For four years I worked at an AIDS service organization in Ontario. The first year I worked there we didn’t have an up-to-date strategic plan for the agency. For the first three years I worked there I didn’t have a job description or a work plan. For the entire four years I worked there I never received a budget for my position. During those four years I would have five different managers, answer to three different executive directors and deal with two different executive boards (after the first board was ousted during a vote of non-confidence).
Staff turnover was exceptionally high, leading to some positions being vacant for months, resulting in workloads constantly being redistributed, responsibilities changing and orientation for new staff ongoing. Our wages were frozen. Our prescription drug coverage was inadequate. We unionized. Yelling, crying and seething hostility at staff meetings became the norm. Amongst all this, the participants we were trying to support were sero-converting, being evicted, falling in love, getting robbed, relapsing, going to jail, getting raped, attempting suicide, dying of cancer and having babies. For four years I worked at an AIDS service organization in Ontario and then I burnt out.
Burnout is a psychological term that is generally defined as “physical, mental and emotional exhaustion brought on by chronic work-related stresses.” Though it is not a recognized disorder in America’s popular Diagnostic and Statistical Manual of Mental Disorders, it is present in the International Statistical Classification of Diseases and Related Health Problems records, which is used by Canada. The symptoms of burnout can manifest in several different ways, including a diminished interest in work, lowered self-efficacy, long-term exhaustion and highly negative attitudes toward oneself, one’s work and one’s life in general. For me, it all began with a growing disillusionment in the effectiveness of the not-for-profit sector, not to mention the suffering I felt in a dysfunctional work environment.
I became increasingly anxious. I began to get stomach aches. I broke out in a rash on my left thigh. I developed agoraphobia, sometimes peeing into cups or old cereal bowls so I wouldn’t have to leave my bedroom. I began depressive sleeping. I put on weight. I HIV-positive and my viral load peaked above undetectable for the first time since starting medication six years prior. Mentally, I was invested in the idea of trying to make the best of a bad situation at the office, but physically, my body was portraying me, telling me I had to stop. At the advice of my doctor, I took a leave of absence.
Social work carries with it one of the highest rates of burnout of any profession. In the HIV sector specifically, if you’re a person living with HIV/AIDS, you can add survivor’s guilt, post-traumatic stress disorder, tokenism, HIV-phobia and discrimination, and numerous other concerns to the already abundant list of problems working in the non-for-profit sector brings. I was like a frog in a pot of gradually warming water. The stresses and conflicts of my job were so gradual that I didn’t realize I was being boiled alive.
While on leave I read about the suicide of HIV/AIDS activist Spencer Cox and I could see myself in him so clearly that it scared me. Cox had burned out, and self-medicating and depression had led to his death. I understood then, as I pored over his obituaries, that if I didn’t start to do some serious self-care, my issues stood the risk of becoming a lot more serious. So I booked an appointment with a psychiatrist. I had “Save Yourself” and an image of a man drowning tattooed on my wrist. I began to think about how to get better and how to disengage from a job I had confused with my own self-worth and identity. I took many, many months, filled with setbacks and hurdles, but I slowly began to get better. And then I did something I should have done two years earlier: I quit.
There are several coping mechanisms to use when dealing with burnout, and one of them is knowing when to walk away. My final act of turning over my office keys was liberating, and so was declining to take any of my personal possessions from my office with me. I left my awards, certificates, media clippings and collages of event flyers and thank-you notes sitting in the cardboard box my successor had thrown them into. I was about to move cities, and the future I was moving toward didn’t need reminders of the past. I wasn’t done being a part of the fight against HIV/AIDS, not by a long shot, but I wasn’t going to help anyone if I couldn’t first save myself.