We live in stressful times. The media appears preoccupied with tales of austerity, recession and its effects on businesses both large and small. The talk in the cafes and bars is one of doom and gloom; “Business is poor this season”, “Nobody is buying property”, “the Banks are still not lending”, “We will need to lay off staff soon”. With all this negative talk executives and managers become more stressed with added pressure from above and added responsibility for their staff. If we are not careful we start to use alcohol or drugs excessively in order to cope. There is the danger of a breakdown or burn out. But what is Burn Out?
Wikipedia describes Burn Out as “a psychological term for the experience of long-term exhaustion and diminished interest”. Burnout is not a recognised disorder in the DSM (the American Psychiatric Association Diagnostic and Statistical manual used by psychiatrists in their diagnosis of mental illnesses) although it is recognized in the ICD-10 (the World Health Organisation’s (WHO) version) as "Problems related to life-management difficulty". Sufferers presenting themselves to their GPs are more than likely to get a diagnosis of [stress induced] depression which in many respects it is although all the criteria for clinical depression may not be present.
We all have stress in our lives. It is part of everyday life and it helps drive us forward, keeps us on our toes and helps us meet our aims and objectives. It is when we allow it to become too much that the problems start. Understanding burnout to be personal and private is problematic when it functions to disregard the ways burn out is largely an organisational problem caused by long hours, little down time, and continual peer, customer and superior surveillance. This equally applies when we are our own boss and are highly critical of our own work input.
How pressure is dealt with determines how much stress someone feels and how close they are to burn out. One individual can experience few stressors, but be unable to handle the pressure well and thus experience burn out. Another person, however, can experience a far greater number of stressors, but effectively deal with them, and avoid burn out.
Burn out is the result of physical and mental exhaustion brought on by working too long hours for too long under too much pressure. It can be likened to constantly adding appliances to the electric socket. When the fuse blows and the lights go out it is too late and only a period of rest and recuperation with therapeutic help will help us get back on our feet again. The secret is to recognise the symptoms and seek help before the fuse blows. Don’t overload the circuit!
It is important to recognise that stress or burn out can affect all of us in the working environment. It is not the private domain of the highly successful Directors of multi-nationals. All of us who are conscientious workers, demanding of self with high expectations of self and others with a perfectionist streak are susceptible to burn out. Recognising it is another matter. When you are used to managing others it is highly likely you will struggle to manage yourself.
There are many symptoms of burn out. Some are easier to identify, others are more hidden. In order to identify the symptoms it is often vital that you listen to others and not ignore what you may hear as criticism. It is also essential you listen to yourself – listen to what your body and your head are telling you. Don’t ignore it. Your performance may decline as you become more tired -you work longer hours to achieve the same output; you become more irritable in the workplace/home; your sleep becomes disrupted; your enjoyment of life outside or work decreases and relationships start to suffer. Tiredness leads to exhaustion and with it physical health problems such as high blood pressure, headaches, ulcers, heart attacks and maybe mental health problems such as clinical depression.
Twelve phases of burnout have been identified, not necessarily followed sequentially and all do not necessarily apply:
- The Compulsion to Prove Oneself
- Working Harder
- Neglecting Their Needs
- Displacement of Conflicts
- Revision of Values
- Denial of Emerging Problems
- Obvious Behavioural Changes
- Inner Emptiness
- Burnout Syndrome
Often found at the beginning is excessive ambition. This is one's desire to prove oneself in the workplace. This desire turns into determination and compulsion.
Because they have to prove themselves to others or try to fit in an organization that does not suit them, people establish high personal expectations. In order to meet these expectations, they tend to focus only on work while they take on more work than they usually would. It may happen that they become obsessed with doing everything themselves. This will show that they are irreplaceable since they are able to do so much work without enlisting in the help of others.
Since they have devoted everything to work, they now have no time and energy for anything else. Friends and family, eating, and sleeping start to become seen as unnecessary or unimportant, as they reduce the time and energy that can be spent on work.
Now, the person has become aware that what they are doing is not right, but they are unable to see the source of the problem. This could lead to a crisis in themselves and become threatening. This is when the first physical symptoms are expressed.
In this stage, people isolate themselves from others, they avoid conflicts and fall into a state of denial towards their basic physical needs while their perceptions change. They also change their value systems. The work consumes all energy they have left, leaving no energy and time for friends and hobbies. Their new value system is their job and they start to be emotionally blunt.
The person begins to become intolerant. They do not like being social and if they were to have social contact, it would be merely unbearable for them. Outsiders tend to see more aggression and sarcasm. It is not uncommon for them to blame their increasing problems on time pressure and all the work that they have to do, instead of on the ways that they have changed themselves.
Their social contact is now at a minimum, soon turning into isolation, a wall. Alcohol or drugs may be sought out for a release since they are obsessively working "by the book". They often have feelings of being without hope or direction.
Co-workers, family, friends, and other people that are in their immediate social circles cannot overlook the behavioural changes of this person.
Losing contact with themselves, it's possible that they no longer see themselves or others as valuable. As well, the person loses track of their personal needs. Their view of life narrows to only seeing in the present time, while their life turns to a series of mechanical functions.
They feel empty inside and to overcome this, they might look for activity such as overeating, sex, alcohol or drugs. These activities are often exaggerated.
Burn out may include depression. In that case, the person is exhausted, hopeless, indifferent, and believe that there is nothing for them in the future. To them, there is no meaning of life. Typical depression symptoms arise.
They collapse physically and emotionally and should seek immediate medical attention. In extreme cases, usually only when depression is involved, suicidal ideation may occur, with it being viewed as an escape from their situation. Only a few people will actually commit suicide.
There is an unfortunate tendency to start to self-medicate at any stage along the road to burn out. Alcohol is often the ‘medication’ chosen by most but in today’s world other drugs such as cocaine are taking an ever increasing role in helping us to cope. Both alcohol and cocaine are highly addictive and although we may start by having a couple of drinks to help us unwind or to get to sleep, or a line of coke to help us unwind, the addictive nature of these drugs is such that you need more and more of the substance to achieve the same effect. Before you know where you are addiction has set in and your job performance suffers even more. This rapidly increasing downward spiral has an inevitable consequence: You lose your job, your business or your family or all three. If you have managed to avoid excessive use of alcohol or drugs there is a strong possibility that clinical depression will result.
Clinical depression is not an illness of the weak – they don’t get overly stressed. It is an illness of the strong. And watch the coffee consumption. It often rises in periods of excessive stress. It has a reputation for keeping you awake but it also keeps you from sleeping and recharging the batteries. It can cause headaches, irritability and it increases your blood pressure. In very large quantities coffee has an addictive quality and for some classic withdrawal symptoms – increased anxiety, slight hand tremor and the craving for the ‘drug’. Cigarette consumption also increases in times of stress. The dangers of this are well known and well publicised
If you can identify the build up to burn out, it may be you will be able to apply self-help techniques and avoid the need to see a Doctor or Therapist. Cut back on alcohol, caffeine and cigarettes or cut them out completely. Alcohol, drugs, cigarettes and caffeine have a negative effect on sleep; either they affect the quality of sleep or they stop you from sleeping. Sleep is essential to rebuild and to regroup after a stressful day. Take a break – a weekend away can be very beneficial and the business will still be there when you get back. Take some regular but not necessarily strenuous exercise – 30 minutes a day two or three times a week. If the gym isn’t your scene, try just simple walking. It’s great exercise.
Find ways to relax –take up Reflexology, Tai Chi, Yoga, Meditation, Cooking, take the dog for a walk. But most important of all and probably one of the more difficult changes you may have to make is recognition that there are so many aspects of your life you cannot change. Recognise what you can change and change it. Accept the things you cannot change and move on.
Stress and Burn Out need to be taken seriously. If you are in any doubt you should consult your Doctor or a qualified Therapist. Don’t put if off. Burn out is not a sign of weakness. Recognising it is a sign of strength. Doing something about it is a sign of taking responsibility. As a manager or company Director you also have a duty of care to your staff and recognising symptoms in them and helping them get help can save you long periods of staff absence, expensive litigation and money.
Do not plan to be back at your desk any day soon. If you resign yourself to being off work for at least a month you will find recovery a lot quicker. Setting impossible deadlines will just heap more stress on an already stressed-out mind and body and could well set you back. And resist the temptation to bring work home or have your secretary pass by on her way home from the office to keep you up-dated. You need to switch off completely and allow the mind and body to repair.
A lot of the repair work that needs to be done is best undertaken with a qualified Therapist who can help you explore the changes that you need to make in your thinking and behaving. Let’s be frank. The way you led your life before the burn out needs to change and change radically and it is best if you consult with someone independent of friends and family. In severe cases this may be best undertaken in a residential setting although there are not many places that offer specific programmes for burn-out. We at Nova Vida Recovery Centre have just such a specific programme which has successfully helped a number of professionals, including airline pilots, return to the work place.
There are a number of areas of your life that need to be addressed and some of them you can start to do yourself. Nutrition and exercise can be addressed almost immediately you have acknowledged the burn out, acknowledged the need to stop everything and acknowledged the need to make some radical changes in your life.
Do not underestimate the importance of the right food for the brain. The delicate balance of neurotransmitters (chemical messengers in the brain responsible for all aspects of our being) is dependent on, amongst other factors, an appropriate nutritional diet. When we are working too many hours for too long we inevitably eat on the run and pay little attention to what we are eating or drinking. This has to stop. If you want to go the whole way and put yourself on an optimum diet there is a lot of information available in books and on the net. If you want to make some basic changes and eat more healthily then look for a balanced diet that you enjoy and not one that you feel is being forced up on you.
The following tips may help:
- Start the day with breakfast and not a cup of coffee and a slice of toast on the way out to the car. Breakfast is an important meal and can be a healthy start. Avoid white bread and excessive fats and processed preserves. Take 20 minutes sitting at the table.
- Avoid processed foods. Buy fresh from your local market and organic if possible.
- Avoid junk food or ‘fast’ food.
- Limit the amount of red meat in your diet
- Eat plenty of fresh fruit and vegetables
- Take a 30 minute minimum break at lunchtime and do not sit at your desk and eat. If you take your own healthy lunch then make sure you still get away from your desk for a break
- Avoid unhealthy snacks mid-morning or mid-afternoon. Make sure you always have fruit or a healthy snack a vailable
- Try to eat the evening meal at a reasonable hour, ideally before 7pm.
- Limit the amount of caffeine you consume in a day. Give de-caff a try – you might like it!
- Limit the amount of alcohol you consume to within the recommended limits. Best of all is to avoid alcohol but that might be asking a bit too much.
- Drink 2 litres of room temperature water a day and more in the very hot weather
When you feel ready it is time to introduce exercise into your daily routine. Exercise comes in many different forms and if you enjoy cycling, swimming, jogging or going to the gym then you have a head start but for many who suffer from burn out exercise was one of the first activities to go. Daily walking is the best exercise you can do but it needs to be more than just walking to the corner shop. Best done in the morning, a 60 minute brisk walk with no interruptions will leave you feeling ready to face the stresses and strains of living in today’s world. If this means going to bed earlier to get up earlier it is a small price to pay for a healthy body and a healthy mind.
Getting your nutritional diet up and running and an exercise regime in place is a great start. You will also need to address sleep which is when our bodies and minds re-charge. The average adult human being needs between 7 and 9 hours of quality sleep in order to be able to function, along with a nutritional diet and exercise, at optimum the next day. In order to ensure you get the quantity and quality of sleep you need it may be necessary to change your lifestyle to avoid packing the evening with stressful events or late nights socialising. You need to allow yourself time to relax before going to bed. This may sound a strange necessity given that you are going to bed to do just that but it is pointless trying to sleep if you go to bed with a head buzzing. And avoid the lights from the TV and Computer in the 20 minutes or so before going to bed as this may inhibit the production of melatonin which is important for sleep.
Of course avoid caffeine a couple of hours before bedtime. Caffeine is a stimulant and can keep you awake. Alcohol may help you sleep but it does not promote quality sleep – avoid it. And avoid sleeping tablets. The ones that work tend to be addictive in the long run. A warm bath and a warm milky drink are both known to be aids to sleep and if sleep just won’t come after 20 minutes or so get up, don’t lie there getting anxious about not sleeping. Read a book, have a hot milky drink and try again in 30 minutes.
The siesta is a fast disappearing aspect of life in Mediterranean countries but we could all learn from the benefits of a short nap in the afternoon particularly if the previous night’s sleep has been disturbed. But keep it short and don’t leave it too late so that it disturbs your sleep that night. Lying down for an hour in a dark room after lunch can leave us feeling refreshed and ready to go again.
Getting your nutrition, exercise and sleep back on track will help give you the energy and strength to start to address the other issues that led to the burn out.
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