What is burnout?

A stressful lifestyle can put people under extreme pressure, to the point that they feel exhausted, empty, burned out, and overwhelmed. Stress at work can also cause physical and mental symptoms. Possible causes include

• feeling either constantly overworked or under-challenged,
• being under time pressure all the time,
• having conflicts with colleagues, and
• extreme commitment that results in people neglecting their own needs.

Problems caused by stress at work are a common reason for taking sick leave. Exhaustion is a perfectly normal reaction to stress. But burnout is more than usual feelings of being stressed. The symptoms are similar to those of other mental health conditions, but there are critical differences.

Burnout is typically thought to be caused by work-related or other kinds of stress. The signs of burnout include:

• Exhaustion: People affected feel drained and emotionally exhausted. They report not having enough energy, being overwhelmed and feeling tired and down. They may also develop physical symptoms like pain and gastrointestinal (stomach or bowel) problems.
• Alienation from (work-related) activities: People who have burnout find their jobs increasingly stressful and frustrating. They may start being cynical about their working conditions or colleagues. They may increasingly distance themselves emotionally, and start showing less interest in their work.
• Reduced performance: Burnout mainly affects everyday tasks at work, at home or when caring for family members. People with burnout are very negative about their tasks, find it hard to concentrate, are listless and lack creativity.

Changes in their professional setting can sometime already help with problems at the workplace. More practical help in everyday life situations can reduce strain on people who feel overwhelmed by caring for a family member at home.

Doctors and psychologists often use questionnaires to diagnose burnout. But because there's no generally accepted definition of burnout, it isn’t clear whether questionnaires can actually “measure” burnout and distinguish it from other illnesses. The most common questionnaire is the “Maslach Burnout Inventory” (MBI), which is available for different professional groups. But this questionnaire was originally developed for research purposes, not for use by doctors.

Online questionnaires on the risk of burnout aren't suitable for determining whether someone has burnout. The symptoms that are said to be a result of burnout can generally also have other causes, including mental or psychosomatic illnesses like depression or anxiety disorders. But physical illnesses or certain medications can cause symptoms such as exhaustion and tiredness too. So it's important to consider other possible causes first together with a doctor.

Certain symptoms that are considered to be typical for burnout also occur in depression. These include

• extreme exhaustion,
• feeling down, and
• reduced performance.

Because the symptoms are similar, some people may be diagnosed with burnout although they really have depression. That can lead to the wrong treatment: People who are exhausted “only” because of work can recover if they go on a longer vacation or take some time off from work. But if people with depression do so it might actually make things worse because the kind of help they need is very different, such as psychological treatment or medication.

Some characteristics of burnout are very specific, though. In depression, negative thoughts and feelings aren’t only about specific demands (such as job-related ones), but about all areas of life. Other typical symptoms of depression include

• low self-esteem,
• feelings of guilt,
• hopelessness and
• suicidal tendencies (thinking about killing yourself).

These aren't regarded as typical symptoms of burnout. So people with burnout don’t always have depression. But burnout may increase the risk of someone getting depression. That makes it even more important to take burnout seriously and to find a medical expert who can make the right diagnosis.