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Physiology of Stress: What is Burnout?

Some individuals fail at coping up with their daily dose of challenges and this most often results to burnout. If stress remains unresolved, burnout happens.

American psychologist Herbert Freudenberger way back in the 1970s observed the consequences of prolonged, severe stress and high ideals among “helping” professions in his book, Burnout: The High Cost of High Achievement. He coined the term “burnout’, using it to refer to “the extinction of motivation or incentive, especially where one's devotion to a cause or relationship fails to produce the desired results.” He observed that helping professions, such as doctors and nurses, often end up being “burned out” after constantly sacrificing themselves for others.

Is it exhaustion, or burnout? Exhaustion is considered a normal response to stressful events and is not necessarily a sign of disease. A stressful lifestyle can subject a person to extreme pressure such that he feels exhausted, burned out, empty, and unable to cope. Exhaustion is one manifestation of burnout.

Burnout is a reaction to a prolonged or chronic intense level of stress. It is characterized by three main areas of symptoms (IQWiG, 2020):

  • Exhaustion

The state of exhaustion refers to being drained and emotionally exhausted with the inability to cope. The individual complains of being tired and down, and simply without enough energy. This is often manifested physically by the onset of pain and gastrointestinal problems.

  • Alienation from (work-related) activities

This is also a state of cynicism – where an individual starts being cynical or skeptical towards working conditions and even colleagues. They will be visibly disengaging themselves emotionally from everyone. This action often leads to further detachment and even depression.

  • Reduced performance

The effect of burnout extends not only to everyday tasks at work but extends to the home and even to care for family members. Individuals with burnout are very pessimistic about their responsibilities and are finding it hard to focus. Most of them are apathetic and lacking creativity. People often find their emotions blunted. They are also noted to lose their motivation, ideals, and hope in the system.

There is no clear-cut definition of burnout. Despite numerous questionnaires out in the open claiming to objectively measure burnout, there are no questionnaires yet for use by doctors for its diagnosis. One commonly used questionnaire is the “Maslach Burnout Inventory” (MBI), which is readily available for different professional groups but is used for research purposes only.

The World Health Organization (2019) classified burnout as an occupational phenomenon, and not as a medical condition. It refers to burnout as a “syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.”

The WHO (2019) further clarifies that burn-out refers to “phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”

The symptoms for burnout may also be present in other illnesses such as in anxiety disorders, depression, and chronic fatigue syndrome. Thus, it is important to rule out with one’s physician other possible causes before concluding on burnout as a diagnosis.

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