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November 28, 2023

All About Burn-out

Burnout. It's a persistently relevant topic. Bookstores are flooded with books about quitting. Most of them tell the story of someone who felt burnout at work, boldly quit, and took their lives in a different direction. Recently, there are also many stories about parenting stress and early divorces. Again, most of these are stories of people who felt burnout in their married lives and decided to make changes. But what exactly is burnout? Am I burnout out? How is burnout 'diagnosed'? How can burnout be 'treated'? Let's look at everything about burnout in this post.

What exactly is burnout?

In 2019, the WHO defined burnout syndrome in the International Classification of Diseases 11 (ICD-11) as 'chronic workplace stress that has not been successfully managed', that specifically occurs in a work environment. It's not officially a disease, but it's recognized as an important phenomenon as many people in modern society experience it. Burnout especially consists of the following three components:

  • Exhaustion: Overwhelming lethargy and fatigue
  • Cynicism: Cynical attitudes towards work and job, and a sense of unwillingness
  • Ineffectiveness: Decreasing work performance and efficiency, and feelings of inadequacy caused by this

If you're not sure if this applies to you, consider these more specific expressions. Exhaustion is expressed as wearing out, loss of energy, depletion, debilitation, and fatigue. Cynicism is expressed as negative or inappropriate attitudes towards clients or team members, irritability, loss of idealism, and withdrawal. On the other hand, Ineffectiveness is expressed as a decrease in personal satisfaction, reduced productivity, low morale, and inability to cope.

Some recent research suggests a few more characteristics that are included in burnout. They include a lack of enthusiasm for work (it's interesting that this factor is included), numbness, laziness, and guilt. Lately, burnout is seen more as a situation on a continuum. On the opposite end of burnout is 'engagement,' which means high energy, high participation and involvement, and a high sense of efficacy.

That said, the definition of burnout is not clear. It's not an official mental disease, so to determine if you are experiencing burnout, you need to refer to the various expressions mentioned above.

What Causes Burnout?

The fundamental model of looking at burnout syndrome is based on the premise that 'certain factors (especially situational and personal factors) lead people to experience burnout, and when burnout occurs, it will produce certain outcomes (situational and personal outcomes)'. However, key research to prove this premise is still lacking. Nonetheless, here are six major factors found by researchers that have been statistically significant.

Excessive Workload

An excessive workload exhausts people. It makes it impossible to ever satisfy demands. It’s okay if this happens for a brief period. It's fine to have occasional periods of hectic busyness. The problem arises when such situations persist chronically. Chronic overwork has a valid correlation with burnout as it takes away the opportunity to recover and balance.

Loss of Control

The loss of control over work and situations is a vital factor in burnout. People have heightened 'engagement' when they have a sense of control over their work, can freely choose their work, and have sufficient access to the resources needed to do that work. Conversely, the probability of burnout significantly increases in the opposite situations.

Compensation Mismatch

Compensation matters. However, compensation here does not simply mean financial rewards. Financial, organizational, or social rewards are all valid. Either way, people have heightened 'engagement' when they feel rewarded for their work. Conversely, inadequate rewards can heighten burnout by lowering self-efficacy, which consequently increases 'inefficiency', the third element of burnout.

Separation from Community

Being well-connected within a community matters. When interactions and relationships between people are weak, support and trust decrease while conflicts increase. This significantly heightens the risk of burnout. Conversely, people who work in communities with well-established social support and effective ways to handle disagreements have heightened 'engagement'.


When people feel fair and equal, they have heightened 'engagement'. Conversely, the risk of burnout increases as cynicism, anger, and hostility increase in situations perceived as unfair.

Lack of Value

Values play a key role in motivation. Values make the goal of work within a work environment more than just a 'practical exchange of money and time'. In situations where values are lacking in the work environment, conflicts occur between individuals or between individuals and institutions, and people feel their work as a mere exchange of money and time, which effectively heightens the risk of burnout.

Aftermath: What are the Symptoms of Burnout?

The occurrence of burnout and the phenomena reported to be statistically significant are as follows. The listed items below could be considered ‘symptoms of burnout’.

  • Increase in negative responses and aggression
  • Decline in work productivity
  • Decline in quality of work
  • Retirement
  • Job dissatisfaction
  • Low engagement
  • Unauthorized absence

Interestingly, these symptoms of burnout are 'contagious'. When burnout occurs, the probability of negatively affecting colleagues is high. And these social interactions perpetuate 'burnout' within that community. Therefore, some scholars suggest that burnout should be considered a collective phenomenon within a work group.

Earlier, it was explained that physical health (exhaustion) induces burnout. However, inversely, burnout also deteriorates physical health. Burnout induces health problems that are similar to stress. Therefore, stress symptoms such as headaches, chronic fatigue, gastrointestinal problems, muscle tension, high blood pressure, colds, sleep problems, etc. can appear. In addition, according to one study that conducted follow-up observations over 10 years, burnout has a significant relationship with the onset of cardiovascular diseases and substance abuse.

Diagnosis: How is Burnout Diagnosed?

There are no separate diagnostic criteria for burnout as it is not an official mental illness. Instead, a variety of evaluation tools exist to assess burnout. The problem, however, is that these tools evaluate differently because burnout is defined in various ways. In fact, burnout was originally a concept established in research focusing on occupations involving people (particularly in the medical field), which is why there are separate evaluation tools for those occupations. In some cases, tools may focus only on a few of the three elements of burnout: exhaustion, cynicism, and inefficiency. Well-known tools include the following. Most of these tools need to be purchased for use. If you're interested, search and try them out.

  • MBI (Maslach Burnout Inventory): It is commonly used as a standard tool. There are tools for medical professionals (MBI-HSS/MP), people-facing occupations (MBI-HSS), education professionals (MBI-ES), students (MBI-GS(S)), and more general use (MBI-GS). It evaluates all three aspects of burnout.
  • BBI (Bergen Burnout Inventory): Like the MBI, it also evaluates all three aspects of burnout.
  • OLBI (Oldenburn Burnout Inventory): It focuses on evaluating 'exhaustion' and 'inefficiency'.
  • SMBM (Shirom-Melamed Burnout Measure): It focuses on evaluating 'exhaustion' of burnout and separates physical exhaustion, emotional exhaustion, and cognitive fatigue (a type of Brain fog).
  • CBI (Copenhagen Burnout Inventory): It focuses on evaluating 'exhaustion' of burnout and separates physical exhaustion from emotional exhaustion.

If using these tools is cumbersome, consider the two pieces of information below to determine if you're experiencing burnout. The first is the pattern in which burnout occurs, and the second is the similarity between burnout and depression.

Progress: How Does Burnout Occur?

There are many models explaining the course of burnout. According to those models, the onset of burnout occurs in the following sequence. 'Exhaustion' is the first to occur due to an overwhelming workload, including both physical and emotional exhaustion. This leads to intensified 'cynicism', resulting in a loss of interest in work and negative reactions to people. If this continues, feelings of worthlessness and uselessness follow, leading to 'inefficiency'. As a result, achievements decrease and mistakes start to increase.

Recent models describe the course of burnout from the perspective of causative factors. According to the model, burnout happens in the following order. First, 'job stressors' appear, mainly due to an imbalance of work demands and the inner or outer resources available to an individual. This creates a 'strain' on the individual, resulting in anxiety along with emotional exhaustion. Individuals under strain exert 'defensive coping strategies', and their coping strategy is cynicism.

  • There are also models like the JD-R (Job Demands-Resources), COR (Conversation of Resources), AW (Areas of Worklife) model that explain the occurrence of burnout from the imbalance between demands and resources.

Depression: Is it Burnout or Depression?

Burnout often appears similar to depression. Many items overlap between a burnout evaluation index (SMBM) and a screening index for depression (PHQ-9) created by WHO. Many studies support that there is a certain correlation between burnout and depression. Burnout and depression are clearly connected. According to a study in Finland, when depression occurs due to problems at work, burnout can be the first phenomenon in that process. So, if you're wondering if you've got burnout, it might be a good idea to assess yourself for depression. Please refer to a separate post for a description of depression.

Treatment and Prevention: How to Overcome or Avoid Burnout?

In addressing burnout, personal effort must precede social or organizational efforts. While research clearly supports the view that situational factors lead to burnout, unfortunately, treatments and preventative measures are more supported by individual efforts. Here are the most recommended approaches:

1.Change Work Patterns
  • Work Less, Reduce Overtime: This is an effective method, if possible (...). To do this, it helps to periodically measure the workload. It's simple, evaluate your workload on a scale of 0-10 each day, and if the workload continues to build, it's essential to consciously reduce it whenever possible (...)
  • Take More Frequent Breaks: It's effective to take a mandatory break away from the work environment every couple of hours to focus on everyday life (such as fully experiencing the taste of coffee without thinking about anything else).
  • Increase the Weight of Spheres other than Work in Life: It doesn't matter which sphere. It could be a hobby or housework.
  • Change Work Methods Periodically: It is helpful to vary the way you perform the same task (known as Job crafting).
2. Learn Coping Strategies
  • Cognitive Behavioral Therapy (CBT): CBT educates individuals on how to effectively deal with the thoughts that come to mind. This becomes a vital resource in resolving burnout and preventing its recurrence.
  • Enhance Problem-solving Abilities: In some cases, learning to solve problems, such as conflict resolution and time management, can also be helpful.
3. Enhance Social Support
  • It's important to increase interaction time with colleagues and family.
  • Especially, a sense of being socially connected is related to reducing 'cynicism'.
4. Utilize Relaxation Strategies
  • Cognitive Behavioral Therapy (CBT): CBT uses progressive muscle relaxation, mindfulness, etc., which are effective in relaxing the body and mind.
  • Meditation, yoga, etc.: Other generally used methods to calm the mind and body are also effective.
5. Promote Physical Health
  • Remember that one of the three elements of burnout is 'exhaustion'? And remember that 'exhaustion' is the first to occur in the model explaining the progress of burnout? Then you'll understand how important physical health is. 'Exhaustion' includes physical fatigue and listlessness. To improve physical health, exercising is effective. According to research, the type of exercise doesn't matter much, but running is the easiest and most effective method. According to a study published in a influential medical journal in July 2023, running at least twice a week for 16 weeks had the same effect as regularly taking antidepressants.
  • Apart from exercise, sufficient sleep and nutrition are essential.
6. Increase Self-Understanding
  • This includes various self-analysis skills, consulting, psychotherapy, etc. Increasing self-understanding means understanding the current situation, your thoughts about it, and your behaviors (coping strategies) towards it. Gaining distance from oneself (referred to as distancing in cognitive therapy) helps prevent specific situations and thoughts from leading to negative emotions.


Burnout consists of the following three elements:
  • Exhaustion: Overwhelming feelings of listlessness and fatigue
  • Cynicism: Cynical attitudes towards and rejection of work
  • Inefficiency: Decreased work efficiency and competence, and feelings of incompetence that result from this.
Since burnout is not a disease, it cannot be diagnosed. However, it can often appear similar to depression.
When burnout occurs, it commonly develops in the order of exhaustion → cynicism → inefficiency.
For treatment and prevention, the following six aspects are important:
  • Change work patterns: Reduce workload. If that's difficult, make changes to the method.
  • Learn coping strategies: Learn how to manage thoughts and increase problem-solving capabilities.
  • Increase social support: Connect more with people.
  • Use relaxation strategies: Practice physical and mental relaxation.
  • Promote physical health: Pay attention to exercise, sleep, and nutrition.
  • Increase self-understanding: Understand the situation and your reactions to it and create distance...


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