According to the American Psychological Association, stress is the "physiological or psychological response to internal or external stressors. Stress involves changing nearly every system of the body, influencing how people feel and behave" [1]. On the other hand, burnout is defined as [1]:

Physical, emotional, or mental exhaustion accompanied by decreased motivation, lowered performance, and negative attitudes towards oneself and others. It results from performing at a high level until stress and tension, especially from extreme and prolonged physical or mental exertion or an overburdening workload, take their toll.

According to the American Psychological Association, stress is the "physiological or psychological response to internal or external stressors. Stress involves changing nearly every system of the body, influencing how people feel and behave" [1]. On the other hand, burnout is defined as [1]:

Physical, emotional, or mental exhaustion accompanied by decreased motivation, lowered performance, and negative attitudes towards oneself and others. It results from performing at a high level until stress and tension, especially from extreme and prolonged physical or mental exertion or an overburdening workload, take their toll.

Interestingly, the word burnout, as described in this passage, was first used by an American psychologist to describe the phenomenon that he observed in human service professionals with unmanageable numbers in their caseloads [3].

As discussed, stress involves too much: too many pressures that demand too much physically and psychologically. But, stressed individuals have hope that if everything were under control, they would feel better. Burnout, on the other hand, is characterized by exhaustion (feeling depleted, overextended, and fatigued), depersonalization (being detached, withdrawing, having negative/cynical feelings toward one's job), and feelings of inefficacy (reduced feelings of accomplishment or productivity). Professionals experiencing burnout often do not see any hope of positive change in their situations [8]. It is clear that stress is not the same as burnout. The essential difference is that stress involves too much and burnout implies nothing at all and no hope of improvement.

As discussed, stress involves too much: too many pressures that demand too much physically and psychologically. But, stressed individuals have hope that if everything were under control, they would feel better. Burnout, on the other hand, is characterized by exhaustion (feeling depleted, overextended, and fatigued), depersonalization (being detached, withdrawing, having negative/cynical feelings toward one's job), and feelings of inefficacy (reduced feelings of accomplishment or productivity). Professionals experiencing burnout often do not see any hope of positive change in their situations [8]. It is clear that stress is not the same as burnout. The essential difference is that stress involves too much and burnout implies nothing at all and no hope of improvement.

Burnout is typically preceded by the mounting effects of stress that have accumulated and gone unaddressed. For some people, this stress builds over many years. For others, the breaking point can come much more rapidly. However, learning to prevent and to deal with stress now can help prevent burnout, which is a much more difficult condition that should be addressed with professionals. In its publication Addressing Burnout in the Behavioral Health Workforce Through Organizational Strategies, the Substance Abuse and Mental Health Services Administration (SAMHSA) identifies six root causes of burnout at the organizational level [8]:

Burnout is typically preceded by the mounting effects of stress that have accumulated and gone unaddressed. For some people, this stress builds over many years. For others, the breaking point can come much more rapidly. However, learning to prevent and to deal with stress now can help prevent burnout, which is a much more difficult condition that should be addressed with professionals. In its publication Addressing Burnout in the Behavioral Health Workforce Through Organizational Strategies, the Substance Abuse and Mental Health Services Administration (SAMHSA) identifies six root causes of burnout at the organizational level [8]:

Burnout is typically preceded by the mounting effects of stress that have accumulated and gone unaddressed. For some people, this stress builds over many years. For others, the breaking point can come much more rapidly. However, learning to prevent and to deal with stress now can help prevent burnout, which is a much more difficult condition that should be addressed with professionals. In its publication Addressing Burnout in the Behavioral Health Workforce Through Organizational Strategies, the Substance Abuse and Mental Health Services Administration (SAMHSA) identifies six root causes of burnout at the organizational level [8]:

Individual-level factors that contribute to burnout include [4,8]:

In addition to organizational and individual level factors, SAMHSA has identified systemic issues in the behavioral health landscape that compound the risk for burnout. These factors include a workforce shortage, an increased need for behavioral health in the general population, budgetary considerations, systemic inequities, and shifts in service delivery and policies (e.g., telehealth, transparency laws) [8].

Some professionals are more vulnerable to experiencing stress and burnout than others. Although work stress and burnout are present in every occupation, human service professionals, who spend their work lives attending to the needs of others, are at the highest risk, especially if their work puts them in frequent contact with the dark or tragic side of human experience. This heightened risk is exacerbated if professionals feel underpaid, underappreciated, or criticized for matters beyond their control [5].

There is a clear connection between workplace stress and physical and emotional issues. Signs of stress and burnout in an individual may include [8,9]:

Evidence indicates that workplace stress plays an important role in several types of chronic health conditions, especially heart disease, musculoskeletal conditions (e.g., back pain, muscle tension), psychological conditions, and substance use disorders [9].

Compassion fatigue, or vicarious or secondary trauma, is a term used to describe the emotional exhaustion associated with caregiving. It is relatively common among those in the helping professions, particularly those who care for trauma victims [15,16]. While related to stress and burnout, compassion fatigue is generally brought on by a specific situation [17,18]. Furthermore, those experiencing compassion fatigue retain the capacity for caring, unlike those with burnout. However, an accumulation of stressors can lead to a progression from compassion fatigue to burnout if symptoms are not adequately addressed. On the opposite end of the spectrum, compassion satisfaction refers to the positive feelings associated with helping others through one's work. Assessment of these dimensions can give important insight into one's risk for (or resilience to) burnout.

Compassion fatigue, or vicarious or secondary trauma, is a term used to describe the emotional exhaustion associated with caregiving. It is relatively common among those in the helping professions, particularly those who care for trauma victims [15,16]. While related to stress and burnout, compassion fatigue is generally brought on by a specific situation [17,18]. Furthermore, those experiencing compassion fatigue retain the capacity for caring, unlike those with burnout. However, an accumulation of stressors can lead to a progression from compassion fatigue to burnout if symptoms are not adequately addressed. On the opposite end of the spectrum, compassion satisfaction refers to the positive feelings associated with helping others through one's work. Assessment of these dimensions can give important insight into one's risk for (or resilience to) burnout.

NIOSH has identified the three essential components of a self-care plan [4,8]:

While this is a good overall framework, many professionals require more specific strategies that will bring the framework to life. The following actions can be taken at work to address feelings of stress and/or burnout; some may be more realistic or applicable than others, depending upon the situation [5]:

While these suggestions may improve a work situation or environment, it is also vital to address stressors in one's personal life. One way to do this is to adopt a healthy lifestyle. Take time to engage in activities that nourish the body and/or mind in a positive way, such as [5]:

Breathing is something most people take for granted. However, not taking the time to really breathe can have serious ramifications on health and wellness. Some have suggested that slow, rhythmic breathing may be the basis of the mechanism synchronizing the brain and the autonomic response. Furthermore, studies have shown a positive relationship between yogic breathing and alleviation of stress, anxiety, and depression [10,11].

The Western medical definition of breath is the air inhaled and exhaled in respiration. Clearly, the absence of breath is typically equated with the absence of life. Those who practice yoga or other Eastern philosophies view breath as even more significant. In Eastern conceptualizations, breath is a life force, the link between the physical and the spiritual. Because most people have not taken the time to notice their breathing patterns, starting breathing exercises can be difficult. Good breathing takes discipline and deliberate practice, but the effects on self-awareness and coping can be considerable.

Like breath work, imagery and meditation are also valuable, cost-effective skills that can be used to increase coping and resilience, but they also take practice and discipline. The technical definition of imagery is the "cognitive generation of sensory input from the five senses, individually or collectively, which is recalled from experience or self-generated in a non-experienced form" [1]. Imagery is often conceptualized as putting the imagination to work. Of course, imagery in therapy can be a positive activity used to enhance relaxation or build positive coping skills, or it can be used to promote catharsis of negative, traumatic memories. Imagery, also called visualization, is a powerful tool. Although the concept of meditation often has spiritual connotations, it can simply be viewed as extended thought, reflection, or contemplation for the purpose of restoring a sense of balance. Clearly, imagery and meditation can go hand-in-hand. Whether used together or independently, both can help restore a professional balance.

Like breath work, imagery and meditation are also valuable, cost-effective skills that can be used to increase coping and resilience, but they also take practice and discipline. The technical definition of imagery is the "cognitive generation of sensory input from the five senses, individually or collectively, which is recalled from experience or self-generated in a non-experienced form" [1]. Imagery is often conceptualized as putting the imagination to work. Of course, imagery in therapy can be a positive activity used to enhance relaxation or build positive coping skills, or it can be used to promote catharsis of negative, traumatic memories. Imagery, also called visualization, is a powerful tool. Although the concept of meditation often has spiritual connotations, it can simply be viewed as extended thought, reflection, or contemplation for the purpose of restoring a sense of balance. Clearly, imagery and meditation can go hand-in-hand. Whether used together or independently, both can help restore a professional balance.

Lack of time is possibly the most common excuse professionals give when they are not engaging in self-care activities. In the modern era, when productivity equals survival, it can be too easy to justify not having the time or resources to take care of oneself. However, it is important for individuals who are experiencing symptoms of stress and/or burnout to consider the costs of not making time to reduce stress. Persons who are burned out have difficulty engaging in all aspects of their lives and being there for family and friends. As discussed, stress and burnout also negatively impact productivity. This is particularly important for professionals whose relentless quest to complete tasks is affecting their work and personal lives.

The acronym ACE (accept, change, or eliminate) can help one explore available options when feeling stuck or overwhelmed. These options are available in any situation in which one is feeling trapped or stressed. The situation can either be accepted for what it is, changed to the extent possible (which generally means changing something about oneself), or eliminated (e.g., leaving a toxic work environment). After the option has been selected, it should not be revisited until it either continues to add stress or may be addressed more completely.

Examples of positive affirmations include:

Many behavioral health professionals enter their chosen field because they have had their own experiences with recovery from an addiction, a mental health issue, or a medical issue. The desire to help others often stems from their gratitude that someone once helped them. Recovering professionals may offer important insights into what clients and patients experience. However, it is important to remember that working with recovering patients is not a way to ensure your own personal wellness and recovery. Being healthy as a professional is contingent upon being healthy as a person. Professionals who are in recovery may have to be especially attentive to their own plans of recovery in order to meet the emotional demands of their profession.