Motivation and emotion/Book/2022/Burnout

Burnout:
What is burnout and how can be it be managed and prevented?

Overview

Have you ever felt physically, mentally or emotionally exhausted from work or life stresses? Are university assignments non-stop? Are work deliverables piling up and household bills increasing until your mind and body eventually give up, making you feel as though you can no longer cope? Well, these are signs of burnout.

This chapter focuses on defining burnout, the causes of burnout and how burnout can be managed and prevented. In order to know how to manage and prevent burnout, an understanding of what burnout is and the causes are required. Knowing the psychological definition of burnout, and the cause of individual burnout, allows for each individual to apply best praises and management and prevention methods specific to their experience, and ultimately reduce or prevent burnout. Also important is the distinction between burnout and stress, as they are often misconceived as the same.

Focus questions:

What is Burnout?[Fix overcapitalisation]
What causes Burnout?
What is the difference between Burnout and Stress?
How can burnout be managed and prevented?

What is burnout?

Burnout has been the object of research for over 50 years (Heinemann & Heinemann, 2017). However, there is still no consensus among scholars on how burnout should be measured and diagnosed (Heinemann & Heinemann, 2017). A recent review by Canu et al. (2021) shows that no less than 13 different definitions of occupational burnout were published between 1974 and 2019. Despite the wide variety of burnout definitions, there is common ground regarding the concept. It is widely recognised that burnout is a psychological syndrome characterised by complete mental, physical, and emotional exhaustion caused by excessive and prolonged stress (Maslach & Leiter, 2016).

The term burnout was introduced in the 1970s by Herbert Freudenberger to describe the gradual emotional depletion and loss of motivation he observed among people who had volunteered to work for aid organizations. Around the same time, Christina Maslach and her colleagues interviewed human services workers in California to find out how they were coping with client-related stressors (Maslach & Jackson, 1981). The human services workers used the term “burnout” and indicated that they experienced feelings of exhaustion, had developed negative attitudes towards their clients (depersonalization), and often felt that they lacked the professional competence needed to help their clients (Schaufeli et al., 2009). Originally, scholars assumed that burnout was a response to chronic emotional and interpersonal or social stressors at work (Maslach et al., 2001). However, the idea that burnout is exclusively found in the human-services sector was rejected in the 1990s. Since then, scholars have adopted a more general conceptualisation and operationalisation of burnout to make it applicable to workers in all kinds of occupations – including those outside the human services (Demerouti et al., 2003; Leiter & Schaufeli, 1996; Shirom & Melamed, 2006). Burnout is now recognized as a legitimate medical disorder by much of mainstream medicine and has even been given its own ICD-10 code (Z73.0 – Burn-out state of vital exhaustion) (Chandawarkar & Chaparro 2021).

Burnout is not caused solely by stressful work environments or too many responsibilities, it can also be caused by lack of adequate social support; taking on more than one can handle at work, school, or interpersonally with family and friends; and poor self-care (Midwestern University, 2019). It can be experienced by anyone with prolonged levels of chronic stress and pressure causing overwhelm as work or home demands. Chronic stress is described as a consistent sense of feeling pressure or overwhelmed (Yale Medicine, 2022). Burnout is a consequence of chronic stress, where one experiences emotional exhaustion (feeling tired, drained, frustrated), cynicism, or detachment (such as caring less about coworkers, clients, family and friends).

The Relationship Between Burnout, Depression, and Anxiety [Move to the references section and cite]
Occupational burnout {{ic|Move to the see also section]]

What is the difference between burnout and stress?

A common misconception is that stress and burnout are the same.

Stress is a normal response due to challenging or new situations. Stress comes and goes and is typically easy to pinpoint to its cause, such as a person or situation (Montanez, 2021). Under stress, you still struggle to cope with pressures.

Burnout can be described as a result of stress (WHO, 2019). Chronic stress leads you to experience more intense and severe symptoms and it impairs your ability to function (Maslach & Leiter 2016). Unlike stress, burnout is complete mental, psychical and emotional exhaustion from prolonged levels of stress or challenging situations (Scott, 2020). When burnout takes hold, this can look like: "you’re out of energy and you’ve given up all hope of overcoming obstacles". When you’re suffering from burnout, it’s more than just fatigue. You have a deep sense of disillusionment and hopelessness that your efforts have been in vain. Burnout is considered a form of prolonged distress. The concept was first measured by social psychologist Christina Maslach, who defined it in 2003 as a “response to long-term emotional and interpersonal stressors". Burnout results in feelings of emptiness and inability to cope with everyday tasks and activities (Scott, 2022). Causes can be work-related, lifestyle causes, or personal traits (Scott, 2020).

Signs and symptoms of burnout

Burnout signs and symptoms can be different for everyone.

Physical symptoms

There are a range of physical symptoms of burnout such as:

Headaches
Fatigue
Frequent illness
Stomach and gut issues
Changes in appetite/sleep (Werner, Schmalbach, Zenger, Brähler, Hinz, Kruse & Kampling, 2022)

Emotional symptoms

Helplessness
Cynicism
Sense of failure or self-doubt
Decreased satisfaction
Feeling detached or alone in the world
Loss of motivation.
Depression (Werner et al., 2022)

Behavioural signs

Reduced performance in everyday tasks - such as cleaning the house, doing assignments, work etc
Withdrawal or isolation from family, friends, colleagues or normal activities
Outbursts - emotional outburst or physical outbursts
Procrastination
Short temper
Substance abuse to cope, such as alcohol or drugs (Iris Healing, 2022)

In a Scientific American article from June 2006, Ulrich Kraft highlights the 12 Stages of Burnout, as outlined by psychologists Herbert Freudenberger and Gail North (De Here, 2020)

The Compulsion to Prove Oneself - individuals with compulsion to constantly prove one's worth is at risk of not having the ability to say 'no'. It puts individuals at risk of exploitation, manipulation and demanding bosses.
Working harder - some individuals are afflicted with the inability to to stop working. This can lead to answering emails or doing work on the weekends, working over time and not taking adequate rest or time off.
Neglecting needs - such as eating healthy, exercise, adequate sleep etc
Displacement of Conflicts - this involves blaming others or your situation for all of your problems, including your stress level
Revision of Values: your friends and family are no longer as important as your work
Denial of Emerging Problems: intolerance; perceiving others at work as stupid, lazy, demanding, or undisciplined
Withdrawal: avoiding or dreading social interaction, using alcohol or drugs to try to feel relief from stress
Odd Behavioural Changes: changes in behaviour such as impatience, aggression, and snapping at friends and family.
Depersonalization:feeling detached – seeing neither yourself nor others as valuable.
Inner Emptiness: feeling empty inside and to overcome this, looking for activity such as overeating, alcohol, or drugs.
Depression: feeling lost and unsure, exhausted, future feels bleak and dark and negative.
Burnout Syndrome: this can include total mental and physical collapse; time for full medical attention.

Impact of Burnout on the Brain

Dr. Amy Arnsten, a Researcher from the Department of Neuroscience at Yale University School of Medicine in New Haven, CT analyses the brain’s prefrontal cortex in responding to and processing stress. One of the most significant effects of burnout on the brain is the thinning of the grey matter of the prefrontal cortex (PFC) (Arnsten & Shanafelt, 2021). The prefrontal cortex helps us to act appropriately, it gives provides us with insight into ourselves and others, and it gives us perspective. Arnsten also states that the prefrontal cortex "allows us to do complex decision-making and to be able to have thoughtful, abstract reasoning rather than concrete or habitual responses"[factual?]. Therefore, when the PFC is compromised our focus and memory are impacted, increasing the likelihood of mistakes, and making it harder to learn new things. Burnout also enlarges the amygdala, which governs our fight-flight-freeze response and threat perception[factual?]. This results in an individual becoming more “primitive” since the brain circuits for fear, irritability and threat perception are stronger (Arnsten & Shanafelt, 2021).

How to manage burnout

Identifying the root cause of your stressors and burnout can be the key to helping yourself and managing your burnout. This can include:

having a rigorous academic schedule
dealing with relationship problems, especially ones that seem to circle with no resolution
caring for a loved one with a serious or chronic health condition (Deborah Weatherspoon, 2021)

Small changes can have a substantial impact. A few tips to manage burnout are:

Seeking support from friends or family or professional help
Try a relaxing activity such as walking or yoga
Exercising
Sleep (Mayo Clinic, 2022)
Set boundaries - learning to say 'no'
Prioritise personal wellbeing (Beyond Blue, 2022).

How to prevent burnout

There are two positions that can be addressed when preventing burnout. Firstly preventing personal burnout and secondly preventing burnout for someone else.

How to prevent personal burnout

Therapy and professional help can be a valuable tool and resource in preventing and managing burnout. Therapies which are used for the treatment of burnout are: psychotherapy, especially cognitive behavioural therapy (CBT), physiotherapy, adjuvant pharmacotherapy and complementary treatments like music therapy or body-mind therapies (Korczak, Wastian & Schneider, 2012).
Having strict boundaries when it comes to work such as time management, saying no to too much work and demanding clients or bosses. It is important to put your mental health and wellbeing above work.
Ensure you are having adequate amounts of sleep per night
Reach out for help if you need it
Be honest with loved ones, friends, colleagues about how you are feeling and if you need a break
Stop multitasking and working on multiple tasks at once, this can lead to high levels of stress and in time lead to burnout

How to prevent burnout in friends or family members

It is important not to assume that you will have the solutions for your loved ones' issues. Ask them how you can help. Instead of assuming, ask them directly how they think you may be of help. Does your loved one need a solution? A listening ear? Advice? Resources? A hug? Moral support? A meal? Someone to exercise with? Let them tell you. Listening, validating the individual's feelings and concerns, being present and performing kind gestures can be valuable steps and tools in helping prevent burnout in friends or family members (Health Line, 2022).

Conclusion

Burnout is a terrible state of psychical, emotional and mental exhaustion. It is important that necessary precautionary measures are taken to manage and prevent burnout.

References

Arnsten, A. F. T., & Shanafelt, T. (2021). Physician Distress and Burnout: The Neurobiological Perspective. Mayo Clinic proceedings, 96(3), 763–769. https://doi.org/10.1016/j.mayocp.2020.12.027

Blue, B. (2022). Beyond Blue. Retrieved 13 October 2022, from https://www.beyondblue.org.au/about-us/who-we-are-and-what-we-do

Chandawarkar, A., & Chaparro, J. D. (2021). Burnout in clinicians. Current problems in pediatric and adolescent health care, 51(11), 101104. https://doi.org/10.1016/j.cppeds.2021.101104

Counseling services. (n.d.). Retrieved November 26, 2022, from https://midwestern.edu/campus-life/student-services/counseling-services

Dealing with Burnout? These Tips and Strategies May Help. (2022). Retrieved 12 October 2022, from https://www.healthline.com/health/mental-health/burnout-recovery

De Hert S. Burnout in Healthcare Workers: Prevalence, Impact and Preventative Strategies. Local Reg Anesth. 2020 Oct 28;13:171-183. doi: 10.2147/LRA.S240564. PMID: 33149664; PMCID: PMC7604257.

Government, A. (2022). Signs you might be experiencing a burnout and how to regain balance in your life. Retrieved 13 October 2022, from https://www.darlingdowns.health.qld.gov.au/about-us/our-stories/feature-articles/signs-you-might-be-experiencing-a-burnout-and-how-to-regain-balance-in-your-life

Heinemann, L. V., & Heinemann, T. (2017). Burnout Research: Emergence and Scientific Investigation of a Contested Diagnosis. SAGE Open, 7(1). https://doi.org/10.1177/2158244017697154

Korczak D, Wastian M, Schneider M. Therapy of the burnout syndrome. GMS Health Technol Assess. 2012;8:Doc05. doi: 10.3205/hta000103. Epub 2012 Jun 14. PMID: 22984372; PMCID: PMC3434360.

Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016 Jun;15(2):103-11. doi: 10.1002/wps.20311. PMID: 27265691; PMCID: PMC4911781.

Medicine, Y. (2022). Chronic Stress. Retrieved 11 October 2022, from https://www.yalemedicine.org/conditions/stress-disorder

Scott, E. (2022). How to Watch for Signs of Burnout in Your Life. Retrieved 15 October 2022, from https://www.verywellmind.com/stress-and-burnout-symptoms-and-causes-3144516

Weatherspoon, D. (2021). Dealing with Burnout? These Tips and Strategies May Help. Retrieved 14 October 2022, from https://www.healthline.com/health/mental-health/burnout-recovery

Werner AM, Schmalbach B, Zenger M, Brähler E, Hinz A, Kruse J, Kampling H. Measuring physical, cognitive, and emotional aspects of exhaustion with the BOSS II-short version - results from a representative population-based study in Germany. BMC Public Health. 2022 Mar 24;22(1):579. doi: 10.1186/s12889-022-12961-z. PMID: 35331192; PMCID: PMC8943994.

World Health Organisation. (2019). Burn-out an "Occupational phenomenon": International Classification of Diseases. Retrieved November 28, 2022, from https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases

External links

Burnout Assessment Tool (Sensa Health)
a new definition of burnout
understanding the burnout experience
the relationship between burnout, anxiety, and depression
5 Ways to Avoid Burnout (YouTube)
How to identify signs of burnout (Medmastery YouTube)
The difference between burnout and stress (YouTube)