The burnout epidemic: finding ways to destress before we hit crisis point

A struggling economy, rampant unemployment, a rapidly changing job market, a global pandemic and a global mental health crisis. It’s a perfect storm for burnout and overwork. But the underlying factors leading to chronic burnout predate the Covid-19 pandemic.

At the start of 2019, insurer and financial consultant PPS conducted an independent survey of 5,837 SA professionals. More than one in five respondents felt overworked. And in certain sectors burnout is not the exception, it’s the rule. Studies of health-care workers in the public sector over the past decade — before Covid-19 — consistently reported burnout rates in excess of 40%.

This was clearly never sustainable, and the events of the past 18 months have pushed the issue to a tipping point. Consider some of the pressures experienced over the past year: home schooling; uncertainty in the face of an unprecedented threat; the loss of loved ones; wave after wave of disease; unemployment; restrictions on movement; rising substance abuse; new virus strains; pay cuts. It’s no wonder that we’re not able to cope and are struggling to balance mental health, our home lives and our careers. Covid-19 has shone a spotlight on the toll that a collapse of the work/life balance can have on our bodies, minds and health.

Microsoft’s recently released 2021 Work Trend Index found that respondents were overwhelmingly overworked. Many were exhausted. This was the result of workloads that were less structured and more pressurised: time spent in online meetings more than doubled over the past year. Meetings were longer, and more frequently ad hoc. A compounding factor is that the ability of workers to push back has been hampered. We all feel the pressure to show that we’re still productive in this shifting world of work and that remote work doesn’t hamper our ability to deliver.

Many of us will relate to the experience of suddenly being made aware that we were physically, mentally or emotionally exhausted. Possibly you snapped at a friend, family member or colleague. Perhaps you sent that e-mail which, in hindsight, you should have left in your drafts folder. Maybe you’re experiencing sleepless nights or finding it impossible to concentrate on even simple tasks.

The good news is that this confrontation with the underlying issues can lead to change that allows us to plot a healthier, more sustainable course.

Though I’m going to discuss personal responses to coping with burnout, it is largely an organisational, not a personal issue. The impact of burnout is substantial, and I believe leaders need to give it focused consideration before it spirals out of control. Burnout results in loss of morale and productivity, increased errors and staff turnover, and quickly sours company culture.

Conversely, company culture is what determines whether burnout is manageable or becomes an epidemic. And as always, the only thing that can change company culture is strong, visible leadership. Leaders have a responsibility, now more than ever, to listen to their people, understand their stressors and put in place empathetic solutions.

Empathy is the key. It is required of leaders both to appreciate the diversity of experience and circumstance within the workforce, and to understand what might constitute valuable help as opposed to lip service. There can’t possibly be a one-size-fits-all organisational solution to burnout. The IT manager suddenly out of their depth and the single mother working from home are both at risk of overload, but require different assistance. Valuing difference in itself is a good step towards building a company culture that is more inclusive and supportive.

But it’s not just our professional lives that are making us feel overloaded. We’ve been under intense emotional and psychological pressure this past year. And we are not all equally affected by this— women are more affected than men, for example.

In Burnout: The Secret to Unlocking the Stress Cycle, a 2019 book from sisters Emily and Amelia Nagoski, they make reference to a concept adapted from a book by moral philosopher Kate Manne. The concept — “human giver syndrome” — refers to the distinction between humans who feel that their role is to express themselves and their humanity without restraint, and humans who are expected to give their time, their lives, their effort and their feelings so the first group can express themselves more fully.

Women often fall into the latter category, as do employees at the bottom of the hierarchy. For these “givers”, the relentless expectation of their availability extracts a grievous toll.

The Nagoski sisters identify three specific components of burnout: emotional exhaustion (the fatigue that comes from caring too much for too long), a decreased sense of accomplishment (the sense of futility you feel when it seems that nothing you do makes any difference) and depersonalisation (the depletion of empathy, caring and compassion).

They write: “Research has found that it’s the first element in burnout, emotional exhaustion, that’s most strongly linked to negative impacts on our health, our relationships and work, especially for women.” Rage, grief, despair, shame, helplessness: these have quantifiable physical and mental effects. Emotions release cascades of electrical and chemical signals that can deplete and exhaust our bodies’ physical resources. Emotions aren’t wishy washy or distant; they’re intricately linked to our neurobiology and our physical health.

The real trouble comes when we can’t complete the emotional or stress response cycle. We’re familiar with the “fight or flight response”, the instinctual, ancient neuromuscular reaction to stress. But these days we’re not actually fighting or fleeing. We’re simply activating all the nervous receptors and chemical systems in the body, and then dealing with the result as best we can. Similarly, social conditioning prevents us from playing out the emotional life cycle. We’re expected not to show visible emotions. If we do, we’re often looked down upon. But the result — bottling up emotions and preventing their resolution — does incalculable harm.

On a personal level, managing stress is all about allowing the stress cycle to complete itself in a non-destructive way. Here are the Nagoski sisters’ tips for reducing the physical and psychological impact of stress:

First, adopt some form of physical activity. Walking, rock climbing, dancing in your living room — as long as you’re moving your body regularly.

Second, take time to consciously breathe. The Nagoski sisters describe breathing as “the gentlest way to completing the stress response cycle”. Slow, deep breathing down-regulates your nervous system.

Third, they recommend laughter. Laughter tells your body that the world is a safe place.

Fourth, hug! “Research suggests a 20-second hug can change your hormones, lower your blood pressure and heart rate and improve mood, all of which are reflected in the post-hug increase of the social bonding hormone oxytocin.”

Fifth, have a good cry. Crying won’t address the root of the stress but it does go a long way to reducing the impact of the stress itself. Give yourself time and space to give in to the emotions that are there in any case.

Their final tip is indulging in creative expression. An act of creation, no matter how modest, allows you to externalise conflicts and emotions, to feel in control, to exercise a part of you that is wholly positive and generative.

SA health educator and consultant Richard Sutton, in his book The Stress Code highlights four ways to better manage stress.

First, change the way you think about it. Acute stress can actually enhance our abilities in the short term. Reframing short-term stress as a positive can prevent it cascading into chronic stress.

Second, look at ways to boost oxytocin levels. This can be achieved through focusing on interpersonal relationships, yoga and listening to music, among other methods.

Third, increase vagus nerve activity. The vagus nerve is one of the longest in the body, and interfaces with key systems including the heart, lungs and digestive tract. It can be stimulated through exercise, meditation and controlled breathing.

Finally, Sutton suggests adopting a lifestyle that allows your body to recover effectively from stress. This might incorporate intermittent fasting, increased exposure to sunlight, consuming antioxidants and sticking to an exercise regime.

But the first step, which precedes any tactic to lower stress, is to realise you might be stressed, to acknowledge that you shouldn’t have to feel that way, and to give yourself the power and freedom to make changes that reduce stress. As my human resources colleague is fond of saying: “It’s OK to not be OK. We are, after all, in this together.”

• Fatima Newman is the Group Chief Risk Officer of EOH.​