What causes working mother burnout?

Some factors are so obvious that they smack us in the face.

The questions that younger working mothers ask me most often are “What causes burnout, and how do I know if I have it?”

My story illustrates for you factors (in bold) 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 were huge factors in my burnout.

Lady doctor with headache, stressed, exhausted

I was working in the NICU too many hours with too many nights on call, and long 11-hour days. There was so muchy pressure to perform well in my academic career, since I had been delayed a promotion due to insufficient publication of papers. I was under constant chronic stress, stress in the NICU with sick babies, and stress to achieve.

I kept pushing forward and taking on one project after another, trying to maintain a large research project while beginning another one – as if I had any extra time. I was unrelenting. I deeply disliked my boss, my division chief or manager. He had no understanding of my personal situation. 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 being alone and stressed.

I had made very few new friends after we moved to this new town. The two other women in my division were not friendly, and I felt as if they disliked me. I had only one good friend to talk with, but she was in another department and just as pessimistic and sarcastic as I was. She would listen to my stories and tell me that I was working too much. My good friend was helpfully honest.

I lacked a reliable support system, like the one 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 hired a nanny to run the children around to their activities and keep up with the laundry. Many working moms struggle to maintain household responsibilities, struggle to manage adequate childcare, and few have adequate help from their spouse or partner.

Resentment of my husband added to my burnout.

I knew that 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. His job was the reason we moved. Clearly, he did not work as dilligently as I did. And he felt no obligation to worry about our children, and simply expected me to take care of everything. “You will take care of it; you always do.” As a result, our relationship became strained.

Like all moms, I carried a heavy “mental load.”

I was lucky since my husband bought the groceries and prepared most of our meals. However, I was the one who read all the books about parenting, discipline, gifted children, and teaching a child with 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. I was a classic example of a mom carrying all all the emotional weight for our household.

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. “Physician” was my identity, as much as “mom” was.

Work vs. mom - my 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 other peoples’ judgments about my ability to balance work and family effectively. I loved being an older mom, however, 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. It still hurt my feelings.

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 my 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 was able to exercise by walking in my neighborhood, but rarely managed to do anything else. Later I joined a health club, and that helped.

Burnout resulted from my tremendous work-life imbalance.

As a busy NICU doctor and mother, 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 pivot to a different job.

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 had to be followed. In addition, there were strict nurse case-managers who thought they knew better than the patient’s doctor or I did what each patient needed.

Those two years away from the NICU, working as an HMO medical director, allowed me the time and space to take better care of myself, resume regular exercise, pick up some 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. And I wanted to get back into the NICU.