Lawyers are prone to burnout because the practice of law is practically a working definition of risk factors attribute to burnout: strong identification with work as one’s primary identification; high workload requiring consistent overtime; little or no control over work demands; and high expectations for performance in a helping profession. Sound familiar?
There is no diagnosis of burnout per se for medical professionals. There is, however, a growing understanding that burnout is a real condition and many in the mental health community are pushing to have the Diagnostic and Statistical Manual of Mental Disorders (DSM) adopt burnout as a diagnosable mental health disorder.
Burnout is a special type of work-related stress. It is a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity. Merriam-Webster defines burnout in two ways which makes it easy to understand:
- Noun: Exhaustion of physical or emotional strength or motivation usually as a result of prolonged stress or frustration
- Verb: To cause to fail, wear out or become exhausted especially from overwork or overuse.
Burnout is not something that happens overnight. It is more likely the boiled frog, the frog that hops into cool waters and doesn’t notice that the water temperature slowly and steadily rises until the frog is dying in boiling water. The practice of law can certainly feel like that. In the beginning, the cases start coming in, the work is challenging but manageable and fulfilling. Then the cases come in faster, the workload becomes unmanageable and there is little opportunity to pay as much attention to each detail as one would like. One day you are sitting at your desk wondering how you got to the point that you dread coming to work and when exactly it was that you lost all love of practicing law.
Symptoms of Burnout:
- Fatigue: Lack of energy to be consistently productive
- Cynicism: Feelingthat the work you do doesn't matter or make a real impact
- Sense of Inefficacy: Exertion of significant effort accompanied by a feeling of futility or lack of recognition
- Lack of Attention: Trouble getting started and trouble staying focused on work
Causes of Burnout:
- Lack of Control
- Unclear Work Expectations
- Dysfunctional Work Dynamics
- Work-Life Imbalance
- Lack of Social Support
Although the emotional toll of burnout is what most know something about, the physical toll of burnout is very serious. Medical studies have linked burnout to coronary heart disease (CDH). One such study found that those identified as being in the top 20% of the burnout scale had a 79% increased risk of CDH. Dr. Sharon Toler of Tel Aviv University, the leading researcher in this study finds these results “alarming” and “more extreme than predicted.” Thus, burnout is a stronger indicator of CHD than classical risk factors such as smoking, blood lipid levels and physical activity. This is likely due to the lower cortisol levels associated with burnout. Cortisol helps restrain the activation of the immune system and stress response. With chronic stress, the immune system is compromised leading to hyperactivity and inflammatory immune responses. This translates to a variety chronic diseases cardio vascular diseases, diabetes and cancer as well as CHD.
There needs to be a multidisciplinary approach to addressing burnout. It is not simply a matter of creating healthier coping skills in response to workplace stress. A successful response to burnout must also address the physical aspects of chronic inflammation, sleep disturbance, diabetes treatment and cardiovascular health.
Finally, there must be honest organizational assessment and implementation of corrective measures of the workplace to create a healthy atmosphere.
EMPLOYEE BURNOUT IS A PROBLEM WITH THE COMPANY, NOT THE PERSON.
The consequences of burnout costs US employers $190 billion annually in medical costs, workers compensation claims, and lost productivity. It is much higher when factoring in turnover and absenteeism.
There are solutions available to address burnout. It does not have to be inevitable consequence of a busy, practicing lawyer. Burnout doesn’t need to develop into clinical depression, serious health problems, ethical missteps or general life misery. There is help. Don’t wait until a problem becomes a crisis. NHLAP is here to help.