Burnout can be defined as a state of emotional, mental and physical exhaustion as a result of chronic stress. It is characterised by feelings of helplessness, hopelessness, cynicism and anger. It occurs when you feel overwhelmed, emotionally drained, and unable to meet constant demands. As the stress continues, you begin to lose interest and motivation, reducing your productivity in the long run as well as depleting your energy. The impact of the burnout is widespread and can infiltrate many aspects of your life e.g. relationships, outcomes, health etc. By recognising the signs of burnout and developing preventative techniques as well as ways to overcome it, we can possibly reduce the incidence of such in the long run.
Medical school is an extremely competitive, challenging environment. The constant pressure and high expectations from those around you can quickly become overwhelming. From academic pressures and educational debt, to personal life events, learning environment and exposure to human suffering, contribute to heightened levels of stress and poor mental health in medical students.
According to research conducted by Cecil et al, more than half of the participants (undergraduate medical students) (54.8%) reported experiencing high levels of Emotional Exhaustion, 34% reported high levels of Depersonalisation and 46.6% reported low levels of Personal Achievement. Overall, 26.7% of participants met the criteria to be considered ‘burned out’.
As doctors and healthcare professionals the constant weight of responsibility, pressure to see a high volume of patients and the vast amount of rules and regulations one is forced to keep up with can negatively impact ones well-being. Being a doctor is certainly a great privilege, but it is also an enormous tax on the emotions and the high stress nature of the job makes doctors particularly susceptible to burnout.
Doctors experiencing burnout are reported to be at a higher risk of making poor decisions; display hostile attitude toward patients; make more medical errors; and have difficult relationships with co-workers. Burnout among doctors also increases risk of depression; anxiety; sleep disturbances; fatigue; alcohol and drug misuse; marital dysfunction; premature retirement and perhaps most seriously suicide.
RECOGNISING SIGNS OF BURNOUT
Burnout has a way of gradually creeping up on you, it’s easy to ignore the subtle initial symptoms however as they progressively worsen, the impact can be detrimental and the sooner they are addressed the better. If you pay attention and act to reduce your stress, you can prevent a major breakdown. Common signs of burnout include:
Chronic exhaustion
Cynical
Feelings of helplessness and hopelessness
Loss of motivation
Detachment
Isolation
Avoidance
Lethargy
Making of mistakes frequently
Lack of focus
Irritability
Loss of interest
Depression
Low feelings of personal accomplishment
CAUSES OF BURNOUT
As individuals our responses to stress differ greatly, so particularly stressors vary in their impact on our wellbeing. Quite often feeling overwhelmed is a common cause of burnout. Other causes of burnout include:
Unmanageable workload
Lack of control
Lack of direction
Lack of sleep/lack of rest
Perfectionist tendencies
Monotonous/ unchallenging work
Lack of support
Big consequences for failure
Impossible/ unclear requirements
PREVENTING BURNOUT
Schedule your rest and incorporate it into your daily routine
Regularly talking to someone whether it be a friend, family or support worker
Know your capability/ don’t take too much on
Exercise/ engage in hobbies regularly
Set aside relaxation time e.g. meditation
Writing/ Journalling thoughts and feelings
Healthy diet e.g. moderate alcohol intake, less refined sugar, more omega 3 fatty acids and avoid nicotine
OVERCOMING BURNOUT
Take a break/ Rest: This is probably the most important point of all. Separate yourself from your source of stress and take this time to readjust your focus and remember why you started. You need to take the time out to restore yourself to the best version of you and rediscover what really makes you happy so slow down and give yourself time to rest, reflect and heal.
Treat yourself: When we give ourselves treats, we feel energized, cared for and contented, which boosts our self-command—and self-command helps us maintain our healthy habits.
Sleep: Feeling tired can exacerbate burnout by causing you to think irrationally. Generally speaking, the more burned out you feel, the more sleep you’re probably going to require. You may have to force yourself. For your body’s sake. And your sanity.
Change your environment: Sometimes a change space is enough to clear your head and remind you of your motivation. Removing yourself from a stressful environment can give you time to think and regain strength to approach the challenges you may be facing.
Talk to someone: This can relieve the burden and you do not have to approach your challenges alone. Talking face to face with a good listener is one of the fastest ways to calm your nervous system and relieve stress.
Outsource: Be realistic about how much work you can handle. Relinquish some of your power and hand over some tasks to someone else. Preferably the tasks you don’t feel like doing yourself.
Set Goals/ Prioritise: This is about creating a practical approach to deal with your stress. Write down what you need to do in order of priority and separate your tasks into different days when you will address them. The process of writing down pending tasks makes it easier to visualise, more achievable and not a distant concept.
Identify the cause of your burnout: This is essential to avoid being in the same rut in the future and will allow you to reframe the way you approach certain tasks or stressors in the future as well as help you to recognise difficulties you are facing in this area earlier on.
REFERENCES
Cecil, J., C. McHale, J. Hart, and A. Laidlaw, 2014, Behaviour and burnout in medical students: Med Educ Online, v. 19, p. 25209.
Kumar S. Burnout and Doctors: Prevalence, Prevention and Intervention. Leggat PA, Smith DR, eds. Healthcare. 2016;4(3):37. doi:10.3390/healthcare4030037.