Are you burnt out? Would you recognise the signs if you were? Apparently, at least here in New Zealand, we are terrible at self-identifying burnout and often go about our lives running on empty, certainly not being the best version of ourselves.

According to New Zealand research, approximately 11 per cent of workers and managers experience burnout to a high or severe level, but very few of them recognise it.

So, how come we don't recognise burnout when it's upon us?

The term burnout has been around since 1975 but it is not actually a medical or psychological diagnosis. More recently, it has been classified as an "occupational syndrome" in the latest International Classification of Diseases (ICD-11). 

Burnout applies to the work that you do (in or out of the home, paid or unpaid) and there are three core elements according to seminal burnout researcher Maslach which include 1) exhaustion, 2) depersonalisation and 3) inefficiency. 

These are like layers of a 3-tiered cake - you can't add the next layer without the previous. Exhaustion results in depersonalisation and these together result in feelings of inefficiency.

 

The three layers of a burnout cake

1. Exhaustion involves the energy depletion and deep fatigue that burnout is most famous for. This occurs after chronic overwhelming physical or psychological demands have been made and is a necessary step to proceed to the full classification of burnout, but not sufficient alone.

2. Depersonalisation involves protective distancing techniques to help cope with the overwhelm occurring due to fatigue and the physical, mental and emotional changes that result. These can include becoming more negative about work and the workplace or more cynical. 

3. Inefficiency results from some combination of these, with fewer feelings of personal accomplishment (or external positive reinforcement from others). This occurs due to feeling chronically exhausted and distanced without respite or resolution. 

But what leads to these conditions of burnout in the first place? 

Six mismatches have been found in Maslach's research and any of these may tip a previously content and energetic worker over into exhaustion and beyond. 

 

Six "mismatches" that create the conditions for burnout

• Workload - too many demands or the wrong type of work for your needs.

• Control - insufficient control or authority over the resources needed to do your work effectively.

• Reward - insufficient financial compensation, social rewards, or intrinsic rewards (e.g., feeling pride in your work).

• Community - loss of a sense of positive connection or membership with your workplace.

• Fairness - disparity within the workplace including pay or disciplinary responses.

• Values - when you must work in ways that you find unethical or work for an organisation with a mission that does not match their practice.

This latest one - values - is big, and can also be described as a "moral injury." This internal conflict creates frustration and despair.

In addition to these workplace mismatches, in modern life, we have a mismatch in how we eat, sleep, move, connect and play from our non-negotiable human needs. We spend a lot of time sedentary on screens, consume a diet lacking in nutrients, get insufficient quality sleep, and don't move our bodies enough or get them outdoors into nature and able to soak up sufficient vitamin D, or connect in meaningful ways and form intimacy with others.

"We have a chronically stressful environment in many different ways and we don't offset this stress sufficiently with periods of rest, joyful activity and fun".

Professor Jarrod Haar, a New Zealand burnout researcher, discusses how there have been some issues with previous measurement tools for burnout. More recent findings have focused on the inclusion of emotional and cognitive changes and impairment - such as becoming emotionally dysregulated or losing cognitive functions like memory and focus. In addition, psychological and psychosomatic symptoms have been included. This is important, given the gut-brain connection and how the nervous system is impacted by burnout with physical as well as psychological implications for many.

Burnout can be a "simple" experience of the 3-tiered cake or can become "complex" and co-occur with mental health concerns such as anxiety or mood disorders, ADHD/neurodiversity, and post-traumatic stress disorder as well as substance use disorders. These have many other considerations in terms of achieving recovery.

I often get asked by burnt-out clients how they can fix it - as though there was a singular and easy prescription I could explain for them to go home and do and then carry on with life. 

But what I've discovered over the years, is that resolving burnout is highly individual and personal. Some people cycle around and around before they make necessary long-term changes to how they work and live. However, there is an overall framework people might consider that can help them figure their own path out for good.

 

A framework to reignite your spark after burnout

Given the lack of personal insight that the research on burnout has found, step one of getting out of burnout is knowing that you are there in the first place. There is no medical test or diagnosis for burnout, but if the three layers of the burnout cake resonated with you and you identified any of the six workplace mismatches then you could well be burnt out. 

For those who like to complete questionnaires, the Burnout Assessment Tool is a validated freely available measure to help further determine your risk of "burnout at a glance". It asks questions in the domains of exhaustion, mental distance, cognitive impairment, emotional impairment, as well as some secondary psychological and somatic symptoms.

Examples include:

"after a day at work I find it difficult to recover my energy,"

"at work I do not think much about what I doing and I function on autopilot,"

"at work I struggle to think clearly,"

"I feel tense and stressed,"

"I often get sick."

This tool can be helpful to reflect on these kinds of questions, but while scoring is available on pages 11-13 of the scoring manual this is slightly complicated to figure out and interpret the degree to which burnout could apply to you.

I've broken the framework for recovery from burnout down into three stages to be followed in this order.  

 

1) Address exhaustion and physical health - hit reset

The reason to do this stage first is that it's really hard to unpack burnout and its causes and solutions while you are feeling shattered with a brain that isn't working at its sharpest. Often some time out from work is needed to start the reset - for some people with milder burnout, a long weekend or a week off is enough to get this going while others may need several weeks. Getting support to negotiate this may be needed from the workplace or at home.

During this time off, what is vital is that there is a reduction of stress and the addition of lots of rest and restorative practices to enable the nervous system to calm down so you can sleep better and physically recover. 

In our clinic, we often recommend natural calming aids to support sleep and relaxation. These are some of the easy win steps that can enable someone to feel physically more resilient and about to cope with working on further steps of change needed. These natural aids can include products such as adaptogenic or nervine herbs as well as the mineral magnesium or the amino acid L-theanine.

• Adaptogen herbs – (Withania etc.) support adrenal function and can help resiliency while going through ongoing stress.

• Nervine herbs – (passionflower etc.) calm anxiety and support sleep.

• Magnesium – citrate, glycinate, orotate – depleted by stress, helps promote GABA (a calming neurotransmitter) and refreshing sleep.

• L-theanine – supports generalized and acute anxiety or panic attacks, and helps the brain focus.

• These are often available via a clinical naturopath or a green pharmacy that has quality products.

In addition to these, given the depletion of vital nutrients that can occur during episodes of prolonged stress, we generally recommend some kind of vitamin and mineral product depending on the individual, any lab test results, and their physical or psychological symptoms and typical dietary pattern. This can include a high-quality multi-nutrient product or more targeted support, such as addressing low Vitamin B12, Folate, Zinc, Vitamin D, Omega-3 fatty acids, or Iron. These are some particularly critical nutrients for mental health and well-being.

Nutritional change is also often recommended but can be a more challenging step when someone is exhausted and may find shopping, planning meals and cooking a challenge. Cutting down inflammatory ultra-processed foods & refined sugar while boosting up hydration with water, and whole foods ensuring adequate protein early in the day and at each meal is a good approach. Eggs at breakfast are a top suggestion for those who like these and a great way to set up the brain for the morning. Often a caffeine and or alcohol reduction or holiday is recommended to remove these additive stressors which impact cortisol production and are known sleep disruptors when under stress. 

Movement is well known to be great for the brain and warding off anxiety and depression. However, the deep exhaustion that comes with burnout means that high-intensity or long endurance-type movement - such as training for marathons - may not be conducive to your recovery. More restorative movement is generally recommended and can include 20 minutes of stretching, yin-type gentle yoga, walking in nature, and practices like tai chi. As burnout lifts, then a return to your usual movement should be possible. Listen to your body and if you notice energy crashes or cold symptoms occurring after exercise this may be a sign it's too much at that time, go back to short regular yin practices. 

On a practical note, having some time off work but continuing to check emails, the news, social media and scrolling on your device won't help. Ensuring you are having screen-free time each day where you put your device on silent or out of sight is important to feeling calm and relaxed. Especially in the two or so hours before bed when you want to have a nice herbal tea, read a book or play some music, and generally focus on relaxing and calm. 

Should you find yourself struggling with racing thoughts and anxiety or rumination about the past, learning a mindfulness practice to come back to the present and let your mind quiet is helpful to switch off stress. Smiling Mind is a great free App that you can use at home to help learn these skills and switch on the relaxation response. 

 

2) Go deeper - this involves asking the question - "how did you get here?"

As you start to feel burnout exhaustion lifting and some symptoms improve, it's time for an honest analysis of the contributing factors that resulted in burnout. It can help to write these down and get clear on what happened and why. You may like to review the six mismatches and reflect on any that apply to you in the workplace and think about what it would take to realign these. This is about the relationship between you and the workplace, so both might need to change. For example:

• Is it the workload, the type of work, or the work setting you are struggling with there?

• Are there any difficult relationships or a loss of sense of community at work?

• Do you feel a moral injury about what you are required to do and that this clashes with your values or integrity?

• Are you feeling micromanaged and that you have no sense of agency?

• Do you feel that you lack any skills, resources and support?

• Can you have some conversations at work with anyone and troubleshoot how to realign some of these areas?

• If not, is this the right work or workplace for you at this time and is a change needed?

In addition to reflecting on workplace mismatches, are there any lifestyle mismatches you know you need to figure out? Here are some of the questions to ponder. 

• Has regular movement dropped off as you don't feel you have energy or time? Or are you overdoing it with intensity or endurance movement on top of a too-busy time at work - creating too much stress on your body?

• Are you no longer eating in a nutritious way for your needs and relying on caffeine and fast carbs for energy?

• How's your relationship with alcohol, medication or other drugs going?

• Have you been ill or tired but "pushed on" as you feel you can't let people down, say no, or give yourself a break?

• Are you having enough downtime on evenings, and weekends as well as taking enough holiday time to recover?

• How's your relationship with technology? Are you scrolling on your phone as your primary "relaxation" method but keeping your brain in drained mode? 

• Do you sleep enough for your needs? 

• How are the relationships in your life - do you nurture true connection with those who matter? Or has this dropped off due to being too busy and tired?

• How's your relationship with yourself? Do you know how to take care of your needs as you would for anyone else you really cared about?

 

3) The last aspect of a recovery framework for burnout is to monitor for relapse and then reassess

A key part of preventing future burnout is to know your early warning signs. For example, if you start to feel constantly tired, crave more coffee or alcohol, wake up with a feeling of dread around work, or notice that you feel more negative and cynical about things at work. If you realise you are dropping the ball at work more often and catching mistakes. Perhaps you slip into a pattern of sleep disturbance - finding it hard to get to sleep or waking in the early hours going over worries at work. You may notice physical symptoms get worse such as "brain fog", low immune resilience to colds and flu or gut symptoms.

Given that it can be hard to have insight about burnout at the time it hits, it may be those closest to you or a work colleague who comment on these changes - like noticing that you seem more stressed or tense or are reacting more intensely to things than usual.

If you find yourself going around and around in a cycle of burnout repeatedly, then it may be time to make a radical change to your work or consider other causes you may have missed by revisiting the "go deeper" stage.

But given that so many of us go through episodes of burnout in modern life you're in good company! So hopefully being able to openly talk about it and troubleshoot using some of the ideas covered in this article you'll get clearer on how to avoid future episodes and reignite your spark should burnout strike.