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Is It Burnout, or Is It Stress? How to Tell.

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Anyone following the healthcare industry over the course of the COVID-19 pandemic—including aspiring medical students like you—is probably aware of reporting about the rising rates of burnout among physicians and other healthcare professionals. According to a November 2022 article from the American Medical Association, 63 per cent of physicians report experiencing symptoms of burnout once a week.

Saving lives is a stressful occupation. Saving them during a global pandemic caused by a new disease with few treatment options compounds that stress significantly. But, while they are related, stress and burnout are different. Understanding the differences between these two conditions—and how to proactively manage them—is important for anyone who aspires to study medicine.

Stress Is Short-Term

People experience stressors every day. Deadlines, traffic jams, arguments, even tough workouts—all these can lead to feelings of anxiety, overwhelm, and hyper-alertness that are an adaptive response to difficult situations. In other words, stress.

Usually, stress comes and goes quickly, or has a specific end in sight. For example, studying for the MCAT is very stressful. However, you know when it will end—on your test day. In the lead-up to your test, you may feel worried, have trouble sleeping or eating, and be motivated to study as hard as you possibly can. It’s unpleasant and difficult, but there’s a goal involved. There will eventually be a release of that stress once the goal is reached.

Burnout Is Long-Term

Burnout comes after years-long periods of stress that have no end in sight. Working in a hospital that is chronically short-staffed, for example, is stressful moment-to-moment, but also over time. A person in that situation may feel they are unable to provide the care patients deserve, and don’t see how they can improve their ability to meet their patients’ needs. 

When they go home at the end of the day, they know the next day will be the same round of stressful situations, and they also know they lack the resources to manage those situations. There is no opportunity to release the stress.

Stress Is Generally More Physical

Stress manifests itself in a range of physical symptoms, including:

  • Raised heartbeat and breathing rates
  • Difficulty sleeping or eating
  • Muscle tension
  • Poor concentration
  • Hyper-alertness or, alternatively, mental and physical fatigue

Stress also has a mental impact on people, usually in the form of a feeling of urgency, or of being overwhelmed—stress is what happens when life is “too much” at the moment. That said, people who are stressed are often capable of effective work if there is an end in sight.

Burnout Is Generally More Emotional

People who are experiencing burnout will often exhibit many physical symptoms of stress. However, there is a marked difference in their emotional state. People with burnout often feel:

  • Helpless or hopeless about their situation
  • Cynical or negative about any proposed solutions
  • Detached from work, activities, and relationships
  • Drained of emotional resources, motivation, or creativity
  • Like they are alternating between irritable and emotionally blank

If stress is a feeling of “too much,” burnout is a feeling of “not enough”—not enough control, not enough resources, not enough energy or creativity. People experiencing burnout often become less effective in their work regardless of the effort they make. They feel disillusioned in a way that a vacation can’t help.

Stress Happens Anywhere

As mentioned above, many situations trigger a stress response. A burst pipe in your apartment, unexpected confrontations with strangers in public, having to drive during a snowstorm—all of these situations cause your body to experience the “fight-or-flight” anxiety that comes with stress. The physiological responses arise in order to help you overcome the immediate situation.

Burnout Is Occupational

Burnout, on the other hand, tends to arise from long-term stress caused by work or education. In fact, in 2019, the World Health Organization defined burnout as a syndrome associated with the workplace.

There are no “upsides” to burnout in the workplace—no trade-offs of increased focus or an urgent drive to get more done. There’s just a feeling of meaninglessness. However, because we center so much of our identities around our work—especially people in the health professions—that meaninglessness can bleed over into other aspects of life if we don’t take steps to intervene.

Managing Stress to Avoid Burnout

Because chronic stress can lead to burnout, it’s important to build a suite of coping mechanisms to deal with stress at the very start of your career path. Many of the stressors you encounter as a student, such as deadlines, major exams, and heavy workloads, can be managed through effective self-care practices, including:

  • Proactively planning to break large tasks into smaller parts, and scheduling complete rest periods
  • Eating nutritious food and getting an appropriate amount of sleep
  • Releasing stress through exercise, hobbies, and socialization
  • Keeping end goals in mind and visualizing positive outcomes

Other stressors, such as the high cost of medical education, are systemic. You will need different strategies for dealing with these issues—strategies that usually involve seeking help from others. For example, chronic financial stress could lead you to ask a financial advisor for help restructuring your budget, or inspire you to take part in a student advocacy group that can improve access to funding for everyone. Anything that helps you feel you have some agency in improving your situation can make stress more manageable, even in the long term. 

And, if you ever find yourself in a place where those stress management strategies don’t work anymore, or where you feel totally disconnected from your day-to-day life, don’t hesitate to seek mental health care to help you cope with burnout. You deserve to feel engaged with and inspired by your work, even if it makes you feel stressed.

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