Navigating PTSD and Burnout for COVID-19 Healthcare Workers

Burnout is a state of exhaustion, both mentally and physically. While it’s not an official diagnosis, burnout is a real phenomenon triggered by stress. Some amount of stress can be beneficial, pushing us to accomplish tasks. When stress is excessive and prolonged, however, it can lead to burnout.

Stress that triggers burnout can come from a number or sources, but for healthcare workers it is related to the pandemic. Signs of burnout include:

• Exhaustion and fatigue without much relief
• Headaches and muscle pains
• Changes in how you eat or sleep
• More frequent illness due to lowered immunity
• A feeling of being helpless or trapped
• Feeling detached
• Low motivation, increased apathy and procrastination
• Withdrawal from responsibilities and loved ones
• Lashing out at others
• Avoiding work
• Self-medicating with alcohol, drugs, or food

Studies conducted this past summer found that healthcare workers experienced increased burnout during the first wave of the coronavirus pandemic. The studies found that rates were higher for women than men.

As the pandemic surges again, healthcare workers report increasing burnout symptoms. They also report something worse than usual burnout. During normal times, burnout results from unmanaged stress. Now, workers are more than just overworked; they also face:

• Uncertainty and fear for personal safety
• Financial worries
• Helplessness in the face of so many patients who cannot be saved
• Fake news and conspiracy theories claiming COVID-19 is a hoax

The burden placed on healthcare workers is huge. Many were already overworked before the pandemic and struggled with stress and other mental health issues. The problem is amplified as hospitals fill up and beds become scarce. As a healthcare worker, there are steps you can take to learn to navigate this situation:

• Accept what you cannot control. A major trigger for stress is the feeling of being out of control. Being able to accept that you cannot control everything reduces stress. Do the best you can with what you have and what the situation allows and try to let go of the rest. Healthcare workers want to save everyone, but it simply isn’t possible.
• Set boundaries. You may need to work a certain number of shifts to earn a living, but beyond that you can control your own boundaries. Set a strict boundary between work and home, for instance. Don’t talk to co-workers until your shift and immerse yourself in family and personal activities when home.
• Find outlets for stress relief. Once you leave a shift, do what helps you feel better. A physical outlet is often most useful. Do a tough workout, go for a run, or go for a walk. Stress and burnout are both mental and physical. As you release stress through your body, you will feel better mentally.
• Rely on your support network. If you get home from work only to find you have more chores and tasks you don’t have the time to do, count on family and friends to help. They know how hard you work and will be happy to step in and do some laundry, make you dinner, or go grocery shopping.
• Talk to someone. Don’t try to bottle up your feelings and be strong. Talking to a friend about your struggles will be a huge relief. If that isn’t enough, consider talking to a mental health professional. They can listen and provide you with healthy coping strategies.

As researchers continue to investigate the effects of the pandemic on healthcare and frontline workers, a new trend has emerged: trauma. One review of studies found the prevalence of trauma and trauma-related stress is as high as 35 percent in healthcare workers, especially nurses and female workers. The researchers discovered three types of traumatic experiences among healthcare workers during the pandemic:

1. Acute stress reactions. Acute stress is an immediate reaction to a situation. Healthcare workers are susceptible to acute stress from working with COVID patients. Many experience trauma-related symptoms as a result, including avoidance, intrusive negative thoughts and memories, irritability, and reactivity.
2. Vicarious traumatization. Trauma does not always result from something that happens directly to you. It can be something you see happen to another person, and healthcare workers are watching record numbers of patients suffer and die. Workers with this kind of trauma experience fatigue, loss of appetite, fear, sleep problems, and relationship conflicts.
3. Traumatic stress. Post-traumatic stress disorder, or PTSD, causes avoidance, intrusive thoughts, and hyperarousal. Many healthcare workers have these symptoms, even if they do not receive a PTSD diagnosis.

Another study found that certain risk factors make some healthcare workers more likely to develop PTSD or related symptoms: being younger, being female, being unmarried, quarantining or being isolated, and having a previous or existing mental illness.

Some healthcare workers will develop PTSD from the pandemic. Others will have trauma-related symptoms. Preventing them may not be possible, but managing and treating symptoms is. If you have risk factors for being adversely affected by trauma, pay attention to your symptoms, mood, and behaviors. The sooner you get treatment, the better. It can prevent the onset of full-blown PTSD.

Recovery from trauma disorders requires professional care, but you can also take other steps to manage the impact of trauma in healthcare work. Use stress-reduction strategies daily, even when you have a minute break at work. Deep breathing, visualization exercises, and meditation can reduce stress significantly and instantly.

Also important is time spent with friends and family. Trauma and PTSD tend to make people feel isolated and withdrawn. Spend time with people who care about you and who can distract you from the current situation. Laughing and having a little fun in the midst of so much trauma is not disrespectful; it’s a healthy coping strategy.