How workplace burnout hurts your health — and what to do about it

Dear doctor,

Of late I have been having recurrent headaches and other body pains that I think are related to my being tired with my job. During the weekend I am okay and very happy, but during the week I am always in a bad mood. I never want to wake up in the morning and I don’t want to talk to anyone. What could this be? Am I depressed? Is there anything I can do about it?

Maureen

Dear Maureen,

You seem to be experiencing burnout. This is the state of being physically, emotionally and mentally exhausted due to a prolonged exposure to workplace stress. It leads to reduced energy, reduced professional efficacy, feelings of negativity and increasingly distancing oneself from the job.

Initially when someone starts a new job, there is a lot of energy, positivity, productivity, creativity and the individual is committed to the job, and feels satisfied, even grateful for the work. After some time, depending on several factors, workplace stress sets in, which may be seen in the reduced focus, lowered productivity, irritability, anxiety, and physical symptoms may start such as headaches, change in sleep habits and changes in appetite. If this continues, then the individual may feel threatened or like they are under pressure, and at the same time, are under-performing and missing deadlines. The person becomes increasingly negative and may be aggressive. Some may take up escapist activities such as excessive alcohol intake and gambling, among others. After this, the person reaches the burnout stage, where there is an obsession with the problems at the workplace, and the overall outlook is always negative. The physical complaints increase or continue, and the person may feel like they do not have a purpose and even begin to doubt themselves, which can lead to self-neglect, social isolation, and eventually, someone may develop depression and anxiety disorders.

Workplace stress may be due to a number of different factors. It may be due to the workplace itself such as having little or no control, having unclear expectations, having expectations that are beyond the individual’s capacity for whatever reason, lack of recognition, having a high pressure or chaotic environment, having too little work or having work that is monotonous or unchallenging. Having a poor physical work environment can also contribute to stress. Other factors that can contribute to workplace stress are: working too much, taking on too much responsibility, poor sleep habits, not having a social support system, adopting negative social habits, being a perfectionist, or high achiever, or always wanting to be in control.

Stress refers to the situation where what you encounter seems to be beyond your ability to cope. Stress is not always negative. Good stress or eustress pushes us to perform better - improved performance in a competition, or working towards an approaching deadline. However, if the demands overwhelm your ability to cope, you go into distress.

The body has a system in place to handle stress that begins in the brain and activates different messengers to improve blood, oxygen and energy supply to the brain and muscles, and also shut down “unnecessary” functions at that time like digestion. This response also has a way to shut itself down so that the effects are temporary and the body can go back to normal functioning. If the system is activated too frequently and for too long, the shut-down mechanism malfunctions, and you experience negative effects of the stress reaction such as palpitations, high blood pressure, sleep disorders, problems with digestion, problems with regulation of blood sugar and immune system dysregulation. Chronic stress also affects how the brain works and can interfere with learning, memory and contribute to anxiety, depression and addiction disorders.

Managing burnout and other forms of stress begins with self-awareness of what you are capable of, what stresses you and why and how you usually react to the stress. This then helps you improve your self-management by getting rid of negative coping mechanisms, adopting positive ones and defining boundaries. Also build connections by prioritising relationships and joining relevant groups. Be more proactive in discovering and working towards your goals and in helping others. Foster personal wellness in all dimensions, including your thought life. You can reach out for assistance from a trusted other and/or from a mental professional.

Doc,

What does the medical term rheumatism mean? Does it affect all parts of body.  Please shed light on this.  Ali

Dear Ali,

Rheumatic disease is an overall term for conditions that cause inflammation of the joints (arthritis) and other conditions that affect joints, bones, muscles, tendons and ligaments, in any part of the body. There are many forms of rheumatic disease, but the most common are:

- Osteoarthritis – wear and tear or degeneration of the tissues of the joint (the cartilage and bone) leads to pain, stiffness and swelling.

- Rheumatoid arthritis – this is an inflammatory disorder caused by the body’s immune cells attacking healthy cells, leading to pain and swelling of the joints

- Gouty arthritis – build-up of urate crystals in a joint causes inflammation

Rheumatic disease can develop as a result of wear and tear over time, or as a result of over-use or injury; or due to infection (such as septic arthritis); or as part of a disease affecting the rest of the body such as auto-immune diseases like lupus or hyper-uricaemia (high uric acid levels) causing gout and some that may not have any identifiable cause, like fibromyalgia. Risk factors for developing joint disease include age, gender, genetics, smoking and overweight or obesity. Children can also develop arthritis, the most common of which is juvenile rheumatoid arthritis.

To reduce the risk of developing rheumatic disease or delay the onset, maintain healthy weight, stop smoking, exercise regularly - with special guided exercises to strengthen joints that you use more than others - and have any underlying diseases treated. For someone who has rheumatoid disease, management of the disease begins with getting adequate information on the condition so as to better understand it, manage it and know how to protect the joints. In addition, it is advisable for the individual to get medical treatment for the symptom as well as use devices as necessary such as knee support or crutches. There are exercises that can help manage the pain and stiffness as directed by the physical therapist. Some rheumatic conditions may require surgical intervention.

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