Key points
- Burnout is a widespread issue with high prevalence rates across various professions and generations.
- There is an ongoing debate about whether burnout should be classified as a diagnosable mental disorder.
- Proponents argue that its prevalence and significant cost for organizations warrant its recognition.
- Critics believe it overlaps with depression, there are no biomarkers, and it may pathologize normal behavior.
Burnout is not a new concept. In fact, it’s been recognized as a concerning workplace phenomenon since the late 1970s. But in recent years, reports of burnout have reached staggering levels.
These extreme rates of burnout are not just contained to one profession or occupation but span entire industries. For example, studies highlight that up to 67 percent of medical practitioners and over 50 percent of teachers experience high burnout. Similar trends are found for dentists, farmers, nurses, social workers, academics, and even university students. This trend also spans generations, with over 50 percent of Gen Z, Millennials, and Gen X reporting high levels of burnout, compared to 31 percent of Baby Boomers.
With its prevalence being so high, it’s clear that we are in a global burnout epidemic. Yet, governments, policymakers, and medical practitioners don’t seem to intervene. A new study by Nadon and colleagues (2022) argues that this is because of how burnout is seen and classified in the medical system. So, the question arises: Should burnout be treated as a diagnosable mental disorder?
Before diving into the debate, let’s explain what burnout actually is. The World Health Organization classifies burnout as an occupational phenomenon linked specifically to chronic workplace stress. De Beer and colleagues’ (2022) new approach to burnout argues that it’s a work-related state of exhaustion that is characterized by extreme tiredness, reduced ability to regulate cognitive and emotional processes, and mental distancing.
To break it down further, burnout has four components:
- Emotional exhaustion refers to feeling drained and depleted of mental energies. For example, a nurse who feels she has nothing left to give to patients by the end of each workday.
- Mental distancing refers to an unwillingness to expend any effort and being cynical about work. For example, a teacher experiencing this might treat students as objects rather than people.
- Cognitive impairment happens when you struggle to process new information or solve basic intellectual tasks. For example, you have to read a sentence on your favorite blog multiple times before you can understand it.
- Emotional impairment also occurs, which reduces your ability to manage or regulate your emotional responses to situations. For example, when you are angry at your colleague for not meeting a deadline, you send rude emails or yell or scream at them.
But burnout doesn’t just happen overnight. It develops gradually over an extended period of time in response to chronic work stress, which is a result of an imbalance between high job demands (e.g., work overload), limited resources (e.g., peer support), and an inability to activate personal resources (e.g., coping skills). It can also develop due to personality characteristics like perfectionism or loyalty. With employee burnout reaching crisis levels, a debate rages on: Should burnout be classified as an actual mental disorder? Let’s examine the case for and against.
The Case for Burnout Being a Diagnosis
There are several arguments suggesting burnout has enough impact to be called its own clinical disorder:
- The World Health Organization’s recognition of burnout as an occupational phenomenon in the International Classification of Diseases (ICD-11) was an important step towards identifying and addressing this issue.
- High prevalence rates suggest it’s a major issue that deserves clinical attention.
- There are strong ties between burnout and other mental health issues, like depression, anxiety, low life satisfaction, and even suicide ideation. Classifying it as a mental disorder could improve access to treatment.
- Burnout is also expensive for organizations as it increases high staff turnover and absenteeism and reduces job performance. Again, classification could help create new prevention and treatment programs.
- Classification could also lead to greater recognition of burnout’s debilitating effects and spur greater development of evidence-based interventions.
The Case Against Making Burnout a Diagnosis
On the other hand, there are also persuasive arguments suggesting burnout may not be suited for classification as a distinct disorder:
- Burnout overlaps significantly with depression as they share symptoms like exhaustion, detachment, and reduced self-efficacy. For example, Bianchi and colleagues (2013) argue that burnout could just be a domain-specific form of depression.
- There are no biomarkers or consistent diagnostic protocols for burnout.
- Burnout is inherently linked to chronic occupational stress, which is dependent on context. Removing that work context could render the diagnosis meaningless.
- There’s too much variability in how burnout is defined and measured. A standard definition and assessment tools are needed before diagnostic classification.
- It could over-pathologize normal responses to stressful work conditions, turning stressed employees into “patients” requiring “treatment.”
Where Do We Go From Here?
Based on the arguments and evidence, the case seems strong that burnout is a valid clinical phenomenon that deserves increased recognition as a diagnosable mental disorder. As work is a central part of adult life, work-induced conditions causing substantial psychological distress and impairment definitely merit the medical community’s attention. However, more research is still needed to establish consistent diagnostic criteria and measurement tools. Further, it would also help to clarify burnout’s relationship with depression. But this shouldn’t prevent burnout from being acknowledged as a legitimate disorder.
In conclusion, classifying burnout as a diagnosable mental condition is an important step to generating solutions and developing validated treatment strategies. Of course, this doesn’t absolve organizations from their responsibility to manage the root causes of burnout, like high work overload and poor management. It’s thus time for the medical community, governments, and policymakers to start treating burnout like the serious occupational health issue that it is.
References
Bianchi, R., Boffy, C., Hingray, C., Truchot, D., & Laurent, E. (2013). Comparative symptomatology of burnout and depression. Journal of Health Psychology, 18(6), 782-787.
De Beer, L. T., Schaufeli, W. B., & De Witte, H. (2022). The psychometric properties and measurement invariance of the Burnout Assessment Tool (BAT-23) in South Africa. BMC Public Health, 22(1), 1-10.
Dee, J., Dhuhaibawi, N., & Hayden, J. C. (2022). A systematic review and pooled prevalence of burnout in pharmacists. International Journal of Clinical Pharmacy, 1-10.
Nadon, L., De Beer, L. T., & Morin, A. J. (2022). Should burnout be conceptualized as a mental disorder?. Behavioral Sciences, 12(3), 82.
Ozamiz-Etxebarria, N., Legorburu Fernnadez, I., Lipnicki, D. M., Idoiaga Mondragon, N., & Santabárbara, J. (2023). Prevalence of Burnout among Teachers during the COVID-19 Pandemic: A Meta-Analysis. International Journal of Environmental Research and Public Health, 20(6), 4866.
Rotenstein, L. S., Torre, M., Ramos, M. A., Rosales, R. C., Guille, C., Sen, S., & Mata, D. A. (2018). Prevalence of burnout among physicians: a systematic review. Jama, 320(11), 1131-1150.
World Health Organization. (2019, May 28). Burn-out an ‘occupational phenomenon’ – International Classification of Diseases.
