The questions that working mothers ask me most often are “What causes burnout, and how do I know if I have it?”
My story illustrates nicely the factors that contribute to our current epidemic of working mother burnout. I was forty-four, a busy working mom of three, when my personal episode of working mom burnout flared up.
Excessive workload and dislike of my boss was a huge factor in my burnout.
Lady doctor with headache, stressed, exhausted, holding head against window glass.
I was working in the NICU too many hours with too many nights on call, and those 11-hour days. There was so muchy pressure to perform well in my academic career, having been delayed a promotion due to insufficient publication of papers.
I kept pushing forward and attempting to maintain a large research project while beginning another one – as if I had any extra time. I deeply disliked my boss, my division chief. Once, when I complained that my nanny could not work more than fifty-hours per week, he looked me straight in the eye and said, “Well then, you need to get a weekend nanny.”
An insufficient support system exacerbated my feelings of burnout.
I found it difficult to make new friends after we moved to a new town. The two other women in my division were not friendly, and I felt that they disliked me. I had one good friend in another department, but she was just as pessimistic and sarcastic as I was. She would listen to my stories and tell me that I was working too much.
I lacked the robust and reliable support system that I had built in Houston during a time of fellowship training (shared struggles), getting married (shared joys), and birthing and raising children (shared joys and struggles). My friends and I had grown into adult doctors and working moms together over the prior ten years, and now they were all far away from me.
I was privileged to have help managing household chores and childcare because we had a nanny to run the children around to their activities and keep up with the laundry. Many working moms struggle to maintain household responsibilities, and few have adequate help from their spouse or partner. I was lucky since my husband bought all the groceries and prepared most of our meals.
Resentment of my husband added to my burnout.
I thought he had a really great job, worked far fewer hours, took less night call, and had a good secretary and several nurses to help him. He felt no obligation to worry about our children, and simply expected me to take care of everything. Our relationship became strained as a result.
Like all moms, I carried a heavy “mental load.”
I was the one who read all the books about parenting, discipline, gifted children, and dyslexia. The school events, meetings with teachers, team practices and uniforms, birthday parties and play dates, pediatrician, and dentist appointments were all my responsibility. I hand made Halloween costumes and outfits for school plays.
In addition, I had severe maternal guilt.
I always felt guilty about spending time away from my children while working but also loved my practice of neonatology. It was a rewarding specialty because the babies tended to respond to treatment, get well, grow, and thrive.
This was, for me, the ultimate paradox. When I was away from my children doing something that I loved to do, I felt guilty for being absent from them. I was confused about others’ judgments about my ability to balance work and family effectively. Once when I was only forty-two years old, standing in the checkout line at Target, some lady asked if my three-year-old daughter was my granddaughter. I must have looked old and tired that day.
I allowed myself little time for self-care.
As a typical working mother, I often prioritized the needs of my children and partners over my own well-being. When I was working full-time in the NICU, sometimes eighty hours a week, I neglected all self-care activities, such as exercise, relaxation, hobbies, or personal time. This trend led to increased stress, fatigue, and burnout. When I only worked forty hours a week, I tried to exercise by walking in my neighborhood, but rarely managed to do anything else.
Burnout resulted from my tremendous work-life imbalance.
As a busy NICU doctor in this setting, achieving a healthy work-life balance became overwhelming for me. The boundaries between work and personal life blurred, and this constant juggling of roles and responsibilities without adequate time for self-care contributed to my burnout. I found myself overwhelmed, angry, and exhausted. I felt like I was no longer making a difference, and I was unable to make the changes I needed for recovery.
Finally, I found the strength to assess my downturn and get the help I needed.
After many months of being miserable, and desperate for a change, I decided to leave clinical medicine and try something different. I began a position as medical director of a small HMO. The new schedule was heavenly, a nine to five office job with no weekends. The position had a steep learning curve, with many bureaucratic constraints and national guidelines for healthcare that must be followed. And there were strict nurse case-managers who thought they knew better than me and the patient’s doctor what each patient needed.
Those two years working as an HMO medical director allowed me the time and space to take better care of myself, resume regular exercise, pick up old hobbies, play the piano, get some weekly psychotherapy, and work on improving my relationship with my husband. In so doing, I slowly began to heal and recover from working mom burnout.
Balancing career and family responsibilities creates a constant juggling act, requiring us to manage our professional obligations while also fulfilling our roles as caregivers and managing household tasks. If we do not manage these correctly, and in a healthy way, it leads to working mother burnout.
