How is my sleep?
Do I lack the energy to engage in social activities, hobbies, or physical fitness outside of work?
Do I feel a sense of achievement or accomplishment with my work?
Am I self-soothing with food or alcohol to escape my current reality?
Do I have constant headaches or bowel issues?
Am I lacking concentration?
Do I feel emotionally withdrawn from other areas of my life?
Start there. Get really honest with yourself and your symptoms and then you can take the next step in addressing your burnout. . . you just have to recognize it first.
Sources:
De Hert S. Burnout in Healthcare Workers: Prevalence, Impact and Preventative Strategies. Local Reg Anesth. 2020 Oct 28;13:171-183. doi: 10.2147/LRA.S240564. PMID: 33149664; PMCID: PMC7604257.
Know the signs of Job Burnout. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642#:~:text=Job%20burnout%20is%20a%20special,as%20depression%2C%20are%20behind%20burnout. Published June 5, 2021. Accessed January 31, 2023.