Burnout

burnout psychotherapy psychiatry counselling dr jonathan haverkampf

Burnout is a type of psychological stress. It can affect you emotionally, physically, and mentally in many ways. Burnout can be a significant risk to mental and physical health. Burnout reduces productivity and saps your energy, leaving you feeling increasingly helpless, hopeless, cynical, and resentful. Eventually, you may feel like you have nothing more to give. Very often one feels like a hamster on a wheel, and the sense of purpose and meaning experienced in a task or relationship declines.

The negative effects of burnout spill over into every area of life—including your home, work, and social life. Burnout can also cause long-term changes to your body that make you vulnerable to illnesses like colds and flu. Because of its many consequences, it’s important to deal with burnout right away.

The Mayo Clinic has put together a set of questions which describe burnout well (Mayo Clinic):

  • Have you become cynical or critical at work?
  • Do you drag yourself to work and have trouble getting started?
  • Have you become irritable or impatient with co-workers, customers or clients?
  • Do you lack the energy to be consistently productive?
  • Do you find it hard to concentrate?
  • Do you lack satisfaction from your achievements?
  • Do you feel disillusioned about your job?
  • Are you using food, drugs or alcohol to feel better or to simply not feel?
  • Have your sleep habits changed?
  • Are you troubled by unexplained headaches, stomach or bowel problems, or other physical complaints?

You may find yourself in several of these questions, and they are not only specific to burnout. For example, a lack of energy, initiative, and motivation is also frequently seen in depression and other conditions. If you feel you are suffering from any of these symptoms, it is helpful to consult a professional. The quicker you get help the more manageable these symptoms are. Often, burnout is a sign that something in life may not be aligning with your needs and aspirations.

Treatment

Psychotherapy and counselling are usually the first-line treatments for burnout. I am happy to discuss with you individual therapy options. Often goals are not just to reduce the symptoms but to make your life overall more enjoyable and help you pursue more effectively what is important to you. As mentioned, burnout usually happens in situations where the alignment between an activity or a relationship and your needs is weakened.

Job Burnout

Occupational burnout or job burnout is characterized by exhaustion, lack of enthusiasm and motivation, feelings of ineffectiveness, and also may have the dimension of frustration or cynicism, and as a result, reduced efficacy within the workplace. [1] People with burnout often describe that they are becoming increasingly detached from others, themselves, and their own emotions. The area of life, such as the workplace or the relationship, is no longer motivating, and one feels like a hamster on a wheel. Other mental and physical symptoms can follow, and the risk of other mental health issues and somatic illnesses increases. According to Gallup, 23% of employees report feeling burnout at work very often or always, while an additional 44% reported feeling it sometimes.

Burnout appears in the WHO’s International Classification of Diseases, 11th Edition (ICD-11) in the section on problems related to employment or unemployment. It is described as:

  • Feelings of energy depletion or exhaustion.
  • Increased mental distance, or feelings of negativism or cynicism related to one’s job.
  • Reduced professional efficacy.

Symptoms

Symptoms of burnout include

  • exhaustion
  • loss of motivation
  • distress, and
  • feelings of ineffectiveness.

Poor coping mechanisms can contribute to or result from burnout.[1] Such coping mechanisms can be improved in therapy, which not only helps to reduce symptoms but also protects you from burnout in the future.

“Burnout”

The term burnout in psychology was coined by Herbert Freudenberger in his 1974 Staff burnout, presumably based on the 1960 novel A Burnt-Out Case by Graham Greene, which describes a protagonist suffering from burnout.[2][3] Since then, burnout has become a very common term and is now unfortunately more prevalent than ever.

The Development of Burnout

Occupational burnout is typically and particularly found within human service professions. Professions with high levels of burnout include social workers, nurses, teachers, lawyers, engineers, medical practitioners, customer service representatives, and police officers. [4] One reason why burnout is so prevalent within the human services field is due in part to the high-stress work environment and emotional demands of the job.[1]

There may be a strong overlap between burnout and depression. Burned-out workers reported as many depressive symptoms as clinically depressed patients.[6] In one study about 90% of burned-out workers meet diagnostic criteria for depression, suggesting that burnout may be a depressive syndrome rather than a distinct entity.[7]

Many factors play a role in burnout. In part, it may be attributable to personality aspects, some of which are inheritable. One cause of burnout includes stressors that a person is unable to cope with fully. Occupational burnout often develops slowly and may not be recognized until it has become severe. When one’s expectations about a job and its reality differ, burnout can begin.[1] How pressure is dealt with determines how much stress someone feels and how close they are to burnout. One individual can experience few stressors, but be unable to handle the pressure well and thus experience burnout. Another person, however, can experience a far greater number of stressors, but effectively deal with them, and avoid burnout. How close someone is to a state of burnout can be determined through various tests.[8]

Burnout is becoming a more common result as the modern workplace changes. Being both economically and psychologically exhausting, the increasingly hostile and demanding environments in which employees work is being studied as a cause. Focusing on the individual’s values, interests and aspirations is effective in fighting burnout and developing people. A review by Demerouti et al. found that burnout can be explained by the two factors of job demands and job resources, and that exhaustion is correlated to job demands, and that job resources are negatively correlated to disengagement. Demerouti also showed that burnout is present in all types of jobs, and not just within human services.[9]

Phases

Psychologists Herbert Freudenberger and Gail North have theorized that the burnout process can be divided into 12 phases, which are not necessarily followed sequentially.[5]

  1. The compulsion to prove oneself
    Often found at the beginning is excessive ambition. The desire to prove oneself in the workplace turns into compulsion.
  2. Working harder
    Because they have to prove themselves to others or try to fit in an organization that does not suit them, people establish high personal expectations. In order to meet these expectations, they tend to focus solely on work while they take on more work than they otherwise would. It may happen that they become obsessed with doing everything themselves to show that they are irreplaceable.
  3. Neglecting their needs
    Since they have to devote everything to work, they now have no time and energy for anything else. Friends and family, eating and sleeping start to be seen as unnecessary or unimportant, as they reduce the time and energy that can be spent on work.
  4. Displacement of conflicts
    They become aware that what they are doing is not right, but they are unable to see the source of the problem. This may lead to a crisis in themselves and become threatening. The first physical symptoms appear.
  5. Revision of values
    While falling into a state of denial of basic physical needs, perceptions and value systems change. Work consumes all energy, leaving none for friends and hobbies. The job is the new value system and people start to become emotionally blunt.
  6. Denial of emerging problems
    People may become intolerant and dislike being social. They may be seen as aggressive and sarcastic. Problems may be blamed on time pressure and all the work that they have to do.
  7. Withdrawal
    Minimal social contact turns into isolation. Alcohol or drugs may be used as a release from obsessive working “by the book”. These people often have feelings of being without hope or direction.
  8. Obvious behavioral changes
    Coworkers, family, friends and others in their immediate social circles cannot overlook the behavioral changes in these people.
  9. Depersonalization
    It is possible that they no longer see themselves or others as valuable. Their view of life narrows to only seeing the moment and life turns to a series of mechanical functions.
  10. Inner emptiness
    They feel empty inside and may exaggerate activities such as overeating or sex to overcome these feelings.
  11. Depression
    Burnout may include depression. In that case, the person is exhausted, hopeless, indifferent, and believes that life has no meaning.
  12. Burnout syndrome
    They collapse physically and emotionally and need immediate medical attention. In extreme cases, suicidal ideation may occur, with it being viewed as an escape from their situation. Only a few people will actually commit suicide.

Many theories of burnout include negative outcomes related to burnout, including measures of job function (performance, output, etc.), health-related outcomes (increases in stress hormones, coronary heart disease, circulatory issues), and mental health problems such as depression. It has been found that patients with chronic burnout have specific cognitive impairments, such as significant reductions in nonverbal memory and auditory and visual attention. [10]

You may be interested in the following articles on burnout on this website:

References

[1] Ruotsalainen JH, Verbeek JH, Mariné A, Serra C (2014). “Preventing occupational stress in healthcare workers”. The Cochrane Database of Systematic Reviews. 12: CD002892. doi:10.1002/14651858.CD002892.pub4. PMID25482522.

[2] Can’t Get No Satisfaction: In a culture where work can be a religion, burnout is its crisis of faith. by Jennifer Senior, November 26, 2006, New York Magazine

[3]Freudenberger, H. J. (1974). “Staff burnout”. Journal of Social Issues. 30 (1): 159–165. doi:10.1111/j.1540-4560.1974.tb00706.x.

[4] Jackson, S.; Schwab, R.; Schuler, R. (1986). “Toward an understanding of the burnout phenomenon”. Journal of Applied Psychology. 71 (4): 630–640. doi:10.1037/0021-9010.71.4.630.

[5] Ulrich Kraft, “Burned Out”, Scientific American Mind, June/July 2006 p. 28-33

[6] Bianchi, R.; Boffy, C.; Hingray, C.; Truchot, D.; Laurent, E. (2013). “Comparative symptomatology of burnout and depression”. Journal of Health Psychology. 18 (6): 782–787. doi:10.1177/1359105313481079.

[7] Bianchi, R.; Schonfeld, I. S.; Laurent, E. (2014). “Is burnout a depressive disorder? A re-examination with special focus on atypical depression”. International Journal of Stress Management. 21 (4): 307–324. doi:10.1037/a0037906.

[8] Truby, B. (2009)

[9] Demerouti, Evangelia; Bakker, Arnold B.; Nachreiner, Friedhelm; Schaufeli, Wilmar B. (2001). “The job demands-resources model of burnout.”. Journal of Applied Psychology. 86(3): 499–512. doi:10.1037/0021-9010.86.3.499.

[10] Sandstrom, A; Rhodin IN; Lundberg M; Olsson T; Nyberg L. (2005). “Impaired cognitive performance in patients with chronic burnout sysndrome.”. Biological Psychology. 69 (3): 271–279. doi:10.1016/j.biopsycho.2004.08.003. Retrieved December 5, 2012.

Further Reading

Cooper, C. L.; Cartwright, S. (1997). “An intervention strategy for workplace stress”. Journal of Psychosomatic Research. 43: 7–16. doi:10.1016/s0022-3999(96)00392-3.

Clanton, L. D.; Rude, S.; Taylor, C. (1992). “Learned resourcefulness as a moderator of burnout in a sample of rehabilitation providers”. Rehabilitation Psychology. 37: 131–140. doi:10.1037/0090-5550.37.2.131.

“A review and integration of research on job burnout”, Cordes, C. and Dougherty, T. (1993). Academy of Management Review, 18, 621-656. Cited in O’Driscoll, M. P. and Cooper, C.L. (1996).

“Sources of Management of Excessive Job Stress and Burnout”, In P. Warr (Ed.), Psychology at Work Fourth Edition. Penguin.

“Tailoring treatment strategies for different types of burnout” Farber, B. A. (1998). Paper presented at the Annual Convention of the American Psychological Association, 106th, San Francisco California, August 14–18. ED 424 517

Freudenberger, H. J. (1974). “Staff burnout”. Journal of Social Issues. 30 (1): 159–165. doi:10.1111/j.1540-4560.1974.tb00706.x.

“Authentic leaders creating healthy work environments for nursing practice”, Shirey M. R. American Journal of Critical Care May 2006. Vol. 15, Iss. 3; p. 256

“Taming burnout’s flame”, Krista Gregoria Lussier, Nursing Management Chicago: April 2006. Vol. 37, Iss. 4; p. 14

“A Scientific Solution To Librarian Burnout”, Craig S. Shaw New Library World Year 1992 Volume: 93 Number: 5

Stress and Burnout in Library Service, Caputo, Janette S. Phoenix, AZ: Oryx Press, 1991.

An assessment of burnout in academic librarians in America using the Maslach Burnout Inventor (the MBI) Ray, Bernice, Ph.D., Rutgers University – New Brunswick, 2002, 90 pages; AAT 3066762

Bakker, A., Demerouti, E., & Sanz-Vergel, A. I. (2014). Burnout and Work Engagement: The JD–R Approach. Annual Review of Organizational Psychology and Organizational Behavior, 1(1), 140114155134003. http://doi.org/10.1146/annurev-orgpsych-031413-091235

Tracy, S (2000). “Becoming a Character for Commerce Emotion”. Management Communication Quarterly. 14: 90–128. doi:10.1177/0893318900141004.

Newton, T. (1995). Managing stress: Emotion and power at work. Thousand Oaks, CA: Sage.

Herbert J. Freudenberger (1980), Burn-Out: The High Cost of High Achievement. Anchor Press

Herbert J. Freudenberger and Gail North (1985). Women’s Burnout: How to Spot It, How to Reverse It, and How to Prevent It, Doubleday

Maslach, C.; Schaufeli, W. B.; Leiter, M. P. (2001). “Job burnout”. Annual Review of Psychology. 52: 397–422. doi:10.1146/annurev.psych.52.1.397.

Maslach, C.; Leiter, M. P. (2008). “Early predictors of job burnout and engagement”. Journal of Applied Psychology. 93: 498–512. doi:10.1037/0021-9010.93.3.498.

Maslach, C. & Leiter, M. P. (1997). The truth about burnout. San Francisco: Jossey Bass.

Shaufeli, W. B.; Leiter, M. P.; Maslach, C. (2009). “Burnout: Thirty-five years of research and practice”. Career Development International. 14: 204–220.

Maslach, C., Jackson, S. E, & Leiter, M. P. MBI: The Maslach Burnout Inventory: Manual. Palo Alto: Consulting Psychologists Press, 1996.

Kristensen, T.S.; Borritz, M.; Villadsen, E.; Christensen, K.B. (2005). “The Copenhagen Burnout Inventory: A new tool for the assessment of burnout”. Work & Stress. 19: 192–207. doi:10.1080/02678370500297720.

Shirom, A. & Melamed, S. Does burnout affect physical health? A review of the evidence. In A.S.G. Antoniou & C.L. Cooper (Eds.), Research companion to organizational health psychology (pp. 599–622). Cheltenham, UK: Edward Elgar, 2005.

Sanders, Marc. (2013) “Existential Depression. How to recognize and cure life-related sadness in gifted people”, Self-Help Manual.

van Dierendonck, D.; Schaufeli, W. B.; Buunk, B. P. (1998). “The evaluation of an individual burnout intervention program: the role of in- equity and social support”. J. Appl. Psychol. 83: 392–407. doi:10.1037/0021-9010.83.3.392.

* Wang, Yang; Ramos, Aaron; Wu, Hui; Liu, Li; Yang, Xiaoshi; Wang, Jiana; Wang, Lie (2014-09-26).”Relationship between occupational stress and burnout among Chinese teachers: a cross-sectional survey in Liaoning, China”. ”International Archives of Occupational and Environmental Health” ”’88”’ (5): 589–597. doi:10.1007/s00420-014-0987-9. ISSN 0340-0131

© Christian Jonathan Haverkampf. All rights reserved.

Psychotherapy & Counselling; Dublin, Ireland

This article is solely a basis for academic discussion and no medical advice can be given in this article, nor should anything herein be construed as advice. Always consult a professional if you believe you might suffer from a physical or mental health condition.

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