3 Signs You've Hit Clinical Burnout and Should Seek Help | Dr Jo Perkins

1. 0:00 – 2:10

   Trailer

   1. APAlex Partridge0:00

      What does burnout look like before the person realizes they're burning out?

   2. JPDr Jo Perkins0:03

      It's depletion on a gradual basis, your capacity, capability, energy, and that can be quite subtle in those early stages. It's different to how you would normally be as a sort of baseline. It's not just, "I'm having a bad morning," or a bad day, or you can point to why it's happening. Things can feel more burdensome.

   3. APAlex Partridge0:19

      Can burnout even make you think you're losing your mind?

   4. JPDr Jo Perkins0:22

      An ADHD person will try harder in response to inconsistent performance, 'cause that's what they've always done. That further compromises those limited resources. It feels like you're losing a grip. You just can't do the simplest things, assuming you're the one at fault.

   5. APAlex Partridge0:39

      What are the three biggest warning signs somebody is about to hit clinical burnout?

   6. JPDr Jo Perkins0:43

      There will be a few indicators, quite likely. So again, everything-

   7. APAlex Partridge0:47

      Can I have just a second of your time? If this podcast has helped you understand your brain or made you feel less alone, can you do me one favor? Can you hit the subscribe button? And I'll repay the favor by continuing to book the best and most exclusive conversations on this topic. Please enjoy the episode, and always remember, you're not broken, just different, and you have always been enough. [upbeat music] Dr Jo Perkins, I am so pleased that I'm sat in front of a Chartered Psychologist talking about burnout, because it certainly had a huge impact on my life. In fact, I think it's put me in hospital in the past. But all of the advice that I see on the internet and other places about burnout, the advice isn't very helpful. It suggests to just have a rest and to take a break, but when you've got a mind like I have, I can't relax when I'm doing nothing because I associate doing nothing with danger, and someone's gonna tell me off for not achieving enough. The only way I can actually relax myself is by doing something and by working, but often I don't have the energy to do that work. So it's a real problem that I've faced in the past, and we're gonna talk about the three warning signs that I wish I knew before I approached severe burnout. But before we get to those,

2. 2:10 – 3:51

   The Biggest Lie About Burnout

   1. APAlex Partridge2:11

      what do you think is the biggest misconception people have about burnout?

   2. JPDr Jo Perkins2:16

      I think you've, in your, you know, summary that you just gave there, Alex, kind of encapsulated it. It's the, the advice being that it's to rest because it suggests that there's... it's about being a bit tired or merely tired, but that isn't burnout. So the misconception is that if you're feeling tired, a bit of rest will do it. But actually, burnout is much more severe than that. Burnout is that cumulation of chronic stress and pressure that's been happening over time. So actually, it's not about rest. Rest isn't the thing that fixes it. It's, it's... Also, the, the another misconception linked to that is that it's because you're not working smart, you're just working too hard. It's not. It's that you've been working maybe too hard in a particular way against conditions over a long period of time, and you're not getting the rest and recovery.

   3. APAlex Partridge3:12

      Mm.

   4. JPDr Jo Perkins3:12

      So burnout is, is, is distinctly different, even if it's not experienced and noticed as, as, as different, as, by biased as individuals to being tired.

   5. APAlex Partridge3:22

      So much of the advice is, like, "Just take your foot off the pedal for a bit, have a break, lie down, try and get some sleep," but-

   6. JPDr Jo Perkins3:29

      Yeah

   7. APAlex Partridge3:29

      ... that is such a stressful thing for me to try to do-

   8. JPDr Jo Perkins3:31

      Yeah

   9. APAlex Partridge3:31

      ... because I feel like my nervous system over the years has almost taught that to do nothing is a bad thing.

   10. JPDr Jo Perkins3:37

       Mm.

   11. APAlex Partridge3:37

       And I associate that with, with being lazy, and I, and I wish I knew before what s- what it might look like, what, what burnout perhaps might look like before I reached the point where I've entered a real crisis.

3. 3:51 – 5:17

   Burnout Before You Realise It’s Happening

   1. JPDr Jo Perkins3:51

      Yeah.

   2. APAlex Partridge3:51

      Like, what do you think burnout can look like before the person realizes that they're experiencing or approaching burnout?

   3. JPDr Jo Perkins3:59

      Certainly for someone... well, for anyone, it's depletion on a gradual basis of your resources, your capacity, your capability, your energy. You will find things just harder, more effortful, typically, and that can be quite subtle in those early stages. But actually, the thing that's important is that it's, it's different to how you would normally be as a sort of baseline. And in ADHD, you know, brains a- a- and bodies, it can be more of the same but exaggerated, so more executive function challenges. So it can feel quite familiar, but I think that what's important is that it's, it's more pervasive. It's not just, "I'm having a bad morning," or a bad day, or you can point to why i- it's happening. It's a struggle to keep performing at the level that you're either expected to or used to doing because you can't access the same kinds of resource.

   4. APAlex Partridge4:59

      Mm.

   5. JPDr Jo Perkins4:59

      So it, everything just feels, you know, harder. You feel more emotionally, maybe short-tempered, irritable. Things can feel more burdensome. You feel more resentment at things that literally a few weeks ago would not have wound you up. [laughs]

   6. APAlex Partridge5:14

      Gosh, yeah, no, it's so relatable. And following on from

4. 5:17 – 6:23

   Does Burnout Hit Suddenly or Build Up?

   1. APAlex Partridge5:17

      that, is burnout, does it happen suddenly, or is it a gradual process?

   2. JPDr Jo Perkins5:21

      It can feel sudden, but no. The, the research would definitely kind of be a, a cumulative-based model, and actually, I see in practice and, and the experiences, it's accumulation, sustained chronic stress over a period of time when the conditions aren't changing. So no, it's definitely cumulative. But it can feel sudden, because if we keep overriding the kind of warning signs or if, if things don't give us any respite, the conditions don't change sufficiently, that goes on over time, and many people just hit their, you know, metaphorical wall and stop being able to function, and that can look different for each of us. That can literally be, in my case for some of the clients I work with, they literally cannot get up one day, so that's quite extreme in terms of overriding the signals. And then there can be, "I'm just not performing," and then- You know, the, the impacts of that

   3. APAlex Partridge6:11

      So Jo, if the end result is one day you wake up and you just can't get out of bed, but before that stage there have been many cumulative moments and warning signs,

5. 6:23 – 9:33

   Why People Miss the Warning Signs

   1. APAlex Partridge6:23

      why do so many people miss those warning signs?

   2. JPDr Jo Perkins6:25

      I think, Tim, there's a few different reasons. It's hard to decipher what's just general having a day of being distracted, struggling because you've had a big weekend or there's more going on. 'Cause often it just doesn't come out of the blue, some of those things. You can kinda go, "Yeah, well, I can point to that, I've got extra projects on," or, "That thing's going on there socially or in my family life," or, "I've got this event that's happened or happening." So we kinda go, "Yeah, I, of course I'm feeling more tired," or, "Of course I'm struggling a bit because I've got less time available, I've got more in my head, more on my to-do list." So we don't go, "Oh, I'm in burnout." So I think it's quite subtle, so we, we don't stop and pay attention, so we keep on going through. But I think as well, another key couple of things that I often see is that we're not all taught to tune in to some of those early warning signs so we can dis- decipher what is a bit of distractibility and just, um, due to not having had much sleep the night before or having a bit of an off day or, you know, an exacerbation of our ADHD symptoms, through to this is a bit more pervasive and this feels and looks different, and it's happening across multiple situations. So when we ignore that because we're not tuning in and knowing that that, that feeling is, is something else, we keep going.

   3. APAlex Partridge7:45

      Mm.

   4. JPDr Jo Perkins7:45

      And so we, we, we benefit from learning how to do that. But also another thing that's, I think, really important, if we're used to showing up and having to do more and compensate, you go into that rather than thinking, "Oh, what's going on?" We as- can assume, particularly again as someone with ADHD, if you're being told that you should be trying harder and that it's your fault, you take responsibility for that and keep on doing the things that you've always done to keep going, and that actually is such a vicious cycle because that's just gonna make it worse, rather than going, "Hang on, maybe it's not me, actually. Maybe the conditions are not conducive."

   5. APAlex Partridge8:29

      Yeah. Yeah. I mean, I think you've hit the nail on the head. I think many people with ADHD, they feel tremendous guilt-

   6. JPDr Jo Perkins8:35

      Yeah

   7. APAlex Partridge8:36

      ... when they do try to take a rest. In fact, it's almost like they take the path of least resistance, and the path of least resistance is to avoid rest because that comes with the emotional pain, that comes with the guilt, that comes with a feeling of, "I'm going to let someone down, I'm gonna be told off." So they push through that and they do more work, and that just perpetuates them through this cycle which the end result is an approach to burnout, which can often lead to a point of real crisis.

   8. JPDr Jo Perkins9:04

      Yeah.

   9. APAlex Partridge9:05

      And often that might lead to them coming to see someone like yourself. And we were fascinatingly speaking off-camera a moment ago, and, and you told me that in, in your practice, there's often a single sentence that somebody might say, that if you hear that sentence, that rings alarm bells in your mind that that person is heading towards trouble. And we're gonna talk about what that sentence is a little bit later on. But firstly, Jo, I mean, how,

6. 9:33 – 16:16

   How Bad Burnout Can Really Get

   1. APAlex Partridge9:33

      how serious can burnout become if it is ignored?

   2. JPDr Jo Perkins9:36

      For me, maybe it's about a step before burnout. Burnout will happen if we do not address the factors c- contributing to burnout. So burnout has a way, you know, that, whether that is that kind of can't get out of bed one morning because you've managed to make it to that point and then come to a shuddering halt or, or, or you stop functioning in the way that you need to. So that is serious enough in itself. Obviously along the way, the seriousness is the fact that people get ill. It compromises our immune system. We start to have anxiety, mood effects, physiological effects. It can, uh, impair our sleep, it can impair our relationships, it can impair our confidence. That has a knock-on effect on how we're showing up at work. So it has many components and aspects that can all worsen over time, and ultimately it can lead to long-term illness. You know, people being out of work because not necessarily the burnout has meant that they should be out of work, but it can affect someone's confidence so much, it can mean that they have got to a point where they can't face going into work because they became so depleted, and actually being in a working environment for them doesn't feel viable.

   3. APAlex Partridge10:55

      It was about six years ago. I was clearly, with the lens of hindsight and awareness that I have now, working through all of those warning signs.

   4. JPDr Jo Perkins11:05

      Mm.

   5. APAlex Partridge11:05

      And as someone who is an alcoholic, that put me in a very risky situation-

   6. JPDr Jo Perkins11:11

      Mm

   7. APAlex Partridge11:11

      ... because I didn't realize that with each warning sign that I was ignoring and each work commitment that I was saying yes to, I was actually teetering closer to that point where that internal conflict of I need to lie down but I can't lie down because I fear letting someone down so much, that it was almost like a catastrophic, catastrophic internal dilemma that I couldn't face, and I picked up a drink after many years of sobriety, and that ended me in hospital with a nurse looking down at me. And I, and I, she couldn't understand why I was there, and I, and I, I, I tried to explain it, and I guess sh- maybe there wasn't the awareness of burnout there.

   8. JPDr Jo Perkins11:52

      Mm.

   9. APAlex Partridge11:52

      But that's where it led me.

   10. JPDr Jo Perkins11:53

       Mm-hmm.

   11. APAlex Partridge11:54

       Do you know anyone who h- has gone through a cycle of burnout or experienced burnout to such an extent that it has such a massive impact on their life?

   12. JPDr Jo Perkins12:04

       Yeah. Well, I mean, as you've just described, it's that pushing on through. And what I'll often say to my clients is n- none of us know where that edge for us is at any one time, and it might not be As, as far out as it has been on previous occasions. So we often think we, we know what we're doing, we can safely, if we're even having that conversation with ourselves, keep pushing through. It's inconvenient, or again, it feels like such a threat and risk to not show up in whatever way we feel we need to show up, you know, to show up at work. And as you've mentioned, it's not about stopping and having a rest. Sometimes it's about that perception of letting others down, and prioritizing others over ourselves, but again, kind of trying to keep our, our core self intact for fear of-

   13. APAlex Partridge12:46

       Mm

   14. JPDr Jo Perkins12:46

       ... the rejection and letting people down that go with that. But actually, for me, what's, um, important about the kind of getting to that wall, people will, I've seen, have a complete change in what they do. So you can hit that burnout in the extreme sense, and wake up from that and go, "Right, now I've recovered," which takes time, and a process in itself, and they'll say, "I'm gonna change everything." They'll change whatever things have got in the way. That might be stopping drinking, it might be changing a job, it might be changing a relationship or how you're living, where you're living. It's, so it can be quite dramatic in that sense. Yes, I've worked with people that have just gone, "I'm not going back into the corporate world," or, "I'm not going to do that job, creative or otherwise, because I need more stability." So it's about finding something that's a better fit, but that's kind of pretty radical because you don't just change a job generally.

   15. APAlex Partridge13:40

       Mm.

   16. JPDr Jo Perkins13:40

       It's a whole sector for, for people if they're doing it at the extreme edge. The other version I would see would be that that could be a real wake-up call to acknowledging, actually, what's worked for me in the past, worked, it is not what's gonna work for me moving forward, and you can see the inherent risk in it, because you don't have that luxury once you've hit burnout, and going through that extreme experience to go, "Well, that makes sense anymore." On the contrary, it's hugely risky. So that will often, again, it takes time and a process, but it's looking at how you overcommit, where you overcompensate, what you say yes to, why, what the costs are to that, and if once you understand your motivations, you can find other ways that are safer, more effective at living life. But again, it will be changing boundaries, changing how you do things, not necessarily believing and acting upon having to kind of keep everyone happy.

   17. APAlex Partridge14:38

       Mm.

   18. JPDr Jo Perkins14:39

       And not necessarily, you know, kind of adapting how you see your identity and how you need to show up in the world. That, that can be a profound change that someone would go through when they've got to that edge, like, "Oh, maybe I don't need to be [laughs] so extreme."

   19. APAlex Partridge14:55

       Yeah. It's so interesting. I remember when I reached for the alcoholic drink, you know, after years of sobriety, I remember that feeling so much. It was absolute emotional numbness, and I didn't see it at the time, but looking back I can reflect, and that's what it was. There was almost like a fear of saying yes to any more commitments, and I guess that was the tipping point maybe. Like, there was one more thing that somebody asked me to do, and there just wasn't the capacity to say no, but I also didn't have the strength inside me not to say yes, because I was so fearful of letting someone down.

   20. JPDr Jo Perkins15:30

       Yeah. And it's, it's a beautiful example of it, Alex, 'cause isn't it? Because it's almost like you didn't have the skill to not keep going, but it's the straw that breaks the camel's back.

   21. APAlex Partridge15:41

       Mm.

   22. JPDr Jo Perkins15:41

       It's like one more demand, and you've ignored the, the, the warning signs, overridden, ridden, keep riding through the red lights, and then there's the wall. It's like, "Oh, I can't go any further." But it can feel, and that's where it can often feel quite sudden.

   23. APAlex Partridge15:56

       Mm. Yeah. The, the warning signs-

   24. JPDr Jo Perkins15:57

       It was clearly not, but-

   25. APAlex Partridge15:59

       The warning signs were there, 100%, and there's three major warning signs that-

   26. JPDr Jo Perkins16:04

       Mm

   27. APAlex Partridge16:04

       ... we're gonna go through in a moment. But just first, talking about the straw that broke the camel's back, like that was certainly the one for me. It was that one final demand of my time that I didn't know how to say no to.

7. 16:16 – 17:20

   Do We All Have a Breaking Point?

   1. APAlex Partridge16:16

      But do you think everyone has a breaking point, no matter how well they think they're coping?

   2. JPDr Jo Perkins16:22

      We're human. [laughs] You know, computers have a capacity. They've got a memory. They, there's a, you know... We are not beings that can just keep digging deep instantaneously. We can develop capacity, develop resilience, but that is a process that, that's when we're being intentional about it. It's not just never ending, and that's the difference. This isn't about growing it consciously, intentionally, gradually, like going to the gym. It's, it's, it's like you can't just get up and walk-

   3. APAlex Partridge16:53

      Mm

   4. JPDr Jo Perkins16:53

      ... you know, 100 miles without any training. Your body isn't prepared for that. So none of us know where that breaking point is for ourselves, but, um, I do believe that everyone must have to have one.

   5. APAlex Partridge17:03

      And I guess that brings us nicely onto like the three warning signs that somebody might be aware of that would probably become visible or they might become, become aware of before that breaking point comes.

   6. JPDr Jo Perkins17:15

      Yeah.

   7. APAlex Partridge17:16

      So I think the three warning signs that everyone should be aware of, and the first one,

8. 17:20 – 19:00

   When Your Body Stops Recovering

   1. APAlex Partridge17:20

      your body stops recovering. Like, why can someone sleep all weekend, for example, and still feel exhausted?

   2. JPDr Jo Perkins17:29

      This is one of the, the kind of confusing things I think about burnout, and some of the messages about... I mean, even if you can, as an ADHD person, slow down and rest, even if that were a possibility, because your brain would shut off, which it doesn't. Actually, it's a misconception that rest is gonna do it, because you can sleep all weekend, but because you're not tired, it's that cumulative wear and tear, build-up of depletion across all of your resources, cognitive decline, emotional capacity being compromised, physical, that a rest isn't going to do it. Because when we're just merely tired, which we'll all experience, you have a bounce back factor when you sleep. When you're not bouncing back from sleep, that's telling you something else is going on. You know? And, I mean, often we'll have a holiday-

   3. APAlex Partridge18:17

      Mm

   4. JPDr Jo Perkins18:17

      ... maybe where you might sleep for the first couple of days more than you would normally, but then you, again, you bounce back and you go, "Oh, I'm recovered. I'm now gonna get into the holiday." That isn't gonna be happening over a weekend, quite likely, and it may not happen if you go on holiday. Uh, you know, again, I'll have clients that come back from their holiday and go, "I didn't kinda hit that day three, but my mojo back-

   5. APAlex Partridge18:36

      Yes. [laughs]

   6. JPDr Jo Perkins18:37

      ..." And it's like, "Well, yeah-

   7. APAlex Partridge18:38

      Mm

   8. JPDr Jo Perkins18:38

      ... because either you've kept on working, or this is more than just being tired before going on holiday."

   9. APAlex Partridge18:45

      Is it possible, Jo, to, to, to recognize if you're not bouncing back? Like, can you be doing all of the right things? Can you be taking the rest, taking the naps, and not even see that you're not bouncing back? Like, the

9. 19:00 – 21:24

   Tired vs Burnt Out (Big Difference)

   1. APAlex Partridge19:00

      question is-

   2. JPDr Jo Perkins19:00

      Mm

   3. APAlex Partridge19:00

      ... how can you tell the difference between being tired and your nervous system no longer recovering properly?

   4. JPDr Jo Perkins19:07

      Yeah, so the- there will be a few indicators, quite likely. So again, everything feeling more effortful in a way that it doesn't usually, and that being more cumulative. So things felt like an effort yesterday and last week, and, but historically they haven't felt effortful. You know, doing the emails in the morning or feeling like you've got too many WhatsApps to answer, whereas normally that's just something you do on your-

   5. APAlex Partridge19:30

      Mm. Yes

   6. JPDr Jo Perkins19:30

      ... your journey home or when you've got five minutes, that is a warning sign that you're not just tired. Again, waking up and feeling still tired, but physically heavy, feeling a sense of dread and overwhelm at what the day might hold for you. Again, the irritability that you might feel when someone asks you to do something that, again, you know historically wouldn't have necessarily felt onerous or too much of a, a kind of stretch. They're things that in isolation aren't a sign. In combination, they're, they're telling you-

   7. APAlex Partridge20:06

      Mm

   8. JPDr Jo Perkins20:06

      ... things are feeling more effortful. You're feeling more emotionally sensitive to being perceived as not doing good enough job or being competent and capable, feeling more anxious. You are doubling down on the compensatory behaviors. Those things in combination are telling you, you're not just having a bad day. This is not you. Something's not working. That's the difference between tiredness. Tiredness, we might be a bit ratty or tired or short-tempered for a day or a morning, but then we pick ourselves back up. We can laugh at something.

   9. APAlex Partridge20:37

      Mm.

   10. JPDr Jo Perkins20:37

       Something will shift our mood. We won't feel anxious or angry when someone's asked to do something extra, the one extra thing that you think, you s- "I, I just don't have capacity," 'cause it can feel so overwhelming.

   11. APAlex Partridge20:54

       I think it can be just the one tiny thing, though, that can-

   12. JPDr Jo Perkins20:57

       Yeah

   13. APAlex Partridge20:57

       ... tip you over the edge. I was looking back, you know. Before I relapsed that particular day, I remember feeling so fearful of being-

   14. JPDr Jo Perkins21:04

       Mm

   15. APAlex Partridge21:05

       ... invited to a party because I knew, A, I wouldn't be able to say no, and B, I didn't have the energy to go. So again, it was that kind of like stuck between a rock and a hard place, and the outcome was, I guess, burnout and ending up in hospital. Now, the second warning sign, Jo, I think this is actually the one that catches people by surprise.

10. 21:24 – 24:38

    When You Stop Feeling Like Yourself

    1. APAlex Partridge21:24

       You stop feeling like yourself. Is losing interest in things you normally love one of the warning signs?

    2. JPDr Jo Perkins21:30

       It can be. If we think about burnout being a cumulative deterioration, depletion of resources, uh, you know, um, it would make sense that even when something we would typically enjoy or may make us feel more energized, if that feels like everything is so much effort anyway, and then to do that thing is gonna be more effort-

    3. APAlex Partridge21:54

       Mm

    4. JPDr Jo Perkins21:55

       ... that can mean that we start to lose interest or stop doing it. The other thing can be actually if our mood is flattened, and we're feeling quite anxious and depleted, we don't really care so much about things. Our motivation is lowered. So actually, even the things that we know we like, we're just like, yeah, uh, you know, if we love cooking, for example, and enjoying a nice meal or going shopping for it, the idea of all of that just feels all we see is the effort, and, and why bother? I just want to do something simple. So again, it, it, it can often be a preservation of energy as well as not feeling the levels of kind of emotion, uh, a- and, and enthusiasm. I will hear clients often saying to me they start canceling stuff, or they stop planning stuff, and it can all look sensible and understandable on the, the surface because you go, "Well, it's just one week where they've done that, and they had a deadline." But then the day gets longer. They're not doing anything for themselves, and actually, they're... What I notice is happening, it might look like quite a practical consequence. They've, they've not had the time to do something, or they've deliberately decided to not do something. But actually, they're preserving their energy and resources to do the work or to do the things that they absolutely have to do. You know, parenting is understandable, but it often means that there's nothing else left to give.

    5. APAlex Partridge23:20

       Yeah.

    6. JPDr Jo Perkins23:20

       So i- i- it, it, it's not always as simple as you stop loving it. There are variables and factors that mean you're not doing the thing you love, and actually, you're not loving much of anything at the moment. So that can be effects. So you actually, the thing that could make you feel better, if that's going to the gym or cooking a nice meal, is the very thing that you can't face doing because it just feels... And more mental load.

    7. APAlex Partridge23:40

       Mm.

    8. JPDr Jo Perkins23:41

       Even filling the shopping basket el- online just feels like I, I can't make a decision, so I, yeah.

    9. APAlex Partridge23:46

       Before I reached burnout in the past, the things that I was doing because I genuinely loved them, they were always the first on the chopping board to get removed from my life. And I think on reflection, it was easy to stop doing those things because the only person I was letting down was myself. You know, if I didn't take my dog on a long walk, or I didn't do that beach walk that I like to do, or if I didn't cook, no one was gonna be let down or disappointed in me because of those things. So I really just focused my energy on doing the things that had a consequence of letting people down, which actually just pushed me faster- [laughs]

    10. JPDr Jo Perkins24:20

        Absolutely

    11. APAlex Partridge24:20

        ... into the burnout. The final warning sign, Jo, which I actually think is the scariest one of the three, and I think this is the one that actually makes people feel like they're genuinely losing their mind. So the third warning sign Number three, your ADHD suddenly gets much worse.

11. 24:38 – 29:43

    Why Burnout Makes ADHD Worse

    1. APAlex Partridge24:38

       So why does burnout make ADHD dramatically worse?

    2. JPDr Jo Perkins24:43

       When we're in burnout, if, again, if we think of it as being that depletion of resources, and ADHD people are already operating at the margins of compensating and using the kind of buffer, if you like, for doing everyday life stuff. The executive function challenges already require that bit extra. So that margin gets compromised.

    3. APAlex Partridge25:08

       Mm.

    4. JPDr Jo Perkins25:09

       That margin all of a sudden is, is, is, is stripped away, which kind of reveals, if you like, more sharply your, you know, ADHD executive functional challenge, executive function challenges. But also you've got that... It's a cycle, so things can be harder, so it, it feels like we're being a bit more distracted, struggling to focus, manage time, and organize ourselves, and again, it can all feel more overwhelming. But also it heightens the emotional component, so we can become more reactive, sensitive to those things, and feel more open to criticism, more, you know, reactive to thinking, you know, "Why me? Why have you given me that? I'm feeling burned. I feel anxious now you've given me that." You know, so again, it, it has an... It's not just a practical component, it also activates the ADHD emotional response. I mean, anyone in burnout will feel more emotionally vulnerable, but it will... It's already playing in on those ADHD challenges that can be in play. But then typically an ADHD person will try harder in response to inconsistent performance, 'cause that's what they've always done. It's like, "Well, I've gotta try harder." So that further compromises those limited resources. So the overcompensation kicks in to, to kind of pedal back-

    5. APAlex Partridge26:33

       Mm

    6. JPDr Jo Perkins26:34

       ... and, and, and, and, and meet the, the baseline. You've lost your margin, and you're feeling more emotionally dysregulated. So everything gets further compromised and heightened. It feels like you're losing a grip, sometimes clients will say to me, or that you just can't do the mo- the simplest things.

    7. APAlex Partridge26:52

       Yeah. Gosh, I, I was speaking to a, a woman who, she said she has ADHD, and she was telling me that she had just come out of what she thought was a big session of burnout that nearly cost her her marriage.

    8. JPDr Jo Perkins27:06

       Mm.

    9. APAlex Partridge27:07

       Uh, she said that she never saw it coming. She works from home. She was sat at her desk doing her emails. She had kids that were running around being quite noisy and, and that was manageable. But then her partner came home from work, closed the door, sat down at the dinner table. He was... They were eating together, and she said, actually, he was chewing loudly. And she said that was the catalyst that actually made her stand up abruptly, and she said she picked up her plate and threw it on the floor, like in pure rage, and she said, "I want a divorce," in that moment. And he was just absolutely taken aback.

    10. JPDr Jo Perkins27:45

        Yeah.

    11. APAlex Partridge27:45

        Shocked. He, he didn't see it coming. He, he was really worried about her 'cause it was very-

    12. JPDr Jo Perkins27:49

        Mm

    13. APAlex Partridge27:49

        ... out of character. There was no indication or clues, at least from his point of view, that there was anything bubbling up under the surface, and yet at the dinner table that evening, it absolutely erupted and blew up in, in, in everyone's face.

    14. JPDr Jo Perkins28:03

        Mm.

    15. APAlex Partridge28:03

        C- can emotional dysregulation, can that be heightened? Can you be more sensitive to criticism a- as you approach burnout?

    16. JPDr Jo Perkins28:11

        Yeah. Absolutely. Because... And actually, what's interesting in that particular example, Alex, 'cause I'm sure it may have surprised that person as well, you know, that that... And why would you not associate it with the fact that it's your husband? And actually it's, it's highly unlikely to be that. I mean, that might also be an issue-

    17. APAlex Partridge28:30

        Yes. [laughs]

    18. JPDr Jo Perkins28:30

        ... but now it's a tension. But my hunch is that, again, a lot of people will talk to me about their head feeling like it's a bit on fire or fizzy or just really sensitive, lights brighter. So again, that sensory overload. So again, the chewing that, that your, you know, person y- you're talking about, um, reacted to was probably, again, that straw that broke the camel's back for her that was just, pssh, snap. But actually, if we're feeling like we're not doing what we're meant to be doing, and we're really struggling despite how we're appearing to the outside world, but it's taking more and more effort to stand still and do the same, that's going to heighten our anxiety. So we may be more hypervigilant to people criticizing us, looking for evidence, and what it, you know, what it's like, we'll find it. It's like, "Oh, they weren't really impressed when I did that," or, "Maybe I didn't do that." And again, the overthinking that happens when you've done something, left a social event or, or d- delivered a piece of work escalates. So again, that, that can heighten the anxiety, and then you can see the likelihood that you're gonna be more-

    19. APAlex Partridge29:38

        Mm

    20. JPDr Jo Perkins29:39

        ... likely to be criticized everywhere and want to avoid it.

12. 29:43 – 31:43

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    1. APAlex Partridge29:43

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13. 31:43 – 36:46

    Can Masking Cause Burnout?

    1. APAlex Partridge31:43

       can that lead to burnout?

    2. JPDr Jo Perkins31:46

       Yeah. From a young age, we didn't know it was masking. You don't know what it, it, it... We wanna fit in, work out social norms. Someone with ADHD may be more likely to suppress what they are being told is too much, not good enough, try harder. And hypervigilance, scanning, monitoring all of the time, and that being a real skill, but also being something that can tie us up in knots, and actually, that leads to the masking. It's like, "Oh, that's how you show up in these situations, but not like me." So again, your, your, your whole kind of identity is, is wrapped up in satisfying what you believe at least is expected, what is desirable, what isn't. And without realizing it, it's about satisfying others or the environment, again, rightly or wrongly or in, i- whether we get it, you know, accurate or not is another matter. But it becomes a part of, of existence really. So it's unconscious a lot of the time until it's not, but it takes a toll. It costs something. It, it, it takes energy. It takes attention. It takes cognitive, you know, energy, emotional energy, 'cause if we're scanning and trying to prevent a risk situation, we're constantly plotting and strategizing, "Well, what do I do, need to do differently?" Again, it, it's second nature, so we don't know the toll it's taking. But that accumulates over time, and actually, not only does that have a cost, we're overriding our wants and needs quite often as a consequence. So I'll often say to someone, "You know, w- what might have contributed to where you're at right now?" And they may not even be able to answer it. It's like, "Well, I wasn't good enough. I wasn't doing enough." But actually, when you really get to it, it's like, w- what point would you have slowed down? What point would you want to say no to that social event? And they're like, "I don't know if I'd want to go or not. It's just something you do, isn't it?" As if it's the first time it's been suggested. So there's a cost of not knowing what you like sometimes, what, what is gonna drain you in advance. There's a cost to not doing the things that might energize you and, you know, that you are gonna get more satisfaction from. So it's, it's kind of, you know, really profound, the effect-

    3. APAlex Partridge34:08

       Mm

    4. JPDr Jo Perkins34:08

       ... that masking can have.

    5. APAlex Partridge34:10

       I used to think that burnout was something that perhaps happened maybe every six months or maybe every year, depending on what you're doing. But is it possible that burnout can actually be happening on a much shorter timeframe, i.e. can it be like a daily occurrence, depending on what you're doing? Like, like one of the biggest lies I used to tell myself when I was running my businesses that I could go to two meetings back to back and be okay afterwards.

    6. JPDr Jo Perkins34:37

       Mm.

    7. APAlex Partridge34:37

       And actually, on reflection, I think there was always this like daily period, perhaps between the hours of 3:00 and 5:00, where I maybe had a little bit of a headache, uh, very irritable, very grumpy, but I didn't see it at the time, so I pushed through it. But is it possible that burnout can actually be a daily occurrence, rather than this thing that we think of happens over a longer time period?

    8. JPDr Jo Perkins34:58

       That would be a version, and I think it goes back to that point of burnout in itself is not, um, does not have a, a, a recognized, you know, accepted diagnostic criteria because it's not-

    9. APAlex Partridge35:10

       Mm

    10. JPDr Jo Perkins35:10

        ... something that we diagnose clinically, um, as such, although it's clinically relevant. So this is where the language, you know, i- i- maybe kind of, you know, we've gotta be careful that we don't label things that might not be that. But I would say that they are definitely examples of needing recovery. So I think that where it's not a problem is if we're getting that one hour a day and we're not pathologizing that as being, "Oh, my gosh, you're so lazy," you know? Instead, you're saying, "No, this is what I... This happens every day. It makes sense. I've had that break." And then you treat it as recovery, give yourself permission to do it, and actually, that that isn't there, and then getting compromised, and compromised, and compromised. So I would say that if that would then be what would be leading to burnout, for me, that would just be kind of your body and brain needing its natural recovery.

    11. APAlex Partridge35:58

        Sure.

    12. JPDr Jo Perkins35:58

        And it's all good if it's getting it. Where the problem will kick in, and it will accumulate, is if the hour's not available to you for whatever reason or you're not using it to recover 'cause you don't recognize that you need it to recover. So you put something else in, and that's what I'll often see people doing. They'll go, "Oh, I shouldn't be doing nothing. I, I'll take on more," or, "I'll start that project," and you disrupt that, that process of recovery. So I'd say that it's recovery, and when you l- don't let it be recovery or recognize it as being recovery, that's what then becomes sustained-

    13. APAlex Partridge36:33

        Mm

    14. JPDr Jo Perkins36:33

        ... cumulative, you know, s- stress, if you like, on our system and will lead to the burnout.

    15. APAlex Partridge36:40

        Speaking of recovery, and really the most important question of the entire interview, when

14. 36:46 – 38:44

    When to Seek Professional Help

    1. APAlex Partridge36:46

       should somebody seek professional help rather than just pushing through?

    2. JPDr Jo Perkins36:51

       So again, it will look different for different people, but I would say if you are noticing that it's not just tiredness, so you're not getting your bounce back and it's not temporary. So we, we will all go through periods of being overwhelmed, and it can feel quite full on, extremely overwhelming. We may be struggling to sleep for a few days. But if we then have some respite- That will pass. It's when that's not passing, and actually we're feeling permanently tired, really struggling to do stuff, and we're not knowing what or how to change something, then it, it's good to talk to someone to say, "Well, what might that be?" If you're noticing that your mood is actually changing, and you've got concerns about that, so if you're feeling higher levels of anxiety, and they're pretty persistent, and you're struggling to get those down, if that's becoming more obsessive. So again, it's not unusual for me if I'm seeing a client that, that's going into burnout where they may have had OCD, they know they've got OCD, but they've largely managed it, but then they say, "Oh, in the last few months it's come back," or their version of it has come back. It's been active. That's when you, you don't ignore that. That's your brain going into overdrive. So that would be s- a, a sign that it-

    3. APAlex Partridge37:59

       Mm

    4. JPDr Jo Perkins37:59

       ... don't ignore those things. You know, it, it's not healthy or natural or normal to be feeling anxious at an elevated level all of the time, so you don't have to suffer that. So I would... So the mood shift, everything permanently kind of feeling harder. Um, and also if you're struggling with your confidence and self-esteem in a way that you haven't before, you know, and it's activating stuff that's kind of causing other issues i- i- in your life, and you're maybe withdrawing more, then it might worth talking to someone.

    5. APAlex Partridge38:30

       I wanna move on to some real tangible tips on how someone can recover-

    6. JPDr Jo Perkins38:34

       Mm

    7. APAlex Partridge38:35

       ... from burnout. But prefer, before that, I wanna go back to the question I asked you at the beginning. And I s- s- I said, when clients come to you,

15. 38:44 – 40:26

    The #1 Warning Sign of Burnout

    1. APAlex Partridge38:44

       is there a sentence that they say that rings alarm bells in your mind that they are approaching trouble? What is that sentence?

    2. JPDr Jo Perkins38:56

       Risk of feeling frustrated, it could be different for different people-

    3. APAlex Partridge38:59

       Sure

    4. JPDr Jo Perkins38:59

       ... in reality, because actually, I, I think that's the, the, the thing about burnout, it is not the same for everyone in terms of how it shows up, and what they may say will be y- you know, their version of what they're noticing. But it might be loads of other things going on. But again, a, a theme that I see quite a lot will be, "Everything's gonna be fine," after having told me that they're, you know, feeling dreadful. Everything's a struggle, stretched beyond belief. When I get to that deadline, or when that project's delivered, or when this family situation is sorted, or when that's out of the way. And yet there's nothing actually that they're also sharing with me that, that will happen after that event, because you know there's something else coming down the line, or that the other features are part of the, the, the issue for them and what they're navigating. That's always a worry, because they're relying on optimism. You... There's, it's like this, the fix is some future-oriented place. There's a finish line that you're gonna get to, and it will all be okay, and then you'll be all right. That, that finish line in real life is rarely there. And actually, if there is a finish line, and it's about a particular thing, that doesn't tend to be burnout. That tends to be, no, you're at a stretch because there's a project, and that actually will get quieter when you've delivered it. So it's, it's that distinction.

    5. APAlex Partridge40:18

       And with your clients, what does the conversation of recovery from burnout look like? Because so far this conversation's been quite frightening. Like,

16. 40:26 – 41:47

    Can You Fully Recover from Burnout?

    1. APAlex Partridge40:26

       can burnout be reversed?

    2. JPDr Jo Perkins40:29

       Yes. Yes. I think that, first of all, burnout doesn't have to be an inevitability. That's, I think... And actually, stress and, you know, breaking through some of our comfort barriers is highly facilitative and can be positive. So I don't want to be too alarming at all, because actually it's great. But again, not when it happens too quickly or over a sustained length of time. So for me, what's really important is the burnout recovery is it requires, depending on where you are at on the, um, burnout severity, it may require complete rest, and rest may not be sleeping per se. Often it's about removing and stepping back from the kind of stimulation on your system, the demand. So for some people that will be at work. Obviously, we can't step away from families if we're parenting, but it might mean that you're sharing the load. So you do need to kind of turn things down and step back. And then you can start to recover and heal. And that can take... It's not, it's not a weekend of sleep. It's not one week's holiday. It's, it's time. It's time. And gradually building things up again. It's, it's like having a broken leg. There'll be a period of recovery. You take the cast off, but it's gonna take time to get full, fully back to strength.

17. 41:47 – 43:17

    The Biggest Recovery Mistake

    1. APAlex Partridge41:47

       What's the biggest mistake someone makes when trying to recover?

    2. JPDr Jo Perkins41:51

       Well, think the, the kind of thing that I will see a lot is that getting back into things too quickly. It's underestimating the, the kind of extent to which, and the risks, a bit like going on the broken leg thing. You know, if we've got a broke leg, yeah, you, y- the cast is off, feeling better. You don't wanna go out running for three miles or 30 miles that day. You wanna get used to gradually putting your weight on it until you're back to full strength. So some people will just go, "I'm feeling fine now." Straight back into the same conditions. If nothing has changed, that's the other mistake. So it's going too fast, mistaking feeling a bit more energized as being back, and being too optimistic about that, and not really tuning in. But also the, um, sense of not changing anything. So if the conditions, whether it be the workplace or the family situation or a relationship, are exactly the same as they were before, you'll burn out again.

    3. APAlex Partridge42:55

       I've got a surprise for you just before we finish.

    4. JPDr Jo Perkins42:58

       Always a worry.

    5. APAlex Partridge42:59

       Yes. [laughs]

    6. JPDr Jo Perkins43:00

       Okay.

    7. APAlex Partridge43:00

       I, I-

    8. JPDr Jo Perkins43:01

       I'm gonna get excited. [laughs]

    9. APAlex Partridge43:02

       Every ADHD Chatter guest writes a letter to the younger version of themselves, and then it gets delivered to the next guest, which is yourself today. So I'm gonna deliver the letter to you, and if you could kindly read that, Jo.

    10. JPDr Jo Perkins43:16

        Thank you.

18. 43:17 – 44:14

    A Letter to My Younger Self

    1. JPDr Jo Perkins43:17

       So, "To my younger self. I know you think you're the problem. One day you'll discover that you were never lazy, broken, or too much. Your brain was simply wired differently, and nobody gave you the words to understand it. Please don't spend your life trying to become someone else just to fit in. Parts of you that feel different today will one day be your biggest strengths. Be kinder to yourself. With love, your future self." That's beautiful.

    2. APAlex Partridge43:45

       Wow. Very nice tone to, to finish on.

    3. JPDr Jo Perkins43:47

       And really resonates with the burnout-

    4. APAlex Partridge43:49

       It does

    5. JPDr Jo Perkins43:49

       ... thing, because actually, stop trying to be something or someone you don't have to be.

    6. APAlex Partridge43:56

       Absolutely.

    7. JPDr Jo Perkins43:57

       Interesting.

    8. APAlex Partridge43:57

       I think it's a, a letter to the previous guest's younger self, but I've no doubt it'll be a letter to the younger self of many of the listeners and viewers too.

    9. JPDr Jo Perkins44:05

       Absolutely. Thank you.

    10. APAlex Partridge44:07

        On behalf of everyone grappling to understand their brain, Jo, thank you so much.

    11. JPDr Jo Perkins44:11

        Been a pleasure. Thank you for having me. [outro music]

Episode duration: 44:15