Burnout, a syndrome of professional exhaustion in French, was first described in 1974 by the American American psychiatrist Herbert Freudenberg.
What is burnout?
A burnout is a physical, emotional and mental exhaustion which is often the result of prolonged overinvestment at work, accompanied by self-inflicted emotional demands. However, it should be noted that burn out is not considered as a mental illness in the reference classifications (WHO International Classification of Diseases ICD-11 and the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders DSM- 5 of the American Psychiatric Association, editor’s note). Rather, it is an emotional disorder, such as suffering at work or an anxiety disorder.
What are the differences between depression, burnout or severe fatigue?
In burnout, we find a set of symptoms at the origin of the syndrome of mental burnout. The manifestations are more or less important and settle very gradually, often in an insidious manner. What is really very characteristic of burnout is the rupture. That is to say that these manifestations create overnight a break with the original emotional state of the person.
Concretely, what are the symptoms of burnout?
On the emotional side, we find anxiety, muscle tension, mood disorder – we oscillate between anger, sadness, hypersensitivity. We find memory problems, a lack of concentration, you are really at the end of your intellectual resources. In terms of motivation, a loss of meaning gradually sets in and results in a disengagement, as if we could no longer understand what motivated us before at work. There is also a decline in the values that we put into this work. We doubt his skills, his ability to perform a task, we question our professional choices. And often, the person devalues himself more and more. We also find very strong signals at the level of behavior: withdrawal into oneself, isolation, aggressiveness and loss of empathy towards those close to them. It is a feeling of endangerment, which creates withdrawal into oneself, without the person really realizing it.
Are there also physical manifestations in burnout?
A whole physical symptomatology yes, with difficulty sleeping, musculoskeletal pain, headaches, dizziness, eating disorders, stomach aches …
And one day, without having seen it coming, it breaks up. That’s right ?
Yes. Without even realizing it, a process of exhaustion sets in and leads to this breaking point. Patients explain: “I woke up one morning and couldn’t get out of bed.” While, as we know, burnout had been taking hold for several weeks or even several months. When you see the patients, they are in a very fragile situation, but in reality, they held on with strength and self-sacrifice for months. These are people who generally don’t listen to themselves and last a very long time, too long. Until the break.
Why, psychologically, does it break at one point?
It is very important to work on the suffering linked to this professional burnout in order to understand this rupture. But special attention must also be paid to the patient’s personal and family history. You have to understand your personal relationship with work, the demands within the family, the demands of your parents. We find in the patient’s family history a parental recognition only conditional on the work accomplished, on the results, a competition within the siblings, failing parents … It is the whole history of the patient that creates the conditions for endangerment at work and burnout.
So the working conditions are not enough to explain a burnout?
Obviously no. Working conditions are also involved, such as overwork, lack of recognition, but personal history is equally important. Why are we to the end in contempt of our emotional, physical, psychological disorders? Usually in the minds of these patients, as long as they haven’t cracked, they can hold on. They are often very surprised when they are diagnosed with burnout. And until the breaking point, they don’t see anything coming. These are people who keep results, who perform at work and never imagine they can crack.
It is only after the rupture that one diagnoses the burn out?
Yes. We do not diagnose a burnout without the patient having reached the rupture. We can alert him to a risk of exhaustion but we are not yet talking about burn out. And when the diagnosis is made, after the rupture, it then takes weeks, sometimes months, for these people to accept it and feel legitimate to be in quitting. Prior to that, they felt they did not live up to what was expected of them at work. For them, they should have fulfilled the objectives, and devalue themselves.
How are patients with burnout syndrome treated?
There is always a need for psychological care. Sometimes drug treatment is needed. When we find in the foreground a deep sadness, anhedonia – loss of the capacity to feel pleasure -, apathy, antidepressants are prescribed to treat this depressive symptomatology. And if it is the anxiety disorder that is prominent like panic attacks, feeling of tightness, difficulty sleeping, dysfunctional, intrusive thoughts, in this case, anti-anxiety medications can help. Treatment can also be offered to help patients who cannot sleep.
What evolution for these patients?
Many of the patients will not return to their old jobs under the same conditions. They seize the opportunity to question themselves, to review their values and the place of work in their life. It is very disturbing for them to realize how much they have inflicted this suffering on themselves. When they realize it, they have this very strong need to understand why so that it does not happen again. ‘What is my path? Do I necessarily have to flourish in self-sacrifice and performance at work? ‘ They seek a better balance between social, professional and family life, the three great spheres of life. These are existential questions that are ultimately salutary. They know that if they return to the same environment, the same causes will create the same consequences. It is therefore a very healthy process, but it can take time.
Can we paint the typical portrait of burnout victims?
According to the High Authority for Health (HAS), women are twice as likely as men to be victims of burnout (3.1% for women, 1.4% for men according to HAS 2012 figures, editor’s note). I personally do not have quantified studies but what I see in my office are women who need to prove something is good student syndrome. They need recognition and affection. I find that very early in childhood, they embraced the belief that if they performed, they existed.
Have you noticed an increase in cases of burnout since the start of the pandemic and the generalization of teleworking?
Completely ! Two reasons for this. The first is that there is a porosity between personal and professional life, in addition to the guilt of being at home, we want to prove that we work. We always answer our emails and we can’t shut down the computer at 6.30pm because we don’t have transport so we work even later. The second reason is overinvestment at work. The Covid has been a source of anxiety and stress. To make sense of it all and hold on despite this feeling of insecurity, some people clung to one of the only areas they could master. They then invested more work to reassure themselves and to find meaning in this period of insecurity and uncertainty.
Can we do prevention against burnout?
It is important tobe attentive to your emotions, to changes in behavior, to the messages transmitted by our body. Work can be beyond a certain threshold, a source of suffering, and you have to keep it in mind. It is essential to ensure the balance between the three main spheres of our life, private, social and professional.
Also read:
- 10 tips to protect yourself at work
- Improve the diagnosis of burnout
- Chronic fatigue: what to do?
