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How integrative psychiatry can help with your burnout

Kale probably isn't going to cut it but meds probably aren't the answer either



You've been tasked with more responsibilities at work than you can manage or you're now working the jobs of 2 people since jobs aren't being filled at your company...or you feel like you're a cog in a wheel, unfulfilled with your work. Perhaps you're in healthcare or teaching and are struggling with adapting in a dysfunctional, buckling system. Burnout can look different to each of us but as a whole it can be defined as a state of exhaustion from prolonged and excessive workplace stress.


Burnout vs. Depression

Burnout is not considered a DSMV diagnosable mental health condition and it can often be distinguished from clinical depression - though someone can be experiencing both clinical depression and burnout so it's not always clear. Symptoms of both burnout and depression are similar and can include headaches, irritability, apathy, insomnia (or sleeping too much), poor concentration, perfectionism, fatigue, muscle tension, anxiety, low mood, low libido, workaholism, and feeling "wired and tired".


One way to distinguish between burnout and depression is to do a check-in with how you feel on vacation - do you still feel depressed, low motivation, low energy, dread, insomnia, with continued irritability/anxiety? That might be depression.


You might be dealing with burnout if you feel better on vacation - less anxious, improved mood, higher energy, more motivation, more relaxed, but anxiety and dread about returning to work. It's important to note that burnout can be debilitating and make you feel terrible. Just because you have burnout symptoms, it doesn't mean you are not suffering and in pain.


Work Environment Changes

While integrative psychiatrists can prescribe supplements, medications, and order labs, that doesn't mean that is where we need to or always start. It's always best to start with looking at the root of the issue of burnout with honesty - and compassion. With burnout, this means we will look together at your work/life situation and discuss what changes might be possible.


Assess your current situation

If you are struggling with burnout, one of the best places to start with improving how you feel is to look critically at your work situation including your hours, autonomy, flexibility, responsibilities, your job's fit with your personality and values, and even your commute. What are the pain points for you and what can potentially be improved?


Creating Ease

What can be done in your current role that creates more ease for you? I really find Tim Ferris' strategy in The Four Hour Work Week to be helpful: Eliminate, automate, and delegate. Eliminate tasks that don't need to be done, automate tasks that can't be eliminated, and delegate any remaining tasks that you can. You might find it helpful to let your supervisor or boss know that you're working on being even more efficient and productive by incorporating this strategy and they hopefully will be supportive of this plan.


Taking your own psychological makeup into consideration

Inner reflection can help you better understand your personality traits or tendencies that may be contributing to burnout. For example, are you highly strung, perfectionistic? Do you struggle with setting boundaries? Does your identity revolve around your work? The good news is, with therapy or coaching you can change unhelpful behaviors and thinking patterns so you don't feel as burned out. It is possible.


Other work modifications

Sometimes the best options are to decrease work hours, change positions, or even seek out a new job. These ideally are decisions that are often complicated and involve financial considerations and many other factors. Honest conversations when you are feeling grounded (and not overly reactive or stressed) with loved ones are probably a good idea.



Integrative Psychiatry Labs for Burnout

There is no particular lab that will tell us "You are Burned out". But we can check for underlying vitamin/nutritional deficiencies and assess for contributing medical issues like thyroid function to make sure we are not missing anything contributing to how you are feeling that can be resolved. I am often thinking about other possible issues going on and ordering targeted labs when people describe fatigue, brain fog, insomnia, weight gain, or metabolic syndrome symptoms such as blood sugar dips/spikes, obesity, and again, fatigue.


Basic Labs for Burnout

In integrative psychiatry, we may recommend basic labs that can be ordered through your insurance and drawn in a clinic lab that is part of your local health care system or a lab chain such as Lab Corps or Quest.


Functional Medicine Labs for Burnout

In addition, integrative psychiatrists may discuss ordering functional labs not covered by insurance such as an Organic Acid Test (OAT), NutraEval, or an assessment of your cortisol levels/pattern, the primary stress hormone. These labs are not required but may point us in the right direction of where to start with a targeted treatment approach. With functional lab testing, we can get a better understanding of how the metabolic pathways in your body are working (or not working), gut function, oxidative stress, and even assess for possible infections or environmental toxins contributing to your brain function and mental health.



Lifestyle Considerations for Burnout

Let's state the obvious: No amount of brightly colored vegetables or Peloton biking will make your toxic job less toxic (possibly the root issue!) - but know that daily habits can help you manage the level of stress you're experiencing.


Mind-Body Practices

Daily mind-body practices is the most effective practice you can do to better deal with stress - over time, they regulate your nervous system and decrease heart rate variability. It is the most important, cheapest, and most effective treatment I recommend!


Find a mindfulness practice that works you and try to do it every single day, even for just 5 minutes if that is all the time you have. Some examples include yoga, breathwork, chanting, sitting meditation, or walking meditation.


Find and have fun

Connect with others on a regular basis and build relationships with people you like being around. Life is hard and a lot of it is so serious. Aim for doing at least one fun thing every day. Again, this doesn't have to be a big production but something small that is fun for you. If it helps to write it down in your journal each day, do that. And use your vacation days - unplug, unwind, and focus on being present rather than drifting into your work responsibilities - that might mean finding somewhere to stay without internet or cell phone access!


Nature Time

Spending time in nature has been shown in multiple studies to decrease stress and make us feel more relaxed. You can try getting outside as often as you can, exploring new parks or trails. Notice how you feel after you've spent some time outside compared to how you felt before you went outside.


Sleep

When we don't get enough sleep, everything can feel harder and more stressful. We can feel more anxious and depressed too. Aim for 7-9 hours of sleep at night and set yourself up for a good night's sleep. Make sure your room is pitch black and colder in temperature (65 degrees F is great for sleep). Create a wind-down routine and try to limit screens at least an hour before bed. Melatonin and magnesium are often first line considerations when people are having trouble with sleep.


Nutrition

Overly restrictive food recommendations can often backfire and feel too overwhelming. So know that you don't necessarily have to do that in order to eat for your brain health - it doesn't have to be all or nothing! It can also be helpful to focus on what to eat more of rather than what to avoid/limit. Focus on upping veggie consumption and foods of different colors. Bone broth and probiotic foods are beneficial for overall mental health. If possible, aim for whole foods rather than highly refined and processed foods. Caffeine and alcohol can worsen anxiety, sleep - and alcohol can worsen mood too. It's a good idea for people to aim for 3 meals a day with 2 snacks to keep your blood sugar levels stable (blood sugar dips can make us feel irritable and anxious).


The information and any products mentioned in this article are not intended to diagnose, treat, cure, or prevent any disease. The information provided is for educational purposes only and not intended to replace the relationships with your physician(s). Before initiating any conventional or integrative treatments, please first consult with a licensed medical provider. Please review references provided at the end of article for scientific support of any claims made.


Looking for an integrative psychiatrist with a personalized medicine approach? Work with me: https://www.driftlessintegrativepsychiatry.com/workwithme