Understanding Burnout

After nearly three years of living with the COVID-19 pandemic and other worrying developments in the world, more and more of us feel ‘burnt out’.

But what is burnout? How is it different from being generally stressed or tired? What causes it, and how can we prevent it?

What is burnout?
The World Health Organisation defines burnout as a syndrome resulting from chronic workplace stress that has not been successfully managed. It refers specifically to experiences in the occupational context, rather than in other areas of life. Of course, if chronic stress is present in other areas of life, workplace stress will be more difficult to manage, and vice versa.

Burnout was first described by psychologist Christina Maslach and her colleagues in the 1970s. They identified this issue among professionals working in human services, such as doctors, nurses, or counsellors. Their research suggested that burnout has three distinct aspects: emotional exhaustion, depersonalization and a reduced sense of personal accomplishment.

Emotional exhaustion refers to a state of feeling overextended, constantly tired, and having a sense of depleted energy, or ‘running on empty’.

Depersonalization, which is sometimes also referred to as cynicism, is the interpersonal dimension of burnout. It is a negative, detached, insensitive, uncaring attitude to work and especially towards one’s clients.

Low personal accomplishment refers to a diminished sense of professional competence, and reduced productivity at work. The Maslach Burnout Inventory is a widely used questionnaire to assess these three aspects of burnout.

Burnout itself is not classified as a medical condition or psychological disorder. There is no ‘cut-off’ point on the questionnaire above which one can be called ‘burnt out’. Instead, high scores on a burnout questionnaire indicate that all is not well: you are exhausted, you don’t care about your clients, and you constantly feel that you are not doing a good enough job.

Burnout is associated with serious physical and psychological health conditions, such as depression, insomnia, chronic pain,
increased susceptibility to respiratory infections, gastrointestinal problems, and cardiovascular diseases.

So, if you do feel burnt out, it is time to look at the causes and to begin doing something to improve the situation.

What causes burnout?
Christina Maslach’s original research showed that burnout was most likely to develop in people who had been suffering from chronic work stress. When a stressful event occurs, the body responds with the activation of a characteristic stress response, called the fight or flight response.

During evolution, the threats we faced were usually physical. We needed to run away or face a potential predator (flight or fight). Even though nowadays we are rarely in such physical danger, our biological system still reacts with the same flight or fight response to social stress, such as an unpleasant encounter at work.

When this response is activated, both body and mind increase preparedness to deal with a potential threat. For example, blood pressure increases, breathing patterns change, blood flow increases towards the large skeletal muscles and away from the guts.

This activation reduces processes needed for rest and recuperation, such as digestion or sleep. Importantly, these bodily changes are accompanied by changes in the mind: you become more vigilant for negative information, and it becomes more likely that you interpret ambiguous information as threatening. In other words, your thinking becomes more negative.

Humans evolved to deal with short term (acute) stress very well. When the stressful event ends, the body returns to its normal state, and it can rest and recuperate. However, if stress is ongoing (chronic), that rest and recuperation can not happen. The constant activation of the stress response can eventually cause physical and psychological health problems, including burnout.

We know that several work circumstances can increase employee stress. These include:

unreasonable time pressure
an unmanageable workload
a lack of role clarity
a lack of control and autonomy
a lack of communication and support from managers
unfair treatment from managers, clients, or co-workers.

However, not everybody reacts to stressful situations the same way.

Personality traits, strongly held beliefs and values, and certain thinking patterns can contribute as well. For example, people who are highly perfectionistic tend to experience more stress, which can then lead to burnout. Strong individual values placed on achievement can also cost personal wellbeing if they are not balanced with a sense of self-care and compassion. Sometimes underlying such tendencies for perfectionism and high achievement orientation is a deep-seated feeling that something is about to go wrong, and one needs to be constantly in control to stave off disaster – even if the nature of that disaster is not always clear in your mind.

What can we do about it?
As most of us are already aware, to avoid burnout, we must reduce chronic stress or manage stressful situations better. If the workplace is open to creating a healthier work environment, talking to a supervisor may solve the problem. Simple self-care strategies, like eating a healthy diet, getting enough exercise, social support, improving your sleep quality, and regular breaks from work may also help to fend off the effects of high-stress jobs. Sometimes a change of position or job is an option.

However, such strategies are often ineffective if one’s personality, beliefs or thinking are at least partially responsible for a tendency towards experiencing chronic stress. No amount of fresh green vegetables and lavender oil will solve the problem for a person whose thinking is habitually negative or self-critical, who keeps putting others’ needs ahead of their own, or who has difficulty relaxing control over minor aspects of life.

If you are that kind of person, start watching your thinking and asking yourself whether a healthier thinking pattern would also be helpful. It is hard work, but it is possible to change our thinking.

If you are experiencing chronic stress or burnout and you’re having difficulty finding your way out, it may be a good idea to seek professional support. Talking to a mental health professional can help clarify the problem and identify strategies to solve it. You deserve to feel your best.

References and further reading

Dr Marianna Szabo is a Clinical Psychologist, a leading expert in Mindfulness and a Senior Lecturer in Psychology at the University of Sydney.

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