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.