First, what is burnout?
The WHO’s International Classification of Diseases describes burnout in the following way: “Burnout is a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed. It is characterised by three dimensions:
1. Feelings of energy depletion or exhaustion;
2. Increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job;
3. Reduced professional efficacy.
While anybody can experience burnout, there are some specific personality traits which can highlight a risk of experiencing it. At highest risk of burnout are idealists, who approach their work with unrealistically high expectations; perfectionists, with unrealistic expectations of themselves and others; and helping professionals (teachers, nurses, social workers, pastors and others in work environments which require regular social interaction), who face high demands on their emotional energy, but have limited control of the situation.
One of the first concepts we need to understand is the difference between excessive stress and burnout. Excessive stress is the overuse of our coping capacities, caused by too much activity and change. Excessive stress results in fatigue, mild depression, physical illness, reduced mental alertness and other warning signals. Burnout, on the other hand, results in complete physical and mental exhaustion that leads to disillusionment, cynicism and self-deprecation. The effects are wide ranging, from chronic stress and fatigue to a weakened immune system, but whatever the results, one thing holds true. The individual is simply overwhelmed by life and can’t function normally.
Even the wise can burn out. King Solomon, the wisest king of ancient times, fully expressed the feelings and sentiments of those in advanced burnout: “Utterly meaningless! Everything is meaningless” (Ecclesiastes 1:1).
One man’s story
I had worked too many 70 to 80-hour weeks during nearly 15 years in a helping profession and my body simply couldn’t take it any longer. I’d been experiencing serious stress warning signals for years but hadn’t recognised them. One night, I woke up and was itchy all over. There were no fleas, and the itch lasted for about an hour. A few months later, I had shingles, a disease related to stress. Yet I didn’t feel stressed or overworked.
It was July 1, the beginning of an extremely busy couple of months. I was in a store when my entire body began to shake. By the time I got home, I was shaking uncontrollably. Reluctant to go to the hospital, I just lay down on the bed, and the whole bed shook. This lasted for about six hours, then stopped just as abruptly as it had begun.
In the middle of September, I embarked on a two-month camping holiday with my loved ones. Our children were both pre-schoolers at the time. Stress can do some strange things. You can manage it quite well until you begin to relax and then it hits you . . . hard.
We were less than three hours out of town when a depression settled over me that I wouldn’t wish on my worst enemy. I didn’t have a positive thought for at least three weeks. I couldn’t concentrate. I should have been under professional care but didn’t realise the seriousness of the situation.
After the two-month break, I thought I was ready to get back to work. But, I finally went to see a physician and learned I was still experiencing serious depression. I slowed down and practised stress management and mindfulness principles. I was fortunate and recovered without having to take medication. The complete process, however, took about three years.
The seven stages to burnout
We all face stress. We can’t avoid it. But as much as possible, we want to manage our stress effectively so that we don’t advance to burnout. There are signs of burnout that you may be able to see and take action against before you are fully burnt out. Noticing the possible risk factors and mitigating them can be key to preventing burnout before it’s too late.The seven stages that we’re going to discuss now are not all bad.
1. The honeymoon stage—this is a period of high energy and satisfaction. You can work hard and long and use up a great amount of energy, but you never feel exhausted, just exhilarated! Any stress you feel is the type of stress that keeps you sharp and doesn’t wear you down.
Here’s some especially good news for some of you. It’s also possible to be in serious burnout and yet return to and stay in the honeymoon stage.
2. The tune-up stage—this is where you have overdrawn on your energy supply. There’s a vague feeling of loss and some of the enthusiasm is gone. Challenge is beginning to be replaced by disillusionment. There isn’t total dissatisfaction. The physical or emotional exhaustion and depression doesn’t last long, but neither does that creative burst of energy that once got you through the day.
The result is inefficiency. You accomplish less and with poorer quality.
3. Early warning stage—now the symptoms of burnout are more noticeable and there are stress warning signs: headaches, indigestion or sleep difficulties. Emotional symptoms may or may not be recognisable at this stage—nervousness and anxiety for no good reason, boredom, edginess and so on. A good health check at this stage will prevent much grief later.
4. The chronic symptom stage—this could be called first-degree burnout. You know you’ve reached stage four when you’re just as tired in the morning as you were the night before. Your tiredness has turned into chronic exhaustion. Your sleep habits are shot, and no matter what you do you can’t get enough sleep. The physical symptoms become more pronounced. You become irritable. Your skin breaks out in hives or eczema. Dizzy spells, shortness of breath, a pounding heart and changes in blood pressure may be common. Numerous health conditions may affect you, none of them good.
Psychological symptoms also increase. You’re emotionally exhausted and feel drained. You erupt in anger in situations that previously would only have caused minor irritation. Depression rolls over you like a tidal wave and you can’t escape.
Get help immediately! Fortunate is the person who, at this stage, has a good friend or family member who can tell them hard truths.
5. The critical symptom stage or what I call second-degree burnout. At this stage, you’re in deep trouble and your symptoms have become critical. Chronic frustration and dissatisfaction rule your days and affect both your work and your personal life. Both physical and psychological symptoms intensify. You may even visit a doctor for medical advice and have a series of tests, but physically, little shows up wrong. At this point, you become obsessed with your problems.
Fear and depression are constant companions. Action is needed immediately, and professional help and healthcare may be required to break the cycle. At this stage, a good counsellor may be as helpful as a medical doctor.
6. The crisis stage—people will continue to push themselves when they can barely function. At this crisis stage, pessimism and cynicism develop, with a callous, insensitive disregard for people. Self-doubt and despair permeate your thinking. At this stage, you can be so negative and depressed that if someone comes on the television smiling and happy, you want to throw a rock at them.
It’s almost impossible to be positive at this stage. This isn’t a time to make major, life-changing decisions like divorcing your spouse or quitting your job. The problem is that at this stage, you feel like a trapped animal. An escape mentality develops: I’ve got to get out of this town, this job, this marriage; I’ve just got to get out of here! Getting help from a health professional or another qualified helper is critical because your physical and mental health are in serious jeopardy.
7. Hitting the wall—this is a phrase that comes from the world of marathon running, when runners experience a devastating depletion of the muscle fuel known as glycogen. Muscle paralysis can occur, with dizziness, fainting and complete collapse, and it means having to drop out of the race. When people reach this stage of burnout, their adaptive energy is depleted just like the runner’s glycogen. They become completely dysfunctional and experience a total breakdown. For some, it puts an end to their working careers forever.
You meet some of these people homeless on the street, in prison or in mental institutions. Others end their lives in suicide. Now you have a better understanding of why they’re there. It’s possible to hit the wall and recover, but it isn’t probable.
Recovering from burnout
If you’re suffering in the critical stages of burnout, remember to be patient in recovery. It took you several years to get to the crisis stage and it will take a minimum of a few months or even years to achieve a complete recovery.
I know we’d like to blame someone or any number of individuals, but the buck stops with us. I can’t overemphasise that the primary secret in preventing, and, yes, also in recovering, from burnout is this: only you can take responsibility for your life. Once you’ve reached the critical stages self-care is an important factor in increasing your wellness and getting back to how things were before.
Here’s a list of six things for you to take control of:
1. Physical health—You can do this by daily giving your body:
- Good, balanced nutrition
- Physical exercise
- Plenty of water (6–8 glasses a day)
- Adequate sunshine (20 minutes a day)
- Practising temperance (self-
control; ie, avoiding addictive substances or overeating) - A good supply of fresh air
- Adequate rest and relaxation
- Trust in God
2. Thoughts and behaviours—Various studies have demonstrated how our thoughts affect our behaviours and vice versa. Focusing on positive, uplifting thoughts will directly affect how you feel and act.
3. Time—Proper time management and planning is a must. Allow yourself enough time for your priorities. Start each day slowly and positively with a good breakfast and with a realistic and practical plan for the day. If you need additional help with time management, the best book I know on the subject is First Things First by Steven Covey and Roger and Rebecca Merrill.
4. Work—Cut back on excessive work hours. Studies clearly demonstrate that if you’re working more than 50 hours a week, you are likely to have poorer mental health, lower quality sleep and an increased risk of stroke. People who frequently work long hours have been shown to perform more poorly at work and to be less satisfied with their work, life and relationships.¹ Finding the right work-life balance and avoiding unnecessary work-related stressors can be key to recovering
5. Relationships and personal support system—Learn how to deal with people, especially your family members and co-workers. Relationships don’t happen automatically. Positive and meaningful relationships with your spouse, children or parents require significant time and effort.
A personal support system means that you have three to five people you can lean on when times get tough and warning signs start to appear again. If possible, some of these should be from outside your regular acquaintances like your family or co-workers.
6. Future—Take an honest assessment of your goals and values, and develop a practical life plan. This will take some time, but if you haven’t done this, now is the time. Earlier, I mentioned that even the wise can and do burn out, like King Solomon. After recovering from burnout and regaining the honeymoon stage, he made this comment: “It is good for people to eat, drink, and enjoy their work under the sun during the short life God has given them, and to accept their lot in life. . . . This is indeed a gift from God” (Ecclesiastes 5:18,19).
You need to make sure that you are making a life and not just a living.
Cameron Johnston is a lifestyle consultant with qualifications in public health and theology. This article is adapted with permission from his latest book, Cooling Down Stress (2020, Signs Publishing).
1. L Sander (2019), “Go home on time! Working long hours increases your chance of having a stroke,” The Conversation, June 28, 2019, <http://theconversation.com/go-home-ontime-working-long-hours-increases-your-chance-of-having-a-stroke-119388>.
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