Johannesburg – Burnout, the state of absolute exhaustion resulting from chronic stress – is considered a work-related condition but with lockdowns and remote working blurring the lines between home and office and classroom, “pandemic fatigue” or “lockdown burnout” is a reality in the “new normal” of Covid-19.
As people juggle working from home with running a household, childcare and assisting children with online learning, along with fear and anxiety about Covid-19 risks, uncertainty about jobs and finances, and lack of access to their usual de-stressing activities, the pressures of daily life are greater and so too the risks of burnout.
Professor Renata Schoeman of the South African Society of Psychiatrists (SASOP) said while burnout was considered an “occupational phenomenon” by the World Health Organisation (WHO)[i], health professionals were now seeing cases of burnout that were not solely work-related but caused by the multiple stresses of living during the Covid-19 pandemic.
One of the keys to preventing burnout is pursuing a healthier lifestyle and with national Healthy Lifestyle Awareness Day on 22 February, finding the balance is now more important than ever, she said.
Burnout has three main elements, she said: a state of energy depletion and “absolute exhaustion”, emotional and physical; “depersonalisation”, feelings of being disconnected from your job and from other people; and, thirdly, a sense of “reduced personal accomplishment”, feelings that one is working harder but getting less done and lacking the sense of achievement that usually comes with completing a challenging task.
“In the work context, burnout is usually the result of an imbalance of resources and demands – what is expected of you at work is out of balance with the resources available to do the job, such as time, finances, and intellectual resources such as training, mentorship and workplace support systems.
“That is even more apt now, where we have the limitations of working from home, with a home office not as well equipped as the work office, but so much more is expected of us and we are juggling work, family and household needs even more frantically than usual,” Prof Schoeman said.
The symptoms of burnout include chronic fatigue and tiredness along with difficulty sleeping, loss of appetite, irritation, anxiety, emotional distress, feeling emotionally drained, feelings of helplessness and hopelessness, frustration, despair and feelings that life is not worth living.
Many of the symptoms overlap and are similar to symptoms of depression and anxiety.
“Because people on the verge of burnout feel the need to keep going even though they are exhausted – a state of “relentless overwork” – by the time they consult a health professional, burnout has often already become depression or anxiety disorder,” Prof Schoeman said.
She said clinical depression was often misdiagnosed as burnout, with the person being booked off work for a month or more to rest and recover, but without proper evaluation, a correct diagnosis and treatment such as therapy and/or medication. A few weeks’ “rest” would not address the underlying issue.
“If nothing is done about treating the condition, and nothing is done about the work situation, there is then the risk that after the period of being booked off work, the person returns to work and the same factors are still there that led to burnout in the first place.”
Prof Schoeman said the onus was on both employees and employers to put strategies in place to prevent burnout.
From the employer’s side, it could be necessary to address clarity of job description, redistribute workloads or rotate posts, provide training or mentoring, improve support systems, or deal with other causes of workplace stress such as working conditions or interpersonal conflict.
“With people working at home, employers need to ensure that employees have the necessary equipment and resources at home to do the job, such as wifi connection or a printer. Also important is making expectations clear (e.g. with regard to online availability and working hours), asking for and providing regular feedback, keeping up communication within teams and continuing the social aspects of work, albeit virtually,” she said. Productivity should also be measured in terms of output and not necessarily “online hours”.
However, she said, it was critical that employees also take responsibility for their own stress management.
“Avoiding burnout is a classic case where prevention is better than cure, and lifestyle is the most effective preventative strategy. Improving your emotional and mental fitness, as well as physical fitness, helps to build resilience which means you can handle stress better and cope with setbacks. Resilience enables you to feel in control of your life, and it’s that feeling of a lack of control that contributes to stress and, ultimately, burnout.”
The always-on nature of work in the digital age is intensified when home is the office and people aren’t ending their work day by leaving the office, so managing use of technology is key and Prof Schoeman advises setting aside “tech-free time”.
“Turn off notifications, switch off the phone and computer. Don’t let technology – and work pressure to be contactable all hours – rule your life.”
Prof Schoeman refers to her burnout prevention strategy as “SEEDSS” – Sleep, Exercise, Education, Diet, Socialise, Spirituality – and said these were also important elements in dealing with “lockdown burnout”:
• Sleep – boosts the immune system and helps foster both mental and emotional resilience.
“Sleep in many respects is a built-in biological source of resilience and the ability to bounce back, while lack of sleep sets the stage for negative thinking and emotional vulnerability,” she said.
Sleep gives the brain some “down time” to process all of the information we are bombarded with daily and store it in our memory banks. This way, it is available and accessible when it is needed. Having enough sleep improves concentration, creativity and assists with learning.
• Exercise – physical exercise directly benefits the brain and boosts the immune system.
Thirty minutes of moderate exercise daily is recommended.
“Not only does exercise decrease depressive symptoms and boost positive emotions, under lockdown conditions it’s also important for your mental health and coping to get out of the house and have a change of scenery – safely masked and physically distanced – at least once a day.”
• Education – just as physical activity keeps the body strong, mental activity keeps the mind sharp and agile.
The more we think, the better our brains function, lifting the mental “fog” that is a symptom of burnout, says Prof Schoeman.
She said “education” in this sense could be learning a new skill – with plenty of options to do this formally or informally online under lockdown – or giving yourself daily mental challenges that stimulate the senses and shake up daily routines. This could be getting dressed with your eyes closed, using your left hand instead of your right to brush your teeth or type on your phone, or listening to music and smelling flowers at the same time.
• Diet – the foods we eat manufacture the chemicals that feed our brains, while obesity increases the risks of mental health disorders.
Follow a healthy diet and, most importantly Prof Schoeman said, pay attention to consumption of alcohol and substances – these can become a “crutch” to cope with the stress of lockdown and boredom, and also contribute to the development of addiction and mental health conditions.
• Socialise – social connectedness, physical connection, laughter is all important in decreasing stress, boosting positive emotions and improving mental health and cognitive functioning.
• Spirituality – whether in the form of organised religion, meditation, or mindfulness, the knowledge and belief in a bigger purpose has been show to increase happiness and boost health and longevity.
“Even though we have to practise physically distancing and, in some cases, self-isolate, we need to make sure not to isolate ourselves socially, and this is where technology can play a really positive role. Maintain social and family connections with a phone call, a Zoom chat or video call, because they are vital to our mental health and provide us with the support network to cope in these strange and challenging times,” Prof Schoeman said.
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