When there’s nothing left to give

Burnout can result in even the most dedicated and passionate individuals feeling overwhelmed, helpless and disengaged in their working and private lives, with potentially severe consequences for their mental and physical health, relationships and productivity.

Given the pressures of the current COVID-19 pandemic, much greater awareness of this often-overlooked syndrome is needed to help prevent its destructive progression, warns Dr Dumakazi Mapatwana, a psychiatrist practising at Netcare Akeso Alberton.

“Burnout is a complex reaction to sustained extreme stress. It is not an overnight phenomenon, but rather a gradual process defined by emotional, physical and mental exhaustion that follows chronic and severe stress, which is most often work-related but may include other kinds of stress, like caring for a sick family member,” she says.

The concept of burnout was developed to describe a multi-faceted syndrome characterised by depersonalisation, emotional exhaustion and a sense of low personal accomplishment that eventually leads to decreased effectiveness at work.

“Sadly, it is often only when burnout has progressed to the point where it is seriously impacting their lives, that people seek the help they need. Persons experiencing burnout may develop depression or anxiety, and they often misuse alcohol or substances in an attempt to cope with their situation, which they often perceive as hopeless.”

Burnout could contribute to heart disease, high blood pressure, type 2 diabetes, obesity, metabolic syndrome, chronic insomnia, high cholesterol and chronic pain, and could make one more vulnerable to illness.

“It can also impair job satisfaction and performance, increase absenteeism, and may ultimately lead to dismissal in extreme cases,” Dr Mapatwana adds.

Diaan Bisogno, a clinical psychologist practising at Netcare Akeso Stepping Stones, says that emotional detachment, hopelessness and helplessness are characteristic of burnout. “People with burnout struggle to find meaning in anything they do, often feel powerless and that nothing they do will make a difference,” she notes.

“We are living in an extremely stressful time, and when there are not enough resources, people get burnt out. We’ve been coping with the pandemic for a long time, and every time people get a little bit of hope that the situation may improve it seems there is some new blow, such as a higher level of lockdown restrictions or a new variant of concern. When you are burnt out, these changes require energy many people just don’t have anymore. The reserves are empty, there is simply nothing left to give,” Bisogno says.

“When you start detaching emotionally, it often numbs relationships with those closest to you. There is no energy left for nurturing other aspects of your life, which further diminishes social support, over and above the physical distancing measures we are practising to prevent contracting and spreading COVID-19.

“It is not uncommon for people facing burnout to turn to drugs or alcohol, or misuse medication, as they struggle to cope. For instance, a person may take cocaine or tik so they can get through 18 hours of work without sleeping, or abuse sleeping pills to counteract insomnia, leading to dependence and addiction that is often linked to depression, anxiety or other mental health conditions,” Bisogno adds.

Burnout in the workplace

“For employers, the consequences of burnout in their team include more absenteeism, reduced productivity, high staff turnover and instability, which only creates more anxiety among the staff members,” Bisogno says.

“For many frontline workers, vicarious or indirect trauma resulting from continuously dealing compassionately with others in distressing situations is an inevitable part of the job. While this occupational hazard can’t be avoided, it can often be managed better through building resilience and spotting and addressing the warning signs early with the help of mental health professionals, so that it does not lead to burnout.”

According to Dr Lerato Motshudi, head of clinical research and programme development at Netcare Akeso, it is possible for individuals to develop skills and techniques to help address these kinds of pressures effectively before they become overwhelming.

“Through a unique combination of skills development and talk therapy, the Netcare Akeso burnout management programme strengthens individual awareness of risk and builds resilience for prevention of burnout,” she says.

The programme makes use of evidence-based psycho-emotional tools shown to be effective in building resilience and grit. The individual is assisted to appreciate their own level of risk of burnout, and this enables them to focus on the areas of greatest personal relevance. Our experience has led to the identification of common workplace stressors which are prevalent in a wide range of corporate and working environments.”

Know the symptoms of burnout

“It is important for all of us to take care of both our mental and physical health, especially in difficult times. We need to be alert to initial signs and red flags, and act on those because if they are ignored and not addressed, burnout can have significant consequences, including serious medical conditions,” Dr Mapatwana says.

The symptoms of burnout may be physical, emotional and behavioural, and could comprise the following:

Physical

  • Feeling tired and drained most of the time;
  • Changes in sleeping and eating habits;
  • Frequent physical complaints: unexplained headaches, stomach problems or muscle aches;
  • Muscle tension;
  • Frequent illnesses from lowered immunity.

Emotional

  • Sense of failure and self-doubt;
  • Feeling helpless, trapped, and defeated;
  • Emotional detachment from others;
  • Feeling alone in the world;
  • Lack of drive or motivation;
  • Increasingly cynical, critical and generally negative outlook;
  • Feeling irritable and impatient with co-workers, customers or clients;
  • Decreased satisfaction and sense of accomplishment.

Behavioural

  • Poor concentration, making mistakes at work;
  • Withdrawing from responsibilities;
  • Isolating yourself from others;
  • Procrastinating, taking longer to get things done;
  • Using food, drugs, or alcohol to cope;
  • Taking out your frustrations on others;
  • Skipping work, or coming in late and leaving early.

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