What burnout is and why it happens

In the wake of the pandemic, burnout has emerged as a formidable challenge for leaders to tackle. Its impact on well-being and productivity is undeniable. To effectively address this issue, it’s crucial to gain a deeper understanding. This article aims to provide you with a concise overview, preparing the ground for actionable strategies that we’ll delve into in upcoming pieces.

Recognising burnout

Burnout is a syndrome that arises in response to chronic stress (Maslach and Leiter, 2016). Over 30 years of research have identified that it has the three main dimensions:

1. Overwhelming exhaustion. Central to the burnout experience is a profound and pervasive sense of exhaustion. This goes beyond mere fatigue; it represents a persistent depletion of physical, emotional, and cognitive resources. Someone in this state finds even the most routine tasks to be arduous, leading to a decline in productivity and a marked reduction in overall well-being.
2. Feelings of cynicism and detachment from the job. Another hallmark of burnout is the emergence of cynicism and detachment towards one’s job. This manifests as a disengagement from tasks, colleagues, and organisational goals. Employees in this state may exhibit signs of withdrawal, expressing indifference or scepticism towards their work environment. This detachment not only hampers individual performance but also erodes organisational cohesion.
3. A sense of ineffectiveness and lack of accomplishment. A pervasive feeling of ineffectiveness, coupled with a sense of futility regarding one’s accomplishments, characterizes this dimension of burnout. Employees grappling with this aspect often perceive their efforts as fruitless or inconsequential. This diminished sense of achievement further compounds the emotional toll of burnout, exacerbating the cycle of disengagement.

Accelerated by the global pandemic, workplace well-being has become an even more pressing concern. Research conducted by McKinsey indicates an alarming surge in burnout rates, affecting a quarter of the 15,000 workers surveyed across 15 countries. Moreover, over half of the respondents reported contending with at least one mental-health challenge. Gallup’s findings further underscore the gravity of the situation, with 44% of employees reporting daily encounters with significant stress.

Mental health and well-being are already a top priority for an estimated four out of five organisations. Already, around 90% have already rolled out some form of wellness program, according to McKinsey. These programmes are mostly at the level of the individual. They aim to equip employees with tools to better navigate the rigors of their daily work lives. Think yoga sessions, meditation apps, wellness days, time management workshops — the whole gamut.

Yet, despite the earnest efforts being poured into well-intentioned initiatives, burnout remains an all-too-common phenomenon. The burning question, so to speak, is why? To understand the answers, we first need to understand the biology of burnout, why it occurs, and the typical paths that lead to it.

Despite the earnest efforts being poured into well-intentioned initiatives, burnout remains an all-too-common phenomenon.

The biology of burnout

Chronic stress has a profound impact on our bodies, triggering a complex cascade of physiological responses. Understanding this biological aspect of burnout is crucial, as it sheds light on why chronic stress can lead to exhaustion and burnout.

Burnout is a biological change

The recognition of a threat initiates the sympathetic nervous system, commonly known as the “fight or flight” response. This response prompts a rapid release of epinephrine, better known as adrenaline, preparing our bodies to react swiftly to the perceived danger.

If the threat persists, another key player enters the stage: cortisol. The hypothalamic–pituitary–adrenal (HPA) system releases a surge of cortisol, which orchestrates various physiological changes throughout the body. These changes span from changes in cardiovascular activity to immune function and even memory formation.

Crucially, once the threat dissipates, cortisol levels decrease, allowing these systems to return to their normal, balanced state.

However, the story takes a different turn when stress becomes chronic. The baseline functioning of the HPA (hypothalamic-pituitary-adrenal) system changes. This shift is often linked to feelings of exhaustion and, eventually, burnout (Melamed et al., 2006). In essence, when stress becomes a constant companion, our body’s natural mechanisms for coping and recovery can be overwhelmed.

Far-reaching biological consequences

The repercussions of burnout on our biology are far-reaching because cortisol regulates numerous bodily processes, from metabolism to immune function and even neurological activity (e.g. Kadmiel & Cidlowski, 2014; Melamed et al., 2006).

One noteworthy effect of cortisol is its ability to induce low-grade inflammation throughout the body. This mechanism contributes to the alarming statistic that burnout increases the risk of coronary heart disease by 79% (Toker, 2012) and all-cause mortality by 35% (Ahola et al., 2010). Additionally, burnout often leads to reduced sleep quality, compounding the issue by impairing the biological recovery processes that typically occur during the night.

The impact extends to the brain as well, setting off a downward spiral of neurological function (Khammissa et al., 2022). Burnout takes a toll on cognitive functioning, resulting in poorer memory, reduced concentration, and impaired attention. A growing body of research now indicates that burnout can lead to structural and volumetric changes in brain regions, alterations in neurochemical signalling, and disruptions in regulatory brain activity (e.g. Jovanovic et al., 2010; Sokka et al., 2016; Golonka et al., 2017). Chronic burnout appears to hinder the brain’s ability to regulate emotions, increasing the likelihood of maladaptive responses that worsen occupational stress.

The silver lining in this challenging narrative is that research suggests these detrimental changes may be reversible with sustained periods of recovery (Liston et al., 2009; Arnsten & Shanafelt, 2021). Nevertheless, prevention is always the better option.

The following figure, which I have adapted from Bayes et al. (2020), summarises these effects.

Why burnout occurs

Understanding why burnout occurs has been the focus of over 600 studies (Heinemann & Heinemann, 2017). Broadly, these investigations align with the Job Demands-Resources (JD-R) model, the most widely recognised framework for understanding work stress and burnout (Bakker et al., 2014).

Demands. Demands are characteristics of a situation that tend to increase physiological stress. They often require effort, deplete mental resources, trigger negative emotions, and heighten the likelihood of burnout.

Resources. Conversely, resources are characteristics of a situation or within ourselves that tend to decrease physiological stress. They empower us, providing a source of vitality to meet demands. They play a crucial role in diminishing the stress induced by demands by fostering positive emotions, motivation, and overall well-being (e.g. Fredrickson, 2001). Resources serve to lower the likelihood of burnout while amplifying feelings of enjoyment, motivation, and engagement in our work.

Stress arises when the demands placed on us surpass the resources we have at our disposal. As this gap widens, so does the level of stress we experience. When this stress lingers and becomes chronic, it places us at risk of experiencing burnout. Burnout occurs when demands outweigh resources for too long.

Burnout occurs when demands outweigh resources for too long.

Different types of demands and resources are like weights on each side of a seesaw. We can categorise them into four key areas:

• Task: The activities we’re tasked with and the skills or knowledge required to execute them effectively.
• Relational: Our interactions and relationships with other individuals, be it colleagues, friends, or family members.
• Psychological: Our beliefs and expectations, which can significantly influence our stress levels.
• Physiological: Physiological processes that have an impact on our stress response.

It’s crucial to recognize that our body’s physiology doesn’t differentiate between work and personal life. This means that stresses we encounter at home or a night of restless sleep can significantly impact the resources we bring to the workplace. To grapple with burnout effectively, we must take into account all the significant demands and resources in a person’s life, not just those confined to the office.

Task demands and resources

Workload and time pressures are two prominent culprits in the realm of job demands, and they are strongly and consistently related to burnout (Maslach et al., 2001). Additionally, the feeling of uncertainty about job responsibilities (role ambiguity) and the clash of competing demands (role conflict) can wield equal significance (Alacron, 2011).

When job resources are adequate, high demands can foster positive psychological states, often described as “flow” (Csikszentmihalyi, 2014). Technical skills and resources to do the job are obviously important. They can use their skills and abilities to perform at their best and effectively meet the challenges.

However, with insufficient resources, the same demands can become highly stressful. As stress mounts, individuals find it increase difficult to perform at their best as distress starts to take over.

Relational demands and resources

Another key source of demands arises from interactions with people on the job. According to McKinsey, the presence of ‘toxic workplace behaviour’ dramatically elevates the risk of burnout. Even without such behaviour, interpersonal conflicts due to differing values or personalities demand additional effort to navigate. As another example, workers in many occupations must suppress the expression of negative emotions or feign positive ones — which is known as “surface acting”. This act of emotional masking demands considerable mental effort.

On the flip side, high-quality relationships can serve as vital support resources. Research underscores the importance of social support as a significant job resource (Bakker & Demerouti, 2007). Considerate organisations, leaders, and colleagues provide practical resources and psychological support that can help staff deal with the demands of their jobs.

Psychological demands and resources

Our beliefs, expectations, and narratives have a profound influence on the interplay between demands and resources. We use these psychological lenses to interpret all of our experiences and interactions, so they play an enormous role in burnout.

Consider perfectionism, for instance. It can make tasks feel more demanding than they inherently are. Specifically, concerns about making mistakes, fearing negative evaluation, falling short, or engaging in self-criticism are closely linked to a significantly higher risk of burnout (Hill & Curran, 2015). These are called perfectionistic concerns. In the workplace, leaders play a pivotal role in influencing these concerns through the organisational culture they cultivate. By nurturing empathy, kindness, and consideration, leaders can foster psychological safety, effectively reducing concerns and the risk of burnout (e.g. Ahmed et al., 2022). Interestingly, perfectionistic concerns are distinct from perfectionistic strivings, which involve setting very high personal performance standards. Surprisingly, perfectionistic strivings are associated with a slightly lower risk of burnout (Hill & Curran, 2015).

Research in well-being science has uncovered a range of psychological resources that buffer against stress and enhance resilience. These include optimism, hope, and self-efficacy — belief in one’s capabilities. In the workplace, these resources are key ingredients of psychological capital, which helps to protect against burnout (e.g. Moyer et al., 2017; Khawda & Himnuan, 2021). Training, coaching, therapy, or exercises can develop these resources to reduce the risk of burnout.

Physiological demands and resources

Burnout is, at its core, a biological process influenced by several biological factors. Physical activity is one these. Engaging in regular physical activity not only contributes to our physical health but also correlates with a reduced risk of burnout (e.g. Taylor et al, 2022). Physical activity helps to balance the “rest-and-digest” system and the “fight-or-flight” stress system (Souza et al., 2021). This equilibrium results in greater heart rate variability, as these two systems send competing signals to the heart. Research shows that higher heart rate variability is associated with a decreased risk of burnout (e.g. Pihlaja et al, 2022).

Another pivotal biological factor is sleep. Poor sleep quality significantly elevates the risk of burnout (Stewart & Arora, 2019). Burnout, in turn, can perpetuate poor sleep quality, creating a challenging cycle (e.g. Membrive-Jiménez et al., 2022). That said, studies have highlighted that improving sleep quality is not only possible but also beneficial for mental health (Scott et al., 2021).

Nutrition is emerging as another avenue in the quest to combat burnout. Preliminary research indicates that better nutrition and healthier eating habits are associated with a reduction in burnout symptoms (Penttinen et al., 2021; Chui et al., 2019). The Mediterranean diet, in particular, has been linked with improved mental health (Esquivel, 2021). Conversely, lower-quality diets have been associated with mental disorders (Teasdale et al., 2019) and even ADHD (Shareghfarid et al., 2020). Nutrition plays a pivotal role in various biological processes, including inflammation, which can significantly impact stress, sleep, and overall well-being (Muscaritoli, 2021). Additionally, diet also shapes the diversity and composition of the gut microbiome, which recent research has linked with well-being (e.g. Lee et al., 2020; Safadi et al., 2022).

The paths to burnout

Life is dynamic, and the scales of demands and resources are in constant flux. The real question isn’t whether there will be times when demands outweigh resources — it’s what we do when that happens. The key to preventing burnout lies in our ability to spot this imbalance and take corrective action early enough. Failing on either front can set us on a course towards burnout.

Failure to notice imbalance

One common pitfall is the failure to notice gradual changes because we tend to adapt to them. As a result, the levels of demands and resources can shift subtly over months, eventually reaching a state of imbalance that leads to burnout. Often, the sudden crisis of burnout is the wake-up call, but recovery can be a prolonged journey. In this path, regular check-ins are crucial to identify and rectify imbalances early.

It is more likely for people to notice increases in demands. These changes often trigger negative emotions that catch our attention. However, declines in resources often slip under the radar. Since our time is limited, an uptick in demands can encroach on the time we allocate to activities that help us recover and reset from stress. By thinking only of increased demands and neglecting the drop in resources, the actual imbalance can be far greater than individuals estimate.

Failure to correct imbalance

In some cases, people are well aware of the imbalance but it goes uncorrected. Driven individuals may willingly endure it, assuming it will be short-lived and that they can “handle it.” They expect a period of discomfort and stress but believe their resources are sufficient to counterbalance the demands. However, these individuals risk burnout when their expectations and beliefs prove overly optimistic. The imbalance may persist longer than anticipated, or they might discover that their physiology cannot cope with the strain.

In many instances, people are acutely aware of the imbalance and are eager to correct it, but they cannot identify an acceptable means to change their situation. For example, healthcare workers during the pandemic displayed unwavering dedication to their community despite experiencing exceptionally high levels of burnout. In other professions, individuals could feel trapped in stressful jobs due to a lack of viable alternative work options.

What can leaders do?

As leaders, our pivotal role in preventing burnout begins by ensuring imbalances are noticed and rectified quickly. Building high-quality connections with our team members serves as the foundation for understanding their levels of demand and resources. Invest in nurturing a trusting and safe environment where team members can authentically and honestly express themselves. Team members must feel that voicing concerns about the balance between their demands and resources carries no social or financial repercussions.

Additionally, leaders can champion the values of awareness, honesty, and open communication when it comes to addressing stress. Recognising and celebrating instances of these values in action can outweigh any potential reputational risks associated with expressing concerns. These values must be matched by genuine care and unwavering support for the well-being of individual team members. When staff know that their well-being is a top priority, they are more likely to speak up if they find themselves grappling with excessive stress.

In upcoming articles, I plan to delve deeper into some underlying drivers of demands and resources. We’ll also explore some specific strategies and actions leaders can take to help prevent burnout.