Jill is a parent carer from Camden and was a member of the team at Camden Carers from 2008 until 2021. Here, Jill talks us through carer burnout - how to stop it, how to heal, and how to reduce the chance of it happening. We can read Jill’s own caring story here.
As carers, it seems as though we are constantly on the go. If we are not busy meeting all the immediate daily needs, we're thinking about everything that has to be done next. It can feel relentless and the constant pressure can overwhelm us and lead to carer fatigue and burnout.
Instead of carrying on until we hit that wall and realise we just can’t keep going – maybe losing the will and compassion to care, or facing a greater breakdown – it’s healthier to find ways to watch for the warning signs of burnout. Below, we will look at what these signs are, what to do and where to go for help if needed.
What is carer burnout?
Burning out means reaching the end of our reserves – a state of emotional, mental and physical exhaustion.
Burnout is caused by excess stress over a sustained period of time. It can make us feel drained, foggy-headed, unable to cope, and this can lead to compassion fatigue, or losing the will to care.
Different types of stress
Let’s look at what we mean by stress and then explore the physiological process of how we respond to stress. Stress comes in two forms: Eustress and Distress. I like to think of these as Useful Stress and Difficult Stress:
1. Eustress is beneficial stress
It helps motivate us and get us out of bed in the morning. Examples of eustress might be getting ready for work on time, booking holidays, taking exercise, anticipation of starting something new, etc. Eustress floods our system with feel good hormones, called endorphins, making us feel motivated and positive.
2. Distress is harmful
Distress implies an external – and usually temporary – cause of great physical or mental strain. If temporary, the distress can be relieved by taking positive action to avoid continuing the strain. Often within the caring situation, the strain and therefore distress is prolonged, and it frequently feels there is no let up. The hormones relating to distress are adrenaline and cortisol.
The stress hormones
Adrenaline is produced by the adrenal glands which are situated at the top of the kidneys. Maybe we have heard the term “adrenaline junkie”, a person who loves the thrill of dangerous activity because of the adrenaline high it gives them.
Adrenaline gives us the strength to cope with a situation of danger. This response is called “fight or flight” and is a hard-wired physiological reaction. When faced with danger, our bodies produce sufficient adrenaline to help us either stay and fight the danger or run away from it.
During periods of prolonged stress, our bodies can go into a more or less continuous state of fight or flight, with little or no time for the adrenal glands to rest and recover. This will lead to adrenal exhaustion with symptoms of fatigue, brain fog, cravings for sugary or salty foods, headaches, mood swings etc. Eventually, there will be little, or no adrenaline being produced to give us the energy we need.
Here is an analogy:
Your car needs oil to run efficiently and enough oil is released in response to the needs of the engine. There is an oil gauge that tells you if the oil is running low and if you don’t replace the oil, the car will eventually be running on empty. This will damage parts of the car – you may begin to hear strange noises; a burning smell and the engine will overheat and eventually fail. When a car has no oil, it's running time is about 15 minutes before it burns out.
Cortisol assists in stressful situations by increasing the available sugars in the bloodstream, enhancing our brain’s use of glucose and increases the availability of substances that repair tissues.
It also raises our heart rate and blood pressure and suppresses bodily functions that would be non-essential or detrimental in a fight-or-flight situation – e.g. digestion. Sustained cortisol production may lead to a failure of cortisol’s protective role, leading to high blood pressure, lowered immunity, inflammation, weight gain and even diabetes.
14 warning signs of carer burnout - our burnout gauge
Referring back to our car analogy – there is a gauge that indicates when the oil is getting low. Is there a human equivalent? What kind of gauge would help us realise that our reserves are running low? The following can be indicators that our burnout gauge is running on empty and we are in danger of hitting the wall:
1. Feeling depressed or emotionally numb
We often feel more detached from what we usually engage with. Because of this, sometimes, we're unable to react.
2. Overreacting emotionally
Every little thing triggers our anxiety. We may have tears, be it angry tears, and snapping at things that we would normally brush off. We are different to how we normally are.
3. Mentally blank, slow and confused
Another sign is that we're unable to make sense of things. We're unable to concentrate or make clear decisions, even for the simplest things.
4. Mentally in a state of “hurry-worry”
reacting automatically without pause in a kind of mental overdrive and hypervigilance, watching all the time for signs of things going wrong.
5. Poor appetite
Ask ourselves, are we starting to have poor eating habits? This could include regularly eating too much or not enough. Grabbing whatever is quick and easy but not necessarily healthy. Perhaps, we feel like we don't have time for ourselves. And that this time could better be used for the person we care for.
6. Smoking more or drinking more alcohol
Some of us may be guilty of this, engaging in habits we know are not good for us in the long run. But gives us immediate gratification and serves as an escape from our caring role.
7. Physical exhaustion
The smallest tasks feel too difficult, leading to jobs piling up and creating more distress.
8. Self-neglect
Not taking care of our own personal needs, even the basics. This may be accompanied by feelings of low self-esteem and hopelessness.
9. Neglect for the person we care for
We may be feeling impatient and irritable with them. This may stem from the growing lack of empathy from juggling everything alone. This is harder to face than neglect of self but remember that if this is happening, it is because we are exhausted.
10. New or worsening health problems
We may also be experiencing frequent illnesses. We may be feeling dehydrated from not drinking enough. Waking up with headaches from overthinking about the future too much. If this is the case, get in touch with Mind - they provide mental health support, including crisis information.
11. Avoiding social activities
Sometimes, we may decline social activities with our friends and family even though deep down we would love to join. We may have carer guilt for being the one who "off-loads" on them about our caring situation and distance ourselves. We may not feel like we can be our true authentic self around them anymore, because internally we feel so low.
12. Bumping along at the bottom, ups and downs
We know that there will occasionally be good days or moments, so that gives us hope and keeps us going. But we often feel like we are far from it. And that we cannot always enjoy the good times when it comes - in fear of anticipating the bad ones.
13. Post-trauma
When we stop and take a break, the feelings of stress catches up with us. Even when the caring role has ended, or improved, the emotions and symptoms stay with us.
"You feel like you are the enemy of the system, and the enemy of the person we care for. It takes a toll on us and we end up feeling like victims" - Unpaid carer
14. Recognising that we don't want to feel like this
What does the opposite of a carer burnout feel like? We know that carer burnout is a long, sustained feeling of stress. We know that we would rather be feeling light and fluffy. Overflowing with positivity and having the energy to do things for ourselves. We want to embody the Hakuna Matata!
How to spot the warning signs
Spotting these warning signs is the first step to recognising we are experiencing carer burnout.
Write a simple list or design our own "Burnout Gauge" using some, or all of the warning signs listed. They can be numbered or coloured steps towards burnout – whatever makes sense to us.
Get a trusted friend or family member to be an external gauge on our behalf – share with them some of our warning signs and ask for their help to watch for those signs.
Think about one area, right now, that is heading towards a “red light” or number 10 on the warning gauge and act on that one thing to support ourself.
Ask for and accept help. This might be difficult if we find ourselves facing some cultural pressures but remember we don’t have to feel we are doing it all alone. Our local carers service, friends or support organisations are all places to get help
What to do if we've already hit burnout
There are no two ways about it – this is a serious situation for both us and the people we care for. There may be safeguarding issues for those involved, especially if we are unable to keep ourselves and the person we care for safe and well.
We need urgent support to ensure we can take a real break, with time to recover – AND to put in place whatever safeguards are needed to prevent burnout happening again.
Do one or more of these – urgently:
Make an appointment with our GP
Speak to the carers support service. We can find our local carer support service here.
Speak to social services. The local council has a duty of care under the Care Act 2014 to us and the person we care for, to keep us safe and supported. Replacement or respite care (short breaks) should be put in place as a matter of urgency.
Ask for immediate extra help from other family members or friends. Help can come in many guises, and we've shared some tips to help grow our support circle.
Join an online support group, such as the Mobilise Community. The internet is a huge place, and as social media grows, there are many groups filled with like-minded people we can choose to join.
Recovering from carer burnout
It's really important to plan our recovery from the total exhaustion that led to us hitting the wall. This might sound like one more thing to do. But if we flip it on its head, we can decide what is one thing we do not want to do - eliminating one thing gives us some space for ourselves.
Looking back at the warning signs, we might make a list that counteracts the effects described.
Try these nourishing techniques:
Nourish your body with good food. If our appetite is poor, then little and often might be better than three larger meals. Ask someone to help us shop and prepare meals.
Nourish your body with rest and plenty of sleep. try some relaxation techniques to help us rest well. Try to let go.
Nourish your mind. brush off negative thoughts and engage with positive ones; maybe try a mantra such as “I am recovering, I am well” – use your own positive message and repeat it whenever negativity looms.
Nourish your emotions. Breathe through any feelings that come up, allowing them to flow naturally - feel the calm of knowing we are recovering.
Nourish your time. Choose wisely which activities we would like and need to do. Use the “50% solution” – only use half our available energy in activity and the other half for our recovery.
Nourish and protect your recovery space. Tell people that we are spending this time to restore our energy and be well again, and allow people who are supportive to help us with this.
Nourish yourself spiritually. Enjoy a hobby, reading, art, watching a favourite TV show, or simply factoring time in for a walk. Engage in activities that feed our spirit.
What's next?
Depending on what has been put in place to support you and the person you care for during your recovery time, it's important that you choose how much of the caring role you pick up again when you feel able to.
Be mindful of not just going back to the old routine that caused your burnout. Don’t waste the investment you and others have made in your recovery. As well as your “Burnout Gauge” – make a “Recovery Checklist” to remind you of what keeps you well.
And finally, keep thinking about the journey of recovery. This is not one moment. It's an ongoing process. Focus on recovering from any challenge as it happens, scheduling short breaks from caring. Taking care of all your needs is a process of recovery from a place of self-neglect. When you keep on top of your recovery, you can thrive!
For some, it's helpful to have someone to check in with along the way. That could be a friend or a contact at our local carers' center.
About the author
As well as being a parent carer, Jill Pay is an Independent Trainer-Facilitator and Life Coach, and was the Breaks and Activities Service Manager at Camden Carers until 2021.
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