This article is dedicated to immigrants and expats seeking help for burnout symptoms in Germany. It’s a topic that is close to my heart. The more clients I help who have faced this issue, the more I realise how important it is to get this information out there.
Just about everyone I know in Germany has a stress or burnout story to share. Some end worse than others. Mine is as follows: after landing in the hospital with a scary pregnancy-related illness, I started to have gradual anxiety symptoms including weird random fainting spells, shortness of breath and nausea. They started small and grew over time. Not understanding what these symptoms meant made them get worse. Once I got a diagnosis that made sense, I did cognitive behavioural therapy, which helped enormously but wasn’t quite enough to curb some pretty dramatic panic attacks. Some years later, I found a medication that worked. I also changed careers. I’ve been symptom-free for 5 years.
That’s the short version. The story has a happy ending because I found help and used it. It didn’t cost me very much money because almost all of it was covered by my public health insurance. But finding the help I needed took a mammoth effort, even as a German speaker who is no stranger to bureaucracy. As an expat whose German skills might not be up to scratch, how are you supposed to know where to find this support and secure it? I hope I can help.
Taking time off work due to burnout
If you are unwell due to a toxic work environment, bullying, burnout or similar issues, try to find a sympathetic general practitioner (Hausarzt / Hausärztin) or psychiatrist (Psychiater:in) in Germany. If they can see you are unwell, they can prescribe time off work as a first step. They might prescribe you a week or two at first and then tell you to come back and see them again, or they might identify a greater need and give you up to six weeks at the get-go. Even if those six weeks go by and you still feel you need more time off, you can always go back and see if more time is possible. If you are off sick for more than six weeks, your health insurance company takes over the costs of your salary from week 7.
In Germany, there is no upper limit for sick days, as long as you have a medical certificate. During this time, you remain employed, you continue to be paid your salary and if you have a work permit tied to your job, it stays valid. If you are already feeling stressed and burned out due to work issues, you have a work permit connected to your job and then you quit, you will also have to stress about your right of residence in Germany, too, which is, quite honestly, the last thing you need. So consider taking time off work as a first step and don’t be afraid to exercise your right to it.
If your medical practitioner or their staff is not supportive, find one who is. In preparation for writing this article, we called a medical practice in Berlin to ask some questions about the process. The receptionist who answered the phone took it upon herself to tell us that what we were suggesting was not possible and that a referral for therapy was the only option for someone with burnout. This is not true. Consider seeing another doctor if you get this sort of response.
In one of my darker moments, I went to a general practitioner without an appointment and received a week off work without question. I have a colleague who was written off sick for six months with similar symptoms and is now working again without issue. Both their doctor and their employer supported this.
Dealing with the Agentur für Arbeit (Employment agency)
If getting out of the job you are in is necessary to preserve your well-being, your (supportive) doctor can issue you a letter recommending that you leave the job for health reasons. With this recommendation from your doctor, you can quit your job without worrying about the Sperrzeit (the 3-month block on your unemployment benefits). This is called a Kündigung auf ärztlichen Rat (termination on medical advice).
In addition to this letter from a doctor or psychiatrist, you should also have evidence that you have spoken with your employer about the problem to try and find a solution that allows you to stay employed. Keep note of who you spoke to, when, and the outcome of the meeting/s.
Even if you can’t find a doctor willing to write you this recommendation, and even if you are subject to this 12-week block on your unemployment benefits, your health insurance and pension contributions will still be covered during that time if you register with the Agentur für Arbeit as unemployed.
Finding a therapist in Germany
My good friend Nicolas Bouliane at All About Berlin has summarized this topic perfectly, so please read his article for excellent and concise information on the topic of therapy, whether you are publicly or privately health insured.
One important thing to reiterate is that psychologists/therapists cannot prescribe medication, whereas psychiatrists and neurologists (who may also work as psychologists) can.
I’ll add my own anecdote here. I asked my GP for a referral for psychotherapy and then approached an English-speaking psychotherapist who came warmly recommended by a good friend. We organized a one-off appointment within a week or two, in which he assessed my need and made an application to my health insurance company to approve a therapy programme of around 37 hours.
Normally, the waiting time to become a regular patient of his would have been around 12 months. This is abysmal. But he had just moved his practice to a different address and had openings sooner. I ended up waiting about 2-3 months to get regular therapy with him, during which time the application had been approved by my health insurance provider. I used my 37 hours over around 2 years.
Finding a psychiatrist in Germany
Waiting times for a psychiatrist with public health insurance are just as bad, at least, they are in Berlin. If you are publicly insured in any German city, I have a tip for you that may save your life. Public health insurance providers offer a service in which they guarantee a specialist appointment within 14 days for urgent cases. You won’t have a choice of provider or location, but in urgent cases such as mine, it hardly matters.
When I approached my public health insurer (DAK), the very kind and sympathetic woman on the other end of the phone recognized the urgency of my request and found me an appointment in Kreuzberg within 48 hours of my phone call. My psychiatrist was an elderly man, very close to retirement, with a friendly face and a rainbow tie on, and he was so kind and right on the mark with his treatment suggestions. He died just a few weeks later. These two people – the anonymous woman on the DAK hotline and the friendly, experienced psychiatrist – were there for me at just the right time and I will never forget their contribution.
How Red Tape Translation can help you
We are not therapists, but we are relocation coaches, and we see clients experiencing burnout symptoms all the time. You might need help navigating the Agentur für Arbeit process to register as unemployed. You might have quit your job due to a toxic environment and now need to deal with your work permit. Whatever the reason, we (Lioba and Kathleen) promise to be kind, compassionate, sympathetic and helpful as relocation coaches. We’ll assist you with getting these parts of your life sorted smoothly so that you can get back on your feet again as quickly as possible.