Modern work life is, for the majority of the population fast-paced and stressful. Work hours are long, we’re always ‘connected’, even when we’re away from the office. Seeing hundreds of mails streaming in during the middle of the night when everyone is ‘supposed to be sleeping’ is a surefire way to induce stress and anxiety in even the most mentally stable of people.
Add to this the fact that many are called upon to do whatever it takes to get the job done, often with little or no support but with the expectation of collaboration, all while playing ‘Office Survivor’ and navigating the politics that goes with that, it’s little wonder that increasing numbers of people feel stressed and hopeless at work.
This collection of these types of daily stressors continues for weeks, months and even years until one day, affected individuals feel as though they just cannot go on due to often professionally debilitating symptoms.
The term ‘burnout’ has long been used to describe these symptoms, yet, until this week, the existing medical definition of this phenomenon was so narrow, that it was not considered a legitimate reason for seeking healthcare.
This meant that such an observation meant that it was often met with speculative eye rolls and dismissed, with the expectation that affected individuals ‘suck it up’ and get on with it, because, after all, everyone is in the same boat… right?
What is burnout?
Burnout is considered to be a syndrome that is characterised by specific physical symptoms and emotional conditions induced by chronic workplace stress, that ultimately affect job performance1.
‘Burnout syndrome’ was first described in 1974 in two scientific articles, one authored by psychologist Herbert Freudenberger and the other by Sigmund Ginsburg. The term ‘burnout’ was popularised by Freudenberger in subsequent publications and as such, he was considered the founding father of the concept even though he did not invent the term2.
Even as early as 1974, the term Freudenberger linked the term to the workplace, describing being burned out as ‘becoming exhausted by making excessive demands on energy, strength or resources’.
He linked it to physical symptoms such as:
- Fatigue
- Exhaustion
- Frequent headaches
- Shortness of breath
- Gastrointestinal issues
- Insomnia
He noted behavioural symptoms as including:
- Frustration
- Anger
- Overconfidence
- Suspicious attitudes
- Cynicism
- Signs of depression
- Excessive use of tranquilisers and barbiturates (sleeping pills)
Interestingly he also made mention of personality traits that led to burnout, nothing that ‘the dedicated and the committed’ were more likely to experience this phenomenon.
What causes burnout?
High stress jobs do not always automatically equate to burnout, especially if stress is managed effectively. However, those in certain occupations are at higher risk and a number of factors contribute to the development of burnout in these individuals.
Experts believe that white-collar workers are most at risk as they are constantly faced with burnout-inducing factors such as:
- Increasing shifts towards service-industry and information-centred careers
- Lack of role clarity
- Lack of communication and support from managers
- Higher levels of collaboration requirement and technology that facilitates this as well as remote work access
- Unmanageable work loads
- Blurred lines between work and home life
- Higher emphasis being placed on constantly keeping all stakeholders ‘in the loop’ while also making one’s voice heard
- Increased time pressure
- Feeling one is being treated unfairly
With an increase in the shift towards service and information-centred careers, near-constant collaboration is often required. This, in the context of complex business environments and the fact that technology increases ease of access to work even after hours, often leads to collaboration overload. While the constant interaction is often not the direct source of burnout, the costs in terms of work interruption and time fragmentation are.
Many also believe that if they admit to feeling chronically stressed by the way in which is conducted, they will seem unprofessional, and so this creates a vicious cycle where this way of working becomes ‘the norm’ and stress becomes a ‘culture’.
Yet, despite Freudenberger’s description of the condition, the identification of these risk factors and the fact that has been studied and identified in a variety of ‘helper’ occupations such as medical professionals, social workers, teachers as well as in those working in the financial sector in the decades that followed, it has remained a source of heated debate in medical and scientific circles. As such, it has never been classified as a distinct, diagnosable medical or psychiatric disorder2.
This lack of clarity and consensus, has not, however, affected the fact that it is still widely noted in modern society and increasingly across all fields of occupation.
Burnout on the rise
The rise in burnout was reflected in the Gallup poll last year, where findings showed that approximately 25% of all employees polled felt burned out often or constantly. 44% reported occasional burnout while just one third didn’t experience this syndrome at all3.
Like many other health issues, chronic stress and burnout has an economic cost. Researchers on the subject estimate that workplace stress costs sufferers in the United States alone an additional $125 to $190 billion dollars in healthcare costs annually. They also estimate that approximately 30,000 deaths can be attributed to high work demands4.
In fact, studies show that burnout is a significant predictor of a number of health consequences, including5:
- Prolonged fatigue
- Headaches
- Musculoskeletal pain
- Changes in pain experiences
- Gastrointestinal complaints
- Respiratory issues
- High cholesterol (hypercholesterolemia)
- Coronary heart disease
- Hospitalization due to cardiovascular disorder
- Type 2 diabetes
- Severe injuries
- Mortality below the age of 45 years
The problem, even though it is a great source of debate and is not classified as a mental or psychiatric disorder, is however, getting more attention. This has recently been reflected in the WHO’s recent ICD burnout definition update.
Burnout redefined
Earlier this week, the World Health Organization (WHO) expanded the definition of burnout in its International Classification of Diseases (ICD). Previously defined as ‘a state of vital exhaustion’, the expanded definition refers to is as a syndrome that is ‘tied to chronic workplace stress that has not been successfully managed’6.
The WHO characterises burnout as a syndrome with three primary dimensions:
- Feelings of energy depletion and exhaustion
- Feeling of negativity and cynicism towards one job and creating a mental distance from it.
- Reduced professional efficacy
The new definition brings it more in line with the way in which researchers and psychologist have understood the affliction for some time.
It is important to note that according to this definition, burnout is still NOT classified as a medical condition and only applies in an occupational context and not to other areas of life experience. Nevertheless, it is recognised as having a legitimate influence on an affected person’s health status and is considered a reason why people may contact health services.
While the practical applications end there, it is hoped that this shift in attitude towards the condition may influence how it is perceived by healthcare professionals and employers alike.
Preventing and treating burnout
While burnout may seem inescapable and permanent due to the fact that, for most people, remaining gainfully employed is vital in modern living, the condition is preventable and reversible.
If you’re feeling burned out, you will have to make some conscious changes to your work environment. This may involve chatting to your manager or approaching the human resources department about areas of concern if these parties are invested in the health of the organisation. If not, a new job may be in order.
From a self-care and management point of view, you need to develop stress reducing strategies like:
- Ensuring that you eat a healthy, balance diet
- Exercise regular
- Get enough good quality sleep
- Find time for things you enjoy
- Seek the encouragement and support of loved ones and colleagues.
- Plan strategically-timed breaks during stressful periods in order to help you to clear your head and feel revitalised.
If you feel like these strategies are not helping and you are not coping on your own, seek professional help. Doing so does not mean that you are weak, but rather that you are intelligent enough to know when an outside perspective is necessary to help you to live and perform at your best.
References
1. Ferriero D, Powers K. Burnout at the Reference Desk. RQ. 1982;21(3):274-279. https://www.jstor.org/stable/25826748. Accessed May 31, 2019.
2. Heinemann L, Heinemann T. Burnout Research. Sage Open. 2017;7(1):215824401769715. doi:10.1177/2158244017697154
3. Gallup I. Employee Burnout, Part 1: The 5 Main Causes. Gallup.com. https://www.gallup.com/workplace/237059/employee-burnout-part-main-causes.aspx. Published 2018. Accessed May 31, 2019.
4. Blanding M. National Health Costs Could Decrease if Managers Reduce Work Stress. HBS Working Knowledge. https://hbswk.hbs.edu/item/national-health-costs-could-decrease-if-managers-reduce-work-stress. Published 2015. Accessed May 31, 2019.
5. Salvagioni D, Melanda F, Mesas A, González A, Gabani F, Andrade S. Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLoS ONE. 2017;12(10):e0185781. doi:10.1371/journal.pone.0185781
6. Burn-out an "occupational phenomenon": International Classification of Diseases. World Health Organization. https://www.who.int/mental_health/evidence/burn-out/en/. Published 2019. Accessed May 31, 2019.