47. How to Prevent Burnout in Parents: Tools and Tips that Work

It's time to talk about the mental health impact of *parenting*... and what we can do about it. Join me and our special guest, Ashley, a working mom, as we explore practical tools and exercises to recognize and address signs of BURNOUT.  This episode is for parents AND for all of us who need to take care of ourselves so that we can care for others.  We talk about practical tools like:

** The stress continuum: Are you green, yellow, orange, or red?

** 'What's on your plate' or 'What's on your mind?': Exercises to assess and reprioritize responsibilities. 

*** Self-care that WORKS to recharge mentally and physically:  including social connections, creative expression, and exercise 

Check out our website PsychEd4Peds.com for more resources.
Follow us on Instagram @psyched4peds

Transcript

Dr. Elise Fallucco: 0:21

Welcome back to PsychEd4Peds, the child mental health podcast for pediatric clinicians, helping you help kids. I'm Elise Fallucco Child psychiatrist and mom. Now many of you may already know that United States surgeon general, Dr. Vivek Murthy recently released a surgeon General's advisory on the mental health and wellbeing of parents. Now this advisory highlighted how parenting can lead to significant stress and burnout and negatively impact our mental health. And one of the stats that he shared was that about half of parents say most days, their stress is completely overwhelming. So today we're going to talk about stress and burnout in parents and share a couple of practical tools and exercises to help us realize when stress is affecting our mind and body. And. More importantly, talk about how we can fix it./So to help me with this, I'm really delighted to have a special guest with us who is a working mom with two kids in elementary school. She has graciously agreed to help me demonstrate how to use some of these burnout tools and do some of these exercises with us. So please join me in welcoming to the pod Miss Ashley.

Ashley: 1:36

Hi, Elise happy to be here.

Dr. Elise Fallucco: 1:39

Thanks so much for being vulnerable and for showing everybody how we use some of these tools, because I think it's more interesting when you get to see them in practice. One of the universal truths about burnout is that we tend not to notice when we're personally burned out until it's very late. My friend from med school, Bianca used to talk about this analogy all the time of the frogs in the pot of hot water. I don't know if you've heard about it, but basically the idea is like we're frogs in a pot of hot water and the temperature gradually rises. And the frogs hardly registered the difference. They notice maybe it's a little bit hotter who knows. Until the point that the water is boiling. And then they're in complete trouble. So I feel sometimes like that frog in the pot of boiling water. And I have no idea how I got there. This has been totally true in my life. This definitely resonates with me and I don't think I ever really. I recognize when the water is even starting to boil it's full on when it's boiling and a little detail here is that I have recently reached that point in my life of complete burnout. And I am flailing to try and stay alive in this boiling pot of water. So this is me right now. Yes. Oh my gosh. We need to get like one of those skimmers to. To get you out. But I think like this. Sadly this half that can happen so easily because it's really hard to recognize it in ourselves. And in an ideal world, we'd be able to identify when we're starting to become less healthy and a little bit more stressed and weed. No, what to do and get help or intervene before we get to the boiling point. So to speak. This is where our first tool comes into play. This tool that I've used with pediatricians, with parents, with various adults. This tool that I'm about to tell you about has helped me check in with my stress level and it's called the stress continuum. And basically. This tool is first created by the us Marine Corps for use in combat settings. And it's used to help us identify how stress is currently affecting our body and mind. So instead of, it being an on off switch, like I'm burnt out or I'm not, it's. This tool categorized as stress, according to a color system where green is ready and healthy. Yellow is reacting, or rather starting to experience some unhealthy responses to stress. Orange is injured from a psychological perspective. And red of course is not where you want to be. And that's considered critical. I'll go into a little bit more detail about what each of these categories is about so that our listeners can figure out where they currently fall on the stress continuum. So green is obviously the ideal state you've got healthy sleep. You're spiritually and emotionally healthy, physically healthy. You are emotionally available, practicing gratitude and have a sense of mission. So this is where we want to be. And obviously we're probably not going to be there all the time, but that's certainly the goal. And then yellow is considered reacting, but it's when you're starting to fall away from that. So that's when you start to notice a little bit of sleep differences maybe you're getting tired during the day. You have some fatigue. You have a shorter fuse. You might be a little bit irritable. You're noticing you're less motivated, maybe cutting corners. You're not so creative. That's your yellow state. And then orange is usually a state where you're having pretty significant sleep issues. You feel a little disengaged in your relationships. You're exhausted, not just a little tired, but super tired. Exhausted. You may have physical symptoms like headaches, stomach problems, worsening of chronic illness. And. Orange would be considered. Burnout. Entering into the burnout phase and then red is beyond burnout. That's where you would have insomnia, we'd expect to see more major mental health problems, like anxiety, panic, depression, thoughts of suicide, hopelessness. And potentially intrusive thoughts and really broken relationships. So Ashley, what do you think when you see this scale? I think. Many individuals often just blow past all of these different colors and then find themselves in the orange to red zone. And I think looking back at this past year as a working parent, I could say that in January I was more in the green zone and then steadily throughout the year, I moved into the different subsequent zones. So I started having an interesting time at work with a very toxic boss and the whole entire organization was really suffering from it. And so at that point, I found myself getting really tired and changes in attitude about, work. And lack of motivation at work, because I didn't want to work for somebody who didn't value their workers. And then a couple months later, I started having to deal with some health issues with my kids. And so adding that on top of the work issues, I slowly started finding myself more exhausted and numb to things at work and that burnout. And you talked about it in one of your recent episodes, having the cynicism and disconnection at work and not really caring about the end result of my work. So that squarely started putting me in this orange zone. And now I would say I'm not quite at the critical point, but I'm starting to see some of that stuff creep in. I definitely have some anxiety and then I do find myself. Like very focused on cleaning and organizing around my house when I feel out of control, because it is my way to try and exert control in a chaotic situation. So I think if I had been looking at this continuum earlier in the year, I would have been able to put my feelings and my physical reactions on this continuum and to see them and be able to try and step back and try and deal with those colors before they kept progressing. Thank you so much for sharing. And I think like what you've described, I think a lot of our listeners can relate to. I think for a lot of us, it starts with having some sleep problems, which then affect your energy level during the day. And then it feels like you're just losing your spark the irony of all of this, or I don't even know if it's ironic is that I stumbled across this stress continuum when I was preparing a Burnout workshop for some of our local pediatricians during the start of the pandemic. And the goal of the workshop was for us to help them. Identify and manage, stress and burnout and et cetera. And when I was practicing on this stress continuum by looking at it regularly and trying to figure out where I was, I was shocked. I was, squarely in the orange. And I'm just thinking, why am I leading the workshop in burnout? I'm completely orange right now. But more to the point that you can't tell. Yeah, I think you can't tell. And I think also some people might look at this and say, oh, I'm in the green because that's where they want to be. So when you do this continuum exercise, you really have to be honest with yourself and determine where you are as opposed to where you want to be in, where you want to project yourself, how you want to project yourself to others. And I think if I had this tool right. Six months ago, and I noticed I was tired and maybe in the yellow zone. If I had noticed that I was tired and saw the other symptoms in this category, I might've had a better tool to help me realize I was burning out because thinking just of fatigue in and of itself. My mind started thinking of, okay, what is wrong with me? Do I have a cold? Am I physically sick? I didn't have the other. List of things to realize that this was more of a psychological and mental health issue. And so having this in front of me, checking in do I have any of these other things? Could that fatigue be something else? I think it would have helped me readjust. And I also wonder if there are other tools to use at each color to help you course correct. So is there something I could do when I'm in the yellow zone versus something I could do in the orange zone? Zone to help me get back to that green. Having self-awareness of where you are is really important. And to your point, I think it's a great idea to think about what are you going to do with this information? So if you're green, I think you pat yourself on the back and you're like, woo, this is great. The I'm managing the stress really well. Like I'm still able to do this. I still have a sense of mission. And I'm feeling like overall I'm healthy and things are going well. And you may even want to self reflect and try to figure out like, what am I doing? That's helping me stay healthy. What are the things that are charging my battery and. Helping me be super resilient at this point. Yeah, that's a really good point. I think a lot of times we focus on the negative, like what is going wrong or what is making us feel bad instead of looking at the positive. Focusing on those good things can help you realize how you can get to that really good spot that you want to be at. Definitely. Yeah. And then let's say you're in the yellow, which is you're reacting, or you're starting to notice that stress is affecting your mind and your body. And you're having sleep problems or whatever else. I think the question at that point is what can I do, maybe. Is there anything I can do to fix this? Do I need to make some changes at work or at home, or to try to take care of myself better, whatever that looks like. Before it gets worse. And I think that's what I struggle with too. Because I can identify that I'm struggling with something, but there's only 24 hours in a day. So how do I make room? For more sleep when I have all of these other commitments and responsibilities to do. In a day. And so I think that is where I would love help with as well. Yes. That is a great segue to our next tool that we're going to talk about. So this next exercise is called what is on your plate? And basically for this exercise, you get a sheet of paper or an actual paper plate, whichever you want to use, and you either write down or draw out the various projects and responsibilities that are on your plate. And this can be, it's really helpful to be as inclusive as you possibly can. What are the specific projects at work that you're involved with or what are the specific things that you're doing at home or responsibilities? With your family and make sure to include, your own personal outside of work and home or extracurricular activities too. So for. And it may be a little bit hard to visualize and everybody does this in a different way. And you can use your creativity. But if I think like right now, my plate is filled with thinking about the kids, various activities Cross-country or sports and their upcoming events. And then we've got an upcoming trip to our annual child psychiatry conference, which of course is across the country. And I just transitioned to a new job and. I'm just naming some of these things starts to stress me out a little bit. But I think the more granular you can be, the more helpful it is to just visualize here are the things that I'm taking care of right now. And potentially, are there any things on this plate that I could delegate or that I maybe don't need to be spending as much time on? But Ashley, what did you think when you did the plate exercise or how did you approach it? I've done a similar exercise like this before, and I think what I really like about the way you framed it is getting into that nitty gritty, granular detail, because when I've previously done it, I've just separated out work from family and myself. Whereas the granular really allows you to dive deep into those specific projects and really understand how you're using your time. So I had a much harder time doing this exercise after your guidance on that granularity. Because you really have to think about all of those little things. So when I did my plate, I really took it literally and drew a steak on my plate and that represented work for me. And then I had mashed potatoes on the side and that represented my husband. And he's going to love. Mashed potatoes. Mashed potatoes with gravy. That's a really delicious. So he gets the delicious one. And then I did green beans and that represented my kids because here a point where you're talking about. All of the things that your kids are doing. Each green being for me represents, different practice, swim lessons, a play date, school meetings, whatever it is for my kids. And then I had a very tiny side salad and that was for me. Each element of the salad represented a different type of volunteer work that I do, or an element of the salad, we'll say cucumbers because they're my favorite. Those represent the fun activities I get to do like with my friends What I did find missing from this exercise is a lot of women these days in particular talk about the mental load and it's the running to-do list. In your head, right? So while this plate separates out all of the different activities, I do it didn't quite capture that constant worrying concern in my head of, okay. I have to call the doctor and make this appointment and I have to contact this friend to set up a play date for my kid. And oh, there's the birthday party this weekend and I have to buy a gift and oh, I have to send the Christmas gifts. Oh. Week in advance so that they arrive on time. All of those smaller activities. And so I like to also think about another way of how to do this exercise, which is like drawing a brain. And I came up with this idea because my six-year-old son actually came home recently. Having done this himself on his own unprompted. And it was very sweet because, he had a brain and inside of his brain was video games, drone movies, all the things that he either loves doing or the things he wants to ask for Christmas. You start early, starting very early. He has written out three lists at least already. Oh my gosh. But taking that hint from him, I think, I actually did it after he brought his home to show him what mine looked like. And I think you can use all of the things that I used on my food plate and put that in my brain, but I can also have a section within that brain that captures those running lists of questions. It's just a little bit more visual to get at what is always going on in my brain. So it's more of the physical and the psychological and mental part of. Things. I really love that. I love the idea of the brain. Like instead of what's on your plate, it's what's on your mind. What's taking up your brain space. Yes. And I agree with you. There's a lot of people who've talked about the mental load. Sometimes particularly heavy for women or for whomever is in charge of the day to day operations in the house with the kids and with the family. And that, and also the person who's more likely to get called by the school when the kid is sick or bite somebody. Although my kids have not been biting anybody. Recently. That's good. I think that emotional load, that mental load also really contributes to that. That burnout. Because even if I take a moment for self care say I take a bubble bath or, go exercise. Guess what I'm thinking about in those moments, all of those tiny little things. And so it's really hard to unplug from that constant running list of things. And I think that's also what adds to the fatigue, why people are tired and can't sleep because they can't turn their brains off. Even when you're taking a bath or trying to relax, even if you relax your body, which is great, you still have the running mind or the monkey mind. Are there things that you can do to recharge your battery to help you feel? Not only physically. Restored, but also mentally and psychologically restored. And, for some people that's yoga for some people that's meditation. So I typically find meditation and baths and all the things that I'm told to do to quiet my mind as not super helpful in recharging my battery. And I think that's because I really thrive on being an extrovert and doing things it's very hard for me to sit on my couch and do nothing. So there are a couple of things that I would love to highlight to your listeners because I know they really help me feel like I have. Have rejuvenated and I have reached out to. Other people and found some joy and happiness. And so one is social connection. I love talking to my friends going out for dinner, whatever it is, just having that connection with friends and family and having a break from the daily grind of work and life at home is huge. And so that can be hard as a working parent with your schedule or trying to find a babysitter, but any chance you can find to incorporate that into your daily. Life I think is huge. Second of all, I think creative expression is very helpful, so I know not everybody he loves arts and crafts or painting, but I do love those things and that has helped me as well. And it sometimes results in an unfinished painting or an unfinished, necklace that I'm making, but it still is a way to focus on something that's mindless aside from your other daily responsibilities I love the idea of the unfinished painting because the whole point of creative expression is just to express yourself in some way. We're such a S capitalistic society that's all about productivity and checking things off lists and the beautiful thing about creative expression and about play in general is that it's not about the end product. It's just about enjoying the process. Exactly. I think the definition of play is basically doing something like some sort of activity. With no purpose. Yep. Yep. I read that definition recently. And you hit the nail on the head because I'm an example is my husband and I used to go out for dinner for date nights. And we suddenly realized we actually hate dinner date nights because we go out and we'd talk about the kids and we talk about work. And so there's no real rejuvenation and recharging for us. So we have realized that we like to do activities together that allow us to just totally have fun. There's no purpose, no end goal. And so whether it's going out and hitting golf balls or going out on a boat or whatever it is, That has really been a better thing for us. To connect over, cause it forces you to get outside of your heads and your to-do list and okay, you're my co-manager for the family or like for our family in incorporated. And so let's take care of it becomes a business meeting sometimes. Yes, exactly. And so if you're distracted and you're playing mini golf or taking, maybe taking a long walk or just doing something where it's not a setup for having a business meeting, then. You can actually physically and emotionally recharge. Yes. And I think the third thing I would advocate for your listeners to do is to exercise. And I know, doctors often recommend that and sometimes it can be hard because it makes it feel like a chore. I know sometimes exercise feels like a chore for me, but I have recently gotten back into swimming with Elise and it's a two for one, because I get the exercise, but I also get to connect with Elise and the other teammates. And it's been really great. And I feel like I am totally just happier, more at ease. And swimming laps for me, allows me to tune out everything in my brain. And I've only ever really had that with two different types of exercise, a swimming and B yoga, where my mind just goes blank. And so that's really been another way to help recharge my battery. Yeah. And the, just any type of movement, it doesn't even have to be like breathtaking you're underwater. And you're like, Gasping for air. Yeah, no, not at all. Even just a walk with a friend or walk your dog today. I did that with a friend and it was great. We got out it's cooler now outside. And so we had a really lovely time just catching up and getting some steps in. That is excellent. I think I have a question for you though, Elise, because we talked about our plate or our brain and we have all of these things. That are going on. And one thing that I struggle with is how to rearrange those plates, right? So if I have a huge steak on my plate, but I want to have more potatoes. How do I do that? Because it's hard for me to find the time when I still have a mountain of green beans on my plate for the kids. Yes. And this is the hard part, like one of my mentors. Madeline once said to me, she said, Anytime you take on a new responsibility, you have to remove something from your plate. Yeah. Which would have been great advice like 20 some years ago. I had started to follow it. Then maybe we wouldn't be doing a podcast about burnout right now. But now once you're in the moment and you're like, okay, prevention too late for that. So what do we do now? This is where self care and burnout strategies become really personal because there is no one size fits all. For each of us, it's going to look differently. The first question is there anything on my plate that I can get rid of and buy, get rid of? We mean can you delegate some of this? Can you say no to it? Can you at least inform somebody from your volunteer board? As of a couple months from now, I'm no longer going to be able to serve on the board or to participate in this. Thank you for this opportunity. It's been great, we have some. Other things going on right now. So just planning to let things go or having a timeframe for how long are you going to keep some of these responsibilities around? And obviously there are things on the plate that we can't delegate and we don't want to. And usually things surrounding our kids. Some people have you get really detailed and basically look at a 24 hour schedule and look at how much time were you spending on your phone? How much time are you spending sleeping? How much time are you spending talking to your friends and recharging? How much at work, how much with your kids? And trying to see if there's any kind of. Any opportunities for you to cut down on social media scrolling or watching Grey's anatomy or whatever it is so that you can devote more time to whatever's truly charging your battery. Yeah. I think that's a great idea to do the 24 hour outline because it, I think a lot of people. In their mind say, oh, I've only, I only look at social media 20 minutes of the day when in reality, it's an hour and a half. And so if you really take the time and I know it's even hard to sit down and map out every single thing you did that day, but if you can just take one day to do that, I think it would really open. People's eyes to see how much they actually do things. And then they might be able to pick. Certain activities to do a different day or to take off their plate completely and then devote that time to something else. Yeah. Definitely. So to close, I wanted to end with our practice of gratitude, which is another exercise to help with burnout. So both Ashley and I are going to try the three good things. Exercise. That we mentioned in the last episode and share three things that we experienced or happen today for which we are grateful. And Ashley, I'm going to put you on the spot. Do you want to go first? Sure. I feel like an obvious one is to say that. This has brought me joy being on this podcast with you. I feel like it's been a tough year for me. And so anything I can do to help other working parents. See where they're at in terms of their journey. And even just to say to themselves, this might be me, and just de-stigmatize burnout. So I love having done this with you. Another thing that I'm grateful for today is the walk I went on with that friend, just getting fresh air and outside was awesome. And I actually would say my husband traveled today. He gets to go overseas, which I must say I am jealous about, but I am grateful. He gets this opportunity because I think this is some self care that he really needs. So all. That's very, it makes me happy. That's very kind and generous. my three things that I'm thankful for today are getting to go to swim practice earlier today after being holed up with the kids at home because of the recent hurricanes, it felt great to go outside and be in the sunshine and with some of our friends. My second thing for which I'm grateful is getting to have a little bit of time with the two older kids who are still out of school today. And we did a little coffee date at the local coffee shop. No, I do not give them coffee, but they got still delicious drinks and we all worked on our laptops and did some work together. And then the third thing for which I'm grateful is my friendship with you. Ah, thank you. And for you very kindly and vulnerably agreeing to share what's going on in your life so that other people can recognize what, ideas and tools and tips and strategies that might help them. And I think for all of us this is a lifelong journey and we are not always going to be in the green and that's okay. And stress is going to affect us because that's what it does. And it doesn't say anything about us. And, the best we can do is try to figure out what are the things for each of us that charge our battery to help us going. I wanted to give a big, thanks to Ms. Ashley. Thank you. Thanks again for having me. And as a brief recap for our psyched for paeds listeners, we talked about the stress continuum, which is that four color scale that determines how stress is affecting your body and mind. And we'll have a link to that on our web page. Psyched, the number four paeds.com. We also talked about a couple of exercises you can do. To increase awareness about the many things that are either on your plate or in your brain. And the purpose of that is not just to stress you out, but rather to help you be empowered, to make decisions about potentially making changes or reprioritizing. Or most importantly, asking for help. And as a final point, I just want to emphasize that none of us is perfect and. That this is a lifelong process of constant juggling and balancing and rebalancing to try to figure out. How to keep ourselves healthy while we take care of others. So thank you so much for listening. I'd love to hear your comments and thoughts, and if you enjoyed this episode or any others, please leave us a five star review and rating. This will help other people find our podcast and also helps our pod. Thanks again so much. We'll talk to you next week.