Note: ‘Doctor in the House’, by General Practitioner A/Prof Magdalena Simonis AM is a regular new column which aims to help the reader learn more about some of the common health issues which might be embarrassing or difficult to talk about. Sometimes, we tend to put our own needs last or we just seek information from ‘Dr Google’ and it’s not until things become serious that we visit our GP or seek attention. The articles in this column aim to share evidence-based medical information in a way that helps people take steps to support their health. It is important to note, that as helpful as this might be for you, this is not a substitute for seeking advice from your own doctor as this is general information which is not specific to any one person. I hope you benefit from reading these and if you have any topics you wish to have covered, please let our editor know.
If you’re already feeling tired and it’s the start of 2024, this could be due to ‘burnout’.
Here are some tips from the Doctor in the House, Associate Professor Magdalena Simonis AM, on how to identify and avoid burnout, so you can start the year with enthusiasm and energy.
Burnout can happen to anyone and it comes from being exposed to continual stress. As a general practitioner with more than 30years of experience working in Melbourne’s central business district, one of the commonest complaints I hear is, ‘I don’t know why, I just feel tired all the time’. In this article we will talk about how feeling tired easily, or all the time might be a symptom of ‘burnout’. People find it difficult or embarrassing to talk about burnout, because there is so much pressure on everyone to cope with the demands of life, all the time.
We are living longer and working for more years, and in this day of technology the expectation is that we are to be accessible all the time. If you don’t start the year with self-care tips and awareness of the risks of ‘burnout’, it’s almost impossible to avoid. This also provides a good opportunity to share some key points around the symptoms of ‘fatigue’, that will help you work out if there is a medical reason for the way you feel too.
Should I worry if I feel tired all the time?
If you do feel tired all the time and tired when waking, you should see your GP to talk about this and make sure that medical reasons for the fatigue have been excluded. Your doctor might decide to run a few tests to determine what the cause is, especially if you have had symptoms for more than four weeks.
Some more serious conditions can present in the following ways:
- Suddenly feeling tired, especially if you were previously well.
- Experiencing weight loss without trying – in medicine we refer to this as ‘unintentional weight loss’.
- Any signs of bleeding in your urine, bowel motions, skin, vomit, or in your sputum when you cough.
- Unexplained changes in your menstrual cycle or seeing blood after the menopause.
- Increased difficulty with breathing either at rest or with activity.
- Enlarged lymph nodes in your neck, armpits and or groin.
- Unexplained fever, especially if you have night sweats for more than 3 weeks.
- Recent changes to your usual symptoms from your pre-existing chronic disease.
- Recent viral illness – long COVID is prevalent but there are other viruses and bacteria that can cause post-infection fatigue.
- A change in your medications.
- Fatigue after long haul travel that is not related to ‘jet lag’.
- Pain – especially if the pain wakes you up from sleep.
Burnout – what is it?
Burnout can happen to anyone and it is commonly a work related issue which the WHO acknowledges, but can be brought on by life stressors outside of work too, and result in a condition called ‘clinical burnout’.
Burnout can have psychological and physical impacts and can cause major mental health issues such as anxiety and depression. Family members and friends might notice this even before you do because people suffering from burnout are so caught up with telling themselves that they have to ‘fix’ the problem, that they don’t see the harm it is causing them and their relationships.
When thinking about work the main features include:
- feeling tired all the time no matter how much sleep you get or even after holidays.
- a dread of going to work, with increased cynicism, lack of purpose, disconnection and disinterest.
- a feeling that you can’t keep up or do the work.
The more physical and psychological impacts present as:
- feeling exhausted after any mental effort such as concentrating, attending meetings.
- persistent and distressing complaints of bodily weakness and exhaustion after minimal effort like walking the dog, your usual exercise.
- a combination of symptoms of poor sleep, difficulty concentrating, remembering or focusing, feelings of pain, palpitations, sweaty palms, nausea and irritable bowel problems, sensitivity to sound and light.
Social withdrawal or increased irritability, or feelings of wanting to ‘escape’.
The feelings of anxiety often cause physical symptoms of nausea or tightness in the chest or palpitations and clammy sweaty palms. When thinking about work you might feel that your colleagues consider you poorly, or that you are incompetent. Burnout creates feelings of low self-worth and that you are never appreciated or not good enough. The worrying thing about burnout, is that it doesn’t necessarily go away even with a change of job or on a holiday. You might still take these feelings with you in your next role which is why it is important to identify this and seek professional help.
Tips to avoid ‘Burnout’ -this starts with self-awareness and lifestyle choices.
- Self-awareness – means being mindful and in the present.
- Listen and give your whole attention the person you are speaking with.
- Social media – cut out the noise by avoiding being distracted by your phone and the alerts when completing a task or in conversation. Prioritise loved ones and those who love and support you, above the other messages that come through.
- Eat well – for this I recommend you maintain a predominantly Mediterranean diet and avoid processed foods.
- Exercise – make it a rule to fit even short bursts throughout the day such as a brisk walk or jog for 3 minutes out of a 15 minute walk can have positive psychological and health impacts. Sometimes, we don’t have the hour to spare but a regular, daily burst of intense exercise is beneficial.
- Laughter – add some of this to your day every day. Avoid gloomy TV series and the news, especially if you are feeling sad or negative about the world.
- Sleep – get good quality sleep and if you have sleep issues, see your doctor to learn about sleep hygiene.
- Alcohol – limit this.
- Support network – maintain daily contact with your loved ones and make regular contact with your social network.
- Spiritual – according to what you connect with – it might be regular walks in nature or local parks; pray, meditate, keep a diary.
If you think you have burnout or identify with the symptoms described in this article, see your GP. Asking for help is a positive step to restoring well-being.
*Bio: Associate Professor Magdalena Simonis AM is a respected General Practitioner and thought leader, who believes that good health stems from empowering people through sharing evidence-based health information, in easy to understand language. Magdalena regularly writes for medical and non-medical media, and is one of Australia’s foremost women’s health experts, climate change and gender equity advocates. Her passion for health equity often takes her out of the consultation room, as a government and health sector advisor. She is the 2023 recipient of the Australian Medical Association (AMA) President’s Award for Excellent Service to medicine and the profession, the AMA(Vic) Patrick-Steggman Award for outstanding service to the community and her colleagues, a lifetime membership award recipient of the Royal Australian College of General Practitioners ( RACGP), and in 2023 was honoured on the King’s Birthday Honour’s list with a Medal of the Order (AM) for significant service to medicine and women’s health, alongside being listed on the King’s COVID-19 Champion’s list.
