The term burnout was coined in 1974 by the psychologist Herbert Freudenberger. He used it to describe the consequences of severe stress and high ideals in "helping" professions. Since then, we now realize how common it is in the workplace. 

Burnout has three hallmark symptoms. They are:

  1. Emotional exhaustion
  2. Depersonalization/Cynicism
  3. Lack of personal accomplishments/ Lack of professional ability

Now, let's take a deeper dive into these common symptoms associated with burnout and make it more practical by talking about the exact feelings that individuals with burnout commonly experience within and outside the workspace. We will observe a common trend here when we see how these feelings negatively impact people's personal lives even outside of work.

1.Emotional exhaustion

People who experience this are emotionally drained, unable to cope, tired and down, and do not have enough energy. Physical symptoms include things like pain and stomach or bowel problems.

But what does it feel like to be emotionally exhausted? 

  • The smallest things, the minutiae that don't go your way, send you into anger, extreme sadness, and an emotional shriveled state.
  • On weekends when you ought to relax, you feel you can't because thoughts of the coming work week bother you. It all combines to leave you emotionally drained continually.
  • When you are home and especially a day before you resume work, your family avoids you because they know you become very irritable.
  • You feel like the people you love the most are the ones making you madder than ever.
  • Work calls while you’re off. You once were eager to help, but now you find any excuse not to call back.

Imagine your emotional state like a drug concentration level. When you do things that build up your emotional state, it’s like taking your once-daily vitamin of steady-state emotional well-being. Exercising, spending time with family, and meditating is like taking an emotional well-being pill. The drug concentration in your body system initially increases and decreases over time as it is utilized. In an ideal state without work pressures, you are filled with mostly positive emotions.

Figure 1: A graph of Emotions against Time under normal conditions.

In a continuously high-stress environment, daily stressors lower your well-being concentration, allowing for negative emotional concentration to increase. You would usually overcome negative experiences at work, naturally allowing positive emotions concentration to rise. But in a burned-out reality, for example, following some bad news, your positive emotions are so low that nothing but negative emotions fills your mental space.

Figure 2: Well Being Concentrations in a Burnout work environment.

For mental wholesomeness, we need more positive emotions than negative ones. Positive behavior changes have long been studied and shown that humans need about a 4: 1 ratio of positive to negative comments to thrive. Many pharmacists who claim emotional exhaustion have told me, “I live in a 1:10 positive to negative ratio.”

When emotionally exhausted, we don't feel like we have the energy to do anything. This feeling applies to tasks unrelated to one’s current job, like planning a vacation or job hunting. Emotional exhaustion makes any task (big or small) feel insurmountable.

In my book, Indispensable: The prescription for a fulfilling pharmacy career, where I shared my personal story about burnout, I explained how I arrived home in a depressive state from work. I had to ask my wife to give me time alone to decompress to become emotionally recharged. I realized if I didn't do that, I was likely to snip at my wife and get aggravated by my kids due to deep-seated feelings of frustration and anger. I knew that I didn't want to treat my family that way.

Acknowledging my emotions led to me quitting my job eventually and starting up several businesses in line with my interests, which provided me with more time to spend with my family while also paying the bills. You may feel the same way, and this should let you know you are experiencing burnout symptoms.

2.Depersonalization/Cynicism

Depersonalization or cynicism is a critical or skeptical attitude towards patients and healthcare workers, colleagues, support team members, and practically anyone else. It leads to being numb on the job. A long-time patient death won’t scratch your emotions.

How can you know you are experiencing this symptom?

  • Do you feel like your organization is never going to improve?
  • Do you feel like everyone you work with talks poorly about you behind your back?
  • Do you think that things are going to get worse and never better?
  • Do you believe that leadership never changes (for good)?
  • Do you think that you are trapped in your job, and there is no way of escape?
  • Do you consider only the worst-case scenarios happening to you?
  • Do you think of your patient(s) more like problems than people?
  • Have you noticed a difference in how you treat and care for your loved ones versus your regular patients?
  • Do you feel like not answering your patients when they ask questions?
  • Do you feel like not talking with your co-workers and bosses?

The general theme with this symptom is the dehumanization of people. Patients are problems, not people. This change didn’t happen overnight. You were (unintentionally) trained by the work environment to eliminate characteristics like empathy, sympathy, love, and compassion. Why? Because the frantically busy workplace won’t allow you (or even punishes you) to display these emotions to the patients. The pharmacy workplace loves efficiency. So, it’s ready to have you be an efficient pharmacist. That means you were forced to put away the idea of “treat every patient like they were your beloved family member.”

When cynicism takes over, patients become obstacles to your well-being. Depersonalization is arguably the most difficult burnout symptom to acknowledge as it makes us accept that we have changed and perhaps are not as good as we think we are. One can feel shame, guilt, and regret about how we truly see people. There is a lot of negativity here, and it can be dangerous to our mental health. It is more difficult to accept as a pharmacist who is supposed to provide pharmaceutical care to your patients. Sadly, it’s worse for your mental health (and career) in the long run to deny this symptom. This guilt and shame cynics feel are, contrary to what you may think, not their fault.

3.Lack of personal accomplishments/ Lack of professional ability

This symptom highlights the effect of pharmacist burnout on everyday tasks. Burned out pharmacists are very pessimistic about their duties and can find concentration difficult. There is a lack of spark of creativity, problem-solving, or excitement that they may have once experienced. They do not just want to do anything.

The familiar lack of professional feelings are:

  • You may feel like you are no longer capable (question your competence).
  • You believe that even if you try to improve a situation or work problem, things won't change (give up easily).
  • When you make an effort to lead your team and improve team morale or improve your communication skills to present your ideas in a better way, you expect to fail despite the effort you put in.
  • You stopped learning a long time ago (maybe since graduation). You no longer care to spend your free time learning new things.
  • If a friend asked you about work, “Anything fun or exciting happened at work?” You would only focus on the bad and never share something you’re proud you accomplished.

This symptom causes you to lose sight of what makes you great. If you feel this symptom, you may have read the previous sentence and thought, “I was never great, to begin with.” If you are a pharmacist, you are great. You are an intelligent human capable of making a significant impact in the world. If this were not true, you would not have survived Pharmacy school rigors and graduated to become a Pharmacist.

You have now lost your creative instincts; you no longer take the initiative or concern yourself with improving processes or the overall outcome. You have come to accept the false belief that you won't win no matter what you do.

You only do that which is assigned to you. Environmental conditioning in the workplace can also reinforce this false belief. You see colleagues committed on the job and take the initiative, but they fail, don’t get recognized, and fail to be promoted. On the other hand, co-workers who make mistakes on-the-job get shamed for it, or worse, they are swept under the rug and ask you to cover their mess.

How can Pharmacists better handle Burnout?

These symptoms are the hallmark but not the only things that happen. Other consequences are also are scary and sad such as depression and suicide.

They do not, however, have to be your default state. You can turn this burnout around.

There are solutions to solving these problems, and it starts by identifying some of the causes.

In a conversation with Lance Kruger, PharmD, he pointed out how a pharmacy management’s concern with metrics rather than patients’ well-being led his wife to quit her job. Her manager told her to reduce the time spent accessing patients’ prescriptions and counseling so she could attend to more patients per day. However, she could not bring herself to compromise her patients' care and had to quit the job.

How did pharmacists get to this point? How did we lose the profession? Another discussion for another day. For now, let’s focus on helping you recover from burnout.

If we feel stuck in the profession, we can also explore other interests that will give us the flexibility and free time we need. That is what we are committed to doing at The Happy PharmD - helping Pharmacists create inspiring work and lives. Feel free to reach out to us, and let's talk about it.




The Feelings and Symptoms of Burnout