Burnout: What is it and what can we do about it?

Most jobs are very demanding, particularly in health and emergency services, social care and education. Ever-increasing workloads, ongoing changes in demands with decreasing resources, lead for many to work long hours for prolonged periods. People express feeling stressed, and it is affecting their health and wellbeing.

It is not uncommon to hear that we need is to build our resilience, although any would say they are being resilient already, and what is needed is resources to deal with the challenges they are facing.

The increasing workload, lack of control and reduced sense of achievement depletes energy resources, which can lead to chronic stress if there is no opportunity to restore balance.

To manage the pressure and prevent burnout, it is essential that we prioritise self-care to restore our energy. In addition, we need others. We are social beings and need connection.

Other people around us, being part of a network where we can support each other, taking time to listen and be understanding, can be a supportive presence. Having a supportive network is a buffer that can help prevent burnout.

What is resilience?

Researchers describe resilience as the individual’s capacity to adapt well and bounce back from challenges. It is complex, multidimensional, and dynamic (Bonnano, 2004).

However, it is necessary to highlight that healthy adaptation depends on the individual and on also on resources available, cultural aspects, and systems (Southwick & Charney, 2013).

In situations where people have been working hard through difficulties and for a prolonged time, it already shows that the individual is resilient and is adjusting to the circumstances. However, their efforts are not sustainable without external conditions to support their work.

In challenging situations, stressors are present in the context, in systems and lack of resources, making the work more difficult. In these situations, it is helpful to focus on what people can control and let go of what they cannot (Southwick & Charney, 2013).

As human beings, we all have an inbuilt stress response to deal with challenges. It is our survival system – it enables us to adapt to the changing environment, regulating homeostasis (McGonigal, 2015).

However, chronic stress is harmful – it suppresses the immune system and can lead to illness (Sapolsky, 2004). If we do not take time to manage stress, it can lead to burnout.

What is burnout?

Burnout was first described as consisting of three elements: a) emotional exhaustion, b) depersonalisation, and c) low sense of achievement (Freudenberger, 1974). Researchers explored the experience of workers in health and social care, where people were experiencing fatigue after caring for a prolonged time.

It was common for workers to feel compassion fatigue and a sense of futility, feeling their work was not making a difference. They described 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).

We can work hard and have a challenging job, however, we can deal with it provided that we have the resources and understanding from others so we can manage the pressure and restore energy daily.

Often, when feeling stressed, it is difficult to focus and with depleted energy it can take us longer to get things done. We think we cannot take a break because there is too much to do and we do not have enough time.

We carry on because of a high sense of responsibility, and we do not want to burden colleagues who are also very busy. So, we overextend beyond our physical and emotional capacity. As a result, it is more likely that mistakes will happen.

When having deadlines, there is less time to review our work, increasing worry thoughts that can affect sleep, increasing tiredness and aggravating stress symptoms.       

What can we do to prevent burnout?

Reframe expectations: focus on what is realistic to achieve in the situation, given the time and resources available. Depending on how we interpret the situation, we can reduce the stress response.

When we think it is something temporary, that it can happen to anyone, and that we can do something about aspects of it, we can restore our sense of agency (Seligman, 1991). We can tap into our curiosity and explore alternatives, asking questions such as: “What other ways are there to deal with this situation?”

Take a break: It may seem that there is no time to take a break as there is so much to do. However, view these moments as charging batteries time. To care for others and do good work, we need to have energy.

Going for a walk, being outdoors, keeping hydrated, healthy eating and protecting sleep are natural ways to restore our strength. Exercise where we move our body (adjusting for medical conditions), will help to process the stress symptoms and restore balance.

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).

Focus on what you can control: Often in distress, we focus on the stressors even if these are not in our control. Instead, we can do something – anything – to restore our sense of self-efficacy. Taking action, no matter how small the step we take, it will engage our body and mind (Bandura, 1997; Nagoski & Nagoski, 2020).

And, by developing emotional agility where we acknowledge our emotions as part of our human experience, we can connect with our values and identify what is meaningful. Emotional agility allows us to adapt to a changing environment while helping us to manage stress symptoms and restore our balance (David, 2016).

Evaluate priorities: Identifying what is most important each day and dedicate time to these tasks. Planning helps to manage our time and energy. We need to include self-care in our priorities so that we have the energy and motivation to manage stress and get through challenging times.

Set 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.

Connect with others: Having supportive colleagues, family and friends, and positive communications with others is a buffer that protects us from developing burnout. When talking with others who understand a common challenge, it can nurture and be reassuring. It helps to regulate our emotions.

Seek support: Some may find it difficult to ask for help because they do not want to burden others. If we keep in mind that we are also part of someone else’s support system, we are more likely to reach out as we want to keep well to help others too. It will help to restore balance (Nagoski & Nagoski, 2020).

In some situations, people may feel there is a stigma associated with contacting services. It is helpful to keep in mind that connection is a human need. It is natural then to contact another human being who can provide support.                                                                                                  

References:

Bonnano, G.A. (2004) Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59, 20-28.

David, S. (2016) Emotional agility. Get unstuck, embrace change and thrive in work and life. London: Penguin Books.

Freudenberger, H.J. (1974), Staff Burn-Out. Journal of Social Issues, 30: 159-165. 

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.

Nagoski, E. & Nagoski, A. (2020) Burnout. Solve your stress cycle. London: Vermilion. 

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.

Seligman, M. (1991) Learned optimism. How to change your mind and your life. New York: Knopf.

Southwick, S.M. & Charney, D.S. (2013) Resilience. The science of mastering life’s greatest challenges. Cambridge: Cambridge University Press. 

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.