Burned out on "burnout": Why hygienists need a better language for stress

What if what you’re calling “burnout” isn’t burnout at all? In this solo episode, Andrew Johnston takes a hard look at why hygienists feel overwhelmed, why the burnout buzzword is failing us, and how to tell the difference between true burnout, depression, stagnation, and normal life stress. He shares practical ways to reconnect with purpose, avoid getting stuck in the “burnout identity,” and find meaning again in your career.

Episode transcript 

Andrew Johnston: Welcome back, everyone, to another episode of A Tale of Two Hygienists, podcast episode number 516. I'm your host, Andrew Johnston. Thank you so much for being with us today.

But I'm really excited about today's episode. Weirdly, it's not a topic I actually love. This episode's going to be about burnout. One of the things I do is kind of script out—or at least bullet-point—some of the talking points that I want to discuss on each episode.

For the ones where I'm doing the monologues, I’ll usually do that. I don't always do that for the episodes where I have interviews. This one I haven’t quite fleshed out all the way. My train of thought sometimes goes off the rails, so hopefully by the end of this, it makes a lot of sense.

And I want to tackle the big issue for me. The big issue is: I'm really tired of seeing topics on burnout. Like, I'm burned out on burnout. Quite frankly, I think it's just not that cool to see people pushing this idea of burnout on everybody, like everyone’s an expert.

Like, “Oh, you must be burned out. You must be burned out,” anytime someone says “I'm exhausted” or “I'm tired,” or shows other signs or symptoms. At the same time, I think I'm kind of burned out.

I think we've all been in this boat at one point in our career. Some of you probably know exactly what I'm talking about right now as this episode’s launching. Some of you have probably gotten through it. Some of you will be going through it in the future.

So on this episode, I just wanted to share some things I've ventured into over the past several weeks. But before that, a quick update on the new co-host search.

Yeah, I emphasized that on purpose—just so you know, there’s two more people coming. It was a few weeks ago, I think, that I gave the last update. At that point, we had finalized the ten candidates that made the last round.

Since then, the committee has completed all the interviews of those ten. They completed the scoring and submitted that. From what I understand, it is a really tough decision. Those top choices were all kind of within a few points of each other.

I believe the contracts are being completed and jobs are being offered. I think that maybe on next week's episode—or maybe the week after that—we’ll be able to announce who the new choices are.

So no contracts yet, no signatures on these contracts, but I know that we're really close. Whoever ends up being chosen, according to the scores—it was really gutted, very thorough—it’s just going to be awesome for your ears, hopefully for many years to come.

Okay, so for this episode, let’s get into the burnout thing.

One of the reasons this is on the brain for me is because of that one thing where you see something once, you take notice of it, and then all of a sudden you see it everywhere. It's known as the Baader-Meinhof phenomenon, or more accurately, the frequency illusion.

Anyway, for a while right after COVID—this is kind of what happened for me—right as things were starting to quiet down a bit and people were going back to work, it felt like the crazy popular topic across all industries, and dentistry of course was no different, was burnout.

By and large, people were forced to stop working during the pandemic for an extended period of time, forced to stay at home. Those acts also forced some perspective on people.

So as the topic got hot, lots of people used it as a way to launch their speaking or writing careers, becoming experts in the field. Then after a couple of years, it seemed like that topic was less and less present at dental meetings, at conferences, and yes, even on this podcast—until you just didn't really see it anywhere anymore.

So much so that I had forgotten about that topic as I was trying to schedule the last several shows, figuring out what I wanted to talk about. It just didn't make it to my registry.

Then, similar to that frequency illusion scenario, I just kept seeing it everywhere again. And of course I wanted to blame it on the algorithm. I’m scrolling and I see something on burnout, someone else speaking on it—“Oh, it’s going to be at this conference.”

But no, it wasn’t even that. It was on a random billboard on the way to the grocery store. Or I’d take a flight, and the ads for the in-flight movie on the plane had something about burnout.

It was kind of everywhere, in real life—not just my online life. And I was like, “Oh man, is this making a comeback?” I don't know if it is or if it isn't. Because it is hitting me right now, I thought I'd take a chance to talk about this particular topic.

I want to talk about some things that have helped me kind of—I don't want to say “solve,” because I don't know that burnout is necessarily solvable. I think it's always on the doorstep for many people. But maybe stave it off or push it away a little bit.

So, a chance to talk about these things and also just random thoughts on the topic in general.

I think a good place to start is always the symptoms of burnout, though I want to talk about it from what I've experienced and what I understand.

Burnout is more like you're feeling overwhelmed with a particular task, you’re just exhausted all the time. That exhaustion can sometimes lead to a secondary symptom, which can be irritation or frustration or other things. It manifests in different ways for different people, depending on who you are.

That’s how I understand it, and I think that broad understanding basically holds up. But the common denominator to define burnout is really when things are taken off your plate, when you've had a chance to rest and you do your recovery things—then the symptoms subside.

I saw a thing from Mental Health America—I’ll put a link in the show notes for you to look through if you have some time. They talked about how people often confuse depression with burnout.

Because if you're able to take a break from the stressors in life and you don't feel better, then that very likely could be on the spectrum of depression. Even more so if it's multiple areas of your life that are affected—that's definitely a sign of depression, not burnout.

On the link I’ll put in the show notes, they have a free tool you can use to see if it’s depression or burnout and what you can do from there.

For me, when I keep hearing people describe their situations, most actually do feel like depression symptoms and not so much burnout. But if it's truly burnout, let's talk about that for a minute.

I spent about ten minutes prepping for this, trying to remember who it was exactly that I saw in this video. On my Instagram feed I have motivational speakers, thought leaders doing TED Talks or whatever—of course Filipino food and travel and comedians. It’s a very small group of people that make it to my feed.

I don't think it was the comedians or food or travel, so I'm going to attribute this—and I could be wrong; I couldn't find the video, so if someone has it, please let me know—to someone that Rachel Wall turned me on to named Dan Martell. Again, I could be wrong; I apologize if this is the wrong attribution.

He was talking about how we don't ever seem to be burned out by the things that we love doing. He also said that when we don't have purpose in the overall project or the job, then the tasks for that job or project will burn us out.

You get what I'm saying there? It's not that you might be burned out because you're seeing patients all day, every day. You're burned out when you've lost your purpose or your “why” for wanting to see those patients every day.

This translates to when people who are burned out start to see hygiene in a completely different way, then all of a sudden change their whole attitude about going into the office.

I'm going to come back to this in a minute, but let's jump back to this idea of task versus purpose, because I think there's a lot of confusion here.

Tasks are things that you do every day. Purpose is the reason those tasks mean something. You can be overwhelmed by tasks but still be energized by purpose. And you can have fairly reasonable tasks but feel completely drained if you've lost that purpose.

This shows up in dentistry all the time. When someone says, “I'm burned out from seeing patients,” sometimes what they really mean is “I no longer feel connected to why this matters.”

That's a completely different problem. If this was about the workload, then the solution would always be fewer days, fewer patients, more breaks in the schedule, right? But we all know people who work crazy schedules—and I was one of them, especially early in my career. I loved loading up the schedule: double-book me, I don’t care.

And they still feel fulfilled. We also know people who work light schedules—maybe they see four or five patients a day—and they feel completely drained and empty.

So the workload alone isn't the full story. When purpose disappears, everything feels heavier. Small annoyances feel enormous. Patients feel like obstacles instead of the human beings that they are. Even good days feel very flat.

That's not a time-off problem. That's a meaning problem that no amount of vacation is going to get rid of.

So the solution for this is finding that “burnout buster,” that thing that injects a sense of meaning and purpose back into work.

For me—you’ve heard me talk about this on the podcast before—it’s dental mission trips. If I have time, I’ll touch on that a little bit more later.

For others, it can be as simple as finding something new within your scope of practice and leaning deeper into that. I don't know if you've ever had this, but I've had lots of dental hygiene acquaintances tell me they took a course on something new—say the oral-systemic connection—and suddenly they’re talking about it nonstop.

They tell you, they tell their patients every new thing they've read or learned. They went from “just being at the office seeing patients” to really engaging with them.

Maybe it's not oral-systemic. Maybe it's something like local anesthesia—that was something that worked for me. Maybe it's a new leadership role, whether it's within organized dentistry, within the office, or even something outside of the profession altogether.

It could be airway. It could be any of those things. They take it, and then all of a sudden they have a drive to be at the office and they’re intervening on their patients’ behalf more than they ever did. It happens all the time.

Another interesting thing I noticed is that burnout often happens because—we humans are just flawed this way—we can't really seem to look ahead. We can't seem to focus on how what we're doing right now relates to a life enhancement or life improvement in the future.

What's more, when everything else stops working in regards to finding meaning in what you're doing, using the future “you” or the future life situation as motivation seems to really work for a lot of people.

I saw a Nikola Tesla quote recently, and I looked it back up for this episode. It says:

“Let the future tell the truth and evaluate each one according to his work and accomplishments. The present is theirs; the future, for which I have really worked, is mine.”

Let’s run through that a little bit. Quotes like this can take on a literal meaning from the author in the moment they wrote it, maybe in response to something else. Then we can use the same words in a different context.

I think what the original quote is meant to mean is that someone shouldn't be too worried about getting their flowers right now for the work they’re currently doing. If their work is good enough, there’s going to be a bigger recognition of accomplishment when the work stands the test of time.

While others might be getting their fame and fortune right now—or seeking that right now—the work that you do, the work that we all do, should last. That's going to be the accomplishment.

When you think in those terms, it's really hard not to be engaged. Being engaged cancels out the burnout, because we're thinking, “Hey, this is for the future.” We don't really know what the future is going to hold, but we know it's going to be better than this if we do a good job now.

So let's work hard and do our best job—that's going to give us energy or the desire to be even better and to stay engaged.

Another interesting idea is that burnout somehow is consistent with stages in life, and knowing that this can be true will give you a bit of self-awareness. When you have that self-awareness of “I just have to get to the next stage,” that in and of itself can help stave off that burnout effect.

At the same time, it helps you seek the specific help that you need with the problem you’re having at that current stage.

Okay, I didn't explain that very well, but this is what I mean. For example, a brand-new hygienist isn't burned out the same way that a 15-year vet is.

Early in our career, burnout is going to sound like: “I'm overwhelmed. My work isn't good enough. I'm scared people don't think my work is good enough. The office is moving at a pace that's way too fast. I can't seem to catch up. I don’t want to disappoint anyone.”

While those things are often termed burnout, it's actually imposter syndrome, mixed in with the pressure everyone feels when they’re learning something new and just the hardship of learning curves.

Mid-career burnout can often sound like: “I'm stuck in my career. I'm just going through the motions. I'm on autopilot. I'm bored.”

While that is often termed burnout, that's actually stagnation. We’re just stagnant in our career. It’s not really burnout—but you can tell it kind of is because we've lost the passion for it.

Late-career burnout often sounds like: “I'm tired of being the one that does everything all the time. I'm the go-to for everything. I’m tired of it. I'm tired of being the person everyone comes to for mentoring, of having to teach the new person, of being the person who has to fix the compressor when it goes down,” or whatever it is.

At the end of the day, these things never change. So again, this is stagnation. These things are easily fixable and might not actually be true burnout. It might be something else.

We often throw out that blanket advice like, “Oh, you’re burned out, just go take a break,” but we're often missing the correct vocabulary needed to fix the issues that are happening to us. We can't get better until we know the real problems.

Sometimes using the blanket statement “You're burned out” isn't really contributing to overcoming the issue.

And then that whole thing—“Hey, go take a break, you’re burned out, go take a break”—I have some thoughts on that, too. This one might be a little bit uncomfortable to hear.

I think that phrase is just really bad advice. We can't rest our way through life. Rest is a tool, it's not a strategy.

When we're fatigued, rest is going to fix fatigue. But it's not going to automatically fix someone who's disengaged or “bored.” You can take a week off, you can take two weeks off, you can go on the best vacation of your life—and if the core issue is lack of purpose, lack of growth, lack of alignment with the philosophies of whatever you're doing, while you might feel physically better, you're still going to feel empty mentally when you come back.

And it's going to hit you day one. It's not going to be “After some time it starts to wear on you again.” No, it's probably going to be right away.

Sometimes taking a break actually makes things worse, because now you've tasted freedom again, and the contrast is even sharper.

Like what I mentioned at the very beginning of all this: when people were forced to stay home during the pandemic, you’d think everyone would come back to the office—and not necessarily just dental offices, but everyone’s workplaces—with all this energy.

Instead, we saw things like “quiet quitting” happening all the time. The contrast was stark.

Sometimes people don't need to work less; they just need different work. It doesn't necessarily mean they have to have a different career or get out of dental hygiene. It might be a scope change.

Sometimes they don't need rest; they need a challenge. Sometimes they don't need to escape; they need a path for progress.

All of that is okay. None of that means that you're broken. It just means that something in the system—internal or external—needs recalibration.

One of the things that started to bother me a lot as I saw the term burnout creeping up everywhere is that burnout itself has kind of turned into a brand. And it's kind of disgusting in a way for me.

I don't want this to come off as an attack, because it's not everyone who makes a brand out of burnout who is at fault here. I know people really need help in this area.

Sometimes the wrong buzzword attracts the people who don't know exactly what they are experiencing. If they think it's burnout and it's really depression, does it really matter as long as they're going to get help? Sometimes getting them to any sort of program is super helpful.

But at the same time, when we went from burnout being something people were quietly struggling with to something that gets thumbnail titles, speaking stages, coaching programs, and entire Instagram accounts—TikTok accounts, for crying out loud—again, some of that awareness is good. Some of these programs are great.

But there's a weird side effect that happens when suffering becomes content. Because when burnout becomes a brand, it starts to subtly teach people that burnout is an identity instead of a season. It turns into something you stay inside of instead of something you actively work through.

Then what happens is everything starts getting labeled as burnout.

“Oh, you're tired? Burnout.”
“You're frustrated with your schedule? Burnout.”
“You're bored with your job? Burnout.”
“You’ve had two hard weeks in a row? Heaven forbid—burnout.”

I just don't think that's very helpful. Sometimes you're not burned out. Sometimes you're just human, and life is hard and can be heavy for a stretch. Sometimes you're just in a frustrating season. Sometimes you're just dealing with a bad system, a bad manager, a bad workflow, a bad coworker.

It's not a broken career.

When burnout becomes the default explanation, we skip past problem-solving and jump straight to exit planning. That’s risky, because now, instead of saying, “What needs to change? What else can we do?” we jump to, “All right, we just need to quit.”

Then the next thing is something else is going to get hard—the next step gets hard—and then we quit that, too, until our identity is “a victim” and “a quitter.”

That's not good for anyone's personal sense of worth. Talk about mental health disorders—this could be crippling for someone who struggles with them.

So my advice is: be really, really careful when you dive too deep into being labeled as having burnout or chronic burnout. There might be something else going on.

I'm going to end this episode with this. I really wanted to go deeper into my thoughts on dental mission trips in this episode, but we’re short on time, so I'm not going to. I definitely have some thoughts about them—they’re in some past episodes you can search.

Finding time to give back, to serve others, and use my dental education at the same time really helped bridge that gap for me.

When I went back to the office, I would have positive feelings about dentistry again because I used dentistry for good. It saved me, I don't know how many times over the years, from feeling that burnout—which for me was losing my sense of purpose and doing the monotonous part of the job.

I didn't like going in and just having “same-same” all the time. So I had to get away and do something different, but I was still a dentist—essentially the same exact job, just a different setting.

Realizing I was really helping people—I would go to places where people had never seen a dentist before and provide even temporary relief and prevention, albeit limited prevention of further destruction—we have an amazing profession when you want to see it.

I need you all to know and believe that. MIT News did a report in 2024 and said that the U.S. Census Bureau tracks the listed job descriptions that respondents provide for every census. Each decade’s job index lists about 35,000 occupations. We are one of 35,000 occupations.

When you see those lists of the best jobs or best careers in the U.S.—and go ahead and Google it right now if you want—where does our profession land? You only have to say “How popular is dental hygiene?” or “Give me the list” and scroll down. You're going to find it within a few scrolls.

U.S. News reported that we are number 28 in the list of top 100 jobs. You all know this to be true. We are always in the top 100 jobs, usually top 50 if not top 30. So we’re number 28 in U.S. News, out of 35,000 possible occupations.

Statistically, it’s unbelievable that so many hygienists claim to be burned out when we have it so good. So it really sounds to me like there's more to this story, and I would guess—again, I'm not a mental health professional—that it likely involves depression and anxiety issues more than true burnout.

For me, I would like to see less chit-chat on burnout and more chit-chat on depression and anxiety. Let's call the problems what they really are and really start helping each other out.

Thanks for listening to this episode. Be sure to check out the show notes for the few things that I mentioned. I will catch you on the next one. Thanks.

Resources

https://news.mit.edu/2024/most-work-is-new-work-us-census-data-shows-0401

https://mhanational.org/resources/burnout-signs-causes-recover/

Screening For Depression vs Burnout with Mental Health America