How therapists cope with stress and deal with their own mental health

Gold, a psychiatrist and assistant professor of psychiatry at the medical school at Washington University, would crash for a few hours then struggle to sleep through the night. She stopped responding to friends’ texts and messages. She would get angry when she received emails asking her to give a talk. She nearly forgot about a presentation she was scheduled to give.

All of this was so out of character for her. The emotional exhaustion she was experiencing from her work was at a different level.

“I didn’t know I was burned out until my therapist told me,” she said. “And I’m a burnout expert.”

Gold, whose research focuses on health care worker burnout and mental health, treats medical faculty, staff and their college-aged children. During the pandemic, her work went entirely remote. Her patients, like mental health patients everywhere, struggled more than ever.

When she realized the toll the circumstances were taking on her own mental health, she had to learn how to prioritize her needs differently.

“We have training in coping skills — we don’t always apply them to ourselves, but we know them intellectually,” she said. Gold began setting better boundaries for herself. She worked on trying to say “no” to extra requests more often without feeling guilty. She worked on limiting time spent on social media before bed. Gold has interviewed mental health workers about how they deal with the stress of their work.

“Most therapists go to therapy. It’s completely the number one thing that protected me (during the pandemic),” she said.

Jessica Rosenberg, a therapist and co-owner of Open Arms Wellness in Brentwood, says mental health workers have to deal with a lot of emotional labor.

“It’s important to take an internal reading of how much capacity you have to extend yourself emotionally,” she said. Creating a positive work-life balance might mean not taking on new clients, even though there is so much demand right now.

“Physical activity is a really great way to process some of that emotional labor,” she said. She takes walks and runs. She also incorporates a regular five- to 10-minute meditation in the morning, to start her day with purpose and intention. It takes conscious effort to separate herself from what her clients are going through.

Her colleague, Kevin Kidd, works to keep his work life separate from his home life. About six years ago, he made a commitment to working out five to seven days a week.

“I make that a huge priority for myself,” he said. Since he works two jobs and about 60 hours a week, he doesn’t answer emails outside of his work hours.

His goal is to be mentally present for his wife, his son and friends when he’s not working. It’s also helpful for him to focus on his clients’ successes and improvement.

He finds that sharing work challenges with close co-workers or a mentor is also crucial to longevity in this career.

“Just about every therapist has those two or three people in their professional life who they can share thoughts about difficult situations with,” he said.

Gold said she heard from a lot of therapists during the pandemic who took on extra clients and worked longer hours during the pandemic — often to the detriment of their own mental health.

She said it’s important to become more aware of one’s own body and warning signs, such as changes in sleep or physical tiredness.

“Burnout is different from depression, but it has a lot of symptoms that look like depression.” She’s changed her reading habits, which used to focus heavily on books about mental health, advocacy, sexism and racism. Now, she’ll opt for a lighter “beach read” or watch mindless television to decompress.

“Particularly in mental health, many are perpetually emotionally exhausted,” she said.