Burnout In Women – Science, Recovery, Strategies, Decisions, Lessons
I have a very personal, vested interest in this article.
I grew up with incredibly strong female role models in my great- and grandmothers, mum, aunts and my three sisters.
Now days, my wife and three sisters work, parent and wear many other hats as do so many other women I count as friends and colleagues. My mum grandparents 15 kids. And while my three daughters are all below ten and my six nieces are awesome, they’re all growing up and will need to understand this topic too.
So when I met Dr Kellie Pritchard-Peschek, I wanted to understand how she’d become so purposeful about the science of women’s health and how it applies in the workplace and beyond.
It turned out that the catalyst was a raw, confronting burnout of her own, the difficult diagnosis and the long complex path back through recovery to health and thriving.
Kellie is a Doctor of Exercise Science which she applied with some of the best athletes in the world before having to turn that science on herself after the burnout and that she now shares with her executive health clients.
So I asked Kellie if she’d be willing to write this piece and she kindly agreed.
For me, as a husband, father, brother, son and friend, I want to understand the science, the warning signs and the daily practices that might help address and prevent some of these complex issues. I want to understand how I can support some of the people most important to me right now and into the future.
And while the lessons here focus specifically on women’s health, there are universal truths.
So whoever you are, I hope you’ll take the time to read this, absorb the lessons and use them to take care of those you love (including yourself).
I hope you find it as valuable as I have.
“I'm a non-functioning human.”
It was a Saturday, and I was lying on my couch on the other side of the world, speaking to my mum on Zoom. “Non-functioning human” were the only words I could find to describe my health in that moment: the bone-deep exhaustion where I slept from Friday night till Sunday, only waking occasionally for food; the complete lack of energy that made it difficult to get out of bed in the morning and move further than the couch; the mental fatigue and brain fog that was so severe I could barely string a few sentences together; and the total emptiness in my body, void of feeling and emotion.
I was a shell of my former self.
Before moving overseas, I was working as a sport scientist with Australia’s top athletes. On the eve of the London Olympic Games, I accepted a role in Europe, setting up a high-performance centre for a national sports institute. Living and working in Europe was a personal dream. I had hit the jack pot.
I loved working in elite sport, and I was ready to give everything I had to this role.
But reality slowly kicked in.
Over time, the mismatch in values and expectations between myself and the organisation intensified, which created friction and frustration. My role and workload constantly increased to an unmanageable level, yet my (multiple) requests for support and resources were never addressed. I was constantly navigating politics and bureaucracy as the only female leader amidst a toxic workplace culture. I was on the other side of the world without my friends and family, or a trusted network around me.
Deep down I knew that this was an unhealthy working environment and an unhealthy way of working. But I was (and am) stubborn, and I refused to quit - that was failing. Instead, I pushed myself beyond limits, and in the process, failed to take control of, and responsibility for, my own health and wellbeing.
My life became a constant state of intense stress. My days were a mess, and I was the definition of “tired but wired”: amped up on 5 or more long blacks per day to get the energy to function; and drinking wine every night to take the edge off. I barely ate, so I could avoid the crippling stomach pains.
Often I would find myself at 2am wandering around my apartment in the dark with insomnia, crying with exhaustion. I remember being so tired during the day, I would walk around the institute with my eyes closed because it was too much effort to keep them open.
Eventually, I was unable to control my frequent emotional outbursts at home and at work.
One particular night, I was lying on my bathroom floor crying, not actually sure how I got there. When I pulled myself up and looked in the bathroom mirror, I saw the pale face and black sunken eyes staring back at me like a zombie. In that moment, I remember thinking with a sense of morbid fascination, “So, that’s what I look like to people”.
I had hit the wall at 100 miles/hour, and I didn’t get up and walk away.
It was my best friend who eventually took me to hospital during one of her visits, that started the long and complicated process of finding a diagnosis. After countless specialist consultations on both sides of the world, an integrated health specialist eventually pulled the pieces of my work and personal life together, and the word "burnout” was spoken.
I remember the emotion I felt in that moment, deep and raw, that hit me like a tidal wave: the utter disbelief, that I of all people could end up in this situation when I sure as hell should have known better. The intense shame I felt at being responsible for the untold physical and mental damage I had inflicted on my body and mind, from stubbornly pushing myself so hard for so long without seeking help or changing my behaviours.
I also remember the deep-seated fear lurking underneath those emotions, stemming from the knowledge that if I had done this to myself once, then I was capable of doing it again. That terrified me, and I knew that I had to change.
So there I found myself, a non-functioning human, on the couch in my apartment on the other side of the world amidst the rubble of my life, wondering how to pull myself out.
Before we go any further, I want to clarify an important point - burnout and stress are not the same thing.
Unfortunately they are used interchangeably too often, which not only muddies the waters about prevention methods at an individual and organisational level, but diminishes the seriousness of the experience of burnout for those who have been through it.
To understand burnout we need to understand its relationship to stress.
The easiest way to describe this is to imagine it as a spectrum: at one end, we have acute stress, which is a natural biological response, is transitory, and resolves itself once the stressor is removed (for example, delivering a conference presentation).
In the middle we have chronic stress, where stress persists, remains unresolved and can become detrimental to our physical and mental health (for example, working months to years on an under-resourced project).
When chronic stress continues unmanaged for a long period of time, it can progress to burnout - the other end of the spectrum.
In 2019, the World Health Organisation added burnout to the 11th Revision of the International Classification of Diseases (ICD-11), officially describing it as "…a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed.” It is characterised by three dimensions, all of which must be present for burnout to occur:
- feelings of energy depletion or exhaustion;
- increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job (i.e. detachment, depersonalisation); and
- reduced professional efficacy
It’s important to recognise, that while organisational factors are contributing causes of burnout, I believe some level of responsibility also lies with the individual, to take care of and prioritise their own health and wellbeing.
When you come to the point of recognition that your workplace is a main contributor to your chronic stress, there are two actions to take:
- seek to make it more manageable by controlling what you can, for example setting healthy boundaries around your work time and load, asking for support and/or resources to address structural limitations, clarifying expectations (from yourself as well as leaders) around your role and KPIs, communicating your needs clearly, and taking perspective over the role work plays in your life more broadly; and
- take responsibility for your health, and carve out time for sufficient rest and recovery, sleep, stress management, and supportive lifestyle behaviours.
Numerous industry reports currently highlight the impact of burnout on our global workforce, including the rising rates in Australia. While burnout is on the rise for both men and women, it is undeniably hitting women harder, as a result of the hybrid and remote working, the resulting pressure to be “always on”, the higher workloads and doing more to support their staff wellbeing, and the “double shift” (time spent on care duties at home).
As a result, we're seeing women downgrade or leave their roles in record numbers, quit their careers entirely, and not fulfil their potential. This ultimately impacts gender diversity and representation of women in leadership. The pandemic has exacerbated this underlying issue of burnout and wellbeing, and suddenly, it prompted deeper questions:
"What's most important to me?” “What role does work play in my life?” "What am I willing to commit (or sacrifice) for my job?” "What price do I put on my health?”
Eight years ago, burnout wasn't talked about, known about, or acknowledged, and I certainly didn't understand enough about it personally to see the warning signs. I was doing the best I could each day with what I had - because that's what we're biologically wired to do.
Even my “diagnosis” was an awkward conversation around my lifestyle, chronic stress, extreme exhaustion, adrenal fatigue, and permeable bowel syndrome (where the stress hormones constantly pumping through my body had separated the lining of my gut, which is intensely painful).
But what we didn't talk about was the emotions, the beliefs and mindset, and the behaviours that drove me to that point, which are actually fundamental to a successful recovery.
It took a health crisis to kick me into action and ditch the unsupportive habits that fuelled such an unhealthy and unsustainable lifestyle. I had to develop a new mindset around the importance of my health, not only for achieving my professional goals sustainably and without burning out (again), but also for my personal life and longevity.
I have spent time reflecting on how and why I burnt out, and what I can do to prevent myself - and others - from experiencing it.
Having tried a multitude of different things in the ensuing years, here are the strategies that worked for me, and for my clients.
- Meditation. This tactic felt quite woo-woo for me initially, but in the intervening years, the use of meditation and mindfulness for reducing stress has grown significantly. I embedded meditation into my daily routine during the initial recovery, starting with a very uncomfortable 5 minutes and a monkey mind, building to over an hour of connection and stillness. There are numerous forms of meditation and I experimented with many until I found a couple of methods that resonated with me, including guided, mantra-based, and transcendental meditations. There are now plenty of apps that offer various forms of meditation and mindfulness techniques, such as Balance, Calm, Headspace, Insight Timer and others, along with content available on YouTube. I still practice meditation, because I enjoy it so much. And when I recognise my stress levels rising, I double-down on practising it at least once daily. Science shows that as little as 10 min of meditation can reduce stress and improve mental wellbeing.
- Breathing. One of the most powerful ways to cut the stress response and enter into a state of relaxation, is through breathing. Breathing is a tactic that I have added into my toolkit recently, particularly diaphragmatic breathing, and the 4-5-7 technique. Many of the aforementioned apps include breathing exercises, which once learnt, can be used anywhere, anytime. This might be in the minutes before delivering a presentation; following a stressful meeting; in moments of overwhelm throughout the day; in the two minutes between back-to-back Teams meetings; or simply to start the day calmly. Breathing can reduce stress in just a few minutes per day.
- Yoga. Whether it's starting a regular yoga practice, or dropping into a few poses throughout the day, the combination of mindful breathing and muscle contraction associated with yoga and yoga poses has been shown to effectively reduce stress. I found yoga to be particularly helpful in reconnecting with myself during the initial recovery phase, but it's a practice I continue with and enjoy. (Note: I had no experience with yoga prior to starting).
- Freewriting. Burnout can take a huge toll mentally and emotionally, as it did for me. One strategy that I found really helpful to process the experience and release the emotion tied to it, was focused freewriting. This is a technique commonly used for creativity and uncensored self-expression, which involves writing non-stop without structure or grammar on a certain topic, until there's nothing left to express. It's powerful.
During the chronic stress and burnout phases, I had extreme difficulty falling asleep due to a "racing mind", and also staying asleep (i.e. the 2am stress wakes), contributing to insomnia. I used a combination of strategies to combat this, in addition to the stress mitigation strategies above.
- Creating a pre-sleep routine. Shut off devices 30-60 min before bed, and use that time to engage with meditation or breathing exercises (using the strategies and apps described above), journalling, reading, or yoga nidra (a guided sleep meditation). I used all of these, and once I found the techniques that worked for me, the benefit came through consistency.
- Minimise caffeine and alcohol intake. I initially rebelled outright at this, but I leant into it when I learnt that: 1) both substances interfere with sleep quality; 2) caffeine elevates stress hormones and contributes to the stress response; and 3) alcohol is considered a toxin by the body, which places it under even more physiological stress to remove it from the system.
Both of these substances can become vices for me during times of stress, so I limit my consumption of caffeine to 1 coffee per day, and avoid it after 12pm. Similarly, I limit alcohol intake to 1-2 drinks per week (or less), stopping 3h before bed.
Due to the gut-brain connection, chronic stress levels can interact with digestive function and cause painful gut issues. The onset of gut issues is one of my major stress indicators, that signals I am not managing my stress effectively and it's reaching chronic levels. I found that working with a nutritionist was key to healing my gut and getting back to a healthy eating pattern.
Healthy amounts of exercise
When I was chronically stressed, I was trying to train for a marathon. Ridiculous, I know. Whilst exercise is great for our physical, mental and cognitive health, excessive amounts can swing in the other direction and be detrimental. Exercise is another form of physiological stress, as it also releases stress hormones into our system.
When we already have high levels of circulating stress hormones, fatigue, and low energy, we need to match our exercise load to our physiological capacity. This means shorter duration, lower intensity, aerobic exercise that minimises stress hormone release, like walking, yoga, gentle swimming etc; not high-intensity interval training (HIIT), strength training, or other forms of vigorous sports (e.g. marathon training).
Nowadays, there are many wearable technologies that enable us to do this. I use the WHOOP strap which I find to be exceptionally accurate, comprehensive and proactive in supporting me to reach optimal daily functioning, not just with exercise, but with my sleep, stress, and recovery.
Chronic stress can impact our reproductive system. I was 31 when I burnt out, and for the years prior when I was chronically stressed, I would experience irregular menses due to the interaction between the stress and reproductive hormones.
Along with gut issues, irregular menses are a key indicator to me that my stress is at chronic levels. When this occurs, I double down on my mindfulness and meditation strategies, minimise caffeine and alcohol intake, moderate exercise levels, and get plenty of rest, so that I regulate my hormones naturally and help them function better.
For women in perimenopause, chronic stress can actually exacerbate your symptoms (and it's a similar case with PMS symptoms), particularly psychological (e.g. mood, emotions, brain fog) and vasomotor (e.g. hot flushes, sweating) symptoms. Fortuitously, engaging with the above-mentioned health and lifestyle strategies, you can manage and often mitigate the frequency and severity of perimenopause symptoms.
The beauty of these strategies is that they are as much prevention tools as they are cures. By embedding these strategies into our daily life, we can proactively create optimal levels of health and performance.
During the recovery process, when I was navigating this completely new lifestyle, I had to re-enter the work environment that contributed to my burnout.
I presented my doctor's certificate to my manager stating I needed to reduce to 50% capacity for a number of weeks. But nothing changed in that environment, nor was my burnout ever acknowledged or addressed. After a few months, when I was back at 100% capacity, my health started declining again and I experienced a return of some of the symptoms associated with high stress levels. Predominantly the gut issues, disturbed sleep, fatigue, and irregular menses.
It terrified me.
The moment of reckoning had arrived.
I recognised that the workplace culture and organisational structure was not going to change; it was my responsibility to decide what to do. Stay, and suffer continual health issues; or leave, and protect my health and wellbeing. I chose myself and my health, and I resigned.
To write that still grates with me.
But in reality, it was my drive to succeed at the expense of my health, that contributed to my burnout in the first place. It took a long time to reframe my resignation as a positive step in honour of myself, but in the end, nothing is more important than my health.
“If I don't have my health I have nothing.”
“I will last longer than any job. I'm not worth sacrificing.”
Two female leadership clients shared these insights with me recently at the end of their coaching program. As senior leaders in their mid-40s, they were juggling their careers, family, relationships, and personal health, trying to win at each. In their respective situations, their job demands had inevitably taken their toll, their home life suffered, and they were racked with "mum guilt”, which made them push even harder to do all the things, but better. Their health fell by the wayside, mental wellbeing declined, and they ignored the signs and symptoms of hormonal disruption.
Here's the thing - data shows that the highest rates of burnout occur between the ages of mid-30s to mid-50s, right when we're in the thick of our careers. Unfortunately, this coincides with the onset of perimenopause and menopause, and the hormonal changes that impact our physical, mental and emotional health. And often, our job performance.
It's the "perfect storm” for career women.
“I love my job, but I just can't do it all anymore.” The tears flowed down her face as she reached for the tissues, apologising to me profusely.
As the only female executive in her company, and a single mum of two, she had reached her limit.
Witnessing this never fails to break my heart and ignite a fire within me simultaneously. I want to prevent other women from experiencing the debilitating effects of burnout that I went through, doing untold damage to their bodies and minds that could be avoided with the right support and guidance.
Women shouldn't have to quit their jobs due to burnout.
What this takes is consistent, dedicated action and self-prioritisation - the ultimate act of self-care.
Here are a few key lessons I learned for myself about my health, through my experience with burnout. Hopefully they're helpful for you too.
Nothing is more important than my health.
This was the fundamental insight and learning for me in the moment (reflected by my clients). I will not be able to achieve anything in life – personally or professionally – if I don’t have my health. This insight continues to guide how I live my life today.
Immediately after my burnout “diagnosis”, I experienced an odd shift in focus, like a giant spotlight turning inwards. Rather than constantly focusing energy externally, every action and behaviour from that point on was in service of my recovery to regain my health. This became my prioritisation tool and decision-making process simultaneously.
For the first time I realised that my greatest strengths can also be my greatest weaknesses when pushed to the extreme - success and destruction are two sides of the same coin. As someone who is passionate about their work, I have to monitor how hard I push myself due to my drive, ambition, perfectionism, and purpose-driven determination to create an impact. I can be all-or-nothing, and I need to make sure I am proactive about staying on the healthy end of that spectrum. Now that I am aware of my strengths, I am aware of my weaknesses.
By taking the time to reflect on what led to my burnout, I was able to identify the factors that I need to address personally, and the organisational warning signs, to prevent this from happening again. I have swapped out the volatile, crash-and-burn modus operandi for a flatter curve, that provides smaller dips and greater health and performance longevity.
Re-assess your priorities.
There are a few key questions I asked myself:
- Where do I sit on my list of life priorities?
- What is my health worth to me?
- Why do I neglect myself yet look after everyone else?
- What am I willing to sacrifice for my job?
Sadly, many of us don’t even make it onto our own lists; but to use a cliché, we can’t pour from an empty cup. I place myself and my health at the top of my list every day, to give myself every opportunity to achieve my goals and create positive impact.
Health is a daily practice, not a one-and-done.
The consistent daily choices I make, the habits and routines I engage in, contribute to building a healthy and sustainable lifestyle. It takes time, effort and energy to create these supportive practices, but ultimately, my ROI is in the enhancement of my health span, performance, happiness, and work-life integration.
I'm on a mission to create high-performing female leaders through the science of wellbeing, by equipping women with the skills to prevent burnout, navigate perimenopause, and perform, lead and succeed in business and life.
This is my purpose and passion. Because I strongly believe that women deserve the opportunity to achieve their greatest potential in life and leadership.
I would love to hear what has worked for you through the stressful times in your career, in the comments below.
About Dr Kellie Pritchard-Peschek
Find out more about working with Dr Kellie here.
If this has resonated with you and you would like to take action, then Dr Kellie is running an International Women's Day event in 2023 - Cracking the Code of High-Performance for Women in Leadership.
Published with permission by the author, Tony Jenkins. First published on LinkedIn.