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Don’t Burn Up Are you watching yourself for signs of burnout? By Mandi Smallhorne,editor Physio SA

“Oh, the sisters of mercy, they are not departed or gone. They were waiting for me when I thought that I just can’t go on. And they brought me their comfort and later they brought me this song.” (Leonard Cohen, Sisters of Mercy)

The sense I’m getting from friends, colleagues and social media is that we all need the comfort and healing of someone like the Sisters of Mercy in this time.

COVID has drained us, drained healthcare professionals in particular, but all of us, with the constraints, the uncertainties, the losses, the demands. And then along came social unrest. Fears, anxieties, more uncertainties. This is what I’m hearing people say: I’m so tired. I feel like staying in bed all day. I feel finished.

It’s not surprising. A body of work looking at the impact of COVID on mental health is emerging. “Different groups have met the qualifying criteria for posttraumatic stress disorder (PTSD) according to DSM-5 as a result of the pandemic: those who have themselves suffered from serious COVID-19 illness and potential death; individuals who, as family members and healthcare workers, have witnessed others’ suffering and death; individuals who have learned about the death or risk of death of a family member or friend due to the virus; and individuals who have experienced extreme exposure to aversive details (e.g., journalists, first responders, medical examiners, and hospital personnel).” (Post-COVID Stress Disorder: Another Emerging Consequence of the Global Pandemic, Psychiatric Times, 8 January 2021) Healthcare professionals.

The impact on people in the medical professions goes deep. A study of 900 health professionals in Singapore and India found that more than half of those who reported symptoms like anxiety, depression and stress had symptoms “in the moderate to extremely severe range. In addition, 67% of respondents reported physical symptoms, especially headache, lethargy, anxiety, and insomnia, suggesting somatic expressions of distress.”

You will all know that stress activates major systems in the body, from the immune system to the metabolism to the orchestra of hormones. Too much ongoing or frequent activation of this nature can lead to physical changes in how the body works that ultimately could have nasty impacts (heart disease, for example). Plus the process of burnout has the potential to have negative consequences for our mental health, our social lives, and our closest relationships, especially if we fail to recognise it has it’s happening.

Eustress and distress

Not all stress is bad stress. Indeed, as this research suggests, living a totally stress-free life may be bad for your mental health!

The mixed benefits of a stressor-free life: The current study compared adults who reported no daily stressors with adults who reported at least one stressor across 8 consecutive days on measures of well-being. Those reporting no stressors were generally older, male, unmarried, and were less likely to work, provide or receive emotional support, or experience positive daily events. They reported greater daily affective well-being and fewer chronic health conditions but had lower levels of cognitive functioning.

Findings suggest that daily stressors may serve as a proxy to engagement in social activities, where a lower level of engagement is related to better physical and emotional well-being but lower levels of cognitive functioning. (Editor’s emphasis) Charles, S T, et al (2021). The mixed benefits of a stressor-free life. Emotion. Advance online publication. https://doi. org/10.1037/emo0000958 The process of burnout has the potential to have negative consequences for our mental health, our social lives, and our closest relationships (From: De Hert S, Burnout in Healthcare Workers: Prevalence, Impact and Preventative Strategies. Local Reg Anesth. 2020;13:1 71-183. Published 2020 Oct 28. doi:10.2147/LRA.S240564)

Psychologist Rajvinder Samra of The Open University, writing in The Conversation last year, said the big changes to watch out for are these three:

• Emotional exhaustion (feeling tired, drained, frustrated and fatigued).

• Cynicism or detachment (caring less about co-workers or clients).

• A loss of satisfaction in one’s work.

1. Psychological detachment (not thinking about work),

2. Relaxation (taking a walk in nature, listening to music, reading a book, doing nothing on the sofa)

3. Mastery (such as seeking out opportunities to do things unrelated to work such as learning languages or pursuing sports and hobbies),

4. Control (choosing how to spend your time and doing things the way you want to do them).

She has some good advice about achieving detachment from work: no smartphones! Well, she’s not quite as rigid as that, but outlines a truth we all know too well: having your phone on and handy after work very often means the lines between work and non-work get blurred, as you take or make calls about work, follow WhatsApp groups that relate to work, or search for work-related information.

In another time, one that feels so long ago, when we still met up with friends to socialise outside work, this could also be a barrier to detachment, as one tends to talk about work, even with people who aren’t colleagues, instead of taking your mind right off it all.

Other tips for managing burnout:

· Admit that you’re in trouble – to your partner or closest friend or family member, if no-one else – and ask for help in detaching and relaxing.

· Make detached relaxation time sacred; nothing should be allowed to intrude on this time that is for you. It’s not selfish, it’s taking care of yourself so you can go on giving in the workplace.

· Your hours of sleep are also ‘medicinal’ and should be observed as religiously as possible.

· Get in touch with your creative or playful self. Make time for activities that awaken other parts of you – from baking to painting to simply rough-housing with your children. Be kind to yourself! 5 AUGUST 2021

Helping others helps you

It may seem strange to suggest ‘helping others’ as a technique for coping with stress caused by ‘helping others’! but ‘prosocial behaviour’ is different from your working responsibilities.

It’s getting involved with activities with the “intent to benefit others”, such as “helping, sharing, donating, co-operating, and volunteering”. Examples would include things like helping out at your local animal welfare operation, cooking for the soup kitchen at your church or a clean-up of the local park or river:

“Recent theories of stress reactivity posit that, when stressed, individuals tend to seek out opportunities to affiliate with and nurture others to prevent or mitigate the negative effects of stress. However, few studies have tested empirically the role of prosocial behaviour in reducing negative emotional responses to stress. […] Results showed that on a given day, prosocial behaviour moderated the effects of stress on positive affect, negative affect, and overall mental health. Findings suggest that affiliative behaviour may be an important component of coping with stress and indicate that engaging in prosocial behaviour might be an effective strategy for reducing the impact of stress on emotional functioning.” (Editor’s emphasis) Raposa EB, Laws HB, Ansell EB. Prosocial Behavior Mitigates the Negative Effects of Stress in Everyday Life. Clinical Psychological Science. 2016;4(4):691-698. doi:10.1177/216770261561107

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