My Experience with Burnout

For nearly 4 years, I dealt with high levels of stress in my life without seeking help. As a consequence, my stress response got stuck "on". While I removed myself from the primary stressor, I took on new stress with an international move, new job, a new house, and reverse culture shock coming back to the USA. Even though these were mostly positive changes, my body kept the stress response active. I knew something was wrong, but I told myself I could manage it. I thrived in stressful situations. I knew my limits.

I was catastrophically wrong. My inability to recognize the severity of my situation lead to three devastating physical health issues I am still actively managing every day. I wish I had reached out for help sooner.

These are the steps I am taking to manage my mental, emotional, and physical health:

  1. I started working with a mental health professional
  2. I removed myself from stressful situations
  3. I exercise regularly
  4. I value my attention

I'd like to share my story of how the stress I experienced manifested physically. If for no other reason than to serve as a warning to folks currently dealing with anxiety and stress. I wish someone would've told me, "you don't have to do this alone. It's OK to ask for help even if you feel like others are in a worse place."

My Story

I woke up Thursday, May 31st, 2018 with an ear ache in my right ear. The scalp on my right side felt slightly tingly and sensitive to the touch. I was flying on Saturday to Monitorama in Portland, so I made an appointment with my doctor to make sure I could fly with my ear bothering me. On Friday, the ear ache had gotten worse and the sensitivity on my scalp was undeniable. My doctor told me that my ear drum was not inflamed, but was irritated. She didn't see signs of a typical ear infection and told me to dose up on over-the-counter pain and allergy medications. She said I was OK to fly and it would probably clear up in a few days. There was no explanation for the tingling and sensitivity on my scalp.

Saturday morning, I woke up and made strawberry pancakes for breakfast As I took a bite of the pancakes, all I could taste was bitterness, acidity, and a strange metallic flavor. I asked my wife if they tasted OK to her, and she said they were fine. I poured on more maple syrup, but I couldn't taste it. I was excited to be going to Monitorama, and chalked this strange taste malfunction up to the allergy medicine. I packed my bags and my wife drove me to the airport. The flight was difficult. My ear ache was agitated by the pressure changes and the food I brought with me tasted off, like I wasn't able to taste the sweet notes in anything I ate. The pain in my ear and on the side of my face intensified. I took more allergy and pain medication and tried desperately to sleep.

I woke up Sunday morning in so much pain I could barely think. I couldn't lay on my right side because the whole right side of my face felt like it was being stabbed by thousands of needles. The pain medication was not helping. I looked for a doctor's office and managed to get an appointment first thing Monday morning. I needed food so I ventured out through the pain to find something to eat.

I found a sandwich shop and ordered a toasted sandwich with fries. The fries tasted edible and I had hope the worst was over. I took a bite of the sandwich and spit it out into the trashcan. It tasted like cigarette ashes smelled. I disassembled the sandwich and was able to eat the avocado on it, but the rest of the sandwich was off in a way I couldn't stomach. I finished the fries and avocado and climbed back into bed to try and get some sleep. Anytime I'd roll over on my right side, I'd shoot straight up in the bed, engulfed in all encompassing pain. I had a doctor's appointment first thing in the morning. Instead of helping setup for the conference, I walked to the doctor's office and got there before they opened.

The doctor diagnosed me with a subdermal skin infection on the right side of my face. Unfortunately, the diagnosis did not explain my inability to taste sweetness which was slowly driving me mad. I was adamant that I needed an explanation and she referred me to an Ear, Nose, Throat (ENT) doctor for a same day appointment.

Later at the ENT doctor, I explained my symptoms and he performed an exam including what appeared to be several neurological tests. After the exam he said "I have good news, and I have bad news. The good news is I know what you have, the bad news is that it's Ramsay Hunt syndrome, also known as Herpes Zoster Oticus." In layman's terms, the virus that causes the chicken pox, had come back to life, as the shingles, only instead of affecting the nerves in my torso, it had localized on the nerve in my jaw and ear. He said this type of presentation was rare, and even rarer for someone only 37 yrs old. He asked me if I was under a lot of stress. Yes, near constant for over 6 years..

He prescribed high dose steroids, antivirals, and pain medication and told me I should to head home immediately. I wasn't yet in the contagious phase, but I would be soon. He warned me to stay away from infants and pregnant women. I went back to my hotel, changed my flight, checked out of my hotel and flew home. I would miss Monitorama this year. That was almost as painful as my illness. Two of my colleagues had made it to the conference this year and I was looking forward to spending the week with them for months. I would now be stuck at home, watching the live stream as I phased in and out of consciousness from the medications.

Back at home, I saw an ENT doctor and an opthamologist. There was a very real possibility of the infection spreading to the optic nerve and blinding me in my right eye. I was on an emotional roller coaster between the steroids, the pain medications, and the anti-virals. The first anti-viral didn't wipe out the infection, and I had to get a second anti-viral added to the mix.

In a matter of minutes, I would cycle between being depressed almost to the point of not being able to move, to so angry that I was literally screaming at my computer screen. I had no control over my emotions and they erupted from my keyboard into work chats. It's a testament to my manager I wasn't fired. Every night I told my wife I was going to quit my job because I was either so depressed or angry.

The cloud of medications started to lift after 3 weeks. A neurologist placed me on gabbapentin to manage the nerve pain. Unfortunately, it made me dizzy and sleepy. My on-call rotation came up, and I had to get a co-worker to cover it because on the gabbapentin, I could sleep, but nothing woke me up until it wore off.

My ability to taste sweetness had not returned. Things I used to love, coffee, beer, grilled food, chocolate ice cream, would make me gag they tasted so terrible. I could eat food and feel physically full, or even bloated, but my brain wasn't getting any feedback from "sweetness" receptors on my tongue. Oddly, this left me feeling mentally starving and physically full. It was the strangest and most uncomfortable feeling I've ever had.

I exhausted my paid time off very quickly, and thanks to a change to our PTO policy, I was not allowed to go negative. My manager encouraged me to try to make use of the company's short term disability policy. Unfortunately, the illness had only devastated my mental and emotional health. The physical effects it had were not enough for me to qualify, so I had to continue working remotely. Exhausted, still in moderate pain, and weening myself off steroids, I was an unpleasant person in every aspect of my life. I was spiraling.

At this point, a coworker reached out to me. He had been dealing with his own personal health issues. In the course of his research, he had read that among people with sensory impairments, suicide rates were the highest among patients who had lost some or all of their ability to taste. He said he was concerned about me and asked me if I had considered seeing a mental health professional.

I had always admired people who had shared that they were working with mental health professionals. I thought of them as wise and brave. However, this machoism-duality in my brain told me "I'm strong enough to deal with my own issues." It wasn't until a male friend I admired admitted to me that he was seeing a mental health professional and said something along the lines of "it's OK if you see one too" that I let myself be OK with the idea.

I started to see a mental health professional in early August that year. I spent most of my time in therapy complaining. During the first few months, maybe even year, I used therapy to point out what the world had done to me. I also felt like I had to prove to my therapist that I didn't need to be in therapy. It's complicated, but I was raised to put on a happy face for strangers. Only the immediate family really ever saw each other's flaws. It took a while for me to get comfortable with the idea of sharing honestly. Even longer for me to really commit to the process in a way that started to have dramatic impact on my life.

During the "toe in the water" phase with therapy, I had my first experience with acid reflux. The first time feeling that type of pain is terrifying. I started freaking out, and had a full on anxiety attack. I was diagnosed with GERD. Only 6 months after getting a mostly normal sense of taste, I'd have to give up all my favorite foods and beverages to manage the condition. My doctor said both conditions were likely triggered by "stress."

Getting Better

My life has been changed forever by the physical health issues caused by my inability to address the stress in my life. I still experience occasional loss of taste due to nerve damage caused by the Ramsay Hunt Syndrome. I am battling with acid reflux, so my intake of coffee and spicy foods is severely limited to none. I regret not taking my stress more seriously.

You may be thinking, "I have a job, my loved ones are relatively safe, I don't have it as hard as everyone else." You may not be wrong about that. You would be wrong if you delayed reaching out or ignored your own mental health. Something Matty Stratton said in his talk Fight, Flight, or Freeze stuck with me: "Stress is relative." You may not have the same problems as someone else, but that doesn't mean your problems will cause you any less stress. Your experience of stress is unique to you. You shouldn't compare your circumstances to others as an excuse to not reach out for help you feel you need.

Consult a mental health professional

If you only take one suggestion on my list, find a mental health professional. I was too close to my issues to see the whole picture. The guidance and perspective of a third party expert will multiply the positive effects of your actions. Be open and honest, and do your best to put the work in from the start. I was slow to commit to the process and that delayed my recovery and lead to more physical health problems.

Remove yourself from the stressful situations

Even if you can't remove yourself from the most stressful situation in your life, there's a good chance there are lesser stressors you can quit. Drop those things and replace them with activities that bring you happiness and calm. I dropped social media apps and limited my TV time. I filled that time with more cycling, meditation, reading, and walking my dogs.

Exercise

I know, exercise. Everyone says exercise. There's research showing exercise helps our bodies and brains close a stress cycle. When you experience a threat in nature, you react with fight, flight, or freeze. Your cortisol and adrenaline spike. Your breathing becomes shallow. Your digestion slows. Exercise reduces your body's cortisol and adrenaline levels naturally. This slows your breathing, improves digestion, and makes it easier to sleep. I like the DownDog Apps as it provides timed exercises that don't require any gym equipment.

Value your attention

What you focus on is who you become.

I highly recommend you watch The Social Dilemma. If you don't value your attention, there are companies making billions of dollars valuing it for you. After watching that documentary, I made some hard decisions and deleted a ton of apps from my phone as well as disabling nearly every notification. Here's what I did to my phone:

  • Deleted any app that fed my dopamine receptors: social media, games, etc.
  • Disabled all but essential notifications: calls and texts from known callers, and my on-call app
  • Deleted all open tabs from my browsers and switched to Firefox Focus on my phone
  • Set an aggressive "Do Not Disturb" window, 8pm - 7am

I made these changes as a revolt against the companies using my personal data for profit, but the changes had a dramatic impact on my wellness. Nothing else in the list aside from exercise had such an immediate and measured impact on my well being. It's also really easy to try these things for a week and revert them if they don't help you.

Mindfulness meditation

Nothing will help you value your attention more than understanding and training your attention. There is no better way to do so than with mindfulness meditation. My therapist recommended meditation constantly. I didn't fully commit to it at first. When I did, I was put off by the presence of spirituality and religion in the guided meditation apps. As an atheist, there's nothing that can snap me out of a mindful state like mentions of religion and spirituality.

It wasn't until I listened to the Next Big Idea's Episode with Sam Harris did I find a practice I could use reliably. Sam Harris is a neuroscientist and approaches mindfulness meditation from a purely scientific and secular angle. His pragmatic approach to guided meditations keeps me engaged.

Meditation isn't something that shows enormous benefits all at once. I initially felt calmer during the meditations, and then got back to my day-to-day life. Over the course of a few weeks, I began to notice I was able to set markers for myself. When I experienced a negative emotion, I could pause and acknowledge it. That process strips the negative emotions of their ability to control me. I'm still learning. I get upset, frustrated, angry, sad, and make all kinds of mistakes. I just make considerably fewer missteps now that I've started a mindfulness practice.

I hope this helps

I wanted to share my experience in the hopes that someone recognizes the stress and anxiety in their life and decides to take action. I'm gradually working my way back to homeostasis, but if I had acted sooner, my life would be a lot different. I'd probably still be able to enjoy coffee and spicy foods!

Take care of yourself, because if you don't, no one else will.