Burnout – Just before the 2020 pandemic, studies and media reports showed a significant incidence of burnout among working people.

Occupations with the highest rates of burnout include the health care, education and service sectors.

It got even more attention when New Zealand Prime Minister Jacinda Ardern announced her resignation earlier this year. 

“I know what the job takes, and I know that I no longer have enough in the tank to do it justice.”

Psychologist Christina Masrach, who has studied work-related stress for decades, has found a term that comes up frequently in her research.  

“She’s talking about an empty tank,” Maslach pointed out.

Maslach said the pandemic shows how important work is to a healthy and functioning society, even when people are tired.  

Modern understanding

Some scholars believe burnout is a modern phenomenon caused by our busy culture, while others believe it’s a fresh iteration of a long series of fatigue problems. .

They mentioned the ancient Greek concept of Asedia, which the 5th-century monk and theologian John Cassian characterized as physical lethargy and yawning hunger.

In the 1970s, Herbert Freudenberger, a consultant psychologist for volunteers working with drug users, coined the term “burnout.”

Freudenberger used this phrase to describe the following characteristics of volunteers:  

• A gradual loss of motivation
• Emotional depletion
• Reduced commitment

Christina Maslach noticed similar trends in interviews with social workers in California, which inspired her to develop a burnout detection tool, the Maslach Burnout Inventory.

They discovered her three traits in Susan Jackson, a doctoral student at the time.

Chronic feelings of fatigue, cynicism and inefficiency, or low personal achievement.

According to Renzo Bianchi, an occupational psychologist at the Norwegian University of Science and Technology, Maslach’s scale has elevated burnout to a legitimate research topic. 

“Before [the Maslach Burnout Inventory], burnout was pop psychology,” said Bianchi.

Definition

Since its inception, Maslach’s inventory has been the most widely used tool for studying burnout, although its definition of the disease has been criticized.

Wilmar Schaufeli and Dirk Enzmann, organizational psychologists, wrote The Burnout Companion to Study and Practice: A Critical Analysis in 1998.

They argued that boxing burnout, defined as a combination of fatigue, cynicism, and inefficiency, was “arbitrary.”  

“What would have happened if other items had been included?” they proposed.

“Most likely, other dimensions would have appeared.”

The three aspects and causes, according to Evangelia Demerouti of Eindhoven University of Technology, are loosely defined.

Nonwork circumstances, such as health concerns and childcare duties, can all contribute to weariness.

Disagreements have developed in competing opinions, one of which is how to use Maslachi’s inventory.

There was no mention of a cutoff point to define when people went from not burnt out to burnt out in the inventory.

It was instead intended to assist academics in identifying patterns in a work environment or profession.

Maslach has limited effect over how others employ the inventory method.

A modified version of the Maslach Burnout Inventory was used in nearly 86% of the physician burnout studies presented at JAMA 2018, some of which reduced the number of statements or assessed fatigue.

They were using an unapproved version of the scale that included a cutoff value, but there was little consensus on its definition.

Among all papers, JAMA researchers found 142 burnout categories.

Researchers identified 11 different assessment tools that did not use inventory variants within the study group.

Concerns have led educators to rethink how burnout is defined and measured. 

“We don’t [have] a good conceptualization of diagnosis of burnout,” said Demerouti.

“We need to start from scratch.”

Read also: Mental health struggles are weighing down college students

Agreements

Experts believe fatigue is a key feature, according to Bianchi and his team in 2021.

Research over the past two decades has focused on the idea that burnout leads to cognitive changes such as memory impairment and difficulty concentrating.

Charlie Renaud of the University of Rennes argues that the problem could lead to forgetfulness.

People’s problems can spill over into personal situations and make leisure activities more difficult.

Renaud argued that as more information becomes available, scientists will include questions about cognitive changes in burnout assessments.

Connection to depression

Depression is usually attributed to individuals, but the concepts seem to contradict each other as sociological causes lead to burnout.

Researchers have questioned whether the latter occurs as a diagnosis in and of itself.

Research shows that the concepts do not contradict each other.

Prolonged stress at work can lead to depression, and mood can lead to burnout.

Furthermore, according to Bianchi and his colleagues, fatigue was associated with depression, not cynicism or inefficiency.

If various symptoms fall under burnout, fatigue and sadness seem to be a more viable combination than Masrach’s inventory. 

“The real problem is that we want to believe that burnout is not a depressive condition [or] as severe as a depressive condition,” said Bianchi, but he said it isn’t true.

Should it be diagnosed?

The diagnosis is controversial because not everyone considers it a good idea. 

“Burnout was never, ever thought of as a clinical diagnosis,” Maslach explained.

However, Bianchi and his team disagreed with this statement.

They developed a proprietary scale, the Occupational Depression Inventory, to measure nine key symptoms associated with major depression, including cognitive impairment and suicide risk, in terms of work.

If burnout is a form of depression, Bianchi says it may need to be addressed.  

“Hopefully, the interventions, the treatments, the forms of support that exist for depressed people can be applied for occupational depression,” he said.

According to Kirsi Ahora of the Finnish Institute of Occupational Health, this treatment does not reduce the work-related stress that causes this condition. 

“[Imagine] the person is on sick leave, for example, for a few weeks and recuperates and rests,” she offered.

“And he comes back to the exactly same situation where the demands are too high and no support and whatever. Then he or she starts burning out again.”

The current Diagnostic and Statistical Manual of Mental Disorders does not include burnout.

Maslach’s theory of burnout got support when the World Health Organization classified the syndrome in his 2019 International Classification of Diseases.

Nevertheless, the World Health Organization has stated that this is an occupational phenomenon and not a medical problem. 

Image source: Greater Good Science Center