#literally stating that empathy + emotions are what cause burnout when working in the mental health field

[bioethicists]

it's actually terrifying how quickly the concept of self care (originally a radical concept rooted in the black panther party's efforts to support other black ppl living through racism) became another tool of self-management which is viewed as both a moral obligation + an individual responsibility. businesses + employers + other institutions now easily wield it as a progressive way to say "if you're upset about xyz, make yourself get over it". "we are going to treat you like shit + you need to learn how to cope with that or else you're doing something wrong"

i have seen job listings where "ability to practice self care" was listed as a requirement for employment. as a case worker, we were repeatedly drilled on "self-care" as a response to unconscionably high case loads, traumatizing experiences, dead end job obligations, + poor living conditions due to subpar pay/high stress. my clients would go to appointments regarding their evictions, food insecurity, active domestic violence situations, etc + receive tips on "self care" without any tangible community, legal, or structural support to follow.

everyone absolutely deserves to care for themselves + it is useful to circulate affirmations + advice on how to do this. this should happen within communities, through a sincere concern/love for one another, as a way of helping everyone live the best life possible while we work towards total liberation. it should not be a replacement for caring for one another!!! it should be one of many ways of caring for one another!!!

[lk-mitogen]

mental health rant

A friend of mine had an explosive breakdown at work today, and he got into a lot of trouble for it (he yelled at an R4 and an external doctor, both of which are...wayyyyyy higher up in rank than we are lmao, we’re at the bottom rung or lower). Talking to him and his girlfriend and another friend individually, I got the gist of why he did it -- his parents are divorcing, he has financial issues because of it, he’s lost faith in becoming a pediatrician and now has no idea who he wants to be, we work under insane pressure every day and no one gives a shit except when we fuck up, etc etc -- and I remembered me in my first year and a bit of med school, how I was just like that, because my own parents were divocing and it was hellish, and people came to know me as “that person who’s always fighting with the teachers” because I didn’t give a shit who you were, if you were wrong I told you and gave you twenty citations to back up my opinion, and it was just disruptive and offensive and it absolutely made me no allies.

He wasn’t wrong to get angry, to get irritated, but there are ways of expressing it that are better and more productive, but the reason I can tell that is because I’m in a better place now.

And like, he’s not the only one. My best medical school friend had a prolonged breakdown from last year until very recently, and it manifested as panic attacks and fainting spells and she would literally tell me “I have to get fresh air” and leave me alone in the emergency room with 20 patients because she just couldn’t handle it anymore, and I hated her a little bit for it, not gonna lie, she abandoned me when I really fucking needed someone to help me over and over and over, even in the middle of a goddamn surgery once, but I understood, I got it, and she got help and she’s better now, and she’s an impeccable doctor, whipsmart and attentive, I’d consult her anyday.

And like, this guy’s girlfriend has lately been complaining about nonspecific abdominal symptoms, and she keeps wanting to find a medical explanation for it, but I know it’s psychological, because she’s dealing with the same stress we’re all under PLUS her boyfriend is going absolutely nuts and in a violent way, it’s not the first time he yells at people when he’s frustrated, it’s just the first time he did it to people high enough and emotionally alien enough to him to report the shit out of him for it, and she’s his onlly emotional support, he’s the kind of boyfriend who would say “if you leave me I’ll kill myself”, so good luck with that sort of insane pressure, even if you have enough money to pay for your own transportation and food without difficulties like some other people have.

Another friend keeps sleeping in, she just can’t get up, I keep telling her put!! an alarm!! earlier!!! and she swears she does, but she says she can’t help herself from turning it off, because she “self-sabotages”, and it’s so!! fucking!!! frustrating!!!! because again, she leaves me to handle the 6:45 am handoff alone every. single. day. because she can’t get up and she arrives at 7:20 am with coffee and an apology and I gotta grit my teeth and bear it, because I GET IT, i really really do, she’s under a lot of stress and it manifests as self-sabotage, like, boy do I get it, I’ve been there, so I try to be kind and understanding and patient but. My god. I legit tune her out now whenever she starts apologizing because I’m 99.999% sick of it. And like! She’s a great doctor! Her bedside manner is A++ I admire her so much for it, and she genuinely cares for our patients, even the worst of the lot, I really wish I had her empathy (only not really because that’s where her self-destructive tendencies come from, I think). Basically, she’s a great person, just. Man. Wake the fuck up on time, PLEASE.

And this other guy, another part of our team, is a total flake, he keeps manifesting nonspecific symptoms like MY JAW HURTS I GOTTA GET MY WISDOM TEETH PULLED OUT!! one day and MY ABDOMEN HURTS I CANT COME TO WORK I THINK I HAVE APENDICITIS!!! and fucking shit like this every goddamn week it’s something new, and he’s on so many different medications for depression and anxiety and sleeping and staying awake and he’s gained easily 20 kilograms this year and I feel for him, I really do, his life is spiraling out of control and he’s clawing the walls all the way down to rock bottom, and I can see it, everyone can see it, but he’s too flakey to ever get anyone on his side, and part of me wants to tell him, buddy, take a sabbatical, but the problem is, he already took one so he can’t take another, and he’s burned me too many times and not reciprocated emotionally enough for me to reach out and help him, because I will drown right alongside him at the rate he’s going.

And then my other friend!! Whom I care about! A lot!! she’s also super empathic and kind but. SHE IS. SO GODDAMN SLOW. AT EVERYTHING. In the time it takes me to see 6 patients and write their SOAP notes she’s done one, and she’s not the sharpest tool in the box, she sometimes suggests treatments that are...not the correct ones, and so I gotta go and help her out, talk it through with her so she doesn’t heck it up, and she’s super cool about it! But!!! SO GODDAMN SLOW!!!!! PLEASE! LEARN TO BE MORE EFFICIENT!!! Even though I know it’s all a symptom of burnout, too, even I’m not cold-hearted enough to not realize it.

We’re all just. Shambling through this year, trying our best, and our best manifests in different ways when under stress, sometimes it’s just showing up to work. Sometimes it’s just managing to write the note, even if it takes you hours. Sometimes it’s asking your buddy if they can cover you so you can go cry in the bathroom for five minutes and then come back. We’re all doing our absolute best to be here and attentive and empathic, and I am really proud of everyone, but I’m also really sick of being the most sane person on the team. A selfish childish part of me is like, I WANNA HAVE MY BREAKDOWN TOO DAMNIT!! But I’m too old for it, and I’ve trained myself quite well to handle my meltdowns in efficient ways, productive ways, so I can get back on the horse quickly and in a stable manner. I’m proud of me for that too, but it does get tiring, having all parts of my team leaking anxiety and depression and stress in psychosomatic ways.

So I’m going to give in to my desire right now and have a very condensed breakdown rant and hopefully get all my high octane frustration out in one go, and then parse it out once it’s text.

For the past 10 months I’ve lived through the best and worst of people. I’ve given folks CPR to the point where their ribs break under my hands, I’ve had to fist a lady’s inverted uterus back into place in the most body horror moment of my life, I legit feared for my life when this dude going through withdrawal physically threatened me, I’ve delivered an extremely deformed baby with gastroschisis manually and their guts were spilling over my hands and though it didn’t die in my arms it died about ten minutes later in mom’s and it was sad as FUCK, I’ve had 13 12 11 and 10 year old girls delivering babies because their brother cousin uncle foster dad abused them and abortion is illegal in my stupid fucking hyper catholic state and this is a never ending cycle cause mom was 14 when they had them and on and on and on, and this other time I was the only fucking doctor at a public hospital once during an overnight shift and I had to suture this guy’s toes back on having 0 prior experience suturing ANYTHING and they fell right off the next day because I didn’t know what the FUCK I was doing and I still feel fucking awful about that, and at that same fucking hospital some IDIOT put formaldehyde in a saline solution bottle and this poor surgical nurse accidentally poured it into some poor patient’s open abdominal cavity IN FRONT OF ME and the fucking suction didn’t work because that public hospital is a piece of SHIT and that patient totally died and the resident told the family it had been something else and I WAS THERE and it was BULLSHIT, and COUNTLESS other horrible, truly horrible, absolutely horrible things, and I’ve tried to take all of that shit and learn something from it, make something good come out of so much, so much, SO MUCH awful, and I’ve patiently, patiently, patiently tried to tolerate my collegue’s breakdowns, and their eternal lateness, and the residents yelling at me, and the external doctors telling us we’re never going to be anything worthy, and I think I’ve been doing a good job of it, to be honest, at this point I feel like I’ve become this politely smiling shell of myself to survive it, because a part of me feels like I’m living in an alternate dimension where morality and ethics and laws no longer exist, because they simply do not apply anymore, someone has just taken all of that important stuff and dismissed it to be kindergarden stuff, and I gotta nod and go with it or else I’m going to be my friend saying “i need air” and leaving, or “i self sabotage like this” and sleeping in, or “i think my wisdom tooth is aching” and taking the day off or just, simply, EXPLODING at everyone until they kick me out, and like

a big part of me is MOURNING the fact that I’ve become like this, that THIS is what becoming a doctor means in my country, that THIS is the type of formation they require of us. This horrible automaton of a person, that is a symbol of so much goodness but underneath it it’s all lawless shit, it’s all under the water shit, it’s all cover everyone’s fuck ups type shit. I hate it. I hate what I’m becoming. This person that can talk about all this and kind of go “yeah, I guess it’s objectively awful, but have I told you about [this even more awful event]?” because if you play that game there’s always a worse story, there’s always lower, and lower, and LOWER.

I’ll always be glad I chose to study this career, for all it’s morphed me into something I never wished to be. Because I can wade in these muddy rotten waters and help my friends and my family navigate it, I can help strangers and underprivileged people navigate it, I can help all of them from my insider privileges, to make their experience better than it would have been without me, more efficient, more smooth, more right, correct, lawful. I can’t help everyone, and I’m human and I’ll fuck up now and again too, because I’m learning, but I know, firm in my heart, that wherever I go it will be better that I was there than if I wasn’t.

Even if it’s just because the bar is so fucking low it’s difficult not to do better, believe you me, a lot of my colleagues are so fucking burnt out that they somehow still do it worse, and I’ve seen it in external doctors as well.

I’ll take all of these horrible awful no good experiences and I’m going to do better, I’m already better, I will make people have a better experience when they are going through the worst parts of their lives. Even if I had to mess myself up a lot to survive it, I think it’s worth it to spend this one life of mine doing this. I really really do.

[chocolate-brownies]

There’s a difference between a period of bad days, which we’ve all encountered, and serious burnout. Burnout is something that creeps up on you. Imagine a leak in your bathroom pipe that has been dripping unassumingly behind the walls for months or even years. One day, the pressure becomes too much, the pipe ruptures, and that water comes bursting through the walls with devastating results.

It’s when every day seems riddled with strife and anxiety until you reach that tipping point where all things seem futile and you find yourself at the point of giving up. To put it in simpler terms: Burnout is a bad day every day.

Look, bad days happen to everyone, and they can certainly snowball. A bad day can become a bad week. A few bad weeks can lead to a bad month. What makes a bad day (or collection of days) differ from burnout, however, is that you know in your heart you can bounce back. Even in these tough patches, you can see the proverbial light at the end of the tunnel, and you can resume (albeit not always easily) your life and still derive enjoyment from it.

Genuine burnout leads to an inability to successfully function on a personal, social and professional level. It steals hope. It squashes motivation. It, quite literally, sucks the life out of you.

Burnout is not so kind. Genuine burnout leads to an inability to successfully function on a personal, social and professional level. It steals hope. It squashes motivation. It, quite literally, sucks the life out of you.

So, how do you know if you’re totally burnt or, perhaps, getting close? There are three telltale symptoms that almost all burnout sufferers find themselves facing:

Three Telltale Signs of Burnout

1.    Emotional and physical exhaustion: People with burnout usually describe experiencing a complete lack of energy that manifests itself physically. Some are even diagnosed by their doctors with Chronic Fatigue Syndrome. Regardless, this troubled state results in a debilitating feeling of dread for what the day will bring, even on days when no major work or personal responsibilities loom. Basic tasks and, sadly, even things that would normally provide joy become chores. Surprisingly, though exhausted, people with burnout often have trouble sleeping to the point they develop chronic insomnia. This inability to rest and recharge makes it harder to concentrate and focus, which eventually shows up in physical forms, such as panic attacks, chest pain, trouble breathing, migraines and stomach pains. These symptoms become so severe and disruptive that it becomes impossible to cope with the challenges (and even pleasures) of daily life.

2.    Detachment and cynicism: Those suffering from burnout tend to become perpetual pessimists. They go well beyond seeing the glass as half empty. For them, the glass is totally empty and there’s zero reason to try and fill it. Feelings of worthlessness, hopelessness, and an inability to accept consolation from others or connect to the empathy offered by others is commonplace. They retreat into themselves and resist socializing. Eventually, fueled by a desire to shut everyone out, they move to a state of total isolation and justify their retreat with a cynical approach to life, family, friends, work, you name it. The feeling of hopelessness transitions into one of helplessness and creates a default response to every suggestion in the vein of “what’s the damn point anyway”.

3.    Feelings of self-doubt and ineffectiveness, lack of accomplishment: Sometimes people experiencing burnout are still capable of going through the motions. They still make it to the office. They still get the job done. They still join the family for dinner and handle the household duties. However, they do it in an almost robotic manner. There is no zest, no pleasure, and, therefore, performance suffers. They find ordinary tasks take longer. They procrastinate and invent excuses as to why they’re less effective. They get frustrated at things that were once easy and now seem overwhelming. Sure, they’re physically present and on some level functioning. But emotionally and mentally, they’re a shell of their former selves and are keenly aware of their inadequacy. This, as you can imagine, only perpetuates those feelings of exhaustion and detachment.

Now before you freak out and come to the immediate conclusion that you’re suffering from all the above, relax and take a breath.

We have all experienced one or more of the signs of burnout in our lives. In fact, they seem so darn familiar to us because in various degrees they are simply a part of dealing with everyday life and its stresses. Remember, the difference between a difficult period and burnout is a matter of a few degrees, a few drops from that leaky pipe behind the wall.

Maybe you’re having a bad stretch right now? That doesn’t necessarily mean you’re burnt out. I’d like to share a few stories from my own life that might resonate and offer up a few tips that can help you recognize and even avoid serious burnout.

A Personal Story About Burnout

My first experience with the creeping onset of burnout happened during the separation period in my first marriage. My ex-husband and I were still cohabitating with my toddler son while the divorce was being finalized. I was working full-time, active in my community, weathering a long commute to work and handling a pretty high-stress job. On top of this, I was trying to keep some sense of normalcy and civility in the home so my son would enjoy a healthy and nurturing environment. As you can imagine, this wasn’t easy while going through such a tense and uncomfortable situation. I found myself not eating right. I stopped meditating (something I swore I’d never do). I was going at an unsustainable pace and began cutting myself off from the friends and family who once filled me with so much joy.

Well, one morning I woke up to find that I could not see. I was completely blind in both eyes. My entire field of vision was nothing more than piercing white. I didn’t know it at the time, but I was experiencing what’s called a “white out”. What I did know in that moment was abject fear of never seeing my son again. After many exams, diagnostic tests and doctor visits, I was diagnosed with an autoimmune condition called Uveitis. My doctors were eventually able to treat the symptoms and I regained my vision.

Still, it took losing my eyesight for me to finally acknowledge the fact that I was burning out.

However, here is what I learned since my diagnosis 13 years ago and as I’ve undergone continuous treatment: the onset of the disease was likely triggered by a prolonged period of stress (and eventual burnout). Autoimmune conditions are prone to flaring up with stress. In fact, in the years immediately following my diagnosis, every time I stressed out I would flare up and partially lose my eyesight again. It got to a point where I knew I needed to regain control of my lifestyle, diet, mindset, and surroundings if I wanted to ensure I could gaze upon my son’s beautiful face as he grew up. Fortunately, with the support of great friends and family and a return to my meditation practice, I was able to make real changes in my life. Still, it took losing my eyesight for me to finally acknowledge the fact that I was burning out.

Recognizing Early Signs of Burnout

If you learn to recognize the onset of burnout, you can minimize the effects and possibly prevent it: The second experience of burnout I’ll share happened in 2016 when I was the president of a mid-sized private firm with a few thousand employees. I was commuting close to three hours per day, was very involved in my son’s school and extracurricular activities, plus I had ramped up my political activism to campaign for the candidates and causes I held dear.  Fortunately for me, unlike my brush with burnout over a decade earlier, this time I was in a wonderful marriage that was supportive and loving. I had a daily meditation practice bolstered by an expansive and caring meditation community. I was far more in tune with my body and mindful of what it was trying to tell me. I first noticed the change at work. I began feeling unmotivated and tasks that used to take me a few hours were suddenly difficult to complete. At the end of each day, I left the office feeling as though I’d accomplished nothing significant.

I started to dread Sunday evenings and began to feel physically ill driving into the office on Monday morning thinking of the week ahead of me.

During evenings at home and on weekends, I would feel zapped of energy and any desire to do the things that once gave me joy. I started to dread Sunday evenings and began to feel physically ill driving into the office on Monday morning thinking of the week ahead of me. I was fortunate enough to have the opportunity to take a two-week vacation in the summer with my family and head deep into nature. On the evening before my flight back to reality, after two-weeks of decompression, deep thought and spending the week reconnecting with myself and my family, I got so violently ill that I spent the entire night in the hotel bathroom just thinking about having to go back to my “old life.” I recognized that I was on the fringe of experiencing burnout and that my priorities in life were taking a backseat to a well-paying job.

I was ready to make a change, and, with the support of family and friends, decided to resign from my position, take a chance at fulfilling my dream of being a mindfulness teacher, and relish in the last few years that my son would still be at home before heading off to college. I resisted the black hole of burnout by recognizing it, knowing what the consequences would be if I got sucked in, and averting them by listening to my heart, my body and my mind.

How to Navigate Your Way out of Burnout

Speaking from my own experience, I highly recommend two things.

Commit to a daily meditation practice of at least 10 minutes, twice per day. This will help you reduce daily stress, become more in tune with your emotions, and hear what your heart, mind and body are telling you. Second, if you notice the signs of burnout are particularly persistent and troublesome, take at least two consecutive days off to detach from work, family and other stressors (FYI, this is where your self-care community can step up to help you make that happen!). One of my non-negotiable habits is my meditation practice. When I get quiet, everything gets really loud – my mind, my body, my gut, intuition. Each part of me begins to give me feedback in these moments of silence and solitude.  I would strongly recommend making meditation a cornerstone practice in your life, one that you can lean on in difficult and overwhelming times.

Take time for yourself when you can. This was my saving grace. If possible, find a place where you can’t do any work, take work-related calls or even check emails or texts. If being in nature brings you peace, immerse yourself in it. If you need a break from your family, find a way to make it happen. Sleep, nourish yourself with healthy food, read books or listen to podcasts, or maybe, don’t do a damn thing. If after those few days you don’t feel the weight lifted and are still dreading what lies ahead the next day, you very well might be suffering from burnout. If so, ask yourself if you’ve ever felt this way before; see if you can understand what led you to this point, and try to determine how long you’ve been feeling this way. Look to the past to understand if it’s just stress or if it may be more than that. If you think it may be burnout, or, even if you aren’t quite sure, it may be time to seek professional help, or, at the very least reach out to discuss your concerns with your inner circle.

It’s also important to remember that communities of care work both ways. There are others in your group who may be experiencing burnout. This is where you can step up. Check-in and connect with a friend you haven’t seen around in a while. Who knows, you just might be the one able to help fix that leaky pipe before it bursts.

And if I can offer one take-away, it’s this: Burnout doesn’t make you weak. It is possible to bounce back from burnout but you will need the help of others. You will need to commit to big changes but change, as you know, only needs to be begin with one step.

The post Is It a Bad Day or Is it Burnout ? appeared first on Mindful.