Exhausted after work? Feeling overwhelmed at the thought of all that must be done tomorrow? With juggling patients, insurance, staff, and personal life, it’s easy to feel overburdened and, at times, burned out. “Burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed,” according to the World Health Organization (WHO). What’s more, 89% of workers say they’ve experienced burnout within the past year, cites Zippia, a job-seeking website.

In this article, I discuss the signs of burnout and the action steps optometrists can take to prevent or reduce it.

SIGNS OF BURNOUT

Burnout manifests in both psychological and physiological ways. More than just feeling tired, burnout includes feelings of energy depletion or exhaustion, increased mental distance or feelings of cynicism related to one’s job; and reduced professional efficacy, according to WHO.

For optometrists this can look like:

• Decreased quality of care as your patient load increases.
• Rushing eye examinations and skipping key diagnostic tests to save time.
• Dissatisfaction with work and annoyance with patients and staff.
• Detachment from the profession.

ACTION STEPS TO OVERCOME BURNOUT

The key to overcoming burnout is to appropriately manage work stress. Admittedly, this is easier said than done, as each day brings a never-ending supply of personal and professional stressors. While it is not possible to eliminate stress, the OD can mitigate its effects. The following action steps worked for me:

• Deep breathing. There’s a reason parents tell their children to take a deep breath to calm down. Deep breathing stimulates the vagus nerve, which activates the parasympathetic (rest and digest) nervous system. Prolonged periods of stress lead to hyperactivity of the sympathetic nervous system, trapping the person in fight or flight mode, according to StatPearls from the National Institute of Health’s National Library of Medicine: ncbi.nlm.nih.gov/books/NBK541120/ . Thus, conscious, deep breathing for a few seconds provides relief in a moment of stress. (For more on deep breathing, see “Relaxation techniques: Breath control helps quell errant stress response,” from Harvard Health Publishing at bit.ly/StressReactionBreathing .) Breath work practices, such as yoga breathing or through apps, such as Breathwrk, can be done daily to dull stress.

• Decreasing cortisol levels. When the body experiences stress, it produces the hormones adrenaline and cortisol, which modulate the stress response. Increased risk of heart disease, insomnia, and increased anxiety/depression are a few ways increased cortisol can manifest in stressed individuals. I have found that the ways to decrease cortisol levels are through food and supplementation.

Food To Reduce Cortisol Levels:

- Food high in vitamin B: eggs, nutritional yeast, organic animal protein.

- Food high in Omega-3 fatty acids: anchovies, avocados, chia + flax seeds, olive oil, walnuts, oysters, fish (salmon, sardines, tuna, etc.).

- Food rich in magnesium: avocados, bananas, broccoli, dark chocolate, spinach.

- Food rich in protein: meat, fish, poultry, beans, legumes, quinoa.

- Food that promotes gut health: Greek yogurt, kefir, kimchi, kombucha, sauerkraut. Incidentally, alcohol, caffeine, high-sugar food, simple carbs, and soda raise cortisol levels. (For more on foods that reduce cortisol levels, see “Eat These Foods to Reduce Stress and Anxiety,” from the Cleveland Clinic’s HealthEssentials Newsletter: health.clevelandclinic.org/eat-these-foods-to-reduce-stress-and-anxiety/ .)

A Few Supplements to Manage Cortisol Levels:

- Ashwagandha: A plant extract adaptogen used to promote balance in the body.

- Omega 3 fatty acids: The three major types — DHA, EPA, and ALA — have been shown to ease psychological + physiological reactions to stress.

- L-theanine: L-theanine is an amino acid that promotes the production of relaxing alpha waves.

Optometrists can research building these foods and supplements into their daily routine for long-term cortisol management. A caveat: ODs should consult with their primary care doctor before using any supplement. (For additional information on supplements that can manage cortisol levels, see “Are There Supplements to Reduce Cortisol [Stress Hormone]” at BuzzRx’s Bee Healthy Blog: bit.ly/3VWkcV3 .)

• Utilizing holistic self-care. While burnout results from chronic stress, that stress could be mental, physical, emotional, spiritual, and/or financial. What’s more, these variable stressors will vary from day-to-day and year-to-year. Therefore, building a robust holistic self-care toolkit comprised of activities that can blunt all stressors makes sense.

Ideas for Holistic Self-Care:

- Physical: Exercise and walking, visits to the doctor, enough sleep (seven or more hours per night), and healthy diet (see “Dietary Guidelines for Americans,” from the U.S. Department of Health and Human Services at bit.ly/AntiStressDiet ).

- Mental: Therapy (e.g., psychiatrist or psychologist), walking, reading a book, silencing notifications on one’s phone.

- Emotional: Journaling, meditation (see this month’s “Glaucoma” column, p.42), and gratitude practice (see “This Daily Gratitude Routine Can Train Your Brain to be Happier,” from NBC, at nbcnews.com/better/health/daily-gratitude-routine-can-train-your-brain-be-happier-ncna912961 .)

- Spiritual: Prayer, church services, mindfulness, cleaning your space, and unplugging from one’s phone, among other electronics.

- Financial: Improving money mindset via audiobooks and podcasts, and automating savings and investing.

A great way to seamlessly integrate self-care into one’s life long-term is to build it into one’s routines. For example, adding a morning walk before breakfast or listening to an audiobook right after dinner.

• Learning to optimize natural energy levels. One of the hallmark signs of burnout is decreased energy. This can manifest as feeling tired, sluggish, or more exhausted than usual after work. To overcome this, optometrists can optimize their natural energy levels by paying attention to how they feel in the morning, the afternoon, and the evening. Overtime ODs will begin to notice patterns and they can start to work with, not against, their natural energy levels. They can achieve this by, for example, leaving their biggest task for the late afternoon, or when their natural energy level is at its highest.

• Creating boundaries around time. To overcome burnout, it’s crucial to become the CEO of one’s time and set boundaries. This means designating certain hours for work, hours for administrative tasks, hours for family time, and hours for self-care (see above). When ODs create firm boundaries around their time, they’re able to be fully present to the task at hand.

Multitasking, on the other hand, increases stress and anxiety (see “5 Ways Multitasking Is Bad for Your Mental Health [and 4 Things to Do Instead]”, from CNET: cnet.com/health/mental/5-ways-multitasking-is-bad-for-your-mental-health-and-4-things-to-do-instead/ ).

• Positive thinking/attitude. The positive thinking associated with optimism is key to effective stress management, according to a Mayo Clinic article. Positive thinking is approaching a challenging situation with the thought that the best, not the worst, is going to happen. One way optometrists can turn negative thinking into positive thinking is to practice positive self-talk, or being gentle and encouraging with themselves, according to the article. (See “Positive thinking: Stop negative self-talk to reduce stress,” from the Mayo Clinic: mayoclinic.org/healthy-lifestyle/stress-management/in-depth/positive-thinking/art-20043950 .)

• Scheduling unstructured down time. During the corporate wellness workshops I give, I talk to clients about the idea of unstructured downtime to overcome burnout. When optometrists, among other professionals, take a break, they usually feel guilty or spend the entire time thinking about what needs to be done, which leads to mental stress.

The idea behind unstructured down time is scheduling a designated break during which ODs are free to use that time in any way they want — reading a book, relaxing to music, taking a nap. They are able to be present during this time by scheduling it on their calendar. I recommend optometrists find two-to-three hours per week just for themselves, and think of this time as mini vacations. This permission is the key to release the self-inflicted mental stress that comes from “taking a break.”

• Connecting with others. Seeking out coaches, mentors, learning and volunteering opportunities are all antidotes to burnout, as they create “rich, interpersonal interactions and continual personal and professional development,” according to an article in Harvard Business Review (see “Beating Burnout,:” https://hbr.org/2016/11/beating-burnout ).

• Reconsidering mode of practice. If after implementing the above, optometrists still find themselves dreading going to work, feeling negative about patients, and miserable in general, it may be time to consider changing mode of practice: As an associate doctor, the OD can make the tradeoff of switching to a job that has fewer patients, although there will be less income. As a practice owner, the optometrist can delegate more of their responsibilities to staff or rethink their current patient volume. (See “Additional Anti-Stress Strategies,” below.)

OVERTURN THE BURN

Remember: Burnout is the result of chronic stress. Don’t let it ruin your love of optometry and patient care. By being aware of the signs of burnsout and then employing the several action steps outlined above, I was able to overcome it; so can you. OM

DR. RICHARDSON is a Los Angeles-based optometrist, wellness entrepreneur, and the author of “The Glow Up Journal.” She takes a holistic approach to wellness in her own life and is passionate about sharing these tools and practices with others. She focuses on creating evidence-based wellness content and yoga experiences to empower busy people to make healthier decisions. She has hosted international yoga retreats, corporate wellness programming, and pop-up events that introduce mindful and health-conscious living to a modern audience.