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The Burn out (Professional Burnout) symptoms causes and treatment

The burnout is best known under the English name burnout. According to the World HealthOrganization (WHO), it is characterized by “a feeling of intense fatigue, loss of control and inability to achieve concrete results at work”.

It was in 1969 that the term burnout was used for the first time. It has been the subject of many definitions since.

In the 1970s, the expression was reserved for employees in the field of helping relationships who were emotionally involved in their work, such as nurses, doctors, social workers and teachers. Now, we know that all workers – from the worker to the entrepreneur – can be exposed to burnout.

Burnout or depression? 
The burnout (or burnout) is necessarily linked to work. In depression, work is not the primary cause, but can be an aggravating factor. Moreover, in case of burnout, the person is always in chronic stress, while this is the case 1 time out of 2 for depression. Physiological differences have also been noted. For example, depressed people would produce too much cortisol and those who are burned out, not enough.

The magnitude of the problem

Since the beginning of the 1990s, the frequency of psychological health problems at work hasincreased alarmingly. They include burnout, depression, post-traumatic stress disorder, anxiety disorders, etc. According to the Canadian Life and Health Insurance Association, which brings together most of the country’s private insurers, mental health issues now account for about 40% of disability benefits (up to 60% in some sectors). Employment (18% in 1990). Today, they are the leading cause of prolonged absence from work, commonly known as “long-term disability”.

Changing work

The effects of chronic stress on the mental health of workers are manifested especially in industrialized countries, according to World Health Organization. This phenomenon would largely result from rapid changes in the world of work: globalization of markets, competitiveness, development of information technology, precarious employment, etc.

Specific statistics on burnout are not available. Still, the latest Statistics Canada survey reveals that just over a quarter of Quebec workers report living a high stress daily. In some workplaces, studies have shown that this rate may increase to 1 of 2 workers.

In Europe, the situation is just as worrying: 1 out of 2 cases of absenteeism is caused by chronic stress , according to a report by the European Agency for Health and Safety at Work published in 2009. This is not to mention the effects of presenteeism: being present at work, but absent from mind, because of a physical or psychological health problem. In Quebec, about half the stress costs for businesses would be attributable to presenteeism, and the other in absenteeism.

Causes of Burn out

From a biological point of view, experts are not yet able to fully explain what leads to burnout. All workers who are going through a period of exhaustion are in a state of chronic stress. It is therefore an important vulnerability factor. The vast majority have a high workload, plus one or more of the following voltage sources.

  • Lack of autonomy: do not participate in any or few decisions related to your task.
  • Imbalance between the efforts made and the recognition obtained from the employer or the immediate superior (salary, esteem, respect, etc.).
  • Low social support: with the superior or between colleagues.
  • Insufficient communication: from management to employees, regarding the vision and organization of the company.

In addition to these factors, individual peculiarities come into play. For example, it is unclear why people experience more stress than others. In addition, some attitudes (overemphasis on work, perfectionism) are more common among individuals experiencing burnout. According to research, it seems that low self-esteem is a determining factor. In addition, certain life contexts, such as heavy family responsibilities or loneliness, can jeopardize work-life balance.

Regardless of the sources of stress at work, there is an imbalance between the pressure and the resources (internal and external, perceived or real) available to deal with it.

Here are the requirements for an event to cause stress

  • A new situation
  • An unexpected situation
  • An impression of lack of control
  • A threatening and destabilizing situation for the individual. At work, this is particularly the case if your supervisor questions your ability to perform your work or if you are a victim of psychological or moral harassment.

With the increasing frequency of mental health problems among workers, most experts argue that the responsibility for stress at work is not individual: it is shared between workers and employers. More and more interventions in business studies show that by acting on work organization, all profit from.

To find out more about the sources of stress at work, see our topic Overcoming Workplace Stress: Finally, Solutions .

Possible consequences of Burn out

A period of burnout can, beyond work, have repercussions in all spheres of life. In such a case, the victim may slip towards the depression.

Some people may experience anxiety, eating disorders, substance abuse problems or, in the extreme, suicidal thoughts. Some workers are exhausted even to the point of leaving their lives. The Japanese term karoshi refers to sudden death from nervous exhaustion at work, caused by a heart attack. The phenomenon was observed for the first time in Japan in the late 1960s.

The chronic stress also leads several disorders physiologically (see box below). We know, for example, that obesity, cardiovascular disease and type 2 diabetes are more common among people who are under severe psychological pressure.

In fact, research is underway to discover biological markers that would identify people who are experiencing chronic stress. This could be done before health problems appear. Fifteen markers are under the magnifying glass of researchers, including blood levels of cortisolinsulinC-reactive protein, cholesterol and triglycerides, as well as blood pressure and waist-to-hip ratio... These markers are often measured in isolation. However, it seems that under the effect of chronic stress, an end of dysregulation of several hormonal systems would occur at the same time. Thus, the markers would remain within the limits of normal, but near the minimum or maximum values.

Stress is also chemical

Stress is not bad in itself. On the contrary, it has always ensured the survival of humanity. It is thanks to him that one can react by fighting or flight against imminent danger, such as the surprise arrival of a polar bear or the burning of a house. The increase in heart rate, the constriction of the blood vessels and the adrenaline rush, among others, make it possible to become more alert and more efficient. But serious problems can arise when stress becomes chronic, which is more and more the case in our modern societies.

A person in chronic stress constantly puts his body on alert. It produces too much stress hormones, mainly adrenaline and cortisol . These hormones which allow escaping from an imminent danger (the bear) are then constantly solicited in situations considered threatening: the arrival in a new school, the fever of the youngest, a situation of harassment at work, etc.

Clear links have been established between abnormal levels of cortisol (too high or too low) and several physiological imbalances that expose, over time, to health problems. On the one hand, by acting in the brain, these hormones can lead to fatigue, exhaustion, depression, impaired concentration and memory problems. On the other hand, researchers now know that there are links between high levels of cortisol and hypertension, heart disease and diabetes. High levels of cortisol can also change the way the body stores fat and thus contribute to obesity.

Several questions remain open. It is unclear from what time stress develops chronically in a particular individual. In addition, experts are trying to understand why some individuals are naturally more resistant to stress. Fortunately, it is possible to turn things around by taking the appropriate means to stabilize the stress hormones.

Diagnostic of Burn out

The burnout falls into the category of adjustment disorder. It is not recognized as a mental illness and therefore does not appear in DSM IV, the Medical Manual of Mental Disorders

The diagnosis is difficult to establish because doctors do not have specific criteria. Thus, distinguishing burnout from depression is not easy. For the moment, doctors are basing themselves on the interview they have with the patient and the symptoms that the patient experiences. In case of doubt, consultation with a psychiatrist is sometimes suggested.

The symptoms of burnout

A long journey

The exhaustion occurs insidiously. The words “depersonalization” and “dehumanization” are sometimes used to describe what happens to the individual, as if he lost, for some time, a part of himself.

Little by little, he deploys a growing energy to accomplish his work, without however obtaining satisfaction. The frustrations accumulate and cynicism increases. The concentration is more difficult to obtain. Physical symptoms may appear, such as back pain or insomnia.

To correct such a situation, the worker often chooses an even greater investment in his work, until exhaustion. This “empty” walk can last for years. The denial is typical of burnout; it is often experienced as an admission of failure.

Note. The following symptoms are the most common, but not necessarily all.

Psychological symptoms

  • Constant demotivation in relation to work
  • Marked irritability, spontaneous anger, frequent crying
  • Cynical attitude and frustration
  • Feeling of being incompetent
  • Taste of isolating
  • Feeling of failure
  • Decline in self-confidence
  • Anxiety, worry and insecurity
  • Difficulty concentrating
  • Loss of memory
  • Difficulty in exercising good judgment
  • Indecision, confusion
  • Suicidal thoughts, in the most serious cases
Where does the spontaneous anger come from?

“If the same situation is constantly stressing me, I can get used to it. I am used, for example, to a colleague devaluing my work in meetings every Tuesday. However, the price to pay is very large: the brain and the body become 3 times more reactive to any other element of stress. This explains the spontaneous anger that occurs elsewhere at work or at home. “

Physical symptoms

  • Persistent fatigue
  • Sometimes pains, depending on the individual fragility: back pain, muscle pain, migraines, etc.
  • Digestive problems, stomach ulcers
  • Sleep disturbed
  • Skin problems
  • Loss or weight gain
  • More frequent infections (cold, flu, otitis, sinusitis, etc.)

Hard, hard weekends …

After a period of excessive work and stress, rest can bring back ailments such as migraine, flu and muscle aches. This often happens on weekends or early holidays. This is called the “workaholic syndrome”. About 3% of workers would be affected, according to a survey conducted in the Netherlands. Adrenaline is partly responsible for this phenomenon. Secreted continuously under stress, it would reduce our immune defenses. The many coffees consumed to maintain the pace as well as the nights without sleep could, in turn, cause migraines.

People at risk of Burn out

According to experts, no one is immune to the exhaustion Professional. Men and women are affected in almost equal proportions. In addition, no age category has been defined as higher risk .

Burnout: a sign of weakness?

“It’s not a weakness. It is the organism that is disrupted. It has recently been discovered that when stress hormones travel back to the brain, they change how the next situation is detected. Hormones change the way of seeing things. The more you are stressed, the more you generate stress responses. The glass becomes more and more empty. We then fall into a vicious circle that can lead to burnout. “

Risk factors

Certain situations, attitudes or individual characteristics can, in a stressful work context, contribute to burnout.

  • Lack of self-esteem For example, when the employer sets a high goal that is ultimately not achieved, people who have low self-esteem may experience it as a personal failure. They tend to take goals for absolutes and not for ideals. A feeling of incompetence can settle. However, the lack of competence is rarely at stake in cases of exhaustion, say the experts.
  • Have difficulty setting limits in a context of work overload.
  • Have high expectations of yourself.
  • The responsibilities outside of work: caring for children, parents or relative in need.
  • Make your work the center of your life.
  • Be perfectionist in all aspects of your work, regardless of priorities.
  • Have a high professional conscience.  When the pressure rises, it is usually the high-performing employees who pay. In addition, they may have difficulty leaving work problems behind at the end of the day.
  • Do not know how to delegate or work in a team.

The prevention of burnout

Basic preventive measures
Here are ways to reduce stress and reduce the risk of burnout.

  • Surround yourself and discuss with your family the difficulties you have at work in order to feel supported. The social support would be the best buffer against chronic stress.
  • Listen to the physical and psychological symptoms of stress.
  • Once the stress is detected, learn to discover its causes.
  • Engage with colleagues and supervisor on work organization. Try to find profitable changes for everyone.
  • In collaboration with the employer, try to set more realistic and rewarding goals.
  • Make a list of priority tasks that help you manage your time better. To help determine priorities, give each task a degree of importance and urgency.
  • Learn to say no once in a while.
  • Know the time required for each task.
  • Learn to delegate.
  • Take the time to think before plunging into a job. Clarify the objective and evaluate the various ways to achieve it.
  • Enjoy your lunch hour, as far as possible, to “pick up”.
  • Between each hour of work, take 5 minutes to change your mind: listen to music, meditate, do some stretching, etc.
  • Be careful not to become a slave to technology: the mobile phone and the Internet can make people accessible 24 hours a day. Offer hours of availability to your employer and try to limit yourself.
  • Exchange tips and experiences between colleagues. In the case of self-employed workers, create a network of contacts with other people in the same situation.
  • To make the examination of his habits of life. Some may contribute to stress, such as high consumption of excitants (coffee, tea, sugar, alcohol, chocolate, soft drinks). Physical exercise, on the other hand, can be a good help to prevent or reduce stress, while facilitating sleep. Experts recommend 30 minutes of exercise, 5 times a week. Maintaining good physical health has a positive effect on psychological health.
  • Set aside time for yourself, your family, your hobbies, etc.

As mentioned before, the prevention of burnout is not only the responsibility of individuals, but also of businesses. Several researchers are working to better equip businesses and managers. For example, in April 2009, a group of experts mandated by the Quebec National Institute of Public Health made public an analysis grid to better target the workplace “at risk”.

To find out more about the measures to be promoted in the organizations, consult our file Overcoming stress at work: finally solutions .

 

Measures to prevent recurrence
When returning from work, discuss with your employer to find a suitable situation. A gradual return may be required, as well as a follow-up by a doctor. In addition, discuss with his employer possible arrangements for the organization of work before going back to it again.

Medical treatments for burnout

The goal of treatment is to regain your health and to design a way to accomplish your work satisfactorily, without running out.

The stoppage of work is often necessary. The duration of sick leave is variable, but is generally not established over a long period. In fact, a very long leave may make the return to work even more difficult.

The rest that sick leave allows is essential since the energy reserves are flat among the victims of burnout. However, it is insufficient to solve the problem and avoid relapses. Indeed, rest does not cure burnout. It is also necessary to set in motion real changes to regain a sense of control over one’s life: it can be the work environment, the way of life, the meaning given to work, the ways of being less affected by sources. Stress, etc.The solution therefore also involves change.

But before initiating change, one must become aware of the reasons that led to burnout. To do this, consulting a trained psychologist or psychotherapist can be of great help. It’s about finding out what’s causing stress and finding solutions to tackle it.

There are several types of psychotherapy. The cognitive behavioral therapy is most commonly used. Other types of therapies may be appropriate, such as the systemic approach, which looks at interactions with others.

When in a workplace, many people are affected by burnout, a work psychologist (organizational psychologist) or a specialist in human resource management can help make the necessary changes that will make the work environment healthier for everyone.

Some questions to ask

  • What are the sources of stress in my work?
  • Why are these situations stressing me?
  • What fears or perceptions prevented me from taking action to try to change the situation?
  • What changes can I make to my work to live less stress?
  • What changes could my employer make?
  • How important are I to my work? Which one would I like to give him?
  • Is my workplace good for me?

Sometimes the solution will be changing the workplace, or a career change.

Regarding the use of antidepressant drugs, experts Douglas Institute believe that hormonal changes that occur during a reposition exhaustion gradually, with the rest 11. However, for some individuals, these medications can give a good boost and help overcome the test. Discuss with your doctor.

According to the World Health Organization, the most satisfied employees  :

  • find in their work an opportunity for personal fulfillment;
  • obtain marks of recognition of the work done;
  • find a meaning;
  • have responsibilities;
  • Have opportunities for advancement.

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