Burnout: Signs, Causes, & Ways to Overcome

What Is Burnout?

Typically, the stressors leading to burnout are work-related, but the effect is understood to cut across both work and personal life with an overall experience of physical and mental fatigue, identity loss and meaninglessness. While career or job burnout (such as therapist or teacher burnout) accounts for the majority of literature on the subject, similar experiences of exhaustion and loss of meaning may result from parenting (resulting in parental or mom burnout), caretaking responsibilities, or even troubled romantic relationships.

Workplace stress accounts for a 50% increase in medical spending in high stress job environments and over 550 million missed workdays.¹ However, the responsibility for treatment is often on the worker rather than organizational mitigation strategies. Additionally, burnout is difficult to identify on an organizational level because the disengagement of the burned out worker may make them more susceptible to failing to use provided resources, such as their PTO, chain of command, human resources department, or EAP.

Am I Burnt Out?

If you answer “yes” to more than two of the questions in this self evaluation you should at least consider a consultation with a therapist to address burnout:

• Have I missed an increasing number of days of work over the past 3-6 months?
• Have I gotten into more conflicts with my colleagues and/or supervisor lately?
• Have I had to “make up” for my lack of engagement at work by doing an increasing amount of work outside of regular work hours?
• Have I been engaging in escape fantasies and maladaptive daydreaming while at work more frequently?
• Have I noticed symptoms of depression or anxiety that are impairing my work performance?
• Has my physical health been declining and I have either failed to address it or been given suggestions by my doctor about self-care that I have failed to follow up on?
• Have I stopped caring about my work performance?

Defining, Diagnosing, & Measuring Burnout

Literature on the topic of burnout began appearing in 1978 but did not exceed 10 publications per year until 1989, with a significant rise starting in 2005.² Studies that attempt to define and diagnose burnout typically look at one of several categories: studies that describe psychological and somatic symptoms, psychometric studies, and biomarker research.

The Maslach Burnout Inventory (MBI) is considered the ‘gold standard’ for measuring burnout, encompassing three scales: emotional exhaustion, depersonalization, and personal accomplishment.³ In a study of Emergency Medicine residents, the MBI was compared to other wellness measures, and a high MBI score was found to correlate with reductions in quality of life, work-life balance, and perceptions of satisfaction with career choice.³

Types of Burnout

Burnout can be further divided by the causes, although sufferers may struggle to identify it at first glance:

Overload Burnout

Overload burnout occurs in high-demand, low-control environments where the objective workload is simply more than can be accomplished in the time allotted. Or, this can occur when a worker lacks the skills to accomplish the work in the time allotted. Sometimes this type of burnout is self imposed where someone continues to take on tasks and is unable to handle the volume. Signs of this type of burnout include a competitive work environment where chronic overwork is the expectation, irritability and frequent lateness on work assignments.

Under-Challenged Burnout

Under-Challenged burnout occurs in entry level or mid level positions where a worker is ready for a new or more challenging environment but has a position that is comprised of repetitive, boring, or low-skills tasks. Workers in this type of environment may express their burnout by arriving late, leaving early, and procrastinating on tasks.

Neglect Burnout

Neglect burnout occurs when someone finds their position meaningless or their work product unacknowledged. This type of burnout is common in a setting where the job may be administrative or a part of production that is largely unseen or does not clearly contribute to the mission or vision of the organization. This type of burnout is also aligned with “moral injury” on the job, where management does not articulate the mission or vision and how the staff member’s contribution fits in with larger goals.

Burnout Symptoms

Primary signs and symptoms of burnout are mental exhaustion, decreased productivity, and feelings of powerlessness. Symptoms that may be observable to loved ones include sleep issues, sexual problems, bitterness, and empathy burnout. Physical symptoms can include back pain, poor digestion, headache, or more frequent colds.

Often, a person may attempt to combat burnout by increased use of caffeine, alcohol, or drug use. Since the issue with burnout is one of prolonged exposure, the concerns may build up over time and may not be easily recognizable as burn-out. Early warning signs may be written off as a bad mood.

Early warning signs of burnout may include:

• Doctor’s visits for vague complaints
• Irritability/lack of sense of humor
• Revenge bedtime procrastination
• Escape fantasies
• Self-pity
• Mistrust of others
• Feelings of guilt
• Feeling time pressured
• Lack of initiative

Severe Burnout Symptoms

As the burnout continues unaddressed, the symptoms and consequences become more pronounced.

Serious and persistent burnout may lead to:

• Heart disease
• Anxiety
• Suicidal ideation
• Major depression
• Substance use disorder
• Relational issues
• Poor work performance

What Is the Difference Between Stress & Burnout?

People who report subjective, toxic stress are generally driven to work more, not less. Burnout is a chronic condition that results in disengagement, low productivity, depersonalization and often health issues.

Given that “burnout” is not an accepted medical diagnosis, there are not clearly articulated symptoms that lead to a differential diagnosis of burnout versus generalized stress. The need for a discrete diagnosis code for burnout has been debated and currently the constellation of burnout symptoms is categorized as an occupational concern in the ICD11.

Burnout might be classified by a provider as adjustment disorder. The constellation of symptoms is similar but, without a discrete diagnostic category for burnout the diagnosis may vary depending upon the cause.

Burnout Vs. Depression

Burnout and depression are related and often overlapping emotional states. However, depression is a medical diagnosis requiring evidence of symptoms over at least a two week period. It is best described by sadness and hopelessness. Burnout is not a medical diagnosis but is seen as an occupational hazard, which is defined by apathy but may also include depressive symptoms.

What Causes Burnout?

Burnout has been associated with the combination of high or unrealistic personal and occupational expectations over an extended period of time with low control, perceived fairness or support. Primary drivers of burnout appear to be related to certain occupational factors.

The top five reasons for burnout are:¹

1. Unfair treatment at work
2. Unmanageable workload
3. Lack of role clarity
4. Lack of communication and support from their manager
5. Unreasonable time pressure

Neuroticism, low agreeableness, and low conscientiousness were risk factors for burnout and are associated with passive coping strategies, such as:⁵

• Venting of emotions
• Denial
• Seeking social support for emotional reasons

Effects of Untreated Burnout Symptoms

The nature of burnout is that it often “creeps up” on workers who keep thinking that they will feel better after the weekend, the completion of the next project, or once another person is hired in their department. Even after those things happen they still find themselves worn out, unmotivated, missing deadlines, and being irritable at work and home. As the weeks turn into months the long term effects can become increasingly serious.

When left unaddressed, burnout can cause more severe problems, such as:

• Poor general health due to weight gain or lack of preventive medical care
• Insomnia and the associated health effects of poor sleep
• Heart disease
• Substance or alcohol use problems
• Family or marital issues
• Poor vocational outlook
• Isolation/lack of social life

How to Deal With Burnout

Methods of intervening require noticing the signs early and taking action before they become more serious. Creating reasonable boundaries and expectations and developing cognitive strategies that support optimism and self-care are keys to sustained well being. Preventing burnout necessitates addressing drivers of work stress on an individual and organizational level. Recovery may be complicated by self-sabotaging behaviors and require additional considerations.⁶

For those experiencing burnout in their personal life or while dealing with caregiving or other stressors, these strategies may help relieve the stress:

1. Develop an Individual Self-Care Plan 

• Reduce complexity in your home routine
• Set a “hard stop” for work related communication during family time
• Prioritize sleep and rest
• Get exercise at least 3x/week
• Engage in a hobby at least once/week
• Explore journaling as a self care practice
• Engage in a gratitude or faith based practice
• Eat healthy and stay hydrated
• Explore meditation
• Partake in activities that help increase mental energy

2. Seek Community Online or in Person 

• Talk to a trusted friend at least once a week for support
• Join a support group—in-person or online

3. Call or Visit a Therapist 

A licensed therapist can help you talk through and process what is causing burnout, and can then assist you in developing personalized strategies for mitigating the stress.

4. Address Your Workload & Reframe How You View Work

• Simplify–focus on no more than 3 goals or priorities at a time
• Explore the Pomodoro method of time management
• Structure your day to fit professional goals

5. Address Communication Issues 

• Seek out communication at home and work
• Develop and model effective and efficient work communication

When to Get Professional Help for Burnout

You may be able to address burnout on your own with the support of friends, colleagues, and loved ones. However, if the burnout you are experiencing is leading to absenteeism, fractured relationships in your work or professional life, physical impairment or suicidal thoughts you should seek professional help. Additionally, if you’re experiencing ergophobia, or an actual fear of work, it’s helpful to speak with a therapist.

The difficulty in making this determination is that, in later stages of burnout, you may feel too detached to accurately judge your condition, and you may also undermine your work situation and wellness. Basically, if you’re wondering if it’s time for therapy, it probably is.

Who Should I Consult for Help in Overcoming Burnout?

A licensed mental health professional can help determine whether the issue you are experiencing is burnout or whether there is also high functioning depression, high functioning anxiety, or possibly another concern. They can offer supportive and skill-building therapeutic interventions that can help increase your sense of self efficacy in recovery from burnout. They can also make referrals to a psychiatrist if a medication evaluation might be indicated, or recommend a family or marriage counselor if relational issues are caused by or making burnout worse.

Therapists with a background in integrated/holistic counseling, mindfulness-based counseling, cognitive behavioral therapy and/or career counseling expertise will be able to help with skills and strategies that can help address issues typical in burnout.

Your employer may offer a free employee assistance program which could provide a set number of counseling sessions each year to employees and/or their family members. These sessions are typically provided on the phone or by video.

How to Find a Therapist 

Therapists can be found through an online therapist directory, a referral from a healthcare provider or through your insurance company. The greatest consideration is whether you feel as though the therapist that you are working with is supportive, empathetic and able to hear your concerns.

Timeline for Treatment

The length of therapy can depend upon the severity of your presenting issue and also the speed of progress. Most therapy is conducted on a weekly basis with an expectation of at least some relief within a 6-12 week timeframe. Sufferers of severe burnout may find that they need to work with a therapist over a more extended period of time, especially if there are also significant work performance or family functioning issues resulting from the burnout.

Cost

Typical costs of therapy range from $60-200 per session, while highly specialized therapists or those in major metropolitan areas may charge more.

How to Support a Loved One Who Is Experiencing Burnout

Loved ones can be instrumental in helping address burnout.

If you loved one is experiencing burnout, consider these actions:

• Encourage your loved one to talk about disconnection and discouragement
• Encourage boundaries around tele-work versus family time
• Help plan healthy meals and activities
• Choose a gratitude or faith practice
• Encourage and plan breaks and social activities
• Actively support therapy
• Explore options for an extended work break or job change

Avoid these well-meaning but harmful behaviors:

• Micro-managing or getting irritated by slow progress
• Taking a stance for or against medication
• Toxic positivity (minimizing the issue) or giving advice