The road to Burnout and beyond is a long one. Making the journey I’ve learned a number of things. I share my story to encourage others to act before they, or someone they know, go where I have been and, to help those who have already checked-in to Burnout Hotel.
According to the HSE’s workplace injury statistics, 826,000 people suffered from work-related stress, anxiety and depression last year. I was one of them.
I was told I was suffering from Burnout and given a not fit for work due to workplace stress note in April 2019. I wasn't considered fit to return for five months.
When I first returned from my stay at Burnout Hotel, due to the impact of stress hormones on my brain, all I could manage was 2hrs/day every other day. After two weeks I had a break (holiday booked) I then gradually built up my hours until I was full-time. All told that took 2.5 months.
This month I have been back in work full-time for a year. It’s a big marker for me because when I first went back, I didn’t think I would ever work full-time again.
Don’t misunderstand me.
Although I am working full-time, I am living with Burnout scars.
A year and a half on I know I do not have the mental ability that I once did. I can not use my cognitive, thinking power how I used to. If I try to do what I could before, I have end of days where I cannot do anything other than sit and stare, my brain fried.
In the hope that someone might take action before they end up where I have been, I am sharing my story.
Jump to items 11-19, if you have checked-in to Burnout Hotel.
1. There are two parts to the burnout equation
I was not alone with an escalating workload. I knew others who were struggling to keep up, pulling long workdays and feeling just as overwhelmed but they didn’t check-in to Burnout Hotel.
According to research (Demerouti et al, 2001), whilst exhaustion, a consequence of intense physical, cognitive or emotional demand/strain, is a component of Burnout, it only results when workplace factors also known to support well-being and engagement, are low or lacking.
In short, it’s the combination of high job demand (let's call them drainers) and low job resources (sustainers) that leads to workers checking-in to Burnout Hotel, a place to recover from exhaustion, futility and loneliness.
2. You don’t see the edge before you drop
Everyone I have spoken to who has been off with workplace stress and/or burnout says the same thing. You don’t realise where you are in relation to the ledge until you fall.
There is no barrier, no vertigo, no sign that you are close to the edge.
Yes, you have a sense things aren’t right. You are not yourself. You are going through the motions, witnessing but not engaging, feeling more and more distanced from your role, colleagues and life in general, nothing holds meaning and all feels worthless, including you.
As a responsible person you push on thinking you can manage, as things will come right someday (workload will reduce, vacancy will be filled, project will finish).
Only, before that day arrives, something happens and you can’t pretend to yourself or others anymore. We cope until we don’t, I heard someone say recently.
If you know that things are not right with you, your coping activities are no longer delivering or things are getting worse, please either ask for help with your load or put it down and recover.
A stitch in time saves nine.
3. The body knows and keeps the score
The 'stress response' aka 'fight/flight' evolved to help us deal with short-term threat, when the danger has passed the body's system returns to normal. However, if the survival response stays on for too long, the changes that are entrained are harmful to our brain and body (Sapolsky, 2004).
Burnout, like a spent candle, takes time. This means the body’s distress alarm rings for months.
It will likely start with sleeping issues and related fatigue but there are other physical, mental, emotional and behavioral changes that occur over time.
A few weeks into the project that increased my work and cognitive load (seven months before I was signed off) I recognised that I was suffering from the physiological symptoms of stress (not sleeping through the night, high sense of alert, sighing a lot, emotionally on edge).
To actively support myself in dealing with the additional demands, I put in place a set of self-care recovery actions when I got home each evening – low lighting, nutrition rich food, limited tech, ambient music, no taxing conversations or thinking.
Had the high workload and subsequent need to work long hours only been for a short period, I am certain these efforts would have ensured I would have coped and not checked-in to Burnout Hotel.
Unfortunately, as things didn’t change, three months later I found myself at the doctor because of various aches and pains. What he began to find through blood markers and scans was that a number of my systems (gastro-intestinal, thyroid etc) were no longer functioning within normal range. With hindsight we know that these were related to chronic workplace stress, they returned to normal during my time off.
And fast-forward another three months, I start shaking on the stairs into work and subsequently collapse. Here was the moment the body said “stop, no more”; no longer trusting me to do the right thing it had taken matters into its own hands.
Even when signed off, I was filled with anxiety whenever I thought about or went near the workplace. This only stopped after three months away.
18 months on my mental functioning is still not what it once was.
According to doctors, my prefrontal cortex (the thinking part of the brain) thinned because stress hormones, glucocorticoids, impact the formation of new neurons in the brain (Briones and Gould, 2019).
This has been the scariest part of my journey back to work and continues to concern me.
“Exhaustion disorder is a brain disease, no doubt about it. Patients often find this difficult to accept. But that is why it takes so long to heal from the disease. Healing brain diseases is a slow process.” Marie Åsberg.
4. We need off as well as on
While physically we can work longer than 40 hours a week, almost 100 years ago Henry Ford discovered (Sky, 2020), confirmed recently by Daniel Cook (2018), that doing so does little for productivity, especially over the long term.
Without adequate rest and recovery, we become increasingly ineffective and if we don't take action we can slide into burnout.
As a workplace mindfulness trainer, I regularly share Professor Marie Åsberg's "Exhaustion Funnel" model and why we need to incorporate ways to recharge into our days and weeks.
Adapted from Williams and Penman, 2011.
The top band of the diagram shows what a balanced life consists of. If work or other demands increase, we conscientiously drop things so that we can focus on what we need to get done. The first things to go are not the chores (I wish); what we drop are activities that we think are optional, nice to-dos.
If the demands continue, we gradually give up more and more, the funnel and our lives becoming narrower and narrower. In the end we are left with just the stressors that drain our resources and nothing to restore us.
Alongside the dwindling of life activities are the accumulating symptoms we experience as we become more and more exhausted.
Looking back I can see that over a six-month period, l slowly gave up nearly every activity that sustained me.
Working 10-12 hour days with up to a 90minute drive each way, I was just about managing to cook myself a decent dinner before getting into bed to do it all again the next day.
I had neither access to restorative, resources at work (no support from manager to prioritise so attempted to do everything; no team with whom to share the load, I even took on part of another’s job when they left; no means to speed up recruitment, the vacancy was later gapped) nor time to recharge with my usual outside of work activities.
I was so drained and numb I didn’t feel like it anyways.
It’s entirely natural to make space for whatever has arisen and needs our attention. It's a coping mechanism. The thing to note is it is not a long-term thing, we can do it for awhile, a season maybe but not longer. We need those nice to-dos. They are not selfish-me activities, they serve a very necessary, energising function.
PS. don't forget to take regular recharge breaks throughout the day, they are just as important.
Related: Are your breaks working?
5. We always have a choice
This has probably been the hardest thing for me to learn. Achievement orientated, programmed to not let others down and obey positions of authority, it was difficult to see I had played any part in arriving at Burnout Hotel.
For a long time I held others 100% responsible for what had occurred.
I believed I had been as responsible as I could be. In the early days I had asked for help twice to prioritise my expanding workload, later on I had waved the flag of overwhelm, logged and repeatedly shared how unsustainable my hours were and identified a need to create a new role. And in the name of delivery, as no one had responded, I thought I had no choice but to continue doing the best I could.
Yes, you can say the employer had not upheld their duty of care but I wasn't being very responsibility for me. This taught me points 6. and 7. too.
There was a job to do and it had my name against it. But when we say yes to one thing, we are saying no to something else. When I said yes to that workload and doing those ridiculous hours, I was saying no to me.
When I admitted I could have taken better care of myself that was the moment I was empowered to look for the lessons and implement a plan so as not to Burnout again.
6. The only person who has your back is you
It doesn’t matter what anyone says, in reality each of us enters and leaves this life alone. And, although you might wish it isn’t so, the only person we can truly rely on is ourselves.
Recognising this truth means we are responsible for self-care; no one else can look after your health for you. This means not just our physical health but our mental well-being, as well.
Work should challenge and stretch, not harm.
Identifying, staking and claiming boundaries is a necessary part of this. But laying down boundaries in the workplace can be hard, especially as the power in the employee/employer relationship can feel very uneven.
We were appointed to do our job: we are not expected to say we can’t.
Nevertheless, we must speak up and maintain our boundaries if the task is bigger than the time allocated, there is an ongoing knock-on effect on things outside of work and/or your health is compromised.
Both you and your employer want you fit for work; therefore it is in both party’s interests that you draw the line.
7. People see what they want to see
If output is what is important then the only time someone may step in is when output does not meet expectation. Unfortunately, high functioning adults can continue to perform even when struggling.
Masters of disguise we can hide what is really going on, even to ourselves.
However, there are tell-tale signs: missing non-essential meetings, irritability or other emotional outbursts, unexpected errors, cynical remarks, a loss of decisiveness, reduced engagement.
Such signs can be missed if others are too busy themselves or caught up in their own issues. And whilst colleagues can’t un-see what they see, they may pretend they didn’t see, when they don’t know what to do. I said earlier we always have a choice so do managers and colleagues.
This means if you are struggling you cannot wait for someone to rescue you, you need to save yourself which will involve talking to those who can assist - friend, colleague, manager, EAP advisor, Mental Health First Aider, GP.
The earlier you do, the sooner recovery can start.
NB Some people need you to stand and shout until they notice (I’ve actually seen this agreed with a manager in a workplace wellness action plan!).
8. The light at the end of the tunnel is a mirage
When we are in a difficult place, it helps if we can see the end is in sight. However, in my experience, the light at the end of the tunnel can be ghosted, gas-lit or no more than a trail of breadcrumbs.
If you are in a tunnel not of your own making, you have no control over its length. But you can control how you respond to finding yourself there; you can decide how long you are going to spend in it before you break for surface and create your own light.
When you are in the Burnout Tunnel, there is always one more thing that needs doing or a reason why things can’t change so the light goes further away. These are distractions from finding that alternative way out.
Start looking around you. Find the light. Make your own exit.
9. The resilience tree analogy is unhelpful
Those who talk about resilience say we can learn to roll with the punches and bounce back. They often use the analogy that a tree bends in a high wind.
This can mean that admitting you are struggling, acknowledging work-related stress or checking-in to Burnout Hotel can leave you feeling ashamed because you think you are somehow lacking resilience.
I have three things to say about this:
1) You use the resources you have access to;
2) You cope for a long time before you arrive at Burnout Hotel; and
3) Trees become mis-shapen if the wind blows long and hard enough so too with human beings.
10. Stigma about mental health is alive and well
The reason for my absence was not shared with my colleagues. This led to me receiving odd emails asking why I was off. Some wondered if I had taken an extended holiday, others thought it was a misconduct issue!
I guess that’s why I didn’t hear from many when I was recovering.
The silence continued on my return which was unhelpful as no one knew I was on reduced duties nor how incapacitated mentally I was. Hence I recommend agreeing a form of words with the workplace (see 12.).
Despite the silence, it was noticeable that some gave me a wide berth and actively avoided encountering me, walking another way if they came across me. A month in they told me they were afraid to talk to me.
One person called me “mental” and “nutter”.
It was similar with my friends. Most were really supportive regularly checking-in, offering to spend time with me or just listen, that’s why they are my friends. Others left me well alone.
I am only now telling my family. Like my friends many get it, a few don’t.
People, we have a long way to go.
If you do check-in to Burnout Hotel…
11. Guilt, shame and failure have no place here
To start with you might not feel anything but shock. Shock that you are here in Burnout Hotel and/or shock that you are currently unable to do the things that you once could.
From shock, it’s only a short walk to feeling bad for needing to take a timeout. Yet there is nothing to feel guilty about you have done nothing wrong apart from maybe being too conscientious.
Like I mentioned earlier (Lessons 2. and 9.), you cope until you don't so forgive yourself for landing here. You did your best and, as Ghandi said, as long as we do that there can be no sense of failure.
You also don’t exist in a vacuum. We are always in relationship with something; a situation, person, object. The hot cross bun model often used in CBT shows how we respond to situations.
Hot Cross Bun Model
Adapted from Sweet, 2010.
I made a list of the people who had contributed to my situation and then gave them each a percentage according to the role they played in what happened. I soon saw I did not hold the majority share. Give that a go, if guilt comes to visit.
12. It's best to agree a form of words about your absence
As soon as you are able, I recommend agreeing a form of words that everyone is to use about your absence. Let them know too if it’s OK to hear from people.
You might appreciate a card, I would have.
Think about whether you want people to contact you, if you want to contact colleagues and when/how often. And don’t be afraid to change that.
Maybe it will just be one person, maybe it will be your team.
13. Recovery = rest + rediscovery
Having strived for so long, it is very hard to surrender to what the body needs which is to rest, to allow the stress response to switch off.
This means taking things easy and creating a really simple daily routine that includes things that feel good.
From the beginning of my recovery, I endeavored to go to bed, wake and get up at the same time. I also aimed to get dressed and to go outside each day. Sometimes just to sit but in time I started to go for a daily morning walk (I still do). These activities helped me navigate my day.
Everyone’s recovery is different.
Use the time to experiment and rediscover the people, activities and things that energise and please you, even if it’s only a tiny weeny bit for just a moment.
Once found build boundaries around all of these; they are sacred, sustaining wellness actions and must never be let go of again.
14. The Return to Work (RTW) procedure may not be great
Workplace activities are managed with policies, procedures and processes; sickness absence is no different. At some point during your time off work, usually after a few weeks, a policy and procedure will kick in.
For the individual who is recovering, how human this feels (it’s a procedure afterall), depends on the quality of the existing relationship between themselves and their manager, how comfortable the manager is with mental health issues and what role HR takes.
I have heard both terrible and terrific stories.
First RTW conversations that had to be face to face with no option for a companion as support for the person who was recovering.
RTW conversations where the person who was recovering from work-related stress was told by their manager that they wouldn't be struggling if they were more like person X. Bruised already, they left the meeting punch-drunk and ashamed.
Wrong RTW letters being sent out telling the Burnout sufferer that they must attend a final stage meeting where the “grandparent manager” will decide their future with the organisation. Causing great distress and compounding feelings of disengagement.
RTW meetings where the Burnout party was accompanied by a friend who stopped the meeting when it became distressing for the employee.
RTW meetings where a wellbeing coach was present who proposed return to work adjustments that would benefit the person’s recovery.
When it came to my situation, a few weeks into recovery I was still shell-shocked to find myself where I was and I certainly was not ready to engage with my manager or the RTW process. I didn't know whether I could tell the workplace that I was not ready for such a meeting so I lied and said I was.
From that moment on, I often felt like I was trying to walk down an up escalator where the top was going back to work. I knew we were following a procedure, I felt very much that I was being processed.
What helped later was creating a return to work plan that was informed by helpful conversations with my doctor and counsellor, as well as developing various coping strategies, some of which are still in place today.
15. The first time back to the workplace is hard
Returning to a place where trauma has occurred is difficult. Returning to the workplace where you experienced burnout will not be a walk in the park so be prepared, arm yourself with strategies that will support you.
My first time back on site was for a third Return to Work meeting. Prior to that we had met in a public space and in HR’s building. The day I was to meet in our office building apprehension (encouraging me to go slow, hold boundaries and be prepared) accompanied me all morning and throughout the afternoon meeting.
Prior to the day, I identified coping strategies to make it through the door:
I wore clothing I felt comfortable and confident in;
I met a colleague for lunch who then walked with me to the office;
I met my manager outside. This meant a) we could go for a walk and talk informally before the formal RTW meeting with HR and b) I didn’t have to use the stairs to reception where I had collapsed, on my own.
I told another colleague I was coming in and arranged a chat afterwards.
As a reward, I planned an early dinner with my partner in a new restaurant nearby. This gave me something positive to focus on.
I recommend that you find informal ways to become comfortable with your place of work before you return, you might do a drive-by, organise meeting up with some colleagues beforehand or drop into the workplace for an informal catch up with your manager.
16. When you think you are ready to return, you aren’t
I knew I had to return one day, I just didn’t know when that would be or how I was supposed to feel. I found this helpful advice "on medical leave for burnout don’t return to work too soon" on a therapist’s website.
She advised when you feel better, wait at least another month then start doing things that are similar to your workday tasks and routine.
When I thought I should/could go back to work, I checked in with myself and discovered I was only able to concentrate for about 5 minutes before it seemed as if my brain went offline. Imagine that!
Over a month, I built up my stamina so that I could read for 20 minutes. I also started getting up at a time that was right for work and driving for the duration of my commute.
Take your time. There is no need to rush back, this is about you.
17. A return to work plan is really helpful
That said, you do not need to be fully well before you start going back to work, in fact returning often helps recovery. However, it needs to be when you feel ready and on terms that will support your recovery.
It is likely if you are in the UK your doctor will give you a “may be fit for work” note stating things like reduced duties, responsibilities and/or hours. But you might also think about changing your start and end times, perhaps because of commute, medication etc. Consider where and how you do your job and who you work to/with.
Consider what contributed to the situation, the HSE workplace stress management standards are helpful here. Discuss what you might try on your return, managers will look at making reasonable adjustments (make sure these are communicated with all who might need to know). Put in place weekly meetings to review how things are working for you. Even if you are a solopreneur, you owe this to yourself.
See your RTW plan as an experiment in working, taking it one day at a time. Be prepared to change things, go slower or stop, if needed.
The sky is the limit when you consider how it might be for you. If you don’t ask, you don’t get.
18. Things may not be the same for some time
To start with all I could manage was a couple of hours of inputting data and running related reports every other day, a far cry from thinking strategically about company communications or wordsmithing blog posts.
I couldn’t answer complex questions, plan campaigns or think conceptually. It felt as if my brain didn’t have the capacity to do any of the things that my role demanded, energised me or provided a sense of purpose.
One day, in my second week back, I stayed an extra 45 minutes to finish some analysis. Afterwards on walking to my car, I realised I was fried and couldn’t drive. I had to walk to a friend’s for a rest. The next time I was in work, I asked colleagues to remind forcefully to leave after two hours.
What I know now is that my prefrontal cortex had thinned. I wasn’t firing as before, it took at least six months to be more like the old me and, even now, there are times when there seems to be no neurons online.
I tell you this so you are not alarmed if you discover it has happened to you.
19. Learn your lesson well
Not only is Burnout Hotel a place to recover, it’s also a place from which to learn and grow. When ready take time to revisit everything that lead up to the need to take time out.
This will help you to identify the “inner canaries” of your stress signature, the signs and symptoms you didn’t take enough notice of last time.
Maybe you become irritable or intolerant, perhaps you get headaches or palpitations, maybe racing or anxious thoughts or perhaps it’s a change in behavior. What tell-tale change can you use as an indicator in future?
For me, it's feeling overwhelmed, that things are out of control and/or unable to think straight, crowded in mind.
Whenever I have those canaries singing, I know its time to review my activities (both drainers and sustainers) and take action.
If after taking action those birds don’t quieten, I know that I need to find other ways to manage my load as either it is too big or the road too long and that includes asking for assistance and asking twice or three times, if necessary.
Take care of you.
May this be of help to those who find themselves here.
I am happy to discuss my experience with anyone who’s interested.
Drop me a line in the comments or use the contact form.
Cook, D. (2008). The 8 Rules of Productivity. Retrieved from https://lostgarden.home.blog
Demerouti, E., Bakker, A.B., Nachreiner, F. & Schaufeli, W.B. (2001). The job demands-resources model of burnout. J Appl Psychol. 2001 Jun;86(3):499-512. PMID: 11419809. Retrieved from www.researchgate.net
HSE, 2020. What are the Management Standards? Retrieved from https://www.hse.gov.uk
Sapolsky, R.M. (2004). Why zebras don't get ulcers. New York: Owl Books.
Schoenfeld, T. J., & Gould, E. (2012). Stress, stress hormones, and adult neurogenesis. Experimental neurology, 233(1), 12–21.
Sweet, C., (2010). Change your Life with CBT: How cognitive behavioural therapy can transform your life. Harlow: Pearson Education Limited.
World Health Organization, 2019. Burn-out an "occupational phenomenon": International Classification of Diseases. Retrieved from https://www.who.int
Williams, M. & Penman, D. (2011). Mindfulness. A Practical Guide to Finding Peace in a Frantic World. London: Piatkus Books.