Burnout in doctors or medics is not uncommon, quite the opposite, huge volumes of research papers have been written on the topic, and it’s one of the most common problems I help doctors with in therapy.
Burnout in Doctors doesn’t happen overnight. It builds slowly, following months or years of doing too much, of ignoring yourself, of pushing beyond your capacity, and doing it all alone.
Burnout feels like complete exhaustion, constant overwhelm, a disconnected feeling and like you’re functioning on auto-pilot – existing, but not really living.
If you’ve ignored all the warning signs after burnout kicked in, and still kept going, eventually you’ll hit a wall, where continuing to function is no longer an option.
Your brain won’t engage, your body won’t let you, and it’s both scary and infuriating.
Coming up in this article I’ll cover:
- Do I have burnout?
- Risk factors for burnout
- The warning signs of burnout
- Burnout versus anxiety or depression
- Why burnout keeps going
- How CBT helps Burnout
- Boundaries and Burnout
- Taking time off work
- When to seek help
- The different therapy routes available to doctors, including funded support
Doctors series
This article is part of a series of 6.
Links for these are at the end of this article.
- Therapy for Doctors
- Therapy for Junior Doctors
- Decision-Making Anxiety and Managing Uncertainty
- PTSD in Doctors
- Return to Work Support for Doctors
1. Do I have burnout?
Have you found yourself wondering if you’re experiencing burnout? Perhaps you’ve googled ‘what does burnout feel like’?
Burnout is a whole body and emotional experience.
What it really looks like:
* Exhaustion, that rest/days off don’t resolve
* Emotional numbness
* Unable to be present, feeling like you’re somewhere else all the time
* Feeling detached from work, including empathy fatigue
* Inability to concentrate, poor memory, and tasks taking much longer
* A loss of joy and motivation, feeling like you’re just existing
* Increased irritability, and reduced patience with others
* Worrying more or being more irrational in your thoughts
A proportion of doctors will still be functioning whilst burnt out. Still turning up, doing the job, doing what’s needed, and then being forced to hibernate when they get home. Others will be further along in burnout and will already be off work after hitting a wall, feeling lost in finding their way back.
Therapy can help you at any stage of Burnout. To support you in understanding the root of your burnout, achieving recovery from burnout, learning new ways to cope, and develop a sustainable way to stay on track.
I’d like to find out more
Chat to Hannah – hannahpaskintherapy.co.uk/book-now/
2. Risk factors for Burnout in Medics
Your upbringing experiences, individual personality traits, and the environment around you can all contribute to increased risk factors for burnout.
Our upbringing – Your worth defined by achievement
For many that go into medicine as a career, academic success and achievement is something that was encouraged growing up. Working hard, doing well, these were things that were valued by the adults around you. Going into a ‘good job’ was also encouraged, with many coming from families of doctors.
This teaches you that our worth and value come from achievement, from always doing our best, no matter what. Your identity becomes tied to this, and so you feel the need to keep achieving, to keep pushing. The line of when to stop, or when it’s enough gets lost, and this is a risk for burnout.
Caring too much – Empathy without boundaries
Doctors deal daily with distress, pain, fear, and grief present with for their patients. Being empathic is a strength, but it needs boundaries for a career in care to be sustainable. Many doctors absorb the emotions of their patients while pushing their own feelings aside in order to function. Without time and space for experiencing emotions and managing them, instead they get suppressed and start to build up underneath, like a ticking time bomb.
It might feel like caring too much is not possible, but when the excessive empathy turns into working late every shift, taking responsibility of things that are for the patient to have ownership of, feeling bad for your colleagues so picking up their work, then empathy without boundaries can become problematic.
When you give more than your capacity, you run the risk of burnout. And when you burn out, continuing to provide care becomes impossible.
Perfectionism & Impossible standards
Perfectionism isn’t about being perfect, it’s about trying to be. Ironically many perfectionists think they’re not good enough to call themselves a perfectionist.
But perfectionism is the pursuit of the impossible, the expectation of yourself to always make the right decision, never miss anything, never make a mistake – basically an expectation that isn’t humanly possible.
There’s lots of words used like ‘must’ and ‘should’ – the things you tell yourself you must always do, the way you should be doing things. And despite these expectations being impossible, you’ll criticise yourself when you fail to achieve what was never doable in the first place.
Read more about Perfectionism – hannahpaskintherapy.co.uk/therapy-for-perfectionism
Terrible self-care
Every doctor knows that for a patient to have good health, they should eat, hydrate, sleep, move and get outside sometimes. Yet many doctors skip lunch, barely hydrate when at work, don’t get any fresh air, and rarely get a good night’s sleep.
You’re doing all the things that are bad for you – eating crap, scrolling on our phone in bed, drinking more wine, watching endless mind-numbing TV and generally just going to work and not much else.
The basics are what help to sustain you, help to increasey our capacity to cope. So, if you aren’t paying attention to those, you are making ourselves more vulnerable of hitting breaking point.
In therapy, we look at the barriers in how we think that prevent us from considering and making time for our own basic needs.
Never stopping
You’re used to just doing it all yourself. You’re used to just pushing forwards. It’s easy for you to ignore your own stuff and focus on others. Resting, relaxing, having fun – they are the bits that have become harder. And don’t even get me started on asking for help or accepting help – eek – you’ll not even consider those, because you don’t want to be a bother to others, to inconvenience them, and you’re not that bad anyway, right? ….
And the constantly being on the go shows up in our personal lives as well as professional. Always the planner, always the volunteer, always say yes – to parents, to kids, to friends, to everyone basically. Hobbies can fall into this too, always setting sporting challenges with moving goal posts.
Want to read more about people-pleasing? – hannahpaskintherapy.co.uk/therapy-for-people-pleasers
3. The warning signs of burnout in doctors
Burnout develops gradually, not suddenly. But for many it feels like they were fine, and then just one day they weren’t. But there were signs, and likely lots of them. You just did too good of a job ignoring them.
Warning signs can be thought of in 4 categories:
> Changes physically
> Changes in how you feel emotionally
> Changes in how you are acting
> Changes in how you are thinking
Warning signs might start small and with minimal impact, escalating to a point where your mind and body force you to stop.
Physical symptoms from burnout can be quite unbelievable at times, at the worst – IBS, hair loss, high blood pressure, panic attacks, skin rashes, increased colds/flu that go on for weeks, tinnitus, muscle twitching, migraines, and so many more.
Emotionally, we become more irritable, less optimistic, more fed up, feelings of detachment, increased anxiety, worsening low mood, a lack of joy, lost motivation, and much more.
When burnout starts to show up in our behaviours, this might look like – stopping exercise or doing it excessively, comfort eating, increased alcohol, reduced socialising, increased time inside at home, reduced care of appearance, stopped doing hobbies, more mindless TV, more snoozing of alarm, more over-working to catch-up and many others.
For our thinking, we are likely to experience increased self-doubt, focusing on the negatives/problems, worrying more about doing things wrong or making mistakes, overthinking past decisions, worrying what people think of you, telling yourself you’re a bad doctor, and other similar examples.
4. Burnout versus anxiety or depression
Burnout, anxiety, and depression often overlap, but they are not the same thing.
Burnout is specifically linked to doing too much for too long, without responding to your needs. It has elements of anxiety in the form of worrying, and elements of depression in the form of reduced interest and motivation.
But the overall emotional experience typically isn’t being anxious or depressed, it’s being overwhelmed and exhausted.
Because there is crossover, a lot of the strategies for anxiety and depression do get adapted to use in therapy.
5. Why burnout keeps going
One of the most frustrating aspects of burnout is that our ways of coping are the very things accidentally making it worse.
Common burnout-maintaining patterns include:
- pushing through exhaustion
- ignoring physical and emotional warning signs
- telling yourself you should cope better
- increasing work effort to compensate for feeling less effective
- avoiding rest because it makes you feel lazy or guilty
These patterns make sense in the context of medical training and culture. However, they keep the nervous system in a stuck state, making recovery impossible.
CBT helps identify and change these cycles.
6. How CBT helps with burnout in doctors
CBT is not about telling doctors to “think positively” or ignore the realities of their job. Therapy will look at things in 4 parts:
> Understanding why we have burnt out
> Recovering from burnout
> Learning strategies to break the cycle
> Have a plan on how to prevent future episodes
CBT provides psycho-education to give you better self-insight, as well as teaching therapy strategies to make changes. It’s proactive, and it’s structured. It does also allow space to work through significant past experiences if appropriate to enabling you to move forwards.
7. Boundaries and burnout
When caring for others is your default role, setting boundaries can feel selfish and rude. In reality they are necessary for us to sustain good emotional and physical wellbeing.
When I work with doctors, I regularly discover that they don’t spot examples of where there should be boundaries and there or not, or don’t identify when what they are being asked or are doing is not reasonable. Before boundaries can be put in place, we have to identify where the issues may be, and why boundaries don’t even feel like a consideration.
In therapy, boundaries are approached practically and compassionately. This isn’t about making you less of a practitioner, it’s actually about being able to improve your functioning, but in a way you can keep up without burning out.
8. Time off alone is rarely enough
Many doctors hope that taking time off will “fix” burnout. While rest is important, time off alone often does not address the underlying patterns that led to burnout in the first place.
Without psychological change, many doctors return to work feeling briefly better, only to slip back into the same cycles of overworking, self-criticism, and exhaustion.
This is why therapy is so valuable in tackling burnout in doctors, it’s not a temporary fix, it gets to the root of the problem.
9. When to seek help for burnout
You do not need to wait until you are off work, having panic attacks, or considering quitting your job to seek support.
If burnout is impacting your sleep, enjoyment of life, confidence at work or your life in other ways, it’s worth seriously considering getting help.
10. Therapy for burnout with me
I’m a BABCP-accredited CBT therapist and I work with doctors across the UK, online and in person in Cheshire.
My approach is structured, practical, and tailored to the realities of medical work. We work collaboratively to understand what has led to burnout, what is keeping it going, and how to make changes that actually make sense for you and your life.
As well as professional experience of burnout, I also have personal experience too. This helps me to really get what’s going on, and means I understand what changes are needing to stop the pattern repeating.
Next steps
1. Book a free discovery call (this is optional)
2. Book your therapy assessment appointment
hannahpaskintherapy.co.uk/book-now/
If you are unable to self-fund therapy, I offer limited availability for funded therapy under the Practitioner Health scheme (via Onebright), message me to find out more.
Links for 5 more articles in the series
- Therapy for Doctors – hannahpaskintherapy.co.uk/therapy-for-doctors
- Therapy for Junior Doctors – http://hannahpaskintherapy.co.uk/therapy-for-junior-doctors
- Decision-making anxiety & managing uncertainty – http://hannahpaskintherapy.co.uk/doctors-with-anxiety
- PTSD in doctors – http://hannahpaskintherapy.co.uk/doctors-with-ptsd
- Return to work support for doctors – http://hannahpaskintherapy.co.uk/return-to-work-doctors
