Burnout is mentioned a lot these days. But what is burnout, exactly? A disease? A disorder? A driving-based video game? Actually, it’s none of these things (well, there is a video game but that’s not what we’re discussing here).
Burnout is the phenomenon where an individual’s health (physical and mental) and functionality suffers due to them experiencing excessive stress for extended periods, specifically from their job. As such, it’s officially classed as an ‘occupational phenomenon’.
There are those who may scoff at this. After all, hard work never hurt anyone, right? It’s character building! You’ve got to work hard if you want to succeed. You don’t get something for nothing, etc. Overall, there are many societal factors and assumptions that can, and do, lead people to assume that constant hard work only has positive outcomes.
The data tells a very different story, however. The reason burnout is mentioned so often is because surveys (conducted in the US) reveal that, pre-pandemic, 43 per cent of workers reported experiencing some form of burnout. Nearly half of the entire workforce.
Alarmingly, yet predictably, the pandemic’s made things worse. The same studies conducted post-2020 reveal that 52 per cent of employees, a 9 per cent increase, now report experiencing it. So burnout now affects over half the workforce. Particularly younger employees, who have many more working years ahead of them; those closer to retirement, in more senior positions, with more savings, report less burnout. But even they’re feeling the pinch of the pandemic.
Why, though? Given everything we’re led to believe about the benefits of hard work, why is burnout such a problem?
Read more about burnout:
- Beat the burnout: How to fight pandemic fatigue with science
- Burnout linked to atrial fibrillation and irregular heartbeat
Stress and its impact on health
A persistent cause of poor health in modern, developed-world humans, is stress. While we’re all familiar with stress, its long-term effects are more profound than most realise, leading to many health problems.
Stress is part of our body and brain’s defence system. It’s essentially a precursor, a build-up stage, to the more potent, but shorter lived, fight-or-flight response. When we encounter things that we perceive as threats (or potential threats), we experience stress. Which has health consequences, often due to the constant presence in our systems of stress chemicals, such as cortisol.
Physically, stress negatively affects our blood pressure, respiration, weight, immune system and more. Mentally, stress can negatively affect our focus, memory, mood and cognition. Stress is also believed to be a key factor in the onset of both depression and anxiety.
It’s well established that burnout causes genuine physical illness, increased feelings of hopelessness or despair, irritability, impatience, and damages relationships with family, friends and co-workers. Burnout can even lead to problems with executive functioning (our ability to think and self-regulate), attention and memory.
Overall, burnout mirrors the consequences of excessive stress. It’s not just severe exhaustion (although that’s a key part of it). However, burnout is specifically a consequence of stress induced by someone’s work, their job.
What’s so special about work stress?
Much modern adult stress comes via the workplace. Psychologically speaking, there are many things about work that reliably trigger stress in the brain, things that we’re less likely to encounter outside of work.
For instance, the human brain likes a sense of control, of autonomy. When we feel we have control over things that affect us, we tend to feel better, more reassured. Most jobs involve adhering to a strict schedule, however, or taking instructions from someone more senior.
And in big organisations, it’s often hard to understand the logic or rationale of the things you’re being made to do. This loss of autonomy is a reliable cause of stress. As is uncertainty, a constant issue when you don’t understand why you’re being made to do what you’re doing.
Humans are also very status-conscious; we instinctively want to be looked up to, respected, approved of. Accordingly, losing status is very stressful. So, constantly being at the mercy of higher-ups or beholden to customers/clients – that causes stress.
Another thing our brains dislike is wasted effort. We have complex neurological systems that assess whether tasks are worth doing, compared to the potential reward they’ll produce. Accordingly, if we put more effort in than the reward warrants, that can be a very stressful experience. Say you work for months on a project, only for a boss to suddenly cancel it on a whim. This induces considerable stress.
Of course, not every job is a recipe for constant stress. There are many jobs that regularly rank highly in terms of satisfaction and employee happiness. And, big surprise, they invariably involve a high level of responsibility, autonomy, tangible outcomes for efforts made and appreciation.
Most other jobs struggle to offer such things, though, so they involve more stress. And if you’re wondering why people persist in doing them, it’s because we need jobs for money and we need money to survive. ‘Not surviving’ is an even greater stress, so not having a job can be even more stressful than having one you don’t particularly enjoy.
Given all this, it’s hardly surprising that burnout is as common as it is.
Burnout in healthcare
Whenever you hear about burnout, it’s often in the context of the field of medicine. There are reasons for this; medicine is an extremely demanding, complex and often under-resourced field, and the one workplace where your decisions and performance can literally mean life or death. It’s no wonder that burnout among medical staff gets the lion’s share of attention.
This is especially valid in the context of the pandemic. Surveys suggest that as many as a third of all medical trainees feel burnt out to a high/very high degree, a significant increase on the numbers pre-pandemic.
Someone regularly dealing with this is consultant paediatrician Dr Serena Haywood, guardian of safe working hours and health and wellbeing champion at St George’s NHS Trust.
“Burnout has always been a part of doctors’ lives. We accept that stress is part of the job. Every headline screams about ambulance waiting times, patients stranded in A&E and stretched waiting times, and that’s an average Tuesday.
"Much of the time we do what we can and enjoy a challenge knowing that we’re ridiculously privileged to work in a career that still is one of the most highly respected and fulfilling. But with one in four people vulnerable to mental health difficulties, a tendency to perfectionism and a drummed-in sense of accountability for everything, doctors can get mired down and exhausted.”
Indeed, when the concept of burnout was first established in the 1970s, it was said to be particularly pertinent to ‘caring’ roles, such as medicine.
One explanation for this would be that humans are very empathetic; we don’t just recognise other people’s emotional state, we share it, we experience it ourselves. So, when you’re already emotionally invested in other people’s wellbeing (as those who willingly work in medicine must logically be, to some extent), being surrounded by the sick, infirm and suffering, will directly affect your emotional state, and cause your brain to be more stressed in dealing with it all.
Thus, burnout becomes more likely. Indeed, research suggests that those who display greater empathy are prone to more severe burnout.
However, the data presents a more nuanced picture. The first officially documented cases of burnout came from air traffic controllers. An important and often stressful job, no doubt. But, given how remote much of it is, one that doesn’t quite fit the definition of a ‘caring’ role.
With burnout now an established and well documented phenomenon, there are many ways to identify and assess it, with tools such as the Maslach Burnout Inventory (MBI), which has several variations, with ones for general use, medics, students, educators, and so on. This reveals an understanding that burnout is far from restricted to the medical field.
But given how we’re currently so dependent on healthcare workers of all types, and increasingly aware of the pressure they’re under, their burnout warrants the most attention.
It can seem like burnout is a modern phenomenon, but as we’ve seen, it’s been recognised for over 50 years at this point. Is it more common these days, though? Perhaps. A growing population means there are more people in the workplace than there were in the 1970s, so, logically, you’d expect to see more burnout as a result. We’re also more ‘aware’ of the condition now, just as we are with health matters in general. Being better able to recognise burnout means we’ll find more cases of it.
And maybe the nature of work has changed too, in ways that increase the odds of burnout. Sure, ‘old-school’ jobs, such as coal miner or soldier, were considerably more dangerous than more modern examples. But they were also much simpler, more straightforward and tangible.
The complex, unpredictable nature of modern work, often customer-facing or with confusing and abstract instructions and outcomes, may be better at exploiting the weaknesses of the human brain, when it comes to experiencing stress and burnout.
Burnout coping strategies
So how do we deal with burnout? Well, there are many things to consider. The most obvious option is to try to change your work situation, by talking to superiors and addressing the issues that are causing you so much stress. However, not every workplace has the flexibility, the resources or, sadly, the understanding to do this successfully.
Finding support elsewhere is also an option, be it friends, family or co-workers. Remember, burnout is heavily intertwined with stress and stress is a surprisingly subjective phenomenon. This means that, as facile or twee as some may find it, advice such as ‘get more exercise’, ‘take up a new hobby’, ‘meditate’, ‘try mindfulness’, and so on, can make a genuine difference in helping people deal with burnout.
Haywood, who does resilience training for healthcare workers, explains.
“I teach that resilience is about learning to fight another day. Learn your rights and responsibilities and escalate concerns. Make sure you remember what it is that you used to enjoy doing before you seemingly worked all hours. Make an apple crumble. And be nice to people, goddammit! One trainee said it was mostly ‘woo’ but there was one bit of it that was her kind of ‘woo’.”
The human brain is incredibly powerful, but also complex and, most importantly, finite. Work is a big part of our lives and, especially during the pandemic, a more stressful one. Increasingly often, that stress becomes more than our brains are able to process, leading to burnout. Ultimately, anything that reduces that stress, as long as it’s not harmful itself (for example, excessive drinking), can help prevent it.
- This article first appeared inissue 372ofBBC Science Focus Magazine–find out how to subscribe here
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