For an online consultation with Dr. Ioana Silion, access this link.
Dr. Ioana Silion, a primary care psychiatrist and doctoral student in medical sciences with extensive research activity, answered a few questions related to burnout, depression, anxiety and the devastating effects of prolonged stress. Dr. Silion is passionate about niche psychiatric pathologies and has as her personal project the development of a project to prevent burnout at the national level. It is a much talked about topic, but for which there are no coherent prevention plans even in large corporations.
Lately, the term "burnout syndrome" has been used frequently, in public discourse, in the press, but not always in the correct sense. Burnout syndrome represents a negative change in a person's conduct, the way they think, their perceptions, their behavior and is caused by prolonged stress at work. We talk about burnout when fatigue felt over a long period of time - which can vary in time depending on the tolerability of each individual - begins to affect daily activities and even change the dynamics of personal life.
Initially, people who end up suffering from burnout go through intense and prolonged stress. Stress, unlike burnout, is a state of alert that manifests itself through excessive involvement in the workplace, emotional hyperactivity, a permanent feeling of urgency with hyperreactivity. This state can last for months until the body exhausts its resources, energy progressively decreases, ultimately leading to states of anxiety and depressive mood.
Depressive mood and prolonged anxiety gradually lead to a lack of involvement in professional activities, affective flattening, with a feeling of emotional exhaustion, a decrease and loss of interest and motivation for daily activities and a feeling of helplessness, with a decrease in professional performance.
You said that anxiety initially sets in. How does anxiety manifest?
Generalized anxiety manifests itself as a state of fear, of anticipation of discomfort. It often appears when people are criticized at work, do not reach their targets or do not receive their bonuses, as a result of diminished performance and lack of appreciation from superiors.
Prolonged anxiety and a state of permanent tension lead to burnout. Sometimes, people feel a state of tension in the morning, from the moment they wake up. Just the thought of starting a new day demoralizes them, they start feeling tired. As this state prolongs, hyperactivity and hyper-involvement in work tasks decrease and a feeling of physical exhaustion and the feeling that they cannot do anything appears. Motivation and pleasure at work disappear and in this way detachment from work tasks sets in, which ultimately leads to the depletion of emotional resources with the onset of depression.
What is depression and how does it manifest itself?
Clinically, depression is a state characterized by a lack of interest and pleasure in activities that were previously enjoyable. People feel emotionally uncomfortable, cry easily, have low energy, irritability, things that did not bother them in the past now become annoying, they have low frustration tolerance, have insomnia or hypersomnia, eating disorders.
These are things that invade personal and professional life and a functional inability sets in. The person with depression can no longer function and then pathologies from the somatic sphere frequently appear. Most patients initially experience a somatic pathology in the digestive sphere, non-specific abdominal pain, transit disorders, dysphagia, difficulty swallowing, they state that they have a lump in their throat, some lose weight or gain a lot of weight because of this, they end up modifying their eating behaviors. Other times, anxiety is felt at the level of the cardio-respiratory system through palpitations, high blood pressure, even panic attacks with a feeling of imminent death.
When the patient reaches the doctor with all these symptoms, there is a chemical deficit in the brain and in the body, because during stress the hypothalamic-pituitary-adrenal axis is activated, which releases cortisol into the body. Cortisol helps the body in combat situations, for the state of stress that the patient has to face, but cortisol eliminated for a long time causes changes both at the biochemical level of the brain and at the level of the body, determining what is called somatization. That is why functional disorders appear at the level of the digestive or cardio-respiratory system in cases of anxiety or depression.
Patients usually turn to specific emergency services, either in gastroenterology or cardiology, where they are shown that they do not have a somatic pathology and are referred to the psychiatric department. With mental balance, the somatic manifestations will also disappear.
How can patients with depression, anxiety or burnout be helped?
First of all, people need to be aware that mental pathology is treated by a doctor and should not have prejudices or be afraid of associated stigmas, because these can do more harm than the pathology itself. Once they reach the doctor, antidepressant or anxiolytic treatment relieves depression and anxiety, after which patients can sleep, see things more clearly and have a different perception of the problems they have had or continue to have. Thus, they can approach them more easily, they can find solutions.
Why do young adults burn out faster?
We live in a fast paced world, in which information and technologies came upon us suddenly, we did not have time to adapt psychologically, and the most affected group, paradoxically, is represented by young people. This is because young people finish their studies, they want to have money, to have a fulfilling life that allows them to spend their free time as they wish, to have a certain comfort at home, to be able to travel. However, these young people, once employed, find that things are not as they imagine, and all these expectations they have become a reason for dissatisfaction, they are hired with low salaries or are given jobs that they do not like. Thus, they become vulnerable and frustrated because of the financial expectations that they anticipated, but which they do not have. In corporations, there is a lot of work, with pressure, tight deadlines and young people end up spending a lot of overtime at work, have little free time, insufficient sleep, disorganized meals, almost non-existent physical exercise, consumption of substances that briefly relieve the state of physical and mental tension – alcohol, medications or drugs.
What are the types of people prone to professional burnout?
Here we are talking about perfectionists in general, about those who cannot delegate tasks, who want to do everything, to make sure, are obsessive-compulsive, people who have to repeat an activity several times to be impeccable, to check several times. Another category is dependent people, who need to be controlled and validated in different situations and cannot function alone. Fewer and fewer people can function balancedly and independently and this aspect was acutely felt during the period when most of us were forced to work from home. Working from home does not suit all employees, so this aspect represents another source of discomfort.
These symptoms can be reduced until they completely disappear during therapy sessions, either in a group or individually, because they will not disappear on their own. Most of the time, untreated, they become more acute with smaller and smaller stimuli and will happen more and more often. The perception of these people can be shaped through various types of therapy. When we have an already established psychiatric pathology and functional impossibility, it is preferable to establish a therapeutic scheme, emotional stabilization, so that the situation can then be addressed through counseling.
How can burnout be prevented?
First of all, it is about managing working time: prioritizing responsibilities, delegating tasks as much as possible, reducing overtime, changing the routine occasionally, completing important projects marked by small rewards, etc. At work, it is recommended to express dissatisfaction and suggestions in a civilized manner and with appropriate arguments and to avoid humiliation from superiors or between colleagues. It is also important to detach from office problems during your free time. Although it sounds good in theory, this cannot always be achieved easily, but awareness of this necessity is needed. Resignation or changing jobs cannot be the first option in case of dissatisfaction, especially when people have financial responsibilities that cannot be postponed. Ideally, we would develop burnout prevention programs at a national level and, taking into account the frequency of cases, treat it as a public health problem.
For an online consultation with Dr. Ioana Silion, access this link.
