The dangers of burnout – a stress-based condition related to overwork – are too often disregarded, says Australian psychiatrist Gordon Parker.
He argues that we need better public education about how to identify and treat burnout.
Photo: Jonathan Borba
Professor Gordon Parker is the founder of the Black Dog Institute and co-author of Burnout: A Guide to Identifying Burnout and Pathways to Recovery.
Over the last 40 years, burnout has been diagnosed when just three symptoms are present – exhaustion, loss of empathy (aka compassion fatigue) and compromised work performance.
Professor Parker tells Jim Mora his research team argues for "a much richer definition" of the condition.
While he gives exhaustion the "big tick" as a key feature of burnout, 'loss of empathy' is not an accurate description of what occurs.
People with burnout have something more like a loss of "feeling tone" – in other words they don't feel much at all.
'Compromised work performance' may not even be a symptom of burnout and just a consequence of exhaustion and feelings of numbness, Professor Parker says.
Instead of looking at impaired performance as a symptom, his research measures impaired cognitive function.
“What people with burnout report is that they can't register information as well, they can't retain it so well.”
Other symptoms can include elevated anxiety levels and depression, he says, and insomnia is almost universal.
People who are burnt out can often develop physical problems, too.
“Because of the impact on the general bodily functions, but also on the immune systems, people are more likely to get infections ... and in extreme cases, people may just not be able to get out of bed.
Unfortunately, the people most likely to develop burnout are what Professor Parker describes as “good people".
“People who are diligent, dutiful, reliable, if not perfectionistic, are much more likely to develop burnout because they put in the hard yards.”
Type A personalities are especially susceptible, he says.
“People [who] are incredibly impatient and driven, they can't stand being in queues, they're more likely to develop burnout.
“So burnout is clearly a stress reaction. But there are diathesis or predisposing factors largely coming from personality, with being dutiful and caring being the key one.
“That helps explain why sociopaths never develop burnout.”
Australian psychiatrist Gordon Parker - a world-leading researcher on burnout Photo: Quest For Life Foundation
Overwork is not entirely related to the number of hours worked, Professor Parker says.
“It's more likely people being available and constantly on, always having their phone available, answering phones during the night and so on and so forth.
“[Burnout] needs to be considered in relation to people working excessive hours. But the more important variable being the need to be always available, always on, always ready”.
He believes the stigma associated with burnout is decreasing.
“If we look at medical practitioners, 30 percent will have burnout at any one time, 60 percent over their career. So, if something is very prevalent, almost ubiquitous in some professions, then of course, that reduces the chance of stigma.
“So, people are generally reasonably comfortable about talking about it.”
People working in caring professions are particularly susceptible, Professor Parker says.
“If we look at teachers, for instance, if they're dutiful and reliable and conscientious, they're not going to do the hours that they're employed for, they're going to do the extra hours, whether it's in the classroom, at the school itself, or when they go home at nights and weekends.
“This is not generally conceded by employers nor by their recipients.”
The Covid-19 pandemic seems to have jolted some people into re-assessing their work lives, he says.
The Boiling Frog effect – a 19th-century science experiment-turned-cultural metaphor for the tendency to disregard slowly advancing threats – might be in effect.
"The point about that analogy is that we generally don't make much change in the way in which we do things if events creep up on us. It's only when some dramatic event occurs that we might be more likely to change.
“I think Covid has actually provided that sort of stimulus.”
One Australian hospital Professor Parker is affiliated with saw a 30 percent loss in their emergency department nursing staff during the pandemic.
“We're seeing people either gently saying 'I must adjust my work-life balance' or doing so abruptly recognising that they have burnout symptoms or that the pain of the work scenario is such that they really do need to consider a new version.”
The problem of mass burnout needs attention on both a systemic and an individual level, he says.
“People need to be educated. Despite the fact that I trained in medicine, and then trained in psychiatry, then worked as a psychiatrist, I've never had a lecture on burnout.
“The information to health practitioners is minimalistic. The problems are therefore multiple.
"If you have burnout and go to see a health professional, you'll probably be told you've got depression.
“And you may well be prescribed an antidepressant medication. So, we need much more awareness by those who potentially experiencing burnout, and by those who are going to come into contact with it, to know what it is all about; the symptoms, the causes, and then how to address it.”
Professor Parker's study of 1000 Australians who'd experienced burnout revealed remedies and strategies that had helped people recover.
Talking about their experience came up a lot, he says, as well as exercise, taking a break and mindfulness or meditation practices.
'Burning out' is a different thing to be 'being burnt out', he says.
“If you are burning out then in fact you may just need a break, a decent holiday. But if you're burnt out [you're] at the end of the book.
"We have a very, very senior professional person, she was at the top of her tree, she again had to take that extended period off, redesign her life.
“Then when she came back, she's been able to achieve at a high level again.”
Even in the most severe cases of burnout there is hope, Professor Parker says.
“People who seemingly have really lost it, they just can't get to work, they can't function, maybe they can't get out of bed, you may think they're lost forever.
“No, the story is far more encouraging, people can recover from even those devastating states.”
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Suzi McAlpine: a New Zealand guide to burnout
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