Do little tasks on your to do list sometimes seem like insurmountable challenges? Are you sometimes overcome with dread on Sunday evening, contemplating the start of another work week? Are you beginning to take on a cynical view of all things work-related? Do you feel tired all the time? If so, you may be experiencing occupational burnout.

Burnout defined

Occupational burnout is the state in which you’ve exhausted all your resources but can’t rid yourself of the nervous compulsion to go on.¹ Its hallmarks are emotional exhaustion, a sense of lack of accomplishment and depersonalization. When burnout is work-related, it is referred to as occupational burnout. Common symptoms include chronic indecision, lack of motivation, frequent mistakes, irritability and a sense of physical, psychological and mental overload.

Occupational burnout is not the same as depression, but those with burnout may also have depression. Generally speaking, burnout is usually work-related, whereas depression pervades all areas of life without necessarily having a specific origin.²

Psychological effects from burnout include insomnia, depression, use of psychotropic and antidepressant medications, higher incidence of hospitalization for mental disorders and other psychological symptoms.³

Studies show that workplace burnout is also a significant risk factor for coronary heart disease. Other studies found similar patterns for high cholesterol, type 2 diabetes, increased hospitalization due to cardiovascular disorders, musculoskeletal pain, prolonged fatigue, headaches, gastrointestinal issues, respiratory problems, severe injuries and early mortality (before age 45).

History of burnout

The symptoms and concept of occupational burnout are not new. Even in the Bible, the book of Ecclesiastes describes melancholic world-weariness. The term burnout was also found to be documented throughout the annals of occupational medicine.⁴

The term neurasthenia was first used as early as 1829 to describe nervous exhaustion in patients run down by the “pace and strain of modern industrial life.”⁴ Americans were particularly prone to neurasthenia, resulting in the nickname "Americanitis."⁵

In 1974, psychoanalyst Herbert J. Freudenberger became the first clinical researcher to publish the term "burnout" in a psychology-related journal. The paper was based on his observations of the volunteer staff at a free clinic for drug addicts.⁶

Physician Burnout: The canary in the coal mine?

A national survey published in the Archives of Internal Medicine in 2012 reported that U.S. physicians suffer more burnout than other American workers. Medscape’s 2019 survey reports that physician burn-out has reached extreme levels at 59%. Note that colloquial depression refers to feeling down, blue or sad, while clinical depression is chronic, severe depression not caused by a grief-associated event.⁷

Physician burnout causes financial strain on the U.S. health care system. Cost-consequence analysis estimates that in the healthcare field, approximately $4.6 billion in costs related to physician turnover and reduced clinical hours is attributable to burnout each year. On an organizational level, the annual economic cost associated with physician burnout related to turnover and reduced clinical hours is approximately $7,600 per employed physician each year.⁸

Physicians are not the only high stress position at risk for burnout. In the general workforce, other job burnout accounts for an estimated $125 billion to $190 billion in health-care spending annually.⁹ One could assume that an occupational burnout epidemic might first manifest itself in the higher stress professions. Other industries where occupational burnout is becoming more prevalent are: social work, emergency response, design, business development and sales, retail, public accounting, and law.¹⁰

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This article was originally featured in the September 2020 Issue of OTR and is re-printed with permission of ON THE RISK, Journal of the Academy of Life Underwriting (www.ontherisk.com).

² Gunti, P. “Burnout – more than just a fashionable complaint.” March 2011, https://www.myhandicap.com/en/information-disability-chonical-illness/health-and-aids/mental-health/burnout/.

³ Cassella, Carly. “Burn-Out” Is Now a Legitimate Syndrome According to the WHO. Here Are The Symptoms.” Science Alert, May 29, 2019. https://www.sciencealert.com/burn-out-is-now-officially-recognised-as-a-legitimate-syndrome-by-the-world-health-organisation.

⁴ Cohen, Josh. “Not Working: Why We Have to Stop.” Granta Books. January 1, 2019.

⁵ Marcus, G (1998-01-26). "One Step Back; Where Are the Elixirs of Yesteryear When We Hurt?” The New York Times.

⁶ Freudenberger, H.J. (1974). "Staff burnout". Journal of Social Issues. 30: 159–165. doi:10.1111/j.1540-4560.1974.tb00706.x.

⁷ Kane, Leslie MA. “Medscape National Physician Burnout, Depression & Suicide Report 2019.” January 16, 2019, https://www.medscape.com/slideshow/2019-lifestyle-burnout-depression-6011056#2

⁸ Han, Shasha, MS; Shanafelt, Tait D., MD; Christine A., Sinsky, MD; Awad, Karim M., MD; Dyrbye, Liselotte N., MD, MHPE; Fiscus, Lynne C., MD, MPH; Trockel, Mickey, MD; Goh, Joel, PhD. “Estimating the Attributable Cost of Physician Burnout in the United States.” Annals of Internal Medicine, June 4, 2019.

⁹ Kraft, Sheryl. “Companies are facing an employee burnout crisis.” CNBC.com. August 28, 2018, https://www.cnbc.com/2018/08/14/5-ways-workers-can-avoid-employee-burnout.html.

¹⁰ Montañez, Rachel. “The 6 Industries Where People Experience Burnout the Fastest.” Fairygodboss. https://fairygodboss.com/articles/the-6-industries-where-people-experience-burn-out-the-fastest. August 2, 2019.