Understanding the neuroscience behind burnout (2022)

https://yaledailynews.com/blog/2022/03/29/how-people-fall-apart-yale-faculty-discuss-the-impact-of-burnout-on-the-brain/

by rzk • 2 years ago

280 208 2 years ago

yaledailynews.com

itsmemattchung• 2 years ago

Arnsten recounted walking in the woods in Vermont, when suddenly along the path, a bear appeared in front of her. Luckily, the bear was facing the other way. Rather than consciously reasoning that most mammals lack a ventral stream, and therefore would not be able to recognize a still object, she froze. In this moment of fear, her reflex of freezing was engaged. When the bear turned around, it did not notice her because of her lack of movement, and ended up wandering off.

Such a great example of how the fear reflex is functional from a survival perspective. We often talk about how we can combat our fears (e.g. public speaking, dancing, etc) and this serves as a good reminder how this primitive response serves a purpose.

guerrilla6• 2 years ago

Such a great example of how the fear reflex is functional from a survival perspective.

All of our emotions (when we're healthy) are tools. They're all programmable to some extent as well. If somethings not actually dangerous, repeated exposure to it will desensitize you to it, for example.

bowsamic10• 2 years ago

repeated exposure to it will desensitize you to it

Not necessarily, as someone who has a difficult anxiety that I have to deal with very often, being exposed to the situation doesn't make me any less fearful of it.

coffeebeqn2• 2 years ago

Even what are healthy emotions is an interesting question. I’m 99% sure my anxiety is work / chronic stress driven largely. It might not be a rational emotion when I’m in my ACd office with snacks and every physical need satisfied.

nradov2• 2 years ago

Arnsten misinterpreted that incident and drew the wrong evolutionary lesson. Black bears (the species in Vermont) aren't particularly aggressive versus other large animals such as humans, and will usually wander off even if they do notice you. The usual advice is not to freeze but to make noise and slowly back away.

https://www.dnr.state.mn.us/livingwith_wildlife/bears/encoun...

I'm disappointed that an error like that made it through the fact checking process. It makes me doubt the rest of the article.

vouaobrasil8• 2 years ago

“The final feature is a reduced sense of personal accomplishment,” Santos said. “You never feel like you’re doing things effectively and so you feel ineffective and like the work you do doesn’t matter. If you notice signs like this, it’s important that you pay attention early on and make some changes in order to feel better.”

I wonder if this had to do with the fact that in modern society, we often have to go through great mental loops to convince ourselves that our jobs are meaningful. After all, they are very far away from doing things like obtaining food and shelter or even learning things we are curious about.

At some point, I feel like the illusion cannot be held for long: it starts in school when the learning is onstensibly about curiosity but then the gradient between curiosity-driven learning and being a cog slowly eats away at the facade that we have constructed in our minds of actually doing something useful in society until burnout becomes inevitable.

Seems rather obvious as society these days is mostly about furthering advanced technology for very little benefit to the average person except that it keeps the economy going only due to the fact that the economy itself is based on broken principles not compatible with our amazingly high human population density.

amunozo• 2 years ago

I find this specially true in "passion-drive" jobs like research. I am doing a PhD and this is so true in so many levels.

vouaobrasil8• 2 years ago

I got a PhD myself. And I think it's definitely at least partially true: I was told flat-out that I should stick to big-business style research (i.e. research areas with large, complex and directed research plans) and forget following my own curiosity. Of course, once you get tenure in places where it exists or you make it, you can deviate from that.

It's even worse in industry, where I worked after academia. I felt like I was using 5% of my brain to do things I was bored to death with. This isn't just me either: many of the people I've worked with feel the same, including virtually all my fellow PhD students.

I feel like the only thing keeping it going is the novelty of working in new places, meeting new people, and getting new projects. It's almost as if we have a basal attraction to novelty because it's a survival instinct, but we have distilled life so that novelty is the only thing left, stripped of substance long ago when we traded thought for automation.

Of course, it's even harder to see it because we have "propagandists" (i.e. then 1% of people who have carved out a protective bubble for themselves due to a combination of luck, ingenuity, and gaming the system) that say that amazing things are happening.

0823498723498722• 2 years ago

That's odd: during my K-12 I had believed (encouraged by MAD magazine?) that school was where we learned how to find meaning in life, despite spending large chunks of it in granfalloons paying (just enough) attention to things other people have deemed Important?

doubled112• 2 years ago

Interesting. Where did you do your K-12? Maybe you had better role models.

It seemed to be mostly about beating the individualism out of us, and memorizing some facts on things we didn't care about.

Make sure you go to university or you'll be a bum.

hobs3• 2 years ago

I definitely got the opposite impression from MAD, it was pillorying everything in life including education.

bowsamic10• 2 years ago

The thing is that in the past, the "non-useful" work (e.g. intellectual work) was often backed up by a philosophical and religious system. Now there is no sacredness to Reason or to science. In a totally secular worldview (I'm an atheist myself) there isn't an inherent value to doing that kind of work.

marginalia_nu• 2 years ago

To be fair, philosophers and religious figure throughout history have struggled with "acedia"[1]; which seems very much like something we'd call burnout today.

[1] https://en.wikipedia.org/wiki/Acedia

graemep• 2 years ago

I think the problem is not a secular worldview per se (and I am a Christian myself) but a materialist secular worldview that encourages things like the hustle culture and the undervaluing of personal relationships and community.

dartos• 2 years ago

I don’t think that is always the case.

I worked at a company making project management software and, although in the grand scheme of things the product wasn’t meaningful, I enjoyed working on it until the company tripled in size and I was fixing bugs for enterprise support team number 3.

I like making things. People find satisfaction in toy making as well (especially at nerf, from what I hear), even though toys are not inherently meaningful.

What killed it for me was realizing that my individual contributions didn’t affect anything with the product.

ericjmorey5• 2 years ago

Toys are very meaningful. Play and entertainment bring joy which is highly valued by people.

vouaobrasil8• 2 years ago

People find satisfaction in toy making as well (especially at nerf, from what I hear), even though toys are not inherently meaningful.

I think toys are meaningful. They encourage exploration and fun. That's certainly meaningful and fun is a basic human instinct. What isn't meaningful is that which does not contribute to an increase in human happiness in the long-run, such as the creation of new iterations of phone models that last only a few years just so people have to upgrade.

It's difficult to define meaningful, but I would include that which allows people to enjoy their life in a sustainable world that is compatible with creating opportunities for freely exploring all aspects of human existence, while maintaining respect for other living beings. Much of what we do in the modern world is not that.

jc6• 2 years ago

Not only that, the rate of change is increasing or speeding up. Brains are not really capable of handling constant change.

There is much more to learn. There are more unknowns. And there is much more competition.

If you take competitive sports and look at size of support stuff its ridiculous these days compared to 20 years back. There is coach, physio, shrink, nutritionist, biz manager, social media manager etc

So now extrapolate and imagine what things will look like 10 years or 20 years from now on the that trend line. Its just not sustainable.

People have to think about rate of change in the environment that surrounds us.

vouaobrasil8• 2 years ago

Very useful comment: the rate of change is just as important as the nature of the change. Hence why the change through evolution in the biosphere is generally much more stable that the change brought upon us by technological innovation.

nonrandomstring• 2 years ago

Its just not sustainable.

Everything feels like that all the time. And yet we constantly find ourselves 10 years down the line, with years of exponential growth piled on top, and some post-Malthusian explanation of how "actually it is sustainable if we just keep pushing through and believe in progress".

I'm not saying this or that _is_ sustainable, just that the point people declare it "unsustainable" is often only the beginning. It's a (mis)perception David Goggins speaks of a lot - about just how much deeper an organism can dig in crisis, or how low our pain/risk thresholds are set. Maybe we unconsciously factor that in.

Personally I think that's reckless and we are better heeding warning signs. But if we'd done that in 1970 climate change wouldn't be a thing, right.

coldtea4• 2 years ago

I wonder if this had to do with the fact that in modern society, we often have to go through great mental loops to convince ourselves that our jobs are meaningful.

Especially since a lot of them are not.

It's often corporations acting as middlemen and extracting value like parasites, bussiness making bullshit for conspicuous consumption, modern mega-bloated bureaucracy and busy work

ericjmorey5• 2 years ago

How is consumption not meaningful?

brookst2• 2 years ago

Was it ever any different? I’m very skeptical that there was ever a time when the average person did personally meaningful and constructive work.

I think we all have this sense that life should be nothing but personal fulfillment, and anything getting in the way of that is a problem. And maybe it’s even true that that’s how things “should” be, but I really don’t think it ever has been.

nullindividual• 2 years ago

I wonder if this had to do with the fact that in modern society, we often have to go through great mental loops to convince ourselves that our jobs are meaningful.

Most of our jobs are not meaningful. They'll carry no impact beyond our tenure, the company's existence, and so on. Most don't help society in any form or fashion, sans generating revenue.

parpfish5• 2 years ago

when i'm feeling down about the meaninglessness of my company/work, i try to find small wins wherever i can.

someday you'll be stuck untangling a giant muddy ball of legacy code to help a company solve a problem that you don't care about (or even arguably makes the world worse). but just re-scope your expectations and realize that "hey, i made life a little easier for some of your coworkers by fixing some annoying things

chasd00• 2 years ago

One thing you can do is think about having a meaningful life instead of job. Your job doesn't have to be meaningful in order to have a meaningful life.

macNchz• 2 years ago

In the same vein, I was thinking recently about how this ever increasing number of “abstraction layers” in the economy impacts day to day life and community–I think it’s much more likely someone would feel connected to their community and a sense of purpose in life if they, for example, worked out of their own small bakery and met their customers all day, versus working in the back room of a corporate chain supermarket making minimum wage. We seem to be losing things that anchor our communities together, and I wonder if being directly dependent on other people in the community, as opposed to indirectly through layers of bigger, abstract businesses, isn’t one.

There are obvious myriad and complex reasons we’ve arrived where we are, but it’s an interesting topic to ponder. I’ve also thought this shift could be responsible for other societal phenomena: it’s fairly well known that some portion of people are pretty awful to the people working in shops or restaurants. Is this perhaps a behavior that only really develops in a world where people rarely visit owner-operated businesses (where they might face consequences for treating the owner poorly)?

JackMorgan• 2 years ago

It's helped me a lot to move to a small town that is thriving near a big city, then volunteer on ambulance and firefighting. I see my neighbors every day when they most need help.

I get to show up and give them a helping hand. In just two years I've met so many people and made so many friends.

It helps to feel like I'm doing something valuable to society and not just fixing the validation on an input form for the 1000th time. I feel deeply connected to my neighbors now in a way that I never would have imagined.

It also breaks up the day to get to run down for a call, and not just be stuck behind a keyboard all day. Sometimes I'll go work from the station, which has great AC and WiFi.

hiAndrewQuinn2• 2 years ago

Womeone is paying me to do a thing. Therefore, what I'm doing must, at least on average and over the long term, be so valuable to some number of people that it's worth continuing those payments.

That's not that abstract to me, and it certainly feels meaningful.

vouaobrasil8• 2 years ago

Womeone is paying me to do a thing. Therefore, what I'm doing must, at least on average and over the long term, be so valuable to some number of people that it's worth continuing those payments.

I feel that is not a logical conclusion. What if someone paid a hitman to kill their boss because they got into a fight with them and they aren't emotionally stable enough to have a discussion?

Yes, an extreme example, but consider this: not every increase in perceived value is necessarily good.

sentimentscan6• 2 years ago

They can pay because they had make a mistake or don't have a knowledge. For example I was working with a team of 6 creating a project for a bank that was discontinued after 3 months, without any reason and code was simply deleted.

FrustratedMonky• 2 years ago

Just substitute money for tubers.

Hunter Gatherer: collect nuts, tubers, kill some bison.

Modern Man: get the money, collect some skills, fire some underlings.

Maybe our brain has adapted those base instincts. And modern burn out is more equivalent to what early man would experience in a famine, during times of scarcity.

If you can't get the money, you starve.

Burn Out is the Modern Man equivalent to the stress the Early Man would feel in a harsh environment and near starving.

koonsolo2• 2 years ago

I highly doubt it. Look at artists, what they do can hardly be described as "survival" or "productive". Yet they seem to get a great amount of joy from their work. Even if no other person cares.

foobarkey• 2 years ago

They care too much about a job where they have no (minimal) equity and trying to reach staff+ carrot?

bowsamic10• 2 years ago

I got burnout and I'm still recovering 3 years even with extensive therapy

EDIT: It would not be an exaggeration to say that I have been (and still am) convinced I will never be able to work again, in any job, at all

me_me_me2• 2 years ago

Could you give an account of how it started and how are you dealing with it?

bowsamic10• 2 years ago

It would take too long to explain all the details. Basically I started my postdoc after my PhD, and my boss was/still is completely absent and left me alone. For specific reasons pertaining to my psychological history as I uncovered in the therapy, this caused a very strong reaction in me of abandonment, and I found it impossible to continue to work. My boss refused to do anything to help me, he would not give me more help or attention. However, my contract is fixed at three years, I am not in my home country, I live in Germany with my wife who I brought here with me who has a "real job", and I get paid a lot. Therefore, I can just remain at home doing nothing (no one cares if I go in or not) and get paid, which also has not helped.

Of course, now I am going to abandon academia, which is very painful, since it is my entire life so far, but I clearly cannot make it work even though I have tried extensively. I need to be in work where you actually are a part of a team, getting feedback, talking to people. As my contract comes to an end I will be forced to look for a job, but of course I'm completely terrified because of the burnout: I've never had a "real job", and when I tried to do some programming work for my stepdad, even though it went well, I felt terrible when doing it and I felt burnt out with that too.

My strategy was of course to seek mental health services, since at the beginning of the burnout my mental health was much worse (suicidal ideation, depression, etc.) and I found my therapist. I won't go into detail about the therapy because it is a kind of psychotherapy that is common and supported by insurance in Europe but that is controversial in the US.

Of course, the therapy has helped hugely. I no longer have thoughts of suicide and I don't have depression anymore. However I am still terrified of work and am almost completely convinced I will have all the same feelings of apathy, disappointment, and lack of motivation when I try.

First step, I need to convince a company that I don't have these fears, and lie to them about my motivations, and hope they believe me.

EDIT: I can no longer reply to any more comments since /u/dang set harsh limits on my account

giuseppe_petri• 2 years ago

I'm 8 years post nervous breakdown, it took me 5 years before I could even consider going back in to work, any kind of work.

You'll get there.

moi2388• 2 years ago

“ Rather than consciously reasoning that most mammals lack a ventral stream, and therefore would not be able to recognize a still object”

Imagining bears and deer just hitting trees left and right because they don’t move is absolutely hilarious.

yetihehe2• 2 years ago

They just differentiate:

Moving - eat or fight

Not moving - go around it

throw3108222• 2 years ago

So if a tree is shaken by the wind, they attack it?

And if you stand still they avoid you as if you were a tree trunk?

derelicta• 2 years ago

I recognize this a lot in my now ex-boyfriend. The loss of ability to focus, the emotional tornado, the depersonalization. I still don't know whether I was the main trigger for this, or if it was work.

ericjmorey5• 2 years ago

It's extremely unlikely to be you.

deskr• 2 years ago

I don't know anything about your case, but in my friend's case I think work was the main trigger. But if the work was the main trigger, then he needed his home to be is sanctuary which is definitely wasn't.

cjbgkagh11• 2 years ago

My usual burnout post; much of burnout is really chronic fatigue (ME/CFS) and much of chronic fatigue is from a genetic predisposition and a trigger. hEDS/HSD appears to be the most common genetic predisposition.

This stuff occurs in smart people more than it should, usually with some sort of anxiety disorder or ADHD. Some of the best public info on this is from Dr Jessica Eccles who examines the relationship between cognition, emotions, and the autonomic nervous system. This stuff shows up in a lot of stats, eg a huge portion of people with long Covid have some sort of hypermobility.

There are effective psychopharmacological treatments for dysautonomia which is usually the underlying mechanism.

zero-sharp• 2 years ago

much of burnout is really chronic fatigue (ME/CFS)

Sorry, I don't see how that could possibly be true. People with CFS have fatigue to the point where they can't get out of bed. The fatigue from burnout is usually driven by workplace conditions. Like sure, they both have some kind of environmental trigger. But CFS can almost become a disability, whereas burnout is much more narrow and temporary.

cjbgkagh11• 2 years ago

That is certainly what people think and why I feel I need to pipe up whenever these threads get started.

While certainly some with ME/CFS are so bad that they cannot get out of bed the vast majority have good and bad days and you don't see them on their bad days and they look just like everyone else on their good days. One of the reasons it's considered an invisible disease. It's a spectrum and some people manage it better than others.

Sometimes the burnout isn't so temporary - even this article talks about how repeated burnout becomes an problem with the person entering a state of depression which bares a lot of similarities to ME/CFS.

Most people with ME/CFS will never be diagnosed and those people will often think they just have issues with burnout. That's what I though for over 20 years and I have a severe form of it. I though I was managing burnout and then graves disease. It never occurred to me that I would have something like ME/CFS until I stumbled on a random twitter comment that linked ME/CFS with hypermobility which I also have a severe form of. So here I am adding my comments to the internet.

There are generally a whole bunch of rather weird and rather rare comorbidities that occur in people i.e. it is known by its associates. That's what a lot of Dr. Jessica Eccles work goes into.

zukzuk• 2 years ago

I'm probably prone to this, with every single predisposition you listed.

I can't overstate how much getting fit helped me. I absolutely still get burned out, with the same depression, anxiety, and existential malaise, but the lows are never as low, and it is always much, much easier to bounce back.

I don't know how much of it is a purely psychological sense of resilience you build up by regularly putting yourself through difficult physical stressors in small doses, and how much of it is from physical changes that (presumably) improve your autonomic function and balance... but whatever it is, it's been life changing, going on about 10+ years now, depending how I count it.

cjbgkagh11• 2 years ago

Just want to add, for some there is the issue of post exertional malaise (PEM) when cardio becomes counter productive. Those can often still weightlift without triggering PEM. This is predominantly how I managed it for most of my life and worked ok until the covid vaccine triggered another setback.

It's directly linked to stress, I think the predispositions are linked to not being able to ameliorate stress so anything that helps manage stress will help.

ericjmorey5• 2 years ago

You've given me a lot to research and explore here. Thanks!

What is hypermobility in this context?

cjbgkagh11• 2 years ago

The official criteria is based on the Beighton score, I think the official thresholds are too high so this test has a bunch of false negatives. I think people can be only mildly hypermobile, especially men, and still show up in the long covid cohorts much more often than they should. It's considered a spectrum, hypermobility spectrum disorder (HSD), where on one end you have Hypermobile Ehlers-Danlos syndrome hEDS and on the other end you have generalized joint hypermobility (GJH). Even GJH shows up in Dr. Jessica Eccles Long covid research far more that they should which would be weird if such hypermobility was truly benign.

https://www.ehlers-danlos.com/assessing-joint-hypermobility/

avgDev3• 2 years ago

Dysautonomia is extremely hard to treat. Symptoms vary from patient to patient and the number of physician is really lacking.

Individuals can have symptoms like fatigue, GERD, poor circulation, neurological problems, psychological effects.

There are many causes too, certain antibiotics, chemo drugs, covid, autoimmune. It is extremely unrecognized.

A specialist in my area used to have a 1+ year waitlist. Now, he moved to a different state.

There is an exciting treatment in the pipeline. WinSanTor is developing a cream with pirenzepine. In clinical studies there was a systemic recovery of nerve damage. I have spoken to a chemist who had nerve damage from flouroquinolone antibiotics, which caused his dysautonomia and he recovered using oral pirenzepine. Keep in mind WinSanTor is targeting diabetic neuropathy in their studies but it should work for other neuropathies.

cjbgkagh11• 2 years ago

It can be really hard to even get diagnosed with dysautonomia, and absolutely it's hard to treat. A total zoo of seemingly unrelated symptoms made all the more difficult with things like brain fog and psychological impairments.

Interesting, pirenzepine is a antimuscarinic agent (M1 selective antagonist). Neatly in the class of psychopharmacological drugs.

I predominately use Amitriptyline and Modafinil as well as Low Dose Naltrexone (LDN) and a very strict diet. Modafinil is a no-go for anyone with gut issues and I don't know the alternatives very well. Modafinil in the morning and Amitriptyline at night help push my autonomic system into the sympathetic and parasympathetic states respectively. I have a very complicated rational around choosing these meds which is not fully fleshed out yet, but they worked for me and work for some others in the long covid cohort. So for now it is good enough and what I'm sticking with. As I understand the science better I might consider switching up the meds and seeing what happens. I still get PEM and would love to be able to fix that.

badcppdev2• 2 years ago

That info about flouroquinolone is interesting. I've discovered that I was treated years ago using antibiotics that would definitely not be prescribed today. I will keep an eye on the drugs like Pirenzepine.

cableshaft• 2 years ago

nerve damage from flouroquinolone antibiotics

That's exciting. I got blind-sided by that. A doctor just said he was prescribing 'an antibiotic' like it was no big deal, and I had never had issues with any other antibiotics. I was told by the pharmacist do not exercise while taking these (found out a few days later it can damage your tendons, several people ended up with snapped achilles tendons) but otherwise nothing else.

Took a single pill and within a few hours I felt fairly strong neuropathy all over my body. Took a few more days and a few more pills before I determined for sure that it was caused by the pills and not something else, and got the antibiotic switched to doxy. I continued to get neuropathy in my limbs quite often for years after that. It's mostly reduced now but I think it might have caused damage in other parts of my body, and may have helped lead to me getting the Tinnitus I've been dealing with for four years now (there's a causal link between the two).

Since they prescribed it to me the surgeon general has slapped big warnings on the pills, but I was shocked a doctor didn't think to warn me about the possibility that there could be any serious side effects (it was also the first medicine I took where I had serious side effects by it, took me by surprise).

Seems it's actually not that uncommon that people have bad reactions to flouroquinolone antibiotics, it just wasn't recognized for many years. Wish I was given an appropriate warning. I might not have risked it, or asked for a different antibiotic I know didn't have issues at least.

richrichie3• 2 years ago

Is long covid still a thing? I thought it was a coping mechanism for managing the regret of taking the vaccine AND then getting covid and/or injured. Is there a proper differential diagnosis?

cjbgkagh11• 2 years ago

Long covid is no longer a thing the same way ME/CFS is no longer a thing. The world moves on without you (me). I did have an adverse reaction and I knew before taking it that I was in a high risk category for adverse effects, i.e. I already knew I had ME/CFS. My main consideration was that I'm also in the high risk category for adverse effect from covid. I'm open to the idea that the pericarditis that I got from the vaccine I would not have gotten from covid but I really don't know. I wish this was something that society would talk about openly and honestly.

Not something I particularly wanted to get into but the genetic predispositions for long covid do seem to appear most frequently in the more intelligent. And since our society is so stratified by intelligence a large portion of the population does not directly interact with intelligent people and are truly sincere when they report that they don't personally know anyone with long covid. My experience is quite different as 1/3rd of my friends that I knew prior to my own issues have developed such long covid/ME/CFS issues of their own. I went through the whole gifted / magnet schooling system so my peer group is substantially biased.

danparsonson2• 2 years ago

...taking the vaccine AND then getting covid...

Your immune system does not generally prevent you from catching anything; it allows your body to fight the infection more effectively the next time you catch it, thereby reducing or eliminating the symptoms. In your lifetime you will likely have caught some illnesses that you are vaccinated against without realising it, because you successfully fought the infection before it became serious. The COVID vaccine in particular never claimed to eliminate the symptoms altogether but reduces the severity so that rather than breathing through a tube for three weeks, you get a nasty cold. Long COVID is still a possibility and yes, very much a real thing albeit not well understood yet; I know at least one person who is recovering from it now.

ivanr• 2 years ago

Sounds like you're in the UK? Any chance you could send me the details of your doctor(s) to ivan.ristic@gmail.com? I've been struggling to find a doctor willing to diagnose me properly. Much appreciated.

cjbgkagh11• 2 years ago

Not in the UK - the UK is weird in that they have some of the worst gaslighting but also that's where Dr. Jessica Eccles is based and they have a decent Low Dose Naltrexone (LDN) medical community https://ldnresearchtrust.org/. While that is starting from a treatment and working backwards doctors who know about LDN and how and why to use it are most likely to know the other things they need to know. I'll send you an email and can probably put you in touch with other UK people in a similar boat.

posix_compliant• 2 years ago

Could you recommend some psychopharmacological treatments? I’m dealing with some flavor of this which is making my life difficult. I’m working with a neurologist, but I’m interested in your thoughts.

cjbgkagh11• 2 years ago

Diet is probably number one, sugar cravings caused by dopamine dysregulation and can also induce dopamine dysregulation causing a rather vicious cycle. Those most addicted to sugar are the most harmed by it.

Low Dose Naltrexone (LDN) is probably the most used and widely accepted med within the patient communities and due to having a rather mild side effect profile is a great place to start. Such side effects include really crazy dreams, insomnia, and nausea. The stronger the side effects the more likely it'll work and the negative side effects will go away in time.

I predominately use amitriptyline and modafinil but I don't have the gut comorbidities that would preclude the use of modafinil. I'm not familiar with alternatives to modafinil but a friend who previously had success with modafinil, until the gut issues became too much for him, switched to levosulpiride and he says that worked great. This appears to be counterintuitive for me but psychopharmacological meds are a tough one because they almost always have more than one receptor binding affinity and there is the interplay between ligands of different types and strengths as well as how the brain and body reacts with it. In general I prefer the weaker ligands than the stronger ones and don't try to over-optimize such that every day is good, I target 80% of them.

I basically looked up what books are used in that field and read a bunch of those; Stahl's Essential Psychopharmacology being one of the better ones. There are also books on dysautonomia but I don't know if there is a particular one I would recommend - the whole dysautonomia space is rather nebulous. My big takeaway from that is that is dysautonomia is super complex and hardly anyone understands it.

rednerrus• 2 years ago

Is it related to HSV? I've been seeing a lot of stuff in my feeds about HSV in the brain as a trigger for higher IQ, etc.

cjbgkagh11• 2 years ago

Yeah, HSV viruses in addition to the SARS viruses are well known ME/CFS triggers. It also appears with toxic mold syndrome and heavy metal stuff.

I suppose it’s theoretically possible for someone to get a IQ bump from HSV I think the correlation is more from selection criteria biased on severity.

There does seem to be a non-zero optimal for brain inflammations effect on IQ which could explain why smart kids have are likely to burn out when an existing predisposition to brain inflammation is made worse with age.

throwaway426683• 2 years ago

I'm a VC-backed founder who's definitely burned out. I know for certain what caused it, and I know for certain when it became unrecoverable, and I know for certain that I charged ahead deeper into it anyway because I had little other choice at the time. There's also a very strong sort of sunk-cost/devil-you-know thing with burnout that sucks you down the rabbit hole.

You simultaneously feel like you're too burned out to be able to do some entirely new thing, if you can even muster the energy to engage in the switching process (e.g. job hunting, etc.), and the familiarity of the thing that's burning you out brings its own kind of perverse comfort.

However, now that I've been deeeeeep in it for a couple years (still doing the thing that's burning me the whole time and even now) I've developed an appreciation for what it probably really is... existential malaise. That's a really useful thing to experience. Because it can be used to redefine a superficial value system you've adopted, to get to this point of dread in the first place, toward things you do actually find personally fulfilling for their own sake. Sometimes in dramatic fashion.

consp• 2 years ago

You simultaneously feel like you're too burned out to be able to do some entirely new thing, if you can even muster the energy to engage in the switching process (e.g. job hunting, etc.), and the familiarity of the thing that's burning you out brings its own kind of perverse comfort.

This describes an average Monday. Though I would not describe it as comfort but as continuous eternal pain you try very hard to ignore.

jajko2• 2 years ago

Well it certainly describes this Monday, but I don't think we talk about same level of things

adamc• 2 years ago

I could same the same of depression (in my case, arising from divorce). Difficult times enable values clarification.

hobs3• 2 years ago

The problem with this journey into lived nihilism is that it so often ends with suicide. Stay safe.

throwaway426683• 2 years ago

Thanks. Appreciate it. I'm probably fortunate that I came to grips with that whole end of things 20 years prior to work-induced burnout. I can probably safely credit the experiences for both the relative ease with which I went down the burnout hole and the relative ease of building a mindset for dealing with it.

Everything has its unsigned and signed integers.

rubicon33• 2 years ago

toward things you do actually find personally fulfilling for their own sake. Sometimes in dramatic fashion.

Go on…

this15testing• 2 years ago

I feel like being forced to spend 40+ hours at any/every job has to create more work to justify that amount of time (an "agreement" that people died for when they were working in factories, not that its based on anything realistic or 'scientific'), and that's not very inspiring and takes SO MUCH ENERGY, at least for me.

On top of that you then are faced with this constant increase in "tech" that is supposed to do so much amazing stuff / make everyone more efficient, so now you are forced to do even more work in those 40 hours or get squeezed by wealth inequality? The new AIM chatbots coming out now can do so much! wowee! now I can be in 4 meetings at once?

Then on top of THAT you also have to wake up each morning facing global climate change where there is no real effort to change the course (you can say all you want about renewables, but as long as these graphs keep going up we're all going down https://www.climate.gov/).

People do get value and meaning from their work, whatever it is, it just feels like this mindset and social structure of the industrial age doesn't match up with any of the challenges we face nor does it feel like it fits with all the knowledge and technology that has been developed. What's the point if what we're doing on a day to day basis takes so much of our energy and then just gets us closer to human caused environmental destruction no matter what it is?

nuancebydefault3• 2 years ago

I'm less pessimistic. I'm convinced that technology will at least considerably decrease the amount of trouble caused by climate change. There are a lot of options, and we will converge to a 'golden' combination of strategies to deal with the effects of climate change. Today we can make huge rockets that can land themselves vertically. What will tomorrow bring?

iprignano• 2 years ago

This sounds like a fallacy. Just because technology is helping humanity achieve incredible things (for profit), it doesn't mean it will be employed to make advancements in climate change prevention strategies (until it's too late?). It hasn't been until now, anyways.

toddmorey2• 2 years ago

I parent a child with autism. The care needs are intense; the burnout is real. But I can't employ usual burnout mitigation techniques like taking time off or making career / lifestyle changes. The world relentlessly marches forward. However, I've learned human resilience is AMAZING. You'll be surprised at what you are capable of when life asks for it.

Here are a few big insights that have really helped me:

- You never have to feel like doing something to start doing it. This insight is so strangely freeing. It really got me out of my head and the loop that I was in berating myself about motivation.

- The act of doing something is usually what creates motivation to continue. Tell yourself you'll spend 30 minutes on whatever it is. No matter what it is, I always know I can survive 30 minutes of it. However, 90% of the time, the timer goes off, but I don't feel like stopping. I've found my grove and I keep going.

- Procrastination isn't poor time management; it's poor emotional management. Be gentle with yourself. Know that you can be scared, frustrated, or angry but don't have to let those emotions define you. CBT works really well here. Don't define emotions as "good" or "bad". Define them as "useful". If the emotion you feel isn't useful, acknowledge it, but realize it's fleeting and let it pass on. Some people like to visualize emotions as clouds drifting by.

"And whatever your labors and aspirations, in the noisy confusion of life, keep peace in your soul. With all its sham, drudgery and broken dreams, it is still a beautiful world. Be cheerful. Strive to be happy."

(My grandmother, who survived the Great Depression on a farm, had the Desiderata posted on her wall. https://www.desiderata.com/desiderata.html)

fatnoah• 2 years ago

The act of doing something is usually what creates motivation to continue.

This is one of the techniques I use when feeling burnout or overwhelmed by an insurmountable task list. I set a goal to just get one thing done. Sometimes that snowballs into getting more things done and sometime it doesn't, but at least one important thing got done, which greatly helps my mental state.

BLKNSLVR• 2 years ago

My parents had the Desiderata on the back of the toilet door. I've read it innumerable times, but it didn't really start meaning anything to me until well after I'd moved out and needed that kind of perspective.

Also, I like all the points you've made and they ring true because I've experienced them more than a handful of times, but I still struggle to grasp their usefulness when I need it.

It's funny how emotional states can be the exact opposite of what may be best at the time.

Lastly, respect for parenting a child with special needs. Putting most of yourself on hold for an unknowable number of years is a rocky uphill trek. Keep a hold of yourself, but a tighter hold of them.

neilv• 2 years ago

My parents had the Desiderata on the back of the toilet door.

An addendum about the merits of fiber, hydration, and exercise could also help in difficult times.

Shrezzing• 2 years ago

The world relentlessly marches forward. However, I've learned human resilience is AMAZING. You'll be surprised at what you are capable of when life asks for it.

What I'm about to say obviously pales in comparison to raising a child with autism, but entering an ultramarathon/triathalon is a quite good way to experience something like this first hand in a safe environment. The amount a human can actually "go through" when it's asked of them is entirely remarkable.

anytime5704• 2 years ago

A friend of mine ran a marathon with 0 training in large part to spite me for laughing at him for saying he would.

Not as extreme as an ultra, but still an unimaginable feat for most people.

I wouldn’t have believed it if he didn’t wake me up to rub it in my face when he got back.

toddmorey2• 2 years ago

Yes! This is so true and requires much of the same skill set.

StefanBatory• 2 years ago

I learned about Desiderata from my computer science class at secondary school in Poland. We had to style and type in a text from a piece of paper, and that was what we were given.

ravishi• 2 years ago

These were the observations that made the most difference in my life too. I also only learned and internalized them after my child was born. He's 3 now and I'm happy to admit that I've grown a lot thanks to him. For the first time in my life I look forward to what's to come next and feel confident to face the challenges.

badcppdev2• 2 years ago

I'm glad you're coping with a very difficult situation. Jumping on a bit of a tangent I'm fascinated how you swap between 'I' and 'You' in your comment and how it could read differently:

"Be gentle with yourself. Know that you can be scared, frustrated, or angry but don't have to let those emotions define you".

could become:

"I'm gently with myself. I know that I can be scared, frustrated, or angry but I don't let those emotions define me".

The difference is interesting to me.

Edit: You just inspired me to rewrite Desiderata in the first person. I'm not conceited enough to believe that my version is doing more than faintly echo the original text but it was a (self) enlightening process. Thanks

I move placidly amid the noise and the haste, and remember the peace there may be in silence. As far as possible, without surrender, be on good terms with all persons.

I speak my truth quietly and clearly; and listen to others, even to the dull and the ignorant; they too have their story.

and so on.

dtx1• 2 years ago

Procrastination isn't poor time management; it's poor emotional management. Be gentle with yourself. Know that you can be scared, frustrated, or angry but don't have to let those emotions define you. CBT works really well here. Don't define emotions as "good" or "bad". Define them as "useful". If the emotion you feel isn't useful, acknowledge it, but realize it's fleeting and let it pass on. Some people like to visualize emotions as clouds drifting by.

As someone who has suffered from depression and related procrastination, thank you for your kind words.

thecleaner• 2 years ago

This is such an amazing write up. Thank you so much for sharing ! Good luck to you.

FuckButtons3• 2 years ago

Psa for anyone who has tried this or similar advice and found that: it actually feels physically impossible to force yourself to do things when you want to, as though you’re trying to push an immovable object, and has found that even did you manage to start something, you just feel more exhausted rather than motivated to continue. Please consider getting tested for adhd, because I spent years of my life not understanding why well meaning advice like this just made things worse for me.

localghost30003• 2 years ago

Diagnosed. Today is day 1 of meds. Wish me luck!!

Everything the GP comment said is still worth considering. It’s just that you might need some assistance if you’re neurodivergent. Also remember that it’s a spectrum and to be kind to yourself.

taneq• 2 years ago

After decades of frustration it turns out that 'discipline' and 'motivation' are available from the local chemist. You're not actually a bad person. Store bought is fine. You might even find that things like to-do lists and calendars, which everyone always told you to try 'because they make it easier', suddenly actually work for you.

Not meditation, though. F**k that.

viccis• 2 years ago

I think I'm gonna try for an official diagnosis soon. It's bad enough that it has been giving me issues for years, but I had the benefit of a very low stress easy job. I've switched to a much more rewarding and challenging job, but have found out the hard way that living with ADHD has completely burned out any drive I had, so I need to get it sorted out before I run out of runway.

thoughtFrame• 2 years ago

Can you explain how ADHD and things being hard in the way you describe are connected? I don't see the connection, but if it's the case, I should go see a doctor...

cwover• 2 years ago

Thank you for posting this. You wrote it better than I could. Much respect and appreciation to the parent commenter for the good insights; for some of us though, that first bullet point is a bit of a sore spot. When I initially read the first bullet point I had to close my browser for a while. For decades, I tried to "just do things" or "find meaning in tasks" or do whatever other advice I could find. About a year ago, I finally went to a doctor, got diagnosed, and started trying different medications. It took months to find the right combo of meds, but once we did I was astonished at how I could now also "just do things" (at least, for part of each day). The meds aren't perfect--I have good days and not-so-good days--but I am thankful to have some predictability now as to when I will be functional.

Also, for those starting out, it might take a few tries to find the right med(s). For me, just a stimulant or just an antidepressant didn't do much, but a stimulant and an antidepressant together has made a great improvement in my life.

7bit• 2 years ago

I value your comment. It revealed some thoughts I never Had, especially your first point.

When you talked about procrastination, ist reminded me of a Video that I watche every time I feel that procrastination overwhelms my life, which ist usually every 1-3 years.If you dont already know it, i Hope you enjoy it: https://youtu.be/mhFQA998WiA?si=YoO06S48xo8H5fKq

PaulStatezny• 2 years ago

- You never have to feel like doing something to start doing it.
- The act of doing something is usually what creates motivation to continue.
- Procrastination isn't poor time management; it's poor emotional management.

Thank you for sharing these. I've heard point #2 many times, but point #1 and #3 are huge insights to me!

ryanjamurphy• 2 years ago

I've recently heard #1 and #2 succinctly said as "Inspiration follows action."

digitalsushi• 2 years ago

when i watch media from 60 years ago i am overwhelmed by how much community there was inside workplaces. people communicated. they had community. ideas were communicative. so was effort. it almost feels like a violation in the modern sense to watch how in each other's business they were. and the backwash of social communication that comes with the transaction of work chat.

well anyways that's starting to feel like, i would not mind that level of familiarity and interaction at my job and maybe in society out with strangers, people i am competing against for resources, like, milk at the grocery store.

it's just me, and, my spouse, that i dump 100% of my social needs on, and i'm a lot, so i exhaust her quickly. i learned to keep bottled up most of my need to deflate after a day because that is basically holding someone hostage, to hear how my day went, as therapeutic as it is for me, it's an exchange of toxic assets that deserves compensation or greater distribution across a wider audience... like a workplace or a society tolerant of exchanging with strangers

so in the vein of lugging all this work around that gives us burnout, i have a theory that we're bottling way more up and solving it solo, poorly, just accumulating baggages that a different world used to exchange freely as part of a social acumen.

anyways i've put myself in a precarious situation of being vulnerable to a bevy of reality checking thread responses, which, i'd gladly take as good medicine to hear what i'm getting wrong; but i think i might have lobbed this point generally in a direction that is accurate, even if not precise: we dont have "our people" anymore and we're rotting together

jajko2• 2 years ago

You are just above average social, or maybe even a bit extroverted and as you mention you need to vent out but not have company to do so. Ie I am the opposite, no need to upload all the daily crap unto others, I deal with it on my own ie via long evening/forest walks, workouts and various sports, smoking weed sometimes (and mixing with long walks).

Its tiring to be mostly on receiving end, either there is a lot of negative stuff being unloaded unto you, or people are hopeless in some basic situations and can't speak up or generally help themselves or similar, and there is very little I can actually help with.

What is important for long term stable relationships is to have them balanced, give what you take in similar if not same ways, and not be a semi-constant source of negativity/complaints, everybody has their limit. The shit I've been told from some of my close folks, without ever asking or wanting to hear that... I would never bother them with such crap, its often borderline rude, and usually there is 0 I can do just listen or stop the whole circus.

deinonychus• 2 years ago

As a suspected introvert, I really love sitting down and hearing about my partner’s day, but this is really crucial:

Its tiring to be mostly on receiving end, either there is a lot of negative stuff being unloaded unto you, or people are hopeless in some basic situations and can't speak up or generally help themselves or similar, and there is very little I can actually help with.

I’m sure OP is wonderful and I don’t want to make assumptions about them, but I’d hate to do this with someone who is really negative and finds too many things to complain about. The other thing you mentioned is that if you’re a certain type of listener, it is an exhaustible skill to engage with so many “i need comfort not solutions” type stories and conversations.

bongodongobob2• 2 years ago

While media can reflect reality to a certain extent, it is still just a fantasy. See 'Friends' and young 20 somethings living in a million dollar loft in NYC while working as a barista. "What happened to those good times in the 90s?"

They never existed.

qp11• 2 years ago

Google Sharon Zukin. She wrote a book on loft living and describes the decline-rejuvination cycles in cities. According to her poor artists are the reason for those million dollar valuations.

Cycle goes something like this. Factories in parts of the city shut down after it get cheaper to run them outside. Those spaces lay empty, rents drop, decay begins. Poor Artists move in. Area starts getting interesting. Yuppies move in cuz of the 'cool' factor. Property developers notice. They start buying everything up. Rents jump. Artists get kicked out. And you end up with boring rich people living in a formally cool area.

TeMPOraL3• 2 years ago

FWIW, wasn't the apartment in "Friends" on rent control? IDK how that works exactly, but maybe it explains the plot hole away.

jogjayr2• 2 years ago

See 'Friends'...living in a million dollar loft in NYC while working as a barista.

I see this comment everywhere and it irks me. Here's my point-by-point, obsessed-fan's rebuttal:

1. It isn't a loft. It's an unusually large apartment.

2. It's explained on the show that it's a rent-controlled sublet illegally inherited from a grandmother of one of the characters. The illegality of the situation is a key plot point in one of the episodes.

3. It's obviously easier to shoot on a larger set than a smaller one. It isn't hard to suspend your disbelief on a fairly minor point. Would it have been a better show if they had shot it on a smaller set purely to satisfy people who want realism?

4. The size of the set is irrelevant to the storylines and characters. The characters don't otherwise live lavishly or appear to spend out of proportion to their income.

5. All but one of the main characters lives with a roommate or romantic partner throughout the entire show's run.

LeChuck• 2 years ago

What has changed, in your view? At my workplace we chat. About our spouses, kids, hobbies etc. Sometimes about difficulties at home or our frustrations and ambitions at work and life. We have dinner or drinks after work sometimes. We’re not friends, per se, but we’re certainly friendly. Are you referring to something else?

omayomay• 2 years ago

can relate the post. but i wonder if what she/he defined is a "burnout" or just the result of the alienation?

no matter which execuses we find, we know that our job is meaningles. KPI's OKR's Jira tickets.. does not mean jackshit to our self.

I've jumped on programming/tech since i got my first computer, i loved how hacking/building something that works and learning new stuff along the way feels. But at the end of the day, this is just another white-collar job, some shits needs to be done, most of the time with coorporating with other people.

If the article defines burnout correctly, i think it is inevitable due to the alienation[]

https://en.wikipedia.org/wiki/Marx%27s_theory_of_alienation

sentimentscan6• 2 years ago

I wish there was a job for burnout people something like:

1. meaningful

2. high impact

3. high authonomy

4. safe (low pressure, stress, etc.)

5. creative

And counterbalance it with lowpay to please market dynamic, something like a work for people with disabilities or requiring special assistance (which is done quite good in EU). I did try open source/own project, but the pay isn't guaranteed and I would like to pay the medical insurance/state pension and some basic (minimum wage) income to simply have peace of mind.

badpun2• 2 years ago

There are hardly any jobs like that in the world. It would also be hard to create them via some state intervention, because it's very hard to create "meaningful, high impact, high autonomy" via bureucratic process.

sentimentscan6• 2 years ago

I don't mean state intervention as most programmers are quite privileged, but a company that creates something like skunk works for people for burned out people

qazxcvbnmlp• 2 years ago

There’s a lot of jobs that follow this if your income is guaranteed. Most of the stress & pressure of a job comes from the fear of not loosing it.

ljlolel2• 2 years ago

Many kinds of hands-on volunteering would do this. The “high impact” part would be the people helped giving direct appreciation.

sentimentscan6• 2 years ago

I agree, but the charities programs I applied only need the marketing/seo or wordpress guy. Most charities don't have a need for the programmers.

parpfish5• 2 years ago

when i got burnt out, i left for a low-pay high-meaning tech job at a nonprofit.

it made things so much worse because it turns out that when you go to a low-paying job the quality of the org and coworker talent drops a LOT. this lead to a highly dysfunctional workspace which added so much more stress because a) dysfunction is stressful and b) you could see how that dysfunction directly harmed the meaningful thing you were supposedly working toward.

parpfish5• 2 years ago

one of my proposals for partially fixing burnout would be to allow devs to take unpaid sabbaticals.

if i could have taken 6-9mo away from my job to do my "meaningful work" and then come back, i would've much preferred that to just outright leaving. i imagine that that'd be a great employee retention tool for the tech co as well.

Joel_Mckay3• 2 years ago

At some point, one realizes a project is in maintenance mode, and most of the issues should be handled by IT tech support.

Better to find something more entertaining to do with your time... than get jettisoned with a product lifecycle.

After a few years, everyone burns out eventually. =)

parpfish5• 2 years ago

i think being allowed to pivot into maintenance mode occasionally would help with burnout. being able to sit back and do a job that's a bit more tedious and focused on routine would be a nice complement to always sprinting to make something new and solve things you've never dealt with before.

Joel_Mckay3• 2 years ago

Some companies do allow lateral movement of roles, but most have tightly-coupled process focused teams.

It it one reason why the churn rate is abnormally high for techs. People can only expect 110% for so long until a team starts dropping like flies.

stuff4ben• 2 years ago

Is it burnout or ADHD or depression? I feel like I have symptoms of all of them. Burned out at work because the project I'm on isn't selling and I don't care about it anymore but I have other busy work to do. Feels like ADHD because I can't stop myself from fidgeting on my phone looking at Reddit or FB or whatever. Feels like depression because I can't focus and I procrastinate like hell and don't feel like doing anything. Literally on the phone now trying to make an appointment with a behavioral health doc to see someone to get a diagnosis.

giantg2• 2 years ago

Well apparently I've been in the full 3-stage burnout for 5 or more years. Guess I'm screwed.

mdnahas• 2 years ago

Having burned out hard, my explanation is hope. Hope is like a zero calorie meal. It will keep you going and focused, but eventually you’ll collapse.

We can learn to push through hard times, but not forever. You need connection, exercise, good food, and nature.

After burning out, I relaxed for a while. Then, I focused on things that were under my control and didn’t depend on others. Exercise, losing weight, etc.

Understanding the neuroscience behind burnout (2022)

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