The A-Z of burnout – a brief, practical guide from a survivor

It seems like all around us we’re hearing of the impact of the pandemic on mental as well as physical health – but what does this mean? I am self-confessed data junky so I turned to the data to see what it could tell us. In a recent survey published by HBR* on the state of burnout and well-being during Covid-19:

• 89% of respondents said their work life was getting worse.
• 85% said their well-being had declined.
• 62% of the people who were struggling to manage their workloads had experienced burnout “often” or “extremely often” in the previous three months.
• Only 21% rated their well-being as “good,” and a mere 2% rated it as “excellent.”

Many of us knew it was going to be bad, but this is a real wake up call. Just based on my own immediate experience talking to a number of clients, many of whom are driven, high achievers; founders of businesses and company executives on missions to make a real difference through their work. They are struggling with the environment in which they find themselves and the volume of demands on their time – nothing new to this you might think. Well, as we are increasingly finding ourselves working from home, juggling additional caring demands and finding no way to delineate between work and home – wellbeing is being seriously impacted with leading for many to feelings of burnout.

Last autumn, I wrote a short blog about my own experiences of burnout. Based on the conversations and exchanges it generated, my intention was always to write a longer, more detailed blog so here goes. By creating an A to Z of burnout, I’ve tried to highlight not only the symptoms, but also share thoughts based on research and experience of avenues readers can explore and act on further on their possible journey to recovery or supporting individuals in their recovery. It’s not an exhaustive list, but it is intended to address the physical, mental, and emotional issues of burnout – recognising that for each sufferer, these are unique to them.

*Beyond Burned Out, HBR 10 Feb 2021 – Jennifer Moss, Michael Leiter, Christina Maslach, and David Whiteside created a survey annalysingthe state of burnout and well-being during Covid-19 assessing employees’ perceptions of work-setting qualities that affect whether they experience engagement or burnout, the results were striking. Combining several evidence-based scales, including the Maslach Burnout Inventory General Survey (MBI-GS), a psychological assessment of occupational burnout, and the Areas of Worklife Survey (AWS), which assesses employees’ perceptions of work-setting qualities that affect whether they experience engagement or burnout. With more than 1,500 respondents in 46 countries, in various sectors, roles, and seniority levels, autumn 2020. Sixty-seven percent of respondents worked at or above a supervisor level.

A is for anxiety, anger and acceptance. 

Often one of the first symptoms burnout sufferers experience is a truly heightened level of anxiety stopping them from doing things previously they found relatively straight forward. Waves of unexplainable anger can also be another manifestation. Where before individuals may have seen themselves as fairly rational, even keeled, they suddenly find themselves experiencing unexplainable anger and / or anxiety at the flick of a switch. For me anxiety has been the single most persistent symptom of my burnout and which years later, I still struggle with most days.

Acknowledgement of your situation and your feelings can really be the first step in facing your burnout. Part of this is facing and accepting your anxieties and frustrations. It’s not a blame game – it’s about accepting where you find yourself and seeking help.

B is for brain fog and boundaries. 

Brain fog are words I had never heard before I started my exploration of burnout. In essence, you have severe trouble navigating your thoughts and taking action. Things feel incredibly cloudy and you end up bogged down unable to make a decision even on the most basic of things which can lead to feeling overwhelmed and exhausted. However, with rest and time, this is usually one of the more straight forward symptoms to address.

Boundaries are not an easy concept especially for driven, high achievers. Boundaries can often be a word that is easy to throw around but almost impossible to clearly articulate and embed into action. And yet, without healthy boundaries you are caught in a potentially destructive cycle. For most it is a continuous work in progress. In my case, I am now more aware of when my boundaries are slipping and I’m falling back into habits that don’t serve me. Having this awareness means I’m quicker to take action.

C is for compassion, creativity and community (to counter-act the cynicism). 

When I was at my worst with burnout, I called a friend and she immediately sprang into action. Within 90 minutes of our phone call, she had organised for me to complete a group based 8-week programme in self-compassionate mindfulness. It was the best thing I could have done. It gave me a focus and routine to my week and my days as well as providing me with a greater understanding of myself and my burnout. To this day, I take time out most days to practice. Compassion, especially for ourselves, is hard but having a practice to rely on which has it at its centre, is a way to ensure you are making yourself the priority you need to be. Even though my homelife (with a young family) and work life (as a self-employed professional as well as being married to someone who is also self-employed) is an unpredictable, daily rollercoaster – I stick to the practice with as much constancy as I can muster. My daughter loves to say in tricky situations – Remember to put on your own oxygen mask first – that’s what this practice is for me.

Part of my recovery has been re-engaging with what makes me. As a child, I was hugely creative. Creating worlds of my own mainly, where others would be invited in to play. As an adult, I gradually lost track of that creativity even with a young family with plenty of opportunities for creativity. I was usually too overloaded and, in a rush. Through my recovery though I’ve found it in places that I would never have thought – like writing this blog!

I think many of us would say one of the things we have come to realise through the pandemic, is the value of reconnecting with the community around us. Community is what helps you through the tough times in particular. Having a community of people around you who you spend time with on a regular basis is key to feeling connected to life. They are there to bear witness and catch you through life’s ups and downs (even if you are a socialised introvert like myself). Living in a city, it can be hard to create community, but I’ve increasingly found ways to do it; through joining a choir, making friends with my local coffee shop owner, going for walks with a friend and her dog and meeting other dog owners as well as reconnecting with neighbours over the garden fence. It means when I walk out my front door there is usually someone there to say a socially distanced hello to. It anchors you and gives you a sense of belonging in a world that can seem very adrift especially in these times.

 D is for drink, drugs and other coping mechanisms (including caffeine and sugar), doctors and diagnosis.

Where to start? Coping mechanisms come in many shapes and forms. My own particular favourites are chocolate, refined carbs of any type pretty much any good wine. On the surface of it, these seem pretty harmless but when consumed in excess as a form of self-medication, the long-term outlook isn’t that great. The challenge is when you’re in the throes of burnout you’ve usually lost sight of what you’re doing to yourself. A good place to start is to look at your alcohol, sugar and caffeine consumption (that includes tea!), as well as any pain killers or other drugs you might be taking (often this can be things like repetitive headaches, sore necks from computer work or recurring infections that won’t go away) and take steps to do something about this.

Everyone has different experiences when it comes to doctors and burnout. Some have very pro-active, open doctors who spend time and energy exploring with their patience the best course of action for recovery. However, for most burnout sufferers I’ve spoken to this is not the case, so they turn detective out of necessity. Many have been offered anti-depressants as a first step in treatment (by the way there is no real agreement on the definition of burn-out amongst doctors – even though the WHO* has since 2019 recognised it – my doctor referred to it as TATT- tired all the time syndrome and others talk about things like adrenal fatigue just adding to the general confusion). The decision whether or not to take medication for symptoms is a personal one. On balance though, I am a believer that we are probably best addressing the root causes rather than masking the symptoms with drugs. However, some individuals need to get back on an even keel before they are ready to do this and medication can be a way of getting to that point.

E is for exhaustion, energy and exercise. 

This one really is a vicious circle. You don’t have the energy to exercise because your levels are on the floor – so you seek professional advice, and you are told to exercise. Based on the research I have done, the most important thing is sleep, rest, cutting back on work or even taking a lengthy break from work, a healthy balanced diet, (re-)connecting emotionally through relationships and disconnecting from technology to accelerate recovery. Once you have regained a modicum of energy, taking a walk in a park or green space on a regular basis building up to a daily regime is the first step in exercise. As energy comes back (and it will), you can always look to do gentle exercise classes in pilates or yoga with some swimming and cycling added to it. Going to the gym, running long distances, doing triathlons etc is probably best avoided until you feel much better (or maybe forever).

 F is for friends and family. 

A cautionary word is probably not what you’re expecting here. However, friends and family may struggle to see you through burnout. They frequently want to help, often with good intentions, but as it’s a poorly documented and understood condition where recovery can take far longer than anticipated and often (not always) leads to some major changes in how sufferers choose to lead their lives – family and friends can be challenging to have around. It can be particularly hard for spouses to understand and support and many relationships falter. Often, there is shame attached to a condition like burnout (as it can be classified in part as a mental health condition) and this can make it harder for sufferers to share and talk about it with family and friends in an open, constructive and supportive way which further complicates things. Make sure you surround yourself with individuals who are going to be truly supportive of you through your recovery and beyond.

*  In 2019 the World Health Organization finally included burnout in its International Classification of Diseases, describing it as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.”

 G is for great outdoors and good habits. 

When my burnout was at its worst, I was spending most of my life either in a very fancy, glass box of an office, crammed on a very busy commuter train or in bed exhausted except for 3-4 weeks of the year when we were on holiday in the great outdoors; camping, skiing or hiking (not that I had any energy to do the latter two). It’s so strange for me looking back that I lived with it for so long. I had lost sight of most of my good habits and the things that really connected me to my wellbeing.

Being outside and connected to nature on a daily basis can make all the difference to how each day plays out. I go for an hour long walk early each day and my daughter often joins me. Most days we’ll walk through a park or open green space and reconnect with nature – at this time of year there’s lots of mud and puddles to have fun with. Even in the howling wind, rain and dark, we head out. But even now, if you ask me: “Do you believe you technically have the time to do it I?” I would still say no, I am almost pre-programmed/hard-wired that work is absolutely my priority and so I simply have to make the time.

 H is for happiness and hormones, including the cortisol roller coaster. 

In my earlier blog, I wrote about the hormone rollercoaster and how very real it is for burnout sufferers. For women in particular, hormonal health can play a major part in their burnout experience. Poor hormonal health can make symptoms so much worse. I would recommend that all adults get a basic grip on their hormonal health by working with their doctor or if you get no joy there then explore other avenues (in my case it was going back to a different doctor in the practice who had a totally different attitude).

As part of my recovery, I’ve looked at what makes me happy or probably a more accurate way of articulating it is – What gives me joy and what can I do to create the conditions in my life where I experience joy? And whilst the last year has certainly presented us with massive curve balls, I stick to this. Whether it’s finding a great comedy programme to sit and laugh at with my family, developing and delivering a project with a fantastic team of associates, to reading a good book or having a glass of wine and a laugh (over Zoom) with friends. When I look back, for a prolonged period, my life felt very grey/sepia toned and even when on holiday doing the things I loved, I was so exhausted it was hard to feel joy. I now make it a priority every day to experience joy in however big or small a way.

I is for information. 

Infobesity – I love that word! It’s what we suffer from in the world today – total information overload. Cutting through the swath of information out there on burnout and making sense of the useful stuff that resonated and worked for me was a long but invaluable process in my recovery. I’ve tried to share in these blogs a little of what I’ve learnt along the way. Whilst my style may feel anecdotal at times, be sure that what I am writing is grounded in hours and hours of research reflection and discussion.

J is for juicing. 

When I was feeling particularly low, I booked an appointment with a fascinating therapist. Much of what he shared I remain fairly ambiguous about but one key take-away that I stuck with for quite a long time was juicing. Every morning I would make my swamp juice and drink it – it was like a ritual. As part of the move away from a diet too reliant on refined carbs – this daily act reminded me of the importance of taking the time and making the space to consider what I was consuming.

K is for karma and kindness. 

Do I believe in Karma? Yes, I do. What do I mean by that? I think my burnout was a long time coming – the seeds were sown a long time back. Whilst it was certainly avoidable in its severity, I have come to realise that it was just a matter of time before it happened. Am I grateful that I went through burnout? Yes and no. I wish I could have been spared some of the PTSD and flashbacks associated with burnout as well as the anxiety and exhaustion which means many of the memories of my daughter when she was young are pretty hazy, but it has led me to the place where I am now. I’m sure I would have arrived here eventually, but my burnout accelerated the journey!

Kindness is really the key in all of this – kindness to yourself and kindness from others (strangers, colleagues, friends, family). It’s the one thing we need to learn, to be and to remember.

L is for loss and learning. 

In many cases, there is a strong sense of loss attached to burnout especially when you’re in the eye of the storm. In the worst moments, you can feel like you’re losing your marbles, your identity, your relationships and so the list goes on. It’s only when looking back with some distance, that you can see that through loss comes growth and new exciting things emerge. Acknowledging the loss to yourself is important but so is getting a sense of perspective on the loss and finding a way to learn, evolve and move forward (check out C, G, M, N, P, R, S & T for some insights and inspiration).

M is for meditation and mindfulness. 

I think I’ve already said about as much as I can on this. If you are religious or have faith, then this can also serve as a way to achieve a similar goal. The neuro-science research coming out now on the benefits of meditation and mindfulness is extremely compelling for longer term health and longevity. The trick at least for me is not to try to be good at it – it’s to just do it and stick to a regular routine as best as possible.

 N is for nutrition. 

The average GP gets just 2 hours of training on nutrition in most curriculums and yet food is the foundation of good health and plays a critical role in recovery from burnout. This presents a potential problem if we look to doctors to advise us. Turning to Doctor Google, there is an overwhelming amount of information about what we should or should not be eating and much of it pretty weird and wonderful. Received wisdom though bears out – a diet made up of lots of green veg, whole grains, low sugar and salt with a limited amount of fat (not processed) is probably a good place to start and alcohol of course in moderation. One thing I hadn’t appreciated though was how nutritionally deficient we become with age and especially women due to experiences like pregnancy. I found it really useful to get a proper diagnosis of my nutritional deficiencies. I now have a comprehensive list of supplements I take on a daily basis and if I don’t take them, I notice. I think we have so much to learn from complementary medicines.

 O is for overwhelm and openness. 

Displays of overwhelm are usually amongst the most obvious indication to those around you that you’re suffering from burnout. It’s hard to explain what overwhelm feels like – for me it was like being in the eye of a never-ending storm where I felt overloaded with commitments both personal professional and everything on my to do list and every decision felt like a mountain to climb – I felt very isolated and bone achingly weary. With time and focus, the overwhelm can subside but it’s good to keep a check on your internal weather as feelings of overwhelm, however big or small, can be a good indicator if another storm in brewing.

The irony of burnout is that once you have it you are more susceptible to further episodes of it. The challenge therefore is to stay open to life and new experiences and not pull up barriers to protect yourself.

 P is for psychological support and purpose. 

For many, talking therapies can really help work through burnout. It can be hard to access these resources particularly if you are self-funding but it’s worth persevering if you can by getting your doctor on board to help you access them. It’s best to consider turning to qualified support in the form of psychologists in the first instance before exploring other therapy avenues like counsellors (the preferred option of many employee support programmes – usually because it is much more cost effective – and whilst it works for some depending on the complexity of their burnout, having fully qualified support is critical).

 Q is for (no) quick (fix). 

There is no average time that it takes to come back from burnout. Each person’s experience is so very individual. There are some professionals who refer to a rule of thumb for recovery but I’m not really sure it stacks up. Research does however bear out that there are no quick fixes and that recovery takes time and that sufferers need to put changes in place to ward against relapse.

R is for routines, relaxation and rest.

The neuroscience emerging around routines is quite interesting as it highlights that by making elements routine you can greatly reduce stress by eliminating additional decisions that need to be taken in life. In the early days of my burnout recovery, I found it easiest to put everything that could be into a routine; to remove any extraneous pressure from myself and I’ve continued to stick with this habit.

Relaxation and rest are the two of the other primary keys along with sleep, nutrition and time in nature that greatly help in burnout recovery based on my research. Type A personalities who are highly susceptible to burnout can really struggle with rest and relaxation. I was so wired that my legs would literally twitch involuntarily in the evenings. I researched alternative therapies extensively to help me move from my wired state to a more relaxed and restful one as I wasn’t able to do it on my own and recognised that I needed help. In particular, sacro-cranial osteopathy along with acupuncture in the early days made a huge difference. For me it wasn’t just a matter of telling myself to relax by having a hot bath and reading a good book although that works for some. I had to seek out ways to help my body to learn to relax and rest – it was almost like I needed to be reprogrammed/reset.

 S is for sleep and sun. 

If there is one thing that can act as a warning to burnout it’s sleep – lack of it or broken sleep or recurring nightmares or all of the aforementioned. Prioritising sleep above all else is absolutely critical and if it proves elusive get help in addressing it. I found a combination of the therapies, time in nature/exercise, no alcohol or caffeine, a healthy diet along with limiting technology and switching off from it by 9pm latest (including TV and reading a book instead) helped my sleep get back on track.

I’ve always struggled through with Seasonal Adjustment Disorder and get bouts of the winter blues – really quite common in more northern parts of the Northern Hemisphere. So, it’s no surprise that sun featured hugely in my recovery. Whenever possible, I spend time outdoors. I now also have a SAD light that is on from late September through to early May every day, all day, above my desk. In fact, it’s on right now as I type.

T is for technology. 

Increasingly, technology is at the root of most of the cases of burnout. With our “always on, always connected” culture driven by handheld devices, we feel compelled to be available to respond at all times to the outside world – these are unreasonable expectations we put on ourselves and others put on us. Having firm boundaries concerning technology is critical. In our case we lock up all technology including phones overnight away from where we sleep. We have gone back to a good old fashioned alarm clock and wrist watches. We take regular holidays and let clients know that we do so and that unless of emergency, we will respond once back in the office. During our holidays phones only get checked once or at most twice a day (we are self-employed). There is no technology during mealtimes, and we hold each other accountable when usage gets out of hand. We need to adopt and integrate healthy behaviours and challenge those who don’t respect our boundaries.

U is for universe. 

When I first took time out from work with burnout, I thought I would be back at my desk within 2 weeks. After 2 weeks, it became evident that it was going to take longer so I extended the time in my mind to 6 weeks and then to 12 weeks and so on. Gradually, I realised it was going to be a long haul. I started to understand that however much I wanted to control the situation it was not going to be resolved through control. Instead, I decided to take a different approach and to put my faith in the universe a little more. Sounds a bit woo woo? And what about if you have bills to pay, a mortgage to meet? Its’s now been almost 4 years since the eye of the storm and I can’t say I’m entirely comfortable with my new approach, but I have learnt to have more faith that the universe usually does show up especially when you need it most.

V is for values. 

When it comes to values, it’s a tricky one. I have a working theory that burnout is often brought on because we find ourselves in situations where our values are being compromised usually over a sustained/lengthy period of time. Increasingly though, especially in my work with impact focused leaders, I’m seeing burnout because individuals’ values are driving them so hard to make a difference that they are compromising their wellbeing. So, it’s not just about knowing and living by your values; it’s about understanding how you can shape your life, so you live a more healthy and balanced life in alignment with your values and sometimes that means making big, courageous life-altering changes.

W is for work(load) and walking (out and on if needed).

For driven, high achievers who are prone to burnout, work is usually a huge or even defining part of their identity. They find it hard to achieve much balance and de-prioritise pretty much everything after work. As one of them, we know this isn’t healthy, but we still do it. We typically convince ourselves that we are doing it for all the right reasons, but ultimately it rarely serves us. Work is part of our identity but not at the cost of everything else. If work isn’t working, then we have options and we need to exercise our agency – oftentimes, it means walking out and on (and yes, even if we have mortgages and bills to pay). Ultimately, though we need to explore and understand what a healthy relationship with work looks like – it will be different for each person.

X is for x-roads. 

Burnout often leads sufferers to a x-road of re-evaluating life and choices on many levels. It’s really the hidden gift that burnout offers sufferers.

 Y is for yes (with wisdom and discernment attached).

Margaret Wheatley, one of my leadership role models, talks about idiotic compassion. I think what I’m getting at here is become good at saying no but also remember to say yes with wisdom and discernment as you never know what might happen – show up and be open (but not idiotically)!

Z is for Zany .– well, Z was always going to be a stretch! Embrace your inner weird or zany-self as my coach recently shared with me. Try lots of different things – zany has lots to offer if you can make the jump.

We are in a period where the stresses and strains of our lives are pushing so many to the brink. Leading us to overlook the rituals and habits that usually provide relief and sustenance. Feeling overwhelmed and despondent is often the outcome, it’s harder to do something about it. Taking agency and being your own detective in your recovery and return to wellbeing from burnout is key – one step at a time.

However, burnout is: “A syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.” as defined by the WHO, and therefore not an issue an employee can or should solve on their own – it’s also an organisational problem! According to Christina Maslach of the University of California, Berkeley, Susan E. Jackson of Rutgers, and Michael Leiter of Deakin University, burnout has six main causes:

1. Unsustainable workload
2. Perceived lack of control
3. Insufficient rewards for effort
4. Lack of a supportive community
5. Lack of fairness
6. Mismatched values and skills

While these are all organisational issues, there is pretty much sole focus on the burden of solving the burnout placed on the sufferer but there’s so much more organisations could be doing to prevent it in the first place (but that’s a whole other blog). The reason I make the point here is that even if you do all the work on yourself to improve your wellbeing, ultimately, it will take both you and your organisation to work together to ensure you remain well – it doesn’t matter how much agency you exercise it will take two to tango.

Are you curious about any of this? You can get in touch with me at rebecca@wisesherpa.co.uk. For more insights, please check out www.wisesherpa.co.uk