Matches burning out
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My husband went to work this morning with a spring in his step. It was the first time in weeks. Why? Because our oldest son was laughing and joking at breakfast after weeks of poor sleep and bad moods. At work, my husband felt energetic. Quite a difference from the previous weeks, when he felt exhausted upon arrival at the office, and had the feeling work was piling up. My husband had been experiencing burnout symptoms, which include feeling exhausted, being negative about work, and lower efficiency.
Burnout is acknowledged by the World Health Organization, which defines it in its International Classification of Diseases-11 as “a syndrome resulting from chronic workplace stress that has not been successfully managed.” More than 50 years of research have been dedicated to understanding burnout. Now, it is being called into question. There are two camps – one consisting of psychologists and psychiatrists questioning the validity and need for the concept of burnout, and the other a group of occupational health researchers underscoring the relevance of burnout. Here are the key points, counterpoints, and takeaway messages that matter for organizations.
Disagreement #1: Does Work Cause Burnout?
The first point adversaries of burnout make is that there is no convincing evidence that work factors primarily cause burnout. Advocates of burnout, however, maintain that the origin of burnout is the workplace.
Understanding precisely what causes burnout is essential, as it can help us find more effective solutions to prevent it. In my husband’s case, I wondered, what caused his burnout complaints? The last few weeks were marked by numerous tight submission deadlines. But it was nothing out of the ordinary for his line of work, and something he otherwise dealt with fine. The added family worries had made it difficult to cope with his work demands.
This is not to say that work cannot be the sole cause of burnout. Many people work in dismal working conditions where work is the clear culprit of burnout complaints. However, it is essential to consider the overall burden placed on employees, both at work and at home. In a study published almost twenty years ago in Journal of Vocational Behavior, professors Tanja van der Lippe, Esther Kluwer, Henk Flap, and I found that employees with children under six years old were more likely to report burnout complaints than those with older children, even when controlling for work pressure and work hours. A meta-analysis published in Human Relations in 2014 confirms that work-family conflict, characterized by insufficient time or energy to perform both roles effectively, can lead to burnout.
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The fact that nonwork factors contribute to burnout does not mean that burnout is not work-related. Work demands, together with nonwork demands, might push someone over the edge. Exhausted employees more often call in sick, perform suboptimal, and have less energy to support colleagues properly. There is thus sufficient reason for organizations to support burned-out employees and ensure they have the necessary resources to recover and fully re-engage in their work. When searching for the right resources, however, it will be critical to understand where someone needs help: at work, at home, or both.
(Dis)agreement #2: How Prevalent is Burnout?
Opponents of burnout argue that burnout researchers exaggerate that burnout is a condition of epidemic magnitude. Proponents, however, also condemn the popular notion that burnout is rampant. As discussed by Professors Hans de Witte from Catholic University Leuven and Wilmar Schaufeli from Utrecht University, the solution lies in clearly differentiating between burnout complaints versus clinically diagnosed burnout. Burnout complaints indicate that an employee often feels exhausted, distances themselves from work, and perceives their accomplishments as lower. These feelings of work stress are, in fact, quite prevalent.
A clinical form of burnout, diagnosed by a medical expert, where the employee is on leave for weeks or months, is relatively rare, and the trend appears to be stable. A longitudinal study published in the Journal of Psychiatric Research suggests that fewer than four percent of German employees received a formal diagnosis of burnout, and this number remained stable between 2012 and 2022. When the media refers to burnout as epidemic, they essentially mean that more employees feel exhausted and cynical about work, which differs from what is suggested by the word burnout alone, namely, an employee who is sick at home.
Disagreement #3: Is Burnout the Same as Depression?
Challengers of burnout argue that it is unclear if burnout is different from depression. Professors Renzo Bianchi from the Norwegian University of Science and Technology and Irvan Sam Schonfeld from City University of New York vouch for retiring the term and instead viewing it as a subset of depressive symptoms. Burnout supporters, however, pinpoint apparent differences – depression is a mood disorder, primarily characterized by depressed mood and loss of interest and pleasure in activities. Professors De Witte and Schaufeli frame burnout as an energy disorder, primarily characterized by emotional exhaustion and physical fatigue.
When asking Christaan Vinkers, Psychiatrist and Professor in Stress and Resilience at the Amsterdam University Medical Center, the Netherlands, if he sees a way out of this impasse, he responds, “We need large-scale studies that examine the differences and similarities between burnout, depression, and anxiety. We don’t know if burnout is truly different from depression, because work stressors can also cause depression, and burnout is not caused by work alone.” Vinkers calls for clinical studies that meticulously map the symptoms of employees who are so distressed that they can no longer perform their work. By focusing on this group, you can determine if there is a clear set of symptoms that belong to the diagnosis of burnout or if these symptoms are so similar to depression and anxiety that they should be categorized there.
Vinkers also underscores the need to examine the underlying stress response in more detail. “It might be even more important to shift focus to the dysregulation process. What causes someone to feel so overwhelmed by life that they can’t function anymore? If we know what pushes people over the edge, we can better prevent and treat stress-related illness, regardless of what we call it.”
Takeaways for Organizations
While some may dismiss this debate as an academic squabble, it contains important lessons for practice. The following guidelines may help organizations.
It is crucial to measure burnout complaints among staff to understand the prevalence of exhaustion, cynicism, and reduced accomplishment within the organization. Some burnout measures also include lack of focus, slow information processing, and memory issues, which are relevant indicators of work-related distress.
Include screening questions for depression and suicidality in health and wellness audits.
Based on this combined information, employees can be categorized into three groups using cut-off points: A) low mental health risks, B) elevated burnout complaints, C) at risk for depression/suicidality.
Organizations can support employees with high burnout complaints by evaluating work and non-work loads, as well as missing resources, to determine the necessary support.
Employees at risk for depression and/or suicidality should be referred to medical experts for further diagnosis and treatment.
The proponents and opponents of burnout both made valid points. Part of the clash might be attributed to two disciplines using different lenses. A psychiatrist’s job is to diagnose people correctly, and for that purpose, better diagnostic burnout tools are necessary. Occupational health psychologists focus on employees who might experience elevated stress at work but are not clinically ill. Both camps have essential roles to play, and these roles seem complementary rather than adversarial.
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