Stress, Burnout, Anxiety and Panic Attacks

Healthy Worry and Stress

Life in Johannesburg is fast paced and stressful.  Everyone has levels of healthy "normal" worries and stress (it's called "being human" !).  There is something called an "optimum level of stress". This is when you perform really well, you feel like you are coping well, you are motivated and excited,  have great relationships, and feel very much in control - in fact you are "at your best".
This differs for each person, and may change depending on your life circumstances, age, illness etc.

The basic effects of stress, excessive worries and anxiety
Stress - Worry - Anxiety



Irritable, worried, tired, overwhelmed, not sleeping....


When your optimum level of stress gets overwhelmed, you start to feel a bit worse. At first it may be slow - not coping so well, you worry more, you get more irritable and reactive, you feel tired all the time etc.
But then if it spirals down further, you move into more severe anxiety, feeling out of control, feeling overwhelmed, feeling  panic, over exhaustion, moving into burnout, and even getting ill -  usually over a period of time.
Or if there is a major life crisis or trauma, this may happen overnight.

Your daily activities, relationships, family, work start to get negatively affected. You start to stress more. Feel distressed. Out of control.  Frustrated and angry.  It just does not go away.  There seem to be no solutions and no ways out.




You start to feel worried all the time, nervous, uneasy.....  Things feel uncertain, even a bit scary at times.  Some of the worries you can see clearly , but sometimes you feel the anxiety is everywhere and there all the time.  It does not go away .... You start to get headaches, migraines, and feel a bit nauseous in your stomach.  You cannot stop worrying and churning over issues.   Your sleep is disturbed and you suffer from nightmares and/or insomnia. You expect the worst to happen...

If this is left, and things in  your life get worse, it can turn into panic and panic attacks.


Panic and Panic Attack

This is more extreme and you can end up having a "panic attack".  A horrible out of control feeling - that is quite scary for most people.

You struggle to breathe, feel short of breath, get heart palpitations (a racing heart); feel like things are 'unreal' or disconnected.  You could even feel pains or tightness in your chest, feel dizzy or unsteady, feel claustrophobic or smothered. You sweat, feel faint.  Sometimes you don't want to fall asleep, in case...

The scary part is that you may fear that you are losing control, or that you are having a heart attack, dying or of "going crazy".  You may end up going to hospital to check out the heart attack, only to find out there are no medical signs of this.

At this point in time, you really have little choice but to seek assistance.



“Burnout”  -  the high cost of high achievement?  Driven, over motivated, over succeeding, or failing, making bad mistakes....

Burnout is not recognized clinical psychiatric or psychological disorder, there are some similar features between burnout and diagnosable conditions such as depression, anxiety disorders or mood disorders.

Burnout is much more common; for example, it is estimated that 25%-60% of practicing physicians experience burnout.

It’s also less severe, more temporary in duration, and clearly caused by situational stressors rather than a biologically mandated chemical imbalance. (It’s kind of like depression’s non-clinical, less intense cousin that just comes for a visit and leaves when you reduce the stress in your life.)

Burnout Symptoms

Depleted Physical Energy: Prolonged stress can be physically draining, causing you to feel tired much of the time, or no longer have the energy you once did. Getting out of bed to face another day of the same gets more difficult.Emotional Exhaustion: You feel impatient, moody, inexplicably sad, or just get frustrated more easily than you normally would. You feel like you can’t deal with life as easily than you once could.Lowered Immunity to Illness: When stress levels are high for a prolonged amount of time, your immune system suffers. People who are suffering from burnout usually get the message from their body that something needs to change, and that message comes in the form of increases susceptibility to colds, flu and other minor illnesses (and sometimes some not so minor ones).

Less Investment in Interpersonal Relationships: Withdrawing somewhat from interpersonal relationships is another possible sign of burnout. You may feel like you have less to give, or less interest in having fun, or just less patience with people.

Increasingly Pessimistic Outlook: It is harder to get excited about life, harder to expect the best, harder to let things roll off your back, and harder to ‘look on the bright side’ in general. Because optimism is a great buffer for stress, those suffering from burnout find it harder to pull out of their rut than they normally would.

Increased Absenteeism and Inefficiency at Work: it gets more difficult just to get out of bed and face more of what’s been overwhelming you in the first place. This may be an unconscious defense against burnout, but those experiencing it tend to be less effective overall and stay home from work more often. (This could also be due to increased illness resulting from lowered immunity.) This is part of why it makes sense for workers to take some time off before they’re feeling burned-out, and why it makes sense for employers to refrain from running their workers into the ground; they might not get back up so quickly!

What Causes Burnout?
Burnout has many causes. They fall into the main categories relating to job structure, lifestyle features, and individual personality characteristics. - Elizabeth Scott 2014