March 10, 2023 • 20 mins
No energy at work? Feeling detached and cynical? Have you lost the sense that you’re accomplishing anything meaningful? All are classic symptoms of burnout. If quitting isn’t an option, Dr. Saltz has practical ways to not only survive burnout, but even improve your work life.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Bees are challenging times, but you don't have to navigate
them alone. Welcome to how can I Help? I'm doctor
Gale Saltz. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:26):
hopefully with understanding, insight and advice. What exactly is burnout?
How does it make you feel? Occupational burnout is not
actually a mental illness. It is not a DSM five diagnosis,
(00:48):
as is typically reported for psychiatric diagnoses. It is, however,
recognized by the World Health Organization as a collection of
symptoms that are related to work. It is a syndrome,
and it is due to an unsuccessful management of chronic
(01:09):
stress related to work. It's basically defined as two or
more weeks of symptoms from three general categories. The first
category is energy depletion emotional and physical. The second category
is feeling distant or cynical or just generally negative about
(01:34):
your job. And the third category is a decrease in
effectiveness in terms of your job and that that is
noticeable to you. It's distressing and it hurts your work.
So today I am answering a question about occupational burnout.
(01:55):
The symptoms result from an overall mismatch between the nature
of the job, in other words, like what you believed
and wish the job to be and the actual job
you are doing. So it may be that it's too
much work, for example, after layoffs when the remaining people
(02:16):
have to pick up all of the extra work. Or
it could be a lack of rewards and the words,
there's no sort of acknowledgement or reward built in to
all the hard work that you're doing. It could be
due to a lack of control. You have no control
(02:36):
over how much and how long and when your employer
has access to you. Could be due to a lack
of fairness or a conflict in your values and those
of your work. Symptoms are feeling exhausted mentally and physically,
(02:58):
feeling sad or alternatively angry and detached or cynical, but
all regarding your work, like you really don't care, maybe
even feeling bad at your job, an inability to concentrate,
(03:18):
feeling particularly irritable or cranky, or as I mentioned before, angry,
feelings of helplessness, feelings of inertia, I can't do this,
I can't get going. It might even be that you
feel physically literally weak. Some people experience a lot of
(03:41):
aches and pains, headaches, stomach aches, backaches, and some people
who have burnout report extreme sensitivity, like a sensitivity to sound. Interestingly,
women tend to experience more of the exhaustion related symptoms
in terms of burnout, and men tend to experience more
(04:04):
of what's called depersonalization, which are those feelings of being
cynical or removed or numb regarding your job. Occupational burnout
can affect workers in a variety of industries and occupations,
but it is most commonly seen in jobs that involve
(04:26):
high levels of stress, long hours, and high levels of responsibility.
Some of the types of workers who are most susceptible
to occupational burnout include healthcare workers, doctors, nurses and other
health professionals, first responders like police officers and firefighters, teachers
(04:52):
and other types of educational professionals, customer service representatives and
other people who are on the front lines, social workers,
therapists and other people in helping professions. Managers and executives
who work in high pressure environments, and it professionals and
(05:16):
other technology workers, but really anyone can experience occupational burnout,
regardless of their industry or their occupation, as long as
they are subjected to chronic job stress. It is not
unusual for workers to have a difficult time acknowledging that
(05:39):
they actually are having occupational burnout, and there are several
reasons why it might be difficult for them to do so.
The first is stigma. Mental health issues, including burnout, still
carry a stigma in some communities, and people may be
reluctant to admit they are struggling with burnout due to
(06:01):
the fear of being judged or even discriminated against. Denial.
People can be in denial about their symptoms and believe,
you know, I'm really just tired or generally stressed, but
not experiencing burnout. A fear of consequences. Admitting to burnout
(06:23):
can lead to concerns about your job security or your
performance evaluations, which can be a barrier to seeking help
for it. Personal pride admitting to burnout can be perceived
as a personal failure, and people may be reluctant to
acknowledge that they are struggling in their work and lack
(06:48):
of awareness some people may not be aware of what
burnout is or may not recognize the symptoms in themselves.
It's important for able to overcome these barriers and seek
help if they are experiencing symptoms of burnout, because early
intervention can help prevent the condition from getting worse and
(07:12):
negatively impacting both their personal and professional life. In addition
to the groups of employees I mentioned earlier who are
at higher risk, workers in businesses that have experienced layoffs recently,
which is many companies these days, and are expected to
(07:32):
pick up all the work of the people who have
left in addition to their own, and therefore have this
increasing burden without often any recognition or particular reward. Those
people are also at quite high risk, and I'm seeing
a lot of those people related to burnout. Researchers examining
(07:57):
occupational burnout and depression have found that there are many
similarities between these two states, more so with depression than,
for example, anxiety disorders, but there are differences, mostly in
severity of symptoms and the number of symptoms, but especially
(08:19):
because a prominent part of burnout is the cynicism about
and the distancing of oneself from their job, occupation or
burnout can bleed over to include feelings stressed and burned
out at home as well, especially if the stresses continue
at home, for example, people with young children or other
(08:44):
situations that simply require a lot of energy, and this
can make the affected person feel burned out all the time.
So with that, right after the break, we'll get to
my listener's question. Welcome back. Let's get to my listener's
(09:13):
question and see how can I help, dear doctor Saltz.
I am a nurse at a community hospital. I have
always wanted to be a nurse and really started my
career with great enthusiasm, feeling I was doing just what
I was meant to do and really liked caring for patients.
(09:35):
Two and twenty and twenty one were very difficult years
in nursing because of the pandemic. It was scary, and
we were often overwhelmed with the number of patients and
how much each patient needed due to their level of illness.
But I also thought, well, this is really a finite
(09:57):
amount of time and I am doing amazing work and
I can handle it. But by twenty twenty two, even
though there were fewer people being hospitalized for COVID, I
found that I was still being pulled too thin, having
an overwhelming amount of work and getting very little support.
(10:18):
But really, on top of that, I have found patience
to be ever more demanding, less and less nice, and
expressing almost constant dissatisfaction. Sometimes patients are outright yelling at
me and nasty, and there seems to be nothing I
can do about it, and nothing my employer does about it.
(10:41):
In all fields, very helpless and miserable and not what
being a nurse or a healthcare provider should be. I
find myself dreading going to work now, feeling dog tired
all the time, even feeling weepy sometimes and often resentful
and angry. Then I come home and I'm cranky, and
(11:06):
that's making my partner and myself pretty miserable too. I
don't even feel that good at my job anymore, and
this is really killing me. I don't think I can
keep going this way, but to be honest, I don't
have the financial luxury of quitting, so I feel trapped
(11:28):
any suggestion of what I can do to make myself
less miserable. Healthcare workers are one of the most affected
groups when it comes to occupational burnout. You are describing
the three hallmark areas of burnout feeling emotionally exhausted, feeling
unconnected to your work, and feeling a loss of personal
(11:51):
accomplishment at work. This has all happened in relation to
the unending, prolonged high stress of your workronment. The clearest
examples of burnout that you describe is that being dog
tired all the time, hating going to work, and the
feeling now that you're bad at your job. I don't
(12:15):
think there is any question this is occupational burnout. I
understand that you are not in a position to quit
or move jobs, but there are things that you can
do within your job to survive and improve the burnout.
Some will come from you, but ideally some would come
(12:36):
from your employer. Speaking to your direct boss about what
support you can get, what can be delegated, what is
reasonable to offer you towards rewards. How can your employers
support setting limits with people who are being angry, aggressive,
(12:57):
and unkind. How can your employer think about rewards in
terms of the financial status of your job as well,
and other types of rewards to help you feel better
about the work and importantly the value of the work
that you are doing. Those are things that could help
(13:18):
you all of them with burnout on your end. There
are also things you could do. First, I really would
plan a break. This could be a vacation, could be
a staycation, or even a mental health day on that
day or days, do zero related to work. Do not
(13:42):
use this time to play catch up, do not answer emails.
And the point of this time is to do only
relaxing and distressing things. This could be exercised if that's
distressing for you, but it could be being in nature,
meeting with friends to talk and get some support, taking
(14:06):
a warm bath, watching a fun movie, reading a great
non work book. The point is to do things and
only things that take down the stress level. Next is
focusing back on the mission and the meaning of your job,
(14:28):
thinking through what aspect of your job gives you a
feeling of purpose and how can you focus more on
that and less on the other parts. And during this
time we can forget to and really need to practice
self compassion, catching up on good sleep, being kinder to yourself,
(14:53):
and making it a real priority to do something every
day that distresses you. Put a time limit on when
you will respond to anything work related. When you get home,
you are home, be home, do not do work, do
(15:15):
something relaxing. This is how you prioritize your mental health.
If your mood continues to sink, however, you might want
to use a mental health day to have a meeting
with a mental health professional to talk and assess whether
you could benefit from some therapy sessions as well. I
(15:38):
hope that was helpful. When should you consider taking a
mental health day? Clear cut examples or signs would be
when you are unable to complete an established routine at
work anymore and really do need to plan a break
in the repetitive, high stress situation of your daily job.
(16:01):
When you recognize that you are struggling with burnout and
can benefit from a day off to recharge, and if
you feel emotionally and physically spent such that the idea
of going into work just fills you with dread, when
you feel miserable at the prospect. Usually it's good to
(16:24):
plan a mental health day with a little lead time,
but of course there may be times when you need
one urgently, and that's if you are feeling so overwrought
you can tell that going in that day will be
completely unproductive. And what would a mental health day look like?
(16:45):
It should be? A day of distressing a day of recovery. Preferably,
I would say with no using social media, which while
not necessarily work related, most people, whether they realize it
or not, find it is stressful, and no email. Plan
(17:09):
instead a relaxing set of joyful activities, which could be,
for example, lunch with a friend, going for a hike,
curling up with a fun book or movie, exercise that
you like, employing some relaxation techniques like paste, deep breathing,
(17:30):
progressive muscle relaxation, taking a warm bath, listening to music
you like, having a meal that you really enjoy. You
may run some needed but not noxious errands, so something
that actually you don't find unpleasant. Maybe that is grocery shopping.
(17:51):
Maybe it's clothing shopping. A therapy appointment could be something
you do on a mental health day and really important.
What you don't want to do on a mental health
day is increase alcohol use or use any drugs. Those
are actually poor ways to cope, will not distress you
(18:13):
in the long term, could build a problem, and not
a suggestion for a mental health day. Burnout is something
that is not really cured, but rather managed. Because this
is a mismatch with work work solutions as well as
personalized solutions are what's needed. For example, stopping answering emails
(18:38):
after six pm, talking to your boss about how to
delegate more, constructing more work achievable goals so that you
can feel satisfied at the completion of something. Consider thinking
about what aspect of work could bring you more meaning
or value or reward. Plan and take vacation days. It
(19:03):
could be a staycation, but do take those days off.
I recognize that being able to change jobs can be
a privilege not everyone has, but sometimes it really might
be what's needed, depending on your circumstance. And working to
decrease stress levels overall by increasing your social support with
(19:28):
regular aerobic exercise three to four times a week, working
on sleep to get good quality, improved sleep, setting boundaries
at work, taking tech breaks from time to time, importantly,
developing a creative outlet, something you enjoy creatively outside of work,
(19:52):
and above all, practicing self compassion. Do you have a
problem I can help with? If so, email yet how
can I help? At senecawomen dot com. All centers remain
anonymous and listen every Friday too. How can I help
with me? Doctor Gale's salts
Bees are challenging times, but you don't have to navigate
them alone. Welcome to how can I Help? I'm doctor
Gale Saltz. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:26):
hopefully with understanding, insight and advice. What exactly is burnout?
How does it make you feel? Occupational burnout is not
actually a mental illness. It is not a DSM five diagnosis,
(00:48):
as is typically reported for psychiatric diagnoses. It is, however,
recognized by the World Health Organization as a collection of
symptoms that are related to work. It is a syndrome,
and it is due to an unsuccessful management of chronic
(01:09):
stress related to work. It's basically defined as two or
more weeks of symptoms from three general categories. The first
category is energy depletion emotional and physical. The second category
is feeling distant or cynical or just generally negative about
(01:34):
your job. And the third category is a decrease in
effectiveness in terms of your job and that that is
noticeable to you. It's distressing and it hurts your work.
So today I am answering a question about occupational burnout.
(01:55):
The symptoms result from an overall mismatch between the nature
of the job, in other words, like what you believed
and wish the job to be and the actual job
you are doing. So it may be that it's too
much work, for example, after layoffs when the remaining people
(02:16):
have to pick up all of the extra work. Or
it could be a lack of rewards and the words,
there's no sort of acknowledgement or reward built in to
all the hard work that you're doing. It could be
due to a lack of control. You have no control
(02:36):
over how much and how long and when your employer
has access to you. Could be due to a lack
of fairness or a conflict in your values and those
of your work. Symptoms are feeling exhausted mentally and physically,
(02:58):
feeling sad or alternatively angry and detached or cynical, but
all regarding your work, like you really don't care, maybe
even feeling bad at your job, an inability to concentrate,
(03:18):
feeling particularly irritable or cranky, or as I mentioned before, angry,
feelings of helplessness, feelings of inertia, I can't do this,
I can't get going. It might even be that you
feel physically literally weak. Some people experience a lot of
(03:41):
aches and pains, headaches, stomach aches, backaches, and some people
who have burnout report extreme sensitivity, like a sensitivity to sound. Interestingly,
women tend to experience more of the exhaustion related symptoms
in terms of burnout, and men tend to experience more
(04:04):
of what's called depersonalization, which are those feelings of being
cynical or removed or numb regarding your job. Occupational burnout
can affect workers in a variety of industries and occupations,
but it is most commonly seen in jobs that involve
(04:26):
high levels of stress, long hours, and high levels of responsibility.
Some of the types of workers who are most susceptible
to occupational burnout include healthcare workers, doctors, nurses and other
health professionals, first responders like police officers and firefighters, teachers
(04:52):
and other types of educational professionals, customer service representatives and
other people who are on the front lines, social workers,
therapists and other people in helping professions. Managers and executives
who work in high pressure environments, and it professionals and
(05:16):
other technology workers, but really anyone can experience occupational burnout,
regardless of their industry or their occupation, as long as
they are subjected to chronic job stress. It is not
unusual for workers to have a difficult time acknowledging that
(05:39):
they actually are having occupational burnout, and there are several
reasons why it might be difficult for them to do so.
The first is stigma. Mental health issues, including burnout, still
carry a stigma in some communities, and people may be
reluctant to admit they are struggling with burnout due to
(06:01):
the fear of being judged or even discriminated against. Denial.
People can be in denial about their symptoms and believe,
you know, I'm really just tired or generally stressed, but
not experiencing burnout. A fear of consequences. Admitting to burnout
(06:23):
can lead to concerns about your job security or your
performance evaluations, which can be a barrier to seeking help
for it. Personal pride admitting to burnout can be perceived
as a personal failure, and people may be reluctant to
acknowledge that they are struggling in their work and lack
(06:48):
of awareness some people may not be aware of what
burnout is or may not recognize the symptoms in themselves.
It's important for able to overcome these barriers and seek
help if they are experiencing symptoms of burnout, because early
intervention can help prevent the condition from getting worse and
(07:12):
negatively impacting both their personal and professional life. In addition
to the groups of employees I mentioned earlier who are
at higher risk, workers in businesses that have experienced layoffs recently,
which is many companies these days, and are expected to
(07:32):
pick up all the work of the people who have
left in addition to their own, and therefore have this
increasing burden without often any recognition or particular reward. Those
people are also at quite high risk, and I'm seeing
a lot of those people related to burnout. Researchers examining
(07:57):
occupational burnout and depression have found that there are many
similarities between these two states, more so with depression than,
for example, anxiety disorders, but there are differences, mostly in
severity of symptoms and the number of symptoms, but especially
(08:19):
because a prominent part of burnout is the cynicism about
and the distancing of oneself from their job, occupation or
burnout can bleed over to include feelings stressed and burned
out at home as well, especially if the stresses continue
at home, for example, people with young children or other
(08:44):
situations that simply require a lot of energy, and this
can make the affected person feel burned out all the time.
So with that, right after the break, we'll get to
my listener's question. Welcome back. Let's get to my listener's
(09:13):
question and see how can I help, dear doctor Saltz.
I am a nurse at a community hospital. I have
always wanted to be a nurse and really started my
career with great enthusiasm, feeling I was doing just what
I was meant to do and really liked caring for patients.
(09:35):
Two and twenty and twenty one were very difficult years
in nursing because of the pandemic. It was scary, and
we were often overwhelmed with the number of patients and
how much each patient needed due to their level of illness.
But I also thought, well, this is really a finite
(09:57):
amount of time and I am doing amazing work and
I can handle it. But by twenty twenty two, even
though there were fewer people being hospitalized for COVID, I
found that I was still being pulled too thin, having
an overwhelming amount of work and getting very little support.
(10:18):
But really, on top of that, I have found patience
to be ever more demanding, less and less nice, and
expressing almost constant dissatisfaction. Sometimes patients are outright yelling at
me and nasty, and there seems to be nothing I
can do about it, and nothing my employer does about it.
(10:41):
In all fields, very helpless and miserable and not what
being a nurse or a healthcare provider should be. I
find myself dreading going to work now, feeling dog tired
all the time, even feeling weepy sometimes and often resentful
and angry. Then I come home and I'm cranky, and
(11:06):
that's making my partner and myself pretty miserable too. I
don't even feel that good at my job anymore, and
this is really killing me. I don't think I can
keep going this way, but to be honest, I don't
have the financial luxury of quitting, so I feel trapped
(11:28):
any suggestion of what I can do to make myself
less miserable. Healthcare workers are one of the most affected
groups when it comes to occupational burnout. You are describing
the three hallmark areas of burnout feeling emotionally exhausted, feeling
unconnected to your work, and feeling a loss of personal
(11:51):
accomplishment at work. This has all happened in relation to
the unending, prolonged high stress of your workronment. The clearest
examples of burnout that you describe is that being dog
tired all the time, hating going to work, and the
feeling now that you're bad at your job. I don't
(12:15):
think there is any question this is occupational burnout. I
understand that you are not in a position to quit
or move jobs, but there are things that you can
do within your job to survive and improve the burnout.
Some will come from you, but ideally some would come
(12:36):
from your employer. Speaking to your direct boss about what
support you can get, what can be delegated, what is
reasonable to offer you towards rewards. How can your employers
support setting limits with people who are being angry, aggressive,
(12:57):
and unkind. How can your employer think about rewards in
terms of the financial status of your job as well,
and other types of rewards to help you feel better
about the work and importantly the value of the work
that you are doing. Those are things that could help
(13:18):
you all of them with burnout on your end. There
are also things you could do. First, I really would
plan a break. This could be a vacation, could be
a staycation, or even a mental health day on that
day or days, do zero related to work. Do not
(13:42):
use this time to play catch up, do not answer emails.
And the point of this time is to do only
relaxing and distressing things. This could be exercised if that's
distressing for you, but it could be being in nature,
meeting with friends to talk and get some support, taking
(14:06):
a warm bath, watching a fun movie, reading a great
non work book. The point is to do things and
only things that take down the stress level. Next is
focusing back on the mission and the meaning of your job,
(14:28):
thinking through what aspect of your job gives you a
feeling of purpose and how can you focus more on
that and less on the other parts. And during this
time we can forget to and really need to practice
self compassion, catching up on good sleep, being kinder to yourself,
(14:53):
and making it a real priority to do something every
day that distresses you. Put a time limit on when
you will respond to anything work related. When you get home,
you are home, be home, do not do work, do
(15:15):
something relaxing. This is how you prioritize your mental health.
If your mood continues to sink, however, you might want
to use a mental health day to have a meeting
with a mental health professional to talk and assess whether
you could benefit from some therapy sessions as well. I
(15:38):
hope that was helpful. When should you consider taking a
mental health day? Clear cut examples or signs would be
when you are unable to complete an established routine at
work anymore and really do need to plan a break
in the repetitive, high stress situation of your daily job.
(16:01):
When you recognize that you are struggling with burnout and
can benefit from a day off to recharge, and if
you feel emotionally and physically spent such that the idea
of going into work just fills you with dread, when
you feel miserable at the prospect. Usually it's good to
(16:24):
plan a mental health day with a little lead time,
but of course there may be times when you need
one urgently, and that's if you are feeling so overwrought
you can tell that going in that day will be
completely unproductive. And what would a mental health day look like?
(16:45):
It should be? A day of distressing a day of recovery. Preferably,
I would say with no using social media, which while
not necessarily work related, most people, whether they realize it
or not, find it is stressful, and no email. Plan
(17:09):
instead a relaxing set of joyful activities, which could be,
for example, lunch with a friend, going for a hike,
curling up with a fun book or movie, exercise that
you like, employing some relaxation techniques like paste, deep breathing,
(17:30):
progressive muscle relaxation, taking a warm bath, listening to music
you like, having a meal that you really enjoy. You
may run some needed but not noxious errands, so something
that actually you don't find unpleasant. Maybe that is grocery shopping.
(17:51):
Maybe it's clothing shopping. A therapy appointment could be something
you do on a mental health day and really important.
What you don't want to do on a mental health
day is increase alcohol use or use any drugs. Those
are actually poor ways to cope, will not distress you
(18:13):
in the long term, could build a problem, and not
a suggestion for a mental health day. Burnout is something
that is not really cured, but rather managed. Because this
is a mismatch with work work solutions as well as
personalized solutions are what's needed. For example, stopping answering emails
(18:38):
after six pm, talking to your boss about how to
delegate more, constructing more work achievable goals so that you
can feel satisfied at the completion of something. Consider thinking
about what aspect of work could bring you more meaning
or value or reward. Plan and take vacation days. It
(19:03):
could be a staycation, but do take those days off.
I recognize that being able to change jobs can be
a privilege not everyone has, but sometimes it really might
be what's needed, depending on your circumstance. And working to
decrease stress levels overall by increasing your social support with
(19:28):
regular aerobic exercise three to four times a week, working
on sleep to get good quality, improved sleep, setting boundaries
at work, taking tech breaks from time to time, importantly,
developing a creative outlet, something you enjoy creatively outside of work,
(19:52):
and above all, practicing self compassion. Do you have a
problem I can help with? If so, email yet how
can I help? At senecawomen dot com. All centers remain
anonymous and listen every Friday too. How can I help
with me? Doctor Gale's salts
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