20/01/2025
What's up with burnout?
In recent decades, the term "burnout" has become increasingly prevalent, depicting the experience of employees who find themselves emotionally drained, cynical, and feeling ineffective at work. The conversation around burnout as a distinct workplace syndrome has garnered significant attention from occupational health experts, psychologists, and the general public. However, contrasting viewpoints exist regarding whether burnout qualifies as a well-defined clinical entity stemming directly from chronic job stress.
On one side of the debate lies growing scientific evidence suggesting burnout represents a legitimate phenomenon with serious consequences. In 2019 the World Health Organisation (W.H.O) updated its International Classification of Diseases (ICD-11) to include Burnout as an ‘occupational phenomenon’ – but it was not classified as a medical condition. The W.H.O refers to the definition established by the widely-used Maslach Burnout Inventory, which has burnout characterized by three core dimensions:
1. overwhelming exhaustion,
2. feelings of cynicism and detachment from one's work, and
3. a sense of diminished professional efficacy.
Neuroimaging studies have revealed that burnout is associated with physical changes in brain areas involved in emotional regulation, cognitive functioning, and the stress response system. Individuals suffering from burnout show alterations in the amygdala, prefrontal cortex, anterior cingulate cortex, and hippocampus. This dysregulation may lead to impairments in cognitive abilities like attention, working memory, and creativity. Moreover, the chronic stress underpinning burnout appears to throw the body's neuroendocrine system off balance, resulting in abnormal cortisol levels that promote systemic inflammation and increase risk for serious conditions like coronary heart disease.
While the negative impacts of burnout seem clear from this research, an opposing perspective challenges the fundamental validity of burnout as a legitimate clinical syndrome directly caused by factors in the workplace. Critics argue that the conceptualization of burnout as a combination of exhaustion, cynicism, and reduced efficacy was largely pre-defined before rigorous empirical research occurred. The reasoning for why these three particular symptoms constitute a distinct syndrome, separate from conditions like depression, remains unclear and lacks a strong clinical or theoretical basis. However, for those of us who have experienced both clinical depression and burnout, there is a distinct difference; if you remove yourself from the situation that is causing burnout – your caring role, your toxic workplace, overwork and or struggle for survival – your symptoms start to resolve. With enough rest and recovery, the burnout symptoms lift. If you are experiencing clinical depression, it does not matter how much rest and recovery you throw at it, the symptoms persist. Without effective treatment such as psychotherapy and or medication, clinical depression symptoms do not resolve.
Furthermore, evidence that burnout is primarily induced by unmanageable work stress is lacking. Job stressors have been found to be relatively weak predictors of burnout, and no conclusive proof exists that they contribute more to burnout than other sources of stress outside the workplace. The proposed causal link between occupational factors and burnout appears tenuous.
After nearly 50 years of research on the topic, the inability to establish validated diagnostic criteria for burnout also raises scepticism about its legitimacy as a clinical entity. Some have proposed that burnout may simply represent an artificial construct lacking enough coherence to allow proper diagnosis and measurement of prevalence rates.
Given these issues, some experts have advocated for revising or removing burnout's status from clinical manuals like the ICD-11, which currently categories it as a factor influencing health status. They argue the various existing categories for stress, anxiety, and depressive disorders provide sufficient means to address job-related distress without a separate, ill-defined burnout classification.
As the debate continues, one perspective views burnout as an insidious condition inducing neurological changes and cognitive impairment from the accumulated toll of chronic workplace stress.
The opposing viewpoint argues burnout lacks sufficient validation as a distinct clinical syndrome stemming specifically from occupational factors. Resolving this controversy will likely require more rigorous, longitudinal research to either solidify burnout as a legitimate occupational phenomenon or refine our understanding of how chronic stress manifests across work and personal life domains. With so much at stake for employee health and productivity, the burnout discussion represents an important priority for the field of occupational health psychology.
In the meantime, what can workplaces do to mitigate the risks of psychosocial hazards that can impact mental health? The answer is Mental Health Literacy training to increase capacity for recognising when a team member is experiencing poor mental health or poor performance related to mental health and gaining the skills needed to have a supportive conversation before any major issues or injury occur.
I have trained over 2000 people in Mental Health Literacy Courses – don’t wait until the symptoms of burnout show up in you, your team or the people you love. Contact me to discuss your training needs.
Sources:
Bianchi R, Schonfeld IS. Examining the evidence base for burnout. Bull World Health Organ. 2023 Nov 1;101(11):743-745. doi: 10.2471/BLT.23.289996. Epub 2023 Oct 4. PMID: 37961064; PMCID: PMC10630726. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630726/
https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
https://www.psychologicalscience.org/observer/burnout-and-the-brain (Note: the article linked was written in 2016 and the ICD-11 was updated in 2019 – otherwise it is an excellent article on the history of burnout and its cognitive impacts on the brain)
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