Burnout Can Affect Anyone

Even though I’ve been a psychiatrist for over 30 years, I still make it a habit to browse medical and psychiatric journals. There’s always something new to learn. For example, over the past few years, the subject of burnout has begun popping up. The patients discussed in these articles were usually doctors, nurses, or others with intense jobs dealing with life-or-death issues. Since COVID-19, this trickle of articles has turned into a flood.

After looking at many of these medical studies, it occurred to me that, without realizing it, I had treated burnout for years, but not in doctors and nurses. My patients worked in factories, warehouses, retail, bookkeeping, and all the common jobs in the state where I practiced.

The way we see burnout presented in the media seems to only affect people in high-intensity jobs, like trauma surgeons or special operations forces. Many people have this impression, but in reality, it is much more common and has more to do with stress control than the intensity of stress at a job.

What Is Burnout?

We all use the word “burnout” in common conversation to mean that we’ve been pushed beyond our tolerance. I’ve had enough! “I’m totally burned out on watching TV.” But, when we say burnout in medicine, we mean something very specific. It is now considered a medical diagnosis and has important implications for anyone who gets it.

So, let’s begin with the definition. There are three types of symptoms that together make for a diagnosis of burnout.

• The first is a feeling of fatigue or depletion. This is not just being tired, sorely in need of a vacation, or like it’s time to go to bed. It feels more like your batteries are drained. The problem is that it does not go away even with rest.
• The second symptoms are very negative feelings towards your workplace. This has been called disdain or cynicism. It is a generally negative attitude towards your job, its management, and most things about it. This may be so even for a job you used to love.
• The third is a feeling of ineffectiveness at work. It feels like everything you do is a waste of time, gets nowhere, and accomplishes little.

Most studies of burnout have been in people with high intensity and even dangerous jobs because of the nature of the stress involved. You might think it’s because of the high-stress level, but that is not quite right. The central issue in burnout is in any stressful situation where you have no control over the stress. Control, in this case, doesn’t mean you need to be in charge or have a dial you could turn down. But it does mean that there would be a system of rules or options that help you control the stress you are experiencing. In other words, you can at least influence the stress. This may mean scheduled breaks, a discussion with a supervisor, a change of schedule, better staffing, a transfer, time off, or even a visit with a mental health professional to discuss your stress. Sadly, in many workplaces, few of these things exist, or if they do, they have little effect on your situation.

Getting Burnout, Getting Worse, and Getting Better

One problem with burnout is that even when you are not at work, you still suffer the symptoms described above. You’re exhausted for no apparent reason, angry at work (which gets transferred to other people, like family members), and feel like you’re wasting your time at your job. In addition, studies have found that burnout puts you at higher risk for high blood pressure, heart disease, depression, and even suicide.

This is where my realization came in about the patients I had seen in my practice over many years. No one came in complaining of burnout. By the time they reached me, they had developed clinical depression. I would treat them with medicine, some talk therapy, and their depressions would improve. But they never seemed completely better. The stresses of work, which were largely out of their control, were still there.

Most of these individuals told me that they loved their jobs and the people they worked with. But over the years, things had changed. Deadlines got shorter. Staffing got reduced. Overtime was no longer optional. You were asked to get more done with less time, fewer people, and fewer of whatever resources you needed to do your job.

And the paperwork! What was formerly straightforward now involved extensive computer documentation, filling out forms, and complying with more and more regulations.

With the passage of the Family Medical Leave Act (which allows not only medical leave but appropriate accommodations for illness or disability), I became involved with medically necessary accommodations for my patients. In other words, I could help them restore some control over their situations. As their doctor, I could now request limited overtime, breaks during the day, or time off when their symptoms became severe if I believed they were necessary for the problem I was treating. Only then did my patients finally begin to feel like themselves again.

I’m sure my description of the modern workplace rings true for many readers. What I hope to convey is that many job conditions may put you in a situation where you are excessively stressed and have no control over it. This may lead to burnout. If this happens and there is no recourse at work, such as a caring manager or a union representative, please reach out and get professional help. Without some break in the uncontrolled stress, burnout can easily set in and lead to other significant medical and psychological problems. Thanks to psychology and Labor Law developments, you do not have to trade your health for your job.