Reimagining how we diagnose burnout.

As I’m focussing this season to look at belonging through the lens of stress, or impacted by burnout I’ve published last weeks episode introducing my observation and theory of what I call: Identity related burnout.

So let me give you a very, very short sum up of last weeks episode as a short reminder – but I strongly advice: go and listen to the whole thing because the topic is so much more detailed and nuanced and I’m asking some thought-provoking questions (at least that’s what I hope I did for you) so here we go – in short:

Last week:
“Once upon a time, the notion of a mid-life crisis was the talk of the town. It was a phenomenon often associated with those who, by societal standards, appeared to have it all – financial success, accomplishment, and influence. These individuals, however, reached more often than not at a certain age a crossroads where they questioned the true essence and meaning of their lives. It was a time of reckoning and they wondered – do I continue on this familiar path or do I need to rebuild my life from the ground up?

Growing up, I remember the generation before us used to look at these individuals with both curiosity and skepticism. To them, a mid-life crisis was a luxury problem, something only few could afford. "Poor little rich person," they would say, dismissing the idea of questioning one's existence as a trivial pursuit. “Who has time to wonder whether you're living a fundamentally good life? And what does good even mean?”

BUT: As the sands of time shifted, so did our understanding of these existential dilemmas. They became more and more common to have. The phenomenon known as mid-life crisis transformed into something more nuanced and prevalent – today we all talk about burnout. But burnout isn't confined to a specific age group or specific people with a certain financial status. It's become everyday- Joes daily bread. It’s more than stress; it's the constant overwhelm of life. It's the feeling that demands are ceaseless, time is elusive, and the link between achievements and self-worth is crushing.”

So dear listener, here we are today: today I’d like to dive even deeper and open up the discussion on: Why, the heck, does it take so long to diagnose and get help for burnout if it is such a common phenomenon all over the world? – and being the designer that I am, I have to ask: is there anything we can do about it? Because I might have a suggestion or two here and I would love to hear back from those that have been there and what they – so if that’s you – what do you remember about the time before having been diagnosed?

Let’s rock it.

So before we can even start the discussion part I feel we need to look into what a diagnosis is and what it takes to obtain one.

So what is a diagnosis?

I looked up the definition of the word and it read: 

diagnosis

/ˌdʌɪəɡˈnəʊsɪs/

noun

• 1. the identification of the nature of an illness or other problem by examination of the symptoms.
  
  
• 2. the distinctive characterization in precise terms of a genus, species, or phenomenon.

Yeah to sum it up in more human words that we all understand:

a highly-educated someone gives you a stamped certificate that you’re not your normal you.

– in the context of needing a medical diagnosis, receiving a diagnosis refers always to something negative: something is wrong, something is broken, something is not as it should be – in the realm of burnout that something is you. 

But let’s not dig into what “normal” means today.

Now, about the time it takes to get a diagnosis:

The internet says it takes on average 1year in order to be eligible for a stable, reliable diagnosis for a chronic disease, or chronic illness, or chronic pain. And burnout, in it’s simplest definition, is ‘chronic exhaustion’.

1 year.

You need to be unwell for an entire year starting from the point you see a medical professional – and since most of us do not like to admit that something is so wrong that we need to see a specialist – it’s much more than a year.

But even if we would instantly go to the doctor:  why does it take so long?

Obviously because it’s complex and personal and we have to make sure we’re not running in the wrong direction with our diagnosis. If you break your arm, we can see it’s broken because we have a reference to what ‘not broken’ looks and feels like. Burnout however is not a plainly physical illness. It’s body, mind and soul and we’re all very unique snowflakes. There’s no one-size-fits-all “normal.” And we can’t scan the mind or soul yet – that’s some sci-fi stuff for the future. All we’re stuck with right now is measuring the physical parameters our body offers us. 

But in the meantime: we need to do something to shorten this incredibly long periode of suffering. And it is suffeering, because before we have a diagnosis, most don’t share their un-wellbeing – they remain alone.

So, in the meantime, what can we do?

To me it sounds obvious that the (at least temporary) solution must be self-evaluation.

I know me best and you know you best. And if things are going wrong on a continuous and reoccuring basis wouldn’t it be nice if there was a framework to guide us through a self-evaluation process to help us gain mental clarity about our emotional state in order to say with more confidence (if confidence is even the appropriate word to use in this context) but at least to say more self assured: “I’m heading into a burnout – here is what is happening to me. What can I do to prevent this? Who can I address to help me?”

Now, let’s get back to burnout and how it sneaks up on so many of us.

We might not have a clear picture of a healthy mind and soul yet, but there’s plenty of data, stories, and recurring patterns to show what “broken” feels like.

Nature loves repetition, after all. So, shall we explore further?

Burnout kicks in when life’s relentless challenges become a never-ending cycle and the good times between the bad cycles become less frequent, until they’re not happening at all and a rough-life is permanent. 

So the behavior we came up with to deal with the stress – the role we were happy to play for a while eventually takes over. Our temporary performance becomes our permanent identity. And that’s hard. Not being yourself on a constant basis is hard, draining and very little rewarding if all you get for it is money, or worse: if all you get in return is: you are just getting by and are barely making ends meet.

So we established that when it comes to diagnosing we’re stuck on medical documention of what an unhealthy or broken body looks and feels like and then we’re forced to find the source of our un-wellbeing. 

And we have the documentation, the tales of those that have been through burnout. Let’s break down what stories and experiences tell us about the anatomy of burnout.

Anatomy of the Physical burnout:

So a healthy body is able and and uses its energy  to make use of its ability. Sure, We all have different energy levels and movement preferences, but we fundamentally enjoy being active. Physical exercise keeps us healthy and good health makes us want to be physically active. 

In burnout, that desire for activity disappears. It’s exhaustion, plain and simple, starting with a dwindling energy supply. First, less energy, then none at all.

And Ignoring the signs leads to severe symptoms, with the body shutting down organs or functions. It’s not just passively conserving energy; it’s actively harming itself, rendering us unable to function. The body switches From passive disagreement to active sabotage.

In full-blown burnout, many can only rest, sleep to combat fatigue, and when awake, barely manage more than idle rest with open eyes.

So as nature like to follow patterns it not shocking to see that mental and emotional burnout follow a similar, if not same path.

It starts with reducing capacity to function healthily, shutting down and finally, potentially self-harming.

This is what Mental burnout looks like: 

Our mind is the organ that makes us interact with the outside world. Our mind filters and evaluates what, where, when and how to engage in social and community life. And as humans thrive through connections. If the expression of a healthy, able body is action, then the expression of a healthy, able mind is: optimism.

Optimism is the belief that the future holds promise, that interacting with the world is worth it. However, much like the exhausted body barely stays awake, the weary mind struggles to remain present and hopeful.

Following the pattern set by physical burnout, pessimism isn’t the sole expression of a broken mind. Pessimism is only like bodily fatigue, a shortage of energy for positive outcomes.  The real danger to the body is when it starts self-harming and actively destroying itself and for that pessimism is simply too passive. The equivalent to harming itself through developing coronary disease, for example. is actually….. cynicism.

Definition: 

Cynicism is a skeptical and distrustful attitude or belief characterized by a general lack of faith in the sincerity, motives, or intentions of others. It often involves a tendency to view actions, statements, and situations with suspicion, expecting ulterior motives or hidden agendas.

Or in other, more human words: Cynicism destroys the one thing we need most for connection the one thing we need most to feel thriving: Cynicism destroys trust.

As stress increases and we struggle to keep up with the mental demands, we get weary and perspectives start shifting. We are creatures of self-preservation Instead of self-reflection, we turn against others. Cynicism becomes a shield against disappointment, And disappointment is our reaction to unfulfilled optimism.

We first start mistrusting the motives our co-humans might have. This skepticism infiltrates relationships, making us doubt others’ authenticity. We question compliments, affection, and goodwill gestures and sometimes even whether our goodness, our optimism is being taken advantage of. 

Cynics go further.

Cynics expect the worst, pointing out irregularities, flaws and they expect hidden agendas.  We end up withdrawing, detaching and distancing ourselves from social interaction, group/family activities and build a resistance to new experiences. A healthy mind seeks to expand. A tired mind seeks to preserve. A cynic mind seeks to destroy.

I know this sounds dramatic but consider the cynic’s favorite tools: irony and sarcasm. 

Irony speaks one thing but means another. Irony can be funny, but more so it’s bittersweet because irony is always about circumstances and situations.

Sarcasm does the same, except it’s making things personal. It is a device to mock someone or something or convey contempt. Sarcasm is personal, using irony to mock or convey contempt, It claims to be amusing, but is actually hurtful.

Both stem from a desire to shield ourselves from emotional pain, but in the end we’re left with a loss of idealism. We start distrusting others, interpret everything negatively, critizise the works of others and are being hurtful through sarcasm. Cynicism is a coping mechanism that resists vulnerability and change, hindering the expansion a healthy mind craves.

We stop resonating with our environment and other people – we start being disconnected. Cynicism does not believe in the goodness, the worthwhile engagement with the world and it’s humanity.

Do you think I sound dramatic? Well, I’m not done yet – I dare you to bare more:

Death of the soul

What is physical ability and a zest for life are  to a healthy body , is self-efficacy to a healthy soul. And What permanent, debilitating exhaustion is to the body is the loss of self-efficacy to the mind: 

Self-efficacy, the belief in our ability to accomplish tasks and achieve goals, is a cornerstone of mental well-being. However, when burnout knocks on our mind’s door, this vital belief slowly ebbs away, mirroring the physical decline we dread.

Here’s how the erosion unfolds:

just as our bodies are sturdy and resilient when we face life’s challenges in the beginning, so we start with sturdy, resilient spirits. But as Stress levels surge, just like in burnout’s physical counterpart, overwhelming our cognitive and emotional capacities. Slowly but surely, we burn the candle at both ends. 

The outcome?

Mental fatigue creeps in, affecting focus, memory, and decision-making when it comes to ourselves. Like the body’s vulnerability to illness, negative self-talk sneaks in, making us question our abilities and worth. We start avoiding more, worry about potential failure more and we can’t muster motivation because there is no more enthusiasm. we begin to socially isolate turning what was intended as a retreat into a lonely place where seeking support feels out of reach, even shameful. Much like the weary body struggles to stay awake, the soul barely manages to extend kindness, compassion, and love inward – to ourselves. Our self-efficacy serves to engage in internal connection with our skills, goals and values, with the positive impact we want to have on environment and relationships. Its loss spells self-destruction in our relationship with ourselves. We lose the ability to engage with the world because we can’t connect with our inner selves –  we don’t have our own back anymore.

Psychology teaches us: All behavior happens to achieve an emotional result and if those positive emotions are not happening - ever - then life doesn’t just feel not rewarding - it feels draining and besides the point. Burnout makes you feel like everything is beside the point.

My personal experience:

And so reflecting back and reading my journals) back from my time in burnout myself – I felt varying degrees of the symptoms mentioned earlier. Mild burnout felt like mild expressions of these issues, sometimes even only isolated to just one area. But the severe episodes,  bad flares – ohhh..bad flares are all of them at oncs…. That’s one shitty, chaotic cocktail to digest.

However, there’s one pivotal moment that shifted me from deteriorating health to the path of healing.

Sitting at my therapist’s office, she suddenly said:

“You give A LOT. You’re an incredibly generous person to everyone around you. I wonder, can you apply some of it to yourself?”

I remember this moment so vividly, because between all the (what felt very repetitive) emotional blah-blah of getting to know each other (yes, I used to call it emotional blah-blah)  – this woke me up because my brain could not compute the question. 

Expats and international folks living abroad, might resonate: Sometimes, after a long day, you understand every word someone says to you in a different language, but the sentence as a whole just doesn’t compute. You’re exhausted, on sensory overload.

That’s how it felt. I was on overload and stunned. All I could stammer was: I don’t understand the question. So she repeated the same thing in two other languages and I broke out in tears, telling her that she broke my brain. I told her that I understood every single word but that the entire concept made no sense to me from whichever side I looked at it.

In the end it took me weeks to put into words why I could not apply generosity onto myself and then years to learn how to change that. Yet in the immediate aftermath of her initial question one emotion that repeatedly surfaced was  anger. It made me incredibly angry to think about generosity and angry for her to even suggest that my life and my actions, everything I did  and everything that led me to feel burned out was fueled by generosity. That was an insane way of looking at it – and clearly she couldn’t be a very good therapist for saying this – or so I thought.

Generosity triggered me so badly that I could only think of her as dumb, or insincere fishing for more emotional blah-blah that I did not see going anywhere at the time.

During burnout, everything I did all day long, everything I had to do, all the responsibilities and people relying on me did not receive generosity from me – they were my obligations. They were everything that HAD TO be done, exactly like this…. if possible even better, but I was not able to provide better – so this had to do. And none of it was done out of generosity. afterall, what is generosity even? It’s for people that have so much they can give it away and not mind the absence of it – whatever “it” might be.

I need to breathe into this for a second.

All this is really hard to remember and does not fill me with particularly good feelings – but at the same time – wow, am I glad this is not me anymore. And when I think of what I had to do to leave this place, honestly, I feel very proud of myself. I was afraid Life as we were living it would fall apart if I dropped my balls. And it did. Everything crumbled to pieces like a jenga tower you’ve been hollowing out for too long. Except that it wasn’t all doom and ruins afterwards – life after burnout makes you a more resilient, more boundary enforcing, kick-ass person.

My professional experience:

As an interior designer, I’ve had my fair share of experiences, and they’ve provided me with unique, intimate insights, not just into peoples homes, but lifestyles and personalities. It’s remarkable how often I encountered clients teetering on the brink of burnout. Some recognized it when they hired me, while others realized it only after our collaboration. The most glowing reviews, however, came from those clients with whom our work went beyond simply beautifying their homes. – they were the ones where we delved into conversations about what needed to change for them to fall back in love with their lives within the walls they called home.

Or let me say it this way: “You only love your home as much as you love the life that is happening within.”

Some clients approached me with a desire to make their homes reflect the image they projected when they weren’t at home. Unsurprisingly, these clients often didn’t feel profoundly affected by the transformation, no matter how stunning the design. Their connection to their space remained as distant and unemotional as when we started. From their emotional standpoint, these projects lacked personal significance.

But others told me at our first meet about how life was hard and how they needed to change something that gave them a break from their version of hard and gave them a break from that person they had to be in the outside world. They wanted to discover, re-discover, or play around with the idea of ‘What else?!’ Those were the ones that would not stop talking about me to their friends and would refer me over and over again. Funnily enough, some of those clients took ages (up to years) to finish the actual work, because we started with the one thing that would make the biggest impact first… and once life started running differently – starting flowing better, finishing the rest could simply take time. No more pressure.

What made the biggest difference:

Now, interior design and the ability to hire a professional to do it for you is by it’s nature a luxury expenditure. You need to be financially affluent to go down this route.

What I noticed as the biggest difference between the happy and the  – how should I call them? – the unmoved, emotionally-detached clients was their level of generosity. Not towards me, but themselves.

The transformed Happy clients gave themselves time and space and the option to question and play and then explore and it became all about fun, passion, shared joy. Generosity expanded simple monetary  ependiture – infact, most solutions we came up with were, from a price perspective: really cheap.

The Unmoved ones were – for lack of better words – stiff, or rigid. Their investment had to fit a certain image, represent a particular something, and yield a return on investment. – it was about impressing the people that visited the home, rather than being loved by the ones that lived inside the home.

And the sentence that comes to mind here is: “Some people are so poor, all they have is money.”

All my clients were financially affluent, but only a few felt truly abundant. The happy ones could draw on an inner wealth of positive, life-reaffirming emotions and it was about their most loving version of intimacy. For the others, the design was stunning but since we built it on a performance and wanting to look competent, it felt detached, distant….and cold, or transactional.

So again: all were affluent, not all came from a place of abundance. While they were all generous in their spending, the question remained: What fueled that generosity?

So there is no more guessing here:

Imagine having a framework, a kind of early-warning system that tells you when you’re on the brink of burnout. What if this tool considered not just your actions but the emotional circumstances surrounding them? I’m talking about assessing your giving and generosity in two different lights: one, stemming from genuine abundance – “I have enough to give, I can take my time, experiment, and play,” and the other, driven by external pressure – “It has to work, it has to look a certain way, it has to… (fill in your pressure button of choice).”

Burnout isn’t just a random outcome; it’s a symptom of something deeper. To make sense of it, we need to explore the actions that led us there and, more importantly, the mental and emotional backdrop against which those actions were executed.

How does that sound?

Now, I know the term “abundance” often gets thrown around in more esoteric conversations, but today, we’re giving it a grounded context. 

• Abundance is about having more than enough in various aspects of life, not just material wealth. It’s a state where you don’t constantly feel like you’re running on empty. 
  
• Generosity, on the other hand, is the beautiful act of giving, sharing, and supporting others selflessly. It embodies empathy and compassion, a desire to positively impact the lives of those around us.

So abundance is a state-of-being or condition where the person in that state genuinely feels they have more than enough – it’s passive and is an emotional reflection about the availability of resources, whether they are material, emotional, or spiritual. And it is rooted in an attitude of positivity and gratitude towards oneself or ones own life and circumstances – abundance is internally facing.

Whereas generosity is an action or behaviour built around sharing with a focus on contributing to other peoples well-being – its focus is empathy and compassion towards others and it has a desire to make a positive impact. Generosity is facing the external world.

Abundance is about self-efficacy and generosity about interconnectedness and community. Abundance is self-focused, while generosity is other-focused.

One of the main reasons we end up in burnout is our one-sided overgiving. And if that is happening then we can’t just look at the behvior by itself. Whilst in itself generosity is a very noble quality, it is also a thin-lined balancing act and people who are overly generous might neglect their own needs, leading to emotional, physical, and mental exhaustion. It’s a dangerous cocktail of too loose boundaries, too much emotional tax paying and mismatched resources.

So here is my proposition to you today – and please let me know what you think:

Instead of only relying on medical diagnoses that typically come after reaching a critical burnout point, because we’re only measuring ‘the hard data’ the physical, why not consider generosity and abundance as early indicators? These metrics can shed light on the question: under which mental and emotional circumstances has the giving been practiced?

A lack of abundance and an inability to be generous can serve as warning signs.

By recognizing and addressing these signs through self-evaluation, we might just prevent burnout from progressing to a critical stage that requires drastic, medical intervention.

What do you think about this idea?

how could we build a framework of self-evaluation around these two to help people come to an assertive statement about their own wellbeing? And what are the questions we need to ask ourselves?

1. Lack of Abundance:

Feeling an ongoing sense of scarcity in various aspects of life can be a significant red flag for burnout. When individuals constantly feel like they lack time, resources, support, or opportunities, it puts them at a higher risk of burnout because they’re more likely to experience chronic stress and overwhelm. Some ways this lack of abundance can manifest will include:

• Time Crunch: When you consistently find yourself rushing from task to task without sufficient time to rest or recharge, it’s an indication that you’re running on empty and might be heading for burnout.
  
• Emotional Drain: If you’re consistently struggling to manage your emotions, feeling emotionally depleted, or unable to find joy in activities you used to enjoy, it could be a sign that you’re burning out.
  
• Work-Related Stress: Feeling like you’re constantly drowning in work, unable to complete tasks, or experiencing a lack of accomplishment despite your efforts can point toward burnout.
  • Abundance is an emotional state: so how do you feel and are those emotions (I don’t want to say) positive, so let’s say: are they satisfying and life-giving?
    

2. Inability to Be Generous:

Generosity doesn’t just pertain to material giving; it includes emotional support, time, and energy given to others. If you notice a decline in your ability to be generous or helpful to others, it might be an early warning sign of burnout:

• Withdrawal: If you find yourself becoming more isolated and less willing to engage with others or offer assistance, it could be due to emotional exhaustion and an inability to extend generosity.
  
• Lack of Empathy: An inability to empathize or connect with others’ needs and struggles might indicate that your emotional reserves are depleted, which is a common precursor to burnout.
  
• Neglected Relationships: Failing to maintain healthy relationships due to a lack of energy or emotional availability can be an early sign that burnout is looming.
  
  • Is there joy in your giving? Does a silly, polianna sentence like ‘Throw kindness around like it was glitter’ make you smile or laugh— or does it annoy the crap out of you? Does your giving make you feel better? – because only then is it  true generosity.

I get it, this might seem like a lot for one episode, but hey, if we’re diving into the work-life balance theme this season, we need to look at all angles, right?

Burnout, as personal as it gets when you’re experiencing it, becomes less private once you have that diagnosis.

I genuinely hope people aren’t keeping it to themselves but are taking action. I hope the very first action you take is reaching out to someone. It’s about reaffirming that sense of belonging, about realizing you’re not in this alone. The purpose of receiving a diagnosis is knowing but also reassurance. It’s about being able to get help, to not having to deal with it alone. 

But before we even get to that point, awareness is key.

There is understanding information, there is knowing what to do and then there is practicing doing the actual thing.

I’d like to believe that there’s a beautiful part to it all– by becoming aware of these signs and practicing self-evaluation, we can halt burnout in its tracks.

I’ve seen it countless times: It’s not about drastic changes; it’s about nurturing a balance between giving and receiving and taking pleasure in and receiving from the act of giving – that means savouring having the resources, being affluent and being able to be generous and be generous with pleasure. Learning to be generous rooted in genuine, no BS abundance is what ultimately saved me from feeling burned out and even built the greatest source of joy within me and for me. And now that I’m heavily biased, – I see this confirmed in everyone I talk to:

When facing burnout the outer circumstances have to change, but not as much as everyone thinks – it is more our ability to chose to see and feel a better reality that makes the greatest difference in people. Everyone I know who has come out the other side of burnout – still works and earns a living, still gives to others, still participates in society. They do all the things they did before, maybe even with more vigor than before, just with less ….I do not know how to call this differently, but: with less BS in their life.

Once we hit burnout a complete halt to life as we know it happens.

Burnout forces a complete halt to the life you once knew. It demands a radical simplification. And while that can certainly help, I firmly believe we shouldn’t have to reach that point in the first place. Instead, we should be asking ourselves,. ‘Where am I deceiving – to the point that i’m bullshitting myself when it comes to my giving, and the resources I have?’ Burnout recoverees are acutely aware of this question.

Self-evaluation my friends becomes a practice of healthy living.

But for it to really hit home, it needs awareness – self-awareness to be precise. ANow, I know “self-awareness” is a term thrown around a lot, but I think it deserves some unpacking for those who haven’t made it a habit yet.  Should we talk about it next week? I hope you’ll join me next week again.

One last comment I’d like to make – there are a million ways to make changes. Privately and socially. But the one way I want to contribute is fighting cynicism. I’ve lived in seven different countries, and no matter where I go, I’ve encountered this cultivated cynicism. People constantly telling themselves and others how terrible the world and life are, how everyone’s out to get them, and how we need to work ourselves to exhaustion just to survive. This is not to say that there arent horrendous things happening that need our attention and our activism to create change…Sure, there are real risks out there, and yes, we need to address them with activism and attention.

But here’s the catch: cultivating cynicism and being constantly negative doesn’t help. It doesn’t help us, it doesn’t help society, and it certainly doesn’t help combat burnout – it’s one step in into propagating burnout even more.

What I’ve chosen to cultivate instead is genuine generosity, both within myself and toward others. And let me tell you, dismantling cynicism has become my personal mission, one I’m willing to fight for openly, even if it’s guerilla-style. Because I believe it’s worth it.

oh wow – I said a lot – if you made it this far: I hope you join the discussion, you’ll give me feedback and I hope I see you again next week.