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Being UnLonely

By Jeremy Nobel, MD, MPH

Workplace Burnout and Loneliness: What You Need to Know

Understanding the reciprocal relationship between loneliness and burnout.

By Jeremy Nobel, MD, MPH
As published on PsychologyToday.com 

Loneliness at work is often affected by other aspects of an employee’s daily experience, and perhaps no factor matters more than workplace stress and burnout. The relationship between burnout and loneliness is a reciprocal one. Burnout can lead to increased feelings of loneliness. When people feel overwhelmed, exhausted and dehumanized, it heightens their risk for isolation. Loneliness, too, can exacerbate burnout, by decreasing one’s capacity for resilience. It is critical for those experiencing loneliness at work to understand workplace burnout, and vice versa, to best navigate the workplace experience in a healthy, connected, and low-stress way.

In recent years, social psychologists, organizational behaviorists, and human resource personnel have noted a significant increase in the chronic and debilitating state of work-related stress known as burnout syndrome. And burnout seems to be increasing. Two-thirds of full-time workers say they experience burnout on the job and burnout among physicians, with a rate of 78%, has been declared nothing less than a public health crisis.

Most of us who go through a rough stretch at work, perhaps feeling overextended or falling behind, recognize that taking some time away from the workplace gives us the chance to relax and recover. But there are gradations of burnout that are deeper and more pervasive—something that a day off or even a two-week vacation can’t remedy.

The Mayo Clinic describes burnout syndrome as “physical or emotional exhaustion that also involves a reduced sense of accomplishment and loss of personal identity.” According to the World Health Organization, burnout is characterized by increased mental distance, feelings of negativism, and cynicism related to one’s job. Burnout erodes one’s sense of engagement and purposefulness and can breed emotional detachment, self-doubt, and shame.

The hallmark of burnout is exhaustion, experienced as a deep sense of fatigue and the depletion of physical, mental, and emotional resources. It isn’t necessarily the quantity of time spent at work that’s so exhausting, but the quality and nature of the time spent.

Pharmacy employee Sara Cox told The Guardian, a major newspaper in the UK, that burnout symptoms emerged with her increased workload. “Every Sunday, I had that feeling of dread that the next day I was going to have to juggle everything all over again,” she said. “I’d wake up exhausted, it felt like every day I was walking through thick mud.

Boston Magazine profiles a lawyer who practiced for 15 years before walking away from his career and getting a job at his favorite cheese shop. “It wasn’t so much the amount of time spent in the office that got to me,” he told the magazine. “It was the mental and emotional strain of feeling like it was never enough, and that I had to always be thinking about work.”

The second characteristic of workplace burnout is apprehension that one is not performing one’s job effectively. Lack of control over one’s own working conditions is often a factor, as when employees feel they have no influence over the scope or complexities of their work and no voice in the decisions that shape it. In addition, workers may believe they lack the skills or access to resources required to complete tasks. This results in feelings of frustration, helplessness, and a diminished sense of personal accomplishment. According to the American Psychological Association, “the chances of burnout increase if you feel that you can’t express yourself on the job, or if you are taking on multiple roles that conflict with one another.

Finally, burnout leaves people with a general sense of futility or lack of purpose causing discomfort— a feeling of: “What’s the point?” Burned-out people often feel disconnected from their jobs, professions, colleagues, and the people they serve, and a general sense of depersonalization. A restaurant manager in a Wall Street Journal article described his experience like being on autopilot, “like you’re just going through the motions.”

Certain workplaces seem to carry a higher risk for burnout among their employees, including healthcare and clinical environments, educational facilities, and community service organizations. What these venues have in common is the tension between the infinite demand for their services and the finite availability of resources. In many cases, complex bureaucratic systems, burdensome clerical and documentation procedures, and the absence of operational processes that facilitate workflow present further obstacles to efficiency and effectiveness. These conditions can compound employees’ feelings of underachievement, futility, pointlessness, and can even make them feel emotionally detached from the recipients of their services.

So, what does workplace burnout have to do with loneliness and isolation? Well, …everything!

Feeling disconnected from the people you serve often disconnects you from yourself, especially for the many of us who are motivated by a sense of mission and purpose. This disconnection can lead to depressionsubstance abuse and even suicide, all well noted burdens associated with loneliness. So, while loneliness may not in itself be a symptom of burnout syndrome, it is almost universally a consequence. And loneliness can actually cause burnout, as well as one’s susceptibility to it. People in the throes of work-related exhaustion, self-doubt, and defeatism are more likely to withdraw, interacting less and less, and effectively isolating themselves from the people around them. And those who already are experiencing loneliness in their lives may lack the emotional and spiritual resources required to feel replenished and resilient under challenging circumstances.  A person in this position can be vulnerable to even more burnout, compounding the feelings of isolation and loneliness.

Dr. Doug Nemecek, Chief Medical Officer for Behavioral Health at Cigna, explained the current challenges that employers face.  “Stress at work is not new. CIGNA has been supporting employers and employees dealing with workplace stress and burnout for decades. But the rising epidemic of loneliness nationwide is putting even greater demands on individuals, limiting their resilience to burnout and increasing their risk for mental and physical health challenges. This makes it all the more urgent to go “upstream” in addressing stress and burnout preventatively, including fostering a sustained sense of connection and belonging in the workplace for all employees.”

Employers recognize that burnout disrupts performance at the organizational as well as  individual level. Burnout among the workforce is strongly associated with low rates of commitment, productivity, and morale, and high rates of absenteeism and staff turnover.

Fortunately, a growing number of leading employers, many of them large health systems, are beginning to identify burnout as a critical issue that needs to be addressed. For example, the Icahn School of Medicine at Mount SinaiStanford School of Medicine, and UC Davis Health have all recently appointed Chief Wellness Officers whose mandates include addressing burnout syndrome among their employees. Non-healthcare employers are also increasingly active in addressing this aspect of wellbeing. The American Bar Association, for example, has a Wellbeing Pledge & Toolkit that guides law firms in addressing the issue.

But implementing such system-wide changes can be challenging, time-consuming, and costly and employers want to know whether the return justifies the investment. A comprehensive meta-analysis published in The Lancet substantiates the benefits of both individual-focused interventions — particularly mindfulness, stress management, and small group discussions — and organizational interventions, such as modifications to clinical work processes, in reducing physician burnout. And in a recent Health Affairs op-ed that was co-authored by 15 leaders in the field of medicine, the group cited “mounting evidence that certain interventions can decrease burnout and depression and enhance optimal well-being.

It is “good news” that a growing number of programs are being deployed by employers to help employees alleviate stress, prevent burnout, and maintain work-life balance. When these efforts begin to truly reflect a company’s culture and are not “one and done” programs, they can also lead to a reduction in loneliness. Ultimately, feeling a stronger sense of purpose, belonging, and connection in the workplace can strengthen an employee’s ability and willingness to handle work-related challenges, and increase resilience when feelings of burnout surface. Stress-reduction interventions do have costs, but with evaluation and measurement strategies to determine benefits and outcomes, employers can calculate the return on investment that justifies these programs’ continued use.

Employers are beginning to think creatively about new ways to foster connection at work. For instance, the signature initiative of the organization I lead, The UnLonely Project, partners with employers to make available streamable short films from its UnLonely Film Festival platform, that can be used to promote dialogue on the issue. We’ve worked with financial service firms, technology companies, healthcare delivery systems, and municipalities to use these provocative films to foster timely and important dialogues addressing loneliness and burnout.

It benefits individuals and employers alike when workers are given the time and the tools they need to perform their jobs; when they enjoy a sense of belonging and connection; when they come to work knowing that they are valued, they have a voice, and they are heard. We think it’s an opportune time for workplaces of all sorts to begin to address burnout syndrome with sustainable solutions, and to pay greater attention to the loneliness and isolation at work that can result from burnout as well as exacerbate it.

Lisa Schinhofen contributed to the research and writing of this blog post.

This column will be a space for us to examine the broad range of scenarios and circumstances wherein loneliness and social isolation affect people. And although it’s become a social epidemic among Americans as a whole – nearly half of all Americans report feeling lonely or left out and one in four feel that they are rarely or never understood by others – certain populations, such as the elderly, the chronically ill and their caregivers, veterans, immigrants, and college students, are particularly susceptible. 

Going forward, join me and the UnLonely Project in exploring the effects of loneliness and social isolation on these communities and the individuals within them, and the variety of innovative approaches that can be used to foster a sense of connection to one’s self and to others. Together, we can forge new pathways to reduce loneliness and its burdens.

Listen Now!

On the radio: Jeremy Nobel, MD, MPH, Founder and President of The Foundation for Art & Healing, joins host Janeane Bernstein on KUCI 88.9fm