One of the most difficult challenges that you face as a veterinarian is the combination of emotional fatigue, compassion fatigue, and burnout. Stress, particularly the mental and emotional stress of a job that tugs on the heartstrings like veterinary care, is a leading driver of burnout.
Unfortunately, the discussion surrounding burnout has been muddled over the years. People talk about being burned out when they're a little tired or sick of their job, and while that can be valid and true, burnout can be a lot more dangerous.
Unfortunately, depression and suicide are serious problems in veterinarians, and burnout is a critical component of mental health.
So, how do you recognize burnout, and how can you address it?
Recognizing the Symptoms of Burnout
Unfortunately, part of our intro may come across as minimizing burnout. The truth is that burnout is a very large umbrella of symptoms, some of which can be so minor that they're easily ignored or written off. That's part of why burnout is so insidious; it builds up in the background through the accumulation of minor stresses until you find that your entire foundation has been eroded and something has to break.
So, what are these symptoms?
Fatigue and Exhaustion
Being tired is natural in a world where we all have to work for 8-12 hours at a time (or more) while also dealing with lives, families, continued education, and finding time to rest, relax, and participate in hobbies. When you have 30 hours worth of stuff to do every 24-hour period, it's easy to try to cram too much into each day, and things like rest and sleep tend to suffer.
Unfortunately, fatigue and exhaustion from burnout can linger even when you're getting plenty of sleep. In fact, one of the key symptoms you can identify to point towards burnout is excessive sleep; eight hours a day never feels like enough, so you sleep for nine, ten, twelve, and even that doesn't feel like enough.
This is all compounded by the physical stresses of life, whether you spend hours in a day commuting to work, have to wrestle with disagreeable animals all the time, or even just use part of your leisure time for physically demanding tasks, such as working out, playing sports, or wrangling young children.
When burnout is reaching dangerous levels, the fatigue and exhaustion never seem to leave, and they affect every aspect of your life. Things you love doing don't recharge you, rest and sleep aren't restful, and everything – mental, emotional, physical – is gray and lifeless.
Cynicism and Detachment
Part of mental and emotional exhaustion is the mind's natural inclination to avoid the things that cause it stress.
With vets, the most common source is emotional fatigue, compassion fatigue, and detachment.
Do you tell dark jokes, potentially at the expense of your patients? Do you check out and give up more easily than you used to? Do you find yourself less and less able to sympathize with your patients and their animals? Do you feel like outlooks are always grim?
These can be signs of increasing burnout. You find yourself getting more and more cynical. It's also not just limited to work; you might find yourself growing more cynical with the world around you, "doom-scrolling" through social media, gloomily listening or watching the news, feeling like insurmountable problems are growing bigger by the day, and no one is doing anything about it.
A related effect is a feeling of a lack of accomplishment. A string of patients you're unable to help can lead you to feel like you just can't do anything right. Combine this with potential failures in other areas of life – themselves fueled by mounting burnout – and the cycle of negativity can build and grow.
Burnout is primarily emotional and mental, but you can't isolate it from the physical. Exhaustion, in particular, is a distinctly physical feeling, even if it stems from mental sources.
Physical symptoms of burnout, other than exhaustion, can include things like:
Getting sick more often or more severely.
Lacking the energy to make it through the day.
Sleeping more while not feeling rested.
Sleeping less because it never helps.
Experiencing bodily problems like headaches, indigestion, or generalized aches and soreness.
All too often, to combat both the physical and mental symptoms, people facing burnout turn to drugs. This can start with things like caffeine and OTC painkillers but can eventually lead to harder drugs like stimulants, benzos, or opioids. The risk and temptation are very high as a vet, particularly when you have access to veterinary medications.
While drug abuse is at the far end of the spectrum of burnout – and most burned-out vets don't reach that far – it's a serious problem regardless.
Identifying Burnout in Others
Another way to recognize burnout is to see it affecting others. If you can recognize burnout in someone else, you can then perhaps recognize it in yourself.
Typical signs of burnout that you can see from afar might include:
Taking on too many responsibilities at once or taking on too much of a workload in an act of martyrdom or self-sacrifice.
Becoming increasingly distant or isolated, particularly from people they used to enjoy spending time with.
Refusing to accept assistance or help, particularly when coupled with taking on an unnecessary burden.
Setting unrealistic goals and then struggling to achieve them.
Obvious and appreciable negative changes to health, like large weight changes, sleep disturbances, and other problems.
Seeing these in others can allow you to step in and help and potentially recognize the symptoms in yourself as well.
Assessing Your Mental Health
If you're a vet and you're worried that you're experiencing burnout, there are a few ways you can try to evaluate yourself.
The first is to read up on burnout with posts like this one and see how much of it feels like what you experience.
Critical note: When evaluating yourself, it's important not to minimize your symptoms. If someone asks if you feel tired all the time, and you think back to a time last week when you felt fine, and you answer no, despite feeling tired five out of seven days every week… you're minimizing your suffering. Many of us struggle with admitting we have a problem and, further, admitting the depth of the problem. Moreover, if you've lived with a situation for long enough, you may think it's normal for everyone when it's not. Be honest with yourself to get the care you need.
The second step is to take a self-evaluation test. There are a few options here.
Identifying the signs of burnout can be as simple as looking at your day-to-day life and thinking, "I feel burned out." It can also be very difficult if you're so deep in a network of coping mechanisms and denial that you have trouble even admitting that you're struggling.
Burnout can also be broken down into four stages of increasing severity. They are:
The zealot phase. In this phase, you feel invincible, take on as much work as you can, stay late and work early, and always feel like even when things are going out of control, all you need to do to salvage it is work harder.
The irritability phase. At this point, you start to lose the humor and energy you had going into practice. You cut corners to handle all the work you took on. You make mistakes, minor or major. You end up cynical and mocking. Even though you're taking on a ton of work, you still feel undervalued and held back by others around you, often blaming your failures on those others for not supporting you properly. You may also be moody and angry more often.
The withdrawal phase. You're exhausted and fatigued, your sleep is altered, and you end up sick quite frequently. People complain about you or get snippy with you, and the entire atmosphere of your workplace becomes hostile. Every new task feels like a burden and an irritation. This is also where you may start looking into unhealthy coping mechanisms, including drugs, alcohol, and substance abuse in general.
The zombie phase. You're going through the motions, but you just don't care. Your job is a means to the end of paying rent, and your patients are all meaningless. You're empty, dried out, depressed, and wish things would end. Negative coping strategies like substance abuse and self-harm are much more likely in this phase.
It's critical to recognize that you're not alone in this struggle and that there's no shame in admitting it and seeking assistance. You got into veterinary care because you want to help animals and the people who care for them, but to do that effectively, you need to care for yourself first.
How to Address Veterinary Burnout
Unfortunately, addressing burnout is very difficult. Part of the problem is that burnout isn't solely related to one part of life; it's a combination of sources of stress across the full spectrum of living. You can be burned out in a fulfilling and enjoyable job if the rest of your personal life is a mess and you're constantly living in stressful situations. Pressures like job security, low bank balances, poor retirement prospects, medical issues, relationship issues, looming bills, and more can all compound.
Addressing burnout, then, requires a comprehensive analysis of your life and addressing the primary sources of stress. There's no one-size-fits-all solution here, so you need to perform this analysis yourself or speak to a professional for help.
Some examples of things you can do include:
Examine your career and see if adjustments are in order. If you've taken on more and more responsibilities you can't handle, reevaluating those responsibilities (and working with a practice manager, boss, or anyone setting responsibilities above you) to reduce workload can be a huge help.
Take a vacation. Taking time off may feel like a betrayal, but the world isn't going to end without you there to carry it. This allows you to rest and reduce your stress levels, recuperate physically, work on personal growth, and more. Moreover, when you return and see that the place hasn't burned down without you, it builds trust in the capabilities of your coworkers and staff and helps you allow yourself to relax and rely on them more.
Work on building healthy habits. Whether it's exercise, dieting, spending time performing a relaxing activity, reading, or even just practicing mindfulness, healthy habits build a stronger foundation and help you become more resistant to stress and burnout.
A key note about healthy habits here: take them slowly and build them up over time. To use nutrition and bodily health as an example, a crash diet doesn't work, and rebounds are common because an abrupt change is extremely hard to maintain over time. Similarly, going from a sedentary lifestyle to an intense program of working out is more likely to injure you than help you. Take things slowly and adjust your lifestyle; don't try to flip a switch to "make things better" because it doesn't work.
Look for toxic influences in your life and work to cut them out. This can be bad habits, addictions to things like drugs or gambling, or even toxic people who constantly bring you down. It can be hard, but cutting these out of your life is a net improvement.
Take some time to focus on delegating and building a team that can handle what you previously took on all by yourself. You won't be able to offload everything, probably, but allowing yourself to trust your employees and coworkers (and even veterinary partners) can be a huge step to helping avoid burnout.
Consider hiring a relief veterinarian. Relief veterinarians are temporary vets who either work with you to lighten the load or take your place while you take a much-needed vacation. Our post, linked above, gives you all you need to know about them.
Similarly, consider working with consultant services. At Hope Vet, we provide third-party consulting for a variety of difficult specialties, including oncology, dermatology, neurology, and critical care. If you're suffering under the stress of making decisions and continually feel like you're making the wrong choices, reach out to us; we can help validate that you're not doing anything wrong.
Finally, if you are facing suicidal ideation, clinical depression, self-harm, thoughts of self-harm, or thoughts of harming others, seek help. Mental health helplines are available via text chat, calls, and other communications channels, and for less emergency situations, therapists and other professionals can assist.