The Burnout Doctor

Doctoring burnt out working professionals to manage stress and achieve career success

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October 4, 2024

Who burns out? Find out the 9 things that are putting you at risk NOW

Who burns out? This is a great question to ask. You can take a group of people, put them all under the same stress at work, and some will burn out and some won’t.

Now, burnout occurs because of prolonged and unsuccessfully managed stress at work. It is, by definition, a workplace problem. Both the cause and the solution to burnout are making changes at work. If you aren’t already familiar with the 6 workplace factors that directly cause burnout, then you can read more about them here.

But, similar to other health problems, there will be some people that are more at risk of developing burnout compared to others. Knowing if you are at increased risk is powerful, because it means you can be proactive about protecting yourself. What it doesn’t mean, however, is that you are to blame if you do end up burning out, because burnout occurs because of unmanageable stress. Even the most resilient people have breaking points.

Who burns out? Why burnout is like a physical health problem

To help you to understand how you might be at an increased chance of burning out, let’s compare burnout to a physical health problem. For this example, lung cancer is a useful problem to compare to. You will already be familiar with the disease, and how it is caused. As most people already know, the cause of lung cancer in the overwhelming majority of cases is smoking.

However, not everyone that smokes will develop lung cancer. Some people will be protected from it due to other factors, such as their genetics, or their environment.

The same is true in burnout. Work factors leading to burnout is similar to how smoking leads to lung cancer. Not everyone that experiences stress at work will burn out, because some people are more protected from it than others.

Let’s go on to talk now about the 9 things that mean you are more likely to burn out when you are stressed at work.

Remember that these are risk factors and not direct causes of burnout! The direct cause is work stress, and so working on your risk factors alone in the context of huge stress at work will not be sufficient to protect you. True burnout prevention requires a multi-factorial approach that tackles the root cause and does not blame the individual that then ends up burning out. 

Who burns out? The 9 things that put you at risk outside of work stress- and why

There are 9 things that mean you are more likely to burn out. It’s important to know what they are, so that you can be empowered to manage your work stress better!

The 9 things that are putting you at risk of burnout (that aren't work stress): Imposter Syndrome, perfectionism, people pleasing, your childhood, trauma, other mental health problems, coping skills and neurodiversity
The 9 things that put you at risk of burnout

1. Imposter syndrome 

Imposter Syndrome is the feeling of being a fraud, and that you don’t deserve your achievements despite being a very high achiever. It increases the risk of burnout by causing the following: overwork, procrastination, avoidance of work, perfectionism and comparison.

2. Perfectionism 

Perfectionism fuels burnout by making you take on too much work, and by worsening emotional exhaustion.

3. People pleasing 

People pleasing puts you at risk from burnout by causing low self esteem and self worth, which then leads to poor professional boundaries. Ultimately, the people pleaser inadvertently takes on too much at work in an attempt to help everyone around them.

4. Personality type

Being an introvert in an extroverted role without enough time to recharge your social batteries causes burnout by causing emotional exhaustion. Type A personalities are also at risk, as they tend to manage stress by avoiding it (see below on coping skills!).

5. Your childhood 

Mixed messages about achievement in childhood means you are more likely to burn out as an adult. Any trauma experienced in childhood also increases burnout risk. This is because brain changes in burnout are very similar to the changes after trauma.

6. Trauma in adulthood 

Traumatic events as an adult cause changes to the brain that are very similar to the burnt out brain.

7. Pre-existing mental health problems 

Burnout isn’t always linked with mental health problems, However, if you already have a mental health problem such as depression or anxiety, then you will be at increased risk of burnout. The reasons for this are multiple.

8. Coping skills 

Most people that end up in full-blown burnout will have used coping strategies to soothe how they feel about the stress, and to manage their own emotions. People that are protected against burnout tend to cope with stress by tackling the root cause (i.e. the stressor itself). This is important, because tackling the root cause means you are making changes to the stressor itself, and therefore reducing its impact.

9. Neurodiversity 

Those with ADHD and ASD in particular experience rapid burnout cycles. These cycles are driven by the effects, and the stress of being neurodivergent in a neurotypical world.

So, now you know who burns out when things get stressful at work.

Who burns out? Now you’ve identified the things that might predispose you to burnout, what can you do about it?

If you have realised that you have one of more of the things that put you into an at-risk group for burnout, then happily there are things that you can to protect yourself.

The first is to tackle your work stress.

The second is to put things in place to help reduce the effects of the risk factors on your ability to cope with stress. This might look like having coaching or therapy to reduce the impact of imposter syndrome on how you cope with work stress. It could mean having support measures put in place to help you if you have ADHD- things like being able to wear noise cancelling ear phones in noisy office environments. Or, it might mean seeing your doctor for help with depression, anxiety or PTSD.

I go into these risk factors in much more detail in my upcoming book The Burnout Doctor! Released on Jan 30th 2025, it is available to pre-order from Amazon UK here.

October 2, 2024

Improve confidence returning to work after maternity leave

Here is how working moms can improve their confidence when going back to work after maternity leave.

After having a baby, so many things come together to reduce confidence in the workplace. 

Your colleagues think you have been off work leisurely meeting your mom friends for coffee, having lazy lunches, snapping pictures of your aesthetically pleasing child (who never cries), and then enjoying a relaxing evening with your partner.  Yes, having a baby is wonderful, but on the flip side, new mothers know that the truth is sleepless nights, depleted energy levels, and a ton of mom guilt.  Then you need to navigate how to step your new role as a working parent when you return to work- and this is very challenging even for those with a great support network.   

How maternity leave reduces your confidence before you return to work:

How having a baby reduces your confidence at work: reduced confidence worrying about work, reduced confidence in how you feel in yourself, reduced confidence because of fatigue and physical changes
How having a baby reduces your confidence at work

Reduced confidence worrying about work

Career anxiety – “What if I’ve fallen so far behind that I’ll never catch up? I can’t shake the fear that I’m no longer good enough. What if my colleagues have outgrown me while I’ve been away? Worse, what if they don’t think I’m committed anymore?”.  Taking a career break with mat leave compounds loss of confidence.

Judgment from others – “There’s this constant fear that I’m being judged — by my colleagues, boss, and even other mums. If I leave work early to pick up my baby, people will think I’m not serious about my career. If I stay late, I feel like I’m failing as a mother. No matter what I do, it feels like I’m doing it wrong. The weight of their silent judgment is crushing me. I just want to be enough, but I’m terrified I’ll never be.”.  New parents really struggle with a lack of confidence when having an honest conversation with team members.  

Breastfeeding and returning to work– “I’m still breastfeeding, and going back to work feels overwhelming. How will I keep up with pumping, the schedule, and the worry about milk supply? I feel torn between doing what’s best for my baby and meeting the demands of work.”. Breastfeeding is hard work even when you’re still on leave.  Returning to work means a new routine, and keeping breastfeeding going is one of the biggest challenges in a successful return to work. 

Financial stress – “We need my income to survive, but I’m terrified I won’t be able to handle it all. The cost of childcare is crippling, and I can’t help but think, is this even worth it?”.  The majority of new moms will be in a similar situation. 

Reduced confidence in how you feel about yourself

Identity crisis – “”I don’t even know who I am anymore. I used to be confident in my work, but now I feel like I’m a stranger in my own life. I’m a mum, but I’m also supposed to be this career woman. How can I be both when I don’t even recognize myself?”  Your new identity as a mom with a new baby is tough to navigate even outside of the pressures of work. 

Relationship strain– “How can we keep this together when we’re both so exhausted and stretched thin?”  This is also a concern when your partner returns to work after their parental leave. 

Guilt and self-doubt – “I feel like a failure as a mum for leaving my baby. But I also feel I’m not being able to give 100% at work. What if I’m making the wrong choice? What if I’m letting everyone down, including myself?”.  Mom guilt is so real! 

Loneliness and isolation – “”Everyone else seems to have it all figured out, but I’m drowning, and no one even notices. It’s like I’ve disappeared, both at work and at home. I don’t know how to reach out or ask for help.”  Having a supportive community is key to the maintenance of good mental health. 

Reduced confidence because of fatigue and physical changes

Physical exhaustion – “I feel like I’m running on fumes. The thought of adding a full workday on top of this exhaustion makes me want to cry. How am I supposed to be productive when I can barely keep my eyes open?”.  Sleep deprivation can lead to reduced performance at work, and thereby confidence issues. 

Body image struggles – “I hate how I look. My body has changed so much. I can’t stand the thought of facing people at work who remember the ‘old’ me. I don’t feel like I belong in my own skin anymore.”  You might not have the body you thought or hoped you would at the end of maternity leave, which can have a negative impact on confidence. 

Recovering from a difficult birth experience– “I can’t escape the memories of my birth. No one understands how traumatic it was. Now I’m supposed to just go back to ‘normal’ as if nothing happened, but inside, I feel broken. How do I heal and work at the same time?”.  Unresolved birth trauma can have a significant impact on confidence levels as you navigate your return to work.

How working moms can improve their confidence

Motherhood deeply impacts self-esteem and identity. It is difficult to keep your confidence at work when there is constant worry about the need to be visible. It is a constant struggle feeling that you always have to go the extra mile just to keep your foot on the career ladder. Maternity leave means that the motherhood gap leaves you fighting to regain your authority and progress in your career. No wonder so many women take career breaks or switch to more flexible jobs after having a baby (with the associated drop in income). 

A lot of the solutions presented in the mainstream to improve confidence tend to be very superficial.  If it was easy to improve confidence we’d all do it in a heartbeat.  

You’re a busy working mom looking after a baby who needs you physically and emotionally still, so it’s hard to prioritize yourself. Here are 2 techniques that you can use as a working mom to improve your confidence at work when you return after maternity leave. 

2 ways you can regain your confidence at work after having a baby: change how you think and feel about yourself.  2. make space for difficult thoughts, and then take action regardless.  Read on to see examples of exactly how you can do this, in order to feel more confident at work
2 ways to regain your confidence at work after having a baby

Improve your confidence on returning to work after maternity leave with your thoughts

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Cognitive Behavioural Therapy- based exercises are great at getting you to consciously notice your critical thoughts that will be sapping your confidence, and then to help reframe them. They are relatively accessible, so this is a great way for working moms to improve confidence. 

A great place to start is this worksheet, entitled “Catching Your Critic”. This worksheet will help you to identify your critical thoughts. Once you have done this, the next step is to work out what your thoughts help you to do. Finally, you assess what they hold you back from.

Once you have identified your critical thoughts, the next step is to challenge them and question whether they are true. You can do this inside your head, or by writing them down. Ask yourself questions, such as: is it true that you always mess up? Are you saying you never do anything right?  What evidence do you have that people think you are messing up?

It can be difficult to get started on this type of exercise. Here is a worked example to help!

A worked example of a working mom improving their confidence using this technique: Emma

Scenario: Emma has just returned to her job in marketing after six months of her first maternity leave. She feels overwhelmed and constantly questions her abilities. She is convinced that she’s no longer capable of doing her job well.

Critical Thought: “I’m not good enough at this anymore. I can’t keep up like I used to, and everyone at work can see that I’m failing.”

Step 1: Catching Your Critic 

Emma identifies her critical thought: “I’m not good enough, and I’m failing“.  She recognizes that this thought is chipping away at her confidence and making her feel anxious about her return to work.

Step 2: Challenging the Thought 

Emma starts to question the validity of this thought. She asks herself:

  • Is it true that I’m not good enough anymore?
    No, I haven’t even been back long enough to gauge how I’m performing. I’m still adjusting.
  • Do I always fail at work?
    No, I’ve been successful in this role before maternity leave. I’ve handled difficult projects and been praised for my work.
  • What evidence do I have that people think I’m failing?
    I haven’t received any negative feedback since returning. My manager said they’re glad to have me back.
Step 3: Reframing the Thought 

Emma reframes her critical thought: “I’m still getting used to balancing work and motherhood, and it’s okay to take time to adjust. I’ve been successful before, and I can be again.”

This CBT-based process helps Emma recognize that her self-doubt is based on distorted thinking. By challenging those thoughts, she’s able to rebuild her confidence step by step.

Now, over to you to try! Remember that therapy is like physio for the brain- you need to practice it regularly to see the benefits! Don’t get down if it doesn’t work immediately. Keep plugging away and you will notice the changes with time.

Improve your confidence on returning to work after maternity leave with your actions

Working moms can improve their confidence by using this technique with or without the one listed above. This technique is quite a big thing to do especially if your confidence is rock bottom. It challenges you to feel the fear and go ahead with doing the thing you’re not confident to do regardless . It helps, especially when you start small and then build up the fear factor over time.

This particular technique is based on the principles of Acceptance and Commitment Therapy. I highly recommend the book “The Happiness Trap” by Russ Harris if you’d like to learn more about this type of life-changing therapy (aff link).

A worked example of a working mom improving confidence using this technique: Meera

Scenario:
Meera has gone back to her job as a project manager after maternity leave, but she’s been holding back from speaking up in meetings for a long time. She doubts whether her ideas are as good as they used to be. Meera keeps thinking, “What if I’m not good enough?”. As a result, she avoids contributing, even though her role needs her to step up and share.

Step 1: Accept the difficult thoughts

Meera notices that her fears and doubts are getting in the way. She admits that she’s scared of being judged or saying something wrong. Instead of fighting those thoughts, she acknowledges them gently: “I’m feeling nervous about speaking up, and that’s okay.” She allows the fear to be there without letting it control her.

Meera can also practice a technique called defusion here. 

Defusion: Creating Distance from Unhelpful Thoughts

Here’s a great technique for working moms to improve confidence at work. It’s called defusion, and it’s all about creating space between you and your thoughts. Often, when we experience self-doubt, it feels like those thoughts are the absolute truth — like “I’m not good enough” or “I’ll mess everything up” — but defusion teaches us that thoughts are just thoughts, not facts.

When you are hooked by your thoughts, they feel like they completely control us. Defusion helps you to step back and look at those thoughts from a distance. It means that you will be able to see them for what they are: just words or ideas passing through our mind. By doing this, you can stop letting those thoughts define you, or stop you from taking action.

How Defusion Works:

  • Notice the thought: First, recognize that you’re having an unhelpful thought. For example, “I’m going to fail.”
  • Label it: Instead of believing it’s true, say to yourself, “I’m having the thought that I’m going to fail.” This creates some distance between you and the thought.
  • Next step: Add “I am noticing” to your thought. Now you are saying to yourself, “I am noticing that I am having the thought that I am going to fail”.
  • Observe without judgment: Let the thought just be there without trying to fight it or push it away. Remind yourself that a thought doesn’t have to be true just because it pops into your head.

By using defusion, you can allow your difficult thoughts to be present without letting them hold you back. It’s about acknowledging that those thoughts exist, but they don’t have to control your actions.

Step 2: Focus on what matters

Meera takes a moment to think about what’s important to her. She values being a leader and working with others. She knows that speaking up is part of who she wants to be at work. Even though she feels scared, she reminds herself that contributing to the team matters to her.

(just FYI- if you’re not sure what your values are, or how they can cause you to feel stressed or burnt out, click here!)

Step 3: Take action, even with the fear

Meera knows that her fear won’t just disappear, so she decides to speak up in the next meeting anyway. She tells herself, “It’s okay to be nervous, but I’m going to share my ideas because they matter”.  During the meeting, she feels her heart race, but she takes a deep breath and says what’s on her mind.

Step 4: Reflect on how it went

After the meeting, Meera realizes that it wasn’t as scary as she thought. People listened to her, and no one judged her harshly. She feels proud of herself for doing something she was afraid of, and she recognizes that she can keep taking these small steps (go Meera!!). 

Step 5: Build on your success

Meera knows that confidence will come over time, so she decides to keep practicing. Next time, she’ll aim to speak up a little sooner or on a bigger topic. Each step forward will help her feel more comfortable and confident.

By being kind to herself and taking small, brave steps, Meera is learning that it’s okay to feel fear and still do what’s important. She doesn’t need to wait until she’s completely confident — she can start now, with compassion and patience.

A bonus tip

Doing this is very challenging. In the example above, Meera finds her voice during a meeting. But, if you’re newly back to work this might be too difficult to do straight away. If you’re finding it hard to get started, here’s where to begin. Pick a small action you can take today that pushes you out of your comfort zone slightly.  Do it, then reflect on how you feel. Rinse and repeat, and challenge yourself more over time.  This will help to build up your confidence.

I hope this is helpful for those of you who are finding it difficult to get the confidence to go for it!  You now know the 2 best ways for working moms to improve their confidence in returning to work after maternity leave.  Use these techniques when you step into work mode.  Whilst returning to work will feel like an incredibly steep learning curve, you will be able to successfully overcome negative thoughts from your first day back.  Using these personal development techniques is a golden opportunity to make your work life work for you!

Please let me know if you have any questions by commenting below. I’m more than happy to personally respond to every one!

August 24, 2024

How to stop burnout in working mums in their 40s

5 ways to properly prevent burnout in working mums in their 40s –>

Working mums in their 40s are at breaking point. This group is being stretched thanks to the combination of work, having kids, caring for elderly parents, and approaching the menopause. This devastating combination of stress is the perfect storm for burnout in working mums in their 40s. 

This blog post will tell you exactly how and why being a working mum can cause burnout. You’ll also find out how being 40 years + puts you at increased risk. Most importantly, you will also learn 5 things that you can do right now to prevent burnout if you are a working mum in your 40s.

Let’s dive right in. To start, let’s consider how the domestic and mental loads contribute to burnout in working mums.

The data referred to here relates to cis-heterosexual relationships.

Understanding why burnout happens to working mums: Working mums do more domestic chores

The domestic load for working women is significant. Women still do more of the household chores compared to men, even when both spouses work full-time jobs. This gap gets bigger when a couple has children. This means you’ll be doing more of the washing, cooking and cleaning than your partner after you have kids.

Working mums also take on more mental load

But, it’s not just more of the domestic workload that you need to do. The mental work of keeping a family running is also your job. You will most likely be the parent responsible for keeping household routines, organising schedules, maintaining order, and providing emotional support for your kids. This disproportionate share of the mental workload is directly linked to a poorer sense of wellbeing for women. It’s also linked with lower levels of satisfaction with their relationships.

However, the increased mental load for working mums is more complicated than just taking on more of it.

Working mums take on the hardest parts of the mental load

Hands up which of you identify with worrying about childcare when you’re at work. Do you constantly dread the phone call of doom from school to say your kid has got a fever? Perhaps you worry about the commute home and getting to nursery pick up in time to avoid a fine? Or maybe you feel guilty for being away from your kids, even though you know that they are safe? 

This is because women are more likely than men to worry about childcare, even when they are not with their kids. It causes huge additional stress, because it is always present – even when you should be concentrating on other things. 

How does this happen? Scientists have identified that the mental load process can be divided into four parts: anticipate, identify, decide, and monitor. What they’ve found is that women disproportionately engage with different parts of the process compared to men. 

What are the different parts of the mental load, and how does this cause burnout in working mums?

The different parts of the mental load

To help you understand this in more detail, let’s imagine that you are thinking about applying for a school place for your child.

“Anticipate” means looking for schools the year before

“Identify” involves setting up tours and talking to others about your options

“Decide” requires choosing the best school for your child;

“Monitor” means making sure the paperwork is turned in, the school uniform is bought (and hopefully not grown out of!), and that your child is ready for their first day.

Women are much more likely to handle the “anticipate” and “monitor” steps in the process. In the majority of families, women are more likely to put an item on the agenda and more likely to follow up to make sure it got done. This is true even for household tasks assigned to the male in the household. Male and female participation in decision-making is roughly equal; essentially, once the item was on the agenda and the research completed, couples tended to make decisions together

(source: Daminger, A, 2019). 

Working mums aren’t just taking on more of the mental load, you’re also taking on the most draining bits. No wonder you’re exhausted.  It’s easy to see why there is a huge problem with burnout in working mums in their 40s!

Steph, founder of Don’t Buy Her Flowers, describes this never ending overwhelm perfectly in her article for The Juggle:

“I think part of the problem is that we can see how lucky we are compared to many, and we do cope. And when I say ‘we’, let’s be straight – women are still carrying the load required to run a family. In fact CNBC reported that as women’s financial contributions increase, they pick up a heavier load when it comes to household chores and caregiving responsibilities. Perhaps because they’re trying to make up for working and not having total focus on the family.

Because we are a guinea pig generation. More women are working in some capacity, but that hasn’t led to a fundamental shift in what happens at home. So we’re just adding, while often trying to simultaneously replicate the more traditional role we saw women in our parent’s generation carry out. Then as we’re having children later, we’re also managing a timely triumvirate of kids that still need us, ageing parents and perimenopause. And we’re wondering why we feel broken?” 

You can see that the increased load on working mums is the perfect storm for burnout.

Understanding why burnout happens to working mums in their 40s

To recap, working mums of all ages deal with more domestic load- and the hardest parts of the mental load. This is one of the reasons why burnout in working mums in their 40s is more of a problem than in working dads.

But, in your 40s, you’re also likely to be looking after ageing parents at a time when you’re entering the peri menopause. The caring burden is a particularly heavy one, and especially so when your kids are still young too. Furthermore, peri menopause affects every woman differently. Some women sail through it, others are crippled by their symptoms. The additional caring and peri menopause loads reduce your capacity for stress, and make it harder to juggle all of your responsibilities without losing your mind.

In addition, the symptoms of burnout might look and feel like peri menopause. Symptoms such as difficulty sleeping, fatigue, irritability- these can be both burnout or peri menopause. Take a look at this post to read more about the symptoms of burnout.

5 ways to properly prevent burnout in working mums in their 40s:

1. Outsource and delegate

Anything you can do to reduce your load will help prevent burnout. You could reduce your domestic load by paying for a cleaner, or buying the occasional convenience meal so you don’t need to cook. For some ways of outsourcing, you do need a degree of financial privilege to be able to do it. However, if you don’t have financial flexibility, don’t worry. Your outsourcing of help doesn’t necessarily have to involve spending money. You could ask your friends and family to help with a spot of babysitting. You can delegate some of the load to your kids if they’re old enough (and you have it in you to deal with any wingeing!).

Don’t be afraid to offload. When you do this, you will gain a bit of space for some of that annoying mental stuff that you tend to carry as a woman (such as “anticipating” and “monitoring”, and worrying about childcare when you’re at work). 

2. Get your partner on board!

Statistically, you’ll be doing much more of the domestic load and the emotional load in your household. So, get your partner to step up! Think about the load that bothers you the most, whether that’s the cleaning, the ironing, cooking. Whatever it is, ask your partner to do their fair share, and in a meaningful way.

3. Therapy

Changing how you think is a powerful tool to managing the load. Cognitive Behavioural Therapy and Acceptance and Commitment Therapy are 2 excellent and evidence based forms of therapy that will help you to carry the mental load, and both are evidenced in burnout too. If you are finding things hard I do recommend that you think about accessing some therapy- trust me, it is a game changer. 

If you are finding it difficult to access therapy, then I highly recommend getting The Happiness Trap by Russ Harris (aff link). The book is all about Acceptance and Commitment Therapy. So many patients and colleagues have told me this book has transformed their lives!

Ignore all the internet bro wellness advice

Don’t get sucked into thinking that you get up at 5am to work out and meditate, so that you can cram your self care into your already busy day. An exhausted mum needs to be asleep at 5am, not doing cardio. Screw the productivity hacks. Most of them are perpetuated by men without kids- or by women who have a lot of help and money! You don’t need an extra hour in your day, what you need is proper physical and emotional support. Focus on getting this and not internet wellness advice (well, apart from this blog!!).

Get expert help if you need it

If you can’t do it all remember that it is NOT your fault. You’re human and your capacity for stress is not infinite. If you are worried about your mental health then please do speak to your doctor. They are there to help with whatever problem or combination of problems you are currently experiencing. Doctors and therapists can’t change how society is structured (smashing the patriarchy isn’t yet on medical school curriculums!), but they can help you through the difficult times, and help you to develop really great coping strategies for stress.

Please feel free to ask any questions in the comments. If there is enough interest then I could write an article on the peri menopause, and how its symptoms can be similar to burnout? Let me know if this something you’d like to read!

References/further reading: 

Domestic load stats: US Government data

Mental load: Ciciolla, Lucia; Luthar, Suniya S (2019).  Invisible Household Labor and Ramifications for Adjustment: Mothers as Captains of Households. Sex Roles; New York Vol. 81, Iss. 7-8, 467-486. DOI:10.1007/s11199-018-1001-x

The different parts of the mental load: Daminger, A. (2019). The Cognitive Dimension of Household Labor. American Sociological Review, 84(4), 609–633. https://doi.org/10.1177/0003122419859007

August 20, 2024

How to tell the signs and symptoms of burnout

In this post, you will learn the signs and symptoms of burnout. Here’s what will be covered:

​A quick recap of the definition of burnout

How and why burnout is not considered to be a mental health, or medical problem 

An explanation of how your stress hormones change in burnout- and how this can cause signs and symptoms 

An outline of the physical symptoms of burnout 

An outline of the emotional and mental symptoms of burnout

How and why chronic stress leads to some shocking long-term health complications in burnout*

How to help a family member that you think might be burning out, based on their signs and symptoms. 

*TRIGGER WARNING

If you are feeling massively burned out right now, then learning about how burnout affects your health might not be helpful for you.  Be kind to yourself if you’re unsure.  Feel free to come back to this at another time when you have a little more capacity.  Please know that the health risks that burnout cause can be reversed with recovery.  What burnout does to your brain and body is TEMPORARY. 

In part one of the burnout basics series, you will have learned the definition of burnout.  You will also have learned how it is different from simple stress.  If you missed the article, you can recap it here, but alternatively, let’s quickly touch on the World Health Organization definition of burnout. 

Let’s get started!

The definition of burnout

Burnout syndrome was first described in the 1970s by psychologist Herbert Freudenberger, who worked with stressed healthcare workers in a free HIV/AIDs clinic in New York.  What they saw was different from other stress-related problems that had previously been defined.  It was a very stressful experience to work in this type of clinic, at this particular point of history.  But what was unique about what was happening to these workers was that their stress was causing them to become unwell for a long period.  Worse, their recovery was more complex and difficult than expected. 

Although burnout was first recognized back in the 1970s, the World Health Organization didn’t officially recognize it, or define it, until 2019.

They describe burnout as, ‘an occupational phenomenon that arises as a result of chronic workplace stress that has not been successfully managed.’ 

The World Health Organisation identifies three parts to burnout:

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  1. Depersonalization: The cynicism, apathy, or lack of caring that develops with burnout.
  2. Emotional exhaustion: The physical and emotional fatigue of caring for too much for too long.
  3. Reduced performance at work.

You must have all three of the above components and have been under intense stress at work for a prolonged period of time, to have burnout syndrome.  

One thing to note about the definition is that burnout is not considered to be a medical condition.  It’s also not considered to be part of the wider group of mental health conditions, which include depression and anxiety. 

This is because burnout develops as a result of work-related stress.  The World Health Organization believes that burnout is the body’s normal response to chronic fatigue, long-term stress, and working a stressful job.  It’s a gradual process that causes mental exhaustion and physical exhaustion- but it happens because of work stress.  

How the signs and symptoms of burnout are linked to your body’s response to chronic stress

When you get stressed and your brain detects a threat, your body produces adrenaline and cortisol.  This stress hormone response is designed to deal with immediate and short-term threats by going into “fight or flight” mode. 

‘Fight or flight’ mode has evolved to help protect from physical threats, such as a lion appearing on the horizon.  But, in the modern world, your stress response tends to be activated more frequently by perceived or emotional threats (such as doing a presentation or opening an email) rather than physical threats. This might mean that by simply walking into your office, your ‘fight or flight’ mode could be activated, causing your heart to start pounding and a feeling of overwhelm.  Your body’s stress response is the same because it does not know the difference between a physical and a perceived threat. 

If your stress is short-lived and not too intense, then a little bit of adrenaline and cortisol can be helpful for performance and productivity at work.  

The stress response curve (or Yerkes-Dodson Law), illustrates the relationship between stress levels and performance nicely.  According to this model, as stress increases, performance initially improves—but only up to a certain point.

Here’s how to interpret the stress-response curve to better understand the signs and symptoms of burnout:

  • Low stress: When stress is too low, we often feel unmotivated or bored. There’s no sense of urgency, so it’s hard to engage fully with tasks. This is the left side of the curve, where performance can stagnate.
  • Moderate stress (The Optimal Zone): With a moderate level of stress, our body releases cortisol and adrenaline, which can increase alertness, focus, and motivation. In this “sweet spot,” we’re energized, driven, and working at peak productivity. This moderate level of stress pushes us just enough to stay engaged, set priorities, and work efficiently without feeling overwhelmed.
  • High stress: When stress levels exceed the optimal point, performance starts to decline. High stress causes fatigue, anxiety, and eventually burnout, placing us on the right side of the curve. Here, stress is no longer helpful; it inhibits productivity and can negatively affect both mental and physical health.

A graphic illustrating the stress response curve.

Stress-response curve (Yerkes-Dodson Law)

  • Low stress (left side): This leads to lower performance due to a lack of motivation or urgency.
  • Optimal zone (center): Moderate stress enhances focus, motivation, and productivity, leading to peak performance.
  • High stress (right side): As stress continues to rise, performance drops off, often resulting in fatigue, anxiety, and burnout.

This curve visually demonstrates why a balanced level of stress can be beneficial while too much stress has the opposite effect on performance. 

In burnout, your stress hormones stop being the helpful, short-term response to a threat that they are designed for.  Instead, this chronic activation of ‘fight or flight’ makes the body’s response to stress change from being potentially helpful to unhelpful and harmful.

Your body’s response to long-term stress is what causes the signs and symptoms of burnout that you experience.  

In the early stages, these symptoms might start as being reactive to work.  But eventually, it will affect all areas of your life, including your personal life.  It will deeply affect your physical health, as well as your emotional health. 

Signs and symptoms of burnout: physical symptoms

Burnout is a surprisingly physical thing to go through, so let’s share the physical symptoms you might experience:

  • Chest pain
  • Heart palpitations
  • Stomach pain 
  • Bloating
  • Shortness of breath 
  • Headaches 
  • Dizziness
  • Increased minor illnesses and reduced immunity 
  • ​Poor sleep 
  • Physical fatigue 
  • Appetite changes
  • Muscle tension and pain
  • High Blood pressure 
  • ​Lack of energy
  • Irregular periods 
  • Very low or high libido
The signs and symptoms of burnout: The physical symptoms of burnout include chest pain, palpitations, stomach pain, bloating, shortness of breath, headaches, dizziness, increased minor illnesses, poor sleep, appetite changes, muscle tension and pain, high blood pressure. fatigue. irregular periods, very high or low libido

Everyone experiences their physical burnout symptoms differently.  For instance, if you are a working mom, then you’re likely to have problems with good sleep and fatigue already.  And, if you were to see your doctor, they would not likely find an underlying medical cause for these symptoms. This is because these physical symptoms are caused by long-term stressful situations and your stress hormones, rather than a problem with the body itself.   

Burnout fact: 

The most commonly experienced physical symptom of burnout is muscle pain. 

Signs and symptoms of burnout: mental symptoms

Here are some of the emotional symptoms of burnout. These include: 

  • Not getting enough sleep (can also be a physical symptom)
  • Low mood 
  • Anxiety 
  • Worry
  • Feelings of guilt 
  • Mild forgetfulness/memory problems
  • Lack of focus
  • Intrusive thoughts
  • Cynicism
  • Detachment
  • Irritability 
  • Anger outbursts
  • Guilt 
  • Decision fatigue
  • Difficulty problem solving 
The signs and symptoms of burnout.  The emotional symptoms of burnout: difficulty sleeping, low mood, anxiety, worry, intrusive thoughts, cynicism, detachment, irritability, anger outbursts, guilt, forgetfulness or poor memory, poor concentration, decision fatigue, difficulty problem solving

Signs and symptoms of burnout fact:

One of the hallmark emotional symptoms of burnout is something called emotional dysregulation.  This is when you find yourself flying off the handle and overreacting to minor things. Things that, before your burnout, you would have managed easily and calmly.  This might look or feel like anger outbursts, irritability, or bursting into tears over small things.  For instance, you could find yourself snapping at your kids, or your partner, when previously you wouldn’t have done. 

If you read my previous blog about the definition of burnout, you’ll already know that burnout is not considered to be a medical or mental health problem.  But, when you look at the list of problems it causes, and what it feels like to experience, it very much looks and feels like one! 

The key to remember here is that burnout is reactive to the environment that you are in. So, when you leave the environment, or if you are able to make significant enough changes to it, then you will get better.  If you are experiencing burnout, then this can feel like a huge mountain to climb, you will get there. 

The shocking health consequences of burnout

Burnout feels like an incredibly difficult thing to experience.  But, not only is it a difficult thing to experience, scientists have proven that burnout causes a significantly increased risk of the following (deep breath!):

  • Type 2 Diabetes
  • High Cholesterol
  • ​Heart Disease
  • Musculoskeletal pain
  • Respiratory infections
  • Stomach problems
  • Severe injuries
  • Increased risk of death from any cause under age 45 
The signs and symptoms of burnout- health consequences of burnout: type 2 diabetes, high cholesterol, heart disease, musculoskeletal pain, fatigue, headaches, respiratory infections, stomach problems, severe injuries, increased risk of death from any cause under age 45

People with high burnout scores have a whopping 79% increased risk of heart disease over 3 years with burnout!

The most shocking health consequence of burnout is that it increases the risk of dying from any cause if you are under the age of 45.  Put simply, you’re more likely to die young with burnout. 

As you can see, burnout really is so much more than simple stress and the consequences are potentially very serious! 

But, how does burnout cause this?  

The science of health complications and early risk of dying with burnout

Here’s the science part!  When you burn out, you develop physical and emotional symptoms because of a rise in your stress hormones.  Initially, stress hormones rise, but over time, they fall. This drop, in the context of ongoing stress, triggers low-grade inflammation throughout the body.  This is just one of the ways that burnout increases the risk of health problems. It also helps to explain why you’re more likely to die young with it too. 

But there’s more to it than that.  Burnout also causes health problems by causing problems with sleep, reduced immunity, and changes to how your blood clots (this is important because this affects your heart health).  It is also thought that the negative impact of burnout on health behaviors also contributes. You’re more likely to smoke, eat poorly, drink more alcohol, and do less exercise when you’re burnt out because you’re just not going to have the energy or motivation. 

What if you are worried that a family member, or loved one, is burning out?

​One of the key things about burnout is that even though the signs and symptoms are significant, they might not be realized by the person who is burning out until they hit physical and emotional collapse.  

However, the changes to the burnt-out person’s behavior and mood will be obvious to their loved ones before they collapse.  Therefore, if you notice any of the common signs outlined above in this post, then you have a great opportunity to help your family member before they end up experiencing long-term burnout.  

But- they are likely to deny the problems, even if they are showing a lot of the warning signs of workplace burnout, and you can see that they are high risk. 

In this instance, a good start is just to open the lines of communication with the person that you think is likely to experience burnout.  The first step might be to simply ask how they are dong, and then see where the conversation goes.  Ensure that you give them the space to open up, without judgment.  If they do realize that they’re burnt out, please sign post them to professional help.      

The good news! 

The good news is that with recovery all of these symptoms and health risks can be reversed.  

It can feel very difficult if you are experiencing burnout to have hope about recovery because recovery is a long and tough road- but you will get there.  

REFERENCES:

Salvagioni, D. A. G., et al. ‘Physical, Psychological and Occupational Consequences of Job Burnout: A systematic review of prospective studies’, PLoS One, 12(10) (4 Oct 2017), https://doi.org/10.1371/journal.pone.0185781

August 13, 2024

What you NEED to know about burnout

BURNOUT BASICS- PART ONE: What is burnout?

Welcome to the burnout basics series. This is a series of posts that is here to help you understand the essentials of exactly what you need to know about burnout in order to effectively prevent it, and recover successfully if you’re already there.  

When you’re stressed, overwhelmed or burnt out then the last thing you need is to waste your time and limited energy on advice that just isn’t going to move the needle for your burnout.  This is particularly relevant for working mums. This is because you have so many responsibilities and balls to juggle, and it’s very difficult to find the time to look after yourself. 

Burnout is a huge hot topic at the moment. Despite this, there is so much misinformation out there about what burnout really is, and how it is different from stress.  As a result, too many mums with burnout waste precious time and energy inadvertently doing things that just don’t help.  This is not your fault, because this was my personal experience with burnout too.  With this blog, you are going to learn exactly what you need to do to deal with burnout effectively.  

Written by a doctor and mum of 2 with a background in neuroscience, and lived experience of burnout, everything that is shared here is evidence based and draws on scientific literature…but explained in a super accessible way!  

Most importantly, the advice given works.  This blog will never tell you that you need to eat more nutritiously, get up at 5am, or take ice baths (or, whatever the latest wellness trend is).  As lovely as those things are for wellbeing, for burnout they just don’t cut the mustard. As a working mum, frankly, who has the time for any of this?  You’re exhausted and time poor. So, you are going to have to concentrate on the things that will really help.  

Burnout is so much more than the experience of stress.  So much more, in fact, that most people that experience burnout need a considerable amount of time off work. The average time needed for sick leave in burnout is 3.5 months. Some people need up to a year off sick. Full recovery takes on average 1-3 years.  This is because what burnout does to the brain and the body is significant.

The Burnout Doctor is a wellness BS- free zone

This series of posts is for you if: 

You’re not burnt out yet, but you work a stressful job and are looking for ways to manage the juggle a bit better 

You think you might be burnt out, but you’re not sure and are looking for guidance and advice about the next steps

You know you’re burnt out, and you’re looking for advice about how best to recover

You’re worried about a friend, colleague or loved one who might be burnt out

You are under a lot of life stress as a working mum.  Maybe you’re going through a difficult time for other reasons as well.  In fact, anyone that is experiencing ongoing stress will benefit from reading this blog!  

To begin, let’s dive into the definition of burnout.

This is so you can start to understand how and why burnout is such a difficult thing to go through, and how it is different from stress. 

Burnout syndrome was first described in the 1970s by a psychologist who worked with stressed healthcare workers in a free HIV/AIDs clinic in New York. What they saw was different to other stress-related problems that had previously been defined.  It was a very stressful experience to work in this type of clinic, at this particular point of history.  But what was unique about what was happening to these workers was that their stress was causing them to become unwell for a long period of time. Worse, their recovery was more complex and difficult than expected. 

Although burnout was first recognised back in the 1970s, the World Health Organisation didn’t officially recognise it, or define it, until 2019 (just 5 years ago!).  

They describe burnout as, ‘an occupational syndrome that arises as a result of prolonged workplace stress that has not been successfully managed.’ 

The 3 key parts of burnout, as per the official definition

They identify three parts to burnout:

  1. Depersonalisation: The cynicism, apathy or lack of caring that develops with burnout.
  2. Emotional exhaustion: The very real physical and emotional fatigue of caring for too much for too long.
  3. Reduced performance at work.

You must have all three of the above components to officially have burnout syndrome.  

The definition does a pretty good job of explaining what burnout is, and why it’s more than simple stress.  

Some points to note about burnout development:

  1. The first component of burnout to develop is usually emotional exhaustion. This is when you feel completely depleted, regardless of how much rest or downtime you are getting. Most mums will feel this hard already!
  2. The second component of burnout to develop is usually depersonalisation. This is when you start to become detached from your work, and you start to care less. 
  3. Not everyone who experiences emotional exhaustion will progress to full blown burnout.  Burnout starts off as being reactive to your work pressures, but eventually it will affect every single aspect of your life.  If you feel stressed at work but you don’t yet identify with all three components, this is the perfect time to act.  You can make changes now to prevent things from progressing further.  If that’s you, I’m so pleased you’re reading this blog – you’re in the right place!

What the definition of burnout misses: 

The definition is not perfect, because there are some groups of people that are at high risk that are missed.  

First, you’ll notice that the definition only recognises burnout as occurring within the workplace. This excludes the huge groups of people that carry out unpaid labour who are also under chronic stress. Groups such as working mums (like yourself) and other caregivers.  Burnout is a problem that often occurs when your capacity for managing stress at work is reduced by things going on outside of it.  Having to work as a mum means having to work like you don’t have children, but simultaneously parenting like you don’t work. It is very stressful having to manage this. There will be lots more about how to handle this better in future blogs, but for now let’s crack on with the basics of burnout. 

Second, the definition does not recognise that those that are neurodiverse are also at increased risk of burnout.  ADHD, in particular, causes rapid cycles of burnout that are directly caused by the pressures of living in a neurotypical world.  Whilst work forms part of the reason why these burnout episodes occur, it’s not the sole reason. 

Is burnout a medical problem?

You’ll notice from the definition that burnout is not considered to be a medical or mental health problem.  The WHO believes that burnout develops as part of the body’s normal reaction to prolonged and unsuccessfully managed stress.  This might feel a bit difficult to get your head around, because burnout definitely feels like it is a mental health problem when you’re in the middle of it.  About 60% of people with burnout also have a mental health problem, such as depression or anxiety, alongside it.  But for 40% (that’s nearly half!) burnout is a stand alone problem that is entirely reactive to workplace pressure.  If you’re not sure for yourself, please speak to your doctor. 

You now have knowledge about what burnout is, why it is different to stress, and why it’s not considered to be a medical or a mental health problem.  

Stayed tuned for part 2 of the burnout basics series, which covers what burnout feels like to experience.  

If you enjoyed this article, then you will love my email newsletter, The Phoenix.  Sign up using this link. 

I LOVE to hear from my readers.  Please let me know your thoughts in the comments.  Did you learn anything new reading this blog?  What are the biggest challenges you face as a working mum at the moment?

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The Burnout Doctor

Dr Claire Ashley, a burnout survivor and educator, is a practicing doctor with a degree in neuroscience and a post graduate certificate in public health.

She is an NHS Clinical Entrepreneur, Doctors In Distress Ambassador, and World Health Organisation FIDES Influencer, offering insights on how to manage stress whilst creating a successful career.

She is also Headspace’s UK Workplace Mental Health Expert, where she helps workplaces to foster work environments that help employees to manage their stress, and both prevent and avoid burnout.

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