Burnout, work, and chronic illness

general descriptions of pain and illness

Advice for burnout, while sometimes varied, typically boils down to the same basic idea: figure out what's causing it so you can understand your options and make changes. The advice will also usually include something about taking a break to give you time to decompress and have some space. Which is nice, because—you know—everyone likes some time away.

It's not bad advice. Maybe it doesn't really get to the point of the matter, which is perhaps that—when it comes to work-induced burnout—capitalism is probably the root cause, and there's very little one can do about that on a personal level. But I suppose it's good enough for helping us make do considering the circumstances.

As you might've guessed, I'm pretty burnt out. According to Healthline's Guide to Burnout, I've got all of the signs:

  • Exhaustion: To be fair, I have chronic fatigue and illnesses that cause fatigue, but given I'm having to save all of my energy for work, waking up more tired than before I slept, and feeling completely depleted during the evening and on weekends... I think it's fair to say I'm exhausted.
  • Isolation: It's admittedly hard to say how isolated I am right now because we've been in a global pandemic the last year and a half, but I've had to force myself to communicate more with friends lately because I realized I wasn't doing it much.
  • Escape fantasies: My fantasies are very tame and not really worth talking about. But, tangentially-related, I've framed every medical procedure I've had in the last year as "time off" because I didn't have to work. My partner has had to remind me on multiple occasions that spending the day at the hospital is not, in fact, a day off. And, apparently, general anesthesia is not "a quick nap."
  • Irritability: Whether or not I've been irritable is maybe a question for my partner, but I am self-aware enough to acknowledge my fuse has been shorter and I've been quicker to get annoyed.
  • Frequent illness: I am currently dealing with a complex recurrence of cellulitis at my feeding tube stoma that's sent me to the emergency room three times over the last few weeks. Even 15 days of antibiotics didn't do the trick (it came back much worse, and it turns out it's a stubborn largely antibiotic-resistant pathogen), so I'm now on three different antibiotics in hopes they all knock it out together. Like an antibiotic Captain Planet and the Planeteers wherein the bacteria is polluting me...  I guess Gaia in this scenario? I don't know. I haven't seen Captain Planet since I was a kid, so I don't actually know what I'm talking about.

It's... a lot. And here's the thing: I've taken some time to examine my life to try to figure out the source of my burnout. While work certainly plays a role, it's not the main culprit. In fact, I'm pretty good at setting boundaries around my job to help prevent burnout.

The real issue here is that I basically have two full-time jobs, and I can't set boundaries around one of them. There's my job job, which has protections set by federal and state laws—and then there's taking care of my chronically ill body, which is unpaid, has shitty hours, and there's no such thing as time off. It turns out the standard advice for burnout doesn't really work when the cause is existing in one's own body.

It's no secret that I'm disabled. I have multiple comorbid chronic illnesses that make my life pretty hell.

This is the part where I'm supposed to pause, laugh that statement off as a joke, and then say, "It's really not that bad," in order to provide you, the reader, some relief from discomfort. But I'm not going to do that. When I say, "My chronic illnesses make my life pretty hell," I mean it.

(Despite what I just said, I do feel obligated to pause here and make a few things clear. First, I'm doing relatively fine mentally. I mean, yes, I'm depressed, but it's a pretty normal side effect of illness. I see a therapist weekly and journal somewhat regularly. Which is to say: you don't need to worry about my mental health right now. Second, saying "my chronic illnesses make my life pretty hell" doesn't mean I don't also have joys. It's not a binary thing. Don't make it one. Let there be nuance; it's not an or, it's an and.)

On a regular day, I wake up feeling like I haven't really slept. What little energy I have has to carry me through the day. I usually have joint and muscular pain pretty consistently throughout the day (and if you're non-disabled and thinking, "I have those too; it's normal for being over thirty"—we are not talking about the same thing).

Plus, there's the pain of having a feeding tube, which always sort of hurts and sometimes hurts extra. I've tried to come up with a suitable analogy for what my tube feels like, but the best I can come up with is what it actually is: it's like a permanent stab wound in my abdomen and plastic in my body where plastic should not be.

So there's the fatigue and the pain, which would be enough on their own. But then there's also the low blood pressure, high heart rate, and general dizziness that comes with having POTS (postural orthostatic tachycardia syndrome). And there's the reason I even have the feeding tube in the first place: the nausea, pain, and general digestive awfulness of gastroparesis. Oh, and the chronic fatigue that results in crashes after I do anything.

This is the short version of what it's like to live in my body day-to-day. I worry, by sharing it, that you'll pity me. I'm not looking for your pity. I really don't want it. Instead, I'm trying to explain that my situation just kind of sucks.

Especially so because I don't get to wake up each day and do whatever feels best for my body. Nope. This is the US of A, baby, and healthcare ain't free. I've got to work for it. You don't even want to know how much it costs to be me. (It's in the thousands each month.) I'm incredibly grateful and privileged to have a job with great health insurance benefits. And also I resent that it's something I have to be grateful for when it really just shouldn't cost this much to simply not die.

What do you do about burnout if there's no way to eliminate the source of it? My illnesses are chronic, which means I'll have them for the rest of my life. While the symptoms can be variable, my medical team doesn't expect I'll make a massive recovery. I'm already treating my conditions the best that I can.

I can't eliminate the source, so I have to look to reducing stress. But also I have very few options for reducing stress:

  • My great health insurance is tied to my job, so I want to stay where I am.
  • I could potentially reduce my hours while still having enough to be covered by health insurance, but I'm uncertain that the workload will actually change significantly. I don't think I need to work five full days to do all of my work (I'm industrious), but I don't have an option for a shorter work week that doesn't involve a pay cut; I don't want a pay cut unless the workload is different.
  • I do not have any energy to pick up a new hobby. I am barely just existing.

Last year, before I had my feeding tube surgically placed, I asked my doctor how much time I would need off of work to rest and recover. He told me I'd need a minimum of three months. I took three weeks. And I know! I know. I'd like to say that if had to do it over again I would make a different choice, but I'm not sure I would with the information I had at the time.

I only took three weeks because I didn't feel like I had other options. I had only been in my job for five months; I wasn't covered by FMLA (Family Medical Leave Act). While the ADA (Americans with Disabilities Act) provided protected leave, three months could have been seen as an undue burden—and also much of it would have been unpaid. It felt undoable.

And yet, it's possible I'm paying for that decision now. I know it's not just because of it, but I can't help but feel like not taking the time I needed then has fucked me over. I mean, I got a feeding tube. I had abdominal surgery that resulted in astronomical life changes. I needed time to figure out my new baseline and how to live with the changes—and I didn't take it.

Instead, I've just been trying to push through. I've been using up all of the energy I can muster on the daily and more. It's not sustainable.

So I'm doing now what I should have done last year; I'm taking a medical leave of absence from work. Given my current situation, my doctor has recommended at least eight weeks—and I'm listening this time. I have no goals for the next eight weeks (my therapist said that was important). I'm not even going to actively focus on trying to improve my health. Instead, I'm just going to rest, (hopefully) recover from this infection, and figure out what to do each day based on how I feel.

Do I feel some ill-placed guilt about this coming up so suddenly at work, especially when I have a newer team? Yes, definitely. But do I also trust that they'll be able to handle things and that the company won't fall apart because I'm out? Also yes.

My best friend suggested to me recently that it'd be great if I got to have some days where I didn't use up all of my energy. I had never even considered that as a possibility. Like, even now, I'm sitting here thinking about how weird it is that there are apparently loads of people who don't use up all of the energy they have just to get through a day. What a concept.

Anyway, maybe in the next eight weeks I'll get a glimpse of what it's like. 🤷🏻