How to avoid burnout and keep your spark

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Confide in someone you trust. Avoid the empty complaining, “Ain’t it awful.” Ventilate your concerns and feelings, and look for honest feedback. Be open to suggestions for action.

Get professional counseling. Burnout is moderate or major depression. Practice what you preach.

Join a support group. Let go of, “Real doctors handle things on their own.” Focus on introspection and solutions.

Consider stress management. Options include seminars or retreats and individual, practice-oriented, and organizational consultations (see Related resources).

Burnout as opportunity

Viewing burnout as an opportunity for transformation gives you a chance to:

Re-evaluate your life and priorities. What is most important to you: Money? Family? Making your community a better place? Spiritual growth? If you knew you had only 1 year to live, how would you be living?

Renew/reinvent yourself. One burned-out psychiatrist moved from Denver to San Francisco, where he started over with no expectations or image to uphold. This made it easier to try new professional and personal ventures.

“The geographical solution” is not necessary, however, and can add stress at a vulnerable time. You can “bloom where you’re planted” and renew yourself wherever you are.

Rediscover your passion. Teaching? Art? Part-time practice and run a bed-and-breakfast? Surfing? Guitar lessons? We know physicians who used each of these to help revitalize themselves.

Case continued: recovery

As my life got worse—a drawn-out divorce, two daughters in private universities, and by now a greatly reduced income—I felt trapped and spent. I had to change or die emotionally (possibly even physically).

Not knowing what to do, I took a leap. I cashed in my retirement fund and resigned. I took a 6-month unpaid sabbatical. With no schedule to keep, I had time to read and think. I resumed my own psychotherapy, went through deep reflection, and re-evaluated my priorities and values. I took up acting for fun and started keeping a gratitude journal.

Eventually I remarried. I started changing my workaholic tendencies, limited my practice to 20 hours a week, and established that my priorities were family, friends, and the joy of helping patients and colleagues. I re-discovered my enthusiasm for teaching, including teaching others about preventing burnout.

Preventative medicine

To prevent burnout, we must learn to recognize and address brownout. This is a much better choice than trying to recover from full-fledged burnout: less disruptive, less costly, less damaging interpersonally.

How do we prevent burnout? Several approaches are particularly useful for psychiatrists:

Self-care. Take time off, but beware of “The Vacation Solution”—psychiatrists’ most popular strategy. As one put it: “I work until I’m ready to drop, then I take 2 weeks off.” This is unhealthy:

• physically (gradually wears you down)
  
• emotionally (we all know the risk of repeated mild depressions, or brownout)
  
• interpersonally (our family members and colleagues suffer as we get exhausted).
  

Get a personal physician to maximize your health; only about one-third of physicians do. You are playing medical roulette if you treat your-self or manage with only informal chats with colleagues and medication samples. Suffer a coronary or stroke or slip into excessive alcohol use or obesity, and your best-laid plans can be derailed.

Give and get affirmation and support. Isolating yourself socially is one of the surest roads to burnout. Compared with solo practitioners, psychiatrists working at community mental health centers often report greater career satisfaction. Although they may have difficult case loads and systemic challenges, group practitioners are supported by nurses, social workers, and case managers. The team helps dilute the stress of caring for the most difficult patients.

If you have a solo practice, try to connect and commiserate with other mental health practitioners by joining a professional organization or forming your own process group. If you prefer not to socialize professionally, consider a book club, temple, or church group.

Take time to interact meaningfully: practice appreciating others at least 3 times a day. Saying, “I really admire how you handled that situation,” or “How are you doing?” takes less than 10 seconds. Appreciate your own efforts, too. Write down—now, as you read this—the names of three people you will affirm or offer support to today. Include one person you usually wouldn’t acknowledge.

Find/create meaning in your work life. When you get tired or frustrated, remind yourself that practicing psychiatry is a privilege. We make a difference with people (service) through intimate emotional connection (relationship). Altruism confers benefits to the giver and the recipient. Some psychiatrists derive meaning by seeing our profession as fulfilling a mission or higher purpose, even as a calling.