I really wasn’t sure in all of this was I burned out from the job or suffering from depression due to life and job stresses. Turns out the answer isn’t an easy or straight forward one.
While they’re not the same, the two are linked and often occur simultaneously. Some psychologists and researchers say that depression is the cause of burnout while others state that depression is more of an end symptom of burnout.
Either way, the two go hand in hand.
Burnout has only really been talked about and taken (somewhat) seriously in the last few years, but it’s a term that was coined originally in 1974.
In 2019 the WHO included it in the ICD-10 but did NOT classify it as a medical condition.
Burnout is defined as a syndrome resulting from chronic stress leading to physical, mental and emotional exhaustion. It’s defined as having 3 main dimensions: exhaustion, cynicism and feeling less capable at work.
Burnout is mainly attributed to workplace stresses but other stresses happening if your life may contribute to it.
In my case: an already stressful job made worse by certain aspects in my current role/hospital, an unwell partner at home. And the pandemic certainly hasn’t helped either.
Burnout vs. Depression
| Burnout Symptoms | My Symptoms | Depression Symptoms |
|---|---|---|
| · Lack of motivation · Physically exhausted/No energy · Hate your job/Dread going to work · Reduced performance · Difficulty concentrating · No satisfaction from work · Cynicism and Pessimism · Emotionally distant/Feel numb · Headaches · Stomach aches/Intestinal issues · Increased irritability · Escape fantasies · Increased illnesses · Sleep disturbances · Alcohol, Drugs, Other comforts | · (VERY) Low energy · Dread going to work · Little satisfaction from work · Headaches · Increased irritability · Escape fantasies · Increased sick days used · Disturbed sleep · Increased alcohol intake (6-8 units per week vs. 6-8 units per year) · Persistent sadness · Lack of interest in hobbies · Poor appetite · Persistent anxiety without cause | · Persistent sadness/low mood · Loss of interests · Fatigue/Low energy · Disturbed sleep · Poor concentration · Low self-confidence · Poor/Increased appetite · Suicidal thoughts · Increased irritability · Guilt |
Causes of Burnout
- Long work hours
- Lack of support from management/seniors
- Unmanageable workload / Unclear expectations
- Unfair treatment (such as unfair pay or bullying in the workplace)
- Extreme chaos / Extreme monotony
- Lack of control over work
- Work-life imbalance
I personally can relate to every single one of those.
And unfortunately I think the majority of them apply to all healthcare workplaces.
Everyday is chaos and you have no control over what comes through the doors or what you will have to deal with.
Honestly though, I think that’s what a lot of us like about the job. For a lot of us monotony is a far worse demon.
The workload is massive, that’s a given, but it’s compounded by the fact that you get next to no support, even when you highlight that you may be struggling.
The work-life imbalance is probably one of the biggest issues for me though. Not having time or energy for the other things in your life that bring you joy just seems like a sure-fire way to arrive at burnout. This starts a horrible cycle of I’m too tired from work for my hobbies, I’m more burnt out and depressed from not engaging in my hobbies, and now I’m even more tired and unable to engage in my hobbies.
What’s the way out of this cycle?
I think my partner becoming unwell has really highlighted the lack of work-life balance for me. I’ve struggled to get time off to attend hospital appointments with them more than once. How can this be tolerated?
It’s one thing to sacrifice my own mental and physical health for the job, it’s another story entirely when I have to sacrifice my family’s health for it too.
Treatment
Treatment/Management of burnout is very similar to the management of depression and anxiety.
- Therapy
- Mindfulness / Relaxation
- Exercise
- Healthy diet
- Spend more time with loved ones and friends
- Spend more time on hobbies
- Take time off work
- Try discuss restructuring of your working role/responsibilities with your boss
I started going to therapy just before Christmas 2021. I attended 3 sessions and had to cancel 4 due to work. I stopped going.
I know I should have kept trying, but when I was cancelling more than I was attending because I couldn’t leave work on time I just gave up.
The next step for me here is going to try and see if I can arrange online counselling at times I know I’ll be able to attend. I let you know how that goes.
I have started practicing mindfulness. It’s a lot harder than you might think! But it’s really helping with my anxiety.
Healthy diet and exercise are still a work in progress but we’re getting there. I used to be really into my fitness. Would be at the gym 3-4 times a week no matter how busy I was and had a very healthy diet. That’s all gone now over the last year.
I’m slowly starting to improve on these things though. I’m not exercising as intensely as I used to but I am getting out for almost daily walks (thanks to a lot of support and encouragement from my partner). And it does seem to be helping a bit.
Spending more time with family and friends has been a hard one. With the way our career moves us to different hospitals every year for ‘the good of our training’ on top of the hours worked, evenings and weekends, this has been near impossible for me to do. I really feel the isolation.
Taking time off work has been a difficult one. I have had 3 holidays/annual leaves cancelled in the last 3 years due to Covid and rota restrictions. The last hospital I worked in I only took a total of 2 weeks annual leave for the entire year……..no wonder I’m burned out.
And it’s been the same in my current hospital. I’ve taken half the leave I am contractually entitled to this year and there is no room in the rota to get the rest. It’s unfortunately the same story for all of my colleagues. And no one in management cares at all. They’ve cancelled more leave than they have approved and have made no effort to try re-instate the leave they cancelled. Morale in the department is at an all time low.
One thing I did do that I’m proud of is I highlighted to my training body the struggles I’ve been having.
They were more supportive than I was expecting.
This was just before Christmas. We came to an arrangement that I would go part-time from January to July. 1 week on, 1 week off.
The hospital has only been supportive in that in words only. It’s been more like 2 weeks on, 1 week off. It’s still made life a little easier though. And I haven’t missed a hospital appointment with my partner since.
This part-time arrangement means I will have another 6 months added onto to my training at the end before being signed off for consultancy. Given that I’ve started putting my foot down about the week on, week off arrangement.
But I still have not had a single week off where I haven’t received a call or text from work.
Whatever progress I make in terms of improving my mental health and anxiety all goes out the window when I get these calls.
I had really hoped the part time arrangement would have made things a lot better but to be honest, it hasn’t.
It has allowed me to better organise things in my home life with my partner now dealing with chronic illness, but I still dread going into work everyday and feel no joy in the weeks I’m at work.
Moving forward
At this point my main goal is to just make it through the last month in this hospital.
When I move in July I will be back to working full time but hopefully getting away from this toxic environment and workplace bullies will help.
We will see, and I will keep documenting.
But I don’t have much hope.