The World Health Organization (WHO) recently announced that starting in 2022, “burn-out” will be an official diagnosis. WHO is responsible for developing and maintaining the International Classification of Diseases, also known as ICD, and its 11th edition will debut at the beginning of 2022 with the new diagnosis.
Burn-out will fall under the category of “Factors influencing health status or contact with health services,” and, more specifically, “Problems associated with employment or unemployment.” Why does this matter? This matters because although most of us have long known about professional stress leading to burn-out, this is the leader in the field giving validity to this problem. Burn-out isn’t about being weak or lazy; it’s a legitimate and potentially serious health condition that needs to be taken seriously.
WHO identifies that burn-out “result[s] from chronic workplace stress that has not been successfully managed.” The term “successfully managed” is extremely subjective. Some people may have low levels of stress but have limited management ability or strategies, resulting in significant distress. Meanwhile, others may have high-stress jobs but are better able to cope, and therefore less likely to experience burn-out.
There are three components to burn-out, according to WHO. They are “feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and reduced professional efficacy.”
WHO specifies this applies only to occupation but not to other areas of a person’s life, such as school or home life. Anyone who has struggled though term papers and finals, or attempted to get kids to all of their activities while managing a household and dealing with a cold, knows that burn-out is hardly limited to work. It’s likely WHO specified burn-out as occupation-related because any changes to ICD must be approved by panels, and because it’s likely work is where most cases of burn-out occur. The diagnosis had the best chance of approval if it was exclusively work-related.
So, now that we have a diagnosis, we need to use it in some way going forward, and the best way to do so is to develop evidence-based treatment.
Although there are many books – professional and self-help – about stress management, self-care, and personal-professional life balance, most of these are simply techniques as opposed to a treatment protocol.
Because of the components of burn-out, it’s fair to assume that a treatment protocol would include aspects of cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT). From CBT, treatment might include identifying thinking errors and challenging assumptions, possibly via thought records. DBT includes a couple of components that could aid in avoiding burn-out, in particular distress tolerance. Mindfulness might also enhance a person’s ability to manage their stress.
Until an evidence-based treatment protocol is developed, people can improve their ability to manage stress in several ways. One is to identify what stress physiologically feels like. It might be tightness in the chest, or a headache, or neck stiffness. The next step is to recognize when these symptoms occur and what’s happening externally prior to those feelings. Once these are clear, steps to reduce internal distress can vary from person to person and might include some trial and error. For some, it might include taking a few minutes to process information before responding to an email. For others, asking others for assistance might lessen the work burden.
Last year, Kimble Applications, a U.K.-based software company, found that 47% of Americans didn’t take all of their vacation time in the previous year, with 21% having five or more unused days of vacation. Breaks are important. How we use this time obviously varies, as some people enjoy beach vacations, while others prefer family trips, and becoming more popular is the staycation.
Regardless of the specific steps taken, burn-out is real and needs to be addressed as such in order to maintain or enhance quality of life, both at work and outside of work.
This post was written by Stephanie Woodrow, LCPC, NCC