Burnout

Burnout

Take Your Brain off Roast

You've been feeling so down and out lately that you're wondering if you've been bitten by a tsetse fly. A friend assures you that African sleeping sickness isn't very common in America, so your next thought is to check your birth certificate to reassure yourself that you are in fact the age you thought you were. Yup. You're still a fairly young woman--at least on paper.

So why are your body and mind behaving as if they had 90,000 miles on them instead of 40,000? Why the sadness? The disenchantment with life? The mysterious aches and pains? The constant fatigue?

It could be burnout.

"Burnout can certainly make you feel old before your time," says C. David Jenkins, Ph.D., professor of preventive medicine and community health at the University of Texas Medical Branch at Galveston. "Burnout tends to drain people of the physiological and mental reserves that are, in youth, typically there to keep them going. Luckily, burnout does not necessarily age people or take years off their lives in a permanent fashion. It can be reversed."

But if you want to stop feeling decades beyond your biological age, you first need to know what's happened to you and why.

No Variety, No Relief

Believe it or not, burnout was once thought to be a man's problem. Today, we know all too well that it's not. "I'm seeing more and more women coming in with symptoms of burnout," says Herbert J. Freudenberger, Ph.D., author of Women's Burnout and Burnout: The High Cost of High Achievement and originator of the term burnout. "In part, I think this is due to the expanded, multi-role lives they lead as mothers, wives and professionals."

Actually, it is not the number of activities in your life but rather a lack of variety among activities that causes burnout, says Faye Crosby, Ph.D., professor of psychology at Smith College in Northampton, Massachusetts, and author of Juggling. "Burnout does not occur by having too many pots boiling on your stove. Many times it occurs because you have only one pot boiling constantly and can never take it over to the sink to fill it up. Eventually, all the water boils away."

Any woman can get burnout, from housewife to corporate president. But those who tackle the responsibilities of both seem most liable. Too often the career woman still ends up acting as the primary nest builder in the home. This means the rejuvenating time she might spend cuddling with her family in front of the fireplace is squeezed out by household duties such as making sure that the kids have clean clothes and that the den doesn't become a permanent resting place for dirty dishes. So while a woman may jump between roles, she still ends up doing goal-oriented activities and has little time for the social, emotional ones, says Dr. Crosby. "In essence, it's still a one-track life."

For many women, the burnout-inducing effects of double duty become most apparent around the holidays. "I have so many women patients who come into my office around the holidays completely frazzled," says Dr. Freudenberger. "One in particular was sobbing because she was up until 4:00 in the morning two days before Thanksgiving--cleaning. This is after a job that she leaves for at 6:00 in the morning and gets home from after 7:00 in the evening. She was actually referred to me by a dermatologist because she had hives, which he'd been treating for years with no success. In fact, the problem was burnout-related."

Perfectionism Hurts

Another burnout-inducing extreme for women is the concept of all-around perfectionism. "The perfect wife, mother and professional," says Dr. Freudenberger. "I hate the idea because it's exactly the kind of impossible goal that leads to burnout. It's a concept that was widely disseminated in the 1970s and 1980s, and although I'm seeing less and less of it today, there are still many women who buy into this false belief."

The pursuit of perfection is not without its costs. One of the highest burnout ratios to be found is in the air traffic controller profession, where people work under conditions that make anything less than perfect performance a matter of catastrophic possibilities. So great is the pressure they're under not to make mistakes that by the time they reach their mid-forties, many of these people have had to leave their jobs, says Dr. Jenkins, who participated in a definitive study of air traffic controllers and burnout. "And in fact, it seems that the professions most prone to burnout are the ones where constant vigilance is demanded and where the cost of mistakes is horrendous. Nurses who work in the intensive care wards of hospitals come to mind," he says.

But not everyone who suffers from burnout is operating in an environment that demands such perfection. Some people do it to themselves simply by setting impossibly high goals and viewing all harmless mistakes as catastrophes.

A Thirst for Recognition

Burnout can also occur when there is a lack of positive feedback and reward. At work, women are still bumping their heads against the glass ceiling. At home, the task of keeping the household running in an orderly fashion is often a thankless job.

The absence or presence of positive feedback can make all the difference between emotional well-being and burnout. "Some years ago, Massachusetts General Hospital was experiencing a burnout problem among its nurses that manifested itself in a high job turnover rate," recalls Dr. Jenkins. "So they called in some of their psychiatrists and started a support therapy group, which met once or twice a week."

Within this group, people shared experiences with their peers, got a lot of gripes off their chests and received praise and understanding from the psychiatrists. "In terms of employee turnover and increased satisfaction, the results were quite good," says Dr. Jenkins. "And all that was really applied was a little feedback and support."

Take a Look at Yourself

How do you know if you have burnout? One way is to listen to whether your friends say you've changed lately. "But you probably won't," says Dr. Freudenberger. "A major coping mechanism that I've noticed in burnout patients is denial--denial that this is happening, denial that this is something they need help to overcome." In other words, the person who knows the least about burnout is the one who is suffering from it.

But if you won't listen to your friends, at least listen to your body. "One of the first signs we noticed in the air traffic controllers who were burning out was a sense of fatigue," says Dr. Jenkins. "And I'm talking about a pervasive mental and physical fatigue that a good night's sleep will not get rid of."

Chest pain, gastrointestinal problems, sleep disturbances, headache, back pain and a higher incidence of minor illness such as colds are some of the body's other responses to burnout. So are skin disorders, adds Dr. Freudenberger. "The woman I mentioned who had hives is not an unusual case. I also see a lot of burnout-induced acne and eczema."

On the mental front, a lack of resilience, characterized by a feeling of being whipped, can be a harbinger of burnout. "Our air traffic controllers called it bounce-back," says Dr. Jenkins. "They couldn't bounce back from a taxing period of heavy controlling and face the next period of activity with any sense of ease, comfort and casualness. They were drained."

Irritability and depression are also possibilities for those who are burning out. "But more interesting is the development of a superperson personality," notes Dr. Freudenberger. "The person feels that she can handle everything, needs no help and may actually become arrogant about it."

Rekindle Your Flame

Whether burnout has made you move, think and feel like a cranky Methuselah on a bad day, or you just want to make sure that you never end up aging 30 years in as many weeks, the following tips will help you "de-burnout" your life.

Listen to others. "The first step to curing burnout is to admit the problem exists," says Dr. Freudenberger. "But that's harder than it sounds, because of the denial mechanism people often use to cope with burnout. So listen to your friends and family members. Pay attention when they say you've changed. You may not notice it yourself, but burnout can be very apparent to those close to you as well as to co-workers who can see the transformation."

Diversify. "Just as a bank must diversify its holdings so that it doesn't have to depend on one source for its profits, people have to diversify their emotional portfolios," says Dr. Crosby. "This means looking at your activities and making sure that you participate in some that are goal-oriented and some where the aim is to feel good and have fun. I actually encourage people to list them in two columns. If you have 2 items in one column and 40 in the other, things are out of whack, and you need to do some account balancing."

Stop being perfect. The trick is to give yourself a little leeway when you can. "Take stock of your situation and see what mistakes you can and can't make," says Dr. Crosby. "Not every miscalculation you make is going to plummet the world into Armageddon. In other words, don't sweat the small stuff." And that goes for all activities, work-related and otherwise.

Know your needs. "If you know that you need positive feedback to replenish yourself, then don't just ignore that fact," counsels Dr. Freudenberger. "Actively solicit feedback from family and friends and in the workplace." Tell them that you would occasionally like to hear "Good job!" when you've done something well. Or find a support group that you can share your feelings, achievements and gripes with. It doesn't have to be anything formal. A few people going through the same things as you will do just fine.

A corollary to this rule is: Ask for help. "Especially around the holidays," adds Dr. Freudenberger. "You're busy, things are hectic, and the last thing you need to be doing is scrambling around at all hours doing prep work." Enlist family members to help clean. When you invite people over, have them bring a salad or side dish.

Volunteer. "Volunteering is a very important anti-burnout device," says Dr. Crosby. "Whether you're at work or at home, worrying over a set of marketing reports or putting up aluminum siding, you have to drop what you're doing, mentally change gears and go interact with a whole new set of people in a whole new environment."

"It doesn't matter if you work in a soup kitchen twice a week, collect clothes or deliver meals. You receive gratification that you are doing something for someone else," adds Dr. Freudenberger. "You may also receive some very important perspective on your life by seeing those less fortunate than you."

Take five. Dr. Crosby prescribes a five-day vacation alone at least once a year. "It's especially important for women not only to get away from the office but also to get away from home," she says. That means leaving the husband, the kids, the dog, the goldfish--everything--behind. They'll get on just fine without you for five days. "As a matter of fact," adds Dr. Crosby, "if you feel that the world will fall apart if you leave for five days, you have a good indicator that you are taking things far too seriously and are probably heading for burnout."

Take 15. "You also have to set aside some relaxation time during the course of the day," says Dr. Freudenberger. "And I mean every day, both at work and at home. When people tell me they can't do that, I make them actually take apart their days piece by piece, and they suddenly find all sorts of little opportunities for 15-minute breaks. And that's all it really takes."

Take off the red cape. Stop trying to be a superwoman. "No one is going to consistently be the perfect wife, mother and professional," says Dr. Crosby. "The trick is to allow yourself the occasional mistake--to recognize pressure release points where mistakes will not mean the end of the world." In other words, mismatched silver at the dinner party you're throwing isn't going to signal the end of civilization. And handing in that report a day late probably won't push the company into bankruptcy.