Burnout: When to Return to Work after Medical Leave

If you are on medical leave for burnout, you may be asking a practical question. How will I know when I’m ready to return to work?

Many people have been exhausted for so long that it can be difficult to tell whether they are fully recovered or still in the process of recovering.

I am a psychologist in private practice, and I work with people who are on medical leave for burnout.

How to Know You’re Ready to Return to Work After Burnout Leave

Below are nine milestones I use with clients to assess whether someone is ready to go back. They come from years of supporting people to successfully return to work.

1. Your Physician Agrees You Are Ready to Return

Before returning to work, it’s essential to speak with your physician about your readiness. Most physicians regularly support patients on medical leave and have seen both successful and unsuccessful returns.

In my experience, physicians are more likely to encourage additional recovery time than to push someone back to work prematurely. If your physician seems hesitant about your readiness to return, it may be a sign that you are underestimating how much you are still struggling.

If you believe you are ready and your physician agrees, that agreement carries weight. If you believe you are ready and your physician does not, take the misalignment seriously.

2. Your Energy Is Consistently High and Reliable

During burnout recovery, your energy level will have improved unevenly. You may have several good days followed by a crash. This is normal and usually reflects limited pacing skills.

As my clients are recovering, I look for a steady upward trend in their average energy level over weeks and months. Crashes give way to dips, and the dips become fewer and smaller as time goes on.

Having several good days in a row is not sufficient to consider returning to work. Your energy needs to have been high and sustained with no dips for at least four to six weeks. Only then do we begin planning a gradual return-to-work program.

If you are still experiencing dips in your energy, or your energy seems to be continuing to improve, then hold off on returning.

3. You Are Sleeping Well Through the Night

Sleep problems rarely resolve after returning to work, so make sure yours have resolved before you consider going back. You should be sleeping through the night with rare exceptions, going to bed and waking at consistent times seven days a week, and waking without an alarm clock. You should have no need for daytime naps, and you should not be tired during the day.

If your sleep is still broken, that is what to work on before anything else. This video is about how to improve your sleep during burnout recovery.

4. You Can Sustain Mental Focus for Several Hours

Once you return to work, you will need to be able to focus for eight hours a day, five days a week, for months at a stretch without a substantial break. That is the standard your recovery has to meet. The tests below are ways of finding out whether you are capable of performing at this level yet.

You should be able to read a demanding book for three hours at a go without tiring, and retain what you have read. Better still, attend a book club and take part in the conversation about the book, or watch a documentary and then discuss it with others.

You should also be able to do a three-hour shift at a volunteer activity.

These suggestions are all ways of asking the same question. Can you show up in the same way that you will be required to show up at work? If the thought of taking these activities on feels overwhelming, returning to full-time work is premature.

5. You Are Taking Care of Your Physical Health

Before returning to work, it’s important to be eating a healthy diet, to have addressed any medical issues and physical injuries, and to have established a regular exercise routine you can sustain over the long term. Research shows that the single most important thing you can do to avoid experiencing a relapse is to participate in regular physical exercise.

If you have already returned to work before you implement these habits, they will be much harder to establish. If this feels like too much to take on, you are likely not ready to return to work.

6. You Have an Active Social Life

Before you went on medical leave, burnout had reduced your life to going to work and doing the bare minimum outside the office.

Before returning to work, I encourage my clients to re-engage in a full, rich social life that they will be able to sustain over the longer term. Having meaningful places to go outside of work with people you care about can help protect against overload and future burnout.

What matters is that you are getting out there again, and that these activities are regularly scheduled.

You should be able to be in the company of others for an entire day without wanting to escape. You should be able to host a dinner party and function the next day.

It should feel like a privilege and a joy to be active again. If it feels like a burden, you are likely not ready to return to work yet.

7. You are Addressing Major Life Stressors

Large ongoing stressors, such as family illnesses, separations, caregiving responsibilities, depression, or an active substance abuse problem, significantly increase the risk of having another episode of burnout.

Have you talked to your physician, hired a lawyer, found a good nanny? Do you have a prescription, are you seeing a psychologist, have you joined a support group?

These stressors do not have to be fully resolved before you return to work. What matters is that you have help in place, because your time and energy will be far more limited once you are working again. If nothing is underway yet, you are not ready.

The first seven milestones are things you can observe about yourself. The last two are conclusions you need to have reached.

8. You Understand that Delaying is Preferable to Failing

Returning to work before you are ready can mean failing in the attempt and having to go back on medical leave. What follows is a loss of confidence in your own decision-making and performance, and a longer recovery overall. A failure of this kind can also cause your company to lose faith in your judgement.

Doing the work upfront dramatically increases the likelihood of a successful return, and is more efficient in the long run than returning too early and failing. I have written elsewhere about why returning too soon can be risky.

If you are chomping at the bit to return to work and negotiating with yourself about the earliest possible date, or hoping you will be fine once you are in the routine rather than ensuring you are ready first, you have not yet accepted that delaying is preferable to failing.

9. You Understand What Caused Your Burnout

If you do not understand why you burned out, it is difficult to prevent it from happening again.

Did you think your career would progress more quickly if you never left your desk? Did you have weak personal boundaries, or fail to set limits about what you would and would not take on? Did you work late because your personal life was disappointing?

Or was the workload genuinely impossible, so that nobody could have carried it? Did you ask for help and find none was forthcoming? If so, there are still questions to answer. Why did you stay when others quit or found another job? Why did you allow this to happen to you?

Many people benefit from working with a psychologist at this stage. Recovering from burnout, and then remaining out of burnout, can require significant changes in how you see yourself and in establishing personal boundaries.

Considering Next Steps

If this post helped you clarify where you are in your recovery, the next step may be to give yourself permission to remain on leave. Returning to work too early is why people find themselves back on medical leave.

I encourage you to meet every one of the nine milestones described above before you return to work. Not most of them. All of them. A return that fails will cost you far more than the extra months on medical leave would have.

If you are uncertain about your readiness, working with a psychologist can be helpful. A clinician experienced in treating burnout can help you assess your readiness, address remaining risk factors, and plan a return that protects both your health and your career.

Reach out to a psychologist in your area who is experienced supporting people recovering from burnout. If you are in Alberta, please contact me.