Three Antidotes to Relieve the Burden of Burnout

The latest edition of the World Health Organization's International Classification of Diseases, ICD-11, lists burnout as a “factor influencing health status” in the section entitled “problems association with employment or unemployment.” They define burnout as a syndrome that includes energy depletion or exhaustion, a sense of mental distance from one’s work, and a feeling of ineffectiveness or lack of accomplishment. Along with defining the problem, this definition can also offer useful guidance on how to begin healing from burnout as well.

Focus on Rest and Recuperation

The first feature of burnout involves a state of energy depletion and exhaustion, and the obvious antidote would be rest and recuperation. How does a person do this? The answer is highly individual, and anyone claiming to have a one-size-fits-all solution is unlikely to be helpful. In order to recharge ourselves, we have to think about what specific things work for us personally. For one person, it might be spending time socializing with friends, while another person might need less interpersonal contact for a while. One person might find going to the gym or a yoga class helps them work out their stress, while another person might find those tasks onerous and unpleasant. The first rule of helping ourselves with burnout is to respect what works for our own unique needs rather than doing what someone else says we “should” do – which, unfortunately, may burn us out even more.

If our hectic work schedule makes us unable to do all the things that would most fully restore us, the situation is not hopeless. At those times, we need to consider the small actions each day that can help us slowly recharge over time. We may not have thirty minutes for a walk outdoors, but we could at least gaze out the window and stretch a little bit for five minutes on our break. It may not seem like enough, but these small actions can add up and make a meaningful difference. They can reduce the risk of your burnout getting worse, and gradually start to replenish you over time.

Develop a Sense of Accomplishment

We also need to address the sense of ineffectiveness or lack of accomplishment in our work. It can be useful to notice what we are mentally screening in or out of our awareness. You might think of your mind as a nonstop information filtering system. If we don’t make an active effort to screen in positive experiences, the mind will likely minimize their importance and screen them out. This is especially true in times of extreme stress where our minds are more inclined to focus on danger and threat.

Take a moment to notice any small task you accomplished or any positive result you achieved in your work, however fleeting. Now sit with that pleasant feeling and give yourself appreciation for your efforts. Also, be sure to set realistic standards for yourself. For instance, sometimes people get sick regardless of what we do as their health care providers. This does not mean we cannot feel effective for the good faith effort we’ve put into our work. In fact, we need to find ways to feel good about our efforts even when events beyond our control lead to outcomes we had hoped to avoid. This may also involve gradually learning to be less perfectionist with ourselves, or truly coming to accept how much of life is not within our control.

Stay Engaged and Realistic

By starting to work on the prior two features of burnout, we will likely have begun to make a difference in this third category. When we aren’t so depleted, and we’re taking in more of the meaningful experiences in our work, then it is harder for negativity and cynicism to fester. We also will naturally stop checking out and start checking back in when we begin to feel more rewarded by our work again.

Nonetheless, sometimes we need to address these difficulties directly. Begin by noticing when cynical or negative thoughts creep in, and what forms they take. Do you feel negative about your patients, your coworkers, the health care system in general, or even all of the above? What types of thoughts do you have? Begin to look at these thoughts with some skepticism and notice how accurate they really are. Often when we are stuck in this way of thinking, we end up thinking in all-or-nothing patterns that don’t provide a realistic appraisal of what is truly happening. Try to notice this, and think things through with more nuance. For example, you might have this cynical thought: “This institution only cares about money.” You might rethink this and decide: “Well, some people in leadership seem to be only focused on money, but I don’t really know their true motives because I’ve never talked to them. I do know that many employees, like myself, care about a lot of other things, too.”

Also, recognize that your mental distancing and negativity are likely trying to help or protect you in some way. You may be tuning out more because it feels too painful to be present, and in small doses this can be an effective coping strategy. There may be a problem if this ends up being a chronic state of mental and emotional disconnection from our work. If this is how you’re feeling, then thoughts about what kinds of supports would help you stay more connected. What would help you manage the challenges that arise in your work without having to mentally “exit the building?” It may be time to practice some new coping skills that are focused on learning to sit with emotional difficulty, or even learning from hardship, instead of relying on the old strategy of emotional distancing that can often make burnout worse in the long term.

Although the ICD-11 characterizes burnout as a problem within an individual, there are systemic factors at play as well. Certain systems of care may be more likely to induce burnout in their employees, and structural solutions may need to be considered. If the system is damaging to your health and does not seem to be improving, sometimes the best plan in the long-term might be an exit strategy and a new work setting. Consulting with colleagues, loved ones, or your own health care team might be beneficial when considering your options. But only you can make that decision for yourself.