How to Deal with Burnout with Dr. Adam Borland

Podcast Transcript

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Annie Zaleski:

Hello, and thank you for joining us for this episode of the Health Essentials podcast. I'm your host, Annie Zaleski, and today we're talking with psychologist Adam Borland about dealing with burnout. If you're feeling exhausted and sluggish, and even simple tasks feel overwhelming to complete—or you find yourself so stressed out that you're quick to get angry or frustrated—you might be experiencing burnout. While frequently associated with a stressful job, burnout can also affect many areas of your life and even cause health problems. Dr. Borland is here to talk about the major symptoms of burnout and provide some tips on how both to deal with burnout and prevent this condition from developing in the future. Dr. Borland, thank you so much for being here.

Dr. Adam Borland:

My pleasure. Thanks for having me.

Annie Zaleski:

So let's talk a little bit first about what burnout is. According to the APA Dictionary of Psychology, burnout is defined as physical, emotional or mental exhaustion, accompanied by decreased motivation, lowered performance and negative attitudes towards oneself and others. So, in practice, what does this mean?

Dr. Borland:

In practice, this means that I am seeing a lot of people who are very tired. Physically, emotionally tired. We often talk about the idea of our gas tanks being on empty. And what we do in therapy is really try and focus on how to refill that tank, because we're living in incredibly stressful times these days, and burnout is incredibly prevalent.

Annie Zaleski:

What are some of the major causes of burnout? I mean, I think we can probably guess a few of them. But what are you typically seeing?

Dr. Borland:

I'm seeing people that are having a very difficult time finding the necessary boundaries in order to manage life, personal life and all the demands that that requires, and then also work demands. And finding that balance has proven to be extremely difficult. We throw in the uncertainty regarding COVID-19, and it is really taking the physical and emotional reserves that we usually hold onto and really depleting them.

Annie Zaleski:

So you mentioned work, why is job burnout so common then, specifically?

Dr. Borland:

Well, I think we have a difficult time saying no. We have a difficult time maintaining necessary boundaries, especially given the technology that plays a significant part in the work field today. We are accessible 24 hours a day. And especially now with telehealth and all the virtual platforms, it takes our ability to disconnect from work and makes it all the more difficult. So people are essentially running constantly in order to address work responsibilities. And I see people across all stages of their career who are really saying, "I need to do a better job finding this balance in order to preserve my physical and emotional health."

Annie Zaleski:

And it sounds like what you're describing are both physical boundaries—maybe you're looking at your phone, your computer—and then also emotional boundaries, that stress, "I need to check my email. Maybe I'm going to miss this message." Is that pretty fair to say?

Dr. Borland:

That's, unfortunately, what we deal with on a day-to-day basis.

Annie Zaleski:

So you mentioned feeling like your tank is basically empty, and being really tired. What are some of the other major signs that you're experiencing burnout?

Dr. Borland:

A lot of the individuals that I work with, there's kind of this question of, "What's the point? The work that I'm doing, is it really making a difference? Do I even really enjoy what I'm doing anymore? Or am I just kind of going through the motions?" And that obviously is indicative of kind of a lack of satisfaction in the work that people are doing. And again, these are people that are new to their field, or maybe right out of college, and then we're talking about individuals who have maybe been in their field for 30-plus years, and all of a sudden they're questioning, "I don't know how much longer I can do this, or I want to do this."

Annie Zaleski:

Now, are you seeing similar symptoms with people who maybe aren't feeling job burnout? Depression is, I would guess, a sign or symptom that you're experiencing burnout then. Is that only from jobs? Can that be from other things as well?

Dr. Borland:

Yeah, we're seeing a tremendous amount of burnout, particularly since the COVID-19 pandemic began, in that individuals are really having a hard time trying to balance the work responsibilities and then, for instance, parenting responsibilities—trying to deal with children and virtual schooling and trying to navigate situations where, frankly, there's no blueprint for any of this. And so, again, those emotional and physical reserves that we often depend on are fairly depleted.

Annie Zaleski:

Besides fatigue, then, are there any other major physical symptoms that tend to crop up if you're feeling burned out?

Dr. Borland:

Yeah, a lot of times people will talk about feeling tension headaches. A lot of my patients deal with pretty significant headaches. We're always going to look for sleep patterns. Are there any significant changes in diet? These are things, the kind of baselines, that we'll always look at. I will always recommend engaging in physical exercise. Regardless of how much energy that person may have on a given day, I think if we can get some sort of physical exercise, that's always going to be a helpful coping tool.

Annie Zaleski:

I can totally see how that would be so difficult some days. If you're just feeling, like, “All I want to do is take a nap,” the thought of exercising, that's like the last thing you want to do. But you hear it so often, just what a great panacea exercise is for anything almost.

Dr. Borland:

Yeah. And reminding ourselves that exercise doesn't have to mean going to the gym. Right? We can get exercise in all sorts of different ways at home. And so really just taking a few minutes every day to get some physical exercise.

Annie Zaleski:

So you mentioned that a lot of the symptoms of burnout might resemble some other physical conditions then. How do you tell that burnout from other things, that there might be something else going on?

Dr. Borland:

Yeah. Oftentimes, burnout and depression can mirror each other. And what we have to remember when it comes to depression is that that is a diagnosable mental health condition, whereas burnout is not. Depression doesn't have to be in response to one specific trigger. Whereas burnout is often in response to something that we can point to and say, "Oh, this person is working more hours than usual," or there's something specifically in their life that's causing this type of burnout. Depression tends to be a bit more general in terms of its symptoms.

One way that I've always explained to my patients in terms of the difference is, let's imagine we took someone who was experiencing depression and put them in a villa in the South of France. The reality is, those depressive symptoms are going to accompany them on that trip. Whereas if we take the person who's dealing with burnout and put them in that same villa, once they're detached from that work or whatever it is that's causing the burnout, they're going to be able to enjoy that vacation. They're going to be able to relax. Whereas the individual who's feeling depressed most likely will not.

Annie Zaleski:

That's a really good way of looking at it. It looks like that it's more situational and it's something almost external to you. That's a good way of looking at it.

Dr. Borland:

Yeah. I think when we're looking at depression as well, we always have to look at self-esteem. Is the individual feeling a sense of worthlessness, a feeling of helplessness, in terms of changing aspects of their lives? Again, it tends to be broader, in general, whereas with burnout, we can really pinpoint what is causing these types of symptoms.

Annie Zaleski:

So, you said there's no medical diagnosis of burnout. Then how can doctors determine what is going on?

Dr. Borland:

Yeah. I think it's really an assessment of, what is the person dealing with on a day-to-day basis? If someone comes in and tells me, "I'm not sleeping because I am so worried about this presentation, and all I've been doing is focusing and preparing for this presentation at work.” And like I said, “I'm not sleeping, I'm not eating, I'm having a terrible time concentrating, I'm not communicating with my family,” or “I'm isolating myself." We can pinpoint that and say, "Okay, it's this presentation that's really causing this person to feel burned out.” Whereas depression, we're looking at other symptoms, more of the underlying symptoms.

Annie Zaleski:

And that's interesting, because I think sometimes people might not even realize that they've reached a burnout phase, that maybe people are just so focused on, "I need to get this thing done, I need to get this thing done at my job," and they don't realize that they've just reached kind of a tipping point as well into burnout.

Dr. Borland:

It's not uncommon for people to operate at such a high baseline that if they take a step back... I often use the example of miles per hour. So if someone is used to going 100 miles an hour, and then all of a sudden they take their foot off the accelerator, and now they're going at 85, which is still a pretty good clip, they may feel that that's somehow not good enough because they are so used to going at 100 miles an hour. And so what we really want to work on is helping them find a healthy cruising speed, with the understanding that, yes, there will be times where you have to go a little faster. But we can't sustain that 100 miles an hour all the time.

Annie Zaleski:

And obviously, something being in that heightened stage for a long period of time is not good for you. What are some of the long-term physical and emotional effects of burnout?

Dr. Borland:

Well, I think, eventually it can lead to depression. So that's something we always want to keep an eye out for. Individuals that are dealing with prolonged burnout, I see just the quality of life, their level of interest in things, the things that have been enjoyable to them, they're just kind of going through the motions at this point. People often talk about this feeling of depersonalization when it comes to burnout. And that's a feeling of just being detached from yourself, almost like you're just going through the motions, due to that heightened level of stress.

Annie Zaleski:

And those are very serious things. I would imagine those can also have an impact on not just your job, but your personal life, your relationships, and your just day-to-day existence.

Dr. Borland:

Absolutely. Burnout can absolutely affect personal relationships. I often hear of individuals whose marriages or relationship with significant others are being affected. And so the branches that come off this tree can be quite extensive.

Annie Zaleski:

Now, burnout, can it have a serious effect on it very soon? Or is it only prolonged burnout that can have an impact? I guess, maybe, what are some of the short-term impacts you tend to see?

Dr. Borland:

Well, I think we have to remember that a lot of times with burnout, people don't necessarily recognize it at its early stages. It's usually once burnout has really taken hold, that's when they say, "Boy, something is really off here." Because I think we are, again, so used to going at that that 100-mile-an-hour clip. So I think it's important that we all do a daily, maybe even hourly, check-in with ourselves, to just see, "How am I doing emotionally? How am I doing physically?" That's one thing that I'm always going to recommend as a coping tool for burnout is, we have to be able to take breaks. We have to be able to step away from the computer or step away from whatever that source of stress is in order to attend to our health and well-being.

Annie Zaleski:

And I mean, that's what I was going to ask you, when you suddenly come to the realization, "I'm burned out, I have burnout," what can you do about it? Obviously, I think taking a break is excellent, and stepping away from your computer and other screens is also a good thing. What else can you do?

Dr. Borland:

I'm sure everyone's heard of the concept of mindfulness, right? The idea of trying to be as emotionally present as possible. And one way to achieve that, I always recommend to my patients, is doing some deep breathing. The great thing about doing deep breathing is it forces us to focus on that one inhale and that one exhale. And in doing that, we are focusing on this very moment. So that's something I always recommend for my patients as kind of a first step in terms of prioritizing the moment.

I think it's really important to establish a healthy daily routine when it comes to sleep, when it comes to diet, when it comes to saying, "Okay, I've put in a hard day's work, now I need to press stop, and I need to attend to social aspects of my life, things that are just fun and relaxing." And so creating and maintaining boundaries, that's something that takes work. It takes work, but it's extremely beneficial.

Annie Zaleski:

I mean, the first thing, especially, it's so within your reach to just stop and take a breath. And I think that's really nice, because it can feel very overwhelming to even know where to begin if your life has just gotten to a point where you're go, go, go all the time.

Dr. Borland:

It is. And it's something that I remind people, it's easy to do, it doesn't require any equipment. People don't even necessarily know that you're doing deep breathing. But the positive effects of it can be wonderful.

Annie Zaleski:

Now, establishing a daily routine, is it one of those things where maybe you want to write down in a notebook what you have to get done, or you maybe set an alarm to say, "All right, it's time for me to stop. I need to do things." Are things like that helpful? Or are there any other methods or techniques that you tend to recommend to people?

Dr. Borland:

I think what you just mentioned is a great way of approaching it. I think when we write things down and then we break them down into small achievable goals, that's a wonderful way to approach things, so that we can cross those things off during the day. Right? And in order to do that, again, we have to take a bigger goal and break it down. Because sometimes if we don't achieve that bigger goal, we can view it as a disappointment or a failure. So I think that that's a very healthy way to approach it and to feel like there's some organization to those goals.

Annie Zaleski:

I would imagine that also speaking to someone as well, and maybe talking to someone, whether a therapist or someone else, to try to also help you get in the mode would also be helpful to kind of give you some outside perspective on what's going on.

Dr. Borland:

Thankfully, therapy and mental health are finally starting to be destigmatized. There's a tremendous need for mental health services these days. And people are seeking it out at record numbers. I'm obviously a little bit biased, but having that safe place to talk with someone who is not a family member, or a friend, or a coworker, or a neighbor—but someone who comes in impartial and is trained to give clinical feedback—it really can be life-changing, especially during these stressful times we're living in.

Annie Zaleski:

And job burnout, specifically, can sometimes be so tricky, because you might not be in a position to quit your job if it's causing you stress. What can people do in situations like that?

Dr. Borland:

It can be tricky. Obviously, if someone has the opportunity to communicate with their boss, with their manager, with someone higher up in the organization, and explain to them some of the difficulties that they're dealing with, that's ideal. And hopefully they can find some sort of schedule or some change in responsibilities or change in daily routine that could help. But not everyone has that opportunity. So we have to go in and try and remember that my health and well-being matters here as well. I have to attend to the balance of the day. And if things are really out of whack, I have to figure out how to do something for myself.

A lot of individuals who don't necessarily feel that type of satisfaction from work, oftentimes will look for things outside of work, whether it's a volunteer opportunity, whether it's some involvement in a club or organization. For some individuals, it might be a religious dynamic, to maybe fill some of that void that they're feeling, that they're not getting from their job.

Annie Zaleski:

I mean, that's always so great because that's your break and it's something you enjoy, and it's something that can bring you joy. Can that sometimes go too much, though? Can it still be like, you're almost burning yourself out on your thing to help you combat burnout? Is that a thing at all?

Dr. Borland:

I suppose it is. And again, I think it really comes down to that balance. Right? And I think, oftentimes, we misconstrue this idea of attending to our self-care as somehow being selfish. And it's not the same, it's really not. And oftentimes, I remind my patients that in order to be the best friend, or spouse, or parent, or child, or whatever it might be, you have to attend to your self-care. If your tank is empty, you can't be the type of person you want to be to these others in your life.

Annie Zaleski:

And it stands to reason that some people, when their tank is empty, they just need to kind of go off by themselves and maybe read a book or sleep or rest, and other people, maybe if they're more extroverted, need that kind of recharging by being around other people. It just really varies by personality.

Dr. Borland:

It does. It does. And it may not be consistent, and that's okay. It might have to be a bit of trial and error.

Annie Zaleski:

So is burnout something that you can recover from? And if so, what does that look like? And how does that feel?

Dr. Borland:

Burnout is something that I believe you can recover from. It takes work. And I think it really, again, comes down to establishing a meaningful daily routine, creating and maintaining these boundaries, so that you can attend to your health and wellbeing while also attending to the responsibilities of your job or your personal life. But I absolutely think that it can improve.

Annie Zaleski:

Now, once you recover from burnout, can you prevent it in the future? And if so, how can you? Is it just kind of sticking to your routines and sticking to what you had implemented? Or are there additional things you can do as well?

Dr. Borland:

Well, I think, once you recognize the symptoms, then hopefully you become more aware of them, and say to yourself, "You know what, I know how bad this felt last time I dealt with this, and therefore, I need to do a better job of maintaining that balance and attending to my self-care and those boundaries, so that I don't let it get to that point that it did last time." Communicating with support systems, making sure that you don't feel like you're going through this alone, is always going to be important. And I think that's another aspect of therapy, is that individuals often learn how to communicate. They're not internalizing these emotions perhaps like they once did.

Annie Zaleski:

And that's great too, because yes, some people really could use some help on, how do I advocate for myself? How do I stand up and say, “I need this”? That could be so difficult for people to do sometimes.

Dr. Borland:

It really can be like learning a new skill, in order to be assertive, in order to put your own needs higher up on the priority list.

Annie Zaleski:

Well, it's a lifelong thing that we're all trying to learn, especially when we're being pulled in many directions.

Dr. Borland:

I agree.

Annie Zaleski:

Mindfulness too, I imagine to be something that's good when you cut off burnout at the pass, before it even develops. That if you're paying attention to what's going on, like you said, when you're really staying in touch with your inner self and your emotions, that also, I bet, would be something that's very helpful.

Dr. Borland:

And one thing I often encourage my patients to do is focus on gratitude. Especially nowadays, it's very easy to look through a lens of negativity, pessimism, how are things not working for me the way that I would like for them to work. And instead, focus on the good things. And that does take work, but I think you will see the benefits pretty quickly, because there are wonderful things out there that unfortunately we tend to overlook.

Annie Zaleski:

Yeah. So are there any tips that are good for avoiding burnout, that you haven't mentioned, that you feel are important to mention or might be helpful to people?

Dr. Borland:

Yeah. I've had a number of individuals who've experienced the benefits of writing as a therapeutic outlet. And what I recommend in that situation is, don't edit yourself, don't worry about spelling or grammar or anything like that. Just start with "I feel," and see where it goes. And when you're done with it, it doesn't matter what you do with it. You can keep it, you can re-read it, you can delete it, throw it away. It doesn't really matter. It's just the process of getting it out.

I worked with a patient years and years ago who started off her week with a very stressful phone call with her boss. Every Monday morning, she knew that at this time, there was going to be that phone call. And so what we worked on was, before that phone call, she would take 10, 15 minutes and just write. Just write out how she was feeling, what she was worried about, the good things that she had done the past week that she could explain to her boss. And we found that it really helped her in terms of approaching that call. It didn't take away the stress 100%, and that really wasn't the expectation, but it helped her loosen that vice grip that she was holding onto things with.

Annie Zaleski:

That's such a great example because that's a concrete example of something that's like, "I know I have it every week. How do I deal with it? How can I solve this problem and make it easier for me, even a little bit? I can't change it, but I can respond to it and help myself." That's excellent.

Dr. Borland:

I think that's a great point that you just brought up, is the idea that we can't change these situations necessarily. It's always up to us to say to ourselves, "How can I respond to it? That's what I have control over—my responses, my behaviors." And when we recognize that, it can be pretty powerful to remember that we have a choice in all of this.

Annie Zaleski:

Just reframing it, reframing the way you look at things, and that kind of unlocks something, when you realize, “I have things in my life I can control. I'm going to focus on those and making those better.” That can be very, very powerful.

Dr. Borland:

And that's a way in which therapy can be effective, is by having someone help you reframe what it is that you're dealing with.

Annie Zaleski:

Now, one of the things I'm sure that has come up in the last couple of years too, is COVID fatigue. We've talked a lot about as well, about pandemic fatigue. People have just had it, I guess, for lack of a better word. How do they kind of inform each other? And is there a difference between feeling burned out from the pandemic and general burnout?

Dr. Borland:

Well, I think the demands that people have had put on them since March of 2020, when the pandemic started, have really gotten intense. As I said before, there's no playbook. There's no blueprint for any of this. We're kind of adapting on the fly. And as a result, people's responsibilities have changed. And a lot of people are doing a lot more work than they did in the past. And because of that, burnout has become more prevalent. The ability to say no, the ability to keep those boundaries, to maintain a daily routine, really got flipped upside down once COVID hit. So that's something that I see quite often in my practice. And as far as the fatigue, you're right. I mean, people are pretty sick of this. And especially this new wave, I have a lot of patients who come to see me that, they're feeling really angry, and rightfully so, because people, they're sick and tired of this, and it affects all area of life.

Annie Zaleski:

Well, hopefully soon, maybe next time when we talk, things will be in a better place. We can all cross our fingers.

Dr. Borland:

Fingers crossed, absolutely.

Annie Zaleski:

Well, is there anything else you want to add about burnout that we haven't talked about, that you feel is important to mention?

Dr. Borland:

I think it's important to be able to use that term burnout, to not shy away from it. I think, thankfully, in this generation, we're seeing that people are recognizing these symptoms and saying, "You know what, this isn't okay." Whereas, frankly, in past generations, it was just kind of this mentality of, you put your head down and you work, and you don't complain. And whatever symptoms you dealt with on the side, well, it was a byproduct of it. But thankfully, people are now talking about burnout and maybe aren't as apprehensive to admit, "I'm dealing with these symptoms."

Annie Zaleski:

And that's great, because acknowledging it and many more people saying, "Hey, I'm dealing with this," will bring it into the lexicon, I guess, and hopefully improve things. Like if you're in a workplace that's very stressful, even acknowledging that can be freeing, to have someone say, "Hey, you might be burned out. Let's try to help solve this for you." That could really be a relief for many people.

Dr. Borland:

Yeah. I think if individuals can communicate with coworkers, with peers, to say, "Hey, this is how I'm feeling. How are you dealing with it?" It can be very validating if a coworker says, "Boy, I'm having a hard time with that as well." Right? So we don't feel like, I'm alone on an island feeling these feelings. So communicate, communicate, communicate.

Annie Zaleski:

Well, Dr. Borland, thank you so much. This has been so valuable. And I think the advice that you've shared today is probably going to help a lot of people in a very tough time.

Dr. Borland:

You're welcome. My pleasure. Thanks for having me.

Annie Zaleski:

Burnout is the result of ongoing stress and can have a serious impact on your mental and physical health. If you'd like to find out more information about how to deal with burnout, or learn about coping mechanisms to prevent burnout from occurring, visit clevelandclinic.org/behavioralhealth.

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