By Liam Mannix
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G’day, Liam Mannix here. Welcome to Examine.
When I pitched this story, I worried I was going too early. It’s not yet Easter. My editor grimaced. “It’s never too early to write about burnout.”
Burnout is, apparently, the modern condition. Take Steve Cook. After working for 13 years in animal welfare – where there always seemed to be too many cases and not enough hours in the day – he found he had almost completely lost his passion for a job he once loved.
Former animal-welfare officer Steve Cook is taking a career break to recover from burnout at work. Credit: Jason South
“I found I could never unwind, never stop thinking about work,” he says. “It does take its toll on your mind, on being able to unwind. Having to do weekend work, on call, it’s fairly relentless.”
Cook had a classic case of what society thinks of as burnout. But the science is murkier.
Researchers are deeply divided and the academic debate red-hot. Some see a crisis, others see “a fashionable diagnosis” or “psychobabble”.
Yikes. Let’s dive into the evidence.
A bottom-up syndrome
Burnout emerged not from psychology but from lived experience. Christina Maslach, one of the field’s key figures, started interviewing people in emotionally exhausting fields – police, nurses, priests – to find a way to sum up their experiences. None of the psychological argot seemed to fit until she tried a new one: burnout.
“[They’d say], ‘yeah, that’s it, oh my gosh’,” Maslach told the American College of Emergency Physicians’ ACEPNow.
“The people themselves said this term captured what they were feeling.”
Graham Greene’s 1961 novel, A Burnt-Out Case, about an architect disillusioned by his job who withdraws into an African leper colony, took the word mainstream (advanced leprosy can produce nerve “burnout”, leaving the patient numb).
Academics soon came to study it. The gold-standard measure the field eventually developed positions burnout on three pillars: exhaustion, cynicism and inefficiency.
But this definition has proven slippery.
First, the logic is circular: people who test highly on a burnout scale have burnout – and burnout is defined as testing highly on the burnout scale. Other burnout scales are drawn from asking people with self-identified burnout how they feel – meaning our definition of burnout is essentially: people who think they have burnout.
Being unproductive at work can be a consequence of exhaustion or cynicism. So then you’re down to two key symptoms. And there’s no established cut-off score for when a person is burnt out. Researchers can use different cut-offs and produce wildly different estimates.
Some, like Professor Gordon Parker, founder of the Black Dog Institute, have tried to solve this with more-detailed burnout inventories (you can try Parker’s Sydney Burnout Measure here).
But these often run into another problem: low specificity. “If you have burnout, you will score over the cut-off,” Parker says. “However, you can also score over the cut-off if you have significant anxiety, significant depression, some significant medical problem.”
Selected questions from the Sydney Burnout Measure
Answer not at all, slightly, moderately, or distinctly.
- I feel emotionally drained and exhausted
- My attention is less focused
- I wake up feeling tired
- I cannot get pleasure out of my work
- I do not look forward to spending time with friends and family any more
This is a key problem: Parker’s test has three hallmark measures: exhaustion, a fuzzy brain and a lack of pleasure in life – but these are also symptoms of depression.
Hence, the central controversy: what are we really measuring? Burnout? Or depression?
Meta-analyses featuring dozens of studies found only small correlations between a job being demanding and a higher risk of burnout. And researchers have been unable to find a biomarker for burnout.
Parker sees that argument, but doesn’t buy it. Burnout has subtle but clear differences – it can be clearly characterised by being driven by workplace demands, and presents as “helplessness” rather than “hopelessness”, he says.
“Depression commonly accompanies burnout, but that does not mean the two are identical.”
Useful models
Studies of mental illnesses often have a common problem: we lack empirical evidence, such as a blood marker. We’re working in the messy, subjective world of feelings. We can argue that a certain pattern of feelings correlates with an underlying condition, but we can’t be sure.
But that’s not the full story.
If a company with many employees who test highly for burnout performs poorly, then burnout likely matters, whatever it is. More importantly, if you can pick out people with burnout and effectively treat them, then burnout really matters.
Here, Parker is convinced that burnout needs different treatment to depression. Identify and treat the triggers, while dosing up on strenuous exercise, holidays, and mindfulness.
That’s what Cook did. He stepped away – he remains on career break – found a new set of hobbies, took up walking and re-engaged with friends and family.
“Talk about the way you’re feeling. And take some time out for yourself,” he says. “It’s easy to be so consumed by these high-pressure roles.”
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