Extinguished and anguished: what is burnout and what can we do about it?

Feeling “burnt out” is a pretty common phrase in daily parlance, but we’re starting to learn more about its longer-term destructive effects. Sufferers often describe feeling exhausted and disconnected, and as though they’re “going through the motions” without motivation or meaning.

Burnout can have serious consequences, including reduced work performance and life satisfaction, and has been associated with other mental health conditions. For instance, it has been linked to depression, as both conditions share a number of symptoms such as fatigue, social withdrawal and decreased work performance.

Read more: Health Check: Stressed at work? How to beat common traps in the rat race

Burnout is usually seen as a consequence of a chronic stressful work environment, emerging as a workplace concern in the 1970s when American researchers found many human services workers were not coping with their jobs and felt “burnt out”.

The workers reported:

• emotional exhaustion: becoming emotionally drained and fatigued

• depersonalisation: a loss of empathy towards clients

• reduced personal accomplishment: feeling incompetent and inept at work.

Since then, burnout research has expanded across other occupations and its definition modified to include cynicism towards work.

However most research still focuses on work-related burnout. But people from all walks of life may experience burnout, and not just from work. For example, burnout may also be experienced by students who are overwhelmed by their study commitments, or a mother (or carer) caring for a severely disabled child.

The risk of burnout for those in caring roles is not a new phenomenon. Records from Christian monks of the 4th Century outline what they call “acedia” (a Greek word which translates as “non-caring”), a state probably akin to burnout. After decades of caring for others, the monks were said to have doubted whether they were doing anything useful and judged each day as “grey”.

Burnout appears to occur across a range of contexts, but we do not know enough about its causes and how to diagnose and manage it successfully.

Read more: Overworked? Good habits, not holidays, are the answer

Causes

We know job-related burnout can be triggered by exposure to multiple and continuing work stressors. While such stressors may differ across occupations, they relate to the demanding and unrelenting nature of a job, combined with a toxic mix of lack of resources and support.

Burnout can also be triggered by certain personality traits. For instance, research has linked burnout to a person’s evaluation of themselves and their abilities, a trait known as core self-evaluation.

Low core self-evaluation is when someone has negative views about their own skills and ability to control situations. People with low core self-evaluation are susceptible to burnout as they likely view difficult work assignments as threatening or overwhelming, rather than achievable challenges.

Perfectionists are also at greater risk of burnout, as they tend to set excessively high performance standards they inevitably fail to meet, thus diminishing their sense of personal accomplishment.

Measurement and diagnosis

The main tool used in research studies to measure burnout is called the Maslach Burnout Inventory (MBI), a survey that requires individuals to answer several questions relating to emotional exhaustion, depersonalisation/cynicism and reduced personal accomplishment.

But it has been widely criticised due to concerns it doesn’t accurately capture the concept of burnout, is not culturally sensitive for use outside of the United States, and was designed to measure burnout in individuals still in the workforce – not those who have stopped working as a consequence of clinical burnout.

In addition to the issues surrounding measuring burnout in a research context, it is also difficult to diagnose in clinical settings. This is because the condition is not recognised in the Diagnostic and Statistical Manual, used internationally to diagnose mental health disorders. So there is no set of indicative criteria for mental health professionals to use to diagnose people suffering from clinically significant burnout.

Read more: Clock off, switch off: tips to stress less outside work hours

This in turn influences treatment, as without a concrete diagnosis it’s difficult for mental health professionals and their patients to make decisions about appropriate treatment.

Management

Management strategies remain quite unclear, however should be targeted to individual sufferers. This means addressing the unique stressors that contribute to burnout in each person.

Management strategies should also acknowledge the individual’s personality style. Strategies that work to remove external stressors (such taking a month off work and lying on a beach) might assist some sufferers, but might further stress others whose personalities don’t allow them to “switch off” outside the office.

Personality styles are generally thought to be unchangeable across a person’s lifespan. So for those who have personality traits that put them at extra risk of burnout, it has been suggested they be taught techniques that help them cope more effectively with external stressors, rather than trying to change their personality.

Successful interventions to prevent and treat burnout depend on a more complete understanding of the condition. Our team at the Black Dog Institute is currently conducting a study that should assist in defining and measuring burnout and its principal causes. You can participate in our study here.