A few years ago, when I worked in a TV network newsroom, our boss announced that the company would begin to offer meditation classes. The next day, a handful of us gathered in the lunchroom, where a serene woman with long, dark hair had arranged folding chairs in a semicircle. As she explained the concept of mindfulness and instructed us to focus on our breath, phones vibrated and people stealthily checked their emails. She closed her eyes and began to lead us in a short, guided meditation. By the time she opened them 10 minutes later, just about everyone had left the room and gone back to work.<\/p>\n
We didn\u2019t mean to be rude. The 20-minute class just wasn\u2019t feasible with our workloads. We worked long hours and frequent overnight shifts, and faced constant pressure to hit tight deadlines. We were all tired, all the time. \u201cI\u2019m so burned out\u201d was a common refrain around the office; we threw around the term casually, not thinking of burnout as a specific diagnosis. And at the time, it wasn’t. But earlier this year, the World Health Organization elevated burnout from an amorphous complaint to a more clearly defined \u2014 and diagnosable \u2014 “occupational phenomenon<\/a>.”<\/p>\n This upgraded designation is an important step in clarifying what burnout is (and isn’t) and validating its impact on wellbeing. You might be tired or stressed from a new baby or the news cycle, but only work can burn you out, clinically speaking. And if your 9-5 life has you feeling drained and dejected, it\u2019s a real problem and it\u2019s not you \u2014 it\u2019s your job. But there\u2019s the Catch-22: While burnout isn\u2019t your fault, it\u2019s also not fully within your control to fix, and a diagnosis won\u2019t change that. Burnout starts at work, and that\u2019s where reform needs to happen. Experts hope the WHO classification will encourage employers to start taking burnout seriously.<\/p>\n The WHO lists every diagnosable disease in a periodically updated, comprehensive guide called the International Classification of Diseases, or ICD. In May, the WHO released the 11th edition of the ICD, which classifies burnout as a \u201csyndrome conceptualized from resulting chronic workplace stress that has not been successfully managed.” The ICD-11 isn’t the first edition to mention burnout, but it is the first one to define it in detail with three specific diagnostic criteria: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from one\u2019s job, or feelings of negativism or cynicism related to one\u2019s job; 3) reduced professional efficacy.<\/p>\n Even though burnout is now diagnosable \u2014 or will be in 2022, when the ICD-11 technically goes into effect \u2014 the WHO is\u00a0careful to point out<\/a> that it isn’t a medical condition, and never will be.\u00a0Still, burnout\u2019s elevated status is significant, and that’s partly because it took so long to happen. Burnout first entered the lexicon back in 1974, when the psychologist Herbert Freudenberger coined the term in his book <\/span>Burnout: The High Cost of High Achievement. <\/span><\/i>In his determination, burnout caused a number of different psychological and physical symptoms, including \u201cthe extinction of motivation or incentive,\u201d fatigue, sleeplessness, headaches and gastrointestinal disturbances. As he explained in a <\/span>1981 radio interview<\/span><\/a>, Freudenberger saw burnout as \u201ca response to stress\u2026 to a demand that an individual may make upon themself in terms of a requirement for perfectionism or drive.\u201d<\/span><\/p>\n \u201cHow do you distinguish between chronic stress and burnout if the two concepts overlap to a certain degree?\u201d<\/span><\/p><\/blockquote>\n Freudenberger\u2019s book put burnout on experts\u2019 radar. Psychologists and other researchers published hundreds of studies on the phenomenon in the following decades. But many efforts to document, understand and prescribe solutions for burnout ran into the same question: What <\/span>is<\/span><\/i> burnout? A mental illness? A chronic physiological condition? A societal epidemic? All of the above? Among other things standing in the way of definitional clarity , it wasn\u2019t always easy to tell burnout apart from other conditions.\u00a0<\/span><\/p>\n \u201cHow do you distinguish between chronic stress and burnout if the two concepts overlap to a certain degree?\u201d asks sociologist Torsten Voigt, professor at RWTH Aachen University in Germany, who published a <\/span>review of existing studies on burnout in 2017<\/span><\/a>. \u201cBoth the physical and psychological symptoms can certainly have long-term effects on the body. Stress and burnout are, for example, linked to higher degrees of stomach and bowel issues that can become chronic.\u201d<\/span><\/p>\n Physical symptoms of burnout, such as trouble with sleep and weight fluctuations, also overlap with those of mental health conditions like anxiety and depression, says Elaine Cheung, research assistant professor of medical social sciences at Northwestern University.\u00a0<\/span><\/p>\n The WHO’s new diagnostic criteria for burnout attempt to resolve some of the confusion, but experts say they don’t quite succeed. \u201c<\/span>We need to better define the state of burnout,\u201d says Voigt. \u201cIt is supposed to be different from mood disorders\u2026but what are the criteria that justify diagnosing burnout instead of a different diagnosis? There needs to be more research on the concept itself.\u201d<\/span><\/p>\n The concept of burnout might also be tailored to certain subsets of the workforce, experts say. Most of the research on burnout in the U.S. has focused on healthcare professionals, particularly physicians, and <\/span>suggests<\/span><\/a> that doctor burnout is a <\/span>widespread scourge<\/span><\/a> that can lead to medical errors and high turnover rates, and even play a role in suicidal behavior.<\/span> It\u2019s also expensive: By <\/span>one recent estimate<\/span><\/a>, burnout costs the healthcare system about $4.6 billion a year.\u00a0<\/span><\/p>\n But burnout isn\u2019t confined to healthcare. By all indications, it infiltrates most industries. <\/span>A 2018 Gallup poll<\/span><\/a> found that nearly two-thirds of people surveyed said they experience burnout on the job. And according to one <\/span>2015 meta-study<\/span><\/a>, burnout risk is especially high for minority workers with low levels of education, a population that few studies have focused on.<\/span><\/p>\n \u201cWe know very little about low socioeconomic status and burnout,\u201d says Lily Brown, assistant professor of<\/span> psychology in psychiatry at the University of Pennsylvania\u2019s <\/span>Center for the Treatment and Study of Anxiety<\/span><\/a>. \u201cNo one deserves to feel burnout more than a person who\u2019s making minimum wage and having to work multiple jobs to support themselves and by and large those are not the people who are represented in research.\u201d<\/span><\/p>\n \u201cAssertiveness is not going to fix all aspects of burnout, but it may help people to gain a sense of empowerment about their role in their job.\u201d<\/span><\/p><\/blockquote>\n Experts question whether the<\/span> WHO\u2019s definition of burnout accounts for the ways in which burnout might manifest differently in Silicon valley engineers vs. fast-food workers. <\/span>\u201cIn a way, burnout is a \u2018luxury,\u2019\u201d as it\u2019s currently defined, says Voigt. As a prerequisite, the definition requires personal investment in your work. \u201cWorking three jobs to make ends meet, you may not have time or mental resources to feel burned out. All you do is rush to get things done.\u201d<\/span><\/p>\n But whether we\u2019re talking about ER nurses, attorneys or burger-flippers, burnout is, at its core, a problem rooted in workplace culture and labor policies that work against employee wellbeing. Making burnout diagnosable doesn\u2019t change that.<\/span><\/p>\n \u201cOne of the challenges in pathologizing burnout is that the burden lies on the patient to fix their issue when the issue might be systemic to the organization,\u201d says Brown. \u201cWhen a patient comes in and describes a toxic work environment, the patient only has so many degrees of freedom in terms of what\u2019s in their control.\u201d<\/span><\/p>\n Still, there are strategies to take the edge off. In her lab, Cheung works with patients on a positive psychology intervention that teaches coping skills. \u201cLearning <\/span>positive reappraisal<\/span><\/a> (focusing on the good), gratitude and self-compassion may be helpful for coping with stress in a toxic work environment,\u201d she says.<\/span><\/p>\n Brown often works with patients to develop stronger boundary-setting at work, putting limits on hours, if possible, and saying no to tasks that don\u2019t feel meaningful. \u201cAssertiveness is not going to fix all aspects of burnout,\u201d she says, \u201cbut it may help people to gain a sense of empowerment about their role in their job.\u201d<\/span><\/p>\n There\u2019s power in numbers, Cheung notes. \u201cWhen you\u2019re able to cope with your stress more effectively, taking action and trying to organize ways that you can round up the troops to talk to leadership and find ways to address the issues in your workplace can be useful for enacting real change over time.\u201d\u00a0\u00a0<\/span><\/p>\n But employees can\u2019t win a fight against burnout on their own. Heavy job demands and inadequate resources are inherently part of the burnout equation. Research supports the need for employers to make structural, operational and even philosophical changes. Symbolic changes aren\u2019t enough. Midday meditation classes, for example, might not do much good if taking a break only causes overextended employees more stress.\u00a0<\/span>By adding staff and helping employees find deeper meaning in their work, according to a <\/span>2017 report in <\/span>JAMA<\/span><\/i><\/a>, organizations can reduce burnout significantly. The problem is global, and in some countries, governments are getting involved, too. Japan, a nation with a notorious reputation for dangerously overworked employees, recently put a legal <\/span>cap on overtime hours<\/span><\/a>.\u00a0<\/span><\/p>\n
\n