Episode 2: The burnout crisis: How long can you fire on all cylinders?

Sep. 1, 2023 |  26 mins  

Join our host Jennifer Botteril as she chats with Dr. Susan Biali Haas, a doctor, health and wellness expert from Vancouver, British Columbia. In this episode you’ll learn what burnout is, how to recognize it, how to prevent it, and what steps you can take to overcome it. 

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You are listening to the Beyond Age podcast series.

Jennifer Botterill:

Hi, and welcome to Beyond Age, a Manulife exclusive podcast. Manulife Caress about the physical, mental, and financial wellbeing of Canadians. And during this podcast series, we chat with industry experts to uncover the truth about holistic health and aging, to keep you living healthier for longer, no matter your age. I'm your host, Jennifer Botterill, and today I'm joined by Dr. Susan Biali Haas, a medical doctor, speaker, author, and mental health expert who focuses on burnout prevention. Dr. Susan is from Vancouver, British Columbia, and we'll be discussing the burnout crisis. Welcome, Dr. Susan.

Dr. Susan Biali Haas:

Thank you so much, Jennifer. I'm really thrilled to be here.

Jennifer Botterill:

Wonderful. Well, why don't we start. May you please tell us a little bit more about yourself and how you first got into this field?

Dr. Susan Biali Haas:

Yes. So, I am a medical doctor by training, and I did work for 20 years in general practice, only really in the last couple of years that I've been working full-time in the mental health and burnout prevention space. But I have been doing it for a very long time. And it all really started during my emergency medicine residency training program. Right after medical school, I experienced severe depression and later came to understand that even perhaps more so than the depression, I was experiencing severe burnout. And I got very, very interested in the topic. Because of that, I wanted to understand what had happened to me and how I could prevent it ever happening again, if at all possible. And the more that I learned about mental health in general and about burnout prevention, the more that I wanted to make it my entire life's work to educate as many people as possible about these issues and how to strengthen and empower themselves.

Jennifer Botterill:

Absolutely. And I think for so many of us, we're trying to learn how do we manage our health, our energy, our overall wellness? And there may be many of us out there who might not know the definition of burnout. May you please help us define burnout?

Dr. Susan Biali Haas:

Yes. It's very common to not actually know what it means exactly. And I would even say that's the case for a lot of physicians. Like this was not something that I was taught in medical school. And it does refer to something very specific, even though the word burnout gets thrown around a lot. And so technically for burnout to be present, for someone to actually have burnout, there have to be three very specific things present. First of all, you experience emotional and physical exhaustion, so you're really, really fatigued. And second, you have a real change in your personality that you become more negative and more cynical specifically about your work. And you also might start drawing more from other people. For example, if you're working with customers, they might start to feel just like numbers or irritants in your day that you have to get through to survive so you can go home.

And then the third piece is not surprisingly, a loss of productivity and effectiveness at your work, but that loss of effectiveness might also be experienced as a loss of confidence in your ability to do your job. Or you might start questioning, am I even doing the right job? And a lot of people, actually, because of my story and the work that I do, I'm an executive coach. I've done that for I think 15 years now. And a lot of people come to me because of my story, because I did quit my residency. And so, they want help quitting whatever they're doing. And it's fascinating to find that the vast majority of those people, they are experiencing burnout. And that's why they're suddenly feeling like they shouldn't be at their job anymore, that they're doing the wrong thing. And most of the people I work with actually don't end up quitting their jobs once we address things at their workplace and also in their own lives, the things that they can control, which I just find really exciting.

Jennifer Botterill:

Right. And empower them to make some adjustments and changes to feel better. So, you shared a lot of those symptoms. How would you describe what causes the burnout that leads to these symptoms? And if you could describe the impact or the toll that it can take on our overall mental and physical health.

Dr. Susan Biali Haas:

Sure. So, in terms of the cause, it's very important to understand that it's not your fault if it's happening to you. And it's well established that the main things that create burnout in us are work related. Like by definition, burnout is a result of chronic work-related stress. And so, we know very well things in the workplace that cause it. Like if people have too high workloads, if they feel like they don't have any control over what's happening at their jobs, if they're working in a very stressful or even toxic kind of community, or if there's like a culture that's really difficult. Things like inequality, not surprisingly. And also, if there are things happening at work that conflict with values that are important to you, those are the classic things that we know to drive burnout. Though, of course, there are things that we can do that make us more vulnerable.

Let's say, if we're not getting enough sleep or we're just cramming everything possible into our life and we never get any rest. So absolutely there are personal things, but fundamentally its workplace related. And your second question about the impact on us. Because burnout, fundamentally what it is, is increasing levels of stress that you are experiencing and all of the mental and physical impacts of that profound chronic stress in your mind and body. So, I already mentioned some of the changes to personality, to your thoughts, to your energy levels that are absolutely classic. But then we also know, because of the toll of burnout on the body, it basically predicts almost every kind of physical illness that you can think of. And I hate to even say that because I don't want to frighten people, and I don't mean this in a doom kind of way.

It's important to know that it can predict cardiovascular disease and diabetes and muscle pain, stomach problems, all those kinds of things. You want to increase your awareness of what burnout is. You want to understand it as best as you can. And you want to be a participant in helping to improve things at your workplace and also taking care of yourself better. And sometimes it can be motivating to know that this really does have a toll on your body. And so, by addressing these things, you're going to give your body a much better chance at being healthy and your whole life feeling better over the long term.

Jennifer Botterill:

Right. I think that's what we're all striving towards, longevity, the health and the wellness for our aging process. And you shared some very personal experiences in medical school and residency. And from your experience, have you noticed that people working in certain sectors are more likely to experience burnout? And why might that be?

Dr. Susan Biali Haas:

Yes. Burnout is definitely increased across all sectors right now and over the last few years, I mean, it's been around well before the pandemic, obviously, but it has gotten worse. I see across the board as well, because I work with so many different types of organizations in my burnout, prevention, education work that I do. And so, so many sectors almost all are experiencing, for example, increased workloads, problems, getting staff. So those kinds of things are happening everywhere. But in terms of particular sectors, of course, healthcare, yes, we're all aware of that. Yes, absolutely. But it's interesting, they look at causes over the last few years of the increase in healthcare burnout. It's still bureaucracy and those frustrations that are innate to the job and understaffing, things like that. It was already a really big issue in healthcare before the pandemic.

Jennifer Botterill:

And in addition, are there also certain demographics that might be more vulnerable or more likely to experience burnout?

Dr. Susan Biali Haas:

Yes, absolutely. From the data that I've seen, women are higher risk for burnout than men. And it's presumed to be to a degree, because women tend to carry more of a load at home as well. So, they're carrying their workplace stresses, but then often have a second shift when they get home. They may have responsibilities not only for children, but for aging parents. So, there does seem to be a demographic effect there. Also, people who are newer in their careers are newer to whatever it is that they're doing because they haven't got that experience of time and how to cope with things and how to problem solve within that context may be more vulnerable as well. And then people who are minorities who have experienced injustice, inequality is one of the primary drivers of burnout in a workplace environment is one of the fundamental drivers. And whenever people are experiencing injustice or inequality, that definitely is a big risk factor. And it's been an exciting time in that there has been such a focus in trying to correct and increase awareness of these types of injustices. Anytime there's unfairness, there's going to be increased risk for burnout. And that again, ties back to what I said about the things we know about the workplace factors that drive it.

Jennifer Botterill:

And so, you've mentioned that a couple of times, the workplace factors or the workplace stress. And so how do you differentiate between manageable amounts of stress at work? Or is burnout caused by this stress? Or is this more of a long-term burnout situation Yes. That you need to deal with? So how can people sort of decide what the difference is between burnout and stress that I can manage?

Dr. Susan Biali Haas:

Yeah. You bring up a really, really excellent point. And we've known this for a long time, that when we look at human performance, that there's this curve. And in terms of where we hit our peak performance and where we really, really thrive as humans. And it's not when we're totally relaxed and have nothing to do. Even though we need rest, yes. But actually, we do really well with stress and having been a challenge in our lives, having goals and things to work for and demands made on us. But the key is the amount of time, right? So, you pointed that out, asking short-term versus long-term chronic. So, let's say you have a big project or a deadline, and that can actually really bring out your very best and not necessarily cause burnout if it's for a fixed period. And after that, you have a bit of a chance to recover.

But let's say that it's been months or even years where there's just chronic demands and pressures and lack of control over them, and maybe a difficult culture that you're in, the demands that the environment is making of you start to exceed your resources, right? Maybe you're sleeping less, you are not having that chance to recharge. Maybe things are getting more difficult in certain aspects of your job that you no longer really feel you can cope with. And that's when we start to slip over into burnout and health issues, mental health issues like depression, et cetera. So, we want to try both workplaces and individuals to do as many things as possible. And it's not to give you more pressure, this is not to stress you out or give you a longer to-do list. It's more about being aware of where is that zone where I feel alive and I've got energy, and I feel good about what I'm doing in my work and in the world, and what are the things that we can do in workplaces and in our own lives to keep us as much in that thriving zone and out of the burnout zone.

Jennifer Botterill:

Absolutely. I know even personally, from my experiences, both as a hockey player and an Olympic athlete, and then even now in the broadcasting world, it was funny. What's your ideal performance state? And I feel like it's a sliding scale for many people between maybe a state of being relaxed on one side and being intense or competitive in athletic setting. And it's sometimes a sliding scale to figure out where that balance is. And every person, every athlete, every professional is going to be different. And you mentioned some of the different symptoms that people might experience on burnout, whether it's the exhaustion, the negativity, the loss of productivity, and is that the chronological order, or could you walk us through the stages that someone would experience during burnout?

Dr. Susan Biali Haas:

Yes. Again, a great question, because when I present those three, it's not a chronological order, right? It's the three components that all three have to be present for there to be burnout. So if you're just tired, but you're overall still feeling really positive about your job and connected to the people that you work with, and you're reasonably productive, and you still are enjoying your job and feel that you're in the right place, like you're starting to get tired, but you're not yet burned out. And as far as I know, there isn't literature that we all agree on. It's more even dependent on the person. Mm. Like the first thing they might notice is that they're starting to get really tired. For another person, they might notice, gee, I'm starting to get a bit snappy at work. I would always notice when I was working as a doctor, when I would find that I would have less patience for my patients.

Jennifer Botterill:

Right.

Dr. Susan Biali Haas:

That would be a flag for me that I was like, okay, I don't have full on burnout yet, but I need to pay attention. I need to make sure that I have lunch today. I need to make sure that I have a good breakfast. I need to make sure that I should plan some kind of a vacation. You know, those are obviously very simple things, but I'm just saying that when I would notice one of those things starting to flare, that would always get my attention. And that's what we want to be watching out for. We want to ideally prevent ourselves from going into the full-blown burnout.

Jennifer Botterill:

And you said maybe they are simple things, but very important reminders for everyone along the way. Yes. So, during those various stages that someone might experience, when might be the right time to seek assistance or support, is it during those stages? Is it before they become too consistent? What timing is right to look for help?

Dr. Susan Biali Haas:

Well, I would say that the timing is actually always right. So yes, I'm an advocate for as early as possible, and that might not be possible for everyone depending on the resources you have access to, depending on the time you have available, if you're a busy working parent. But in addition to that, I also don't want to make anybody think that it's ever too late. It's basically always worth it. If you have that thought, maybe I could use some help or some support, or somebody suggests it to you, I would really encourage you to act on it and to get the help. It is just so priceless. And we know that counseling support, for example, for conditions like depression, and certainly helpful with burnout, we know that those can be even more effective than medication in the early to moderate stages of these things. It's not just talking. It's really, really impactful for the brain and for the body to have that kind of support.

Jennifer Botterill:

Definitely. We're going to take a quick break, and we'll be right back after this message.

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Jennifer Botterill:

Welcome back to Beyond Age. Dr. Susan, you've also answered a couple of times the importance of recovery, and perhaps that's both on the short term and on the longer term, and it does take planning to make sure that you can integrate those moments of recovery. And then you talked as well about the workplace and the stress that can be created and the demands there. Are there specific things that you've seen employees or employers do that have led to burnout?

Dr. Susan Biali Haas:

Yes. That's tied directly to that longstanding research I mentioned where we know those main things that are driving burnout. I don't necessarily want to make employers feel bad because so many of these factors are often beyond their control, like goals that they need to achieve. If they're understaffed, the work needs to get done somehow. And so, I think it's really important for employees to have awareness of those six factors, the work overloads, lack of control, community issues, inequality and values conflict, to be aware of those and think about how they leverage those pieces to better support their employees. Like, for example, the control piece. This is the most exciting thing about the times that we're in. There's so much interest right now in supporting employees. I hear that from all sectors day and night practically. People are reaching out. They want to support and help their people.

That is really the spirit of the time. They want to help. And the two-way conversation is so important. That's why it's so important to educate the people as well about these factors. And so, when it comes to the control piece, I encourage employers to have a conversation with their people to say, what would help you feel like you have more control? Is there something to do with how we do your schedule? Or a way that you approach your work? Is there something that drives you crazy that is getting in the way? Are there bureaucratic things? The workers are the ones that know those things. And I've often seen well-intentioned employers come up with ideas for how to help their people, but they haven't actually talked to the people about them. And so, they're not the most powerful, most impactful thing that would help. But then also, sometimes employers, they may not be able to do the ideal thing, but they can do something. Overall, understanding what the drivers of burnout are as an organization, and then working together with the people to identify what are the things that we can change that will just help everyone.

Jennifer Botterill:

In identifying those factors. And you mentioned as well, communication and conversation on both fronts. We look at the other side of things here. Instead of, you know, things that have led to burnout. You sort of mentioned a couple of examples on how to potentially prevent it. So, are there other steps or common approaches that you would recommend for workplaces or for employees to take that can be a part of this prevention piece?

Dr. Susan Biali Haas:

Yeah, lots of them. One that comes to mind that I actually think I forgot to mention when listing the factors is lack of recognition or lack of rewards. In that sense, that's a big driver of burnout when people don't feel recognized and appreciated for the value that they bring to an organization. And they think that that was a big part of what drove the great resignation phenomenon. And why I love this piece is because often those people who didn't feel valued, they actually were, it just wasn't communicated to them enough, or in a way that they could really hear it. So that is something that both on the employer side, the leader side, and the workforce side, is something that we can all do to strengthen the culture and the people wherever we're working. I always give it as a piece of homework when I speak to organizations.

So, anyone who's listening the next time, and every time after that, that you have a thought about, a colleague, about something they did well, something that you appreciate, do not keep it to yourself because it is so powerful. So, tell people how much you appreciate them when it occurs to you, when you notice it. But then also when someone appreciates you, really let it sink in, really receive it. Let yourself acknowledge that you are good at what you do, that you are making a positive difference. Because that also, when we really let ourselves receive that appreciation, it's very, very protective for us in terms of preventing burnout.

Jennifer Botterill:

Absolutely. And I think for all of us to take those moments to be present. And to absorb it, not just pass by and get onto the next task, but just take a simple moment to celebrate your value, your success in what you bring. And so, with many of these things that you've shared, when it comes to burnout and aging, can burnout lead to physical changes in our bodies? And can it impact how we age?

Dr. Susan Biali Haas:

Yes. I'm afraid it does. Yes.

So, I get so excited about this because I like knowing these things. Because then, we are learning more and more. I wrote about this a lot in my book, The Resilient Life, is that we are learning that the body is capable of recovery. As you mentioned, I mentioned that a few times, like even at a DNA level. So, we know that if people are under chronic stress, absolutely, it ages us faster at a cellular level, which translates to all aspects of our mind and body. But that doesn't mean that it has to stay that way. We know, for example, things like mind body practices, like meditation, yoga, that sort of thing, or getting more sleep, eating a healthier diet, decreasing stress, if there's aspects of it that you can control or learning to manage stress better in the way that you think about it and handle it. And even again, talking to a counselor, those kinds of things have been shown to actually heal our DNA and reverse some of those negative impacts that the chronic stress has had. So yes, it's serious, but as long as you're still here on this planet, it can be improved.

Jennifer Botterill:

Right. And so, is there anything else that you wanted to add to that in terms of how important is recovery? Or how can people integrate these recovery pieces or to make sure in their planning and their schedule, they allow time for meal planning, for healthy nutrition, for meditation, for yoga windows, even if it's a short time, maybe they don't have a whole hour to go to a yoga class, but maybe it's a 20 minute yoga session. What are some other things that you think are huge priorities to help prevent potential burnout?

Dr. Susan Biali Haas:

Yeah, there are lots of things that we can do, which of course can also be overwhelming. So, I would say for a busy, overwhelmed person, that actually the best thing on the fly that you can do is deep breathing. Right? Whenever you feel stressed, I'll even do it. If I'm waiting for something to download, I use a 4, 6, 8 breath where you breathe in through your nose for four, hold it in your chest for six, not seconds, just counts. And then breathe out my stress for count of eight. And we know that the impact of chronic stress and short-term stress is mediated through the sympathetic nervous system, which is our stress system. And when you take a deep breath, especially when you make the exhalation, when you breathe out for a really nice long time and empty your lungs and really calm yourself, that that stimulates what we call the parasympathetic nervous system, which is the opposing relaxing nervous system.

And you can actually start to stop the stress response in your entire body by just taking a few deep breaths at any time. So that's a simple thing. But then also, I would really encourage you to think about what works for you, because anything that you incorporate, you want to enjoy it. It has to work for you. Ideally, you want to like it, it has to work with your lifestyle. And so, you might even think like at another time in your life, when you felt better, when you felt healthier, when you had maybe some habits, maybe you were going for walks every day. Maybe you were going to bed earlier, maybe you weren't watching Netflix for five hours a night. Think about those times in your life and also times that you felt restored, like after certain vacations or certain things that you used to do on a weekend. Think about what's worked for you in the past, and how can you get those things back into your life, even just for like a few minutes at a time. Every bit counts.

Jennifer Botterill:

And I think finding the purpose in each of those little elements can be so valuable, I think, for all of us. I mean, if we think about our lives, every person's going to be in a unique situation with their lives, their careers, their personal lives. And I think we all know that it can be demanding, it can be busy. Yeah. But for us to set aside time for planning and purpose, to make sure all of these elements that make us our most healthy, our most well are part of our daily planning. And become part of our routine. Now with some of the conversations surrounding burnout, are there myths or are there misconceptions about burnout that you'd like to clarify?

Dr. Susan Biali Haas:

I'd say one of the longer standing myths is that it's an individual problem that burnout rests on the shoulders in terms of the cause on the individual, that if you're burning out, it must be your fault, you must be doing something wrong. And that's not true. As I've mentioned, we know that the primary driver are these work-related causes that you often don't have a lot of control over, at least initially. So, if you're experiencing burnout, there's no shame. It's not a sign of weakness. It's a totally predictable outcome when human beings are exposed to a certain set of stresses. And then second would be that it's something that just a vacation will fix. And we know that vacations are super important, and they are absolutely part of a strategy for preventing, avoiding and recovering from burnout. But it really is how we live our lives.

And as you've said, how you build in those things that support you. And I would say maybe the biggest myth that I come across, and I primarily see it in women, but men of course too, is that it's selfish to make time to take care of yourself. Working parents have such a hard time with this, and it's like, no, I want to get through to everybody, that when you take care of yourself, everyone benefits. Even in the moment, if they might be complaining that your mom has gone off to do something and the kids are not happy about it, it's so important. And ultimately, your workplace, your family, your friends, your community, the world will benefit if you are taking care of yourself. It is the best thing you can do.

Jennifer Botterill:

Such a good reminder. I have three young children, and I think that's an important one for all of us. You know, I think so many of us want to help other people and be the best for those around us, but such an important message that it's important to make sure that you keep yourself a priority, and that's what's better for everybody that you're surrounded by. And so, I mean, so much valuable information, Dr. Susan that you've been sharing with us. If you could summarize, are there one or two key takeaways or a couple of things that you think are most important that you would really like our listeners to take away from what we've discussed today?

Dr. Susan Biali Haas:

Of course. So, the biggest part really is to take care of yourself and know what that looks like and how that works for you. So that would be the top second is to pay really close attention to how you're doing. How is your energy? How are you feeling? Are you feeling a bit more grumpy, more irritable? Paying attention to those early signs, and then getting support sooner than later, and ideally having it also just built into your life. But don't hesitate to reach out and get that support. Know what your benefits are that you have access to through your work, for example, and use them. That's what I would leave you with.

Jennifer Botterill:

So very helpful, Dr. Susan. Such a pleasure. This really has been tremendous. I know that all of us will have many, many takeaways from our discussion. So, thank you for taking the time and sharing these insights with us today. Thanks, Dr. Susan.

Dr. Susan Biali Haas:

It's my great pleasure. Thank you so much.

Jennifer Botterill:

So that's it. Thanks for tuning in to Beyond Age, an exclusive podcast from Manulife. Tune into the next episode where we talk to Dr. Greg Wells from Toronto, Ontario, all about wearable technology and your health. Don't forget to visit our website, manulife.ca/livehealthier for more tips, videos, and content for Manulife that can help you live healthier for longer, no matter your age.

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