Spit If You Think You Have Burnout!

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But let me duck first!

Your saliva may predict whether or not you might be at high risk for burnout, according to researchers in Montreal, as reported in Psychoneuroendocrinology.

By analyzing a sample of spit, abnormally low levels of the stress hormone cortisol can be detected – a red flag for impending burnout.

Dr. Robert-Paul Juster, one of the investigators said, “This could have very strong implications in terms of helping to prevent burnout.”

Under acute stress, elevated levels of cortisol can be detected in the saliva.  However, during chronic stress, which can precipitate burnout, cortisol levels actually drop significantly.

And what if you are confused about whether you have depression or burnout?

Cortisol tends to be high in those with depression, and low in individuals suffering from burnout.  The saliva test may help to differentiate these two conditions, which can have overlapping symptoms.

If an individual with burnout is treated with antidepressants, this can be a therapeutic mistake, Juster said, since one of the effects of antidepressants is to lower cortisol levels.

“Great!” You may be thinking. “A test to predict those at risk for burnout.  Use that for medical students; I’m already burned out.”

I find that a lot of doctors feel burned out, but have not been given much, if any, information on burnout and what can be done.  Because burnout occurs in stages, and has a variety of symptoms and causes, there are no simple “one-size fits all” explanations or pat remedies.

But there are some fundamentals we can begin with.

In a nutshell, burnout is the experience of long-term exhaustion and diminished interest.

Burnout has 3 main components:

  • Emotional Exhaustion – those in the helping professions who deal with illness and death are especially at risk.  No surprises here.
  • Depersonalization – people are seen more as objects; cynicism develops, and there is a tendency to isolate.
  • Decreased Personal Accomplishment – work becomes less satisfying; there is joyless striving.

If you are feeling emotionally drained, have difficulty being empathetic towards your patients, and dread going to work, you may be on the road to burnout.

Dr. Tait Shanafelt, director of Mayo Clinic’s Physician Well-Being program, has reported that at any given time, 1 in 3 physicians is experiencing burnout.

Do you feel like you might be that 1 in 3 with burnout? Here is a 1 minute online survey you can take to assess your degree of burnout.  Please note that this is a non-validated assessment.  The gold standard for assessing burnout is the Maslach Burnout Inventory, which is used in most of the studies on burnout.

In my next blog I will be discussing some of the causes of burnout.   Feel free to post a comment on your own experience with burnout.

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2 Comments

  1. Michelle on March 25, 2018 at 11:54 am

    Hello, my psychologist says antidepressants don’t help with my level of burnout. My GP savoys that he is not wanting to put me on any again as he has tried everything except lithium and I am antidepressant resistant. I’m feeling beyond being able to be helped. Since I was on antidepressants for many years – which stopped working so I stopped taking them and felt a lot better for a time – I am wondering if antidepressants won’t help me. If I were not previously depressed and I now have burnout then I would think depression is part of the process, however, I was previously depressed. I am struggling to see another day. It is so deep at the moment that my previous psychologist (I’ve moved towns) is worried I won’t make it. Can you advise on if you think I should try antidepressants now, in my state?

    • Heather Fork on March 25, 2018 at 2:42 pm

      Hello Michelle, I am so sorry that you are experiencing such a difficult time and there is confusion about what is the best approach to your burnout and depression. I do apologize that I am not able to advise you on whether or not you should try antidepressants this time. I would recommend seeing someone who is an expert in this area, preferably a practitioner with a lot of experience in burnout and depression. Sometimes it is hard tell which is primary, but reducing one’s work responsibilities if possible can be helpful in teasing apart how much is burnout and how much is pure depression. Without fully knowing all the details of your situation it is impossible to tell. Are you currently practicing medicine? Please try to find the best professional to help you whom you trust and feel understands what you are dealing with. I’ll be thinking of you and hoping for some positive changes. Please feel free to keep us posted.

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