Recovering from Burnout

Counselling for stress and burnout
Photo by Andrea Piacquadio on Pexels.com

This is the second in a series of three blogs exploring burnout.  In the previous blog, we considered what burnout is, the signs and symptoms of burnout and who is at risk.  Here, we cover practical self-help strategies you can employ to help manage burnout if you feel you are beginning to suffer from or are firmly in the grip of burnout. 

Photo by Luca Nardone on Pexels.com

Burnout:  No fuel left in the tank

Burnout is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress.   If you’ve begun to spot some of the physical, emotional, mental and behavioural symptoms of burnout, then it’s time to take action.  Self-care and self-help for recovering from burnout are essentially about taking steps to reduce stress and to find ways to re-resource.    Burnout is a diagnosable health condition resulting from continuous and long-term stress exposure (ICD-10 International Statistical Classification of Diseases and Related Health Problems, 10th Revision).  And, as with any health condition, a return to good health can take time and comes after rest and active treatment. 

Reduce Your Exposure to Stress to Tackle Burnout

Stress and pressure can lead to burnout
Photo by Andrea Piacquadio on Pexels.com

At the point of burnout, we’ve borne the brunt of stress and pressure for too long.  The depletion of burnout comes after exposure to stress and suffering, causing us to remain in a state of flight or fight – on high alert, for too long, without sufficient respite.  Therefore, once you recognise that you are experiencing burnout, it is essential that you reduce your exposure to stress.  Your brain and body need chance to regulate and recover. 

A significant aspect of self-care and self-help for burnout is taking a long hard look at what you can do to reduce stress and pressure in your life.   Do you need to take a break for a few weeks?  It may be prudent to book in annual leave as a matter of urgency to give yourself a total break.  For some people, burnout means that they are not well enough to work and require a break from the pressure and stress of work.  In which case, speak to your GP.  Remember, burnout is an accepted health condition.

Consider, too, the various commitments that add to your daily or weekly load.  What can you pause or take a break from in order to reduce your exposure to stress?  Perhaps it would help to hire a cleaner for a couple of months to reduce any household pressures.  Or, at least accept that – for this season at least – some jobs will just need to remain undone.  Step back from volunteering for a while.  Learn the art of saying “no”.  The last thing you need right now is more commitment.   However you manage it, it is essential you have a respite and reprieve from stress and pressure for a while. 

Filling the Tank After Burnout. 

As well as reducing your exposure to stress, it’s also important to find ways to replenish after experiencing burnout.  If we take the analogy of a fuel tank, reducing our exposure to stress helps to cover the “hole” in the tank that’s been leaking fuel.  But there is a need to now refuel and restock your energy levels. 

How to refuel?  Take a long hard think about what it is that gives you energy and gives you life.  What makes you feel alive, feel engaged, feel like “you”?  Dancing?  Meditation?  A yoga class?  Time alone to read, relax and create?  Socialising with precious friends?  Walking in nature?  Watching your favourite film or show?  You’ll know yourself what helps you to feel energised and enlivened. It’s different for each of us, and only you really know what feels a perfect fit for you and your own needs.   It is important that you schedule plenty of opportunities to do the things that help, that bring you joy.  These things are a powerful antidote to burnout.  Make space in your diary and prioritise these activities to fill the tank and refuel after burnout. 

Give Yourself Time

Take time to recover from burnout
Photo by KoolShooters on Pexels.com

Consider that burnout often takes months to take a hold.  Burnout occurs after the prolonged exposure to stress and pressure.  Therefore, you need to allow time for recovery from burnout.  Give yourself time and aim to adopt an attitude of self-compassion and patience with yourself as you slowly recover from burnout. 

Take time to make changes to your daily, weekly and monthly routines so that you are in a position to recover from burnout.  Give yourself time each day for some relaxation, and rest and chance to replenish.  Re-evaluate the expectations you place upon yourself about what you can cram into each day, each week, each month.  Build in time to rest and time to recover.  These are lifestyle changes that will help you to recover from burnout but will also help you to safeguard against future burnout. 

Seek Professional Help

Counselling for stress and burnout in Preston
Photo by cottonbro on Pexels.com

Many people seek therapy and professional counselling or psychotherapy as space to explore how they feel about the experience of burnout.  Burnout can trigger a range of feelings and responses.  For example, some people feel ashamed that they have reached a point of burnout.  They are suddenly faced with their own vulnerability and fragility and may feel shocked and shaken at this recognition.  The experience of burnout may also challenge self-beliefs and personal constructs. For example, if we hold a “be strong” mindset, the experience of burnout may lead us to question our own identity.  Perhaps we are someone who has gained our sense of self-worth from doing, and from helping others.  Burnout can challenge that and leave us questioning whether we are worthy or okay as a person.  Therapy is a place to explore and examine our own beliefs and feelings about ourselves, as well as offering opportunity to consider alternatives that can help towards recovery from burnout. 

Burnout….. so what?

We’ve explored some of the important aspects of recovering from burnout.  Recognising burnout is a first step towards recovery, that takes time and deliberate and active action to helps us towards a healthier future. 

The final blog post in this series will explore how to take actions to protect yourself from burnout in the future. 

Let me know what works for you in terms of recognising and managing burnout in your own unique circumstances.  And do get in touch if you’d like to discuss how counselling can help you in your recovery from burnout. 

Free to be Counselling offers professional counselling in Preston for anxiety, depression and self-esteem.
Counselling in Preston for anxiety, depression and self-esteem

What is Burnout?

Stress and sustained pressure can take its toll upon people.  Whilst it might be possible to cope with stress and pressure in the short term, over the long term, we’re at serious risk of burnout.  In this first blog in a series of posts, we’ll look at what burnout is, who it affects and what the signs and symptoms of burnout involve.  Other blogs will explore how to take preventative action to avoid burnout and how to recover from burnout

Burnout:  No fuel left in the tank

Burnout is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress.  A vehicle’s fuel tank is a good analogy here.  If you drive for too long, too fast without stopping to re-fuel, eventually your vehicle grinds to a halt.  You need to take time to find a source of fuel, and then re-fuel the tank before you can carry in.   For many people, the various stresses and strains of life mean that they’re driving too fast, for too long.  That’s not sustainable in the long-term and places a person at risk of burnout. 

And, its worth mentioning, that burnout can also involve the slow and almost imperceptible depletion of energy and resources to cope with the pressures upon us.  We can think of burnout as also being about a hole in the fuel tank.  Without remedial action to stem the flow, there’s a gradual leaking of fuel from the tank which, eventually, results in the vehicle grinding to a halt. 

Photo by Harrison Haines on Pexels.com

What is burnout?

Burnout was first identified and described in 1974 by clinical psychologist Herbert Freudenberger, in his study of nurses.  He noticed that pressures of work led to nurses becoming depleted.  Affected medical staff began to show signs of disengagement, feelings of helplessness and emotional exhaustion.  Now, burnout is widely recognised as a health condition that impacts significant numbers of people every year.  The ICD-10 (International Statistical Classification of Diseases and Related Health Problems, 10th Revision) includes burnout as a diagnosable health condition resulting from continuous and long-term stress exposure.  And the World Health Organization recognises burnout as an ‘occupational phenomenon’. 

Signs of burnout encompass emotional, physical, mental and behavioural symptoms.  Let’s look at some of the different signs and symptoms associated with burnout:

Emotional symptoms of burnout:
  • Depressed mood
  • Irritability
  • Sense of hopelessness
  • Disillusionment
  • Detachment
  • Resentment
Physical symptoms of burnout
  • Tired
  • Rundown
  • Sleep problems
  • Muscle tension
  • Headaches
  • Stomach complaints
Mental symptoms of burnout:
  • Finding it hard to concentrate / make decisions
  • Persistent thoughts about patients / clients
  • Intrusive imagery of work-related issues 
Behavioural symptoms of burnout:
  • May exhibit robotic actions,
  • Impaired practice with questionable ethical actions and increased errors
  • Jumpy / restless
  • Greater use of alcohol / other drugs. 
Photo by energepic.com on Pexels.com

Our brains on burnout

The human brain is equipped to respond to short bursts of periods of stress. The adrenaline that is released under pressure helps us to perform.  That’s useful when we need take prompt action in response to a stressor.  Our brain begins to release the stress hormone, cortisol, equipping us to stay alert in the face of challenge.

However, when pressure and stress are prolonged, our brain is flooded with cortisol and we remain for far too long in a flight or fight states, on high alert without sufficient respite.   In time, the brain begins to struggle to produce cortisol leading to adrenal fatigue.  Over time, the drip-drip effect of prolonged pressure and demands mean our brain is less efficient at regulating our stress response and we find we are less equipped to manage stress.  We label this experience burnout.    

Who’s at risk of burnout? 

The short answer is, anyone and everyone. A recent Gallup survey revealed 76% of employees occasionally experience symptoms of burnout, and 28% say they are burned out “very often” or “always” at work.  Life in the 2021 is stressful and there’s a great deal of pressure on most people. 

However, research also points to people withing caring professions as being at particular risk of burnout.  Recent estimates suggest that up to 40% of UK Doctors may be experiencing burnout.   A European study in shows that 42% of UK nurses report burnout compared with a European average of 28%.  We know that people engaged in the care professions, and where work involves a significant degree of interpersonal contact and exposure to other people’s suffering, are at greater risk of burnout.  That means people engaged in “high touch” (as opposed to high tech!) employment are at greatest risk of burnout.   Social workers, teachers, medical professionals, carers (paid and unpaid), police, firefighters, aid workers, counsellors, members of the clergy…. the list goes on.  Anyone in these roles is at risk of burnout.  Charles Figley, a key researcher in this area speaks about the “cost of caring”:  the empathy and compassion that make people in caring roles so good at their job is what can lead to burnout in the long-term. 

Photo by Jonathan Borba on Pexels.com

Burnout….. so what?

We’ve explored what burnout is, the signs and symptoms of burnout and who is at risk of burnout.  So, how can you use this information to help you?  Well, many people do seek therapy to explore their relationship with burnout and to have space to find freedom from the negative impacts of burnout.  Some enlightened workplaces offer access to EAP and other wellbeing support, which can help employees at risk of burnout to access counselling. 

In my next blog, we’ll look at some practical self-help strategies you can employ to help manage burnout. A final blog post in this series will explore how to take actions to protect yourself from burnout. 

Let me know what works for you in terms of recognising and managing burnout in your own unique circumstances. 

Finding Freedom from Anxiety

“It’s a little Anxious,” Piglet said to himself, “to be a

Very Small Animal Entirely Surrounded by Water”

A.A. Milne

Piglet, companion to A.A. Milne’s Winnie the Pooh, is familiar with the feelings of fear, dread and apprehension that we label as “anxiety”.  Piglet is aware of danger and threat and easily connects with thoughts and imaginings of “what if….” when facing the challenge of the water.  He anxiously begins to ruminate and contemplate what may happen, and concludes:

“Here am I, surrounded by
water and I can’t do anything”.

In this blog, we’ll take a look at what anxiety is, and the purpose it serves for us as humans.  We’ll consider ways to find freedom from the unpleasant and sometimes life-impacting consequences of anxiety.  For many people, working with a therapist to find ways to understand and manage anxiety can be powerful.  There’s also a lot of self-help ideas and techniques that can be useful in finding relief from anxiety.

What is anxiety?

Anxiety is the unpleasant feeling of fear, worry or dread.  It’s thought that the word “anxiety” stems from the Latin word “angō”, which means “I cause physical pain” or “I torment or distress”. Alternatively, the English word anxiety may also have developed from the Latin ‘angere’, meaning to choke, or strangle.  Either way, the etymology of anxiety helps us to have a sense of what anxiety feels like and how it can impact a person’s life.  Anxiety can cause physical discomfort and pain, leading to tense muscles, difficulty breathing and tension headaches and digestive issues.  The troubling thoughts and endless rumination often associated with anxiety can really feel like torment or torture, especially when such thoughts disturb sleep or rest. There is not doubt about it, anxiety can cause real distress. 

Anxiety is defined by the NHS as a “Common Mental Disorder”.  Research shows that 5.9% of UK adults experience Generalised Anxiety Disorder (GAD) within a given week.  Other anxiety-based conditions such as phobias, OCD and Panic Disorder means that over 10% of UK adults have symptoms of anxiety that may or may not be treated and managed. 

Counselling for anxiety

As a Psychotherapist, I’m interested in finding out what a person’s own relationship to their unique experience of anxiety. I’m curious about what your anxiety is like for you, and what purpose or meaning it may hold for you in your unique environment and situation.  I certainly don’t want to treat you as a medical diagnosis, or presume your experience of anxiety has one simple cause and one simple solution.  You are far more than a label, and far more that “a person with anxiety”.  

Most people feel anxious or scared at times, and it’s natural to feel anxious when facing change and stressful life events.  In terms of evolution, a certain amount of anxiety is useful to humans and other mammals.  An anxious response to some perceived danger or threat results in the release of certain hormones, such as adrenaline and cortisol. These hormones alert us to be responsive and attuned to threat so that we can act.   For example, heart rate increases to carry blood quickly to reach the parts of our body needed to run or fight the threat and that can result in feelings of wobbliness and breathlessness.    This response is useful when we need to take prompt action to ensure our survival.  However, for some people, the warning and action system of anxiety remains on high alert when a threat has passed, or the threat is assessed by others as “minor”.  It’s easy for others around us to dismiss you as “over-reacting” or that you are “too sensitive”.  Yet, such responses risk shaming and blaming. 

I wonder what sort of beliefs and messages you carry about your own sense of safety in the world?  I wonder what might have happened to you that has resulted in feelings of fear and anxiety in the present? In what ways do you feel, and have you felt, out of control and unsafe?   I am also curious about the messages you tell yourself when you experience anxiety.  I’m interested in discovering what we can learn together about your own needs and wants.

Freedom from anxiety

Whilst anxiety, with all its various symptoms can impact on a person’s day-to-day functioning and quality of life, and positive news is that, with support, you can can find ways to better understand and then make choices that can help you to find relief from debilitating anxiety. 

The NHS recognises a range of responses can help manage anxiety.   These include education about anxiety, Talking Therapy and psychological approaches, self-help and medication.  Therapy can sometimes explore practical self-help approaches and allow space for consideration and discussion of self-help approaches.  In this blog, we’ll take a look at 3 well-known self-help approaches for anxiety that you can consider using, whether that’s to complement or as an alternative to counselling for anxiety.

Mindfulness & meditation for anxiety

Mindful meditation can support in finding balance

Mindfulness and Meditation are ancient practices that have received a great deal of attention and interest in recent years.  Recent research points to mindfulness as an effective tool for promoting mental health for many people.   Mindful meditation is essentially a way of paying more attention to the present moment and to your own thoughts and feelings and well as to the world around you.  Mindfulness and meditation practices encourage awareness and noticing.  Whilst mindful meditation may not be everyone’s cup of tea, or indeed may not be effective for everyone, mindfulness for anxiety is a accessible tool that requires zero financial investment.  There’s simple mindful meditations available online.  For example, the HeadSpace App provides a range of free resources via the HeadSpace YouTube channel.  There’s also the Waking Up App, developed by neuroscientist, Sam Harris, which combines mindfulness meditation theory and practice in accessible chunks with free access to a range of resources. 

Step-into-nature to manage anxiety

Nature encourages a live-in-the-moment experience

Time in the natural world can help relieve stress and anxiety and boost overall wellbeing.  Taking a walk outside, cultivating nature in your garden, or a trip to the coast to watch the waves are all ways you can benefit.  And, even if you can’t get outside you can still find ways to benefit from nature.  A recent study showed that visualising natural scenes helped in reducing anxiety symptoms. 

Eat your way to freedom for anxiety

A diet rich in vegetables can help mental wellbeing

We know that certain foods or drink can increase anxiety levels.  Excessive caffeine, alcohol and refined sugars are commonly cited triggers for anxiety.  A healthy diet can, by contrast, support both our physical and mental health.

A 2018 research study demonstrated that a Mediterranean diet, high in vegetables, fruits, legumes, nuts, beans, cereals, grains, fish, and unsaturated fats, can support mental wellness.     

A study in the journal Psychiatry Research  has shown a possible link between probiotic foods and a reduction in symptoms of social anxiety. Eating probiotic-rich foods such as pickles, sauerkraut, and kefir was linked with fewer symptoms.

So, if you feel a little bit, or even a lot, like Piglet at times, have hope.  There are many accessible self-help strategies out there that you can consider.  Psychotherapy and counselling are effective ways to find freedom from anxiety.  I’d be interested to hear from you about what has helped you with any experience of anxiety that has impacted you.  Feel free to comment below……

Breathing Support for Anxiety

Breathing is our basic support system. In times of stress and difficulty, simply focusing on breathing can restore a sense of inner capability and calm. It’s for this reason that my eye was drawn to two recent books on the topic of breathing: Breath, by James Nestor and Close your Mouth by Patrick McKeown, founder of the Buteyko Clinic

I’ve enjoyed sitting down to read both of these accessible books. It’s felt relaxing and strangely productive at the same time. And, based on a resting respiratory rate of 12 breath cycles per minute, I’ve taken somewhere close to 72,000 breaths as I’ve read. It’s caused me to be far more aware of my breathing, moment-to-moment, and has got me thinking about the role breathing plays in emotional and neurological regulation, particularly when experiencing anxiety. 

Breath Awareness: A Powerful Tool

Become more aware of our breathing in any given moment provides valuable data about our experiencing within and our relationship to the world around us. For anyone who wants to build breath awareness into daily life, it can help to try sitting and tuning into what you experience in the present moment. Aim to narrate or describe what it is you experience about your breathing.   Begin each sentence with the phrase, “right now, I’m aware that…..” 

Questions that can support this awareness exercise include:

·      What word describes my breathing right now? Is your breathing laboured? Smooth? What other word(s) express the felt sense of your experiencing? 

·      Consider the pace of your breathing: fast, slow, gradually increasing or decreasing in pace?

·      Consider the depth of your breathing: shallow, light breaths or somewhere closer to deep breathing? 

·      Consider anything you notice about the outbreath as distinct from the inbreath. How does your exhale differ from your inhale?  

·      Consider where in your body you sense the breath as it moves within your system. Which muscles move as you breathe? Does your breath change with your increasing awareness? 

Having greater awareness allows us to notice thought patterns, breathing changes and tension in our body. Our breathing patterns can be signals of anxiety building and allow us to choose to respond in a way that is self-supporting and self-caring. 

Breathing and the Autonomic Nervous System

When we experience anxiety, or face some stress or threat, our autonomic nervous system prepares the body for fight or flight in response.  Our heart rate increases, muscles tense and our digestion slows. Most aspects of our nervous system cannot be consciously controlled.  Breathing is unique in that, through conscious breathing, you can regulate your nervous system. 

The autonomic nervous system (ANS) is the way our body regulates processes for rest and activity, and this process happens automatically. It consists of 2 main branches: the sympathetic and the parasympathetic. The sympathetic branch of the ANS stimulate the body’s fight or flight response. When faced with a danger, or potential danger, the sympathetic system causes changes in our heart rate, rate of respiration, digestion and muscle tension so that we are physically prepared to fight or flee. This happens as soon as our brain detects threat, even if the brain is mistaken. For example, on seeing a coil of rope from the corner or your eye, your heart may begin to beat fast and your breathing rate will automatically increase.  Your brain has read the sensory data as “snake” and responded in much the same way as it would if you saw an actual snake. This process is extremely useful to our survival. However, when we remain in a state of heightened sympathetic stimulation, our body remains tense, on edge and anxious. 

The parasympathetic branch of the ANS is focussed on restoring calm and balance to our bodies after sympathetic stimulation. It prevents the body from overworking and brings our breathing, heart rate and muscle tension back to a more regulated state in order to facilitate rest and recovery. Breathing has a vital role to play in kickstarting the parasympathetic response of calm and balance. It’s been shown that deep breathing can activate the parasympathetic branch of the ANS and decrease levels of the cortisol stress hormone. Consider building in helpful slow and deep breathing practice, particularly focusing on the releasing exhale breath, when you sense your nervous system would benefit from calm and balanced regulation.

Sunlight on water
Like the ebb and flow of the sea, breath comes in, breath goes out.

I’d like to share with you three simple breathing exercises that I’ve found beneficial for tapping into the power of the breath to aid emotional and neurological regulation. 

Attend to Posture

Aim for posture that is supportive of breathing by allowing space and expansion of the respiratory muscles of the diaphragm. Allow your body to do what it naturally does: breathe. Brething can be well supported when your posture allows your spine to extend, with your shoulders back and without tension. Aim to notice ease in your body and to allow your posture to support efficient and effective breathing.

Slow Down

When we are relaxed, our breathing slows down. By slowing down your breathing, you can affect other bodily systems so that heart rate decreases, and cortisol levels drop.  

·      Find a comfortable sitting position, and place your feet flat on the ground. 

·      Let your breath flow as deep down into your belly as is comfortable, without forcing it.

·      Try breathing in through your nose and out through your mouth.

·      Breathe in gently and regularly. Some people find it helpful to count steadily from 1 to 5. You may not be able to reach 5 at first.

·      Then, without pausing or holding your breath, let it flow out gently, counting from 1 to 5 again, if you find this helpful. In time, you can begin to slow down and extend the outbreath. 

·      Keep doing this for 3 to 5 minutes.

Square Breathing

This technique requires us to concentrate on our breathing and can bring a greater sense of balance and harmony. 

·      Begin by slowly exhaling all your air out.

·      Then, gently inhale through your nose to a slow count of 4.

·      Hold at the top of the breath for a count of 4.

·      Then gently exhale through your mouth for a count of 4.

·      At the bottom of the breath, pause and hold for the count of 4.

Killer whale breathing
Find freedom from anxiety with breathwork

Take a Moment to Breathe and Put it into Practice.

So, in these times of economical uncertainty and elevated tension, attending to the breath can be a cost effective (i.e., free!) form of self-care and self-support, equipping you to find greater ease, calm and balance in your daily life. I’d love to hear if any of the suggestions here free you up to catch our breath, and breath a sigh of relief during an otherwise hectic world.  And if you are curious to know more, I’d certainly recommend Nestor’s and McKeown’s books.

References:

·      Gerritsen, R., & Band, G. (2018). Breath of Life: The Respiratory Vagal Stimulation Model of Contemplative Activity. Frontiers in human neuroscience, 12, 397.

·      Ma, X., Yue, Z. Q., Gong, Z. Q., Zhang, H., Duan, N. Y., Shi, Y. T., Wei, G. X., & Li, Y. F. (2017). The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Frontiers in psychology, 8, 874.

·      McKeown, P. (2004). Close Your Mouth. Buteyko Books: Moycullen.

·      Nestor, J. (2020). Breath: The New Science of a Lost Art. Penguin Books: London.