Even before we started hearing about the Great Resignation, there were signs of an increasing awareness of burnout. The World Health Organization added burnout to its International Classification of Diseases in 2019, describing it as an “occupational phenomenon” rather than a strictly medical condition. The term itself gives most people enough of a picture to guess at the broad strokes of this state of physical, emotional, and mental exhaustion. But how to recognize the tipping point where feeling crazy-busy turns to burnout? In the American Psychological Association’s definition, “it results from performing at a high level until stress and tension, especially from extreme and prolonged physical or mental exertion or an overburdening workload, take their toll.”
If you trace the burnout surge by the news, the first wave hit health care workers on the front lines as they became overwhelmed from treating COVID-19 cases; then working parents who were home-schooling kids seemed to reach their multitasking limits; and now the spotlight is on, well, any of us who are experiencing the new normal of work having invaded our home lives. In my psychotherapy practice — I have been a licensed clinical social worker for 23 years — I am seeing more and more burnout in my patients, which has most certainly been heightened by the pandemic. And yes, they are physicians and parents and people of all professions.
What Burnout Looks Like
One patient — let’s call her Ellen — is a doctor at a busy New York City hospital, and describes punishing days of seeing patient after patient while others on shift regularly call out sick, leaving her with no backup. She is often on the verge of tears in our sessions because she feels pulled at from so many directions.
“Jason” had largely managed to get his anxiety under control but was experiencing a recent spike. I dug in to try to figure out why. “I think it’s work,” he said. Jason had just been promoted at his job, a position he worked hard for, but now, he said, “the emails never stop. I can’t even finish reading a chain of emails before my boss asks why I haven’t replied.”
Making matters worse, he said, is the fact that he is working with new colleagues whom he has never met in person because of the pandemic. “It’s not like I can go into my co-worker’s office to vent about it,” he said with exasperation. “Denise” who started a new and exciting job early in the pandemic, has talked lately of a complete lack of interest in work and difficulty mustering energy to log on each morning.
She is so tired when she clocks out at 7 or 8 p.m. each night that she cannot summon the will to go to the gym or play piano. This had long been a creative outlet for her. What these snapshots show is that when we give our systems more stressful stimulation than they can handle, we burn out. The good news is, there are ways to reclaim your sense of well-being and control without quitting your job and giving up your goals. The first step is taking stock of where you stand.
What are the signs?
The three big components are overwhelming exhaustion, cynicism and detachment from one’s job, and a sense of ineffectiveness and lack of accomplishment, according to research by Christina Maslach, PhD, a professor emeritus at the University of California, Berkeley, and co-editor of the journal Burnout Research, who developed a widely used measure of burnout. Early on, studies began to pick up on the sort of work tendencies that strain our health. Back in 1974, cardiologists Meyer Friedman, MD, and R.H. Rosenman, MD, famous for studying the differences between types A and B personalities, discovered that high-risk heart patients shared some common characteristics related to work: a chronic and/or severe sense of time urgency; involvement in multiple projects with deadlines; desire for recognition and advancement to enhance self-esteem; neglect of most aspects of life outside of work; and a habit of taking on excessive responsibility.
Work is the most obvious culprit we look at for burnout, but stress overload shows up in plenty of other scenarios. Harried and exhausted parents know all too well what it feels like to try to balance feeding and caring for your children, earning a living, and maintaining some semblance of housekeeping. Students struggle with mounds of homework, daily sports practices, and test prep. Adults caring for elderly parents feel the physical and emotional weight of helping their family members get to doctor’s appointments, take their medication, and stay safe as they age. We all could use tools to manage this form of extreme stress.
How do you guard against it?
You don’t always have a say when it comes to hard and fast deadlines or the coming busy season, but a couple key strategies can provide buffers to becoming overwhelmed. First, set boundaries. Be clear about how much you can and are willing to handle. To help visualize your priorities, try this exercise from Heather Edwards, LMHC, a psychotherapist and life coach in New York City who works with her clients to help clarify all that they own, and what is the responsibility of others: “Draw a large circle on a piece of paper. Draw a smaller circle in its center. In the large circle, brain dump everything that is a concern to you. In the center circle write down what you actually have control over. Notice the differences.”
Next, learn to say no. We all want a leg up at work; we all want to show that we are willing to work hard. But if your plate is full and you cannot do an assignment without sacrificing sleep, personal life, and your health, say no, says Jill Lewis, LCSW, a therapist in Atlanta who specializes in eating disorders, and has seen an uptick in cases fueled by stress created during the pandemic. “As the level of need from clients put more stress on myself and my clinicians, it has meant saying no to always being on call,” she says. “We created our own mental health days to take breaks, adjusted schedules to not get overwhelmed, turn our phones off after hours and put on out-of-office messages.”
What can help break the mental exhaustion cycle?
It’s a matter of addressing the external pressures we face as well as the internal pressures we put on ourselves. For the former, it’s important to be an advocate for yourself and to speak up. I often rehearse with my patients what they can say to, or ask of, their managers. Maybe they need more flexible hours or extra compensation is in order — so they are not suffering in silence. This can be challenging for people who struggle with confrontation. If that’s you, try turning to friends to help you find your voice. As for the latter, worrying less about perfection helps. Psychoanalyst D.W. Winnicott famously wrote about the idea of the “good enough mother” sufficing for children to experience a healthy upbringing. Your efforts don’t need to be perfect for a successful outcome. Oftentimes, they just have to be good enough to get the job done.
A version of this article appeared in our partner magazine, How To Beat Stress: The Ultimate Guide To Feeling Happier, in 2022.