In 2019, the International Classification of Diseases (ICD-11) classified burnout as an occupational phenomenon “resulting from chronic workplace stress that has not been successfully managed”. 

There are three dimensions to burnout, as characterised by the ICD-11:

1. Emotional exhaustion: feelings of energy depletion or exhaustion;
2. Depersonalisation: increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job;
3. Personal accomplishment: a sense of ineffectiveness and lack of accomplishment.

These symptoms may resemble depression, but it is important to distinguish between them. 

“Some of it manifests like depression, and the two often co-occur. But actually, these are two separate diagnoses, explains Gina Görgens-Ekermans, who specialises in employee health and wellbeing and is an associate professor in the department of Industrial Psychology at Stellenbosch University. “Depression would typically span across all life domains, whereas burnout is very specifically linked to your workplace.”

To better understand burnout, social psychologist Christina Maslach and her colleagues developed the Maslach Burnout Inventory in 1981, defining burnout as a “syndrome of emotional exhaustion and cynicism that occurs frequently among individuals who do ‘people-work’”. Maslach’s research found that people with burnout would develop the three symptoms in succession. 

First comes emotional exhaustion, where employees feel overextended by their work. Then, people with burnout go on to develop cynicism or depersonalisation, which manifest prominently in interactions with others, where burnt-out employees distance themselves from clients and aren’t emotionally involved anymore, Görgens-Ekermans explains. Eventually, that will then result in reduced personal efficacy, where employees are no longer satisfied with past or present accomplishments and have low expectations of their continued effectiveness at work. 

“You see this process of extreme mental exhaustion, where you can’t get up in the morning, you can’t face another day, you’re very low and completely overwhelmed,” says Görgens-Ekermans. “It then progresses to this idea that ‘I can’t interact with clients anymore, I can’t gauge the emotional content of what the client is saying and I cannot respond adequately’. Eventually, it becomes reduced personal efficacy, where a person was previously performing well and now their performance starts to drop.”

What causes burnout?

In explaining the development of burnout,  Görgens-Ekermans refers to a theory called the Job Demands–Resources theory, which posits that demanding jobs are not necessarily the cause of burnout, but rather the individual’s ability to respond to those demands. 

“In any work environment, there are two processes that can play out: a strain process or a motivational process. There are always certain demands in the workplace and certain resources that a person has to meet their demands. So when these two are in balance, then employees will be engaged with their jobs — even if the demands are high,” Görgens-Ekermans explains. 

“And the theory actually says that where we have high demands, but we also have enough resources, it actually creates a process of flow, where people are engaged with their work and they perform well. 

“But unfortunately, when there is this disconnect between the job demands, which are very high, and your resources, which are very low, that’s where we start to see the strain process, and the outcome is often burnout. So we need to think of burnout as a syndrome that develops due to exposure to chronic stress in the workplace; too many demands, and too little resources.”

Rest and recover

Görgens-Ekermans explains that similar to depression, burnout manifests with a change in regular patterns, routines and habits, resulting in a marked difference in a person’s behaviour.

For example, people who slept well before might find themselves struggling with insomnia, those who exercised regularly now find it difficult to even get out of bed and some experience dramatic changes in eating habits. Even sleeping may not put a dent in the feeling of extreme exhaustion and fatigue. 

What often leads to burnout, Görgens-Ekermans explains, is when people don’t give themselves time to rest and recover. “That could be reading, exercising, getting good sleep, so that the next morning you’re in a recovered state and you have the energy to meet demands. But the problem comes in when people don’t recover,” she says. 

With burnout, this often turns into a negative spiral where people struggle to rest at all. Therefore, Görgens-Ekermans stresses that it is important that people know what rest means for them and to be able to identify the personal signs that indicate when they are not getting enough of it. 

“Don’t go and read a book, if you know that recovery for you is actually to exercise,” she illustrates. “Self-care, from an individual perspective, is probably the best thing you can do to avoid burnout. Remember, this is something that develops over time, so if you can identify it early on, then hopefully, you won’t go to the next phases of cynicism and reduced personal efficacy.”

If you are struggling with burnout, Görgens-Ekermans also recommends seeking help with a health care professional. “I think there is a stigma in terms of mental health. People don’t want to talk about it, they feel embarrassed about it, but it’s very real.” 

Tips for employers

Görgens-Ekermans emphasises that just as individuals should take care of their wellbeing, organisations and line managers also have the responsibility to look out for signs of burnout, as well as to prevent it.

“The important thing is to understand that burnout is an occupational phenomenon and that it predominantly sits in the domain of a person’s job. And that actually creates the responsibility on the side of the employer to create an environment that’s not conducive to the development of burnout,” she says.

 Görgens-Ekermans offered a few tips: 

• Be in contact with your employees, check-in with them regularly. Take note when people stop communicating.
• Be aware of when a person’s performance suddenly drops.
• Look out for presenteeism, which is when people come to work sick or when they are at work but do not perform.
• Similarly, look out for absenteeism, where people are taking a lot of sick leave.
• Be aware of signs of procrastination.

“What one really needs to look critically at is when you see an employee who previously performed well and then there’s a very sudden turnaround,” Görgens-Ekermans explains. “Yes, there is a responsibility on the employee, but there’s also a responsibility on the employer because burnout develops from this interplay between the work environment and the individual. Both sides need to come to the party to address the situation.” 

Burnout 101

In brief, here is what you should know about burnout:

• Burnout is an occupational phenomenon, which means it occurs in relation to someone’s work;
• There are three dimensions to burnout, which come in succession: emotional exhaustion, depersonalisation and cynicism, and reduced personal efficacy;
• Burnout occurs when someone does not have the resources to handle the demands of work;
• It is important to rest and to find the best ways to refill your own tank;
• Employers also have a responsibility to prevent and help with burnout.

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