Burnout is universal but the right kind of sleep, food, and exercise can help

(written by lawrence krubner, however indented passages are often quotes). You can contact lawrence at: lawrence@krubner.com

Depression can end your career, end your marriage, and end your life. But long before most people find themselves facing a serious depression, they typically pass through an earlier stage, more mild and more subtle. What if we could all catch ourselves at that earlier stage?

I’m talking about burnout. Perhaps we can think of it as the mildest form of depression, or a mid-point between true mental health and outright depression. How do we identify something so subtle? Specific anecdotes are useful, because people need to be able to hear a story similar to what they are going through.

As I’ve gone through my 30s and 40s, I’ve been surprised at how many of my friends have suffered some kind of burnout. In fact, between the ages of 15 and 45, I would say that everyone I know personally has had at least one bad year. Back when I was in school, it seemed like some people were reliably happy, and other people were reliably depressed. And yes, many of those personality traits turned out to be consistent over several decades. But it was a surprise to realize that even the happiest people could fall into a dark spot. Some people are highly resilient, but no one is infinitely resilient.

I’m going to share some anecdotes, to illustrate some of the patterns of burnout I’ve seen, to help other people recognize when they are slipping into a dark place, in the hopes that such stories can help people catch themselves before they slip very far.

Some of you might be tempted to ask me something like, “Show me the peer-reviewed literature containing proof,” but then you’d be missing the point. I’m trying to talk about something too mild to get a diagnosis and therefore not subject to peer-reviewed studies.

Likewise, those of you who respond to this by saying, “Your examples are too diverse to be any one thing, they lack a coherent theme,” again, you miss the point. I am here talking about something too vague to get an entry in the Diagnostic and Statistical Manual of Mental Disorders. I’m using “burnout” as an umbrella term to refer to the many different ways people fall into a space that is somewhere between severe depression and true mental health.

Hopefully these stories are useful and illustrate some of the patterns by which people fall apart. Please add your own stories in the comments.

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One guy was hilarious. His friends loved his humor. When he got to college he joined a literary group and transformed it into a comedy club. They had a test one had to take to apply to the group, and he ensured the questions revealed the satire that became central to the group. For instance, one question was “Your moma’s ugly. You gonna take that?”

Some people were occasionally uncomfortable. There was an aggressive edge to his humor. He experimented with subject matter and delivery. Most of the time he got it right, and most of the time he left people laughing.

But something changed in his mid 30s. He would call up old friends and say harsh things to them. They would push back, they would express their surprise. He explained that he was just being funny. Couldn’t they take a joke? Why were they so serious?

Even when people said “You just insulted me. That really hurt.” he did not back down.

Some old friends made an effort to save the relationship. They would set aside time to talk to him about his new behavior. They would explain that he needed to be respectful. He would ask “Why are you trying to censor me?” He became strangely defensive — he felt persecuted.

One by one, he lost his friends. They all sensed that something had changed. He wasn’t funny any more, but rather, he was aggressive and very angry. And he couldn’t hide that fact simply by saying he was joking.

I later found out that he was facing a long period of unemployment.

A sad truth is that people under stress, lashing out at others, often feel they are being rational. They accuse others of being crazy. I wrote about this in You’re so irrational.

A man who alienates all of his old friends can not be in a good way. I’m not saying he was depressed, but I am saying he was slipping into an unpleasant mental space. A man who was once well liked thanks to his humor was now lashing out with rage, and trying to disguise it as humor. Something had gone badly wrong.

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I know a woman who started her career doing video work for commercials. She was living in a college town in one of the southern states of the U.S. Local businesses reached out to her to produce and edit 30-second and 60-second ads.

One of the sub-cultures that thrived in her town struck her as interesting enough to justify a documentary. For the next two years, she was busy interviewing people in that scene. She ended up with a popular 80-minute film, which she took on tour. She was a hit at SXSW. Eventually PBS contracted with her for a 58-minute version. Her documentary is still available on Netflix, where it has a small cult following.

Two years of touring and promotion went by, and she did well, in terms of both money and reputation. Then the question arose: What next?

Out at a bar, her friends would buy her drinks and nudge her. What was she working on? She’d go to parties and hear, “I loved your film! What are you doing now?” At one point she told me, “Once you’ve had a hit, you just want more hits. You want your career to go up, not down.”

Panic crept into her life. She had hundreds of ideas but she wasn’t sure if any of them would be as good as her first film. She imagined how cruel and derisive people would be if her next film was a bomb. “A one-hit wonder” would become her sobriquet.

She spent more time going out. “I just need to relax,” is what she told everyone. People assumed she was blowing off steam after too many long hours of work. But in fact she was working less and less. She was paralyzed by fear.

Finally, she decided she would do a documentary about spirituality in Peru. For a year she traveled the country interviewing those who practiced traditional rites. But why was she doing this? Would the viewer wonder? Should she put herself in the film? Was it necessary or entertaining for her to describe her own views?

The critical voices in her head grew stronger. Could she really translate traditional spiritualism in a way that North Americans would understand? She was an outsider. Surely someone from Peru could produce a better version of this film? Surely someone who better understood the language would have more insight? Why was she here? What was she doing?

She returned to the U.S. She went to parties or bars seven days a week. After a while she felt she was running away from the project. She was never an alcoholic, but it struck her that she was drinking for unhealthy reasons. She stopped drinking. But this did not help deal with the stress. In the space of a year she dove into a romantic relationship, got married, had a child, and forgot all about doing documentaries.

I could tell similar stories about many of the artists I’ve known.

90% of everything is junk. And 90% of the ideas we have are stupid. Maybe 99%. One of the most difficult things about being a creative person is that you have to balance the generation of new ideas with a critical voice that weeds out the stupid ideas.

And most artists fail in either direction: either their critical voice is too weak and they think every idea is awesome, so they produce a large amount of junk, or their critical voice is too strong, and so they come to feel that everything they do is stupid and worthless. These artists become their own censors, they go to war with themselves, they set fire to the civilization in their mind that would otherwise generate new ideas.

It’s the rare person who finds the perfect balance, and this is why great art is rare.

An episode of extreme perfectionism should be thought of as a kind of burnout. The stress gets to you, and you become hyper-critical of your own ideas. And while the specifics look a bit different for computer programmers or lawyers or doctors, the underlying psychology is the same – a person pushes themselves to be better and better, till they are reaching for an impossible ideal, at which point they panic and realize they will never be good enough. The surgeon who is no longer able to do surgery, the lawyer who has lost confidence in the courtroom, the computer programmer who is terrified what other people will think of their code – in every case, it is a kind of burnout, in response to too much stress.

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My client Sen was creating a new startup, and he needed to find someone skilled who could be his CTO. A number of candidates had come forward, through various venues. Sen had a reasonable exchange with a guy named Lev. As adviser, I was asked for a second opinion.

Over at Turkish Kitchen on 3rd Avenue, Lev and I introduced ourselves and chatted about our startup experiences. For some years, he’d been working as the lead technical person for a startup that was slowly building a customer base, selling software for online ecommerce.

Surprisingly, he was entirely transparent about how much he felt disrespected by Aaron, his current CEO. Suppressed rage was the underlying theme. We spoke for two hours, and he spent much of that time complaining.

He was working 80 hours a week. The pay was low. As the top technical person, he felt his title should be “CTO” rather than “lead engineer.” He’d been offered stock options, but they’d been diluted when they raised money, and he suspected they would be diluted more in the next round. Aaron kept deciding to pivot the company, and he expected Lev to reshape the technology to meet their new objectives. The deadlines were impossible. Lev voiced concerns about the buildup of technical debt, but Aaron didn’t listen.

I was puzzled by this narrative, as it made Lev sound like a passive victim, with no ability to shape events. Why didn’t he simply say no to the deadlines? Had he tried? What would happen if he did? Clearly, he felt that he was underpaid, overworked, and unheard. What was he doing to change that?

Lev had a fair amount of pent-up rage, but he was not expressing it in a clear and confident way. It seemed like he needed to confront the CEO, demanding more money and more control over the deadlines. An important responsibility of the CTO is to say “No” to the CEO. No, we can not make that deadline. No, we can not add that feature. No, we can not outsource this work. If the CEO didn’t want to respond to reasonable requests, then it was time to leave.

For some reason, Lev was afraid to have a confrontation. Instead, he was pushing himself harder and harder and becoming more and more angry. And to top it off, he was undermining his own career – because in this case, when he went to meet someone new (me) about a potential new job, he spent hours venting his frustrations, rather than advertising his strengths.

Needless to say, I did not recommend him to my friend Sen. I can be a sympathetic listener, but still, it was a bit odd that Lev treated our first meeting as a kind of therapy session, where he felt free to vent. As an alternative, I thought it would have been wise for him to hire a life coach or go see a therapist, both perfectly reasonable options.

Whenever you find yourself so angry with your life that you vent to anyone who will listen sympathetically, you are certainly dealing with a degree of burnout.

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In my book “How To Destroy A Tech Startup In Three Easy Steps,” I wrote about Milburn:

There wasn’t much about Milburn online, but I looked over his LinkedIn profile, and I looked up the companies that he had been active with. Lying comes naturally to great salespeople, so I wasn’t surprised that he’d been successful in that field. But what did that really mean? A great salesperson has a repertoire of psychological tricks. They can make you their friend, or they can make you feel guilt; they know when to offer a compliment; they also know how to disguise a negative comment as a neutral observation and thus undercut the confidence of their prey.

Milburn’s career had apparently done especially well during the 1990s. I wondered if he was now feeling stuck. Stagnancy in middle age leads to all kinds of wild adventures — usually a romantic affair or an expensive car — but perhaps it was Milburn’s style to try to launch a business. Anything to revive that old feeling of success.

Apparently he was also somewhat technical. He’d learned Microsoft Excel in the 1990s, and he knew some VisualBasic. Perhaps he’d written some VBA code and connected some Excel spreadsheets to some databases. He knew more about computers than the average salesperson. From the sounds of it, he knew exactly enough to be a disaster.

And he started a business for all the wrong reasons, and it ended in disaster. His motivation wasn’t so much excitement about the project, as a hatred of what his life had become, and a desire to escape to some happier reality. Motivations are important. If he’d been excited about the project he would have dived into the details, and learned what was necessary to build his idea into a success. Instead, he started the company as a vehicle for an escapist fantasty, and at key moments, when he had to make strategic decisions, he made the wrong decision, because he hadn’t bothered to learn enough of the details to understand what was really needed. And I believe that in the end, after two years of effort, he was left even more depressed than when he started. If the whole project had been an attempt to revive the old feeling of success, how much more awful it must have been to face yet another defeat?

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Sometimes you have no option except to work insane hours. This is especially true if you decide to become a doctor. I had several friends who became doctors in the state of Virginia before 2006. At times they had to work 110 hours a week. In 2006 the government of Virginia changed the law, declaring that medical residents could no longer be asked to work more than 80 hours a week. That made life a bit easier for my friends, although even 80 hours a week, for several years, is extremely hard to bear.

I had a friend who ran up $390,000 in student debt while trying to get through medical school. She was supervised by an older doctor who hated her. The doctor would insult her intelligence, her skill, her looks, her background and her manner of speaking. My friend would go home (when allowed, which was rare) and cry. For years, it was normal for her to cry herself to sleep.

She told me she wanted to drop out of school, but she had no way to pay her debt, other than becoming a doctor. Somehow she pushed through. As a doctor, she’s established a good reputation. All the same, her school experience was traumatic, and I think it still haunts her, even now, 12 years later. She was in a relationship for awhile, and she had a child, but the relationship fell apart. She is professionally successful, but in other ways her life has not come together the way she once hoped.

I could write an essay suggesting that these kinds of hazing rituals are stupid to have, especially in the medical industry, but that would be a different essay, so I’ll leave that subject alone for now.

The question is, if you have to work insane hours, and have no option about that, and no way to cut back, then what else can you do to try to keep your sanity? Defaults matter. Only the force of habit can carry a person through a long era of stress. Studies show that chronic sleep deprivation damages our ability to make good decisions, and most medical schools have curricula that are explicitly designed to test people’s abilities to survive prolonged episodes of sleep deprivation. In such situations, what sort of defaults can you put in place that will keep you as healthy as possible? Can healthy food be made a default? There is no time to cook, so the question is, can you find a source of healthy, prepared food? Can you make it a default to go to that source of food?

What about clothing? Can you find a reliable source of professional attire, perhaps a favored brand that you know suits you most of the time?

Are there things you can do to maximize the chances that you will fall asleep quickly, when you are lucky enough to catch up on your sleep? Perhaps you should get rid of your television, and cancel your subscription to HBO and Netflix and Hulu. Get rid of anything that might keep you awake. You need to design your life so that you can get to sleep.

Remember, you won’t have much time or energy to make good decisions, so as much as possible, you need to find an okay choice that is easy for you, because it needs to be the default, the thing you will do when you are too tired to think clearly.

Obviously, a person is lucky if they have a loving romantic partner to help them through such an episode, but everyone I know was single when they went through medical school. And it wasn’t a great time to meet people, as they had so few free hours.

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Here is my own personal story: I lost a year after my father died of cancer. He died at the end of 2007, and for all of 2008 I was in a fog, lost in grief.

There had been a long stretch of many years when I really loved software development. I would work 70 hours a week simply because I thought writing software was so much fun that I didn’t want to do much else. Also, the money was good. My business partner and I had our own web design agency, and we had more work than we could handle, with clients we loved. After my father died, however, I had trouble concentrating. I would daydream a lot, but not the kind that were useful. (See what I wrote in Commercially viable daydreams versus distracting fantasy.) I was very close to my father, and when he died I lost one of my best friends. It hit me hard. I found myself more anxious. Even 30 hours of work a week now seemed like too much.

I started playing video games. Not even good ones, just whatever random ones I found on whatever machines I had access to. I discovered that my dad had SimCity on his machine, and I started playing that. I think I played it for maybe 40 hours in one week, as if that was my full-time job. Around that time, Desktop Tower Defense came out, and was mentioned on TechCrunch, and then I lost two weeks just playing that, over and over again. I’d never played games before, except at Thanksgiving when visiting friends who were into Halo, and now suddenly the games took up much of my waking hours.

I have nothing against video games; I have friends who play Halo and they seem to have fun with it. But I think video games can be like alcohol – a little bit is fun and too much is dangerous. At least for my long-term life goals, I think it’s best if I avoid all video games, but for several months I was playing way too much.

Reality was painful. I wanted to be distracted from reality.

Several things helped:

1.) I got more serious about running. In 2009, I ran more than 50 kilometers a week, every week, for the whole summer. I was in the best physical shape that I’d been in years. This helped.

2.) I did a long fast, going several days without food. Just water. This helped me clarify some things.

3.) For a while I took Paxil, and for a portion of this time I saw a therapist. This interaction was an education for me. I initially went in and I pushed him for what amounted to productivity tips. But ultimately I realized that is not what a therapist is for. During my first few sessions, I kept asking him, “What should I do to get back to work? I really need to get back to work.” He, in turn, kept redirecting the conversation. “Why aren’t you working? What stops you? Are you sad? Let’s talk about that.” My conclusion: therapy can be helpful, but you can’t go into it thinking that it’s simply a matter of getting a little advice.

On the issue of advice: that is what a life coach (or a career coach) is for. When do you need a life coach versus a therapist? I find that to be a subtle question. I think in many ways they offer something similar – someone to talk to, someone who can give you a more objective perspective. If I had to create a bright line rule, I would say that a life coach is appropriate when your life is going well, and a therapist is appropriate when your life is not. But most of us are facing a mix of those trends, the majority of the time. In 2008 my career was going great but I was grieving the loss of my father. Some things in our lives are good, and some things are bad — that is the common condition. I suppose one should default to seeing a therapist since the label of “life coach” is new and poorly regulated. Though in all matters of personal help, what tends to matter most is finding someone who understands you, and that is a rare thing.

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How to protect yourself from burnout? Let’s talk about 4 things:

1.) food

2.) sleep

3.) exercise

4.) contemplation

I’ll go through this in order:

FOOD

Of my friends who have suffered burnout, some of have consumed too much alcohol and some have smoked too much weed, but neither of those was a universal experience. What was a universal experience was bad eating – either bad food or too much food. Often both.

Chris Dillon has a post that touches on part of this issue:

After a long soul-destroying day, people seek relief in drink or junk food. As James Bloodworth writes:

When we walked through the door at midnight at the end of a shift, we kicked off our boots and collapsed onto our beds with a bag of McDonalds and a can of beer. We did not – and nor have I met anyone in a similar job who behaves this way – come home and stand about in the kitchen for half an hour boiling broccoli. Regularity of dietary habit is simply incompatible with irregularity of work and income (Hired, p52)

For me, irregularity of sleep is the most likely thing to cause me to eat badly. I don’t have any food discipline when I’m sleep deprived.

I think it is common that people eat badly when they are under a lot of stress, and this further undermines their physical and mental health, causing a spiral downward. But the process is not inevitable. As I said, if you can find a way to make healthy food your default option, something that is easy to get even when you are exhausted, then at least this one part of your life can go well, and that can be the start of a process whereby you turn around other aspects of your life.

Also, for me, when I’m under stress, I tend to eat too much. So for me, the most powerful form of self-care that I have discovered is fasting. After months working hard on a project, I’ll find a week when I can go without food. Seven days of nothing but water is the most powerful form of rejuvenation that I know of. And I don’t usually use this kind of rhetoric, but going without food is purifying in a literal sense — your cells will engage in autophage, meaning they will break down the proteins inside of them and recycle them. All kinds of intra-cellular structures that are sitting there, a waste of space and resources, suddenly get taken down and used for something important. I’ve read that before the Industrial Revolution, most humans suffered famine for about 10% of their lives. So our bodies are built for famine. Our bodies are not built for a world where you can go into a grocery store and get food whenever we want. Fasting is something our bodies need.

SLEEP

Lack of sleep is like sex or drugs, it can be awesome or terrible, depending on the overall context. Like if you go out with friends and have an amazing night, and have a few drinks, that doesn’t mean that you have a drinking problem. But if you are sitting alone at home, and you drink because you hate yourself, then you probably have a drinking problem. The context matters. When I was building my first business I had a lot of fun, and sometimes I worked crazy hours. I recall I once worked 20 hours, then slept for 3 hours, then worked for another 20 hours. Excitement carried me forward, adrenaline kept me focused. Everyone once in a while I’d crash and sleep 12 hours. The lack of sleep doesn’t seem to cost much so long as we are having fun. But often we lack sleep because of circumstances, such as my friends who had to work 110 hours a week because they were in medical school. In such terrible situations, the only thing we can do is to try, as much as possible, to make sleep easy, whenever we get a chance. Avoid habits that will keep you awake when you have a chance to sleep. Avoid television and video games, limit the type of stimulants you take, turn off your phone, limit the amount of time your friends are allowed to talk to you.

Also, consider how well you handle the lack of sleep, before you enter into circumstances that you know will leave you sleep deprived. My friend had no option but to continue with medical school, because she had no other way to pay off $390,000 of school debt, especially since the laws in the USA make it difficult to get out of school debt. If you don’t think you can survive several years of sleep deprivation, don’t try to become a doctor.

EXERCISE

Consider this, Exercise is an all-natural treatment to fight depression / Exercise is as effective as drugs in some cases.

Exercising starts a biological cascade of events that results in many health benefits, such as protecting against heart disease and diabetes, improving sleep, and lowering blood pressure. High-intensity exercise releases the body’s feel-good chemicals called endorphins, resulting in the “runner’s high” that joggers report. But for most of us, the real value is in low-intensity exercise sustained over time. That kind of activity spurs the release of proteins called neurotrophic or growth factors, which cause nerve cells to grow and make new connections. The improvement in brain function makes you feel better. “In people who are depressed, neuroscientists have noticed that the hippocampus in the brain—the region that helps regulate mood—is smaller. Exercise supports nerve cell growth in the hippocampus, improving nerve cell connections, which helps relieve depression,” explains Dr. Miller.

If jogging helps with depression, it probably also helps with burnout. The problem, of course, is where to find the motivation, which tends to be the first thing that goes. Indeed, I suggest many people who spiral down into a dark place go through steps such as these:

1. burnout

2. loss of motivation to eat well, get good sleep, and get exercise

3. loss of resistance to bad habits, bad food, watching too much television or Netflix or HBO or Hulu or playing too many video games

4. depression

In other words, the loss of motivation to do all the good stuff is probably the main thing that opens that trapdoor through which some people fall a great distance. So if, a year ago, you were good about jogging, and now you are burned out, and you can no longer motivate yourself to go jogging, what can you do? I’d suggest that you should always do exactly the positive thing that you can motivate yourself to do. For instance, maybe you are sitting at your apartment, and you can not convince yourself to go jogging, but can you convince yourself to go for a walk? That’s still better for you that staying home and watching Netflix till 4 AM. Every minute you are walking is still a minor bit of exercise, and it will let you go home and get good sleep, versus staying at the apartment and playing some video game all night, and facing the next day badly sleep deprived. And if you can’t motivate to even go walking? What about doing the laundry? What about taking a shower? What about shaving? What about cooking food? No matter how burned out you are, try to find something positive you can motivate yourself to do, something that still represents some kind of self-care.

CONTEMPLATION

This is obvious, but if you’ve been through some stressful times, maybe you should slow down and spend more time with friends or family. Read a book. Go for long walks through a park. Perhaps writing things helps you organize your thoughts. Perhaps talking to an old friend helps you process the scramble of emotions you feel regarding recent events. Perhaps prayer comforts you. Perhaps meditation centers you. Everyone is different. What works for one person won’t work for the next. Some people find meditation a powerful practice, others are driven insane by it. All of that is obvious. What is less obvious is when these practices are insufficient.

After terrible times, people sometimes need more succor than they can draw from ordinary activities. Never feel ashamed if you think you need to talk to a therapist. Too many people avoid this option because they see it as shameful or weak. Sometimes we talk too much with our friends, when we actually need to speak to someone who is highly trained. Men in particular fall into the vice of treating their girlfriends as amateur therapists, but girlfriends are bad therapists, simply because they are untrained. Women sometimes vent their stresses to their boyfriends, but if they do it too often, they get the label “high maintenance” so they don’t do it too often. This mistake is more common with guys, simply because they face less criticism for the indulgence. But few people really want to bear the burden of their lover’s depression. It’s better to talk to a professional.

If one’s burnout is mild, and if one is merely reacting to professional setbacks, then it may make more sense to talk to some kind of life coach or career coach or mentor or an old professor with whom you had good rapport. If you think you would bounce back if only your career was going a bit better, then indeed a career coach might be the most effective use of your time. Those who are religious might prefer to speak to their priest or minister. One has to find someone trustworthy, who has experience counseling others, and who can be reasonably objective. Venting your emotions can offer a powerful relief. But you need to find the right person with whom to do that. If you’ve been through something highly stressful, the right person is probably not your friend, lover, or family member. Find someone with professional experience in counseling others.

If you feel you need a therapist, the question then becomes, “How to find the right therapist?” If you are lucky enough to have the money or good insurance, I strongly recommend that you go to 3 or 4 different therapists, at least once, and see if you click with any of them. In some sense, there are no “generally good therapists” there is only the therapist who is good for you. One therapist might be great for someone else, but terrible for you. It’s a very unique relationship, and it takes some work to find it. But if you lack the money or insurance that might provide you with the option to try several therapists, then another option, not quite as good but cheaper, is to go online and talk to others who suffer your particular version of burnout, and ask them if they would recommend someone in your area.

Also, if your struggles overlap with the kinds of struggles that are addressed by any kind of 12 Step program, then going to the local chapter of that 12 Step program is almost always going to be your best bet.

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Everyone is unique and everyone who recovers from burnout does so in their own way. There are some basic things we can do to take care of ourselves. Sometimes that is enough. Sometimes it isn’t enough. If you find the years are going by and you still can’t bounce back to where you were before, don’t be angry with yourself. Hatred of one’s limits is itself part of burnout. All you can do is take care of yourself, to the best of your ability.

I’ve tried to share some stories of people I know, to show different patterns of burnout. I invite you to add your own story in the comments.

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