By Kelly Hearn
If there is one word I associate with Lockdown 3.0 in the UK, it is burnout. Burnout – the emotional, physical and mental exhaustion caused by prolonged and excessive stress – has been a constant theme in my client work since the beginning of the year. Often, burnout is associated with the workplace and, indeed, job-related demands are a big factor here. But work and burnout can be more broadly applicable in these Covid-19 days. First coined in the 1970s by the American psychologist Herbert Freudenberger, the term burnout was then used to describe stress and exhaustion felt by those in the ‘helping’ professions. In 2021, with hospital admissions still near highs, we understand how real burnout features for our NHS and other frontline workers. And while most of us aren’t in those extreme conditions, we shouldn’t minimise the prolonged stress that living and working nearly one year into the pandemic has caused in our own lives. Leading to….burnout.
‘I’m done, drained, depleted….I feel like I have nothing left to give.’ Anna,* a 42 year-old mother, tells me that between home schooling and distance working and trying to remotely manage her elderly parents’ care she is ‘feeling crushed.’ She worries she is depressed, wonders if she should go on medication. And while it is important to explore her symptoms in more depth, I speak to her (and others) about the differences between burnout and depression because they can look, and feel, quite similar. Broadly speaking, the characteristics of burnout are:
–Mental, physical & emotional exhaustion caused by prolonged stress, often work-related
–Lack of engagement / Feelings of negativism or cynicism leading to mental distance from work
–Sense of incompetence / Reduced abilities, efficacy or productivity (Tell-tale signs: ‘This isn’t me! I usually have no problem with these types of things!)
The above may be present with depression as well, but with depression there are also other symptoms not associated with burnout including:
–Low self-esteem (Burnout may say ‘I’m falling short here.’ Depression feels like ‘I will always fall short because of who I am.’)
–Hopelessness (Burnout: ‘This seems endless, I’m not sure how much longer I can take it!’ Depression: ‘There is no way out, this will always be my life…’)
–Suicidal ideation (With burnout, we may feel like we want an ‘eject button’ out of our circumstances, not our life. With depression, suicidal thoughts are often present.)
Note: If you are experiencing these symptoms, see here for further information and seek help from a GP or therapist.
In general, burnout is more situational – regarding our work, broadly defined – and depression more pervasive, extending to all areas of life. With burnout, the symptoms go away when the stressors are removed (weekends, holidays) as rejuvenation provides relief. Not so with depression. While depression features regularly in my work, much of what I am seeing currently is Covid-related burnout. Clients know they will feel better once life returns to some semblance of ‘normal’ but this doesn’t make their current struggles today any less real. With that in mind, how to handle?
The Demand-Control-Support model, developed by Robert Karasek in 1979 to combat workplace stress, is one we can apply to Covid stress as well. The model suggests we have three levers at our disposal: Decrease demands, increase control over our situation and/or bolster support for dealing with the circumstances.
Decreasing Demands
Some would say this isn’t possible in the current environment. I respectfully disagree. There are always things we can say no to. Most of us are a little out of practice using our ‘no.’ No time like the present to strengthen the muscle. Pull out your diary and set yourself a challenge to cross at least a few things out. Sometimes this necessitates an honest conversation with a boss, colleague, partner or child. Other times it is more a question of letting ourselves off the hook in terms of how much responsibility we assume, even if only emotionally. A gentle reminder: It is not your responsibility that your boss is feeling the strain, acting testy and irritable. It is not your fault your child is bouncing off the walls frustrated with home schooling. It is not on you that the world still hasn’t re-opened so your Q1 numbers are looking weak. A formerly perfectionist client of mine told me her ‘secret to success’ under lockdown is setting her expectations appropriately low. Amen.
Increasing Control
In the traditional model, increasing control is about having the freedom, autonomy and skills with which to meet the high-demand environment. A sense of agency goes a long way. In some sense, working from home does allow for certain freedoms an office-based day doesn’t. In others, it can feel even more ‘out of control’ as boundaries between work and home, home and school have become so blurred and unruly. There is a lot we have little control over: how and when our world opens up again is the subject of much debate but less visibility. I encourage clients (and myself!) to focus on what we can control, no matter how seemingly insignificant. We can control what time we get up in the morning, what food we eat, how we move our bodies, what media we read (or avoid). We can also control how we choose to show up in these incredibly difficult times. ‘I can get stressed out and then my 7 year-old gets stressed out and then we’re both stressed out during his maths lesson,’ says Marc*, ‘or I can just remind myself my goal is for us all to try and just get on with it, and for me to be there for him in a way that is calm and supportive.’ When there is little choice over what we can do, we can instead focus on how we want to be.
Ramping Up Support
When demands are high, the support to meet these demands needs to be similarly high. It’s so common sense we don’t need a model to spell it out, but then a handy acronym is a helpful reminder, and the fact the model has been used successfully for decades speaks to its merits. Most commonly, support here is referring to social support as positive social interactions serve as an antidote to stress. Some managers have understood this completely under Covid and ramped up interactions with employees accordingly. Others haven’t, and here is where the support of colleagues is crucial. In fact, sometimes this peer support is even more important as it is more immediate and egalitarian so can be more a source of companionship in high-demand environments. Beyond leaning on others, there is much support we can provide ourselves. I’ve been advising clients to make a list of actions large and small that make them feel better, and those that make them feel worse. Layering in a couple of the former, reducing the latter. Simple (in theory) and very effective if put into practice. These actions may differ person to person, but I can highlight a few I find impactful more generally.
1. Prioritise daily physical activity. Stress is held in the body and requires a physical release. Sometimes this is called ‘completing the stress cycle.’ Physical movement also gets us out of our overly-anxious heads and into our bodies. Walking, running, dancing, boxing yoga…it doesn’t matter, just do it, and daily. We can all find 20 minutes if we prioritise it. One of my clients who works long and taxing shifts as a nurse comes home utterly spent. The idea of physical activity first seemed impossible after 12 hours on her feet. But she found that a half hour of restorative yoga helps calm her nervous system, transition to the safety of home and allow for better sleep. ‘I leave the horrors of the hospital on the mat,’ she says. Another client knows the only time he will have to himself all day is if he gets up 30 minutes earlier in the morning to squeeze in his run. He claims his entire day rests on making that time for himself and so ensures it happens, even if this means going to bed a bit earlier (which also limits his ‘doom scrolling’ the news, an added bonus of reducing an activity that makes him feel worse). Key here is not forcing your body into anything but rather listening to what it needs, and when. There is no point coercing a night owl to do an early morning run as this would defeat the point.
2. Work with the breath. We rarely experiment with something so simple. Maybe because breathing exercises are so easy and accessible we discredit or overlook them? Breathing practices aren’t just for yogis or meditators. Even the elite US navy SEALs do them for the straightforward reason that they are effective: in a matter of minutes, the breath can help activate the parasympathetic nervous system (PSNS) and help calm the body. No apps needed, no gurus to guide. Simple. Breathing. A couple different techniques I’ll mention here:
Tactical breathing. This is merely focusing on slowing the breath rate down, counting to four for each inhalation and exhalation, and maintaining for a few minutes. Some practitioners prefer to tinker with timings and so may inhale to a count of three and exhale for a count of six. Play with it, see what works for you.
Box breathing. Inhale for 4 counts, hold your breath for 4 counts, exhale for 4 counts, hold again for 4 counts. Repeat 5-10 times.
3. Take a self-support break**. Three stages to this quick ‘check in’ you can keep in your pocket and utilise as needed. First, notice and name what you are feeling in the moment. Maybe there is fear, or frustration, or anger, or sadness. Just name it. As surprising as it may sound, merely naming negative feelings – known as ‘affect labelling’ – is shown to have positive calming effects. Next, broaden your perspective and allow for the fact that many people are suffering just like you. Too often we personalise our struggles and in doing so compound the suffering. Recognise that others are likely experiencing these same difficulties; you are not alone. Third, ask what small gesture or words of support you need in the moment. Physical touch can be extremely calming – a hand resting on the on heart or a little self hug. Nurturing words go a long way as well. Four of my favourite: This too shall pass. The basic point is to offer support to ourselves, rather than berate ourselves (as is all too common) in moments of suffering. This shift is nothing short of profound.
As I write, we are nearing the anniversary of the first lockdown. At this point, Covid has become such a part of our lives that it is easy to forget just how extraordinary the demands on us are. And so we may also underestimate how crucial the extra support needed to meet these demands is. Perhaps the Demand-Control-Support model can remind us. Separately, I find people are so worn down by now that even the green shoots of spring and early success with vaccinations are hard to take in. Let’s not overlook these either, although admittedly the sight of daffodils in the snow is confusing. Ultimately, the best way to beat burnout is to change the underlying circumstances that caused it. When it comes to Covid-19, this too shall pass. But then burnout was a phenomenon before the pandemic and is likely persist after; developing tools to manage it will remain important long after lockdown ends.
*Names have been changed and permissions granted.
** This practice is adapted from Kristin Neff’s Self Compassion Break.
