Burnout: Information and burnout doctors

Leading Medicine Guide Editors
Author
Leading Medicine Guide Editors

Burnout syndrome is a state of mental, emotional and physical exhaustion. The term stands for a state of exhaustion caused by the work of the person affected: someone is on fire for their work - and at some point feels burnt out.

This article provides detailed information about burnout, the symptoms and which treatment approaches are currently available. You can also find competent burnout doctors.

ICD codes for this diseases: Z73

Recommended specialists

Brief overview:

  • What is burnout? A condition characterized by mental, emotional and physical exhaustion. It is associated with the clinical pictures of depression, an adjustment disorder or an exhaustion syndrome.
  • Progression: Burnout develops gradually from high ambition and work commitment, coupled with putting one's own needs on the back burner. Stress, denial of problems and social withdrawal can then lead to typical burnout symptoms.
  • Symptoms: insomnia, fatigue, malaise. Inner emptiness, lack of drive and motivation, a feeling of meaninglessness and hopelessness, depression and finally physical and mental collapse.
  • Diagnosis: As a rule, the family doctor refers the affected person to specialists in order to rule out physical causes. A psychologist then makes the diagnosis.
  • Causes: Unrealistic expectations of oneself and one's job as well as difficulty in dealing with one's own mistakes or even failure promote burnout syndrome.
  • Treatment: The patient needs to be relieved for a while and given some distance from their environment. Psychotherapy, mindfulness training, relaxation techniques and behavioral training can treat burnout well. Therapy can be carried out on an outpatient or inpatient basis or in a day clinic.
  • Prevention: The most important prevention is to know yourself, your own abilities, needs and priorities well and not to overload yourself accordingly. You should learn not to take on more than you can and want to do.

Article overview

Burnout: a term and its history

The term "burnout" first appeared in the 1970s. The German-American psychologist Herbert Freudenberger coined the term "staff burnout". He used it to describe a condition that he observed in people in social professions.

C. Maslach described the symptoms as follows in 1996:

  • great exhaustion ("overwhelming exhaustion"),
  • cynical, detached attitude towards the profession ("detachment") and
  • the feeling of being unable to achieve anything or too little ("inefficacy").

Since then, the description of the phenomenon of burnout has been extended to other professional groups . Reports about burnout syndrome regularly appear in the media. Athletes such as Sven Hannawald or TV chef Tim Mälzer have come out as burnt out.

In medicine, burnout syndrome is the subject of controversial debate. Some doctors and psychologists regard the syndrome as a disease in its own right. Others see burnout cases as meeting the criteria

are met.

Burnout is not currently an independent mental illness. In the World Health Organization's (WHO) ICD-10 diagnostic catalog, it is assigned to code Z.73 "Problems related to difficulties in coping with life". It does not appear in ICD-10, Chapter V "Mental and behavioral disorders", which includes mental illnesses. This has not changed in the new, completely revised ICD-11, which entered the test phase in 2018.

Modern therapeutic approaches are tailored to the individual needs of each patient. Therefore, those affected still receive suitable treatment.

Symptoms: The stages of burnout

Burnout syndrome usually develops slowly and in stages. It usually begins with an overcommitment to one thing and ends with complete exhaustion. The symptoms initially relate to the working environment. There is a high risk that they will spread to the rest of your life.

People who are prone to burnout usually exhibit the following characteristics:

  • very high demands on themselves,
  • great commitment to their work and
  • a tendency towards idealism.
  • Sometimes they also try to strengthen their low self-esteem through work.

Factors that increase the risk of burnout are

  • Unfavorable working conditions,
  • high effort with low pay,
  • great responsibility with little control and
  • insecure workplace situations.

There are two models that describe the development of burnout.

12-phase model according to Freudenberger

  1. Ambition and work commitment: There is an excessive desire to prove something to yourself and others and to assert yourself.
  2. Increased work effort: Because recognition and success are not achieved to the desired extent, the work effort is increased even more.
  3. Denial of own needs: In order to manage the workload, one's own needs are suppressed. The imbalance is felt, but also denied.
  4. Repression of conflicts: There is just enough energy to cope with the work, conflicts are not acted out and resolved, but pushed away.
  5. Change of priorities: Only work still counts. Family, friends and former hobbies no longer seem to be of any value.
  6. Denial of problems: Any problems are blamed on work and time pressure, the actual problems are not perceived.
  7. Social withdrawal: Relationships and conversations are avoided, contact with others is kept to a minimum.
  8. Changes in behavior: There is a lack of drive and motivation.
  9. Functional status: It's all about functioning.
  10. Inner emptiness: People with burnout feel empty and perceive their actions and possibly their whole life as pointless.
  11. Hopelessness and depression: In this phase, the symptoms extend to the whole of life. It is difficult to distinguish between burnout and depression.
  12. Full-blown burnout syndrome: People are at the end of their tether and literally collapse both physically and mentally.

Starke Kopfschmerzen und Migräne
Headaches and exhaustion are one of many symptoms of burnout © zinkevych | AdobeStock

7-phase model according to Burisch

  1. Chronic stress due to excessive commitment to a task. The number of working hours increases, the hours for sleep and rest decrease. The nervous system reacts with the first signs of overstimulation such as diarrhea, dizziness, sweating and trembling.
  2. Exhaustion (burnout), reduced commitment and an increasingly negative attitude. The previously positive attitude towards the task changes to a negative one. People only try to keep up the workload somehow. There is no longer any real interest or even enjoyment.
  3. Development of depressive symptoms such as a lack of drive and joy and a depressed mood. There is also a feeling of being constantly overwhelmed. Hopelessness and resignation set in.
  4. Concentration, attention and thinking disorders. These difficulties make it almost impossible to continue to cope with tasks and mistakes are made.
  5. Neglect of social life, general lack of interest. Interest in family and friends decreases. Activities are reduced to a minimum.
  6. Tension headaches, sleep and eating disorders. Physical complaints increase. Often numerous visits to the doctor, during which no physical illnesses are usually found.
  7. Despair and depression. The mood is constantly depressed, brooding occurs, life itself is questioned. Sometimes suicidal thoughts arise.

Burnout syndrome usually develops over a longer period of time. It can last for years.

The diagnosis: is it burnout?

A diagnosis helps the patient because their symptoms have a name. He then knows that he is ill and can take active steps to combat it. The doctor needs a diagnosis in order to initiate the appropriate treatment. At the same time, diagnoses play a central role for experts, for example in the case of early retirement.

For those affected, the following applies first and foremost: a diagnosis is a medical term. For this reason, you should understand the diagnosis as an orientation aid in dealing with the symptoms. You do not have to identify with it.

For a long time, patients with mental illnesses in particular feared that they would be marked with a lifelong label. This concern is unfounded. Mental disorders - just like physical illnesses - are an unpleasant and normal aspect of life. And just like most physical ailments, mental illnesses are easily treatable.

Burnout is not yet considered an illness in its own right. It merges seamlessly into depression, chronic fatigue syndrome and an adjustment disorder. Burnout is not clearly defined in this respect.

Patients with states of exhaustion usually speak to their GP first. They complain about

  • Sleep disorders,
  • tiredness or
  • malaise.

The general practitioner will refer the patient to a specialist to rule out physical causes for the symptoms. For example, an underactive thyroid gland can also lead to fatigue.

Burnout syndrome is usually diagnosed by a specialist in neurology and psychiatry or psychosomatics. Psychotherapists can also make the diagnosis.

You can find a test on the website of the Technical University of Dresden. You can use it to check your personal risk of burnout: Click here for the self-test. Note: The test will help you to better assess your situation. It is not a substitute for a medical examination.

Causes of burnout syndrome

Various factors can contribute to the development of burnout syndrome:

  • Unrealistic expectations of yourself and your job, as well as
  • difficult external circumstances.

People with excessive expectations set themselves very high goals. The risk of failure - and thus experiencing disappointment - increases accordingly. At the same time, those affected tend to find it difficult to come to terms with their mistakes or even failure. They want to be successful and popular.

However, monotony and a lack of mental effort can also lead to exhaustion. Such examples can be found in the media under the keyword "bore-out".

Therapy for burnout syndrome

Burnout syndrome can be treated well today. Whether outpatient therapy is sufficient depends on the individual case. In some cases, admission to a day clinic or inpatient facility is more helpful.

In some cases, it can also be helpful to involve the employer in the considerations. You can then look for solutions together with them. Alternatively, employers and employees can reflect on the professional situation as part of supervision or mediation. In this way, it can be managed more consciously and influenced positively.

Relief is important in any case. In some cases, the person affected should leave their stressful environment for a certain period of time. Strategies for better stress management help to improve the acute state of the illness. At the same time, these methods serve as relapse prophylaxis. Here are a few examples:

  • Mindfulness training: for example MBSR (mindfulness-based stress reduction),
  • Relaxation methods: such as progressive muscle relaxation according to Jacobsen or autogenic training,
  • Behavioral training: non-violent communication.

In the case of severe sleep disorders, it may be necessary to take measures to promote sleep. Medication may also be used for a short time.

The measures described are primarily aimed at alleviating the symptoms. Through psychotherapy , those affected learn, among other things

  • perceive and express their feelings more clearly,
  • assert themselves against external pressure and
  • acquire conflict and stress management strategies.

The aim of the therapy is to change behaviors that have contributed to the overload and excessive demands.

Bewegung und Ausdauertraining
Hobbies and socializing are an important part of therapy for burnout © elnariz | AdobeStock

It is just as important to reflect on the priorities in your own life and align your everyday life accordingly. It is helpful to resume neglected contacts and hobbies. Tapping into new areas of interest can also make life worth living again.

Self-help: behavioral tips for burnout

  • Make sure you eat a balanced diet, exercise regularly and get enough sleep.
  • Plan regular breaks to relax.
  • Make time for enjoyable things.
  • Try to reduce stress through relaxation techniques.
  • Review your expectations of yourself.
  • Define achievable goals and say goodbye to unachievable goals.
  • Review your motivation and values.
  • Make time for family and friends.

Burnout prevention: a joint task for employees and managers

Those who know and respect their needs are better protected against burnout. Ignoring personal boundaries increases the risk of burnout. Employers should ensure

  • Sufficient reward for work,
  • sufficient feedback,
  • transparency,
  • time and space

and space. Clear, unambiguous structures create calm. Employees know what is expected of them and who they can turn to with which questions.

Digital technology and global markets have been causing acceleration and sometimes rapid change for years. Against this backdrop, burnout prevention is of central importance. At the same time, it represents a particular challenge for companies and individual employees.

Prevention for each individual

  • Are you doing a job that suits your abilities or do you want to prove something to yourself and others?
  • How self-confident do you feel? Can you accept yourself as you are or are you trying to make up for a lack of self-confidence through your job?
  • Do you set your goals too high and do you want to "improve the world" instead of just looking at your own sphere of influence and doing your best here?
  • Do you give your hobbies enough space and time?
  • Is there a balance between work and leisure time? And do you plan your free time in such a way that it does not lead to stress?
  • Do you know your needs and make sure that they are adequately met?
  • Do you maintain your contacts and make enough time for family and friends?
  • Do you know your stressors and do you have coping strategies?

Prevention in companies

  • Are employees deployed according to their abilities?
  • Are the hierarchies and structures in the working environment clear? Does every employee know who is authorized to give instructions and from whom they can receive support?
  • Are there regular team meetings in which employees have their say?
  • Do employees have enough time to complete their tasks?
  • Does the company have a positive feedback and error culture?
  • Is there appropriate remuneration for the work in question?
  • Is there a point of contact in the event of bullying situations?
  • Are the workplaces set up in such a way that employees feel comfortable?
  • What about appreciation and recognition?

Who is a burnout specialist?

The following specialists and therapists should be contacted in the event of burnout syndrome:

  • Specialists in psychotherapy and psychiatry
  • Psychological psychotherapists
  • Specialists for psychosomatic medicine
All doctors and therapists offer outpatient treatment. Burnout clinics bring together three specialist areas: psychological psychotherapists, psychiatrists and specialists in psychosomatic medicine.
We will be happy to help you find a burnout specialist in your area. We have thoroughly checked the specialists, therapists and clinics we have listed for you.
Find your burnout specialist now and contact them directly!

    Conclusion

    At the beginning of the 20th century, the writer Edmund von Hórvath noted that every era has "its plague". Alongside obesity, exhaustion in its various forms is one of the typical diseases of the modern world.

    The good news is that people have never had so much knowledge and resources at their disposal to combat illness. An optimistic-realistic attitude is appropriate in the face of burnout syndrome and at the same time strengthens resistance.

    References

    • Hillert A & Marwitz M. (2006): Die Burnout-Epidemie. Oder: Brennt die Leistungsgesellschaft aus? Verlag: Beck.
    • Hillert et al. (2017): Burnout und chronischer beruflicher Stress: Ein Ratgeber für Betroffene und Angehörige. Hogrefe-Verlag.
    • Michalak et al. (2017): Achtsamkeit üben: Hilfe bei Stress, Depression, Ängsten und häufigem Grübeln. Hogrefe-Verlag.
    • Berger. T. (2015): Burnout-Prävention. Erschöpfung verhindern – Energie aufbauen – Selbsthilfe in 12 Stufen. Verlag: Schattauer.
    • Hoffmann, N. & Hofmann, B. (2017): Anpassungsstörung und Lebenskrise: Materialien für Therapie, Beratung und Selbsthilfe. BELTZ-Verlag.
    • Positionspapier der Deutschen Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde (DGPPN) zur Burnout-Debatte: https://deutsch.medscape.com/artikel/4900548
    • 12-Phasen-Modell nach Freudenberger: https://dg-pg.de/information/psychische-gesundheit/burnout/was-ist-burnout/
    • 7-Phasen-Modell nach Burisch: http://www.cconsult.info/fileadmin/Media/PDF/Netzwerk-Forum/Vortrag_-_Prof._Dr._Burisch.pdf
    Whatsapp Facebook Instagram YouTube E-Mail Print