Burnout

Burnout is a condition that affects both the body and the mind, which usually develops over years when recovery from psychological exhaustion is not possible. Recovery from burnout often takes place in stages.

Burnout is a disorder of the body and mind caused by persistent, intolerable psychological stress. At its worst, burnout can lead to depression and other stress-related somatic diseases.

Many people are familiar with seasonal stress or a stressful period in their studies or work. Many changes in life, such as a new job, divorce, moving or a family member falling ill, may also cause psychological stress. If the stressful situation or mental strain continues for a long time, and evenings, weekends and holidays are not sufficient for recovery, the temporary stressful situation may escalate to burnout.

Burnout is common: according to some estimates, up to one in ten employees is suffering from burnout and an increased risk of burnout affects one in four. Outside these numbers are people who get burnout outside the work environment.

Burnout may also enter your life in other stressful life situations than those related to work or studies, in which psychological stress is long-lasting and unsustainable. Such situations may include living with a chronic or long-term illness, informal care or parenthood of a special child.

What are the symptoms of burnout?

Burnout is a condition that affects both the body and the mind, which usually develops over years. In essence, it’s an imbalance between the body and the mind, in which recovery from psychological stress is not possible.

The first symptoms are often physical, such as continuous headache, stomach and intestinal symptoms or dizziness. Similarly, insomnia, awakening in the early morning or intermittent sleep are typical symptoms of burnout.

According to research related to burnout at work, key symptoms of burnout include insurmountable fatigue, cynical attitudes towards work, weakened professional self-esteem and cognitive problems. Especially in early research, the symptoms have been summarised in the first three symptoms.

Insurmountable fatigue means fatigue that doesn’t ease up at weekends or during holidays. Cynical attitude towards work, on the other hand, means that work starts to seem meaningless and the meaningfulness of the work disappears. As professional self-esteem weakens, belief in one’s own competence and abilities deteriorates and it feels like you can no longer get things done. The most common cognitive difficulties are memory problems, reduced concentration and, as burnout progresses, problems regulating emotions.

There is a diagnosis for burnout in Sweden

Sweden has developed a diagnosis for fatigue (ICD 10, 43.8A), according to which:

• Physical or psychological symptoms have been present for at least two weeks. Symptoms have evolved as a result of two or more identified stressors and have occurred for the past six months.
• Significant lack of psychological energy, which manifests as reduced activity or resilience, or an increase in the time required for recovery in connection with psychological strain.
• At least four of the following symptoms occur daily during the same two-week period:
  • concentration problems or memory problems
  • significantly impaired ability to handle demands or get things done
  • emotional instability or irritability
  • sleep difficulties
  • significant physical weakness or exhaustion
  • physical symptoms such as pain, abdominal pain, intestinal problems, dizziness or sensitivity to sound
• The symptoms significantly disrupt performance at work, in interactions or in other important relationships.
• The condition is not directly caused by, for example, the effects of medicines or intoxicants, somatic disorders or injury, such as thyroid insufficiency.

In Finland, there has been a desire to link burnout and its diagnosis primarily to work and the working environment, so that the employer is responsible and obliged to intervene in situations and working conditions where burnout occurs. In Finland, burnout is not defined as a disease in medical classifications, but as a problem related to life situation management. The World Health Organization, WHO, defines burnout as a phenomenon related to work.

How is burnout diagnosed?

Burnout is difficult to diagnose due to its diverse symptoms. In addition, it’s often difficult for the burned-out person to admit that they have burnout, especially if it has developed over years. The symptoms may have become such a normal part of life that they are no longer recognised as symptoms. The body may also have adapted to a long-term stress state so that it no longer recognises the symptoms as a disorder.

In Sweden, the Karolinska Institutet has developed a survey of burnout symptoms (KEDS), which is available to anyone free of charge. The survey can be used to test both the symptoms of burnout and to monitor your recovery. The survey can be found at the MentalHub.

How can you recover from burnout?

Recovery from burnout often requires many kinds of changes. It’s important to try to influence the conditions that led to burnout. It’s equally important that the burned-out person finds ways to control stress.

Conditions that have led to burnout cannot always be influenced, in which case it’s vital that you learn to manage stress yourself. Many people receive help from different therapeutic methods, such as cognitive behavioural therapy or acceptance and dedication therapy. In addition, various mindfulness exercises are recommended, as well as being able to be compassionate to oneself.

If the burnout is related to work and working conditions, the workload must be reduced. There are many ways to do this and they are agreed upon together with the employer. Frequently used methods include changes in the way work is performed, changes in the pace of work, changes in the content of work and different working time arrangements.

Habits, sufficient sleep, exercise and regular and versatile eating also have their own roles in promoting recovery. In the spiral of burnout, you may begin to compromise on sleep and exercise may also be reduced. At the beginning of recovery, sleeping can take all your time, but you should also learn to reserve time for it after recovery. At the most difficult times, exercise may seem like an impossible idea, but low-pulse movement, such as calm walking or yoga, helps calm the body. Regular, versatile eating promotes mental wellbeing.

There is no medicine for burnout, but at the most difficult stage, many benefit from medications for mood disorders or insomnia.

Gradual recovery

Recovery from burnout is often described in stages. According to the self-care programme found in the MentalHub, there are six stages of recovery:

1. Recognising the situation: Burnout is difficult to identify, but do you notice that you have changed? Has something changed in your life? What kind of coping methods do you use?

2. Taking a distance: Do you need sick leave? Would that help break the cycle?

3. Let your body and mind recover: Are you sleeping enough? Do you recognise your body’s states of alertness?

4. Find out what is important: Do you know what is really important to you in life? What are your most important values?

5. Change as an opportunity: Could the changes needed in life be an opportunity? Do you want to change your behaviour? Or your relationships? Change your work? What brings you more energy? 6. Make concrete changes: What kind of changes are you prepared to make? Are they big or small enough? What changes is your energy sufficient for now?