by Peter S. Silin, MSW, RSW
I often ask my clients who are caregivers, to think of themselves as a watering can, and the person they are caring for, as the plan they water.
“Imagine,” I will say to them, “ that your plant needs a lot of care and attention, and so you end up watering it every day. But because you are busy, and worries about the plant, and maybe have a job to attend to, you don’t put more water in the can. At the end of a week or two, what is going to happen?”
Then I stop for a minute, and point out, “ If there is no more water in the watering can, you cannot take care of the plant. And if you can’t take care of the plant, what will happen?”
This is, in a nutshell, what happens with caregivers, and why they burn out. They end up, sometimes in a crisis, sometimes insidiously, forgetting to take care of themselves. They end up exhausted and empty. The result is the very opposite of what they are trying to achieve. Instead of providing care and support to a loved one, they have nothing more to give.
At a physiological level, stress and burnout occur when an organism has been too long at a heightened state of awareness/alertness. After reacting to a perceived danger our bodies react with the flight/fight response by the activation of the sympathetic nervous system. Adrenaline, norepinephrine, and cortisol are stimulated. Our heart rate and breathing increase. More energy through sugars goes to our muscles. Thus, we are ready to react—sometimes flight, and sometimes fight. At the same time, bodily functions and systems not necessary for flight/fight are inhibited, such as digestion and the immune system.
The problem is, this is a physiological response to a crisis. Originally, a crisis for people was physical and which would pass. Today, it is more commonly emotional abd caregiver stress, is not short term. If we stay at this heightened level, the body exhausts itself. The immune system becomes impaired, the heart can become damaged, we exhaust the hormones. When this happens we do not return to a base line of functioning, we go below that—burnout.
This tell us three things. One, caregivers need to be aware of stress. They need to be able to read their bodies and understand when they are reacting to the stressors. Two, it tells us caregivers need to learn and utilize stress management techniques. Stress management techniques are what can prevent burnout. The third thing this tells us is that, we need to be able to recognize when we are being overwhelmed, and are unable to fill the watering can up enough and often enough, to take care of the plant.
There are many symptoms of burnout, they are mostly also the signs of depression. These include:
- Feelings of hopelessness, helplessness, despair
- Irritability, cynicism, short fuse
- Physical or emotional exhaustion.
- Decreased libido (sex drive) or appetite
- Problems with sleep
- Increased use of pills or alcohol
- Social withdrawal
- Cognitive problems, such as memory, decision making, and problem solving, concentration.
- Headaches, stomach problems