Burnout or Stress: What’s the Difference?

Stress is an occupational hazard that, over time and if left untreated, can lead to burnout. Stress is on a continuum and is needed to actually get work done. Stress and pressure are two similar dimensions. Stress is needed to get us out of bed. We need a boost of cortisol in the morning just to get us up and going. Stress can also be useful to meet deadlines, which is why some people leave things to the last minute. They may get a kick out of the adrenalin that kicks in. Pressure is a bit of strain. For many, pressure is manageable. Some people strive on stress and actively pursue it, but for others, if stress is too much, and goes on for too long without respite, it can cause a problem.

Chronic or acute stress can cause anxiety disorders and depression. It places pressure on the immune system and can actively deplete serotonin (and other feel-good neurotransmitters), leading to mental illness. Burnout differs to ordinary occupational stress in that it is characterised by three dimensions. These include: exhaustion, cynicism and depersonalisation. While it shares some characteristics with stress, and stress is one of the causes and symptoms of burnout, burnout differs in that it is often prolonged and acute.

Stress at work is on the rise. Its impact is causing great costs to both the organisation and the employee, leading to occupational burnout with potentially grave consequences. Employees affected by burnout display a number of physical and emotional symptoms, such as heart problems, stress response, anxiety, depression and withdrawal from activities. Their performance at work is compromised and the impact also effects family and social life.

Occupational burnout is a psychological syndrome that causes emotional exhaustion, depersonalisation or cynicism and a lack of accomplishment or inefficacy, which is the result of prolonged stress. There are five further costs: physical, emotional, interpersonal, attitudinal and behavioural. Occupational burnout is both an organisational and employee issue. It is linked to lower job satisfaction, higher attrition rates, morale problems and staff turnover. The impacts of burnout cost organisations through loss of employees, rising sickness absence, and even presenteeist behaviour. Burnout compromises an employee’s performance, leading to lowered productivity and further organisational costs. In employees, burnout causes both mental and physical health problems. The causes of with have been linked to office politics, menial tasks that interfere with actual work and job characteristics such as role ambiguity, conflict, work overload and lack of autonomy. Problems with managers are also an issue, as are the lack of reciprocation in the psychological contract.

To summarise, we all need a bit of stress in our lives. Our body needs adrenalin to get us out of sticky situations. It’s the fight or flight mode. Too much stress can cause:

• Nausea
• Anxiety and worry
• Depression
• Low mood
• Reduced morale
• Tension at work
• Complaining
• Under productivity

Stress can also lead to burnout, which is characterised by:

• Acute exhaustion
• Cynicism
• Underachieving and lack of productivity
• Frenetic behaviour
• Feeling frazzled
• Chronic fatigue
• Depression
• Tearfulness
• Suicidal ideation

Burnout Research has shown a burnout cycle, whereby employees display certain burnout tendencies and behaviours. They begin with feeling exhausted so engage in presenteeist behaviour, which later leads to exasperated levels of exhaustion. Employees begin to work hard to mediate against the effects of burnout, but in doing so they cause greater exhaustion. Other perspectives centre on employees working hard and long hours, displaying presenteeist behaviours, which leads to further exhaustion, followed by more presenteeism. It’s a chicken and egg phenomenon.

Researchers are on the fence as to what causes it- whether it is situational, individual or both. However, while individual differences, such as personality type and behavioural traits do play a role. Burnout is mostly caused by situational factors, especially situational factors that do not breed the desired result. In fact, the better the worker, the more prone to burnout.

Job demands, such as that discussed in the Job Demands Model, are linked to occupational stress and therefore burnout, which can be mediated by support from family and friends. While burnout was originally researched in the helping or people professions, it is not limited to these professions. Burnout is on the rise in occupations within the so-called square miles, where individuals are becoming deflated by the long hours, lack of organisational commitment and no real sense of purpose. Its impact transcends the organisational impact, and not only impacts on health and wellbeing, but the negative attitudes and loss of feeling caused by exhaustion, coupled with loss of idealism and purpose means that family and social life is affected.

Burnout leads to withdrawal of normal behaviours and pleasures, which further impacts on the wellbeing of the employee. For those in the service-related industry such as teaching, health and social care, it is particularly problematic because it impacts on the wellbeing of patients under the employee’s care. It can lead to decreased performance that impacts on patient care. Likewise, the impact of suffering in patients can affect employees, leading to burnout. Those in mental healthcare are particularly prone due to the embodying nature of their role and use of empathy, with those in longer service exhibiting high rates of burnout. Social workers and psychiatrists are particularly effected, rather than their colleagues, psychologists and support workers, who exhibit less signs overall, which risk a loss of compassion and empathy towards their clients. Outside of healthcare, those working in people faced roles such as teaching and lecturing are also at risk. Journalists working on sensationalised news pieces that deal with violent and traumatic events are also at risk.

The Health and Safety Executive (HSE) have issued a report into stress reduction in the workplace and offered advice for organisations to help reduce stress. This is known as their Management Standards and includes six areas: demand, control, support, relationships, role and change. Their advice is for workplaces to manage these characteristics properly to mediate the effects of organisational stress that can lead to burnout. Healthy working environments, work-life balance and social support are proven mediators against organisational stress
#burnoutandstress #stressatwork #occupationalstress #healthatwork #drfarhanshahzad

Dr Farhan Shahzad FAFOEM MFOM FRCPI

Consultant Occupational and Environmental Medicine

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