 1. What are some of the symptoms of burnout?
Burnout is the experience of long-term exhaustion and diminished interest, usually (but not always) related to the work place. Sufferers are over-extended and depleted of their physical and emotional resources and feel drained and used up without any source of replenishment. They lack energy to face another day or another problem. Burnout is sometimes referred to as executive stress (although housewives with burnout doing household chores involving non-executive functions, can also suffer from burnout). Burnout presents with a myriad of symptoms some of which can, for convenience, be roughly categorized as involving:
a. mood:
experienced as feelings of nervousness and being ill at ease, feeling keyed up and overexcited, worrying excessively, becoming confused and forgetful, having difficulty in concentrating, feeling generally irritable, becoming depressed and feeling bored or apathetic;
b. body organs:
characterized by rapid breathing, pounding heart, stomach upsets, easy perspiration, feeling lightheaded and faint, dry mouth and throat, cold hands or feet, a need to urinate frequently, diarrhea or constipation, a flushed face and high blood pressure;
c. Muscles:
characterized by trembling hands and fingers, nervous twitches, inability to sit still, stiff and tense muscles, stuttering or stammering, a clenched jaw and grinding teeth, headaches and eye tension and low back pain;
d. Behaviour:
characterized by a short temper, being withdrawn, underachieving, a change in appetite, a lowered sex drive, a tendency to sleep or stay in bed too long, insomnia, accident proneness, making frequent mistakes, an increase in medication and excessive use of alcohol.
These symptoms are closely aligned to classical depression and anxiety. Careful discrimination between these symptoms and the more classic disease clusters is important if correct diagnosis and treatment is to take place.
2. What are some of the causes?
High stress jobs and situations such as taxi drivers, law enforcement agents, air traffic controllers, emergency service workers, police and the armed forces, teachers and health care providers and high school and college students are inherently prone to burnout because they usually involve work shift change, long hours, little down time, and continual monitoring by peers, customers, and supervisors and other mechanisms like cameras. These duties involve extreme demands, many demands at once, time pressures, carrying too great a responsibility, lack of stimulation (such as in a repetitious job), lack of balance between work and leisure and stimulation and relaxation imbalances.
Burnout also raises its head where there are ongoing threats to one’s present lifestyle, constant financial difficulties, constant feelings of unworthiness, constant lack of recognition and approval by others, unreal expectations and feelings of obligation to another and feelings of, and being under, someone’s control.
Some burnout victims have a predisposition to succumb more easily than others to burnout situations. Others have a natural immunity (biological, psychological)
to most types of sustained stress and are able to endure where others crumble in the face of sustained pressure. It can be argued however that everyone has a "breaking point".
3. What are some of the effects -- e.g. for family members, friends, colleagues?
In families with one or more members suffering from burnout, these so-called "vulnerable families" exhibit a low sense of purpose, a high sense of meaningless in life and less sense of being appreciated.
The effects of burnout on family members are invariably highly detrimental particularly where the burnout condition is not recognized as such and allowances are not made for the behaviour of the burnout sufferer. The victim of burnout can easily become a scapegoat for many things that go wrong in the family. The most dramatic effect of burnout in the family is the ending of family ties by either the sufferer (or the family of same), through abandonment, divorce or separation leading to little or no contact. The family becomes vulnerable to the breakdown of family members collective commitment to one another and to work together in harmony. The same abandonment and distancing processes may be seen among friends of the person suffering from burnout leading to increased social isolation, aggravating the burnout in a vicious cycle of further alienation and despair. "Pull yourself together" is not recommended advice from friends at this point.
4. What are some of the coping methods people may use?
Negative coping mechanisms involve the use of drugs and alcohol and making snap decisions that are at first considered beneficial only to later to be recognized as poor judgment. Abandonment of family, partnerships and the work place and the excessive use of prescription drugs worsen the situation. Reckless and compulsive behaviour is not uncommon among those who would seek to cope with their burnout.
Positive coping mechanisms involve seeking out professional advice and help by persons skilled in the science and art of recognizing burnout and in formulating a program of recovery.
5. Are they often unaware it is burnout they are suffering from? What are some of the interpretations they place on their behaviour/feelings?
Depending on their degree of sophistication in matters psychological, most persons suffering from burnout recognize that they have reached a point of physical and emotional exhaustion. Not knowing what to call this condition may lead to self condemnation and low self-esteem because they blame themselves for not being "good enough" for the job. They may consider themselves to be physically very ill, take medication and even consider surgery.
6. What should they do to address the problem? i.e.. what treatment methods are being used for cases of varying severity?
Where feasible the sufferer should avoid being in the stressful environment or situation and avoid it by asking for leave of absence or sick leave.
Where possible, restructuring of the (work/domestic) environment is recommended. Where the work environment proves to be inflexible, resigning from the job may be the only solution.
The sufferer is advised to seek professional advice and help by persons skilled in the science and art of recognizing burnout and in formulating a program of recovery.
Corporate counseling in-situ may be helpful as might family psychotherapy involving the whole family where necessary.
The goal of all treatment methods should be the discovery, examination and exorcising of irrational beliefs and attitudes involving one’s performance and the de-linking of one’s worth as a human being from one’s worth in the work place. The adoption of healthier attitudes toward self, work and the definition of coping should be encouraged.
Cognitive Behaviour Therapy (CBT) produces excellent results. It is a fast, efficient, action orientated approach that uses the person’s capacity for emotional growth and the ability to change unhelpful patterns of behaviour. With CBT one learns how to avoid burnout situations and hoe to increase immunity to naturally occurring burnout situations that are part and parcel of their jobs.
Short term (two weeks) medication in conjunction with psychotherapy is sometimes recommended.
7. How long does it take to recover from burnout, and are there any lasting symptoms/damage?
On average, burnout can take from two weeks to three months to resolve. The most lasting damage is that caused by the making of poor judgment decisions during the burnout phase. For example decisions like premature job-abandonment, divorce escapism and abuseful and illegal behaviour are often later regretted.
Dr Aharon M Segal, Ph.D.
Clinical Psychologist
Johannesburg
0833781197
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