oh snap

The data does not support the assumption that all burned out people can “recover.” And when we fully appreciate what burnout signals in the body, and where it comes from on a social, economic, and psychological level, it should become clear to us that there’s nothing beneficial in returning to an unsustainable status quo. 

The term “burned out” is sometimes used to simply mean “stressed” or “tired,” and many organizations benefit from framing the condition in such light terms. Short-term, casual burnout (like you might get after one particularly stressful work deadline, or following final exams) has a positive prognosis: within three months of enjoying a reduced workload and increased time for rest and leisure, 80% of mildly burned-out workers are able to make a full return to their jobs. 

But there’s a lot of unanswered questions lurking behind this happy statistic. For instance, how many workers in this economy actually have the ability to take three months off work to focus on burnout recovery? What happens if a mildly burnt-out person does not get that rest, and has to keep toiling away as more deadlines pile up? And what is the point of returning to work if the job is going to remain as grueling and uncontrollable as it was when it first burned the worker out? 

Burnout that is not treated swiftly can become far more severe. Clinical psychologist and burnout expert Arno van Dam writes that when left unattended (or forcibly pushed through), mild burnout can metastasize into clinical burnout, which the International Classification of Diseases defines as feelings of energy depletion, increased mental distance, and a reduced sense of personal agency. Clinically burned-out people are not only tired, they also feel detached from other people and no longer in control of their lives, in other words.

Unfortunately, clinical burnout has quite a dismal trajectory. Multiple studies by van Dam and others have found that clinical burnout sufferers may require a year or more of rest following treatment before they can feel better, and that some of burnout’s lingering effects don’t go away easily, if at all. 

In one study conducted by Anita Eskildsen, for example, burnout sufferers continued to show memory and processing speed declines one year after burnout. Their cognitive processing skills improved slightly since seeking treatment, but the experience of having been burnt out had still left them operating significantly below their non-burned-out peers or their prior self, with no signs of bouncing back. 

It took two years for subjects in one of van Dam’s studies to return to “normal” levels of involvement and competence at work. following an incident of clinical burnout. However, even after a multi-year recovery period they still performed worse than the non-burned-out control group on a cognitive task designed to test their planning and preparation abilities. Though they no longer qualified as clinically burned out, former burnout sufferers still reported greater exhaustion, fatigue, depression, and distress than controls.

In his review of the scientific literature, van Dam reports that anywhere from 25% to 50% of clinical burnout sufferers do not make a full recovery even four years after their illness. Studies generally find that burnout sufferers make most of their mental and physical health gains in the first year after treatment, but continue to underperform on neuropsychological tests for many years afterward, compared to control subjects who were never burned out. 

People who have experienced burnout report worse memories, slower reaction times, less attentiveness, lower motivation, greater exhaustion, reduced work capability, and more negative health symptoms, long after their period of overwork has stopped. It’s as if burnout sufferers have fallen off their previous life trajectory, and cannot ever climb fully back up. 

And that’s just among the people who receive some kind of treatment for their burnout and have the opportunity to rest. I found one study that followed burned-out teachers for seven years and reported over 14% of them remained highly burnt-out the entire time. These teachers continued feeling depersonalized, emotionally drained, ineffective, dizzy, sick to their stomachs, and desperate to leave their jobs for the better part of a decade. But they kept working in spite of it (or more likely, from a lack of other options), lowering their odds of ever healing all the while. 

Van Dam observes that clinical burnout patients tend to suffer from an excess of perseverance, rather than the opposite: “Patients with clinical burnout…report that they ignored stress symptoms for several years,” he writes. “Living a stressful life was a normal condition for them. Some were not even aware of the stressfulness of their lives, until they collapsed.”

Instead of seeking help for workplace problems or reducing their workload, as most people do, clinical burnout sufferers typically push themselves through unpleasant circumstances and avoid asking for help. They’re also less likely to give up when placed under frustrating circumstances, instead throttling the gas in hopes that their problems can be fixed with extra effort. They become hyperactive, unable to rest or enjoy holidays, their bodies wired to treat work as the solution to every problem. It is only after living at this unrelenting pace for years that they tumble into severe burnout. 

Among both masked Autistics and overworked employees, the people most likely to reach catastrophic, body-breaking levels of burnout are the people most primed to ignore their own physical boundaries for as long as possible. Clinical burnout sufferers work far past the point that virtually anyone else would ask for help, take a break, or stop caring about their work.

And when viewed from this perspective, we can see burnout as the saving grace of the compulsive workaholic — and the path to liberation for the masked disabled person who has nearly killed themselves trying to pass as a diligent worker bee. 

I wrote about the latest data on burnout "recovery," and the similarities and differences between Autistic burnout and conventional clinical burnout. The full piece is free to read or have narrated to you in the Substack app at drdevonprice.substack.com

Yes this happened to me

It was about 3 years ago. It took about a year after I hit the wall to be able to reliably work at volunteer jobs ~9 hours a week. My tolerance for sensory input, social stamina and resilience to stress still haven't fully rebounded and i no longer engage in many of the activities and hobbies that I used to enjoy.

It's taken the past 3 years to regain the unhealthy amount of weight that I lost (when I dropped out of school I was the same size I had been at age 14 and my vision went completely black every time I stood up) and my overall health and immune functioning is worse than it used to be.

Even with a lesser work load my performance in school is also much lower nowadays, which hurts.

— Anne Carson, from Grief Lessons: Four Plays by Euripides; Tragedy: A Curious Art Form.

I was diagnosed as autistic during a 2 week stay in a psychiatric ward. Many other autistics are diagnosed after hitting autistic burnout or completely melting down.

My hope is that less and less autistic people need to hit rock bottom just to discover they're autistic.

Did you still have to pay for the diagnosis?

Thankfully no, but only because I was a minor (17)

When I say, “My anxiety is acting up,” I’m really saying, “There’s no reason to be afraid. It’s just my disorder talking, and I can do something to calm down.” It’s positive.

When I say, “My depression is bad today,” I’m really saying, “I’m not worthless and I don’t deserve to die or give up. It’s just my disorder talking, and I should get up and look for what’s good about today.” It’s positive.

When I say, “My ADHD means my brain is wired differently,” I’m really saying, “I’m not a stupid piece of shit who will amount to nothing. It’s just that my brain needs help making certain connections and chemicals, and with certain processes, and there are lots of things I can try to work with it instead of against it.” It’s positive.

Talking about and accepting my disorders is the most radically positive thing I can do. It isn’t pessimism; it’s optimism. It isn’t defeatism; it’s hope. It’s direction, and action, and learning to regain control of my life.

So I don’t give a fuck if it annoys you or makes you uncomfortable. I don’t care if you think I need to think of myself as “more than my disorders”. Because I don’t think that having disorders makes me lesser. And I’m not going to silence myself because you disagree.

You’re fucking wrong, and I won’t let my own silence be the death of me.

One day you won’t wake up with such a heavy heart.

And I hope that day comes sooner rather than later for you.

i don't know who needs to hear this, but guilt, self-hatred and shame are not sustainable sources of growth and healing. you can't hate yourself into feeling better, or being better. you can't repeatedly punish yourself for your flawed humanity and expect wholesome results.

i have. a lot of big complicated thoughts about how people tend to treat depression as like. as if it’s nothing. like it’s the most basic easiest mental illness ever. why do we do this. depression kills people. constantly. people will throw around “depression and anxiety” and say they’re totally normalized nonstigmatized disorders and then you realize they only think mild versions of these disorders exist. i have a laundry list of mental disorders and the only one that’s ever actually put my life at risk was depression. if you throw around depression as if it’s the mildest least harmful mental illness ever have you considered shutting the fuck up.

No matter what your intrusive thoughts might tell you, there is nobody who can replace you. It’s impossible. You are completely unique, with your own thoughts, experiences, and personality. Nobody can replace you: it’s impossible. 🌱

Credit to @the_depression_chronicles11 on instagram (reposted with permission)!

Sometimes the help you need isn’t the help you want. Call 1-800-273-8255 if you’re thinking of suicide.

This comic meant a whole lot to me. It was sincere in its depiction and treated the issue through the eyes of a grounded person. Not some godly hero saying everything is better than it seems, but a person trying his best before bringing her somewhere who can actually help.

the older i get and the closer i am to reaching 30, the more the people around me try to deny me my age. it’s a constant ‘oh you’re just turning 29 again teehee 🤭’ or ‘dont tell your SO that, he’ll leave you for a younger model 😉’ and i just???? hate it?????????

i spent my entire teenaged years fighting for my life. i crawled through the deepest pits of my depression to cling to the promise of a life beyond that pain. i was so convinced that i was going to die young, that i would never see the grace of my age starting with a 2, let alone 3.

so im going to turn 30, and there’s not a damn thing anyone can do to stop me from loving it.

this post was up for like five minutes and already im being told how wrong i am

fuck you, you can kiss my 30 year old ass

As someone who has been living with severe suicidal ideation my entire life I wanna tell you all something, you don’t have to stay alive for yourself. People will say it’s a bad idea to live for external things because they’re temporary, and it’s true living for yourself is ideal but if you’re not to that point yet that’s ok too. 

I’ve lived for my dog for the past 4 years, before that I lived for my snakes, before that I lived for my cat. You can live for whatever needs you and whatever matters to you. Live for your best friend, live for your plants, live for your pets, live for your animal crossing town. Live for whatever keeps you alive and the day will come when you can live for yourself.

This is something everyone should see. Thank you for sharing this.

Transformers kept me alive. When the 2007 movie was announced I was going through an incredibly hard time emotionally. I saw the preview and every time I thought about killing myself I thought, “but then I won’t get to see this thing I’ve always wanted to see, good or not.” And it got me through.

I’m in a place where I live for myself now, but don’t toss away a life preserver just because other people think you should be able to swim on your own.

don’t toss away a life preserver just because other people think you should be able to swim on your own

[ID: A white speech bubble against a textured teal background, with a black spoon next to it. The text reads:

My pain is a medical condition, not a personal failure. My depression is a medical condition, not a personal failure. My anxiety is a medical condition, not a personal failure. - Bipolar Beauty

/End ID]

One of the many weird things about depression is that it retcons your life. Not only are you lying in bed feeling like a piece of shit and that everything is awful, but you start projecting those feelings back along your own time stream - you start low-key believing you've always felt this way, that nothing good has ever happened, or if it has it happened a long time ago.

On January 1st of last year I decided to start keeping a tally of good days and bad days, because I stopped trusting my brain to report on that accurately. I expected to come and look at the tally when I was depressed and go "oh, I had a good day only a few days ago. this hasn't always been like this."

What I didn't expect was that the process of asking myself whether a day had been good or bad would radically shift my perspective on what a bad day was and what a good day was. On the very first day, when I'd achieved nothing and had felt sad and slow all day, I went to put a notch in the Bad Day column before stopping myself:

wait, i thought. has today actually been bad? not bad enough to write it off. i played rummikub online with my partner. i drank some water. i had a long bath. no, today wasn't a bad day.

And so I put a notch in the Good Day column and went to bed. The next day I did the same thing, and the next day, and the next day. Just the process of going over my day every day meant that I found at least one good thing that happened every day. I had a good meal. I went to the pub and was around people, albeit quietly. I went for a walk. I saw a duck. There were days where truly awful, terrible things happened, but even on those days there was always something - even if the something was a simple as We Were There For Each Other or We Reminisced.

On December 31st I put the final tally down. Not a single day had been so bad that I could justify writing it off as a bad day. The bad day column was completely empty.

I'm still depressed, occasionally deeply, but I think I have more perspective. Depression is a physical feeling, and an emotional feeling, but even without trying *something* comes along every day that makes me glad I'm here despite that feeling.

I know it’s uncomfortable cutting people of but you deserve better than microaggressions and negativity. You don’t have to keep surrounding yourself with people who make you unhappy out of politeness.

I fucking hate it when you’re in such a fantastically giddy mood and then you see one simple little thing that makes you think, “oh” and then you just get this empty feeling in your chest and you get nauseous and the world just crumbles and you want to just lay under a blanket and close your eyes and fall asleep and never wake up. 

From what my therapist told me, this happens because our emotions aren’t really on the ‘opposite’ ends like we tend to think of it. Happiness is not ‘up’ and sadness is not ‘down’-. In a way they’re actually right ‘next’ to each other.

If you’re super happy, it can turn into super sad very easily, because your emotions are already highly elevated and it’s only a very minor shift as far as your brain is concerned.

Knowing this can help you fight it, and it can help you be more aware of what’s going on while you’re happy and help avoid shifting towards misery.

I used to always wonder why it seemed like my happy days ‘couldn’t last’ or that bad things would ‘always’ happen when I was happy. It’s not that happiness is doomed to fail, it’s that emotions are volatile. I hope that helps people who experience this too- when you understand what’s going on more it’s easier to manage.