Burnout

Dealing with burnout

In terms of human beings, burnout is widely regarded as a healthcare issue. In fact, it is defined by the World Health Organisation as a syndrome, a type of condition that can be diagnosed when a series of different symptoms occur at the same time. Burnout can occur in many ways, and it often affects people uniquely. However, the primary form of the syndrome that healthcare professionals experience is referred to as workplace burnout. This occurs when people have been working for a prolonged period without sufficient respite, usually under a great deal of stress. Sometimes the condition comes on gradually, but in other cases, it can lead to a sudden event causing a trauma, which is debilitating. Since it is a widespread phenomenon, multiple definitions are available, of which no single one has established itself as the dominant explanation.

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It is not possible to say burnout itself causes clinical depression on its own. However, people who are suffering from the syndrome will often show a range of what are considered to be depressive symptoms. These include, but are not limited to, sleep deprivation, low mood feelings, cognitive alterations and lethargy. In fact, Herbert Freudenberger, who was the first psychologist to publish in an academic journal using the terms 'burnout', referred to burned-out people as looking, acting and seeming depressed. So while the displayed symptoms might be similar to those of a depression, it is not necessarily true that burnout itself causes depression.

It is important not to confuse the terms burnout and stress as the two are, in fact, not interchangeable. This is because stress, especially when it is felt in the workplace, is not necessarily a problem for many workers unless it goes on unchecked. When people start to feel burned out, it is usually because there have not been sufficient breaks from stressful situations or that the level of stress they have been put under has reached intolerable levels. In other words, excessive stress – along with other factors - may lead to someone being burned out, but they are not precisely the same thing.

Research suggests that workers who may be susceptible to burnout have been working in a crucial role with lots of responsibility for a long period of time. This is especially the case when their particular role is not sufficiently recognised, supported or rewarded by management. People who are more predisposed to conditions like anxiety or depression are also considered to be more susceptible to burnout because they are usually less able to cope with the stressors they face in a healthy way. Too few resources, excessive workloads and carrying too much responsibility are common factors reported by people who have become burned out.

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Making sure to take more rest, avoiding overly long hours and seeking assistance from colleagues are all good ways to avoid burnout in your place of work. Developing a cynical attitude to the workplace and the overall work situation is something to be avoided, too. If this applies to you, try to talk openly with your boss about the situation or, if all other measures fail, look for alternative work opportunities before you burn yourself out. Another thing that can help to make sure to avoid you reach a state of burnout is to figure out how you can best figure out your levels of stress management and find what triggers it.

According to the American Psychiatric Association (APA), burnout is not considered to be a mental health disorder in its own right, although it may be associated with one. This makes obtaining a clinical diagnosis almost impossible despite the prevalence of the issue, especially in the workplace. That said, the APA is not the only body to take a view on diagnosing burnout. For example, the Royal Dutch Medical Association sees things differently and will classify someone who has burned themselves out as suffering from a particular type of adjustment disorder. Generally speaking, adjustment disorders are characterised by a maladapted response to a single or set of psychological stressors. In other words, the inability to cope fully – or at all – with something stressful, such as work, may be the best way of diagnosing cases of burnout. When someone simply cannot cope with their responsibilities at home or at work, then they are said to have been burned out. These days, most psychologists use a Maslach Burnout Inventory (MBI) test to assess potentially burned-out people. You can use an MBI test on yourself to give you an indication of your own current state.

Yes, it can. The evidence for this is not overwhelming, however. That said, some people who have been burned out and recovered will report memory problems. It is unlikely that an individual will suffer from wide-ranging memory loss as a result of occupational burnout, however. It is more likely that the sort of concentration that is needed in the workplace becomes too difficult for people who are extremely stressed and pressurised. This means that they may not be able to take on new information even when it is presented clearly to them, something that turns out to be like memory loss down the line. In reality, the information was never taken on board fully, and no memory of it ever existed. Some studies have detected a thinning of the cerebral cortex in areas of the brain associated with memory function, but this does not occur to everyone. It is not yet clear exactly how this might cause memory loss as distinct from other issues, such as cognitive ability and concentration.

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Occupational burnout is associated with a job that places too many demands on a person such that they can no longer cope, either fully or in part. For this reason, some people do not associate the sense of being burned out with home life. However, as many people now work from home and are placed under pressure to perform, so they can end up working longer and longer hours, often unchecked with an appraisal or managerial review. In such cases, burnout can occur just as it would in the workplace. Furthermore, some people who have lots of responsibilities in their home life – such as caregiving for children or elderly relatives, for example – may feel as though they are burning out from the stress involved even though it is not their job. Needless to say, this is just the same sort of occupational burnout that comes with stress, even though it may not be caused by employment.

Some people who are feeling burned out will report dizziness being one of their symptoms. This is not the case for everyone suffering from burnout, however, but it seems to be linked to people who are also experiencing symptoms of nausea and sweating. It is important to note that the root cause of feeling dizzy is not fully understood by clinicians. That said, it appears to be that the vestibular system, the one which regulates how we all feel balance and bodily orientation, can become overloaded by all of the sensory input we have when we are very stressed. As such, it can start to send the wrong sorts of signals to the brain, which, in the end, we notice as dizziness and nausea.

According to the aforementioned MBI, there are various scores that people will achieve according to how they respond to the tests involved and how they currently feel about their levels of stress and anxiety. Those at the upper end of the MBI scale may be diagnosed with burnout syndrome. However, the fact of the matter is that some professionals will simply say 'burnout' instead of 'burnout syndrome'. In other words, there is nothing to distinguish between the two terms other than the latter is generally reserved for the worst cases. In truth, many people use them interchangeably. In large organisations where employee burnout can be a problem, the term syndrome tends to be used across the board to explain how much burned-out people cost. Replacing burned-out people or waiting for them to get better can be a big part of the financial planning associated with large bodies, such as public healthcare systems, for example, where recruiting and retraining people is expensive.

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Most of the academic literature that focusses on burnout is centred on prevention rather than cure. Simply put, it is much easier to deal with the problem if it is identified at an early enough stage and countermeasures put in place to combat it. Stress management techniques, CBT cognitive behavioural therapy and the use of relaxation methods have all been found to be helpful in this regard. However, if someone has got to the point that they are already burned out in their job, they will have to stop doing it. By this time, they have nothing else to give, so only time off away from all of the demands of a job role is needed. Only when the individual has regained their confidence should they attempt a return to work. This should be managed very carefully with light duties at first before more work is taken on within agreed stages.

As previously mentioned, people who care for others informally can suffer from a condition known as caregiver stress. This usually manifests itself in angry episodes and cases of extreme fatigue. It is a type of burnout associated with both professional caregivers as well as those volunteering. Another sub-type is called wear-out. Some people will also refer to this sub-type as brown-out. Essentially, it occurs when someone sees too little by way of rewards for the effort they are putting in, so they quit in order to seek other opportunities. Frenetic burnout occurs when someone feels pressurised, so they work more and more, often creating greater stress as they do so. This can eventually lead to becoming burned out unless a managerial intervention is made by leadership. At the other end of the scale is a sub-type known as under-challenged burnout. This is basically when someone feels unrewarded because their workload is not challenging or interesting enough.

In some cases, an individual can recover from feeling burned out with nothing more than a two-week break from work, perhaps by going on holiday or taking unpaid leave. This is rare, though. It depends on the nature of the individual as well as the level of stress they have been exposed to. It is not simply the case that a quick recovery indicates that the person concerned was not really that badly burned out in the first place. Some people simply recover better than others, so not being judgemental about the speed of recovery is important for all concerned. For some, months away from work and stress is needed before a much slower recovery can begin. For others still, it can take years of effort to get back to something like their former selves. Rushing back tends to have unwanted outcomes and may exacerbate the problem.

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Although it is a substantial healthcare issue that has a wide economic impact, there is no globally agreed definition of exactly what burnout is or how to explain it. Even so, most people will recognise it for what it is – the inability to function normally due to the excessive amounts of stress someone is under, for whatever reason. Whether they place themselves under such stress themselves or excessive demands are made on them doesn't matter at all. The point is that being burned out can occur to anyone who is not cautious about their stress management, their work-life balance and their workload - both in a work-related sense and in their private life.

In the workplace, people can help each other by looking out for the signs of stress that often manifest themselves. Examples of this could be, for instance, working late hours, finding it difficult to concentrate for long periods of time or the need always to hurry what you're doing. Managers, in particular, should ask their team members about their feelings surrounding their workloads in a non-judgemental manner. When an employee is asked whether they are coping, it can be tricky to admit to struggling if they are always expected to perform at a given level. By giving people a safe space to discuss their difficulties and stress, managers can avoid the problems that are associated with burnout. These include – but are not limited to – the loss of skilled employees, augmented recruitment costs and a bad reputation as an employer.