Burnout: More than just exhaustion

This informal CPD article, ‘Burnout: More than just exhaustion’, was provided by Isle Listen, who provide comprehensive professional mental health training courses and employee counselling services aimed at improving workplace wellbeing in community groups and businesses across the Isle of Man.

Burnout: More than just exhaustion

Recognising and managing burnout has become a key factor in many organisations’ wellbeing programmes. Statistics measuring the prevalence of burnout differ, but the evidence does agree that numbers experiencing one or more symptoms has increased over the last few years, alongside an increase in reports of workplace stresses ^{1, 2}.

When we think about burnout, we often picture an exhausted figure, laden down with work and with an empty battery hovering over their head. And while fatigue is a key symptom burnout, it’s important to recognise that it is just one component and by placing too much focus on it we might not spot other signs that someone is on the path to burnout.

Burnout is defined in the 11th Revision of the International Classification of Diseases (ICD-11)³ as:

“…a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:

• feelings of energy depletion or exhaustion;
• increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and
• reduced professional efficacy. 

Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”

This definition is reflected in The Maslach Burnout Inventory (MBI) which can be used to measure the scale of each component. Higher scores across all three components would then be an indicator for burnout, rather than a cumulative score.

Physical Exhaustion

While exhaustion is often the most recognised sign of burnout, it goes beyond everyday tiredness to a persistent feeling of fatigue. This could present as disrupted or lack of sleep, but could also include headaches, muscle pain, digestive issues and a weakened immune system. When we are under stress our body produces cortisol – often referred to as the “stress hormone”. Cortisol impacts the production of certain chemicals and bodily functions and at normal levels is key in balancing and regulating these processes. However, an imbalance (too high or too low) can have a harmful effect.

In the early stages of stress and burnout, we experience high levels of cortisol, with chronically high levels connected to weight gain, high blood sugar, high blood pressure and an increased risk of Alzheimer's. Poor sleep, alongside other physical symptoms, can lead to the ingrained feeling of fatigue and exhaustion that characterises burnout and can also impact our emotional state with increased irritability, poor memory and lack of concentration.

These changes in physical and emotional health are often the signs that we might be more likely to spot in someone dealing with stress and potential burnout. But we also need to recognise the impact of other components that may be harder to spot.

Cynicism and Depersonalisation

Negativity and cynicism form the second key component of burnout. This dimension is characterised by a growing sense of disengagement with one’s role and detachment from customers and colleagues, and a shift in personal values. This could present as a decline in empathy and patience or viewing others as frustrations rather than people who deserve our respect and understanding. In the healthcare industry this could lead to decreased compassion, leading to poorer quality care, or in education could appear as reduced patience and understanding, leading to poorer learning experiences for students.

The impact of cynicism and depersonalisation clearly affects relationships with others, which can lead to conflict, avoidance of social interactions and even relationship breakdowns. These can all exacerbate feelings of guilt and isolation.

Reduced Personal Efficacy

A reduced sense of personal accomplishment is the third component burnout, and is often overlooked as a symptom. It appears as a reduced confidence in one’s abilities or effectiveness at work, leading to doubts in competence, poorer self-esteem and less motivation. At work this then leads to lower job satisfaction and reduced productivity, which in turn contributes to the negative stress cycle.

Albert Bandura’s ⁴ work around self-efficacy outlines its importance in motivation. High self-efficacy makes us more resilient, promotes healthier habits and coping tools and helps us in developing a growth mindset. We have a greater belief in our capacity to achieve. It is clear to see, therefore, how a reduction in our feelings of personal and professional efficacy can lead to negative stress and the feeling of being overwhelmed, a feeling that can persist outside of the workplace. 

Addressing Burnout

Once we acknowledge burnout is a multidimensional issue, and can recognise the impact of each component, we can be in a better position to respond to the early signs within our organisations and teams. Early intervention is key in minimising the impact on the individuals involved, as well as the wider organisation, rather than trying to act reactively and firefighting issues down the line.

At the core of this is knowing your colleagues, checking in with them and recognising changes in their behaviours, as well as creating environments where people feel able to talk openly and empowering employees with skills to build resilience and decrease the impact of stress. Through this knowledge and understanding you can build a picture of patterns around stress and burnout, which provides opportunities for positive change.

Regular and open communication, as well as education around each element of burnout, can help identify those who might be experiencing a symptom that, while less visible, could still be having an equally damaging impact.

We hope this article was helpful. For more information from Isle Listen, please visit their CPD Member Directory page. Alternatively, you can go to the CPD Industry Hubs for more articles, courses and events relevant to your Continuing Professional Development requirements.

References:

¹ Deloitte (2022), Mental health and employers: The case for investment – pandemic and beyond

² https://mentalhealth-uk.org/burnout/

³ https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/129180281

⁴ Bandura, A. (1977), Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215.