
Avoiding Burnout - jennita
http://andrewdumont.me/avoiding-burnout
======
DanielRibeiro
I remember reading this published insight[1] from Marissa Mayer a few months
ago:

 _Burnout is caused by resentment_

Which sounded amazing, until this guy who dated a neuroscientist commented[2]:

 _No. Burnout is caused when you repeatedly make large amounts of sacrifice
and or effort into high-risk problems that fail. It's the result of a negative
prediction error in the nucleus accumbens. You effectively condition your
brain to associate work with failure.

Subconsciously, then eventually, consciously, you wonder if it's worth it. The
best way to prevent burnout is to follow up a serious failure with doing small
things that you know are going to work. As a biologist, I frequently put in
50-70 and sometimes 100 hour workweeks. The very nature of experimental
science (lots of unkowns) means that failure happens. The nature of the
culture means that grad students are "groomed" by sticking them on low-
probability of success, high reward fishing expeditions (gotta get those
nature, science papers) I used to burn out for months after accumulating many
many hours of work on high-risk projects. I saw other grad students get it
really bad, and burn out for years.

During my first postdoc, I dated a neuroscientist and reprogrammed my work
habits. On the heels of the failure of a project where I have spent weeks
building up for, I will quickly force myself to do routine molecular biology,
or general lab tasks, or a repeat of an experiment that I have gotten to work
in the past. These all have an immediate reward. Now I don't burn out anymore,
and find it easier to re-attempt very difficult things, with a clearer
mindset.

For coders, I would posit that most burnout comes on the heels of failure that
is not in the hands of the coder (management decisions, market realities,
etc). My suggested remedy would be to reassociate work with success by doing
routine things such as debugging or code testing that will restore the act of
working with the little "pops" of endorphins.

That is not to say that having a healthy life schedule makes burnout less
likely (I think it does; and one should have a healthy lifestyle for its own
sake) but I don't think it addresses the main issue._

Then I finally realized how many times I've burnt out in my life, and I became
much better into avoiding it. Which is really hard to do.

And it seems to me that this is one of the many points that Ben Horowitz talks
about on his _What’s The Most Difficult CEO Skill? Managing Your Own
Psychology_ [3]

[1] [http://iamnotaprogrammer.com/Burnout-is-caused-by-
resentment...](http://iamnotaprogrammer.com/Burnout-is-caused-by-
resentment.html)

[2] [http://iamnotaprogrammer.com/Burnout-is-caused-by-
resentment...](http://iamnotaprogrammer.com/Burnout-is-caused-by-
resentment.html#comment-478842490)

[3] [http://bhorowitz.com/2011/04/01/what%E2%80%99s-the-most-
diff...](http://bhorowitz.com/2011/04/01/what%E2%80%99s-the-most-difficult-
ceo-skill-managing-your-own-psychology/)

~~~
ahoyhere
The people in the know now understand that what we call "burnout" is not a
psychological disorder at all, but sub-clinical[1] adrenal fatigue caused by
stress, period. In other countries with superior medical system integration,
like Austria/Germany, this is an accepted medical fact.

If you stress out a rat long enough, its adrenal glands will actually bleed.
If you stress out a human long enough, you cause first a huge ongoing spike in
cortisol etc., and later, a serious drop as the damage is done. This can be
measured easily using a 24-hour cortisol saliva or blood test, but it rarely
is. (Related hormones: DHEA, thyroid).

Symptoms of burnout are just like the symptoms of CFS/low thyroid because they
are part of the HPA (Hypothalamic-Pituitary-Adrenals) Axis. They're tightly
coupled.

While short bursts of endorphins will make you feel better, the effect will be
temporary. Endorphins will not make your adrenal glands or thyroid work again.
Instead, they mask the symptoms… but only for a while. There are only three
ways to get better: Dramatically cut stress. Wait. Take medication. Pick 2.

[1] "Sub-clinical" usually means "not measurable," but in the case of
"burnout" and adrenal fatigue, it is absolutely measurable. However, I call it
sub-clinical because of the way most doctors think of the adrenal glands. Most
doctors believe that the adrenal glands are binary: they are either working
perfectly, or totally non-functional (Addison's disease). Unless you're on the
verge of death from lack of cortisol, they will tell you you're fine.

If you have burnout, get your 24-hour saliva test. Take your morning
temperature with an old-fashioned thermometer under your arm for 10 min. Look
up the other symptoms of adrenal fatigue and hypothyroid. There's plenty of
research published about how burnout is measurable and related to the HPA axis
-- you don't have to take my word for it. There are lots of support groups,
too, where the sufferers have often presaged the research.

And for god's sake, stop telling yourself it's about failure or investment or
whatever and _stop stressing yourself out, period_ , or you can get like I am
and it can become _permanent_.

EDIT: If you google "burnout syndrome" you will read several sources claiming
that there is no proof it's a real thing. This is 100% false. They also say
it's not accepted by the medical community, but rather a quacky way to sell
supplements. It's true that most doctors are unaware of the research, but the
ones who do treat it with real medicine (see below).

It's painfully easy to say "There's no proof" but a 5-minute search of Google
Scholar shows otherwise:

<http://www.psychosomaticmedicine.org/content/61/2/197.short> (from 1999!)

[http://psycnet.apa.org/index.cfm?fa=search.displayRecord&...](http://psycnet.apa.org/index.cfm?fa=search.displayRecord&UID=2005-13290-009)

[http://www.sciencedirect.com/science/article/pii/S0022399999...](http://www.sciencedirect.com/science/article/pii/S0022399999000070)

<http://www.psychosomaticmedicine.org/content/62/2/286.short>

<http://gimle.fsm.it/28/1s_psi/05.pdf>

The theories from doctors who've spent their lifetime researching it go as
follows: Burnout happens in stages. In the early stages, cortisol etc. are
elevated. In the later stages, the "fatigue" sets in, and cortisol is too low.
I personally spent 3+ months in low-cortisol hell and it was the most awful
time in my life… and there have been some really bad times in my life. .

And there are quite a lot of endocrinologists etc. who will treat low-testing
cortisol patients with hydrocortisone, isocort or florinef or other _drugs_
which are not "supplements" by any stretch of the imagination.

IF you are stressing yourself out, and IF you keep going down that road, this
is what you have to look forward to:

Being unable to get out of bed. Being unable to make the simplest of decisions
without feeling like you're having a panic attack. Being unable to read,
because it's too much information at once. Being unable to watch TV shows that
have too many "facts" in them. All of the above -- including simple questions
of "What do you want for lunch, honey?" -- triggered panic-like attacks in me,
who'd never had a panic attack despite years of physical and emotional abuse
as a child. It was like being surrounded and squeezed and shouted at by a
million people all at once, just to try to _listen to my lunch options_. That
is because cortisol is required to rise to the "stress" of every day living…
standing up from sitting is a stress, making decisions, etc., all create tiny
spikes of cortisol to help you cope. If your cortisol is too low, you are
screwed.

Is there any "victory" worth a life like that? Can you even call that a life?

~~~
outworlder
> Being unable to get out of bed. Being unable to make the simplest of
> decisions without feeling like you're having a panic attack. Being unable to
> read, because it's too much information at once. Being unable to watch TV
> shows that have too many "facts" in them. All of the above -- including
> simple questions of "What do you want for lunch, honey?" -- triggered panic-
> like attacks in me, who'd never had a panic attack despite years of physical
> and emotional abuse as a child. It was like being surrounded and squeezed
> and shouted at by a million people all at once, just to try to listen to my
> lunch options.

Holy...! You have described my current condition even better than I could.
Interestingly, I just came back from a doctor who, after reviewing my blood
tests(standard blood tests), said that there wasn't anything wrong with me and
my issues were lack of exercise. Which may be true, but getting out of the bed
currently IS an exercise for me. It is getting better though, two months after
quitting my job - I can even enjoy Hacker News again.

Since you've gone down this path, what would you suggest? I am having a hard
time convincing any doctors to do a more complete examination. I was going to
focus next on sleep disorders, but now I think it might be worth talking to an
endocrinologist...

~~~
cpncrunch
Unfortunately there is no standard blood test for CFS/burnout. I agree with
Amy that cortisol might be useful, but the problem is that it isn't always a
reliable indicator of illness.

Anyway, just keep doing what you are doing and you will gradually recover. For
more info, see: <http://www.mind-body-health.net/recovery.html> (a site I
developed 10 years ago after recovering myself).

Unfortunately this is a very misunderstood area of medicine because doctors
(and patients) like to pigeonhole illnesses as either physical or
psychological, and psychiatric/psychosomatic illness has a very bad negative
stereotype.

~~~
ahoyhere
There are plenty of tests which can show what's wrong with you - but they're
not "standard" in the sense of doctors using them.

If your morning cortisol is above a certain level or below a certain level; if
your morning, before-you-get-out-bed axillary body temperature is above or
below a certain temperature (under 97.8 or above 98.6); if your blood pressure
deviates by a certain amount over a 16-hour day; if your average temps deviate
by more than 0.2 F from day to day; if you have post-exertional malaise… you
have an HPA malfunction of one kind or another.

I'd say "you should also get your thyroid checked" but the blood tests for
that are atrociously useless. Check the symptoms. Low body temp, especially in
the morning before you get out of bed (mine ranges from 96.5-97.4), slow heart
rate if you're not an athlete (mine is 50-60 bpm and I am NOT an athlete!),
puffy face/eyes, myxedema (non pitting) swelling/thickened rubbery skin on
your upper outer arm or shin, changed ankle-tap reflexes, very cold
extremities, Raynaud's phenomenon, etc., those are the signs that are actually
diagnostic of a thyroid insufficiency.

These are how doctors have diagnosed and treated low thyroid successfully for
a hundred years. The blood tests are a new thing but they aren't very
indicative of actual dysfunction (or function).

All of the above is like a lot like low blood pressure. Low blood pressure is
only defined by numbers when it becomes _dangerous to life_. Otherwise, you're
diagnosed with low blood pressure if your blood pressure is "normal" or below
and you have symptoms. E.g. I have low blood pressure at 100-110/60-70 even
though that's considered just fine, because I feel faint when I stand up and
other symptoms.

Generally, the best resource I've found is _From Fatigued to Fantastic_. It
helped me get much, much, better.

~~~
cpncrunch
While I agree with most of what you say, the problem is that a lot of studies
have been done on the HPA axis and cortisol in CFS/burnout, but there is no
agreement. Some studies find low cortisol, others don't. There is definitely
HPA axis dysfunction, but nobody can seem to pin it down. I suspect that if
you measured cortisol throughout the day and correlated it to a symptom diary
and/or a stress test, you might be able to come up with a diagnostic test.

The other issue is that there is no cheap and easy cortisol test like there is
for blood glucose. As far as I can tell it would be possible to develop such a
test, but nobody has done it yet for a number of reasons (lack of demand,
cost, FDA approval, etc).

If someone were to [1] figure out a definitive test for burnout/CFS and [2]
develop/patent a home testing kit they would be very rich and help a lot of
people into the bargain.

As for Teitelbaum: while he does have some useful stuff to say, he also
peddles a lot of quackery.

~~~
ahoyhere
Re: the contradictory studies… if you go with the group of practitioners who
argue that there are different stages to the disorder, they're not
contradictory at all. The stages argument says a person starts off with very
high cortisol output (because you're under stress) and this is what causes the
damage and fall-off of production later:

<http://www.ncbi.nlm.nih.gov/pubmed/10633533>

The 24-hour saliva cortisol test costs about $100 and should tell you a lot:

[http://labtestsonline.org/understanding/analytes/cortisol/ta...](http://labtestsonline.org/understanding/analytes/cortisol/tab/test)

There are definitive clinical (non-blood) tests for hypothyroid (I mentioned
several of them), there are also ways to test for FM/CFS (muscle recovery
among others). They just don't get used a lot.

As for quackery -- the only quackery I read in Teitelbaum's book was about the
allergy treatment and it's not any more or less quacky than acupuncture (where
the research was discredited) so I consider it harmless. Every "canonical"
scientist has some kind of nutty side, from Isaac Newton on down the line.
(Note: Not comparing Teitelbaum to Newton whatsoever. It's just an ideal,
extreme, example.) Everything else in his book is supported with research
citations. I've checked them, and others, because I followed his advice.

------
dangero
These ideas all seem like bandaids to me if they aren't personal goals that
you care about. I've seen studies that show that burnout is caused by
sustained imbalance between your personal goals and how you're living your
life. This can also happen retro actively. For example, if you were to find
out that you weren't going to get paid for a job you'd been working the last 6
months on, you would almost instantly be burned out. That is, if you were
doing it for the money of course. Your personal goal is to spend a certain
percentage of your time on things that will increase your wealth, and if you
weren't to get paid, the sudden overwhelming sense of losing six months would
burn you out immediately.

Likewise in a startup, I think the studies would say that you find yourself
burned out because at some point, something inside you says, "80 hours a week
for the last year wasn't really completely in line with all my personal goals.
I have a goal to have personal relationships, spend time with my family, and
exercise, yet this startup is the only thing I've been doing." At some point a
voice inside says, "It wasn't worth it."

People have very different goals, so results will vary as to what causes
burnout, but as a boss, something I know will cause burnout is anything that
will pull the rug out from under an employee regarding benefits that they
expected to receive. For startups this is super tricky because some employees
are expecting an IPO with big payouts, and when they get disillusioned about
that, there's really no way to stop the burnout.

------
pserwylo
I feel like this is useful information for much more than just people involved
in work. Specifically, as PhD students, my partner and I (and pretty much all
of our colleagues) often face burnout, and are always looking for ways to
combat it.

I quite like the sound of most things in this article, and think I will try to
adopt some of the principles to my study and see if they will help.
Specifically, I need to get back into fiction, because that really did help
when I read lots a few months ago. Also, evening walks sounds like a beautiful
way to wind down.

Does anybody else here have other advice on ways to combat burnout during a
PhD? I (and every other student) would be most interested to hear.

~~~
dkural
I have very clear advice for PhD: Agree to work 4 hours a day on your thesis +
papers (including reading literature!), and stop. You won't get more done
anyways, so enjoy the rest of your day guilt-free. It is a marathon, and the
consistent 4-hour days add up. If you miss one day, don't do 8 hours the next
day; just do another 4. Don't make more than 4 hours mandatory.

~~~
pserwylo
I completely agree. The only point where I fail at this is when I compare it
to the 8 hour days I do once a week as a web developer (unrelated to the PhD).
It seems so easy to power through the 8 hours and still feel like you could
get more done. Then you go to uni, and if you manage 4 hours, it is a success.
I always feel like I should be able to manage 8 hour days at Uni too, but of
course it is a different kind of work which stresses different parts of your
brain.

------
veb
It's funny. I work in New Zealand, and I do my 37.5 hours a week as required
(any more than that, and I get over-time) but that 37.5 hours takes such. a.
long. time!

When I was working for a startup, and working from whatever time I woke up,
till 3am in the morning, time flew by so quickly. I could easily do 80 hours,
and have great fun. I was creative, and energised.

As soon as I went from a startup to working for a large employer and was
forced to do 8.30am till 5.00pm all my productivity and energy flew right out
the window.

Sigh.

~~~
rcfox
Sounds like there's a simple (to explain, not necessarily to do) solution for
you. What's keeping you at the sucky job?

~~~
abcd_f
Not an OP, but I can answer the same.

Good pay, benefits, stability, lots of free time and overall an ability to
"have life" now (between 5 and 8:30) as opposed to having it after a startup
_maybe_ exits.

------
peterkelly
Excellent article.

This is the first time I've deliberately activated the Kudos mouse-over thing
on this guy's blog.

I can't count the number of times I've done it accidentally.

~~~
amercade
Agree on this Kudos :) I activated it by accident (didn't know how they work).
I don't regret it. The article was entertaining. Ok. But. The number of false
positives with this kudos system is probably very high. You should click to
confirm. Anyway, I don't like a web page where I have to be very careful where
I put my mouse over. Feels like a minefield. </off-topic>

~~~
mnicole
Totally agree, I think the Kudos system implemented in Svbtle and other clones
is fundamentally broken until there's a way to undo it. Just hovering and
waiting in place for a trivial action is a pain (and many people toggle with
it accidentally thinking it's some whimsical animation), no less that being at
the top of the page is completely backwards in itself; put it at the bottom
after I've already read the post enough to judge it.

------
navs
I've been sitting here at my computer since almost 8pm yesterday. It's 8PM
now. I can absolutely identify with the OP. It's not just startups, having a
full time job and going to uni as a full time student was a stupid move.

It's bad enough I work myself like this but there's also all that caffeine.
The coke, chocolate bars, energy drinks I consume and not forgetting the
smoking.

I tell myself 2 more months and I'll graduate. In the meantime I've made moves
by dropping the nicotine, dropping coke and energy drinks and keeping a large
bottle of water with me while I work. When the water runs out, that's my cue
to get up, stretch, refill and maybe take a power nap.

------
UniZero
This article really hit home for me. If I could I would take this advice, but
I literally can't afford to. My only option is to continue working 12 hour
days or I'll actually become homeless. So if anyone here has been through a
similar situation I would appreciate any advice you may have to offer.

~~~
bermanoid
If you're billing each hour of those 12 hour days and can't make ends meet,
then you have a problem managing your finances.

If you're salaried and would lose your job if you didn't pull those hours,
then I assure you you can find a more reasonable job.

If you're struggling to get a business off the ground, then I doubt that
you're getting as much done in the long run at 12 hours a day as you would at
10.

12 hour day crunches can be effective if you do them for a couple weeks; after
a month or two the tortoise that stuck with a 40 hour week is probably going
to beat you.

At least that's true if you're writing code - longer days can still be semi
productive if you're doing softer work.

------
cl8ton
You have a good regiment for burnout.

You can always feel burnout approaching which is usually about 2 weeks before
it really happens (waking up and dreading working on the same thing).

Stop what you're doing and do something totally different for a while. For me
its working on a vastly different project and spending weekends in the
mountains.

This has never failed me yet as I always re-approach the offending project
with the same drive I had when starting it.

~~~
dredmorbius
> You have a good regiment for burnout.

Sounds like you've turned burnout into a military problem.

------
auctiontheory
Obama makes the right call on the suits. Here's Dan Ariely on "ego depletion":
<http://danariely.com/2012/08/15/understanding-ego-depletion/>

------
proles
while often overlooked in our industry, it's the importance of hitting the
"reset" button. we're making sure clients are happy, sales people have the
information they need, and that can creep very hard into the rest of they day.
instituting a "hard stop" can go a long way, it did for me. i've spent
12-15hrs at the office, per day, dealing with meetings, questions, providing
guidance and the like. eventually you must put you interests first. whether
it's picking up that book, working on that personal project, or calling that
friend who works in a different field. ultimately, the problems are not crazy
new, but it's the day to day that burns people out. there's knowledge to be
shared but when you feel like day in and day out it's the same old, then all
the more reason to institute basic guides/metrics that let us know things are
on track. vacation is equally important, truly the 'reset' button, get off the
grid. after all, it things fall apart while we're getting replenished, it's
time to rethink our priorities.

------
ttunguz
Coincidentally, NPR profiled a productivity researcher from HBS this morning.
(I haven't been able to find the segment yet, but when they post it I will
link to it.) According to her research, the most important driver of
productivity is motivation which aligns with Daniel's comment.

Her recommendation for improving motivation? Use tools like IDoneThis to track
what you've accomplished each day and take the time now and again to reflect
on your progress through that journey.

At Google, we had an internal product called Snippets which is functionally
identical to IDoneThis. I'd always believed the purpose of Snippets was to
improve communication across a team and company about the contributions of
employees. But perhaps I missed perhaps the more important benefit: motivation
management and burnout prevention.

~~~
gertef
What if your Snippets just say "tried to fix stuff. still broken" over and
over and over again?

~~~
ttunguz
ha!

------
gdonelli
Has anyone ever thought that Hackathons are teaching kids how to code as well
as how to get burn out?

------
bconway
Excellent post. One of the top reasons I don't let employees work more than 40
hours a week, and start kicking people out of the office at 5:30 (if they're
still there).

------
marcbarros
Totally. I just left Contour and realized I spent most of my twenties behind
my laptop. I was completely exhausted and it has taken me almost six months of
doing nothing to have my full energy back. I wrote a similar piece about
enjoying the ride. I missed a lot of it at Contour.
<http://marcbarros.com/enjoying-the-ride/>

------
ZirconCode
Judging from the comments and the articles, it seems like I've never had a
proper burnout. I always recover within days, this seems to be a longer matter
however. The author talks about warning signs, and many of you mention you can
feel it coming, even two weeks advanced.

Would it be possible to describe this to someone like me? Not the burnout, but
the warning signs?

~~~
cpncrunch
Google 'chronic fatigue syndrome' to see what the end-point of burnout is
like.

Some warning signs: depression, anxiety, insomnia, loss of appetite, constant
illnesses, dreading going into work, racing heartrate, etc. Although to be
honest by the time you've got to that point you are already pretty burned out
and you're well on your way to CFS.

My solution for the past 10 years has been to live my life so there is
little/no possibility of ever having burnout (and it has worked :)

~~~
ZirconCode
Ah thanks, those were the pointers I was looking for =)

------
obvious1111
So your saying to avoid burn out dont work as much, this is amazing cant
believe others havent thought of that!

------
dabeeeenster
I cannot understand people who feel "on top of the world" yet are still
working within a business that is not cash-flow positive month to month.

"We didn't need a break, we felt great. Better than great."

Yet they are still burning up runway. Just lunacy.

~~~
asdashopping
Because for some people happiness is about more than cash flow.

------
PhilipA
Excellent article. The funny thing is that when you don't have time to
exercise, then it is the time you need it the most.

~~~
Hydraulix989
Same can be said about getting enough sleep.

~~~
ultimoo
Same can be said about socializing.

In fact, here in grad school we have a rule: "Choose any two from -- Grades,
Social Life, or Sleep".

~~~
arethuza
A friend (who was an international level rower) was told at Cambridge: rowing,
classes, social life - pick two. He tried all three and failed the classes!

------
quotha
So basically get a life

------
ttrreeww
You never burn out buying lotto tickets.

