How to Prevent Burnout for People with ADHD

Burnout is defined as “a state of exhaustion resulting from prolonged and excessive workplace stress” [2]. Although burnout is typically associated with mentally and emotionally demanding jobs such as nurse, social worker, and teacher, people employed in any occupation are vulnerable to burnout under the right conditions. An emerging body of research indicates that neurodivergent people may be at greater risk of burnout, due to the added strain of maintaining strict control of behaviour in everyday life and not just at work. More on that later. Physical and mental health outcomes of burnout are invariably negative: with burnout predicting depression, anxiety, reduced performance and self-esteem, and physical illness [7].

So, how do you know if you’ve got burnout?

Researchers have identified three main categories of burnout symptoms: emotional exhaustion, cynicism, and low sense of personal accomplishment [1]. Emotional exhaustion refers to a sense of physical or emotional depletion and stress; this category of symptoms is perhaps what most people think of when they think of burnout. Here are some symptoms of emotional exhaustion:

· A sense of being emotionally drained

· Frustration towards work and work-related tasks

· A sense of being overworked

· Dread at the prospect of going to work

· Having ‘nothing left’ to devote to leisure activities after work

Cynicism is another key facet of burnout. It refers to dissatisfaction and apathy towards one’s job. Here are some symptoms of cynicism:

· Being uninterested in work tasks

· Frequently questioning the usefulness of the job you do

· A significant reduction in positive emotions or enthusiasm towards work

Finally, there is low sense of personal accomplishment, which is associated with:

· A sense of incompetence

· Feeling that work being done is not productive

· Lacking a sense of achievement at work, and feeling little satisfaction in achievements

If you have ADHD, you may have already noticed that many of the symptoms under ‘emotional exhaustion’ and ‘low sense of personal accomplishment’ are almost universally relatable to people with attention and concentration difficulties. ADHD itself is of course separate from burnout syndrome, but the two are linked in a few important ways. For example, low sense of achievement is linked to the sustaining effect of procrastination on the burnout cycle, described below.

The Burnout Cycle

Work demands outstrip our ability to meet those demands, which leads to stress, which leads to poor job performance and procrastination, which leads to accumulating demands, which in turn leads to work demands outstripping our ability to meet those demands. Feelings of inadequacy and low self-efficacy, symptomatic of low sense of personal achievement, are a natural consequence of this self-sustaining cycle [8].

Emotional exhaustion is also linked with ADHD, as research on burnout in neurodivergent people will tell us. Many of us with neurodivergent conditions can relate to the notion that both work and everyday social situations require us to monitor and correct (ie. mask) our behaviour to a substantial degree. Researchers have identified the causal risk of masking as a separate type of burnout known as ‘autistic burnout’, but as we know masking is also common in people with ADHD [4].

With this in mind, here are some practical strategies to prevent burnout before it happens and tips on what steps to take if you realise you already have burnout.

How to prevent burnout before it happens

1. Find ways to reduce the ambiguity of your role at work

Role ambiguity is when you are unsure what the limits of your role at work is. This state has been repeatedly shown to contribute to burnout [3], with employees who know exactly what they are expected to do at work tending to be less stressed than employees who don’t know where their job ends and someone else’s begins.

2. Identify and resolve conflicting demands

Performing at your best is never easy to sustain – but when performing well at one task necessitates falling behind on another, it is time to pause and re-assess rather than powering ahead. Conflicting demands can be between work life and home life, such as having an important family commitment consistently overlap with important work dates, or it can be between work and work – such as working on two highly demanding projects at once.

3. Interrupt the burnout cycle at the stage of your choice

Depending on your circumstances, it may be easiest to start by spending a day catching up on your tasks (accumulating demands), speaking to your manager (work demands), or reducing stress. Something you can action right now is to practice self-compassion – the negative self-talk that tends to accompany professional burnout is emotionally exhausting and unproductive. We have a few tips to help you replace self-criticism with self-compassion.

4. Find time to reset between work and life

Autistic burnout theory tells us that the additional strain of carefully managing neurodivergent behaviour in everyday life can contribute significantly to the development of burnout at work. However, the risk of burnout shouldn’t mean you are forced to change the way you spend your leisure time. Instead, take a moment to reset when transitioning between times when there are demands on you and times when there are not - e.g. work and home, or home and a social event.

If you realise you are already suffering from burnout, here are the next steps

1. Develop a routine that works for you

The demands employment places on us can be overwhelming, but sometimes even more overwhelming are the demands we make for ourselves. If you have burnout, it is time to evaluate how you schedule your days and weeks. This article has some helpful tips on managing a routine.

2. Create a dopamenu

Dopamine is a neurotransmitter best known for its relationship with motivation. A well-functioning dopamine system helps you to motivate yourself to do things you would otherwise prefer not to do, such as spend a weekend concentrating on a difficult project, by giving you a feeling of pleasure as a reward for task completion. We know that ADHD interferes with the functioning of the dopamine system. Still, research also suggests that dopamine plays a role in burnout, as those suffering from burnout have lower dopaminergic function compared to healthy controls [9]. To stay motivated, you can simulate better dopamine function by creating a 'dopamenu' of pleasurable activities that acts as an external source of reward to replace the internal reward that dopamine would have provided.

3. Evaluate your circumstances and make a plan

Burnout is not, by itself, an indication that your job is not right for you. However, if you feel you have tried everything and still find that your place of work is impacting your health, it may be time to plan a route toward a less stressful job. This could be as minor as going part-time, or as major as changing employers. Something you can action right now is to speak with your manager or HR department and report how you feel – if your workplace does not know how you’re going, they won’t know to reduce your demands. Organisational changes made by employers have been shown to be highly effective at improving burnout outcomes [8], so taking your burnout symptoms up with a trusted advisor is worth the inconvenience.

Research supports the notion that ADHD is associated with an increased likelihood of burnout; however, many of us with ADHD have an advantage in that we are already well attuned to detect feelings workload stress and overwhelm. Therefore, we can better pick up the signs of burnout before they reach an unmanageable point. Even small changes can improve your stressof levels considerably, so there may be no need to restructure your work life entirely. Instead, consider which of the strategies suggested in this article are best for you and implement them to the extent you feel comfortable. Take care, Meriel

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References

1. Aronsson, G., Theorell, T., Grape, T., Hammarström, A., Hogstedt, C., Marteinsdottir, I., Skoog, I., Träskman-Bendz, L., & Hall, C. (2017). A systematic review including meta-analysis of work environment and burnout symptoms. BMC Public Health, 17(1). https://doi.org/10.1186/s12889-017-4153-7

2. Bayes, A., Tavella, G., & Parker, G. (2021). The biology of burnout: Causes and consequences. The World Journal of Biological Psychiatry, 1–13. https://doi.org/10.1080/15622975.2021.1907713

3. Ghorpade, J., Lackritz, J., & Singh, G. (2011). Personality as a Moderator of the Relationship Between Role Conflict, Role Ambiguity, and Burnout. Journal of Applied Social Psychology, 41(6), 1275–1298. https://doi.org/10.1111/j.1559-1816.2011.00763.x

4. Holthe, M. E. G., & Langvik, E. (2017). The Strives, Struggles, and Successes of Women Diagnosed With ADHD as Adults. SAGE Open, 7(1), 215824401770179.

https://doi.org/10.1177/2158244017701799

5. Mantzalas, J., Richdale, A. L., & Dissanayake, C. (2022). A conceptual model of risk and protective factors for autistic burnout. Autism Research. https://doi.org/10.1002/aur.2722

6. Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Organizational Behavior, 2(2), 99–113. https://doi.org/10.1002/job.4030020205

7. Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job Burnout. Annual Review of Psychology, 52(1), 397–422. https://doi.org/10.1146/annurev.psych.52.1.397

8. Panagioti, M., Panagopoulou, E., Bower, P., Lewith, G., Kontopantelis, E., Chew-Graham, C., Dawson, S., van Marwijk, H., Geraghty, K., & Esmail, A. (2017). Controlled Interventions to Reduce Burnout in Physicians: A Systematic Review and Meta-analysis. JAMA Internal Medicine, 177(2), 195–205. https://doi.org/10.1001/jamainternmed.2016.7674

9. Tops, M., Boksem, M. A. S., Wijers, A. A., van Duinen, H., Den Boer, J. A., Meijman, T. F., & Korf, J. (2007). The Psychobiology of Burnout: Are There Two Different Syndromes? Neuropsychobiology, 55(3-4), 143–150. https://doi.org/10.1159/000106056