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Coping with caring --- the dangers of chronic stress and burnout
by Kristin Duare McKinnon, MSW
July 6, 1998

You Can't Do it All
Working for charities and nonprofit organizations is rewarding and inspiring for many of us. However, in today's climate of change and uncertainty, helping work can also take its toll. Managers, staff, and volunteers in our field are always at risk of chronic stress and burnout.
Fortunately, our minds and bodies recognize when we are under stress and send us warning signs to change. This article looks at the warning signs of chronic stress and burnout, along with strategies to live a less stressful personal and professional life.

Working for charities and nonprofit organizations is rewarding and inspiring for many of us. Whether reaching out to help people, pets, the arts, or the earth, the work of giving is the work of meaning and purpose. However, like everything in life, giving can get the best of us. Managers, staff and volunteers working in our field are always at risk of chronic stress and burnout.

The pressures on charities and non-profit organizations today are unprecedented. Funding and staff cutbacks, competition for fundraising dollars, and the increased need for, and dependence on, volunteers adds up to an environment of never-ending uncertainty for even the best-run organization and its staff. As we struggle with these outside realities, the needs of those we serve continue to become more urgent and complex. It seems there is always hurting, always need, and often more bad news than good. And in these times, when the conservative and more right wing ideology rules, it may often seem like we are fighting a losing battle.

Feelings of defeat and desperation can cause tremendous stress for managers, employees and volunteers of charities and nonprofit organizations. This stress, if unchecked, can become chronic, leading to apathy, depression and ultimately, burnout. Now more than ever, it is vital that we are aware of the toll that caring work can take - and that we learn to recognize the warning signs of stress and burnout. We cannot take care of others if we do not take care of ourselves. Only by recognizing and addressing our own stress, we can continue our vital work with enthusiasm, dedication and success.

Don't Believe Me?
I worked for a social service organization whose leaders were trying to cut costs by realizing savings in the employee benefits package. They investigated several insurance companies to find one that would offer lower rates than the current provider. Of the four companies contacted, only one would provide benefits to our organization. The other three refused because of the high rate of disability in human service organizations - largely due to stress and stress-related illnesses. Caring work can take its toll.

What is stress and burnout?
Stress has many definitions, simple and complex, serious and humourous. I define stress as the experience of discomfort, which can be emotional, physical, mental, or a combination of all three. This discomfort is caused by our inability to meet certain demands or expectations in our lives, which in turn leaves us feeling threatened, inadequate and vulnerable. Stress can be external - caused by change or the lack of control - or internal - based on our perceptions and expectations. Usually stress is the result of external and internal factors, and can be caused by both positive (e.g. getting married, starting a new job) and negative (e.g. divorce, lay-off) events.

Feeling stress is our mind and body's unique way of letting us know that something is wrong and that we need to make changes to feel good again. Unfortunately, we often ignore these warning signs and learn to adapt to a stressful lifestyle instead of taking steps to reduce and control our stress. The danger of ignoring our stress is that it can become chronic - negatively affecting all facets of our lives. Experiencing chronic stress over long periods of time can lead us to the mental, physical and emotional exhaustion known as burnout. Burnout, which happens when our minds and bodies simply cannot continue to function under the stress of our lives, can lead to serious emotional or physical illness, disability or even death. Under these conditions, carrying out our work or volunteer duties becomes a temporary or permanent impossibility.

The warning signs
There are many warning signs that our mind and body send us when we are experiencing dangerous levels of stress. The following is a list of the common warning signs.

  • The Mind
    • Thinking that you are indispensable - "I have to do this or everything will fall apart." Thinking that the fate of an entire organization, project or cause lies solely in your lap causes tremendous pressure under which it can be impossible to cope. This type of thinking is usually unrealistic and erroneous as well, putting the focus on personal adequacy instead of organizational roles and responsibilities.
    • Negative thinking - expecting the worst, complaining constantly and only seeing the down side of every situation. This point of view negates the good things that happen in life. Negative thinking at the very least can rob your life of pleasure and at the very most, can lead to serious depression.
    • Extreme, exaggerated or misplaced emotional reactions. When we overreact emotionally to minor situations, there is usually another cause for that emotion that we haven't acknowledged - whether that emotion is anger, defeat, frustration or any range of other negative feelings. We can take these emotions out a work, at home, in the car - just about anywhere. "Road rage" is an example of extreme and misplaced anger. We may fight the primal urge to run some "jerk" off the road instead of addressing that we feel angry and powerless at work.
    • Getting away physically but not mentally. If you are always thinking of or talking about your work, no matter where you are or what you're doing, be concerned. Related warning signs: You aren't able to relax and just spend time doing something you enjoy because you can't get work off your mind. You lose interest in activities you used to like because work is all thatyou do.
    • Giving up and giving in. You used to love and care about your work. You had a passion for your cause and believed that you could make a difference. Now the problems you face seem insurmountable. You feel ineffective and receive no enjoyment from your work. Your focus is just getting through the day and the week.
    • Agitation and loss of concentration. You always feel agitated and rushed, like there are a million things to do and you will never get them done. In your rush, you make mistakes and things take even longer. You have difficulty concentrating: you are losing, forgetting and bumping into things more often.
  • The Body
    • Eating too little, too much, or poorly. Nutrition suffers for speed and convenience.
    • Sleeping too little, too much, or poorly. It takes a long time to fall asleep or you wake up too early. You never seem to get enough sleep; getting up in the mornings is a challenge.
    • Fatigue and lack of energy. You always feel tired, even when you do get sleep.
    • You're out of shape because you have not kept up your exercise routine. When we are under stress, exercise, diet and good sleep are even more vital than usual to maintain good health. However, these tend to be the first three things we neglect. The excuse is always that there "isn't enough time" - even though everything we do takes more time and effort when we feel poorly.
    • Physical symptoms such as headaches and body aches. You experience new health problems or recurring ones return - stomach problems, muscle aches, migraines and skin irritations to name a few.
    • Frequent or prolonged illness. When our mental and physical defenses are down, we get sick more easily, more often, and more seriously. You are taking more sick days and getting further behind in your work, or coming into the office and "sharing" your germs with everyone else. It's a lose-lose situation.
    • Developing or worsening bad habits. This can include smoking, eating poorly, drinking, and inactivity ... starting or doing more of anything that isn't good for you.
    • Depression is the ultimate danger for anyone experiencing ongoing, chronic stress or burnout. Depression can last for weeks, months or years if not treated and has a negative impact on every facet of life. Depression can also be deadly because of the related danger of suicide.
  • Relationships
    • Family stress. You are experiencing stress in your family because you are never home, are always preoccupied with work, or are taking your frustrations from work out at home. What time you do spend with your family is rushed, stressful and focused on what needs to be done, not on enjoying one another's company. A reliable sign of stress at home is the unplanned end of routines - for example, the family no longer eats together or spends Saturday mornings doing the housework.
    • The neglect of other relationships. You rarely see or talk to your friends, or go out with other people. Friendships are ending from neglect and you have no opportunities to meet new people. When you do socialize, it is with colleagues from your office ... and you talk about work.
    • Poor relationships at work. When stress mounts at work, it is common to begin demonizing your "enemies" (anyone who doesn't see eye-to-eye with you) - be it your boss, co-worker, a Director, funder, colleague, other organizations or a government official. "He doesn't care at all about us or our clients. He only cares about himself." If you resent the work you're doing, or people you work with, it is because you are feeling them impinge on the rest of your life. Of particular concern: when you begin to resent those you are there to help.

Survival Strategies
Chronic stress and burnout do not have to be foregone conclusion in today's charitable and not-for-profit organizations. There are steps that can be taken, in your work and at home, to combat stress and prevent burnout.

At Work
  • Changing Your Perceptions
    • There is always a solution. The more minds that are working on a problem, the more solutions there are to be found. Don't shut out the possibilities. Be more willing to ask for help, share ideas with someone else, or even admit when you are at a loss and need someone else to take on the task or project.
    • Be aware of your own expectations and accomplishments. Stress is often caused by our own expectations, which can be unrealistic and destructive. Be aware that you may often expect the impossible from yourself. Adjust your work habits and routines to allow for more flexibility in tasks, timelines and outcomes. Also be sure to recognize and acknowledge your accomplishments. Mentally reviewing our successes can be positive and motivating in our ongoing work, as well as countering the feeling that we aren't doing enough.
    • Appreciate small victories. As helping professionals, we often fall into the trap of feeling that we can't make a difference because the need we see day-to-day is so great. It is important to appreciate small victories. The situations that we deal with have been created over years and are the result incredibly complex factors and circumstances. We cannot expect to solve them overnight, or even in five or ten years. Every journey starts with a single step - notice and appreciate the steps taken.
    • Learn to set limits. For some of us, learning to say "no" is a challenging concept, because our work is to help to others. However, in today's climate, we can become consumed with demands on our time and energy if we don't know how to set limits. There is always a new need to be filled and new work to be done. Learning to set limits or to negotiate new responsibilities is vital to avoid burnout. Volunteers in particular must feel comfortable to turn down a task or request. We rely so much on volunteers that we often risk overloading them - which can lead to poor morale or resignation.
    • Only own your stress. When the stress is mounting, find its source. We tend to pass our stress on to those around us. If the boss yells at you, is that really a reflection on your performance or did she just receive more bad news about the budget? Never own someone else's stress - you cannot change it and you have enough of your own.
    • Remember that political climate is temporary. Today, many people in helping organizations feel defeated by the conservative, "right wing" political climate. But governments come and governments go. History bears out on this one. If the effects of right wing agenda are overwhelming you, take action. You will feel more effective getting involved than you will feel being worried. There are many groups working to change the current political agenda.
  • Maximizing Human Resources
    • You can't do it alone. Nobody has all the answers and the fate of an organization, group or cause never lies in the hands of just one person. Work fully with the others in your organization, including your managers, colleagues, staff, Directors and volunteers. Take advantage of outside resources as well - committees, alliances and partnerships, which are working towards the same goal as you or your organization. Having colleagues whom you can trust and respect can help you gain perspective when the stress is on.
    • Take advantage of all human resources, particularly programs that are free of cost. These include placements through high school, college and university programs, the Canada Employment Centre and social service departments, diversion projects, youth opportunity and training programs, corporate volunteer initiatives for employees and retirees, and service groups. Certain professionals also offer free or low rates to non-profit organizations, such as lawyers, fundraisers, and accountants. Be aware of what's out there and use it! Some people shy away from such placements because of the additional work involved in training, orientation and supervision. However, with a well thought out program in place, the benefits far outweigh the drawbacks.
    • Understand and appreciate your colleagues. Understand that everyone you work with is a human being, with unique needs, experiences and motivations. Just because someone thinks or works in a different manner than you, does not mean she is wrong or bad. Most of us are here to help. Treat people well. If you are positive and supportive in your work relationships, the rewards will come back to you ten-fold: relationships will improve, work will be done better, and you'll receive support and appreciation.
    • Stay away from the pessimists. Almost every workplace has them - people who complain endlessly about their jobs and just about everything else. They see everything in a negative light and are artfully skilled at picking up on people's shortcomings. They can even sabotage our work. Recognize how destructive these people are and stay away if you can.
Opportunities for Growth & Change
  • On the Job
    • Take advantage of evaluations. Evaluations are often set aside because workers and their bosses have so little time just to "get the job done." However, evaluations give both parties a chance to review expectations, discuss performance and priorities, and put supports in place. Evaluations also create an opportunity to give and receive positive feedback, tackle lingering problems, and clarify direction. Much of the stress at work comes from not being clear on what we are doing, and not getting recognition for a job well done.
    • Look for opportunities. We all need the opportunity to learn new things, meet new people, and just to get out once an awhile. Take advantage of training opportunities even if you are refreshing something you already know.
    • Volunteer somewhere new. Helpers have a tendency to do volunteer work that is related to our paid work. Make a change - volunteer at something that is totally different. You will meet new people, have fun, get away from the stresses of work, and gain perspective.
  • Getting Away
    • Go on holidays. Take your holidays and make an oath not to think of work. Go somewhere that is geographically away from your work and home - even if just for a few nights. Physically removing ourselves from the routines of work and home gives us a new perspective on the world and allows us to relax. P.S. No calls to the office are allowed!
    • Recognize when it is time to go. There may be a time when the only option is to move on to another job or a new career. Whether it is a dysfunctional workplace, a job that doesn't "fit," or simply a need for change that spurs on this realization, it is important to know when it is time for a change.
  • At Home
    • Taking Care of Your Health
      • Eat well. Follow the old rule - three balanced meals a day. Skipping meals leads to more snacking - often on junk food - later in the day. If meals are skipped or leave a lot to be desired, take supplements, such as vitamins.
      • Exercise regularly. Find an exercise that you enjoy and practice regularly. If you are bored easily, choose from a variety of activities (e.g. walking, swimming, squash etc.). Make it a point to exercise more when you are feeling stressed, not less. Exercise increases alertness, makes our bodies and mind feel better, and improves our energy level.
      • Control your bad habits, particularly smoking, drinking and the intake of caffeine. Although these substances seem to help us in the short run, they have long term effects that are detrimental to our health - and can be deadly.
      • Schedule an annual physical. "An ounce of prevention is worth a pound of cure." Make it a priority to go for a full physical every year. Our bodies are like our cars - regular maintenance avoids major breakdowns.
      • Take advantage of alternative care. Be it chiropody, reflexology, aromatherapy, or massage, take advantage of alternative methods of care. Many have both preventative and therapeutic value. Avoid looking to the medical profession to solve all of your problems.
      • Know when you need help. Everyone needs help once and awhile. We all have our breaking point, and when stresses at work and home pile up, we sometimes need help to handle it. Seek counselling or support, especially if you may be depressed. Take advantage of employee assistance programs and community services. They are there for all of us.
    • Learning To Relax
      • Do what feels good. Petting a cat or dog is proven to bring down blood pressure. Having friends and family who care helps us get well faster and live longer. Listening to music, laughing, and hugging lifts us emotionally while writing down thoughts and feelings helps us manage stress. These are all proven prescriptions for life. Do things to make yourself feel better.
      • Revisit something you love. We all have activities we love. Whether it is painting, bird watching or taking night courses, revisit something you love. You will gain in confidence, feel better and meet new people.
      • Take time to relax with yourself. The first step is to be able to stop "doing things." Read a book, sit in the sun, do nothing. The next step is to be able to relax alone. Being alone gives us time to think about what we're doing and what we want in life.
    • Maximizing Social Supports
      • Spend quality time with your family. It is important to chose to spend time with your family instead of feeling that you must. Spend quality time with your spouse and children - together and individually.
      • Spend time with friends. Friends are important supports. Make it a priority to spend time with them and to meet new people. If time is scarce, combine social and recreational or family outings - play squash with a friend or plan a multi-family picnic and baseball game.
      • Gravitate towards positive people. Everyone has bad days and sad times. But some people are sad, angry and depressed all the time. Gravitate towards people who are happy and are successful in getting what they want out of life. You feel better.
      • Learn to set limits. Setting limits pertains to your personal life too. Recognize when you have reached the limits on your time and act accordingly. If there is ongoing pressure to take on a new responsibility, negotiate to delegate an old one - whether with your family, friends, church, or volunteer work. Don't think of it as quitting or "letting someone down." You are being mature about your responsibilities and commitments.
    • Getting Out
      • Get away. We all need to get away to get a perspective on our lives and their place in the world. Go somewhere different and forget about your obligations for awhile.
      • Start something new. There are opportunities out there that are perfect for you. Don't be limited by fear, geography or your own comfort level. Explore and learn. Be daring.
      • Practice your faith. Many people find that faith brings them peace and hope. Being involved in a church or faith community also provides direction, support and purpose.
      • Most important of all: remember you're human. Extend the caring and dedication to yourself that you give of so easily to others. You're worth it.
 
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HA

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Resources
Bolles, Richard Nelson.
What Color is Your Parachute?
Berkeley, CA: Ten Speed Press. ISBN: 0-89815-844-3.
This book is updated annually so look for the latest edition. Excellent resource for deciding the direction you want to go in your professional work life. Includes a workbook and resource guide, a quick job hunting map, tips for the impatient job hunter, looking for jobs on the internet and changing careers without going back to school. Very comprehensive and insightful, easy to read. Don't let the 297 pages frighten you - depending where you're at, you don't need to read it all.

Bourgault, Denise & Meloche, Monique (Fall, 1982.)
Burnout or Dying of Exhaustion Like a Chameleon on a Kilt
The Social Worker, Vol. 50, No. 3,pp. 109-115.
I received this article while still in my undergraduate social work course - a timeless look at the realities of chronic stress and burnout in the field, and what to do about it. Only weakness is that the authors tend to concentrate on the caseload and the client as the source of stress while overlooking organizational, bureaucratic and political contributors.

Brahm, Barbara J. (1990).
Calm Down - How to Manage Stress at Work
Glenview, Illinois: Scott, Foresman and Company.
A simple, straightforward look at coping with on-the-job stresses. A quick read covering the basics.

Burns, David D. (1980).
Feeling Good - The New Mood Therapy. Subtitle: The Clinically Proven Drug-free Treatment for Depression
New York: Avon Books. ISBN: 0-380-71803-0.
A good book for anyone experiencing stress or depression. Easy to read, practical, workable solutions.

Canfield, Jack & Hansen, Mark Victor.
Chicken Soup for the Soul series
Deerfield Beach, Florida: Health Communications, Inc.
Available at any bookstore. Full of wonderful stories of people bringing joy to people. Even the hardest cynic will shed a tear. You can't help but feel good. Website: http://www.chickensoup.com.

Kabat-Zinn, Jon (1994).
Wherever You Go, There You Are. Subtitle: Mindfulness Meditation in Everyday Life.
New York: Hyperion. ISBN: 1-56282-769-3.
It's all about slowing down, letting go, and taking life less seriously. A quiet, gentle read.

Robbins, Anthony (1989).
Personal Power - A 30-Day Program for Unlimited Success
Irwindale, CA: Robbins Research International.
(12-cassette tape set). Although there are no quick fixes, Mr. Robbins takes you through the barriers you put up to your own success - be it at work, home or anywhere else - and gives you insight on how to cope and live better. Well worth a listen - ideas and solutions are practical, simple and workable. An excellent walking companion if you have a Walkman.

Vineyard, Sue (1987).
How to Take Care of YOU ... So You can Take Care of Others
Subtitle: A Survival Guide for Human Service Workers and Volunteers.
Downers Grove, Illinois: Heritage Arts Publishing. Distributed by Partners Plus (416) 886-8585. ISBN: 0-911029-06-0.
Excellent resource on understanding and coping with stress and burnout in the helping professions.

Kristin Duare McKinnon has diverse front-line and administrative experience in nonprofit organizations providing health, social, and community services. She now has her own business, KDM, which offers program support to the non-profit sector. Kristin's special interests include leadership and service excellence, program development and evaluation, volunteer management, and working with seniors and people with disabilities. She can be reached at KDM, P.O. Box 429, Pontypool, ON Phone (705) 277-3262; Fax (705) 277-2921.
 

newla

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This looks really useful. I need to spend some time on this board exploring all the useful resources.

Thanks you
 

jlconsultants

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Excellent articles! Two brief thoughts: The first is that the dangers of chronic stress are medically linked via numerous scientific articles (mainly due to the excess production of cortisol which occurs when the body is under stress). Consistent high levels of stress are linked to excessively high (and consistently high) levels of cortisol, which causes low level inflammation throughout the body-- now believed to be a key factor in a host of degenerative diseases.

In addition, it has been shown in studies with rats that they will die sooner having forgone sleep than having forgone water. That is quite significant, as animal bodies (rat and human), are composed largely of water (and not so much out of sleep :) ).

Aside from the actual physical toll stress takes on the body, our actions under stress tend to be less beneficial for ourselves than we would like. Rather than head home at 10pm and make a nice healthy salad, we grab a fast food bite, or "feel" like eating comfort food. We neglect our excercise due to fatigue. We act snappishly, creating conflict, and thus, more stress for us.

All in all, chronic stress is a vicious cycle that once in her grasp is hard to gain release. But we must, and the best way is by setting appropriate boundaries for what we can and cannot do, delegating certain tasks, and realizing that if certain things do not get done today, or done perfectly, the world will not erupt into fire and brimstone.

Take Care All,
jlconsultants
 

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