Life in Singapore can be demanding.

Work hours can be long. School and academic expectations can be high. Many adults are looking after children while also caring for ageing parents. Others may be dealing with financial pressures, relationship difficulties, illness or uncertainty at work.

And because most of us are constantly connected to our phones, work and bad news can follow us almost everywhere.

Most people can cope with short periods of stress. The problem is when the stress does not let up.

Over time, you may notice that you are more tired, irritable or impatient. Things that you previously managed quite easily may suddenly require much more effort. You may find it harder to concentrate, lose interest in things you normally enjoy, or simply feel that you are not quite yourself.

Sometimes there is an obvious reason. Sometimes there isn’t.

This is often what people mean when they describe themselves as emotionally exhausted.

What is emotional exhaustion?

Emotional exhaustion describes a state of feeling mentally and emotionally depleted after a prolonged period of stress.

It usually develops gradually.

You may still go to work, care for your family and keep up with your daily responsibilities. From the outside, you may appear to be functioning normally.

But internally, it may feel as though your battery is constantly running at 10 per cent.

That distinction is important. People do not have to completely fall apart before they are struggling.

In my clinical work, I often see people who have continued functioning for months despite feeling increasingly exhausted. They tell themselves, “I’m still going to work, so I must be okay.”

Functioning, however, does not necessarily mean that someone is coping well.

Sometimes it simply means they have become very good at pushing through.

What causes emotional exhaustion?

There is rarely only one cause.

Common contributors include:

• Work or academic pressure – long hours, heavy workloads, deadlines, examinations, difficult colleagues or a work environment that feels relentless.
• Caregiving responsibilities – looking after children, ageing parents or a family member who is unwell.
• Relationship difficulties – marital conflict, divorce, family tensions or the breakdown of an important relationship.
• Financial pressures – worries about employment, housing, debt or the rising cost of living.
• Bereavement or loss – the death of someone close, but also other forms of loss such as losing a job, relationship or sense of direction.
• Health problems – living with chronic pain, illness or injury.
• Several smaller stresses happening at once – something I see quite commonly. No single problem seems overwhelming, but collectively they become too much.

People sometimes ask me, “Why can’t I cope? Other people seem to manage.”

That comparison is usually not very helpful.

Stress is cumulative. What matters is not simply how serious one problem appears from the outside, but how many demands a person is carrying, how long they have been carrying them and how much opportunity they have had to recover.

How to recognise emotional exhaustion

Emotional exhaustion can look different from person to person.

Common signs include:

• Feeling constantly tired
  • You may wake up tired despite having slept, or feel that you have very little energy left by the end of the day.
• Becoming more irritable
  • Small things may annoy you more than they used to. You may lose patience more easily with colleagues, your partner or your children.
• Loss of motivation
  • You may procrastinate more, find it difficult to get started, or stop caring as much about things that used to matter to you.
• Poor concentration
  • You may become forgetful, make more mistakes or find yourself reading the same email several times before taking anything in.
• Feeling emotionally numb
  • Not everyone who is exhausted feels sad. Some people simply stop feeling very much at all.
• Sleep problems
  • You may struggle to fall asleep, wake repeatedly during the night, or find your mind continuing to work even when your body is tired.
  • Poor sleep can then make the exhaustion worse. Persistent sleep deprivation can affect concentration, judgement, mood and our ability to manage everyday demands.
• Physical symptoms
  • Stress can also show up physically, with headaches, muscle tension, stomach problems, palpitations or dizziness.
• Becoming more withdrawn
  • You may stop replying to messages, avoid social situations or simply want to be left alone.
  • Occasionally wanting some space is perfectly normal. But when withdrawal becomes persistent, it may be a sign that something more is going on.
    

Is emotional exhaustion the same as burnout?

Not exactly.

The term “burnout” is often used quite loosely these days, but the World Health Organization defines burnout specifically in relation to chronic workplace stress that has not been successfully managed.

Its main features are exhaustion, increasing mental distance or cynicism towards one’s job, and reduced professional effectiveness.

So someone can certainly feel emotionally exhausted without being burnt out.

Someone can feel emotionally exhausted without experiencing burnout. A parent caring for an elderly parent with dementia may feel emotionally drained, but they are not technically experiencing occupational burnout.

However, if work-related stress persists over a prolonged period, it can contribute to burnout, with emotional exhaustion becoming one of its key components.

Is emotional exhaustion the same as depression?

This is an important distinction.

No.

Emotional exhaustion is not a psychiatric diagnosis, and feeling exhausted does not automatically mean that someone has depression. There is, however, considerable overlap.

Both can involve poor concentration, tiredness, sleep disturbance, irritability, low motivation and reduced enjoyment. One useful question is what happens when the stress reduces.

Someone who is mainly exhausted from work may feel considerably better after a proper break.

A person with clinical depression may go on holiday, have nothing particularly stressful to do, and still wake feeling empty, hopeless or unable to enjoy anything. That is not a perfect test, but it illustrates the difference.

As psychiatrists, we do not diagnose someone simply because they tick one or two symptoms on a checklist. We look at the overall pattern, how long the symptoms have lasted, their severity, the person’s circumstances and how much their functioning has changed.

What can you do about emotional exhaustion?

There is no single solution.

And sometimes the answer is not another breathing exercise.

If someone is working 14-hour days, sleeping five hours a night and answering emails at midnight, teaching them relaxation techniques without addressing the underlying situation is unlikely to solve very much.

The starting point is usually to ask: What is draining me? Sometimes the answer is obvious. Sometimes it takes a little thought.

Once you know what is contributing to the problem, you can decide what is actually within your control.

When should you seek professional help?

You do not need to see a psychiatrist simply because you are stressed or emotionally tired.

Stress is part of life. But you should consider seeking professional help if:

• the symptoms have persisted for several weeks and are not improving
• your sleep is significantly affected
• you are struggling to function at work or school
• your relationships are being affected
• you have lost interest in most things you normally enjoy
• you feel persistently anxious, low or hopeless
• you are increasingly relying on alcohol, sleeping tablets or other substances to cope
• you simply feel that something is not right

Sometimes people wait because they think their problems are “not serious enough”.

You do not have to wait until things become severe before asking for help.

A GP, psychologist, counsellor or psychiatrist can help work out whether what you are experiencing is mainly a response to stress or whether there may be an underlying condition such as depression or anxiety that requires treatment.

And if you are having thoughts of harming yourself, wishing you were dead or feeling that you may not be able to keep yourself safe, seek help promptly.

Final thoughts

Over the years, I have met many highly capable people who became emotionally exhausted.

Often, the very qualities that helped them succeed were also part of the problem.

They were responsible. The thought of letting others down never sat well with them. When challenges arose, they kept going. They were used to being the person others relied on.

Those are useful qualities. But there is a difference between perseverance and running yourself into the ground.

Sometimes the warning sign is not that you have stopped functioning. It is that functioning has started to cost you far more than it used to. That is worth paying attention to.