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3rd December, 2024

How to Catch Stress Early Before You Spiral into Burnout

With Rachel Morris

Dr Rachel Morris

Listen to this episode

On this episode

It’s easy to think stress is a normal part of life, especially if you work in healthcare. This way of thinking puts us at risk of burnout, because we end up tolerating long-term distress and ignoring the early warning signs.

Recognising stress early on is key to preventing burnout. We can break the cycle by identifying those warning signs (feeling irritated or neglecting self-care, for example). Small changes, like taking breaks or reconnecting with friends, can make a big difference. And it’s vital to give yourself permission to do these things, because self-care is not selfish.

Burnout isn’t just a linear progression from stress; it accelerates if we don’t address it. It can lead to fatigue, a lack of empathy, and decreased performance overall. The closer we get to burnout, the harder it is to recover and return to optimal performance.

But we can avoid this by paying attention to our stress levels and making small adjustments today.

Show links

Reasons to listen

  • To recognise early signs of stress to prevent burnout and maintain peak performance
  • For practical tips on managing workload and resources to avoid the overwhelming vortex of busyness
  • To understand the importance of taking small, proactive steps to maintain wellbeing and improve professional and personal life

Episode highlights

00:01:50

The slippery slope to burnout

00:04:34

Just enough pressure to perform

00:06:16

Peak performance

00:08:17

The performance dip

00:09:52

How to diagnose burnout

00:11:27

Identify your early warning signs

Episode transcript

[00:00:00] Rachel: I wonder, how many of you, when you ask your colleagues, how are you, just expect them to say, you know, busy, stressed? For me, it’s just become the norm to get that response, particularly when I’m talking to people in healthcare. In fact, I was quite shocked the other day I was on a teams call with the GP. And he said he wasn’t stressed at all, and his workload was the best it’s been in 20 years.

[00:00:21] Rachel: Now drop us a line. If he wants to know how he’s done that. And maybe we’ll get home the podcast. But I remember when I was talking to him, I felt quite shocked because I hadn’t heard that for a very, very long time.

[00:00:32] Rachel: And I remember talking to a physio recently, she was telling me about a patient she had, who was a runner. And he had quite significant knee injury. And when he’d gone to see her, he said to her, well, of course, I’m going to get injured aren’t I? because I’m a runner, injury is just normal for us.

[00:00:46] Rachel: And she was quite shocked as well. She said, well, now it’s not normal. Being injured is not normal. Now it might be common, but it’s not normal. And I’ve done episodes on this before that stress is common, particularly at the moment, but it is not normal

[00:01:00] Rachel: And if you continue to believe that, well, stress is just normal, particularly the sorts of work that I do, then you are really in danger of being like that frog in boiling water, just not noticing how hot the temperature has become until you burn out. And that’s what I wants to talk about today. Because I think most of us leave it far too late to do anything about stress and to do anything about burnout.

[00:01:24] Rachel: This is a You Are Not a Frog quick dip, a tiny taster of the kinds of things we talk about on our full podcast episodes. I’ve chosen today’s topic to give you a helpful boost in the time it takes to have a cup of tea so you can return to whatever else you’re up to feeling energized and inspired. For more tools, tips, and insights to help you thrive at work, don’t forget to subscribe to You Are Not a Frog wherever you get your podcasts.

[00:01:51] Rachel: And I guess if we think that being stressed is normal, then it feels like we’re making a fuss. If we do anything about it, or if we seek help or we try and change things with it, I think we’re overreacting or even more toxic mindset that we get is that, well, maybe it’s just me that can’t keep cause of stress is this normal? And I’m not having a good time right here. And I really worried about my own health, then what is wrong with me?

[00:02:16] Rachel: So I want to talk to you today about the pathway into burnout and why it is quite literally a slippery slope. Because many of us think, and, and I have thought this for a long, long time as well that you can predict when you’re going to burn out. You can predict as the stress gets worse and worse and you feel worse that it’s a pretty linear process. And there’s a, a normal progression between being stressed, getting worse, feeling overwhelmed into burnout.

[00:02:40] Rachel: And so consequently, we think that when we get to a particular level, that’s when we need to do something about it. And typically we leave it far, far too long to do something, to make the changes that we need, to take time off and to rest.

[00:02:54] Rachel: But what I’ve come to realize recently is that it’s not a linear process. Because there’s a real risk that if you don’t recognize stress and overwhelm early, you find yourself in burnout much, much sooner than you thought you would. And by that time, you don’t have the chance or the opportunity to do anything about it. The feather you get into burnout, the harder it is to treat, the more time off you need to take, the more it will affect your life. And the bigger the cost for you both emotionally. Financially and professionally.

[00:03:25] Rachel: We know that doctors with high levels of burnout have a 63% greater chance of medical error. So when we’re in burnout, we make mistakes. It damages our relationships because we’re not reacting well to people, and it just makes us feel awful. Anybody who’s had a significant burnout does anything they can not to have it again and often makes radical, radical changes to their lives because it’s just not a nice place to be.

[00:03:48] Rachel: And so many of us wait until we’re at the burnout stage or on the edge of burnout to make any changes or do anything different. But if we do recognize this early, we have a chance to do something about it. It’s much, much easier to prevent and small actions will make a much, much bigger difference. We’ll feel better. We’ll be performing better. There’ll be less of a soft sick, which as we know, creates a vicious cycle of sickness and stress in other people too. And so our organizations and our teams are going to perform better too.

[00:04:18] Rachel: So I believe that this descent through stress and overwhelm and burnout, it’s not linear. And we can see this using the Yerkes-Dodson Stress Curve. You can download a copy of the stress curve PDF, and if you’re in truck extra, we’ll be providing you a full pod sheet workbook. With all the reflective questions and the stress curve in it.

[00:04:36] Rachel: Now the Yerkes-Dodson Stress Curve or the pressure performance curve, as it’s sometimes known shows what happens to our performance under increasing pressure. So if you just imagine a graph with pressure on the X axis and performance on the y-axis, with a bell shape curve. It essentially tells us that as the pressure increases on us, our performance increases.

[00:04:57] Rachel: Now we just launched FrogXtra. And there were quite a few bits and pieces to get ready for it. And as the pressure increased, so me and the team were working harder and harder. It’s to get us all ready to prepare the pod courses and all the resources that go into it.

[00:05:11] Rachel: And a few days before it was released, we were working at pretty optimal performance. Now in an ideal world, as the deadline got closer, we just keep getting better and better and better. Unfortunately, we don’t live in the ideal world do we? We live in the real world.

[00:05:25] Rachel: And so after a time at peak performance, as the pressure increased and I was online just trying to fix a few links and just getting stuff ready, I’d been at work for sort of 10 hours or so, my brain was starting to wear out, the pressure was increasing, but I could just feel my performance dipping. And it does, doesn’t it for all sorts of reasons. Not least we can’t work for a sustained period without any breaks. So that was part of it.

[00:05:50] Rachel: But as the pressure increases, we become more anxious. And we start telling us us I’m not going to get everything done. And then we go into our threat zones, our adrenaline, sympathetic zones, where we stop thinking straight because the brain goes from our prefrontal cortex.

[00:06:04] Rachel: So I love this curve because it pretty much matches reality. It shows us that as we become overwhelmed with pressure, our brains literally stopped working and we can’t perform, we get tired, we get anxious.

[00:06:17] Rachel: So as the line goes upwards to the right, from no performance to peak performance under a certain amount of pressure, you will find that the line starts to bend downwards into a curve and your performance starts to decrease as the pressure increases. And so we’ve got this lovely bell shaped curve.

[00:06:34] Rachel: Now when the workload starts to build up just like it did with that membership and the pressure builds up, normally, we just work harder and harder, which is okay to a point. And let’s face it. It’s the way that we’ve responded to all our lives. Isn’t it? But when we don’t have enough resources to meet all the demands that we need, we keep working harder and harder and so what we do is we try and increase our own resources by getting more time. So we’ll stop doing things like meeting our friends for coffee or exercise or sleeping or resting in order to make way for the work.

[00:07:06] Rachel: Now that can work. Okay. In short periods of time and in short birth. But if we keep doing that, what we find happens is that when neglecting doing those things that we need to do to re-energize ourselves.

[00:07:17] Rachel: And

[00:07:18] Rachel: a few years ago, I was preparing a course for Red Whale and we had a publishing deadline. I had lots of articles that needed to be done very quickly. I didn’t think I had time to do It. So. I put my children in extra childcare. I stopped going smite exercise classes. I stopped going for coffee with my friends. And I soon found myself feeling really tired because I wasn’t sleeping very well because I was waking up thinking about all that extra work, even though I was enjoying what I was doing. As I got tireder and tireder, I started getting grouchier and grouchier with my kids, and then getting a little bit tearful and thinking, gosh, is this all there is to life, just work, work, work?

[00:07:58] Rachel: And I soon realized I was starting to slip down the vortex of busyness. And at the bottom of the vortex of busyness is burnout. Because when the workload builds up, our tendency is just to work harder and harder. And then we stopped doing those very things that we need to do to keep ourselves well and make us feel physically and mentally fit.

[00:08:18] Rachel: And this is what happens on the stress curve. As we start to slip off peak performance, then we start to go down. It’s not a linear process. It actually gets steeper and steeper and the vortex gets faster and faster and faster and we find ourselves sucked down. So, whereas it might be quite a slow progression from peak performance to starting to feel stressed and then into overwhelm as we get deeper and deeper into the vortex and going down the stress curve, it actually speeds up. And I think we get to a point of no return where it’s very, very difficult to pull ourselves out and get back up the curve towards peak performance.

[00:08:55] Rachel: Now, I think in black holes, there’s a point of no return where the gravity is sucking matter in so fast that nothing can actually accelerate out of it. And that is called the event horizon, please correct me if I’m wrong. So I think there was a bit of an event horizon when it comes to stress and burnout. If you’re far enough down the vortex, it’s very, very difficult to then prevent yourself going into burnout.

[00:09:19] Rachel: Now, the treatment for burnout and stress can be quite different. Well, it is totally possible to recover from burnout, but you need to take quite drastic action. You need to take quite significant time off. You need to do some really deep work and reset your life, and you can’t go straight back into exactly the same situation as you were in before, otherwise what’s going to happen is you get burnout on repeat. But if you start to recognize and treat stress at a very early stage, then there will be some quite small changes that you can make. It’s much, much easier to avoid burnout and prevent it in the first place than it is to treat it.

[00:09:54] Rachel: Now, if you notice that you are in burnout right now, I want you to stop and I want you to go and get some help. And burnout is characterized by extreme fatigue that doesn’t get better with a rest. It’s characterized by a lack of empathy, you might feel yourself really cynical or just not caring in the way you used to. And it’s also characterized by a feeling that you’re performing really, really badly. And oftentimes you are. And I think it’s very, very difficult to be performing at a top level with burnout, as we know from the stress curve.

[00:10:22] Rachel: So, if that sounds like you, or even you’ve got a feeling it might be, please stop, get some help, go talk to somebody, go and see a healthcare professional, your GP, occupational health, or your own employee assistance program.

[00:10:35] Rachel: And I think the reason why the vortex gets faster and faster and the curve gets steeper and steeper is because the less we pay attention to taking breaks and resting, the less our brain can function. The more, we start to tell ourselves stories about, well, I’m not good enough. I’m not performing well.

[00:10:54] Rachel: And of course as the workload’s built up and you’re worried that you’re not performing well, so you try and work harder and harder, you then don’t give your brain the chance to catch up, and it becomes a real vicious cycle. And so you’re not seeing the stuff your brain needs, therefore you’re not performing as well, therefore you try and work even harder and ignore what your brain needs, therefore, it just gets worse and worse and worse. And eventually you end up in burnout.

[00:11:20] Rachel: So how can we recognize stress earlier so that we can avoid it rather than going down into that vortex and getting into burnout?

[00:11:28] Rachel: Well, here’s a few suggestions. Firstly, understand yourself. What are your early warning signs? A friend of mine. So she knows she’s slipping down the stress curve when she’s walking through town and everybody’s getting in her way. Are there certain things that you tend to do, like revenge bedtime procrastination?

[00:11:44] Rachel: Now that is when you so busy, do you sit down at about half 11, you know, you should be going to bed, but you think no, this is my time now, I’m not going to spread. I’m just going to binge three episodes of my favorite show on Netflix. Then you end up staying up till one or two in the morning. Just because you deserve it. But obviously the only person that suffers is you, ’cause you’re knackered the next day. That’s one of my tells.

[00:12:05] Rachel: Maybe you can spot some sort of recurrent thoughts that start going through your, your brain, or you start to feel a bit irritated with people you wouldn’t normally feel irritated with. Perhaps you’re feeling a little bit tearful, or you’re moved to tears a bit quicker than you would be otherwise.

[00:12:21] Rachel: I certainly felt like that a couple of months ago, um, when I had an episode of near burnout and I’ve talked about that in the episode called You Can’t Organize Your Way Out of Overwhelm.

[00:12:31] Rachel: You could also ask your friends and family. I know if I went to my kids and said to them, right, now, can you just tell me how you know that I’m stressed or overwhelmed, I know they will say straight away, well, you just snap this quicker. You accused us of not clearing up the kitchen, all those sorts of things.

[00:12:46] Rachel: Of course, we know that stress is a massive cause of ill health and 50% of symptoms that presents the GPs are medically unexplained. I think stress accounts for many, many, many of those symptoms. Headaches gastrointestinal problems. It puts your blood pressure up. You might be getting chest pains, all those sorts of things. And obviously you don’t just put those signs of stress. You go get yourself, checked out. But stress, like I said, is not normal physiological condition and it ups your risk factors for all sorts of medical problems.

[00:13:19] Rachel: The behavioral signs of, of withdrawal or increased emotional ability. So you might be angry very quickly or upset very quickly. You might get very defensive with people. You might turn to behaviors that just self-sooth or addictive behaviors which aren’t particularly helpful to anybody. Then you’ve got the, the mental things that affects us as well like. not sleeping properly.

[00:13:43] Rachel: And of course, if you have any red flag symptoms, please go get yourself checked out. These are low mood, these are thinking that life’s just not worth it, feeling very hopeless about stuff, please, please, please see a medical professional if that’s you.

[00:13:55] Rachel: Another thing that I found helpful in recognizing when I’m getting stressed is what am I stopping doing? How have I given up seeing that friend? Or am I staying up really late doing lots of work rather than talking to my family? So one of the first things I ask people to do in our training. Um, to maintain their wellbeing is to think of that first thing that you give up that reenergizes you physically and or mentally. What’s the first thing that you give up when you start to slip down that vortex of busyness? That is one of your early warning signs.

[00:14:27] Rachel: And a quick wellbeing tip is that the first thing you need to see if your wellbeing is put that thing into your diary every single week so that you. At the very least aren’t maintaining that one thing that, you know, you really, really need to do.

[00:14:40] Rachel: And when you start to spot those early signs, then a really helpful thing is to plot it on the stress curve. Just print off the stress curve that we’ve given you, or just draw on it piece of paper and say, where am I at the moment? And put across where you think you are.

[00:14:55] Rachel: You could also ask other people, where do you think I am at the moment? And side note, if you support anybody else, if you’re a team leader or if you’re a coach or a mentor, then you can use the stress curve to find out where other people are.

[00:15:06] Rachel: Now, if you’ve rated yourself just past area two, just past peak performance, then you’re probably further down than you think you are. And the question you could ask yourself is then what, what could I do to get myself back up that stress curve? What quick wins are there? Because there might be some really, really obvious things that you could see very quickly to get yourself up the stress curve and let me just give you permission now to do those things.

[00:15:30] Rachel: Because there’ll be all sorts of things stopping you. You might think I can’t possibly because my colleagues will think I’m dumping them or this or that. But believe me, unless you do those things and get yourself back up the stress curve and out of the vortex, it will be much worse for everybody in the long term.

[00:15:45] Rachel: So permission granted to do those quick wins, those things that you need to get yourself up the stress curve, back to peak performance. Because the signs and the symptoms of stress, they creep up on us. We think we’ve got all the time in the world to sorted out, but the further we go down the curve, the further we go into the vortex, the quicker it goes, the faster it gets worse. And soon you find yourself quite a long way down why it’s much more of a struggle. It’s a climb back up and so climb out of the vortex. So these small things that you can do right now are really, really important. They make a huge amount of difference.

[00:16:21] Rachel: And finally, please get the help that you need. I know it’s a bit of a cliche, but it’s a very brave thing to ask for help. Because we’ve got this ridiculous idea that we should just be able to keep with anything that life throws at us. My life is so much better since asking for help and getting some therapy and reading my self-help books and trying to understand myself more and really maximizing on the self-care or as I call it necessary care. Because I know when I’m doing that, my performance will be so much better.

[00:16:53] Rachel: And what does good performance mean? That means making an impact in the world, and pick out for help people in the way that I want to help people. So it’s not self-indulgent. This is for that. This is for other people. And it makes me feel better as well. And I just enjoy life a lot better. So do what you can to access the help that you need. Get the resources that you need. Do some courses. Meet with some friends. Rates and good books. And we’ll put some recommendations for things that, that, that have helped us in the CPD work book that goes with this episode.

[00:17:24] Rachel: And if you won’t see, we also have some courses that may help. We’ve got a short course called Get Your Life Back, which has helped when you were in overwhelm. We have our flagship Beat Stress and Thrive course. And of course, we’ve got the FrogXtra membership. So if you want to check this out, do you have look at the links in the show notes.

[00:17:39] Rachel: So don’t underestimate stress, don’t underestimate overwhelm, and certainly don’t underestimate how quickly burnout can happen.