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Burnout: Signs, Symptoms, What to Do

By Nita Gage, DSPS, MA

Note: Although this is written for Physicians most of what you will find here applies to everyone!

Recognizing Burnout in Oneself and Others

Burnout is a term that is bantered about by virtually every profession, but what does it mean, really?

Mosby’s Medical Dictionary defines burnout as:

“…a popular term for a mental or physical energy depletion after a period of chronic, unrelieved job-related stress characterized sometimes by physical illness. The person suffering from burnout may lose concern or respect for other people and often has cynical, dehumanized perceptions of people, labelling them in a derogatory manner.”

The effects and progression of prolonged stress were first mapped out in a 1946 study by R.L. Swank, MD et al of World War II soldiers who were exposed to continuous combat conditions.  Four stages of encountering stress were identified. In the first stage, the situation can be viewed as a challenge, and we rise to meet the challenge with increased performance.  As the level of challenge rises in stage two, we reach a point of maximum efficiency.  In a third stage our ability to perform at our best is compromised.

We start working longer and harder just to keep up. Most people don’t notice it in themselves, but performance slips. This relationship between challenge and performance is referred to as The Stress Performance Curve.

As challenge rises, our performance can rise as well, up to a point of maximum efficiency.    However, sustained and/or increased challenge levels beyond a certain point decreases performance and is accompanied by negative psychological effects.   Hyper-vigilance develops and performance continues to degrade as stress levels increase, all of which can lead to burnout or even breakdown.

Burnout is often the collapse of initially healthy response to challenge, precipitated by unrelenting stress.

Physical and Emotional Interplay of Stress

It is important to understand that stress itself is interplay between two factors. The first factor is the body’s automatic response to external stimulus, such as recoiling before we step on a snake that might be dangerous, or dodging a bullet fired in our direction in combat.  The second factor is the emotional response triggered by instinct or stored memory from past experience.  Our emotional response causes the physical release of stress hormones, which prepare us for the emotion, and physicality of fight or flight.

With each new similar event, the physical, emotional, and hormonal response kicks in more automatically based upon stored memory of previous events.  When we experience sustained challenge, perceived as stress, the system goes into overload and burnout occurs.

Burnout is the indicator of too much stress.  It is also however the body’s automatic shut off system intended to protect us from further stress that we can’t handle.

The Good News about Burnout

Yes, there is good news!  Burnout, if recognized and understood can be an important and ultimately positive event.

 “…burnout is so powerfully transformative that it appears to be a signal not of failure, but of a challenge to create a new way of life. In fact burnout is probably the best thing that ever happened to us.” – Gloverman, 2003.

Avoiding Stress is the Key to Preventing Burnout

 Avoiding stress?  Is that Possible? Isn’t stress an inevitable part of modern life, particularly in a healthcare  profession?  Well, we know that a fair amount of stress can be managed, if we so choose.  Below are three skills that can be learned to reduce stress.

While external events may trigger hormone release, the actual cause of the release is our own heart-to-brain communication system.  The heart is known to have its own nerve center and in fact sends more communication to the brain than the brain sends to the heart.

Significant numbers of healthcare professionals are experiencing burnout, partially resulting in leaving the profession for that reason.

People can avoid and recover from stress and burnout without a change in the environment.  Skills can be learned to manage heart-rate variability, reduce the release of stress hormones, unlearning deeply held and out-of-date emotional rules, reconnecting with core values, and practicing gratitude and appreciation.

Reframed, burnout can be a calling to transformation, and a new way of life, either within medicine, or outside.

Learn how to:
  • Control your physical heart rate
  • Manage negative emotions
  • Identify and affirm core values

Learn more by downloading the full and complete free e-book today.


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