12 warning signs of carer burnout
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 are thinking about everything that has to be done next. It can feel relentless and the constant pressure can overwhelm us and lead to 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:
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.
Distress is harmful and 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 are 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 which 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, its 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 increasing 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.
12 warning signs of carer burnout - our burnout gauge
Referring back to our car analogy – there is a gauge which 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:
Feeling depressed or emotionally numb: detached and unable to react; OR
Overreacting emotionally: every little thing triggers our anxiety, anger, tears etc.
Mentally blank, slow and confused: unable to make sense of things, to concentrate or make clear decisions; OR
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.
Poor appetite – or poor eating habits: regularly eating too much or not enough; grabbing whatever is quick and easy but not necessarily healthy.
Smoking more or drinking more alcohol.
Physical exhaustion: the smallest tasks feel too difficult, leading to jobs piling up and creating more distress.
Self-neglect: not taking care of our own personal needs, even basics – this may be accompanied by feelings of low self-esteem and hopelessness.
Neglect of our cared-for, feeling impatient and irritable with them. This is harder to face than neglect of self but remember that if this is happening it is because we are exhausted.
New or worsening health problems, frequent illnesses.
Avoiding social activities, even those we really enjoy.
How to spot the warning signs
Make a “Burnout Gauge” using some or all of the warning signs listed. Write a simple list or design our gauge with 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. We don’t have to feel we are doing it all alone – our local carers support service, our GP, friends and family and social services are all places to get help and support.
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 ourself and our cared-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 social services. The local authority has a duty of care to us and our cared-for, to keep us safe and supported. Replacement or respite care 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 our blog can help you get started with our support circle.
Recovering from carer burnout
It is really important to plan our recovery from the total exhaustion that led to us hitting the wall. Looking back at the warning signs – we might make a list which counteracts the effects described. It might help to think of how we might support someone after a serious illness.
At the very least do these nourishing things:
Nourish your body with good food – if our appetite is poor, then little and often might be better than 3 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 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, allow people who are supportive to help us with this.
Nourish yourself spiritually: enjoy a hobby, reading, arts or crafts, TV, walking, etc. Engage with activities that feed our spirit.
Depending on what has been put in place to support you and your cared-for during your recovery time, it is 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 is an ongoing process. Focus on recovering from any challenge as it happens, scheduling breaks from caring to provide space for regular recovery. 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!
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About the author
As well as being a parent carer, Jill Pay is an Independent Trainer-Facilitator and Life Coach, and was the Breaks & Activities Service Manager at Camden Carers until 2021.