3 signs that you’ve hit clinical burnout and should seek help | Laurie Santos

These days, we talk a lot about 'burnout,' but as a psychologist, I recognize that we have a lot of misconceptions when it comes to burnout. We think burnout is anytime you're feeling a little bit overworked or a little bit stressed or a little bit tired. But it turns out that burnout is a very special kind of clinical syndrome that has a couple of very particular symptoms.

One of the symptoms we often think about is a sense of emotional exhaustion—but this is richer than just a sense of physical exhaustion. Emotional exhaustion isn't just about being tired; it's really about feeling like you cannot emotionally handle another thing on your plate. If one thing comes on, you know, that's it, the whole house of cards is gonna fall. Even when you get a really great night rest or a week off, you're still feeling kind of emotionally tired and overloaded. That's the first symptom: the sense of emotional exhaustion.

The second symptom, which I think is even more profound, is a sense of what's often called 'depersonalization' or cynicism. You're just kind of on a short fuse with the people around you, whether that's the people you're serving in your job, your clients or your patients, or your other teammates. It's like everything they say kind of irks you a little bit, and it feels like if there's one more request, you're just gonna lose it and freak out. You're also very cynical about people's intentions. You kind of feel like they have bad intentions for the asks that are coming your way—that's a sense of depersonalization.

But the third symptom is a sense of personal ineffectiveness. You just feel like even if you were doing your job perfectly, it wouldn't matter, or there are structural constraints that make it impossible to do what you really value doing. So even if you're doing your job well, you feel like it kinda doesn't matter. It's not giving you the same value it was before. So this is burnout: It's not just a sense of stress or overwork. So I think it's important to distinguish between stress and burnout; we sometimes lump the two together, but burnout is a very particular kind of clinical syndrome.

We tend to think of burnout as a modern phenomenon, but there's evidence that something like burnout has been happening for a while, at least since the Industrial Revolution. But some of the best research on burnout happened in the 1980s and 1990s and was mostly done by this fantastic researcher, Christina Maslach, who's talked about some of the features that tend to lead to burnout. One of the features that tends to lead to burnout is an increased workload or workload that really feels just too overwhelming. That isn't enough to lead to burnout over time, but this can be an exacerbating feature.

Another feature that tends to lead to burnout is what Maslach calls a 'values mismatch.' You get into your job thinking you're doing something, but in practice, in the trenches, the job feels like something else. I'm speaking about burnout right now as a scientist, but also as somebody who's experienced this syndrome a little bit myself. I feel like I became a college professor and a head of college on campus because I wanted students to have a fantastic experience. But then when COVID hit, it just felt like, you know, what we were doing wasn't what I signed up for anymore; there was this mismatch.

Another feature that can lead to burnout in an organization is a sense of unfairness. This can also cause a certain sense of community breakdown. When there's a sense that things are a little bit unfair, maybe there's differences in compensation, that can lead to a sense of burnout. The final thing that's really important for burnout is your sense of reward. What leads us to kind of get flow and feel happy in our jobs is a sense of intrinsic reward.

When things become pushed more towards the extrinsic reward, and also when those extrinsic rewards, especially when they start feeling a little bit unfair, that can lead to a sense of burnout over time. If you're wondering if you're going through burnout, a few questions you can ask yourself involve those big symptoms we just talked about. First, this sense of emotional exhaustion: Are you really, really exhausted, not just physically exhausted, but emotionally exhausted?

When you take a weekend off, are you still as depleted when you go back on Monday morning? And does it really feel like a form of exhaustion that's very emotional? It's not just that you're tired, but that you're feeling really depressed; emotionally, you're on just a really short fuse. Are you experiencing changes in how you relate to people at your work, either the people that you serve, your clients, your patients, or the people that you work with? Are you embarrassed about the length of your fuse? Do you feel like you're going through some compassion fatigue?

That's a clear sense that you're experiencing depersonalization. And is your sense of meaning going away in terms of what you're doing? Do you feel like your work has changed, that you simply can't do a good job right now because of some of the structures of what you're asked to do or the fairness in your own institution? If you're answering "yes" to some of those questions, you may be on the verge of burnout, and it's important to address that before it gets worse.

So what if you're already feeling a little bit emotionally exhausted, a little bit cynical, a little bit like your job isn't effective as much anymore? This is the point when you need to think about treating burnout, and we can think about treatment as having an organizational side and a personal side. Organizationally, I think different industries need to pay a lot of attention to burnout—and one of the main ways to fix burnout is to make some changes to people's workloads, to people's sense of values, and to the rewards that people are getting.

Those changes are really essential steps to treating burnout once it's there. But as an individual, you know, the best thing that you can do, aside from kind of trying to promote more of these structural changes at work, is to really take good care of yourself. And I mean that in particular, not just in terms of the kinds of things you do which matter, getting more social connection, making sure you have some free time, but also to think about how you're structuring your relationship with work.

Often, we bring the best of ourselves to work and leave the leftovers for everything else, for our families, for leisure, and so on. If you're really putting too much of your identity emphasis on work, that's the kind of thing that can lead to burnout because those values feel like they matter so much to you; it's all of your identity that's wrapped up in this. When there's a mismatch, it can hit you even harder.

So to address my own burnout, I decided to take a sabbatical, but it was important that I stayed very intentional about paying attention to my value systems during that sabbatical. I really tried to invest more in my relationships outside of work, so it wasn't just friendships at work that were making up my whole social life. I tried to reengage more with other things that I value—hobbies, things as silly as, like, playing a little bit more Guitar Hero—but also engaging a little bit more with things like my health, like making sure I'm moving my body.

It's really trying to engage all the values and the things you care about outside of work, so you can start to develop an identity in that, and not just in what you're doing for your job.