Burnout, fatigue, depression, and DevOps

This post, published 8/30/2015, is a first draft and is posted specifically to solicit feedback. I admit the limitations in my knowledge and encourage medical professionals, psychologists, HR managers, employment lawyers, and career counselors to submit additions and corrections.

While at DevOps Days Chicago 2015, I was privileged to take part in a conversation about burnout, depression, and how to approach it with a DevOps sympathetic problem-solving attitude. Over the course of my life, I have had to face anxiety issues, emotional issues, and job burnout. I have had some luck with psychiatry, employee resources, good managers, and studies on my own, so I will share what I have learned over my journey. Hopefully this will help a struggling worker or a sympathetic manager to find ways of preventing or coping with burnout.

I will preface this by saying I am not a doctor or trained psychologist nor has this blog post been reviewed by any medical professional. Please don’t take this as medical advice and if you feel you or anyone is in danger of self-harm or harming others, call your emergency services (911 in the US) right away and they can find help.

Happiness

I like to tell people that there are only four things in the world that make anyone happy. Those are epinephrine, norepinephrine, serotonin, and dopamine. Everything else we do is a way of generating or balancing those four neurotransmitters. There are other things that exacerbate our reactions to things (for example: danger, physical pain, or high blood pressure can change emotional states) but the presence and balance of these four neurotransmitters are a good indication of  happiness.

This is important to know because all of the symptoms and states described below have some impact on brain chemistry. Neuropsychology is hard work and it is not my field of study so I'll leave the technical details. Just remember: If a person is exhibiting symptoms of stress, anxiety, depression or burnout, ask yourself, "Is this person unhappy because of a bad situation or is a bad situation arising from unhappiness?" 

It is possible for one to cause the other. If my brain cannot balance neurotransmitters and I become depressed, my depressive mind will reduce my motivation which will reduce my work performance. Conversely, my work life could be so bad that my brain sinks to a depressive state which manifests itself outside of work. When helping someone (or yourself) in situations like these, it is important to consider both the situation and the neuropsychology - and professional (psychiatrists, therapists, and career counselors) help is a good way to do it. 

Identifying the Issue

There are several things that can be happening when someone shows symptoms of burnout. They can happen individually or all at once. If you notice difficulty with concentrating or completing tasks, a lack of motivation especially to start new tasks or try new things, and a general lack of energy, you may say a person is burned out. The first reaction may be to attempt to find new motivation or to just take a break (and these help) but the layers beneath burnout may require fixing several things at once. Burnout, stress, anxiety, situational depression, and clinical depression all have ways of feeding each other.

Stress vs. Burnout

The first determination to make is between stress and burnout. They have different ways of presenting themselves and they require different kinds of help. Generally speaking, stress is the result of deadlines, pressure, and demands. Burnout is more of a feeling of hopelessness, apathy, and despair. Stress symptoms are physical and manifest as blood pressure, heart rate, headaches, and such. Burnout symptoms are more emotional and manifest as hopelessness, despair, and detachment. A stressed person often feels they can fix it themselves if they work hard enough, but a burned out person will see their problems as a permanent part of their job. 

Burnout vs Depression

Symptoms of burnout and depression manifest from both clinical depression and from what I call “occupational fatigue.”  That is not a medical term, but it does help differentiate the two. Occupational fatigue is specific and exclusive to work. The person simply has less energy to express interest in their job, company, team, or accomplishments. It could be due to a lack of motivation, team harmony, or goals. A person who is starting the road to burnout will likely just be tired of their job or surroundings and that is the easiest and fastest thing to treat. A change in duties, environment, team, or even employer can refresh someone who is dealing with occupational fatigue but it requires more patience and attention when it becomes pervasive and turns into depression.

Situational vs Clinical Depression

Major (clinical) depression, however, IS a medical term. It is a mood disorder explicitly outlined in the DSM with key symptoms (sadness, guilt, diminished ability to feel pleasure, sleep problems, and more) and has a well-established battery of psychological and medical treatments available. The non-medical term I use, "Situational depression" is what I call it when a depressed mood is less pervasive and long-lasting. Missing out on a promotion, getting a tiny raise, or having a big project fail can cause all the symptoms of depression, including symptoms you take home with you like insomnia and fatigue. However, clinical depression rarely has a single identifiable marker that triggers the condition. Another change in circumstances (a new project, a new path to advancement, or a new job) can clear up situational depression before it grows into a long-term, pervasive depressed state. Clinical depression is best treated with a psychiatrist who can provide both the medical and the psychological tools to cope and recover.

What can I do?

The information above is more useful to the individual employee who feels the symptoms of burnout. As a co-worker, HR rep, or manager, it will naturally be far more difficult to determine exactly which and how many states the employee is facing.

Not Everyone Needs A Solution

As an engineer in the DevOps world, I am accustomed to trying to solve a problem as soon as someone presents it to me. This person is talking to me because there is something wrong that may be in my power to fix, so my brain starts going down all the paths to the solution.

Feelings are not an engineering problem, though. Sometimes a person may approach you and talk about stress and anxiety just for validation, empathy, or venting. In this case, it's OK to ask directly if they're looking for sympathy or looking for actual helpful advice. In a work situation, sometimes all that is needed is someone to take your side and say "Yes, I agree that this sucks" in a bad situation. That way, the individual who is reaching out knows that the job may be difficult, but they are not alone in their feelings and are not crazy for being upset at a justifiably upsetting situation.

Privacy and Policy

There may be company policy and medical privacy concerns that will prevent you from looking too deeply into these matters, so it's best to check for HR policies before asking deep questions. If you have a co-worker who is showing symptoms of burnout, make sure to enter the conversation with a work focus. Talk about projects, schedules, on-call rotation, or goals and what changes they would make to the environment. If they volunteer outside information (like a bad medical diagnosis, family problems, or personal problems,) be as sympathetic as you can without crossing the borders of medical privacy or company policy. When possible, coordinate between the manager and HR to introduce/remind the employee of the resources available to them provided by the company like medical benefits and anonymous crisis/therapy call centers. 

Psychiatry and Medication

If an employee is seeing a psychiatrist and is put on psychiatric medication, saying "Take any time you need to deal with doctor appointments or side effects" is a great show of support, but "Did you see your doctor recently?" or "Did you remember to take your medication?" is both patronizing and infringing on medical privacy. Also remember that most psychiatric medications have a number of unpleasant side-effects and it may be valuable to expand work-from-home policies or other helpful programs. 

There is a big stigma around psychiatric diagnosis and especially medication. Highly intelligent people can still think a psychiatric problem is "a problem with how I think" and therefore "I can think my way out of it." Additionally, people who believe they are intelligent problem solvers may come up with some rationalization that will "explain" their feelings without ever having them examined by anyone else - much less a trained psychiatrist or psychologist. I thought exactly that way for a very long time until I realized that no amount of logic can change the balance of neurotransmitters in the brain. If a person doesn't have the ability (either temporarily or permanently) to properly regulate the happiness chemicals, that person will never feel happiness regardless of how good life is to them. Also, do not self-diagnose and do not self-medicate or self-treat outside of the care of a trained doctor, counselor, or therapist. You may do more harm than good.

The best argument I heard about psychiatric medication is one I credit to my mother: Patients with heart disease can help their situation through diet, exercise, and lifestyle changes but the problem is still medical and the only way to be TRULY SAFE is with medical treatment. The same is true with psychiatry. Medication can help alleviate the the hopelessness, lethargy, apathy, and guilt long enough for the patient to develop the habits needed to feel happiness again. Psychiatric medication doesn't cause happiness, but it can help chip at the walls that keep someone stuck in misery.

There are also plenty of good options for treatment that does not involve medication. I do not have any personal experience with neurofeedback, TMS, or other non-chemical therapy methods, but thee are a number of studies showing efficacy in those options. If one psychiatrist tells you the ONLY way to explore treatment is through medication or only through talk therapy, you have a choice and can talk to other psychiatrists as well. [Paragraph added from feedback - thanks Jared]  

Remember that the very best to do in the workplace is to remove the stigma or shame surrounding psychiatric care. Jokes about "being crazy" and "getting your head shrunk" may be met with laughs on the outside, but can tear someone up inside.

Employer Resources

Here is a short list of helpful resources that may be available through an employer that can help with burnout, depression, and anxiety:

  • Crisis or counseling hotlines.
  • Personal/sick days or work-from-home policies.
  • Career development counseling.
  • One-on-one manager-employee meetings.
  • Focus rooms (places where an employee can work in relative quiet, privacy, or without distraction - especially valuable in workplaces with those awful "open floor plans" that are so popular.)
  • Employee-led leadership exercises. (Giving an employee domain over a project is very empowering) 

You Can Only Do So Much

While a job in the DevOps world is full of both empathy and problem-solving, there is one crucial fact to remember: The only person responsible for an employee's happiness is that individual. A depressed, anxious, burned out, or stressed person who refuses to acknowledge it, seek help, or take advantage of helpful resources ultimately cannot be the responsibility of anybody else. There are people who will sit on a problem forever without attempting to fix it. 

As a teammate, your job is to offer sympathy, assistance, and resources but NOT take full responsibility for someone else's emotional state. If you throw a life vest to a person drowning in a river and they refuse to put it on, you cannot be blamed if they eventually drown. Likewise, if someone throws you a life vest and you do not try it on, you shouldn't be surprised if you eventually end up in water that's too deep.

On Suicide

There have been a number of suicides in this industry and there has been some worry that it is a result of the high-stress, high-results, fast-paced nature of the industry. While continued application of stress can lead to anxiety or depression, it is important to realize that suicide is NOT inevitable and is always an exceptional circumstance. 

Suicide has touched my life several times and I spent a lot of time reading and thinking about the subject. I will go against the flow of most of psychology and medicine (they are not my fields, after all) and say that I believe there are some suicides that happen which are entirely understandable and justifiable. For example: If a beloved grandparent spent over sixty years married to one woman, raised a big family, suddenly lost his life partner, and decides to end his own life, we can be saddened by it but we should not be angry or blame ourselves. Suicide happens when the pain of continued living entirely eclipses fear of death or possibility of pleasure in the future. 

It is extremely important to remind yourself that a person who is determined to suicide will find a way to do it. Short of locking them in a padded room tied to a gurney, there is nothing you can do to stop a person absolutely determined to take their own life. They are NOT thinking rationally so any rational approach you may possibly have offered will have been dismissed. 

The cliche "suicide is a permanent solution to a temporary problem" is often, but not always, true. Do everything you can to help someone and be especially sensitive to hopeless phrases like "I just can't do this anymore" or "This will never get better." If you can, try to show them how they CAN keep going and how it WILL get better. However, if they decide to leave permanently, do not assign blame. Especially not to yourself. I will repeat this, though: If you feel you or anyone is in danger of self-harm or harming others, call your emergency services (911 in the US) right away and they can find help.

Further Reading

I intentionally did not reference many academic studies or therapeutic guides. I wrote about what I know: what causes burnout, how burnout is different from other conditions that exhibit the same symptoms, and what we can hope to do if we face it in a DevOps team. I did not cover a lot of points in this post like:

  • How do psychiatrists treat depression and anxiety?
  • What can I expect from psychiatric care for depression or anxiety?
  • How do career counselors help people cope with burnout?
  • What are the medical and privacy laws that cover psychiatric treatment?
  • How does a team cope with a single individual who is facing burnout without having the feeling spread across the team?

Those are questions better suited for the doctors, lawyers, and managers who are trained to answer such questions. I will instead close with what I DO know:

  • If you ignore stress and depression, it will probably get worse.
  • There is nothing wrong with feeling stressed or depressed and seeking help is a POSITIVE move.
  • Be sympathetic, honest and open with your team, be fair to them, and be true to yourself.
  • YOU ARE NOT ALONE.