The Silent Epidemic: Exploring the Impact of Burnout and Workplace Stress

Burnout has become ordinary.

What used to be a pretty niche diagnosis, perhaps exemplified by the cliché of a male executive rearing out of his office chair, punching a wall and having to be led from the office, is now being seen in large numbers of people.  It’s worth making a few distinctions.

The World Health Organization defines burnout as "a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed." It is “an occupational phenomenon.” “Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”

This is important.

Burnout is linked to poor management in the workplace. Not to an individual failing to manage their own stress.

Forbes says:
We often think of burnout as an individual problem, solvable with simple-fix techniques like “learning to say no”, more yoga, better breathing, practicing resilience. Yet, evidence is mounting that personal, band-aid solutions are not enough to combat an epic and rapidly evolving workplace phenomenon. In fact, they might be harming, not helping the battle. With “burnout” now officially recognized by the World Health Organization, the responsibility for managing it has shifted away from employees and toward employers.

The top 5 causes of burnout are

• Unfair treatment at work
• Unmanageable workload
• Lack of role clarity
• Lack of communication and support from their manager
• Unreasonable time pressure

WHO emphasises the need for organisations to address systemic issues related to workplace stress, support employees in managing their workload and maintaining their mental health.


By contrast, workplace stress:

• refers to the specific pressures, demands and challenges that individuals encounter in their work environments.
• has various sources including high workloads, tight deadlines, conflicts with colleagues or supervisors, job insecurity, lack of autonomy, and unclear job expectations.
• can be acute, arising from specific events or situations, or chronic, resulting from ongoing, persistent stressors in the work environment.
• Unlike burnout, which is a more severe and complex condition, workplace stress may be temporary and may not necessarily lead to burnout if effectively managed or mitigated.
  
  
  
  In my own practice, I've noticed that a cardinal sign on oncoming burnout is that the feeling that reducing or modifying workload is impossible.
  
  Workplace stress is a serious issue resulting in thousands of lost working days every year. Burnout is a problem of a different magnitude, with far reaching and long lasting consequences for individuals. Too much stress is awful but manageable. Burnout can result in people being unable to do much more than lie in bed for weeks. It can realistically take a year for people to recover from.
  
  It's clear that people whose circumstances mean that they aren’t able to lie in bed or take the time they genuinely need to recover,  are forced to return to work and are often able to perform in a manner that fools their managers and team. They may well fool themselves not least because, against all the evidence, responsibility for workplace stress and burnout is inevitably dumped on the individual suffering it. The shame can be crippling. 
  
  Like the entire nation, my own profession has enthusiastically swallowed the mantra that “Work Is Good For You” at the same time as repeating all kinds of noise about how awful workplace stress is and not acknowledging any tension between these statements. Most of us, psychotherapists as well as the public, have to think twice when we’re asked to define ‘work’ ‘employment’ and ‘activity.’ We're all in a bit of a mess.
  
  So what can you do?
  
  Acknowledge, at least to yourself, if your work has become meaningless to you. Everyone being ‘excited’ about everything has become weird, it’s a creepy expectation that’s become a demand. Unless you’ve created a cure for something or stabilised nuclear fusion, genuine excitement at work is rare. Pleasure, satisfaction, enjoyment are part of a good workplace but the pressure to 'lean in,' 'be resilient' to bad practices and so on largely exist to benefit your bosses, not you. 

There are periods when everyone’s employment becomes or at least feels dull and purposeless and it is absolutely fine to accept that. It might be the impetus to go for promotion, it might be the realisation that things are not as they should be: listen to those feelings, they exist for a reason.

Take early responsibility to act on them.

If a project is dull or even pretty brutal but you know it’ll end, put things in place that will support you. Tell friends that you love them but won’t have the time to be as social as you’d like to be for a while. Ask them and others who might want to, for help. It’s logical to realise that when a workplace requires a 50+ hour week and so many people are living alone, support is necessary, it’s something we can offer each other and request in return.

It’s bizarre that I find myself writing ‘Try to get enough sleep’ but there we are. Balancing sleep, rest, decent food, water, daylight, physical movement, human contact and work (all this before thinking about anyone else in your household) has become difficult for huge numbers of people. Please recognise that this is outlandish and that you’re not alone.

If your feelings aren’t attached to a particular project but have become routine, visit your GP, describe how you're feeling and ask about taking routine blood tests of red blood cell count, white blood cell count, thyroid function and blood sugar. When very basic physical things are not as they should be they can manifest as anxiety, depression, tiredness or becoming unproductive, and all the therapy in the world will not change that anywhere near as effectively as addressing them will. Ask for support. Pay careful attention to how you feel when you imagine negotiating a change in workload. And think about what you need to do in order to move on from this situation.

I’m biased of course, but I believe that therapy can help in both cases, not least because I meet with people experiencing both. Why we do what we do, why we endure things that others might not, how to rectify things that have gone out of balance, are worthy questions at any time.


Management
There are multiple, global causes of the increase in workplace stress and burnout. Poor management and poor leadership are two of them. The UK has a reputation for both.

No one in their school careers interview says, “When I grow up I’d really like to make people’s lives a misery.” Few 5 year plans include taking no responsibility for maliciously harming people. Yet if you’ve watched even the smallest part of any public inquiry or read any report about any scandal, its clear that this is routine behaviour. Policies and procedures serve to remove accountability out which is why the phrase, “Lessons will be learned” sounds so hollow. 

There’s no easy answer to this one. The UK simply does not invest in management training, if we remain in a profession long enough we're very likely to end up being a manager whether we want to or not. Meaningful structural, professional, strategic and cultural changes require time, expertise and enthusiasm, but there’s little motivation to invest in any of them. Accepting that, since so many people are poor managers and leaders, there might just be a chance that we too could be mildly suboptimal is a start. 
​
Therapy - and I mean more than 6 sessions of goal focused CBT - offers the space and time to build an environment of trust so that you can safely consider what might be going on. Jerks, not all of whom are talented, seldom come to therapy.

Take workplace stress seriously, take burnout very seriously. By definition, a lot of it is out of your control, but some of it is in your hands, even - perhaps especially - when it can feel as if it really is not.