Ergopathology (BURNOUT) with Kandi Wiens

Exhaustion! Numbness! Anger! You’re stressed out. I get it. Let’s fix it. I cornered one of the world’s experts on Ergopathology, scholar and author Dr. Kandi Wiens, to ask about the causes of burnout, warning signs, what professions are more at risk, how to recover from burnout and prevent it in the future, which was the focus of her book, “Burnout Immunity.” We also chat about neurodiversity, hockey mascots, childhood trauma, how do you tell your boss you're burned the F out, grit, and guilt. Also, you don't need to wait until you're on a tropical vacation to recharge. In fact, don't. Content warning: we briefly discuss suicide rates in certain professions.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Alie Ward?

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• 0:42Alie Ward?

  Their proactive safety features help keep you more aware, connected, and engaged during every drive, which means your car does more than help protect you. It makes you a safer driver, which helps protect everyone. That's why Mazda has been named Consumer Reports' safest new car brand. To learn more, visit mazdausa.com. Consumer Reports does not endorse products or services. This podcast is brought to you by Aura. Your body has a lot going on. Sleep, stress, recovery. You would be surprised how connected it all is. Aura Ring tracks more than 50 metrics from your finger, and the Aura app brings that information together to help you see patterns across your sleep, and stress, activity, and more.

• 1:26Alie Ward?

  So you can start connecting the dots and figure out what works for you. Learn more at aura ring dot com. Wear your best life with Aura. Oh, hey, it's your coworker who makes bund cakes, Ally Ward. And speaking of work, let's get right into it. How are we doing? How are our brains? How are you feeling? Are you feeling like a little bit like wilted lettuce? You feeling like a swollen infection gonna pop? We get it, I get it. So this episode has been a long time coming, and I cornered one of the world's leading experts on burnout. They got their MBA at the University of Oregon and a doctorate of education at the University of Pennsylvania, where they are currently a senior fellow. They're the director of the Penn Masters in Medical Education Program, too. They wrote the book.

• 2:10Alie Ward?

  Burnout. It's called burnout immunity. So ergopathology, it's the science of ergon, which is work in Greek and pathology, which is something bad. But what exactly is burnout? Okay, obviously, we're going to cover it. But if you're experiencing exhaustion, cynicism, and professional inefficiency, you're going to want to keep listening. Before we get to it, though, thank you to all the patrons at patreon.com for submitting your questions for this episode. You can get sneak peeks at future episodes and you can submit questions for them by joining Patreon for as low as a dollar a month. And for $0, thank you to everyone leaving reviews, which help the show so much. Like, for example, this week, Euphonium Shorty left a review that said,

• 2:53Alie Ward?

  "I couldn't possibly care less about the making of street murals. At least that's what I thought until Ally explained it all to me. That's happened to me at least a dozen times with this podcast. That's why I love it. Amazing, really, the frequency with which they come out. If I could change one thing," they write, "it'd be Ally taking better care of herself." Euphonium Shorty, timely. "I'm doing much better, and I'll tell you how I balance life with work that I legitimately love." Also, speaking of love, lots of love back to reviewer Amari. You know who you are. Okay, let's get into it. Please take a load off, lie down on a carpet. You can recline against a tree trunk. Take some time to listen and absorb the teachings about what is burnout? Who burns out faster than others? Who doesn't burn out?

• 3:36Alie Ward?

  What professions are more at risk for fatigue and mental health repercussions? How do you tell your boss you're burned out? Neurodiversity and burnout, grit, the myths of guilt, hockey mascots, childhood trauma, and lingering anxiety, and how to tell your brain to tell your body that you got this? And when to acknowledge, no, I do not got this. Baby needs to rest. Also, how you don't need to wait until you're on a tropical vacation to recharge. In fact, don't. With scholar, author, and burnout expert, ergopathologist Dr. Candy Wiens.

• 4:26Speaker 01

  Candy Wiens, she/her.

• 4:28Alie Ward?

  Mm-hmm. Burnout expert. How does it happen? How does one become a burnout expert? Just like diving right in. I'm like, tell me everything.

• 4:38Speaker 01

  Well, let me tell you, when I was probably nine, 10 years old, that's the last thing I ever thought I would be. In fact, I didn't even hear the word burnout until just probably, I don't know, eight, well, 12 years ago. So becoming a burnout expert, for me anyway, started with me having a life-threatening wake-up call experience with burnout. The kind where I was having a hypertensive emergency and just decided to go on a quest to figure out like what was going on with me, learn how to deal with my stress. And then as I started nerding out and geeking out on the whole thing, I decided to go get my doctorate. It was like one of those, okay, I'm gonna go figure this out for real. I'm gonna science the shit out of this thing and I'm gonna find out why some people just seem to be somewhat immune to burnout.

• 5:22Speaker 01

  They are clearly experiencing a lot of stress, but they work alongside people like me that are experiencing the same sort of stressors, but they're not burned out. What's going on with them?

• 5:32Alie Ward?

  Can you tell me a little bit about that hypertensive emergency? If it's not true traumatic, but what was the moment you realized that it was related to stress?

• 5:43Speaker 01

  Yeah. So at the time, this is back in 2011, I was a management consultant, on the road a lot, had three young kids at home, living the whole type A personality sort of career. Loved what I did, threw myself into it, super engaged in work, loved my colleagues and my clients and all of that. And I felt at the time like I was experiencing a lot of stress, but to me it felt like the good kind of keeping myself motivated sort of stress. Alongside a lot of the other bad stress too, but I, my approach back then was just stuff that stress, like put it in a box, put it in a, put that box in a closet, like lock that closet and don't touch that stress until you're ready for it. What happened was when I had this hypertensive emergency, which I had no idea I was even having one, I went into my doctor's

• 6:26Speaker 01

  Office just for a routine annual physical. You know, that kind where you go in and they check your blood pressure and they check all your vital signs. And you're in and out in about 20 minutes, they give you your A and say, see you back here next year. I thought it was one of those, but what happened was I was in the exam room, the nurse checked my, my vital signs. She checked my blood pressure four times before saying anything. And the only thing she said to me was, I'm going to go talk to the doctor. And instead of like taking that seriously and thinking, holy cow, like, what is this about? What's gone on with my blood pressure? Instead, I picked up my phone and started working again. Because that was the norm for me. And I know it's like, I'm hearing stories from so many people that that's what they would have done too.

• 7:08Speaker 01

  Because the stress I was feeling at the time had just become to feel so normal to me. That I wasn't recognizing the fact that when my doctor came in, she told me that my blood pressure was 200 over 110. Yeah, I didn't know what that meant at the time.

• 7:22Alie Ward?

  Just a side note, I had to look this up. Normal blood pressure, 120 over 80. It's considered high around 130 over 80. Stage two is like 140. But if you get a blood pressure reading over 180 over 120, you need to call 911. Or go to the ER immediately. Like you could die on the spot. And again, Dr. Wiens was 200 over 110. What? So this is what's called a hypertensive crisis and it's usually caused by people forgetting to take blood pressure meds. Or kidney disease underlying or heart disease, some pregnancy complications, taking meth.

• 8:01Alie Ward?

  Or really high anxiety. And according to the CDC, heart disease is the leading cause of death for women in the United States. Killing over 300,000 women in 2021, or about one in every five female deaths. We do have a cardiology episode coming up, of course, but yeah, her blood pressure was well into the range of all hands on deck. Holy shit.

• 8:24Speaker 01

  And then, of course, she gave me a huge dosis Xanax, which I'd never had before. And brought my blood pressure down. And so like an hour later, she called my husband to have him come pick me up. And about an hour later, I was finally, you know, stable enough where they could send me home and not to the emergency room. I was basically like ordered to be on bed rest for several days. And my first thought when she told me that was, there's no way I can be on bed rest because I have this big leadership development program to run. And I almost panicked, like it almost sent me back into another stress spiral. But then the second thought was, well, thank God, someone's finally telling me I can go home and rest, like giving me permission to rest because I wasn't giving myself enough rest.

• 9:09Speaker 01

  And I hear this so often from people that I work with and people who hear me speak. But then my third thought was, you know, she's absolutely right. My doctor is telling me I'm not fine. I need to take this seriously. I need to stay home and not work. And so for a few days laying on the couch on Xanax and blood pressure medicine, I had a lot of time to think and started reading some books and started digging around on, you know, what are the best stress management techniques and doing just also a lot of self-reflection. And it started to dawn on me then that I needed help. I needed to make changes because my work environment was not going to change anytime soon. So I needed to think about for myself, what were some immediate things I could do. But then also it really dawned on me too, like longer term,

• 9:54Speaker 01

  I really need to find a work environment and the right conditions where I can really thrive without burning out. So that's kind of how it started, my interest and my like geeky curiosity on stress and burnout. And then it eventually turned into me wanting to get my doctorate so I could study it for real.

• 10:12Alie Ward?

  When you realized that you had to make some changes, where do you start? Like, did the doctor say like, okay, you need to do medicine? Or they're just like, your blood pressure is good, you gotta figure out the rest?

• 10:24Speaker 01

  It was like, you know, gave me medicine and told me to go home and basically figure it out for myself. She didn't recommend anything at all. And this was again, back in 2011, where very few people, if any, were talking about burnout. Like I wasn't really hearing about it. And I worked in healthcare consulting. So it wasn't really until like 2012, 2013, that I started reading studies about this stuff and reading some other stress management books and like practitioner kinds of books. But then when I started digging into the research, I started seeing, okay, there is this thing called burnout. And then I was able to put my finger on what I was experiencing.

• 10:58Alie Ward?

  What exactly, looking back now that you have your doctorate and now you've been working in this for so long, can you pick apart a little bit of what was happening during a burnout episode? I imagine that it can show up in your heart or your brain. I imagine that whatever crisis people might finally get to can show up in all kinds of ways, right?

• 11:20Speaker 01

  So there are really a number of ways that we can pay attention to the fact that stress is turning into something that's a little bit more dangerous, potentially getting to a point where we're going to break down or burn out. And I would say, first and foremost, pay attention to the physical signs. Most of us can notice things like headaches, not sleeping well, not being interested in exercise, not being interested in intimacy with our partner, you know, all kinds of physical manifestations. That if we were to just really pay attention, they are there, those signs are there. But then also, like, some of the psychological ways that burnout manifests, that things like, just, you know, lack of interest in things that we once loved to do, starting to feel more negative and cynical about work or about other people.

• 12:05Speaker 01

  And then we also might notice changes in our relationships. Some people tell me that they notice the first signs of burnout when they start to notice their relationships are kind of fraying and starting to become more tense, that they start lashing out, maybe at people that they really love or they even enjoy working with. So there are a number of ways that you can pay attention to how stress is affecting you. And it's really noticing the fact that burnout is really this thing that can be quite insidious, meaning that it can really sneak up on you if you're just going through the motions of life and keeping with the grind that you've always been doing, which was my case, and a lot of people that I talked to who have been burned out, that's how they experience

• 12:47Speaker 01

  it, because they're so focused on performing or achieving or helping other people or just juggling life and family and everything all at once, that it's really easy to lose track of what's going on with yourself.

• 13:01Alie Ward?

  And what's happening from a scientific perspective? Like, I know the amygdala has so many things to say when it comes to stress. I know we've got cortisol, we've got adrenaline, we've got dopamine, we've got serotonin, we've got all kinds of things going on. What is happening under stress where it finally just, like, the roof caves in?

• 13:26Speaker 01

  Well, so for some people, it caves in on a physical level. And burnout, for the most part, is a psychological experience with stress. Our body goes through all kinds of chemical reactions. When our amygdala goes off, it's that part of our brain that that triggers the fight, flight, or freeze response. And very few of us, though, are actually threatened by bears coming out of nowhere.

• 13:48Alie Ward?

  Yeah.

• 13:49Speaker 01

  Or being chased by a tiger. Or, you know, in my case, I actually am going through something that it's not physically threatening, but it's psychologically threatening to me. So that, to me, is much more stressful than something like coming on the Ologies podcast, where I was nervous to come on, but also excited. Like, there's stress involved in both of those scenarios. But one triggers a threat response to stress. The other one, coming on your podcast, triggers what's known as the challenge response to stress. So our body's going to react differently in each of those situations. And what's really important, and what I write about in my book, is learning how to pay attention to those signs so that you can regulate your nervous system.

• 14:32Speaker 01

  Whether you're truly being threatened, or if the stressor is something that you are excited about and looking forward to, you can learn how to regulate your nervous system in a healthy, productive way, so you can show up as your best.

• 14:44Alie Ward?

  So Dr. Wiens says that the challenge response to stress kicks in when we want to perform or achieve something. And why it doesn't freak you out is because you've told yourself that it's not life-threatening. And so your body uses those fight-or-flight hormones, like if you were exercising, or trying to beat your brother-in-law in a potato sack race. So the challenge response gives you energy and focus and motivation, and just a little bit of swagger. So how do you respond that way, instead of throwing up in a garbage can before your annual performance review? Dr. Wiens writes that you have to gently brainwash yourself, or you have to un-brainwash yourself by telling yourself inside, hey, you can do it. You can go crush this.

• 15:29Alie Ward?

  So don't try to suppress the stress, because that makes it worse. And she says to tell yourself, I'm stressed right now. But that's okay. I've experienced stress before. I always get through it. Or say, hey, why not go for broke? I'm stressed right now, but this ain't my first rodeo and I'm going to kick some ass. She writes in her book. She also says other quick mindset shifts include remembering all your strengths, remembering all the prep you did for the challenge, all the times you overcame similar challenges, imagining your loved ones rooting for you, or having a mantra like, I've got this, I can handle this. Or again, her personal favorite is, this ain't my first rodeo. And she confesses in her book that she'll actually wear a T-shirt

• 16:13Alie Ward?

  that says, this ain't my first rodeo, under her suits when she gives like a big keynote. I tell myself to show up like you belong and have fun, which I guess I didn't realize that I was shifting my terror into a challenge response to stress. And I have to do it every week before I record. Hi, doing it right now.

• 16:34Speaker 01

  Neuroscience researchers who look at this stuff and look at really all the chemical reactions to stress, and not just burnout, but everyday stress for long periods of time. Sometimes it may lead to burnout, other times it may not. It may lead to other psychological conditions. But yeah, when we get stressed and that turns on our nervous system and that nervous system switch is turned on for a long period of time or it gets stuck in the on position, we start to burn through our adrenaline first and then our cortisol kicks in and that's meant to protect us. But over time, burning through all that cortisol really, really quickly can lead to other physical symptoms. It will immediately cause your blood vessels to constrict. So you're then experiencing lack of oxygen and healthy blood flow to your brain,

• 17:19Speaker 01

  which then puts you in what we call fast thinking mode. So it's like a chain reaction where we first have an unconscious physical reaction through the release of these kinds of hormones, whether it's adrenaline or cortisol, or in some cases with good stress, it's dopamine and oxytocin and other things that help us manage stress. But it's those physical things that happen without us even knowing it before we start to feel the psychological effects of stress and then eventually burnout.

• 17:49Alie Ward?

  So the chemical background here is that adrenaline helps you survive in physical stress. It gives you this fuel boost in the form of glucose, which helps you get out of dodge, or fight, or hide in a bush, or whatever it takes to evade an attack. Now, the hormone cortisol, this is outlined in the Frontiers in Psychology paper, Burnout and Hypocortisolism: A Matter of Severity? Cortisol Responses to Acute Psychosocial Stress. Cortisol gives us the energy mobilization to fight off that attack. But, as anyone who's ever had nervous diarrhea knows, it's not always helpful. And it continues this paper that long-term exposure to stressful circumstances without enough recovery is hypothesized to be the

• 18:33Alie Ward?

  cause of fatigue and exhaustion symptoms in people experiencing burnout. So, things might be happening physically to you under stress, but, like your own BO, sometimes you can't even detect it. You're just accustomed to it. And you might not even notice your burnout and your anxiety symptoms until your body's very mad at you, or your sanity starts to fray. And I'm speaking from experience. Do you think some people are more predisposed to burnouts? Like, if you have an anxiety disorder pre-existing, or you have depression, or if you're a neurodivergent, do those people tend to push beyond their limits? Or have a lower threshold for this kind of stuff?

• 19:14Speaker 01

  Yeah, so there's interesting research that shows the relationship between, you can look at it by temperament. So each of us is born with a certain type of temperament that doesn't necessarily change as we age and get older. And then we also all have personality traits that may change through life experiences. Anxiety is an interesting one. So people who have just like underlying anxiety disorders, or tend to be, one of the personality traits is neuroticism. So people who are high on the neuroticism scale

• 19:45Speaker 02

  Hey, it's me.

• 19:46Speaker 01

  tend to be more prone to burnout in certain contexts because they are more easily triggered. But it's also not just with people who tend to run anxious. I would say what's important to look at for everybody is not Not necessarily whether you have an anxiety disorder or depression or anything like that, but really think about the interaction between what you want and need out of a work and life environment and what you're actually getting. What is the environment that you're actually in? Because it's really the interaction between you and that environment that makes you more vulnerable to burnout in certain contexts or in certain environments.

• 20:23Alie Ward?

  Yeah, I'm laughing about the neuroticism because we did a personality psychology episode. I took a test and it was like, your neuroticism is so high, we can barely measure it. It was just like, oh shit, how do they know? So I know definitely some of us are predisposed. And we'll link to that personality psychology episode. It is a banger. We'll put that in the show notes. But the cheat sheet is that there is a scholarly five factor model of these five core personality traits, which are agreeableness, conscientiousness, extraversion, neuroticism, and openness. And there was a 2023 study titled, "The Big Five Model Personality Traits and Job Burnout: A Systematic Literature Review."

• 21:07Alie Ward?

  And it showed that higher levels of neuroticism and lower levels of agreeableness, conscientiousness, extraversion, and openness are associated with higher levels of burnout. No surprise. So the neuroticism and hiding from the world and being stubborn that I think protects me from failure. Nope, it does not. Why aren't we like this? Do you think that there's anything in our pasts that makes us more prone to pushing through? I understand things like, you know, childhood trauma or codependency issues, things like that might make us take on more than we necessarily should be handling.

• 21:51Alie Ward?

  Does childhood experience or does codependency or does like, I can give more than the average person because I should? Does that figure into being predisposed for burnout?

• 22:04Speaker 01

  It absolutely does. Yeah, absolutely. So if you think about like, what really contributes to my vulnerability to burnout and yours, Ali, your vulnerability might be different. It's two things. Like, what are we born with? We're born with a certain kind of temperament and personality, but then also, what's the environment? What are the conditions that we're exposed to in our early childhood, all the way up until where we are today? And so, you know, aside from personality and temperament, which are hard for us to change in general, when we are able to reflect on the early experiences we had in childhood, and not just the experience itself, but who helped us or who did not help us through stressful experiences.

• 22:44Alie Ward?

  And chronic trauma, like surviving long-term intimate partner abuse, or war, or sex trafficking, or childhood trauma, that can result in what's called CPTSD, or complex post-traumatic stress disorder. And as for CPTSD being distinct from PTSD, some experts fight about that, which is not chill.

• 23:06Speaker 01

  And it's interesting, because there's really good research that shows a correlation between people who have had a number of what we call ACEs, adverse childhood events or experiences. And the studies are mixed. It's really showing that people who have a number of ACEs, like in my case, the whole first chapter of the book, it describes my experience from early childhood and how I went through a lot of adversity.

• 23:30Alie Ward?

  And her book details more of that, but she writes, "I grew up on an Indian reservation in eastern Montana. Picture big blue skies, golden wheat fields, and the rich beauty of Native American culture, alongside abject poverty, little opportunity for education, and, on my mom's side of the family, a long history of mental illness and alcoholism." She writes, "My parents divorced after the tragic death of my two-year-old middle sister, leaving my mom to care for a newborn and me. Needless to say," she shares, "we struggled a lot. My mom was traumatized and grieving in ways I couldn't begin to understand, and we lived in government-subsidized housing and relied on food stamps and Indian healthcare

• 24:11Alie Ward?

  for basics. I was constantly bullied at school for being too skinny. Not my fault," I would think to myself, "I've barely eaten in the last five days. So began my struggle with adversity-induced stress," she writes. So, childhood adversity is even more crushing with systemic oppression and lack of financial resources and support.

• 24:32Speaker 01

  And at the same time, I had a really loving, supportive family environment, even though it was very unstable and I felt at times very, very insecure. And that led me to all kinds of bad patterns and habits around overachieving and immersing myself to an unhealthy level. That was offset by the fact that I had parents who loved me and I had other caregivers and people in my life who were supportive and tried their best to give me as secure of an environment as possible. So that all factors in to both my patterns and how I've responded to stress up until today, as well as how I perceive stressors now and into the future and how that might make me more vulnerable to burnout. One that's really interesting that I'd want to hit on a little bit

• 25:15Speaker 01

  because I think a lot of people can relate to this one is we hear a lot about grit. And that grit is a good thing, the ability to persevere and work through things, you know, big, hard challenges. And we find that a lot of people who go through really advanced education, like physicians, go through, you know, med school and then residency fellowship, that they learn how to persevere, like they have grit like nobody's business sort of thing. So I started digging into that. And sure enough, there are studies that show that that grit protects people from burnout.

• 25:48Alie Ward?

  So according to a 2018 paper, "The Relationship Between Grit, Burnout, and Well-Being in Emergency Medicine Residents." "Grit is this personality trait marked by perseverance and passion for long-term goals, especially over a sustained period of time." And this study found that residents with higher grit appear to be less likely to experience burnout. So how do you know if you're gritty? If you're the Philadelphia Flyers hockey team mascot Gritty, a huge furry orange thing whose lore involves being disturbed from his secret hideout while the Wells Fargo Stadium was being built, you definitely have grit because Gritty gets his name from the grit of the Flyers team. Because when you're from Philly, you go through things like corrupt public officials and winter.

• 26:33Alie Ward?

  Now, Gritty looks kind of like a Jim Henson character who owns more than one bong. And he was designed to represent someone that you'd high five. But not hug. And they really got that dialed in. So gritty has grit. Maybe you're not gritty, but you have grit. There's a test for that. It's called the grit scale. And grit, I just learned this, it's not just about like, someone who'd rubbed dirt in a wound. It actually stands for something. It stands for growth, resilience, instinct, and tenacity. And this scholar, author, and psychologist, Dr. Angela Duckworth pioneered a test for it, which includes statements like, setbacks don't discourage me. I finish whatever I begin. And this quiz tragically honestly reads

• 27:15Alie Ward?

  like a reverse assessment for ADHD, which we cover in depth on our three-part ADHD episode, linked in the show notes with Dr. Russell Barkley. And we'll also cover neurodivergence later in this episode. So the grit scale, though, has its critics. Scores are kind of said to be in line with higher GPAs for students and spelling bee championships and military academy success. But as Dr. Wiens explains, it's not an immunity amulet to future despair.

• 27:44Speaker 01

  But in my case, I thought, you know what, I'm a really gritty person. I'm kind of off the scales when it comes to grit. But why did I get burned out? Well, my theory and what I found through my research is that grit without self-awareness can get you in trouble.

• 27:59Alie Ward?

  Oh.

• 28:00Speaker 01

  It may serve us really well to get through things like medical school, or whatever these hard things are that you're working for. But then at some point, that pattern and those ways of working become so ingrained in us that we lose track of, lose sight of the fact that it's actually pretty unhealthy for us to keep going at that pace.

• 28:19Alie Ward?

  When you do research on this, how do you approach that? Do you have to go and find subjects? Where do you even start? I imagine people who are going through a burnout are like, I don't have time to talk to you.

• 28:31Speaker 01

  Oh, totally. I was worried about that. Actually, when I started my first study, which was my dissertation, I thought, okay, here's what I want to do. I want to find people who are in probably one of the most stressful jobs I've ever been exposed to. A lot of my clients were really busy physicians and clinicians. And then there are a number of physicians who have both clinical responsibility and then they also So have leadership responsibilities. So I thought, okay, let me study chief medical officers because I know I've worked with a number of them and they just, the pressure and the demands on them is just like so extreme. So I thought, but wait, they're probably not going to talk to me or it will be extremely hard to get on their calendar. Well, I was actually surprised because many of them wanted to sign up when they heard that I was studying stress and burnout.

• 29:15Speaker 01

  They were like, oh, let's talk about that. I have some thoughts. I want to tell you my experience. So I started studying that group of people and the findings were really the basis of what turned into more research. The next big study I did was with over 200 police chiefs and other senior law enforcement officers. So again, I went after what, what profession do I think has, you know, very regular, very high stress for very long periods of time. And sure enough, you know, when I had studied police chiefs along with the chief medical officers, what I would have them do is first tell me like on a scale of one to 10, how would you characterize your stress with 10 being worst possible? Zero, no stress.

• 29:59Speaker 01

  And the ones who showed up as a seven or above, which, think about that for a second, they were telling me that their stress for a long period of time is severe, very severe or worst possible. And then I have them, I actually measured them. I have a psychometric tool that's a lot of researchers use.

• 30:17Alie Ward?

  So this quiz is the burnout risk assessment and it's included in her book and it asks participants to rate their degree of agreement or disagreement with statements like, I feel comfortable asking others for help when I'm stressed out. I'm experiencing a lot of conflict with other people at work. I'm working longer and harder than I want to. My stress level does not feel sustainable and I feel emotionally exhausted at the end of the workday. So this burnout risk assessment, it's kind of like a quiz in a magazine about like, should I have a threesome? But instead it's used to determine feelings like, does my life stress make me wish I was a box turtle so I can hibernate five months out of the year? That's what it boils down to.

• 31:02Speaker 01

  So I found that there's this unique population of people who have this high level, seven or above stress for a long period of time, but they're not burned out. So then I conduct very in-depth interviews with them, sometimes speak to them multiple times or follow them over a couple of months period to really dig in and understand what are they doing to protect themselves. And that's really the basis of the research. But aside from these really high-stress jobs, I also interview people who are frontline workers and bartenders and baristas and babysitters, people who just experience everyday stress that a lot of people can relate to.

• 31:38Alie Ward?

  And we're going to talk about money issues in a bit. Especially in the medical field, I've heard from so many friends who are going through med school, it's just beyond. I mean, you're learning everything for the first time, you're studying, you're on the floor, you're expected to work 20-hour shifts. How does the medical field come into this when a lot of the culture and the work around it is already pretty fucked up?

• 32:07Speaker 01

  It is, really. And this is one of the things that some of my colleagues and I have really been looking at is I did a study with a number of physicians who wanted to look at, you know, why are our residents and fellows getting so burned out? Why is the rate so high? And why are they not coming forward to ask for help? First of all, in the medical professions, there's a lot of stigma around coming forward about mental health issues. And there's a lot of concern that if I raise my hand and ask for help, that's shameful. Like, I should not be asking for help. I should be an expert. I've been getting straight A's throughout college and medical school, and now I don't know what the fuck I'm doing. And then there's a lot of pressure on me. And so if I'm the one

• 32:50Speaker 01

  out of these other 12 residents who raises my hand and asks for help, what is that going to say about me?

• 32:55Alie Ward?

  Yeah.

• 32:56Speaker 01

  And so there's that kind of culture. And I'm seeing it change in some institutions, which is a good sign. But we need more research on this. We need more just awareness of what's going on. What are the cultural conditions that are really both causing the burnout, but also preventing people from coming forward and asking for help?

• 33:13Alie Ward?

  You know, there's a lot of folks too who just are feeling so burned out from You know, four and a half years of pandemic, from lockdown, from increased screen time, from decreased social interactions. For more on some current stressors too, you can see our episode on genocideology with genocide expert Dr. Dirk Moses. Or just look at the news in any capacity. So we've been trained to be on high alert, looking for information at all hours of the day and night. Is there something about the way that we are so tethered to devices that doesn't allow us to rest

• 33:55Alie Ward?

  the part of our brains or our souls that need it?

• 34:00Speaker 01

  Totally, yeah, totally. It's become so common. Like, if you walk through any airport, I mean, just about anywhere you go, bus or train stations or whatever, you see people on their phones. Like, how often do you actually go through a public place where people are engaging and talking to each other? It's much more common that people are looking at their devices. So there's that. There's not enough time for people to really take their brains offline. Because when our brains are always online, even if we're consuming good, productive content, it's not allowing your brain or your psyche enough time to rest. And burnout, for the most part, is a psychological syndrome. And so when we're not giving our psyche a break, it's more likely that we're going to be susceptible to burnout.

• 34:43Alie Ward?

  And you could see our recent episode about fun with Catherine Price, who also wrote the book, How to Break Up With Your Phone: The 30 Day Plan to Take Back Your Life. What about working hours? Because our open signs are just kind of always on. We're like, I got my phone on me. Like, we're always at a computer because it's in our pocket. Has it been helpful for some people to be like, I start work at nine and I'm off at 5:30 and no one can tell me otherwise? Although, even if you did that, what if you've got kids? And they're like, need... Food and bathing. It's like, this is obviously from someone whose dog is asleep very gently in the corner because I could not handle it. But like, where do you start to put limits on it so that your psyche can sort of repair

• 35:28Alie Ward?

  itself?

• 35:30Speaker 01

  That's, that's the question of the day that each of us needs to really do some soul searching on. Here's how I look at it and how I think about it. This has been one of the most helpful things for me because during this research, which I consider to be action research, meaning that when I was researching people, I was applying this stuff on myself. So one of the things I've learned and I still use to this day is to do just a daily, or for me, sometimes it's even a couple of times a day, just a quick check in, like, where am I on my stress curve? So if you think about, like, we all need a little bit of stress or even some, a good amount of stress to feel motivated and engaged and all of that. It gets us motivated and makes us want to perform and do good things for the world and other people and all that.

• 36:15Speaker 01

  But then at some point, we get way too much stress, like way more things to do with all the kids and all the home things and all that, that we get out of what's, we call the sweet spot of stress. So the exercise where I really find a lot of value is just checking in to see, am I, have I tipped over past my sweet spot of stress? Not just today, but like, if I were to think about this past week and how it's gone for me, what am I doing and what is it really doing to me? So what am I doing to take care of myself and how is that really helping me create conditions to keep me in a zone, in a sweet spot of stress where I'm really challenged and engaged, but I'm not, you know, flipping out and breaking down and burning out? Or what am I doing that's not good for me?

• 37:00Speaker 01

  Maybe, huh, okay, turns out that I'm saying yes to everything. I'm not setting boundaries or I set boundaries, but I don't uphold them. How can I focus on the things I can control to keep myself in that zone of sweet spot of stress?

• 37:15Alie Ward?

  So what if you're in a sour spot, not sweet at all? So Dr. Wiens writes in her book that optimism can prolong longevity, if you do want to live longer. But also optimism going into stress can help you make choices that kind of better equip you to handle the stress. And some of those choices are like engaging in more movement, or less alcohol or tobacco consumption. And if Dr. Wiens knows she's going to have a tough week, like the day we recorded this, she had a few important meetings, and then, right after we stopped recording this, she was headed straight to a big book signing event. Or if she feels overloaded, she dials down some things and adds others.

• 37:56Speaker 01

  You know, not drinking, eating really well, exercising, getting enough sleep. I know those things for sure will set me up for a day or two of just good clarity and a good ability to focus and a good ability to tolerate stress that I knew was going to come along. And sure enough, today is one of those days where I've got both the bad kind of stress, the threat response kind of stress, as well as some good challenge response kind of stress coming on. So I feel good about what I did the last several days, just to help set myself up to be able to handle today really well. And then I also know that at the end of today, because it's going to be a long day and there's a lot going on, I know that I have a really fun dinner to look forward to.

• 38:38Speaker 01

  It will be a long day, but I get to go do a book signing that I'm looking forward to, and I get to have dinner with three people that I absolutely love and adore. So those are just like, for example, for me, it's all about not just how do you manage stress in the moment, or how do you take care of yourself afterwards, but it's also what do you do to set yourself up when you know you're going to go into a period of high stress?

• 38:58Alie Ward?

  Mm-hmm. That makes total sense. Can I ask you some questions from listeners?

• 39:03Speaker 01

  Sure.

• 39:04Alie Ward?

  Okay. We have a lot, because I think a lot of people are feeling very burned out. But before we get to your questions about capitalism and neurodivergence and prevention of burnout, we're going to donate to a charity of Dr. Wiens' choice, and she selected the Lorna Breen Heroes Foundation, whose mission is to reduce burnout of healthcare professionals and to safeguard Their well being and their job satisfaction. And they also worked to pass in 2022, the Dr. Lorna Breen Healthcare Provider Protection Act, which supported healthcare workers' mental health and well being. And we're actually going to hear a little bit more about that backstory in a few minutes. But they're linked in the show notes at drlor nabreen.org. And that donation was made possible by sponsors of the show, who you may hear about now.

• 39:48Alie Ward?

  How's your ponytail looking? Maybe like a little thinner than it used to? We've talked about this in our menopause episode. At some point, it's bound to happen to all of us. So if you're ready for thicker, fuller hair, start your free online visit today at forhers.com/ologies for personalized care. So that's F O R H E R S dot com slash ologies. Individual results may vary. Featured products include compounded drug products, which the FDA does not approve or verify for safety, effectiveness, or quality. Prescription required. Price varies based on product and subscription plan. See website for full details, restrictions, and important safety information. This episode of Ologies with Ali Ward is brought to you by Alloy Health. As you may know, we've talked a lot about estrogen and hormones on this podcast. We have a three-part menopause episode.

• 40:32Alie Ward?

  And there's something that nobody tells you. And this is that your skin changes that start in your 40s. They aren't just aging, they are hormonal, specifically estrogen loss. So estrogen naturally helps maintain collagen. It helps support elasticity, keeps your skin hydrated. And as it declines, your skin gets thinner and drier. So if your skin is feeling thin or dry or dull after 40, Alloy has prescription M4 skincare. It's designed for perimenopause and beyond with convenient virtual consultations and redelivery. So try M4 skincare from Alloy and see results in as little as eight weeks. Head to myalloy.com and use the code OLOGIES to get 20% off your first order. So your menopause specialized doctor will help you build a skincare plan for your needs.

• 41:16Alie Ward?

  Plus, you get $0 unlimited messaging with your doctor. So head to myalloy.com and use code OLOGIES to get 20% off your first order. This code is valid on products only. These are compounded products, not subject to FDA approval. I can't tell you how many times. Your mother and I have been like, what are we gonna eat? It's constant. You know what I mean? Busy schedules, you got nutrition goals, you have your stomach and brain maybe not agreeing. Maybe you got picky eaters. This is where Hungry Root comes in. I think they are great. Hungry Root figures out what foods you like, what you don't, what kind of fits your life. And then they're like, hey, how about these groceries? And how about these recipes? And you're like, what are you, my second brain?

• 41:59Alie Ward?

  For me and Jared, we are eating more plant-based meals. Jared is also dairy-free. So it's been really helpful to take the guesswork out of mealtime and also learn more recipes that maybe we hadn't tried before. I also like that we're not spending time meal planning or grocery shopping because it just shows up for us. Some of my favorite recipes for Hungry Root, they have a lot of really great curry bowls and stir fries. I signed up for snacks too, because I'm a human being. So explore my digital cookbook, Pod Mom and Dad's High Protein and Low Dairy Menu, for free at hungryroot.com/ologies. And for a limited time, you can get 40% off your first order plus a free item in every box for life with Codeologies. Let's have dinner.

• 42:43Alie Ward?

  Ologies with Ally Ward is sponsored by Sylvania. It's time to upgrade your nighttime drive with Sylvania LED Ultra Fog and Power Sport Lights. These powerful lights deliver cool white clarity and crisp visibility that's built to last. And thanks to their compact design, Sylvania LED Ultra Fog and Power Sport Lights are engineered for a DIY install, no mechanic required. They're also backed by a limited lifetime warranty and 125 years of lighting expertise, bringing you LED Ultra Night Vision to help you see better at night. Switch today and see better tonight with Sylvania LED Ultra Fog and Power Sport Lights. Every time I record a Quince ad, I'm like, look at me wearing head-to-toe Quince. I feel like this is enough of an ad, I can just stop here. But if you're like, huh, what is that?

• 43:27Alie Ward?

  Quince sells clothes and shoes and bags, even stuff for your house that are classic, well-made, and priced at 50 to 80% less than similar brands because they cut out the middleman, they work directly with ethical factories. So you have luxury quality pieces without a luxury price tag. Perhaps this holiday Season, do you know what it feels like to get a cashmere sweater as a gift? I don't, because I'm the one getting them for people, and so can you, and they're affordable, too. They also have 14-earr gold earrings, high-quality down outerwear, cozy gloves made of cashmere, leather bags, they have great bedding, cookware, luggage. So whether you're giving that to you or to someone else, you can give the gift of quality this holiday season.

• 44:10Alie Ward?

  Download the Quince app for app-exclusive offers, or you can go to quince.com. Get free shipping on your order and 365-day returns, now available in Canada and the UK, too. And when Quince asks you where you heard about them, just let them know it was Ologies. It's the best way to support the show. Okay, on to your questions. This one's right on the money. A lot of people, Jess, Sydney Koenig, Anna Lauren, Jacob Shepherd, Olivia Remple, Earl of Grammalkin, Jennifer Froh, Brianna L., Vanessa Adams, Diana Cohello, all wanted to know, in Jess's words, "How do you deal with it when you gotta have a job to, you know, live in this capitalist world?" Anna asked about, "Is burnout primarily a phenomenon of living, working in such an intensely

• 44:54Alie Ward?

  capitalist system? Does burnout exist outside of capitalism?"

• 44:59Speaker 01

  Well, I need the names of everybody who submitted that question, because I want to send them all a handwritten thank you note for asking that question, because those are the kind of questions that we need to be asking. And I would say one is to focus on what I call meaningful connections. And so for people who actually, in these kinds of experiences, like their jobs, they might even love their jobs, but there's just too much of it, and there's not enough breaks, and they feel the capitalism sort of pressure, is to be very clear about the things and the people in your life that bring meaning to you. And that means getting super clear on what your values are. And values might be really small things, like, "I value a good night's sleep. I need to get at least six, seven hours of sleep a night or more."

• 45:43Speaker 01

  Or a big value, like, "I value quality time with my partner or with my pets, even just sitting down with my dog for half an hour every day and just like connecting with my dog."

• 45:54Alie Ward?

  Or your human children. Dr. Wiens has three of them. Or maybe it's volunteering at a raccoon rehab center, or whittling, or bird watching, or coding, or reading about sci-fi apocalypses. Whatever makes you go, "Ah, this is so good. I like this."

• 46:10Speaker 01

  And maybe the big thing for all of us to be thinking about is that For many of us, the type of companies that we work in are not going to change the fact that they are capitalist oriented organizations. They just, it's not going to happen overnight. So how do we continue to operate and survive in these conditions? Well, also creating workplaces where there are microcultures that support people to raise their hands when they need help, to not make them feel bad when they need to take a mental health day off.

• 46:42Alie Ward?

  So if you run a company or if you manage people, you can be part of the solution rather than the problem. Now, if you're undergoing this also, if you're on the receiving side and you feel like you have no power, consider asking other employees if they're having similar experiences and maybe approach management as a unified force. And you can remind your bosses that more burnout leads to higher turnover and staff and also reduced efficiency at your job. Now, what if you were raised Catholic like me? So many patrons asked about guilt, such as Jennifer Frow, who said, "Why do I feel so much guilt when not working?" Full-time mom and author Samwise asked about this, Rebecca Fitchett, Sarah

• 47:27Alie Ward?

  Mans, and Mims, who asked, "How do you stop yourself from feeling guilty about needing a break?" Asking for me. Mims, not alone. A bunch of people wanted to know, in Winn Constanini's words, "How can people deal with the shame and guilt that comes with literally not being able to be productive?" Mouse Paxton wanted to know, "Any tips on feeling guilty when you're too burnt out to do things with people?"

• 47:50Speaker 01

  Yeah, that was my experience for a long period of time. And I felt like I should not be raising my hand because everybody else around me is going through the grind and performing in there. They don't seem burned out. So I was carrying that shame and then the shame creates more stress. So it's a total vicious cycle, which you've got to get yourself off that hamster wheel as quick as you can. The sooner you can Find someone to connect with, you know, whether it's someone that's currently in our circle of relationships or a professional that we can reach out to. It's sometimes really just starts with one conversation with the right person to get a head start on the support and the help that you need.

• 48:28Alie Ward?

  And in her book, Dr. Wiens explains that excess pressure on yourself, like should statements impose a set of expectations that aren't likely to be met because they aren't grounded in reality? Like, it's not possible to make zero mistakes. And believing that you should be flawless just sets you up for a lot of self-blame and shame and guilt. And she calls this a form of thinking trap or a cognitive distortion that you pull on yourself. And it's about as effective, from my experience, as punching yourself in the kidneys. So what do you do if misplaced guilt is ruining your life? Dr. Wiens tells the story of a physician's assistant she met who went through therapy and learned that her work guilt

• 49:12Alie Ward?

  was itself a stress response and it stemmed from a traumatic event from childhood, which helped her tap into self-compassion instead. So she was able to brush it off and not take the guilt seriously, just giving herself a damn break. Because again, giving yourself a break and some self-compassion and lowering the stakes could actually save your own life. And on that note, Daniel Oopdal, Neen, Kelly Dooling, Essie Ru, and Sugar Puff Daddykins asked, in Sugar Puff Daddykins' words, "Can we please talk about mental illness and burnout?" Yes, let's. A bunch of people did kind of ask about that mental health aspect too and about reaching out. And like, Kleb and Faran wanted to know if there are links between burnout and suicide.

• 49:57Alie Ward?

  We just did a suicidology episode. So could burnout ever lead to suicidal ideation for people?

• 50:04Speaker 01

  Sure, it does, yeah. There is a correlation there, you know, studies are showing that. But we've also heard stories of individuals who... Are suicidal with previous history of expressing, you know, stress and burnout issues. And we do see higher rates within the medical profession, for examples. That's where some of these studies have been done. And I hear actual stories, like, this is really sad, but I hear, I would say, at least one story a year from someone that's close to me, like, someone that I work with, that I know well, telling me that someone who's a resident or a fellow that they know of, or mentored, or something like that, um, you know, died by suicide. Fortunately, we've got some organizations out there that are

• 50:47Speaker 01

  working as hard as they possibly can, and they have some really dedicated, talented people, like the Lorna Breen Foundation. It's one that I'm starting to get involved in.

• 50:56Alie Ward?

  And Dr. Lorna Breen, who we talked about, and whose foundation we donated to, was an emergency medicine physician who died by suicide in late April of 2020, after being on the front lines of COVID. And despite having no known mental health difficulties prior, experienced a burnout and a fear of poor performance that was so intense that it led to her taking her own life. And the foundation started in her honor, states that, in the US, 400 physicians die each year by suicide, and female physicians are more at risk, especially in emergency medicine. And for more on these statistics, you can see the 2010 study, Burnout, Hopelessness, and Suicide Risk in Medical Doctors,

• 51:38Alie Ward?

  which concluded that even 15 years ago, people in charge of workers' health should pay particular attention to the burnout in doctors, and intervene with changes in the work environment. Another 2012 study titled, High Risk Occupations for Suicide, found that there were increases in rates of suicide in the occupations of coal mining and construction laborers, too. And I've gotten questions in the past about veterinary medicine and mental health. And there was a 2015 paper, Suicide in Veterinary Medicine. Let's talk about it. And it cites that the rate of suicide in the veterinary profession has been pegged at more than twice that of the medical profession, and four times the rate of the general population, and the American veterinary medical

• 52:22Alie Ward?

  Association said that burnout among animal healthcare workers is even higher lately due to higher expectations for pet owners, overwhelming workloads, the impact of the global pandemic, educational debts, and, this was surprising, instances of cyberbullying are taking a toll, which then leads to compassion fatigue, which is this physical and emotional exhaustion that can result from caring too much about your job and high stakes matters. And from vets to vets, military personnel are also experiencing post-traumatic stressors and burnout. And we go more into depth on that in the traumatology episode two, which we'll link in the show notes. So, jobs are hard in a lot of sectors. The world is tough.

• 53:04Alie Ward?

  And of course, people are trying to help the helpers, like the Dr. Laura Bring-Heraus Foundation. Dr. Wiens continues.

• 53:11Speaker 01

  And that foundation is doing some incredible research and some incredible just like philanthropy work to change the way hospitals evaluate their physicians and the types of conditions that physicians work under.

• 53:24Alie Ward?

  And you mentioned working with police chiefs and, you know, medical residents and chief medical officers. What do we see about burnout on the other side of the finance scale where, like Tyler Bates asked, how does one balance not working extra because of burnout, but when you low-key need the money? Tao, also known as Nasty Garden Rat, says, "What's the effect of money or financial stability on burnout? My job had me so exhausted at $18 an hour, but much less so at 20, even though I'm doing the same work. Still burned out, though. Woof," they say. Dave Cannon wants to know, would winning the Lotto help burnout, or is it something deeper? When you've got to grind, or you need that grit because you're working three jobs,

• 54:08Alie Ward?

  how can you even begin to start to balance that?

• 54:11Speaker 01

  Yeah, well, I would say, first of all, I think one of the things we haven't really talked about is that oftentimes people characterize what they're feeling and experiencing as burnout. When these examples you just shared, I wonder a little bit, it may not be burnout, it may actually be overwhelm, overwork, over-functioning, meaning that you have just way too much work, not enough resources, not enough time, not enough support. A lot of those people are just overworked and overextended. The remedy for people who are overworked is oftentimes more recovery time in the form of not just, I don't mean just like vacations or spa days and all that. I mean, micro recoveries where you're truly taking a mental, physical, psychological break, and you are forcing yourself, like really intentionally creating space in your life

• 54:56Speaker 01

  where you are connecting to the things and the people in your life. You're giving yourself positive energy to offset the feelings of overwork, you know, so that you can create, have that psychological capacity. So you can go to your boss and say, I've been working 70 hour weeks for the last however long. I can't do it anymore. Like this is what it's doing to me. So the goal is to help people get the psychological strength to go to their leaders or whoever and say, here's what I need in order to be my, my most effective at work.

• 55:30Alie Ward?

  So yeah, if you're thinking every day, one day I'll just go to an island for a week and I will fix all of this. It's actually easier than that. I mean, yes, it's wonderful to have something to look forward to. And this positive anticipation has been shown in studies to fight depression. But it doesn't have to be an expensive escape to a piece of land in an ocean. You can create a tiny little safe space every day, even for 10 minutes, sitting and meditating, listening to chill music and closing your eyes, breathing deeply, reading a chapter in a book or doing a craft. And I know it might feel more stressful at the beginning to carve that time out. Trust me, you're like, I have no time. How can I possibly do this?

• 56:15Alie Ward?

  Or maybe you have to wake up a little earlier than your kids or work, or you have to ask for support to carve out that time. It might not feel like it's helping immediately, but the routine of doing something even for 10 minutes a day that feels chill and feels like a treat that's not scrolling, helps you know that you have that little respite daily reliably and that you have your own back. And I wanted to get back to this because you were mentioning the people who don't experience burnout, even though they're in the seven to 10 scale. What did you find in your research that was common to that? I'm like, are they just sociopaths? Do they not feel emotions? Or do they have like really good recovery systems?

• 56:58Speaker 01

  Exactly. That's what I wondered too. Like who are these people? They have like. I don't know, were they raised by unusually cool-headed parents? Or they have like Jedi mind tricks that they play on themselves so that they can survive in some crazy stressful environment. That, I mean, that's exactly what I went after in my research. That was my primary research question. So a lot of it has to do with our emotional intelligence. That's the whole basis of my research in the book is that stress creates emotional responses. So it's learning as much as we possibly can about how we respond emotionally to different types of stressors. That includes things like understanding what triggers my stress and not just what triggers me and ticks me off, but what's underneath that? Where did that come from?

• 57:42Speaker 01

  What happened in my past that led me to have this trigger?

• 57:46Alie Ward?

  So it's not just about avoiding stress entirely, but understanding and clocking your own reactions to it and your own unique sensitivities to it.

• 57:55Speaker 01

  So emotional self-awareness is a big attribute that these people with burnout immunity have. They're very in tune with their emotional response to stress, very clear on what their triggers are, what ticks them off. They're also clear on what makes them tick, you know, what motivates them, what gives them good positive energy. And then they're able to regulate. This is the emotional regulation part of emotional intelligence. They're able to regulate their emotions, their thoughts, and their behaviors, working in very stressful conditions. But just emotional self-awareness and emotional regulation are some of the big cornerstones of creating burnout immunity. But it's also things like staying really connected to your values, to people that you love, meaningful relationships.

• 58:40Speaker 01

  It also has a lot to do with your outlook on life. Some people thrive in certain conditions better because their outlook on that type of an environment is more positive. And so that passion, that calling that they felt. Is protective, our general like mindset and the way we think about the world, the way we think about work.

• 58:59Alie Ward?

  So emotional awareness and regulation being the cornerstone of burnout immunity means a bit more challenge to folks who are neurodivergent. My hand is raised right now. Now, the National Institutes of Health ADHD Support Toolkit recommends people wanting to support someone with ADHD, up their empathy and refrain from blaming and shaming someone who's struggling to handle a heavy load with executive function issues. So be patient, be empathetic, and it encourages for those with ADHD to take short breaks during tasks that require continued focus. And there was this brand new study in 2024 titled, "Executive Function Deficits Mediate

• 59:42Alie Ward?

  the Relationship Between Employees' ADHD and Job Burnout," and it found that, hell yeah, lower executive function contributes to faster burnout and fatigue. Not to mention masking, which is a term that means you spend a ton of your energy pretending to be neurotypical in a world built for this productive grind of working like 10 hours a day, usually sitting at a desk. And this masking is common in autistic adults and kids as well. And Stanford Medical School has a neurodiversity project, and one presenter, Katie Oswald, laid out that autistic burnout arises from chronic life stress and this mismatch of expectations and abilities without adequate support.

• 1:00:24Alie Ward?

  And symptoms include long-term, typically over three months, exhaustion and loss of function and a reduced response to stimuli. And some causes of this autistic burnout are life stressors and masking and cumulative overwhelm, lack of empathy and dismissal of struggles and lack of support from others. But it recommends some interventions like peer-led support groups and meditation and exercise, trauma-informed care, art therapy, animal-assisted therapy, and interventions that are peer-led help a lot. So without this kind of support and empathy shown from others and ourselves.

• 1:01:04Alie Ward?

  It's much harder to maintain this optimism and self-confidence and self-care, like rest and time away from screens and healthy hobbies that we need to avoid burnout. But for all of us, Dr. Wiens has a chapter that details how to recover from burnout using what she's coined the three R prescription, or three RX. And that means recover, reconnect, and reimagine. And she acknowledges with the recovery that a certain painful irony exists that comes along with recommending tips and strategies for making a full burnout recovery. Because the ultimate responsibility for burnout recovery, and certainly prevention, lies with the employer, she writes, not the employee. But we can try to do what's in our control.

• 1:01:45Alie Ward?

  And sometimes you can't get better in the environment that's making you sick. In which case, you gotta bounce. But you can try to change your mindset and set boundaries. And the reconnect R involves getting in touch with things outside of work, like people and hobbies and downtime and group activities, or even your values or your vision of your ideal self. And then the third R helps you reimagine your life going forward. So she details all these strategies in her book. But they can help you regulate your approach to stress and the emotions that come up from it to lessen the impact on your life and your brain and your body. And emotional regulation, I understand, is not the same thing as stuffing your feelings down and not feeling them.

• 1:02:28Speaker 01

  No. That was me. And a lot of us think, oh, well, that will just make it all go away if I stuff it. I have one guy tell me, one of my research participants, he was a chief medical officer, told me that he was a professional stuffer, like stuffed stress like crazy, until he ended up with diverticulitis, which is like really bad things happening to your intestines.

• 1:02:51Alie Ward?

  Not to mention, of course, cardiac and metabolic disease and autoimmune diseases. And there was one study, a 2018 paper, Association of Stress-Related Disorders with Subsequent Autoimmune Disease. And it found that, yes, stress-related disorders were significantly associated with increased risk of autoimmune disease. So being exposed to high stress and not having the outlets to cope or to explore it or to get support, or essentially developing what psychologists call emotional intelligence or regulation, can be deadly. Yeah. Oy, no. Better to deal with the emotions than... Whatever's going on in them guts, you know? But yeah, I was like, I have an idea. What if I just don't feel the bad feelings?

• 1:03:35Alie Ward?

  And I scroll instead. Hmm, ah, poof, I made them disappear. It's like, no, you didn't.

• 1:03:40Speaker 01

  Until they come back again and they haunt you.

• 1:03:42Alie Ward?

  Exactly. Well, this is, okay, this was my last listener question. Matthew Walker, I mean, so many people, The Lady is a Geek, Katie Bardi, wanted to know, in the lady's words, does burnout leave a scar? If you've had one burnout, are you more likely to have another? Or experience it more easily? Same thing, Katie had that question too. If you get it once, are you more predisposed to it?

• 1:04:04Speaker 01

  Oh, it depends what you do with that information. Totally depends on how you were able to recover from that burnout experience? And what, what, what did you learn from it? What, what do you not want to do again? Because all of us, when we're burned out, all of a sudden it becomes clear, like, oh, that's what was causing the burnout. Oh, that's, you know, what triggered me. Oh, that's what I wasn't doing, or that's what I was doing that made me more vulnerable. So it depends what you choose to do with that information. In my case, I was like hell bent on not ever getting burned out again. And I, you know, like I said, I, when I was nine or 10, I never wanted to be a burnout expert. I never, never crossed my mind. But now I'm glad that I am because it forces me to really pay attention. And I made a commitment to myself, I'm not going to let that happen again.

• 1:04:48Speaker 01

  I want to live a full, happy life while I'm here. I want to have stress in my life. I actually want to have good stress and, and stress that will challenge me and help me learn and grow. But also know, like, I have a limit. I need to be really, really aware of what that limit is. And it's my responsibility to get myself out of it. And that doesn't mean, and I, I get it, people might be wondering, well, I don't have the luxury of getting myself out of it. I didn't feel like I had the luxury either when I was burned out. So I took my time. It took me a couple of years for me to create an exit ramp and a path, a new plan for myself, to where I was going in a direction that I knew was going to be right for me and wasn't going to cause burnout for me.

• 1:05:30Alie Ward?

  I think it's also interesting that everyone else can see you on an absolute crash course a mile away and you're like, nah, I got this. And a lot of times, there's at least, you know, one or two people in your life that are like, you're gonna burn out. And you're like, other people might burn out, not me. Watch this. And then you're just in a ditch crying.

• 1:05:49Speaker 01

  Oh, yeah. Denial. It's a thing.

• 1:05:52Alie Ward?

  Yeah. I always ask people the worst thing about their job. And I am wondering, what is the hardest thing about your work in burnout?

• 1:06:03Speaker 01

  Oh.

• 1:06:04Alie Ward?

  And not getting burned out?

• 1:06:06Speaker 01

  That's a, oh, it's a hard one, but maybe it's, maybe it's actually an easy one. The hardest part for me is, well, I feel really, I guess, blessed that I get to hear that people feel comfortable opening up to me about their burnout experiences. And I feel honored that they do. So that's a good thing. But at the same time, the hard part about it is I want to help everybody.

• 1:06:25Alie Ward?

  Yeah.

• 1:06:26Speaker 01

  I would love to take everybody under my wing and just say, you know, follow me. Let's do these things and you're gonna be just fine. And I promise you, we're gonna get you out of this. And I just, I can't do that. I mean, I help as many people as I can. And then I also have my limits where it's just that that's what can cause me to burn out because I'm expressing so much empathy and compassion for other people. But then it turns into me not having good boundaries for myself.

• 1:06:52Alie Ward?

  What about the best thing about what you do?

• 1:06:55Speaker 01

  The best thing I think is really just bringing awareness to something that so many people are struggling with. And after a speaking event or a podcast, or, you know, people will reach out and say, you know, your story really resonated with me. I felt like you were in my head. And I just feel super honored that people are opening up more about it. And my hope is that the more we talk about it, the more we bring awareness to it and try to really decrease the stigma associated with it, that we will start to see cultures change. But it's gonna take people like me and you and others who have been burned out and recovered to get back in there and say, look, there are ways to create cultures where we can expect, you know, really high performance out of people, but also

• 1:07:39Speaker 01

  Not to the point where we're, we're going to lose them.

• 1:07:41Alie Ward?

  Yeah, it is. I think speaking out about it is so helpful for me to hear other people talk about it and to know that it's not just like a moral failing.

• 1:07:50Speaker 01

  No, it's not.

• 1:07:52Alie Ward?

  I'm so glad I got a chance to talk to you. I imagine there's so many avenues you can go down. Do you see yourself doing this, just wanting to ask and answer questions for, you know, as long as you can?

• 1:08:06Speaker 01

  It's so fun. Like, that is one of the best parts of my job, too. Like, I've always been someone who's just naturally curious. I mean, I love researching itself. To go in there and dig into people's lives and really, truly understand at an empirical level, what is going on? Burnout is a phenomenon, so it's one of those things that we can get in there and study by, but we need to talk to people and hear about their life experiences. And that's pretty fun.

• 1:08:27Alie Ward?

  I mean, there's no shortage of need or examples. That's great.

• 1:08:32Speaker 01

  That's true.

• 1:08:33Alie Ward?

  You are guaranteed a job in this culture and economy.

• 1:08:38Speaker 01

  I don't know if that's a good thing.

• 1:08:39Alie Ward?

  Yeah, exactly. So ask experts amateur questions because honestly, it might save your life. Now, this was recorded a month or two ago, when optimism and hope may have been easier to come by. So it might seem like easier said than done, which let's be honest, that's like most things in life. But unfortunately, keeping tabs on your mental health is more important than ever, because you're an ape wearing a shirt and you're really not built for this, I'm sorry to say. So part of combating global stress is learning when it's getting to be too much and taking care of yourself in constructive and not just numbing and dissociating ways.

• 1:09:22Alie Ward?

  Trust me, scrolling is not helping you. So heed my warnings, please. And for more info, you can pick up Candy Wiens's book, Burnout Immunity, which we'll link in the show notes. And we'll also link where you can follow and find out more about her work. So thank you so much for being on, Dr. Wiens's. So you can learn more about Ologies and you can follow us at Ologies on Blue Sky and Instagram. You can find me at Ally Ward on both platforms. We also have shorter, kid-friendly episodes available. In their own podcast feed, it's called Smallologies, wherever you get podcasts, you can look for the new green logo, which was designed by Portland artist Bonnie Dutch. We also have Ologies merch available at ologiesmerch.com, where the link in the show notes. Erin Talbert admin's the Ologies Podcast Facebook group. Avaleen Malik makes our professional

• 1:10:05Alie Ward?

  transcripts. Noelle Dilworth is our scheduling producer. Kelly Ardwire makes the website. Susan Hale managing directs the whole shebang. Jake Chaffee co-edits the show and lead editor. And Canadian, who is trying not to burn out with American and global genocide stressors, is Mercedes Maitland of Maitland Audio. Nick Thorburn, Nick Thorburnout made the theme music. And if you stick around until the end of the episode, I tell you a secret. And this week, it's, I'm the ghost of burnout, past and future. And I'm here to tell you, no matter how strong you are, or how good at suffering, or how much you want to fix the world, you have to take care of yourself, or you will possibly be sick and sadder and

• 1:10:47Alie Ward?

  less able to do the things you want to, to change the world. So I have been through that. I thought I was tougher than anyone else. And I thought I could just get through things. As you might know, last summer, I had an excruciating burnout that landed me in the hospital a few times. And then I had to take a bunch of time off and relearn how to talk to my own brain. So everyone warned me for years ahead of time, I was going to burn out. I love this job. I love a lot of jobs that I have and have had all at once. And I just didn't know how to live like a normal person. I was like, I'm a robot. I'm a machine. I keep work. No. So you're a person, if you're listening to this, unless

• 1:11:30Alie Ward?

  you're on AI, which is weird, but you're a person and you got to take care of yourself. So what I do, which has been helping me a ton, I mentioned this in another episode, but I have a list of things that I do to keep myself alive. And I print it out. I check it off every day. It's helped so much in the last few months. Again, I print out a new sheet every week. Each day, I get a point for things like drinking at least 64 ounces of water, or meditating, or going on a walk, or reading a book. Even one page, journaling, avoiding too much caffeine, avoiding alcohol, avoiding scrolling, doing a hobby. I love cross stitch because I can't use my phone and it's zero stakes. And for some reason, it like calms my nervous system. I literally get a point

• 1:12:14Alie Ward?

  for showering and then I add up the points of the day to see how I'm doing. And it's kind of like a game to play. But doing something, if you need to gamify it, if you need to have a checklist of stuff you do, don't do it because you have to do it because you deserve to do it. And it'll start becoming a routine that helps. So checking in with yourself and giving your little ape brain the comfort that you need takes less time than what you would spend staring into space and worrying. Whatever you want to do to contribute to a more just world, you'll be able to do it if you're nice to yourself first. So there's my secret. There's my advice. Do not grind yourself into a nub. The world needs you to take your survival and your health seriously. And I honestly, as your

• 1:12:58Alie Ward?

  dad ward, as your internet dad, let me be a cautionary tale that it just doesn't work long term. You will nosedive at one point and you deserve it. Every single person deserves to take care of themselves. So if you're still sitting under that tree or lying on the carpet, just think of things that make you happy and make you feel better. And please do them for yourself. Doesn't have to be a vacation. Okay, go drink some water. All right. Bye bye.

• 1:13:40Speaker 03

  We all agreed that you deserve a break.

• 1:13:42Speaker 04

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• 1:14:08Speaker 05

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