Feeling stressed? How to prevent burnout?
Are you feeling exhausted, slower at work and doubting yourself? Are you experiencing compassion fatigue? Do you notice it is difficult to empathise with those in your care?
It can be a distressing feeling for all those working in services such as emergency services, health care and education. We go into these professions because of a strong belief in contributing to society and helping others.
Since Covid-19, many have expressed feeling exhausted due to an increasing workload, dealing with multiple challenges in a climate of ongoing uncertainty and change.
Understanding stress makes a difference to how we manage challenges, and by prioritising healthy habits, we can restore energy, manage our emotions and maintain our physical and emotional wellbeing. It enables us to build resilience to maintain our strength during challenging times and prevent burning out.
What is stress?
It is the physiological reaction our body experiences when demands exceed our resources. It is normal to experience symptoms of stress during our lifetime. The stress response occurs when we face challenges and do not have the physical and mental capacity to cope with the demands.
The body’s stress response is adaptive – it enables us to adapt to the changing environment, regulating homeostasis (McGonigal, 2015). It is common to notice physical symptoms such as aches and pains, rapid heartbeat, headaches, stomach problems, irritability, sadness, altered sleep, fatigue, worry thoughts. However, chronic stress is harmful – it suppresses the immune system and can lead to illness (Sapolsky, 2004). During Covid-19, we have had to adjust to working from home, which can be stressful to rearrange and blend work and home life (Peña Bizama & Cooper, 2021).
What is burnout?
It is a state of emotional, physical, and mental exhaustion caused by significant stress over a prolonged time. It starts in the work setting and can affect home and social life.
People experiencing burnout describe feeling overwhelmed, feeling physically and emotionally exhausted, having a sense of detachment, disillusioned and cynicism, feeling disengaged from the job. They describe feeling distressed that they feel numb, unable to care for their patients or those they serve at work. Compassion fatigue prevents them from deriving satisfaction from the job. In addition, having feelings of self-doubt and loss of confidence, worrying whether they can continue to do the job at the standard they expect of themselves (Maslach et al., 2017).
Symptoms manifest in ongoing fatigue that does not ease after taking a break or a few days off work. The loss of energy and feeling unwell causes concern and distress, wondering when they will feel better again. The longer the symptoms persist, the more it affects physically and emotionally, experiencing low mood and nervousness. Part of the worry is related to work performance, worrying about loss of confidence.There may be a tendency to shy away from responsibilities and withdraw from others, leading to feeling isolated and lonely (Peña Bizama, 2010).
Symptoms begin gradually, but there is a tendency to overlook them, pushing through using willpower and determination, until it they no longer can do this because of physical and mental exhaustion.
What can lead to burnout?
It can start with changes in work demands, for example, increased workload and more responsibilities in a short period that continues over a prolonged time (Maslach, et al., 2017). There may be changes in the work where there is not sufficient autonomy to perform the role. During Covid-19, many have had to work under continued pressure with unclear goals and not enough guidance or support. Sometimes, people perceive unfairness, mainly when working hard and going the extra mile, but it is not noticed or acknowledged.
People who have a high sense of responsibility and commitment to the job and tend to overextend beyond their physical and emotional capacity are more at risk of developing burnout. They feel the need to keep up with tasks and responsibilities, so they find it challenging to take a break feeling guilty as there is so much to do (Peña Bizama, 2010).
People may tend to perfectionism and worry about making mistakes, concerned about potential consequences to others. It can lead to increased worry thoughts that can affect sleep, preventing recovery time.
They are likely to have additional pressures in their personal life. Because of the busy work schedule, they may not feel able to dedicate time to social activities and maintain relationships, feeling they cannot manage a healthy work-life balance (Maslach, et al., 2017)
What are the differences between stress and burnout?
Stress is a normal physiological response when having too many demands over a prolonged period and when the work is demanding both physically and mentally. However, it is possible to maintain the hope that things can improve over time.
On the other hand, burnout is experienced as feeling mentally exhausted, losing interest and feeling detached, unable to think clearly or care about the work. When taking a break, it does not feel restorative, and the ongoing effort to keep going is overwhelming reducing confidence and hope in the possibility that things will improve.
Having an understanding of stress and burnout and what are the potential triggers can help us to identify signs early. It is essential to take preventative action to manage symptoms as soon as we notice them and prevent them from getting worse, affecting our health.
So what can we do to manage stress symptoms and prevent burnout?
It is essential to start implementing positive coping strategies to build inner resources to deal with challenging times while protecting our health and wellbeing.
Maintaining a routine: When dealing with stressful situations, we tend to have unstructured days, affecting our body’s ability to restore energy. To manage our energy level and keep well, we need to structure our day, including having regular meals, eating healthy food, and have a bedtime routine that protects sleep time. Maintaining healthy habits also supports our immune system – essential to protect our health (Macciochi, 2020).
Taking regular breaks: Viewing these as an essential part of maintaining a healthy routine to manage our energy level. It is necessary to take breaks from screens and move to benefit our bodies and minds.
Practice relaxation exercises: Paying attention to breathing and noticing physical sensations will help to restore balance. Unplugging from digital devices and focusing on our body as we move will reduce tension and restore balance.
Exercise: Movement helps to release muscle tension, and as we move, it will relax the body and maintain flexibility. It enables the nervous system to restore balance by focusing on our breathing and relaxing tense muscles.
Being outdoors: Nature has a positive effect on our nervous system and whole body. Paying attention to sounds, looking at vegetation, feeling the fresh air and absorbing natural daylight will release tension, having a sense of wellbeing, and it will also help to sleep better.
Protect sleep time: It is essential to develop a sleep routine that includes going to bed and getting up at the same time every day of the week, limiting stimulants like alcohol and coffee. Health professionals recommend not taking caffeine after 2 pm as it can affect sleep. Lowering the lights about 1 hr before bedtime helps to create a nighttime feeling. Our body picks up the cues from the environment that signal it is nighttime.
We are used to having our digital devices nearby all the time, but they can keep us awake. Turning off digital devices about 1hr before bed will help to reduce distractions and prevent the backlight from disrupting our sleep. Also, keeping the bedroom quiet, dark and cool (not too cold, not hot) will help us sleep better (Walker, 2014).
Practice mindful breathing: It is a technique that helps us to be calm and restore balance. It recommended that we settle in a comfortable, quiet place, without distractions. Then, start to inhale for four counts, hold for four counts, and exhale for four counts. We can adapt the pace to what feels comfortable. The aim is to pay attention to each breath, noticing sounds, smells, and how textures feel (Gilbert, 2010).
Developing self-awareness: Learning to identify what triggers our tension, being aware of thought patterns to identify alternatives to manage challenging situations. It helps to understand our emotions, which enables us to regulate them and build resilience (Gilbert, 2010).
Practice self-compassion: It is our human capacity to be understanding of our vulnerabilities and strengths. We can restore our balance by acknowledging that our feelings are part of the human condition. Then, being understanding and kind toward ourselves, like we would treat our best friend (Williams & Penman, 2011).
Strengthen resilience: Often in distress, we focus on our vulnerability and miss that we have experienced previous challenges. We can explore insights we have gained from past experiences to apply to the current situation. Focusing on what we can control and letting go of what we cannot help us manage uncertainty. Developing emotional agility allows us to adapt to a changing environment. And, connecting with our values enables us to identify what is meaningful and what gives us a sense of purpose (McGonigal, 2015).
What can we do about work-related factors to prevent burnout?
Reframing the way we view work: Directing our focus to what is meaningful/of value can provide us with a purpose and help to guide our decisions.
Re-evaluating priorities: Identifying what is most important and dedicating time to these tasks will enable us to allocate our time and energy. We need to include self-care in our priorities – if we do not feel well or become ill, we will not be able to do our work or help others. It is best to discuss with a line manager or supervisor the workload and the changing nature of the work/role to find what is possible to do given the limited resources (Peña Bizama, 2010).
Setting boundaries: Taking time to evaluate commitments and responsibilities. If it is difficult to say no, we need to reflect on why this is so. Discussing the need to overextend with trusted others will help discover what is preventing us from prioritising our health to continue doing a good job.
Maintaining a social network: It is fundamental to being healthy at work, to have positive relationships with our co-workers. Having supportive colleagues and positive communications with others are a buffer that protects us from developing burnout.
When we feel others understand and feel we share a common challenge that we face working together, can be nurturing and reassuring.
Seeking support: It is helpful to discuss our work concerns with a line manager or supervisor to find solutions. And when our health begins to be affected, it is essential to contact a doctor, or a health professional, to discuss treatment options if symptoms persist.
Gilbert, P. (2010) The compassionate mind. London: Constable & Robinson, Ltd.
Macciochi, J. (2020) Immunity. The science of staying well. London: Thorsons.
McGonigal, K. (2015) The upside of stress. Why stress is good for you (and how to get good at it). London: Vermilion.
Maslach, C., Schaufeli, W.B, & Marek, T. (Eds) (2017) (2nd Ed) Professional burnout. Recent developments in Theory and Research. London: Taylor & Francis Ltd.
Peña Bizama, M. A. (2010). An exploratory Study of the factors influencing individuals’ recovery and ability to retour to work after experiencing stress, burnout, anxiety, or depression. (Unpublished doctoral dissertation). University of East London, England.
Peña Bizama, M. A. & Cooper, C. (2021). Chapter 13: Coaching and stress. In J. Passmore (Ed) Excellence in Coaching. Theory, Tools and techniques to achieve outstanding coaching performance. (4th Ed) pp 237-258. London: Kogan Page
Sapolsky, R. (2004) Why zebras don’t get ulcers. The acclaimed guide to stress, stress-related diseases, and coping. Revised and updated. New York: Hold Paperbacks.
Walker, M. (2014) Why we sleep. London: Penguin, Random House.
Williams, M. & Penman, D. (2011) Mindfulness: a practical guide to finding peace in a frantic world. London: Piatkus.