Welcome to Joy Lab!: [00:00:00] Welcome to the Joy Lab podcast, where we help you uncover and foster your most joyful self. Your hosts, Dr. Henry Emmons and Dr. Aimee Prasek, bring you the ideal mix of soulful and scientifically sound tools to spark your joy, even when it feels dark. When you're ready to experiment with more joy, combine this podcast with the full Joy Lab program over at JoyLab.coach
Aimee: Well, hi everyone. Aimee here, just coming in before this episode begins to give you a little intro to this encore episode. So this was a conversation we had with our Joy Lab community a while back. And during this, this month of equanimity, our element of joy, this conversation around burnout and depression comes up a lot. I know a lot of us are burned out and it is a big deal because it can look a lot like depression.
It can feel [00:01:00] a lot like depression. But there are differences and there are different ways to go about caring for yourself. So listen in for some tips and strategies to help you get out of burnout and also make it less likely in the future. And then in next episode, there will be a special burnout meditation, that'll be a perfect followup to this, a practice to help you feel more confident in your ability to handle stress and to get out of burnout.
And if you are in the Joy Lab program, you've already seen this meditation as an optional infusion. So I hope that you are able to experience that if not, here's a great chance to do it now. So yes, everybody enjoy this episode. I hope it serves you well.
Henry: So, we're talking about burnout today, not because our staff is burned out, right?
But because it's just such an important, [00:02:00] timely topic and there's so much going on about this if you if you stay attuned to the literature or the even the popular press, you know about what's going on in the world of work. This is a really big topic. It's an especially big topic in healthcare or maybe it's just what I'm most, most aware of. But that's a big part of why we're talking about it now. Because there's just so much going on. . So, I personally have an interest in this topic of burnout and I'll share a little bit why. Early in my career, and I know a lot of people can relate to this, certainly health professionals can relate, but early in one's career the tendency is just to work too hard. You know just to work so much. And for me personally, [00:03:00] I've written about this and talked about it before, but my early work as a psychiatrist in the in the way that psychiatry has evolved was simply not very satisfying.
I just wasn't getting fed enough from the work I was doing, and I didn't feel that the people I was working with were really getting their needs met, even though I felt we had good relationships and people got better, but it just wasn't going far enough.
So this combination for, for the first several years of my career, this would have been mostly in my 30s, too much work, not being very satisfying, and then I also had young kids, and a lot of people can relate to that, and it also is not a source of burnout, but it's just, it's just an awful lot of work. And time and effort. So that combination of things had me just right on the [00:04:00] edge of a very early burnout, or you might say an early midlife crisis.
So at that time in Minnesota, there was a fellowship offered at the time it was just for physicians, it was called the Bush Medical Fellowship. Bush Foundation sponsored it. And it basically gave physicians in practice an opportunity to take a sabbatical. Which sounded awfully good to me. They had one stipulation though, it was for mid career physicians and their definition of that was you had to be in practice for seven years.
So, after about two years I was getting mailings about this fellowship sabbatical and I just thought oh, jeez, I gotta wait five more years. And so every year I'd get another mailing. I'd think not yet, not yet. And then finally year seven I was [00:05:00] on it and I applied immediately and luckily I was granted the fellowship, which was a very graceful way for me to exit, the work that wasn't satisfying and shift gears into something very different, which is really very much what I'm still doing.
So I did this fellowship. It was focused on three things. One, and you'll see these all kind of fitting in with our work here now through Natural Mental Health and Joy Lab. So one was to focus on natural therapies for, uh, in psychiatry for depression and anxiety. Second was to find better ways to talk about and incorporate mindfulness strategies for mental health conditions.
So obviously a lot of that showing up here in Joy Lab. The third thing was to try to find ways to help other [00:06:00] health professionals who were also on the verge of burnout to somehow renew their work, their career, their passion for what they're doing. And so out of that I started a program when I finished my fellowship that was called the Inner Life of Healers.
And it was really geared towards working at somewhat of a deeper level, a more reflective kind of level about how to build our resilience, but also to renew our passion for this beautiful work of healthcare, which is truly an honor and a privilege, but you have to be able to sustain it, and that's not so easy to do.
So, this was a long time ago, you know, some 25 years or more ago, and unfortunately, the changes that have occurred since then, have largely just made things even harder. It's made it worse. There is [00:07:00] a real effort amongst health care institutions and organizations to try to address this problem because it is, there's a looming crisis, I think, in terms of people dropping out of the field and so Mayo Clinic is one of the places that's been kind of at the forefront of this. And they did a survey in 2015, that date is important, 2015, before the pandemic, and that survey showed that 54 percent of physicians were showing signs of burnout. 54 percent over half, and obviously that number hasn't gone away or gotten better since the pandemic and the lockdown and everything, it has only made things worse, harder on health professionals.
So, this is obviously not an issue that's limited to physicians either. So I just want to share one other little piece of research here. [00:08:00] There was a survey done by the Gallup organization called Gallup Daily that was looking at employee engagement, not healthcare, just employees all over. And in the U. S., they found that only about 32 percent of people say that they are engaged by their work. Worldwide, the numbers are even worse. It's only about 13 percent who feel engaged. And what they mean by that, the definition is to be involved, enthusiastic, and committed to their work and workplace. That's what it means to be engaged.
So, what does burnout look like? The Mayo Clinic, for their survey, this is how they describe burnout: a lack of interest, chronic fatigue, unprofessional behaviors with patients such as a lack of empathy, anger, impatience, or irritation. I've seen those things in a clinic from time to [00:09:00] time. And there was this recent study that I was mentioning earlier that kind of prompted us to take this on now was looking at workers in Norway and here is how they'd looked at the signs, described the signs that you might be at risk of burnout: feeling mentally exhausted at work, struggling to feel enthusiastic about your job, having trouble concentrating while working, and sometimes overreacting, emotionally, without meaning to, while you're at work. Now, these two descriptions, there's a lot of overlap between them. There's also a lot of overlap with depression, isn't there? You know, lack of interest, loss of energy, emotional reactivity, trouble concentrating. Very, very similar to many descriptions of depression.
I don't think they're the same thing exactly and I'm going to talk more about that later. I think there is a distinction that we can [00:10:00] make and it's important because it makes a difference in terms of how we might address it. But I'm going to turn it over to Aimee now to talk about this in a little different way.
Aimee: Yeah, before we talk about the distinction as well, I think it's helpful to have a big view of work. And so I want to sort of highlight there that burnout can show up in areas that might not so immediately be categorized as a nine to five. So work can include parenting. Henry, you noted that early on, caring for an aging parent or spouse or friend or partner, volunteering.
So there's many ways that labor can show up. And then adding any of these or many of these to perhaps like a usual work situation, you can see how burnout can surge pretty quickly. Even this morning, I was having a conversation while waiting for our daughter's bus with a friend, and we were [00:11:00] talking about how we're caring for our parents.
I'm caring for my mom, who's in memory care, and then, you know, our five year old daughter. That's the sandwich generation that's often discussed. And this is more common than ever. It's estimated that 25 percent of the US population is sort of stuck in that sandwich.
And particularly if your division of labor in the home is fully on you, or it's lopsided, you're getting that brunt of work as well. These things can really add up.
So I think it's good to think pretty large about what labor looks like, and then consider those variables as possible contributors to burnout. So also to note, you know, parenting is work, caretaking is work, you can love it, and it can still burn you out.
Henry: So, um, just to help kind of put us in the ballpark of what we're really faced with here and what we can [00:12:00] do about it. I want to kind of expand this to talk about the impact on mood and kind of the relationship between burnout and depression. So I think that very term burnout is kind of descriptive of having been too close to the fire, let's say, um, the fire of stress for too long.
And so that you've been kind of singed by the flame and then the energy or the emotion that keeps you really engaged and alive at work, it gets diminished. And, and of course that can also be a description for depression. So I want to try to frame this in the way that I view depression as being kind of just in different categories if you will. Right now I'm not talking so much about symptom categories, but more just about what's the nature of the depression?
What causes it? What's [00:13:00] under underneath it? So in my view if you were looking at a hundred people who were given the diagnostic label of depression, clinical depression, let's say they go to their primary care clinic or maybe even a therapist and whoever they're seeing has to submit something to insurance.
So they have to have an official diagnosis in order for it to be covered. Let's say that the term is, is loosely depression. Even though there's some different signifiers, different categories. My own belief is that of those a hundred people, there's only about 20 of 'em, about 20% that I think actually have clinical depression, as I define it.
The rest of them have something that's called an adjustment disorder or an adjustment reaction. And that really means simply that it's because of the stresses that they're [00:14:00] facing, that they're struggling so much. So this is what happens, I think, with burnout. Not that we have to label it as depression, but I think that there are so many things where the stress has been present for so long that a person gets depleted.
Their tank of resilience, their resilience skills become depleted. And what happens energetically then is often you go from the way I was in my early 30s in work where you're kind of frantic and anxious and feeling this over activity in your body and your mind. That can go on for a long time. I'm testament to that.
You can do that for a long time, but you don't want to do it so long that you lose the ability to create that kind of stress or intensity, because then you're in more trouble. That's when you get to that point of your whole [00:15:00] system burning out, if you will, becoming depleted. Which can literally be true, I think, for the adrenal system, the stress system, when you can no longer become stressed and hyper focused and into fight or flight, even if you should be, that's a bigger problem.
So we want to get at this early. We want to kind of come at it proactively and preventively. So the way I think of what I'll call true depression or clinical depression is oftentimes it's genetic, oftentimes it occurs for no apparent reason, and it can kind of take on a life of its own. It can come at times when you don't see anything that really triggered it.
That is more of a biological thing. Now, the distinction isn't the only important thing, because you might treat it very similarly, whether it's that genetic thing [00:16:00] or whether it's more of a stress related, temporary thing. You might treat it with medications, you might treat it with therapy, with natural therapies.
The big difference is that with anything that's stress related, you also need to address the root cause. You need to address the source of the stress or how you're engaging it or do something to change that dynamic, because if you don't, you'll feel better for a while, but it will just keep coming back.
And this is super important when it comes to work related stress. We have to find ways to work around it, If we have to work for a living, and our work is making us sick, we've got to find a way to do it differently, find something different, or take care of ourselves in a much, you know, kind of deeper, more fundamental way, or we simply can't sustain it.
One of those ways is to do our inner work. And so we're going to do that next [00:17:00] episode with a kind of practice that can kind of change the story here and, and get us back to, you know, to really feeling and functioning the way that we want to and need to.
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