Brain Science – Episode #33

Your brain on burnout

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We’re back! This is from our “lost episodes” — This is your brain…and this is your brain on burnout, any questions? OK, but seriously, burnout effects everyone, even if they/you don’t admit it. Burnout is a state of physical, emotional, and mental exhaustion caused by prolonged stress. It can affect ANYONE, but it is especially common among high-performers who push themselves to the limit. In this episode, we dive into the latest research on burnout and its effects on the brain, as well as offer practical advice for preventing and managing burnout. If you’re heading into 2023 feeling overwhelmed and drained, this episode is for you.

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Chapters

1 00:00 Preamble
2 01:07 Disclaimer
3 01:25 Start the show!
4 03:18 Burnout is...
5 05:01 Burnout efffects everything!
6 05:56 This isn't a place anyone wants to be
7 09:50 It's sneaky. It's cunning.
8 13:57 Burnout isn't new
9 16:20 Burnout emerges when...
10 19:30 The state of burnout
11 24:24 Burnout is pro-aging
12 29:04 Pushing back
13 32:18 Pandemic induced burnout
14 33:56 More perspective!
15 36:09 Focus on what you have agency over
16 37:22 How long can you sustain your pace?
17 43:13 You can reverse burnout
18 44:51 Words of advice mocing forward
19 45:49 Outro

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So it’s the end of the year, and this is the time of the year when people assess, they review, they determine their future to some degree, or at least their ambitions for the future, their desires for the future… And in many cases, you sort of retrospectively look at your life, your choices, your circumstances and what you’ve been doing, and sometimes you’re just “I don’t know if I can keep doing this.” And not like in a morbid way, but more “Can I sustain what I’m doing?” and that leads to burnout. So let’s talk about burnout and the brain. Thank you to Alexandria; I’m not trying to say your last name, but she wrote an awesome article in 2016 for the Association for Psychological Science, and it’s a great post, and I think one we want to deep-dive into… So let’s do that.

Yeah. Thanks, Adam. I’m really excited to talk about this today. Not because I love burnout, but because I think that this conversation can be helpful to so many people during this season of life; the way we’ve had to live life differently and sustain things wherein change is at the forefront of nearly all that we do… Like, “Hey, you thought it was going to look like this… Just kidding. We’re going to go this way.” And so this perpetual recalibration can be exhausting when we’re this far in… And that hasn’t changed.

Yeah. And burnout is very – I think it’s very elusive, in terms of you can’t really define it, shape it very well. Someone’s definition may be very good, another person’s definition may be very good, and there’s no real – you can’t call the spade a spade, for lack of better terms, you know? And the way she opens the article that she wrote was very good. She says – I’ll try to read as much as I can. She says “It’s a mistake to assume that burnout is merely an emotional response to long hours or a challenging job. Rather, mounting scientific evidence shows that burnout takes a profound physical toll that cascades well beyond our professional lives. Using cutting-edge techniques, integrative research teams are demonstrating that burnout is not just a state of mind, but a condition that leaves its mark on the brain as well as the body.” And it kind of transcend just simply “I am working too hard”, and it leads to so many of the things that stifles how we operate as individuals, as professionals, as husbands, wives, children, whatever. It’s terrible.

It is. I mean, one of the most fascinating things I’ve found when we were preparing for this conversation was that it’s actually a diagnosable code according to the ICD-10. And if you’re familiar at all with medicine, that’s our guidebook for how we diagnose conditions.

So I really want to give legitimacy to this, to go “Hey, you’re not making it up. Some of the symptoms and challenges you’re experiencing are legitimate, and as recognized by our international code of diseases.”

Yeah. And she mentioned that emergency research shows that the chronic psychological stress that characterizes burnout not only impairs people’s personal lives and their social functioning, it can also overwhelm their cognitive skills, so memory recall, and things like that. The neuro-endocrine systems, as it said - they eventually lead to distinctive changes in the anatomy and function of the brain.

So the people listening to this show are like “Hey, how’s my brain work? How can I do me better, essentially?” And so burnout isn’t just simply “Oh, I’m experiencing it.” It’s something that sort of changes us. You know, awareness leads to change; we say that. And so if you’re not aware, one, of your personal burnout, or the idea of burnout, or the aspects of it, or in this case potentially the long-term change of your brain, then you may just keep keeping on until you burn out.

Yup. And this is a place that I don’t think anyone wants to be, but realizing that, you know, when you’re saying neuro- endocrine, it’s our body’s systems. And our body is always trying to manage its energy resources, and so it’s saying, “Hey, I’ve upset the homeostasis internally for so long that my body continues to reallocate, and not in a helpful way.”

[06:24] We’ve talked about this in previous shows, around the difference between homeostasis and in humans allostasis, wherein our bodies and brains don’t go back to a baseline pre-perception of threat or reaction to threat, but actually reallocates upwards regarding that threat. So when I am perpetually stressed, my brain and my body, its system relative to cortisol - cortisol is our stress hormone - that it stays high. And that’s what creates the tipping point for longer-term, longer-range system problems internally. So no matter your efforts, it’s a systemic, internal thing, and we want to be considerate of that to go - hey, we want to look for ways that we can be creative, and ironically, stress isn’t going to help us do that.

Yeah. And you mentioned the fact that it’s now an ICD code… Alexandra says “Many of the symptoms of burnout overlap with the hallmarks of depression, including extreme fatigue, loss of passion”, which you were talking about there, to some degree, “creativity, and intensifying cynicism and negativity.” I mean, this can probably describe a lot of people but, the legitimacy of this being given a mainstream medicine medical code that you can diagnose, which is “burnout state of vital exhaustion” - that’s something I think that gives credence to what some might feel, which is almost shame. “I have burnout, so I have shame. I’ve done something wrong, I can’t do my work right. I’m not a good employee, I’m not a good co-worker, I’m not a good teammate, or I’m not good professionally”, or “I’m, I’m…”, whatever it might be. And there’s some sort of shame that might be attached to this word “burnout”, this state that affects our brain cognitively, that has a medical code assigned to it, thankfully, and is legitimized yet. There’s almost like denial. “I don’t want to be burned out. I don’t want to admit that I’m burned out. I don’t want to deal with being burned out. I don’t want to change because of burnout.” And how often I’ve said that myself in the past… And there’s definitely some shame attached to this. But thankfully, it’s legitimized by at least being a medical code that we can diagnose.

Yeah. Look, and this is so prevalent in the mental health world… Look, anybody who’s depressed doesn’t wake up and go, “Oh, I think that’s a great idea. Let’s do that. Let’s make everything harder, so I feel like I’m operating through molasses in every activity I choose to do today.” No! Oh my word, no. But it just really is this disparity between effort and outcomes. And so for those of us who have this strong internal locus of control, like “I believe I’m in charge of my world and how I operate”, it wouldn’t be surprising that I’m somewhat susceptible to see that I’m responsible for how I’m feeling, and therefore What’s wrong with you that you can’t feel differently when you know better? Ouch…! Ouch! And as if anybody needs more challenges given that, right?

[09:48] Yeah. It’s sneaky, it’s cunning… As this other fella who wrote another article. Having been through burnout, Kieran Thai, self-described as a freelance writer, originally from Sydney, Australia, but now living in Denver, wrote a post called “Recovering from burnout” on his personal blog. And one thing he had written about, which was about losing balance - he called burnout “a cunning thief”. He says “Burnout is a cunning thief. It feeds on your passion, your energy, and your enthusiasm, taking these positive qualities and turning them into exhaustion, frustration and self-doubt. It’s way more than just having a bad day or being tired or worn out. It’s a problem that’s both physical and existential.” And that to me is just like – it’s kind of a clincher. But he goes on to kind of describe what he knows is the best definition of burnout. He says it’s this: a chronic state of being out of sync with one or more aspects of your life.

But this idea that it’s a thief - like, it’s sneaky, it’s cunning… It’s almost like it’s out the getcha. In the pre-call we were talking through some of the details of this… I’m like “Well, that’s just kind of doing life.” And we can kind of go through what we were talking about there, but you know, all the things that sort of lead to burnout, which is like just sort of doing life - having boundaries at work, and all these different things… It’s just sort of sneaky. It feeds on your passion, as he says, your energy, and your enthusiasm. And before you know you’re just – you’re burnt.

Yeah. I think of it like the drift. We don’t recognize drift until we look back. And so this is why I think this topic is so timely, because we’re closing out a year, and a tough one for many of us. And going “Can you look back and see how you’re drifting? Or have you set up sort of tethers in a way to keep you more stabilized in certain directions? And what will those look as you go forward into the new year?”

Yeah. In regards to the drift, I think it’s – some have said in regards to remote work and sort of progression in certain directions, I wonder if there’s regression in the other directions, which haven’t really been talked about. So there’s been discussions around, “Oh, COVID and the global pandemic has just sped up the process of remote work. Like, it was going to happen. This, where we’re at right now with remote work - it was going to happen no matter what.” But this year, fast-forward 10 years - I wonder if some cases, or if some people have experienced a fast-forward into burnout; a regression, essentially, of balance, because of the state of the world. Because I know this year has been uniquely hard for many reasons, but I feel like there’s been some acceleration in the regression state, for some things for me even. And it’s like “What did I personally do to allow that?” You used the word “tether”… You know, “Where did I not tether properly to disable those things from happening?”

Right. And I think for you and all of our industries – I mean, I’m so familiar with healthcare, and this is what we’ve been trying to manage… Because one thing that healthcare workers don’t have control over is flow.

Yeah. There’s sort of a – they’re at the mercy of flow.

Yeah. And look, many people in the field of healthcare go into healthcare because they do what? They care about people. And they want to help people. And guess what it feels like this year? They’re not helping, because they can’t help to the degree or in the way in which they want to help. And so really looking at things going forward around what things are in my locus of control and what things aren’t, and recognizing that I am going to plant so many more seeds than what I will ever be able to water or cultivate. And that doesn’t mean you’re doing it wrong, it just is an acknowledgement around constraints or limits.

What I find interesting from Alexandra’s article is that this topic of burnout was broached 1976.

[14:08] You might as well just say 1776.

I mean, that’s a long time ago. I mean, it’s many years ago. Rough math - sub 50 years ago, right? The title of the article from – I’m not sure how you say this fella’s name; I think that might be a fellow. I’m assuming, at least… [unintelligible 00:14:22.07] is the person’s name. An article titled “Burned out.” It was published in a magazine called Human Behavior, and it generated huge public response. But yet, we’re here many, many years later, still talking about it. So I suppose life moves on, and I suppose to some degree the legitimacy of the medical code is one step forward, at least here in the US; it’s a medical code in the U.S. I don’t know if it’s the same for a global state… But just the fact that it’s been that kind of topic for so long; I’m sure there’s been many more studies that’s gone on since then that we could talk about as part of Alexandra’s article… But this is not new. This is quite old in terms of a discussion.

Yeah. We often talk about the importance of naming things, right? That this has been around, but it hasn’t necessarily allowed people to recognize that it’s not a personal thing. It’s not somebody trying to do this to themselves. It’s an interplay issue. And so again, even the World Health Organization talks about this relative to evidence that burnout looks like high job demands, low control, and I love this - “Effort/reward imbalance”, as risk factors for these mental and physical health problems, right? Like we talk about all the time, there’s interplay; how I think and how my body regulates are always interacting and trying to collaborate, but when there’s disparities, it’s just got to work harder. Like, where is my baseline and how do I get to more of a steady state? …because that’s how I have more sort of savings account to utilize. And when I can’t, I’m just always right on the cusp of going into debt.

Alexandra says - a few sentences down from that section where I was reading, she says “Burnout emerges when the demands of a job outstrip a person’s ability to cope with the stress.”

And newsflash, I was incorrect assuming gender there. [unintelligible 00:16:33.20] is a woman. She discusses that just a few sentences later; I could have read a little further… Sorry about that.

Yeah. This is what is just so, so challenging - we just can’t adapt. In the world of mental health I work with people doing this routinely, and it’s so important, guys, to be able to acknowledge legitimacy around constraints. Like, it does stink; it’s aversive. “I don’t want to be navigating this.” But coping looks like “Alright, while this is the case, what can I do within those constraints?”

One of the things I’ve encountered a lot throughout this year is people struggling with loss. And be it people in their lives, or expectations they had for things they were going to do… I mean, even more locally, for my world, is adolescents who have worked their whole lives to prepare for college in a sport of some sort, and there’s no recruiters. Nobody’s out watching them play games, because guess what’s not happening? Games. So they’re going, “Seriously, I’ve worked all my life for this thing to move to the next level, and there isn’t even an opportunity or access to do that.” And so, welcome loss.

[18:04] So we then have to switch gears and go, “How can I find a way to buffer and cope with that loss? And are there opportunities that lie within some of those disappointments?” And in no way am I negating the loss, but I’m also going to look at it like an addition equation and go, “What other opportunities are there for benefit that were unexpected, but desired?”

I’ll give you a real funny/simple example. Repurposing parking lots.

Right? So just yesterday we did an outdoor museum, essentially. It was an outdoor exhibit of dinosaurs; larger than life dinosaurs. We drove through it in our car, and it was in a mall parking lot.

Two weeks before that, when we had family here - I know it’s early, but we went and saw Christmas lights. We did an outdoor drive-through of Christmas lights. Guess where it was at? A parking lot. So it’s not a one-to-one, but it may be negative that the parking lots are empty… But it’s a positive that there’s a way to reuse them, that one, still moves the economics of the world, which is a great thing; enjoyment for families to get out and do fun things even in the kind of world we’re in, in a safe manner… But it’s a repurpose. And you can be “Oh, my parking lot…”, but then you can be like “Oh, my parking lot!”

So… Write that book if you want to.

I love it. And that is so key, because part of our buy-in around these sort of challenges is going “How does it have purpose, or in what way does it provide meaning to me?” Because loss stings, any way you look at it; but at the same time, in what way can I find meaning within that, that holds value for me as an individual? And that’s going to look different for each and every one of us.

But if I don’t go reflect and go, “I want to expand my mind to the broad view. I got to look bigger and wider”, which - emotions are involved in that process. Because if I’m stressed, guess what I’m not going to be able to do? I’m going to see the itty-bitty, narrow, square view. Definitely no picture-in-picture opportunities for me. But that’s what’s going to help me be able to see that this experience, while aversive, has purpose and meaning to me, which will help buffer going forward.

You know, the one thing that’s interesting that she points out here is this vicious cycle; she mentions that new research is showing just how devastating this kind of occupational stress can be to the brain. Talks about resisting state functional MRIs… I think we might have talked about that in our “I’m so stressed” episode, which could to some degree accompany this; we’ll put it in the show notes… But it talked about this resisting state functional MRI, and it mentioned – I’m looking for the language here… Paraphrasing, to some degree; there was a study, functional MRIs were being done, examining the brain of people with and without burnout, or assumed to be with or without burnout… And it says those diagnosed with burnout reported more difficulty modulating their strong negative emotional responses compared to those with the healthy controls, which was confirmed by their physical responses; they had dramatically stronger reactions to the startling noise than did the control group.
So it was just sort of comparing these two… But this idea of this neurological dysfunction that can come from this vicious cycle; this long-term change that’s stress, which we talked about in “I’m so stressed.” But if burnout is sort of an umbrella of many things - you’ve got stress, you’ve got emotional fatigue, you’ve got physical fatigue, you’ve got all these things that sort of encompass it… It’s now legitimized as a medical code, and all that good stuff, but it’s more than just simply “I’m burned out. I feel a certain way.” It’s long-term change to your brain. And she mentions it as a vicious cycle.

[22:01] Right. So we’ve talked about this relative to our amygdala, which is sort of the seed of emotional processing, and then our prefrontal cortex, which is sort of like our executive assistant in our brain. And the issue is that our prefrontal cortex, which is responsible for attention, working memory, set shifting, all of these things, doesn’t work in the same way, and will continue to not work in the same way because it’s reallocating around that negative emotional energy and stress.

So we’ve long said, but stress is really deleterious, or bad, just bad over the long haul for our bodies and our brains, because we’re not designed to do that. This is fight or flight; if we look at stress, it’s going “Do I fight, flight or freeze?”, that’s designed for a purpose, to help us survive really threatening things. So I don’t want to be in a constant state of stress, because it’s really eroding my brain’s ability to function on a more routine basis.

And this is what was super-interesting… There’s a neurologist out of the Department of Women and Children’s Health, Ivanka Savic, who confirmed this, that our brains suffering from burnout - they don’t just function differently, guys; the structure changes.

Yeah, you see sort of a regression, or this change inside of your brain from all these different things, like a growing or a shrinking of the amygdala, for example.

Right. So this research [unintelligible 00:23:42.25] and took these MRI - so MRIs are super-fascinating, because they give us more access to the brain, in different ways… And so it looked at measurements of cortical thickness in the amygdala, the anterior cingulate cortex, and this medial prefrontal cortex volumes, to go “Let’s gauge the impact of stress on our brains.” So it says the normal effects of aging were more prominent in the scans of the burnout group. So it really is this sort of expediting of the aging process, which I don’t think any of us are wanting.

Yeah. Well, life - we’re all dying, so to speak… Life is a process, I suppose, to get to death, or some sort of fatal point… And some of us speed up that timeline or slow it down; they call it anti-aging. It doesn’t mean you’re actually turning around time, it means the way that your cells, or in this case your brain operates is at a slower aging rate than someone else who may not be exercising those same controls to age sooner, or faster etc.

Yeah, it’s interesting how there’s this cognitive cost, too. Beyond just simply changing the brain’s anatomy, she says scientists are beginning to understand how burnout can affect people’s cognitive function; so disrupting their creativity, not being able to problem-solve so easily in dealing with working memory… And this is where I started to pick up, because maybe it’s literal burn out, who the heck knows, maybe it’s a flavor of it, but I’ve experienced some of these things, where I’m like “I can’t do that person’s name. He was just on a podcast the other day, and I can’t remember this person’s name.” And I was surprised I couldn’t remember their name, because I’m a big fan of them and what they do. It was either one of those moments where I just – they call it brain farts. Maybe I did that, I don’t know. But I was like “Man…” And then I read this, and I’m kind of like – what’s the word where you think you have every disease?

Hypochondria?

That’s one of them, but I’m… See, now I’m blanking.

Okay. Maybe I’m okay then [unintelligible 00:25:53.24] But you know, you think you have something because you read about it. The doctor says, “Hey, don’t go google this, because you will find things and hear stories… Here’s what your real prognosis is; here’s your real diagnosis”, and they say “Don’t go googling it.” And maybe this is just a case where it’s just sheer luck, timing or whatever, but I was like “I can’t remember that thing, that person’s name…”

[26:21] Anyways. So the point is - cognitive costs. It’s not just simply losing your ability to function as well as you can, or having that constant chronic stress towards things that are sort of imbalanced in your life, but this inability to be as creative as you once were. And it kind of goes back to that - the sneaky part that our friend Kieran said, this cunning thief. It feeds on your passion, and your energy, and your enthusiasm, because you begin to not be as creative as possible, as you once were prior to states of burnout.

Yeah. I think I’ve referenced this before, but this is part of what I love about the work that I’ve done and continue to do, is looking at – I do evaluations for people who think they have attention deficit hyperactivity disorder, and/or cognitive deficits, or sort of neurocognitive issues. And what’s fascinating is that people will read these checklists around symptoms, and think that they have it because they’re identifying and resonating with these lists, which is similar to what we’re seeing in burnout. And the difference with disorders like ADD, ADHD, is that that’s actually a neurophysiological issue. So that’s what you came with early on. And what testing does is go, “Okay, no, or yes. Which category does it fall under, so that we can help you better navigate it?” And I love being able to help articulate and identify for both clients and other providers, to go “How can I then best help this individual figure out what they need to do differently?”, because they can’t pay attention. This working memory - and if you’re not familiar with what I’m referencing in that, it’s like “Can I hold something in my head, in my sphere of attention, and manipulate it at the same time, or sort of similar times?” And that that doesn’t work in the same sort of way.

And similar to that, people come in, “Hey, I’m concerned. This person is having memory impairments”, which might look like a degenerative process, like dementia, and they had been severely stressed for a long period of time, and going “There isn’t a sort of pattern which is consistent with what we would expect for someone with dementia. This is likely relative to stress.”

So I don’t want to scare people in any way about this, but I just want to give legitimacy to like you’re not making this up, and then how do you move over into “Okay, if I know this is the case”, behavior change - “What do I do different?”

Well, the easy answer would be stop being so stressed.

But that’s very difficult.

When you have chosen a stressful path in life, let’s say a public figure, or someone who’s in Hollywood, or famous, for some reason; singer, songwriter, actor…

Expert in the field of anything…

…rock star of anything, essentially, whatever accomplishment may have been achieved - you kind of think like “Well, doesn’t stress sort of come with life?” And I think it does. But then you’ve gotta say, “Well, coping skills.” But that doesn’t change the fact that you are or are not going to be stressed in life. And maybe in the case of, let’s say, your friend who is a medical worker, someone on the frontlines in the medical field - they’re not in control of the flow. So if you’re in an environment where your control is not available to you, you can’t really push back on the stress that’s going to come at you. All you can do is cope with how you deal with it.

But at some point, most people will snap, or hit their limit; there is limits to all ability to cope with something, I’m sure.

Right. But this is why I would say, like with the awareness, to recognize before you hit the threshold of limits, right?

Yeah. So then the question I suppose is either how to deal with, or how to reverse. So if you can push back on it, what’s the antidote to stress, as one of the examples of the umbrella that is encompassed by burnout? You’ve got fatigue, you’ve got psychological issues, you’ve got cognitive issues, things like that… How do you push back on, or reverse, or avoid?

Well, so part of it looks like going “How can I reframe?” We talk about perspective-taking, and buffering. So if there are opportunities to take a reprieve… Do I need a day off? Do I need to step back? Or we’ve talked about time-blocking. Which sort of things – like, what do I have charge over? Do I have charge over my schedule, and who or what I do, when? Because that enhances my sense of control over what I’m doing. And then, alright, in what way does this have meaning, and/or do I know or have a sense of when this could end? Because look, one thing that’s super-important in navigating stress is having a sense of hope. And I think that at a new year, that’s part of what we’re doing - we’re forward-facing, looking ahead and going, “I have hope for a new year, and a redo”, or like “I get a clean slate, because 2020 will be done, and it’s like I get a do-over each new year.”

Yeah. Well, hopefully that’s true. Right? There’s the hope. Right?

Hopefully that is true. Because just because it’s a calendar new year doesn’t mean it’s the beginning. To some degree, it can be a psychological new beginning. It doesn’t mean it’s a literal – I guess in this case it is a literal new beginning. But is that true? And that’s the cynic in me, is challenging “Is it true?” So that’s what I’m trying to say.

Right. And I’m going to challenge you and be like “But Adam, it has to do with your perspective.” Because look, for lack of a better way to say it, and pardon my frankness, but it can suck. But if I am only focused on the suck, that is not going to enhance any positive emotions, because my brain is fixated on what I don’t want, what I don’t like, and then I’m going to cycle in that pattern.

Yeah, I suppose what I’m guarding against is the misleading fact that it may or may not get better from a pandemic physical world, is kind of what I’m guarding against. Because sure, like you said, it may suck, but I don’t want people to enter or prepare to exit 2020 thinking 2021 is going to “be better” in terms of the pandemic shifting, or things like that. I want that, but I want people to be prepared for truth. And I think truth - I’m not in the sciences around that. I don’t study all the research around it, but just from a layman’s perspective, have some hope for yourself, but geez, if it doesn’t get better, don’t base your ability to cope for next year on it being “better” from a pandemic level. Keep doing what you can.

Right. And this is why I would say you can’t only –

Perspective.

More perspective, Mireille? Okay… Here we go. I’m ready. I wanna hear it.

This is not just for me, it’s for the audience too, so I’m ready. Go for it.

One of the things that we are taught as psychologists when we’re learning to do assessments is that it’s never prudent to use one data point. If I look at one test, and then go, “Yep, you’ve got that”, that I’m banking everything on one piece of information, which might, and likely often presents a biased or incomplete view. So in no way would I ever – well, one, I’m not going to use “better”, because I’d have to actually quantify that, for the scientist in me… But two, would I ever solely identify my hope as rooted in whether or not things get better relative to a pandemic. So I’m gonna go, “What else can I get better?” And I think one of the things that I take away from this year amidst everything is I have really learned to fall in love with process, and like in what way can I make micro movements that contribute to a sense of good feelings and wins? Like, I did that.

I think I’ve shared before my sort of negative association in the past relative to cardiovascular exercise, because it’s rooted in being a gymnast as an adolescent, in like 110 degree heat in Arizona… And so that has never been like “Oh, yeah, let’s do that.” And not to mention the not breathing, struggling to breathe part of it… And this year, I’ve really been able to modify that through a different perspective of trying to – I love apps, right? So it constituted a different framework for me to get points for some of the exercise I do. Now, bear in mind, because I like it now, and I’m like “Ooh, this is fun”, and I like earning points - I can’t do too much of that as well.

Moderation.

Mm-hm. So I can get excited then, and I’m like “Ooh! I get to do this today, and I get to – I know, it’s crazy up there, I’ll tell you.”

What I hear you saying, and correct me if I’m wrong, is you focus on what you have agency over.

What you can control. And less on what you can’t control. And in some cases, it might seem like you’re distracting yourself.

Yeah. And I think too, taking away the opportunities around people showing up for a game… Like, whenever any athlete shows up to play, do they know what the outcome is going to be? No. And neither do we. So I can’t look at my days and go “I know exactly how today is going to play out.” But what’s the process in that, and can I find ways to thread in positive feelings that get me excited, legitimately? …not like “Ugh… Okay, sure…” But that that’s then motivating. So I’m working on a different reward center, which means guess what my brain is getting more often? That lovely neurochemical we call dopamine. And that helps me buffer. Because we’re coming back to – I really am trying to buffer all of the negative feelings. And we are very much in negative feeling management mode these days.

Yeah. And I think that’s where you have to really focus on what you can control, and maybe even say no to specific news feeds, channels etc. that might be triggers for you.

I know one thing that I use a lot for learning is YouTube. There’s so many things I’ve actually learned from watching or following certain people on YouTube. Everything from how to season my cast-iron skillet, to barbecuing a brisket, Texas style, for example.

[37:53] And those are great things, right? Those are fun backyard things I could do with my family, my cast-iron skillet provides us nourishment, and I’ve got to take care of it so it’s nonstick… And it’s all these nuanced, unique, geeky things that seemingly are just okay, but that same newsfeed on YouTube is cluttered with political things, or things that might pull me in a certain direction emotionally, or it might share something that I’m just not in the mood to be dealing with. So I have to exercise my control over that and say, “I don’t see it anymore.” Block certain things from my list, my ability.

And so just essentially being aware of what pulls you in a certain direction and limiting your exposure to that, or completely denying it. Certain people might be that, certain aspects of your job might be that. It might require you to change positions, or move somewhere else, or making a major change in your life to do that. But I think what you said before, we need to have that awareness, and that’s what we need to be aware of… As we close out this year and think about this next year, “What can I do to sustain? And how can I get by?”

I want to bring up this one thing that I don’t think we mentioned on the show, but we did in the pre-call, which was sort of the piquing interest for me. It was a fella named Ben McCormack. Ben is a fellow engineering manager out there, and he wrote a blog post called “Simple burnout triage.” And this is what really got my interest in this. He says this is the question he asks when he’s concerned about himself, or his team heading in the wrong direction, in terms of towards burnout or not… And he says this; this is the question you ask yourself, “If you take the pace and the quality of the last two months of your life, and you repeat it again, and again, how long would you be able to sustain it?”

Right. Hold on, I’ve gotta interrupt… Because I want you to say that again. Because I think it is that important. Because if we talk about a framework for our listeners, I want you to get a framework that he’s offering.

Yeah. I’ll say it again then. “If you take the pace and quality of the last two months of your life and you repeated it again and again, how long would you be able to sustain it?” And so that’s what piqued my interest further into this idea of burnout. And I suppose more so being able to triage it, being able to diagnose it, self-diagnose it… Sure, have a mental health professional in your life as necessary based upon your own desires, but just self-litmus-test; if you do what you do today for the next two months, and you repeat it again for the next few months and the two months after that, can you sustain it?

So this is a little bit deeper, but he says that when he asks this question, it tends to elicit three types of responses. And I’ll just go over the titles first; we can go in deeper if you want to, but he says the first response is, “I can’t go on like this.” No surprise there. The second response is “I can make this work, but…” And the third one is “I love my life, and I can keep going forever. I can keep doing this forever.”

And so the first one, when you read the deeper details of “I can’t go on like this”, the deeper details is the current pace is unsustainable, and we’re probably already well into the burnout phase, where tasks are being dropped, personal needs are not being met, and everyday life has become overwhelming. So if you pause the show and you think about that one alone…

Yeah, but I think that that is what is critical, because why we have these conversations is really that’s the hope that I want everyone to have, and what motivates me to keep going and keep sharing, is that - guys, there is so much hope around this, and there are ways; there’s just ways that, I like to say, are more functional, or more adaptive, and ones that are less functional, or maladaptive. And Adam, what I would highlight in that is, it’s about the prolonged effect. So when you go “Man, I’ve sort of teetered on this”, like, you have the awareness, and then we’re like “Oh, I need to be deliberate around changing this. So what things do I need to do that will help me come back?” And it’s so much easier if we come back earlier on, as opposed to when we’re too far gone.

[42:18] Yeah, those boundaries… Very clear, so that you can bounce back.

And this is why I think having people – like, we’ve talked about the key people in our lives… This is why, and I have friends, and my husband, who are like “Hey, Mireille, let’s have a little conversation.” Or like “Are you aware of X, Y or Z, when you start to tip this direction?” And so it’s easier to reallocate at that point in time, as opposed to further on down the road. And so then I can go, “Alright, what are some deliberate things I can set up as tethers or anchor points, or even guardrails? …so that too I’m more likely to achieve what I want in terms of the form of my life professionally and personally, when I have guardrails setup, and accountability around them.”

Mm-hm. What we said before though, about this idea of whether or not burnout can be reversed… And so going back to Alexandra’s article, she talked about a different study that went deeper into the MRIs we talked about… I’ll give the TL;DR. She encaps it by saying, obviously – and it’s talking about the depth of the research and whatnot. So I’ll just paraphrase some of it, and you can read it for yourself later on; we’ll link it in the show notes. It says “Obviously, four weeks of exam prep is not equivalent to the years of stress that many people endure at their jobs”, describing this test, of course; this research. “However, this study does suggest that interventions and recovery at the neurological level are possible for people suffering from burnout.” So… Hope. We’ve said before, your brain can change; we have a show titled that, talking about neuroplasticity, and it may be in this realm. There’s a lot that you can do to change your brain; I’m sure that, Mireille, you can go deeper into how well you cannot change your brain. At some point, you probably can’t. But the point is is that there are ways to recover if you have the ability to sort of like not go too far into burnout, or suffering, or despair.

Yeah. And so just to give a little more context to what Adam’s saying, and the article - the population and what she’s referencing to four weeks was 20 students who are taking the U.S. medical licensing exam. And so what was their level of stress like, because they’d been in medical school, and then let’s look at it in those four weeks before taking the most important test of their lives, so that they can practice medicine independently.

And you know, this is just it… Like, it really is around management. So we don’t need to panic when things aren’t working, but rather go ask ourselves, reflect and go, “What could I do differently? Is there some way or thing that would pay dividends?” Right? I mean, very much like we manage our money, manage our weight… I want people to see that we manage our mental and physical health too, and it’s not a binary construct, because we have all these systems at play.

I mean, could you imagine - you guys are all in the world of tech… Like, “Oh, I just fixed one part of the system and then it worked okay”? I don’t think that’s how it works, because they’re always communicating with each other. Right? And so we want to enhance communication within ourselves and within our environment, and capitalize on where we can utilize our own locus of control.

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