Burnout Recovery

There was a time when I didn't think it would ever be possible to recover from burnout.

Burnout hit me in such a spectacular way that I felt suffocated, almost like I had dug myself an enormous sand hole at the beach and the walls were now caving in on me... struggling to take a breath and the sky rapidly closing in. I often say when I'm recounting these awful moments that the sickening sense of panic I felt was not just 'burnout' by that stage, it was a complete physical collapse. My body was now following suit on a mutiny that my mind had started some time earlier as my sleep began to suffer, my enjoyment of work was waning and my ability to deal with the uncertainty of day to day demands meant that I was micromanaging more and more. In hindsight, this was the not unexpected final stop for this express train to burnout that I had ignorantly been riding on for longer than I realised.

So how could I, a General Practitioner who prided myself on how well I was able to help support my patients with their mental health struggles, miss the warning signs of my own impending collapse?

You cannot change what you do not see.

I was used to being able to do nearly everything I put my mind to. I had pushed myself through medical school and speciality training in General Practice even in the moments I was sure I would give up. I had two children during my training, dealing with the sleepless nights and endless breastfeeding as well as late nights studying and long days at work. I loved helping my patients and my work as a GP was really important to me. 

Burnout took me by surprise. I honestly thought I would be the last person that this would happen to.

I was tired- sure.

I was stressed- isn't everyone?

The final panic attack I had that literally stopped me from getting out of my front door was something totally unexpected and very, very scary.

I couldn't change my trajectory towards this point though, because I honestly didn't see it coming. I lacked the self awareness to realise that I was on a collision course with burnout and my sense of interoception was so out of whack that I couldn't even pin point why I was feeling so awful in the lead up to that fateful day. Just as the train driver who doesn't see the signal the tracks ahead are damaged won't put on the brakes, I had no reason to slow down or ask for help. It was business as usual...

Until it wasn't.

Burnout... an occupational phenomenon?

The ICD-11 defines burnout as:

"Burn-out 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; and 3) reduced professional efficacy. Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life."

Burnout is so ubiquitous these days that it's harder to find someone who hasn't experienced it than someone who has. As defined in the ICD-11 above, it is an occupational phenomenon- meaning that it should only be applied to strictly work related situations. Now as a doctor, I have the upmost respect for the International Classification of Diseases. We learn these classifications for disease at length through out our training and it is important to have such rigorous diagnostic standards, even more so in psychiatry where there is rarely a definitive diagnostic test in order to diagnose illness. But I do have some misgivings about limiting the definition of burnout to be so narrow. While an "occupational context" doesn't have to be only paid work the implication by that statement is that it is possible to delineate between the parts of someone that make up their occupation and all the other parts of them.

When I first burnt out, I agreed with the current definition 100%. It felt to me like the rest of my life was functioning OK but my ability to function in a workplace setting was completely compromised. I even blogged about it here. As I have reflected and grown over the ensuing years, I have come to question this restrictive definition as it doesn't seem to include other groups that I know experience burnout like parents and autistic people. The symptoms are largely the same in these contexts and while it can easily be argued that taking care of children or masking to exist in a neurotypical world could be considered as much 'work' as any paid job, I don't feel like the current definition fully encompasses these experiences.

The other component I have noticed in my journey is there were many deeply entrenched patterns of thought and behaviour I carried with me that contributed to the path of self sacrifice and perfectionism making my journey towards burnout more rapid. I was drawn to a profession that by it's nature celebrated these two traits and made it difficult to hold boundaries at work, manage my work load and workplace stress. By simply focussing on the down stream manifestations of this in my work life- I would have missed a golden opportunity to compassionately work on these parts of me that would if ignored would have resulted in a repeat experience of burnout in the future.  

How do you recover from burnout?

The answer to this question is of course different for everyone, from working with your primary care provider, to mental health professionals to professional coaches and other forms of objective support. Additionally, a period of rest for your body and mind- away from the added stressors of your work environment- is crucial in allowing your body to once again find a stable baseline that isn't plagued by constant demands. Working with your employer to devise strategies to better manage stress at work is a key feature of the broader systemic response to burnout. This is more than workplaces offering a lunch time yoga session or free pizza one Friday a month- that sort of 'wellbeing washing' is sadly not uncommon in this day and age of ubiquitous burnout. But what I'm talking about is a balanced work environment that champions rest, promotes values based action and encourages individuals to maintain connections in their lives both within and outside of the workplace.

That being said, when I look at my own path post burn out, it is the individual factors that have had the most profound impact on my trajectory. Things such as:

1. Building self awareness- through compassionate self inquiry, both supported (by mental health professionals) and through contemplative practices such as meditation.
2. Defining my core values- this can be a difficult process but without awareness of where these 'guiding lights' are in our lives, we're essentially flying blind.
3. Committing to mindful self care- which for me includes my meditation practice, prioritising time for connection as well as rest and mindful movement such as yoga.
4. Embracing imperfection- this has been really hard for a recovering perfectionist like me. It involves allowing myself to be vulnerable and making space for the discomfort that arises from that.
5. Mastering self compassion- this is more than simply "being kind to yourself". It is a profound practice that includes many elements of mindfulness as well as gently challenging our natural sense of self judgement and actively embracing our common humanity. 
6. Learning how to adjust to the ebbs and flow of life- similar to the imperfection point, as someone who used to try and plan and predict things heavily, this is a huge step for me. Being able to roll with the changes in mood, energy and motivation that are a completely NORMAL part of being human, without berating myself with guilt or negativity has been the most notable manifestation of my self compassion practice... and surprisingly, has unlocked new levels of performance and achievement that I could have only dreamed of in the past.

While I may have manifested my 'burnout' through my inability to manage the chronic stress that arose out of my work as a doctor, I feel like this occurred because I spent more hours a week being a doctor than I did anything else. That I had unintentionally found myself walking down a path of devoting more and more of myself to this occupation in an unconscious attempt to soothe the discomfort within me that had a much more nuanced origin than simply "workplace stress". And while it could be argued that in that case, what I experienced wasn't burnout- the more I work professionally in supporting people who have or are experiencing burnout, the more I see huge commonalities between their experience and my own. That's not to say that occupational factors need be ignored in burnout recovery and mitigation but just as mindfulness teaches us to be curious about our own role in experiences, learning how to reflect without judgement on those parts of us that we can work to nurture and build has been integral in not only my recovery from burnout but my thriving life post.

Want to learn more about how you can work with me either to support you and help manage burnout or to learn some amazing new skills like meditation, self compassion or breath work for nervous system regulation? Then check out my services page 🤗

You CAN recover from burnout and even more than that, you can live a flourishing, values based life that shifts you from just surviving to thriving.