Has ‘Burn Out’ Lost All Its Meaning?

It is often stated that we are in the midst of an epidemic of burnout. Particularly over the past year, as coronavirus wreaks havoc on individuals’ mental health and pushes many frontline workers to breaking point. Yet there is still little clarity as to what, exactly, constitutes burnout. In fact, one meta-analysis of 182 scientific articles found there to be 142 different definitions of the condition. 

The ubiquity of the term – which has been accelerated by the pandemic – has only made it more nebulous. There’s now social burnout: the overwhelming effect of seeing friends and family again post-lockdown; influencer burnout: the ennui of being a social media star; Zoom burnout: the fatigue associated with video calls; cooking burnout: the loss of inspiration surrounding daily meal preparation. The list goes on. 

These instances of burnout are all likely to be vastly different from the burnout experienced by, for example, a healthcare worker, which raises the question: is overuse of the term diluting its meaning? 

Natalie LaBossier, a 24-year-old medical student from the US, thinks so. She says that burnout has become "normalised" partly because of just how pervasive the issue is in medical school – a situation exacerbated by the pandemic. "We’ve had lectures where the teacher has said: 'Every physician will experience burnout at some point in their careers'," explains Natalie. "Sometimes, people think it makes you a better doctor to have really tough experiences and be hardened by them."

Earlier this year, when Natalie started to experience exhaustion and loss of motivation, she went to her college dean and told him that she was experiencing burnout. He responded by telling her to "take an afternoon off". She recalls feeling outraged, noting: "An afternoon off doesn’t fix the fact that my entire career success is predicated on one exam."

The suggestion made by Natalie’s dean mirrors the deluge of articles listing steps to recover from burnout, which range from taking a vacation to a hot bath, positive thinking or simply learning to "love your job again". While often well-meaning, these 'solutions' speak to the wider phenomenon of locating structural problems – such as racial and gender-based inequality – in individuals and only dealing with the symptoms, rather than the causes, of burnout.

Not only do these solutions fail to see burnout as systemic or the product of work under capitalism, they could also be preventing people from getting the help they need. Natalie shares the concerns of experts who say that burnout could mask depression. "If you normalise an experience too much, then people see it as just a normal part of life as opposed to a problem," she says. "Then, we won't seek out help."

Often, people find it easier to say they feel burned out because of the stigma that depression carries. And because burnout has become a buzzword – particularly since Anne Helen Peterson’s viral 2019 article designated it a hallmark of the millennial generation – it arguably isn’t always taken as seriously as coming forward with depression. As Natalie speculates: "If I had said to the dean, 'I have depression', maybe he would have said the school accepts that as a valid medical reason."

"I think burnout is probably being applied very broadly, even when what people are experiencing would meet the criteria for mental health issues," adds Natalie. Jonathan Malesic, the author of The End of Burnout, concurs. "There is a real danger that claiming burnout can cover up depression," he says. "People who are experiencing burnout should be screened for depression."

People may also be more likely to say they are experiencing burnout because the term can be worn as a badge of honour. As Sarah Jaffe, author of Work Won’t Love You Back, writes: "We’re supposed to value ‘busy’ and ‘productive’, and capital has always valued these things. Bosses want us to work as much as and as hard as we possibly can. The expectation that we've internalised this as employees, rather than as bosses, is a relatively new thing."

Sarah says this idea that we should prize productivity above all else marks a shift away from the industrial model – such as work in the coal mines – where employment was seen as more adversarial. In today’s hustle culture, "being super busy is somehow a sign that we have status, when usually, it’s just a sign that we don’t get paid enough." The term 'burnout', Sarah argues, has become inextricably bound up with this idea that we should love our jobs. As she puts it: "Burnout becomes the space between being told that you should love your job and the reality that your job still sucks."

Do we need a new language to talk about burnout, or one that more explicitly deglorifies overwork, such as 'toxic productivity'? Sarah is unconvinced. "Literally, productivity is killing us, as individuals and the planet. So there’s sort of no ‘non-toxic’ productivity," she says. While terms such as burnout have become "vacated of meaning … their origins were really powerful," Sarah notes. "I think it's useful to drill down into where terms [like burnout] come from, because often, it tells us a lot about what's actually going on and what we're actually dealing with." 

These origins stretch back to the 1970s, when psychologist Herbert Freudenberger first identified the consequences of severe stress experienced by workers in "helping" professions. Freudenberger found that doctors and nurses who were expected to be self-sacrificing while facing high pressure at work would lose their motivation and ability to cope. As Jaffe suggests, recalling how the term was coined could strengthen our understanding of burnout today and inform our approach to the heavy toll faced by social and healthcare staff amid COVID. 

For Malesic, the solution could lie with "developing a more precise vocabulary" to talk about burnout and recognising that "burnout isn’t one thing, but rather, a spectrum of experiences". This could see some patients scoring higher or lower across the three dimensions of burnout set out by Maslach burnout theory: exhaustion, cynicism and reduced efficacy. 

Malesic explains: "If we had a decent diagnostic tool for burnout, we could say, 'This person fits the cynical burnout profile' or 'This person who is more classically burnout fits all three dimensions'. And then we could develop a different set of interventions proven to help people."

Others have made the case for recognising burnout as a form of depression, rather than a distinct clinical condition – an argument supported by a recent study. This could help overcome the tendency to see burnout as somehow milder than – or a stepping stone to – more serious mental health issues. 

"Burnout and depression share common etiological pathways, symptoms (including the most severe, such as suicidal thoughts), risk factors, long-term outcomes, and can be treated with the same methods," says Renzo Bianchi, an author of the study. "By overlooking the depressive nature of burnout, we reduce our chance to help people suffering from burnout effectively." Renzo says that the World Health Organization either needs to update its definition so that burnout is recognised as a depressive medical condition, or rely on existing depression categories.

Not everyone agrees that we should view burnout and depression as one entity. "I do think that it makes sense to think of burnout as a work-specific disorder," says Malesic. He questions the study’s finding that burnout’s core – exhaustion – more frequently correlates with depressive symptoms than with either detachment or efficacy. "Maybe we shouldn’t expect them [the three dimensions] to correlate," he says, again pointing to the idea that burnout exists along a spectrum. 

Yumiko Kadota, a former surgeon who writes about her experience of burnout in her book Emotional Female, similarly stresses the importance of seeing burnout as distinct from depression – even though statistically, there is significant overlap. "By changing the workplace, you can make things better for people who are burned out, but that's not necessarily going to make it any different for someone who has depression," argues Yumiko. "By calling [burnout] depression, workplaces will see it as an individual's illness. And it's easy to blame the individual when you do that."

Yumiko agrees that the term is overused and "anyone who feels a little bit stressed at work now uses the word 'burnout'" when really the focus should be on the aforementioned three dimensions. But there may be some benefits to the widespread use of the term. Yumiko – who says that her burnout was so severe, it became depression – thinks that while the discourse around burnout could mask depression for some, for others it could make discussions around mental health more accessible, and offer "a gentle way of introducing mental health strategies to a wider community".

What is needed, perhaps, is a more robust definition of burnout and one that offers solutions which no longer frame the condition as an individual failing. There are things workers can do to change their company culture – such as joining a union – which can offer a more sustainable approach to burnout than, say, aromatherapy. But ultimately, what needs to change is the capitalist structures which expect a total deference from workers towards their jobs. The first step to curing burnout might just be the realisation that work, to borrow Jaffe’s phrase, won’t love us back.