Burn out, peri or something else?

[Brokenandexhausted]

Help!
I work in the NHS. I have an unmanageable caseload. I work stupid hours to try and get through the number of patients I am expected to manage. I'm not coping well

I parent teens, one who has recently started having panic attacks and the other is awaiting an assessment for asd & ADHD.

I have no history of mh issues but right now my confidence is on the floor, I feel I'm a rubbish professional, difficult to manage. My mood is all over the place. Some days I function quite well. Others, I have zero motivation or focus, can't achieve even simple tasks - I'll set myself 3 simple tasks to do but with distraction and procrastination, 5 hrs worth of work can start at 9am but I don't actually finish the tasks until 1am.
Some days I boss it. Other days I spent most of my energy trying not to cry. I am completely coping, until 5 mins later I'm overwhelmed, feel I can't cope and I'm a mess.
A couple of months ago I reached the point where ending my life seemed reasonable. That scared me and I referred myself into my services and visited the go and started hrt (because menopause is easier to admit to than mh issues)

I'm now being encouraged by colleagues and management to get myself signed off.
I have a large caseload and a long waiting list. My caseload is my responsibility ( I'm the only person who does what I do in my area) and nobody on it will receive routine treatment until I'm back.

I'm scared that if I don't go off sick that I'll make stupid mistakes and screw up professionally but if I do, when I come back the workload will be unmanageable. Not working isn't an option. I need to keep a family of 4 fed, watered and housed.
Is this burnout? Is it something else? Is it recoverable?

Sorry you're feeling this way OP. Sounds like you have a lot on your plate.

How old are you? Did the HRT help?

How long have you been doing this job, and how recently have you been feeling like this (ie did you used to manage this fine and then it changed?). Is it just work that sends you spiralling or is it everything?

It sounds like burnout with likely hormones contributing. Taking a break may be inevitable... you can't pour from an empty cup. Just to focus on the kids for a while and reset? Give hrt or meds time to work?

I don't know, but all I can say is I'm pretty sure I'd have burnout in your shoes. It's totally reasonable and understandable that you're struggling!

Oh lovely op. I read your post and nodded along (except I don't work in the nhs so don't have that added responsibility).

You need a break. Genuinely it won't get better until you do. Things I attributed to peri were not, they were stress/burnout. I only realised when I was away from it.

Peri probably doesn't help of course but hrt isn't a magic wand for everyone.

Take some time. You can't battle through and it won't get better on its own, something has to change/re set.

Take a few weeks. If management are encouraging you to do that then ask them what their plans are to cover your absence. I appreciate it's not that easy of course but they surely would need to have a plan if you left?

But take the time. Even if you do come back to the same shit you will have fuel
In the tank.

This may be a stupid question but is looking for a new role in a different trust an option? Appreciate the problems would likely be the same but a new environment may help?

Thanks @PinkCherryBlossoms and@Gobimanchurian .
It's always felt a bit like this. I was in the same boat 3yrs ago at the start of covid but I was able to hide it better because we were all working from home.

I've been in my current role 4 years.

Hrt started a couple of months ago. I've already increased the oestrogen to see if it helped .

The highs are less high and the lows less low - but still too deep that I can hide them in work.
Taking time off feels so indulgent when there's so much that needs doing. And I'd swap the pressures of the NHS for the dirty chaos if my house which needs a lot of attention to make it clean and tidy and somewhere I can relax . Mainly I switch one overwhelming to do list at work for one at home.

Maybe just dealing with one set of overwhelming things is enough.

Ohhhh NO to this mindset young lady! If you are off work you are off home as much as you possibly can be! Yes feed/clothe/basic parent but this has to be time for you to do you. It has to be or nothing will change!

You need to look after yourself OP before you can look after others. If not the burnout will get too much and the consequences worse. Why not get signed off for a few weeks initially, let the HRT settle down, rest and recover until you feel stronger. I assume you have sick pay? While your dedication to your work is admirable and very much appreciated you have to think what would happen if you left tomorrow or were run over by a bus (hopefully not) there would be no choice but to replace you. Maybe something needs to give for the higher ups to take notice. You cannot carry it all look after yourself because no one else will

It is completely possible to recover from burnout, I know as I have done it and I was chronically stressed (third sector, sudden illness, mid life ADHD diagnosis).

Take a month off, my GP advised 2 weeks is often not enough as people start to feel stressed about going back after a week.

Just potter, sleep, eat well, rest, do light exercise, walk, see friends, go to a class, do a hobby. It is all about resetting your cortisol levels and getting out of the fight, flight, freeze mode.

If you rely on sugar in your diet, I'd highly recommend cutting it out as for me it was a massive cortisol trigger. The other thing that saved me (and I tried lots of medications, anti depressants, ADHD focus meds) was regular exercise. Long term that has been the most amazing sustainable thing that has helped my hormones.

Good luck and please do not feel guilty 🌷

Same circumstances as you (NHS/peri/kids) but I didn't notice the warning signs until it became inevitable. I felt really unwell at work last year headache, ringing in my ears and palpitations, I couldn't even speak to my DH when I got home. I intended just to take 1 day off but I couldn't face going back, I spoke to the GP who said I was close to a break down. I had 2 months off coupled with counselling and I am somewhat better.

I did feel awfully guilty but my GP says it needs to be treated like a physical illness. I second some time away if your manager suggested it, it sounds like they have noticed. Time to concentrate on you.

In addition to the other very sensible comments above I would like to add the NHS slant.. I was in a very similar position with caseload and role that few could provide. Meaning it all rested on me. Particularly the emotional load. Fast forward a few years and a trust merger and the role was literally obliterated overnight. You are totally dispensable in the eyes of the NHS. We leave, retire, die and the vacancy control goes forward the same week. Please look after yourself.

Thank you all. That's really helpful - especially @Allthecatseverywhereallatonce and @MistyTrains2 for your survival stories.

I'm under pressure to clear my waiting list and I have a couple of important things on in the next 2 weeks but I will try and get a gp appointment for after that. It's beginning to feel like the most sensible option.