Years ago, I was diagnosed with depression during my Emergency Medicine residency. Given that I was experiencing increasing levels of despair and hopelessness, I believe that diagnosis was partially correct.
When I look back, though, I can also see that severe burnout was part of the picture. (Researchers have pointed out that the two conditions can overlap.) At the time, unfortunately, no one saw or addressed the burnout.
I ended up quitting my residency and switching to a less stressful practice and a more balanced life. I committed to taking care of myself properly and sought positive activities outside of work, such as dancing and writing. I felt dramatically better—shockingly better, actually—within weeks.
We know now that physicians are at extremely high risk for burnout: It affects approximately 50 percent of us at any given time. In the early days of the research, it was thought that burnout exclusively affected people in the helping professions, such as doctors, nurses, and social workers. It’s now established that burnout can creep up on anyone, in any vocation, if they experience a certain combination of difficult circumstances.
When I was suffering from burnout, I wasn’t aware of what was going on. You’d think that 80-hour work weeks and too many night shifts would have been a clue. In a way, I was lucky that my work life—and I—fell apart, as I was able to rebuild both in a healthier, comparatively burnout-proof framework.
Ever since, I have been speaking to groups and organizations about how to recognize, address, and prevent burnout. Every time I teach on the subject, people come up to me wide-eyed afterward, saying, “This is what’s wrong with me! I just thought I was exhausted and stressed.”
So how do you know whether the challenges you are experiencing are simply everyday work stress or the signs of burnout?
For a person to be diagnosed with burnout, these three components need to be present:
1. Emotional exhaustion.
You feel tired all the time. You don’t feel up to facing your workday, even if it’s just a normal day. You may wake up every morning with a feeling of dread. Day after day you feel this, and it doesn’t lift, even after a week off. It’s more than likely that you are dealing with heavy workloads or difficult workplace circumstances that are wearing you out.
2. Cynicism/depersonalization.
You may have started out as someone who really enjoyed working with people or dealing with clients. Now, you find yourself feeling increasingly angry and irritable toward them. You have a growing sense of detachment from your work and may even be alarmed by how cynical you’ve become.
Once, I was speaking to an association of specialist physicians on this topic. There was a rather unfriendly gentleman who sat way at the back (in fact, he warned me, before I went up to give my speech, that he didn’t want to be there and would probably leave partway through).
Imagine my shock when the very same doctor called me the next day from the airport on his way back home. He told me that while listening to me, he had been stunned to realize that he was suffering from severe burnout:
"My family has been complaining to me for years that I’ve become this angry, cynical person. I felt terrible about it and didn’t know what to do, so I just got more cynical. Now I understand that I’m burned out, and that I need to get help to make some changes. Thank you."
It seems there are so many people out there suffering, in a similar way, unaware of the root cause of these personality changes. (Obviously there can be other causes of personality change and chronic bad moods; given his profession, though, it is quite probable that burnout played a role.)
3. Reduced personal efficacy.
You’re losing confidence in your ability to do your job, even though you used to be quite good at it. You work harder and harder, but seem to accomplish less. Your productivity has dropped significantly, and your belief in yourself has fallen along with it.
As mentioned above, you need to be experiencing all three of these components to be suffering from full-fledged burnout. Even if you are just experiencing one or two, pay attention. As leading burnout researchers Christina Maslach and Michael Leiter describe in the article, "There is More to the Job Experience Than Just Burnout," you may initially experience just one of the above profiles, as you head down the road from healthy work engagement to full-fledged burnout.
If you relate to any of the above points or are struggling in your work (or your life), seek the advice of your doctor or a qualified mental health professional. I wrote this post to provide useful information on the topic; it is not designed for you to diagnose and treat yourself—leave that to the professionals.
Copyright Dr. Susan Biali Haas 2018
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