SINGAPORE: One day at work, Ms Jamuna Raj was striking off “to-dos” from a neat hand-written list, thinking she had a lid on all her tasks at work. But the next day, she was bawling when her boss asked her if she was okay.

The 31-year-old, who was handling multiple roles in client management, events, editorial management and production in a small publishing house, did not know what sparked it, but it was the start of her journey towards realising that she was experiencing burnout.



“I was striking the to-dos off, but for every one that I did, there were five more. Still, because I was striking things out, I thought I could handle it,” she told CNA. At the time, she had multiple deadlines looming ahead of her.

Her boss had checked on her because she had changed and her colleagues noticed it, said Ms Jamuna, a Singaporean who lives in Melbourne. From being cheery, she had become withdrawn.

“As soon as he (her boss) asked me that, I started bawling. It wasn’t tears, it was straight-up ugly crying,” she said.



She was given a day off, but when she returned to work the day after, there was no improvement.

CRYING OVER EVERYTHING

“I went back, and I saw my emails, I cried. This went on for a few days. I was calling my husband and crying, going to the toilet and crying,” Ms Jamuna said.

Her colleagues saw what was happening and became concerned. They suggested that she see a therapist, something she was initially not open to.

“I was conditioned to think that seeking help for mental health like going for therapy has negative connotations,” she said. However, because her colleagues were empathetic and normalised it, she went. Her work-triggered emotions were also affecting her marriage and relationships, and she wanted to change that, she said.

The therapy sessions made her realise she was experiencing burnout. She still follows the strategies she learnt during these sessions on a day-to-day basis, she said. The biggest lesson, she said, was learning to ask for and accept help.

“Because I thought I had a handle on things, I didn’t want to trouble anyone else, and took it upon myself,” Ms Jamuna said.

Her company and colleagues were also supportive, which was important, she added.

She left the publishing house last year, close to two years after experiencing burnout, and now works as a project manager at another company.

BURNOUT FROM CHRONIC WORKPLACE STRESS

Ms Jamuna’s situation is being recognised by the World Health Organisation (WHO), which recently defined burnout as "a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed". This is the first time burnout has been related to work-induced stress.

In WHO’s latest catalogue of diseases and injuries, burnout is characterised by feelings of energy depletion or exhaustion, increased mental distance from one's job, or feelings of negativism or cynicism related to one's job and reduced professional efficacy.



It is currently defined as a “state of vital exhaustion".

General Practitioner Lye Tong Fong told CNA that when he encounters patients who are experiencing burnout, beyond giving them time to rest, he advises them to discuss their situation with their work managers.

“It’s always good to communicate, so that burnout won’t disrupt their work. Medical leave is a solution, but not a good one. It’s a short reprieve, but it doesn’t address the underlying problem,” he said.

It is not just shift workers or manual labourers who have seen him with signs of burnout such as difficulty in sleeping, loss of appetite, low energy level, anxiety and worries about work.

Dr Lye said professionals such as accountants, those in the creative industry and even doctors also experience burnout, he said.

It is not uncommon. At his clinic in Pasir Ris, he sees one or two such patients a week.

Psychiatrist at Gleneagles Hospital Dr Lim Boon Leng similarly sees two to three patients a week, he told CNA.

“I am seeing more burnout cases and I have been giving out medical certificates (MCs) to them. Ironically, many individuals would refuse to consume these MCs as they are either too committed to their work or are afraid of being judged negatively by superiors and peers,” he said.

PEOPLE IN CERTAIN PROFESSIONS SUFFER MORE FROM SYNDROME

While Dr Lim said “no one is spared from burnout”, people in certain professions suffer more from this condition, he said naming doctors, lawyers and teachers.

Psychiatrist at Nobel Psychological Wellness Centre Dr Marcus Tan said that most of the individuals who suffer from burnout tend to be high-functioning.

“Often, these persons over-identify with work and are convinced they have to take on whatever comes their way. At the same time, they also have difficulty turning down extra work that is assigned to them, even when they have a chance to do so,” he said.

He added that they lack work-personal life balance, have high workloads that frequently require them to work overtime and feel that they have little or no control over it.

COMMON SYMPTOMS AND TREATMENT

The individual continues to feel a lack of satisfaction, despite what has been achieved at work, Dr Tan said.

“In an attempt to cope with this, some may turn to alcohol, illicit substances or overeating to feel better,” he said.

Doctors also said that individuals experiencing burnout are also at higher risk of high blood pressure, cardiovascular disease and Type II Diabetes. If burnout is chronic, it can also lead to depression, if there is no outlet, they added.

In most cases, treatment of burnout involves taking time out from work to re-establish a self-care routine, Dr Tan said.

This includes prescribed rest or exercise and the medical management of emotional distress such as anxiety, depressive feelings and insomnia - if these symptoms persist despite having the individual having taken time out. Often, psychotherapy is required too, he added.

“Once the person feels better, an exploration into the conditions or factors contributing or pre-disposing him or her to burnout will be important to help improve understanding of what happened and formulate strategies to prevent recurrence,” he said.

WHEN BURNOUT IS NOT RECOGNISED BY A COMPANY

Family physician Mark Yap, who has a special interest in mental health, recalled a situation faced by one of his patients, a man in his 50s who had been working for more than 20 years with the same company.

He had asked for a memo from the clinic to take one-year of No Pay Leave as he needed a break from the stressful environment but it was rejected by his company, as they said burnout is not a medical condition.

The company told him it was not acceptable for him to take the time off and questioned his need for it, since he was still able to come to work every day and appeared normal.

“It is a very stressful job, and he no longer found joy in it. Instead, he was anxious about how the day would go, and whether he would have any interpersonal problems with the management,” Dr Yap said.

His medical records also showed a history of headaches, nausea, light-headedness and problems with sleep, Dr Yap added.

COMPANIES CAN SUPPORT BURNT-OUT STAFF

While Dr Yap’s patient recognised that he needed a break, Ms Linda Teo, country manager of ManpowerGroup Singapore, a recruitment firm, said that not many people will voice out if they are burnt-out even though they are more aware of the syndrome and its causes.

“This is partially due to the fact that some employees mistake burnout as feelings of stress. Additionally, some employees are worried that they will be judged as incompetent, thus not many will reveal their condition unless necessary,” she said.

She added with more employees doing work-related activities at home and on their mobile, employees who are unable to switch off their work mode are more likely to feel burnt-out.

“Some ways companies can support their burnt-out staff include encouraging them to use their leave entitlements and ensuring their workload is manageable to enable them to have sufficient rest, as prolonged stress is often the cause of burn-outs,” Ms Teo said.

She pointed to the banking industry as an example, as it is known for its mandatory block leave, where the company is not allowed to contact the employee and vice versa during this period.

Burnout can also be caused by employees expecting too much of themselves or having unrealistic expectations placed on them by their managers, she said.

To avoid this scenario, managers or employers can set realistic targets for the employees and ensure they understand what is expected of them to help balance their expectations, Ms Teo said.

Companies can also train their frontline managers to spot early symptoms of burnout in employees and how to respond accordingly.

Additionally, companies can encourage open communication and employee feedback to keep tabs on the workplace environment and possible burnout triggers, she added.

For Ms Jamuna, it was having such support from her boss and colleagues that helped her cope with her burnout.

She said: "When you are in it, you won’t know it. The onus is on bosses and colleagues as well."