Author of the article: Maria Barnikova (psychiatrist)

Burnout syndrome

20.11.2015

Maria Barnikova

Burnout syndrome is a term used to describe the process of increasing physical, mental, and moral exhaustion of an individual.

Burnout syndrome- a term used in psychology since 1974 to designate the process of increasing physical, mental, and moral exhaustion of the individual. As the severity of the disorder increases, global changes occur in the sphere of interpersonal communications, up to the formation of persistent cognitive defects.

Among the explanations proposed by psychologists for the essence of burnout syndrome, according to many scientists, the most reliable is the three-factor model created by K. Maslach and S. Jackson. In their view, burnout syndrome is a multidimensional construct with three components:

• mental and physical exhaustion;
• self-perception disorder ();
• a change towards simplification of individual achievements (reduction).

The main component of burnout syndrome is the depletion of personal resources in the physical, psychological and cognitive aspects. The main manifestations of the development of the pathological process: reduced mental reactions, indifference, indifference, mental apathy.

The second element – ​​depersonalization has a huge impact on the deterioration of the quality of an individual’s relationships in society. A disorder of self-perception can manifest itself in two ways: either by increasing dependence on other people, or by the conscious manifestation of an extremely negative attitude towards a certain group of others, cynical demands on them, shameless statements, shameless thoughts.

The third link involves a change in a person’s personal assessment: excessive criticism of oneself, a deliberate downplaying of professional skills, a deliberate limitation of real-life prospects for career growth.

Manifestations of burnout syndrome

It is worth noting that burnout syndrome is not a static, but a dynamic process that develops over time and has certain phases (stages). In its development, this disorder of the senses demonstrates three main groups of body reactions to influence:

• physiological symptoms;
• affective-cognitive effects (psycho-emotional signs);
• behavioral reactions.

Signs of burnout syndrome do not all appear at the same time: the disorder is characterized by a long latent period. Over time, manifestations increase in intensity, leading without the necessary corrective and therapeutic measures to a significant deterioration in the individual’s quality of life in various areas. The result of neglected conditions can be neurotic disorders and psychosomatic pathologies.

Among the somatic and vegetative manifestations of emotional burnout syndrome:

• fatigue;
• fatigue after a full rest;
• muscle weakness;
• frequent attacks of tension headaches;
• deterioration of the functions of the immune system and, as a result, frequent viral and infectious diseases;
• joint pain;
• profuse sweating, internal trembling;
• persistent sleep problems;
• frequent dizziness.

Common affective-cognitive effects of burnout syndrome include:

• depletion of motivation;
• “mental” apathy;
• feelings of loneliness and worthlessness;
• depersonalization;
• decomposition of the moral sphere:
• denial of moral standards;
• intolerance and blaming others;
• indifference to current events;
• lack of interest in changing the way of life;
• denial of one's capabilities and disbelief in potential;
• collapse of ideals;
• self-accusation, self-criticism and depiction of one’s qualities in gloomy tones;
• irritability, short temper, nervousness, fussiness;
• constant sad mood;
• frequent complaints about “insurmountable” difficulties;
• expressing exclusively negative forecasts.

The most common behavioral reactions in burnout syndrome are:

• complete or partial maladjustment – ​​loss of skills to adapt to the demands of society;
• distancing from the performance of official duties;
• avoiding responsibility for one's actions;
• low labor productivity;
• limitation of social contacts, desire for loneliness;
• active expression in one’s actions of hostility, anger, and envy of colleagues;
• attempts to “escape” from reality by taking drugs or alcohol, the desire to “cheer up” with abundant gluttony.

Burnout syndrome is very similar in clinical symptoms to depressive disorder. However, unlike depression, in most cases it is possible to accurately determine the cause of the disorder, predict the course of the disorder and return the person to normal life much faster.

Risk group and provoking factors

Individuals with certain character traits are more susceptible to burnout syndrome, such as:

• tendency to perceive the environment in extremes: either black or white;
• excessive adherence to principles;
• the desire to hone all actions to perfection;
• impeccable performance;
• high level of self-control;
• hyper-responsibility;
• tendency to self-sacrifice;
• daydreaming, romanticism, leading to the individual’s presence in a world of illusions;
• presence of fanatical ideas;
• low self-esteem.

People predisposed to burnout syndrome: overly sympathetic, soft-hearted, prone to intense experience of events. It is also worth noting that individuals with a lack of autonomy are susceptible to the disorder, especially those who grew up under excessive parental control.

A special risk group consists of “dependent” people who are accustomed to stimulating themselves with energy drinks, alcohol, or pharmacological drugs that increase the activity of the central nervous system. Such prolonged unnatural stimulation of the body, in addition to persistent addiction, leads to depletion of the resources of the nervous system and rewards a person with various malfunctions, including emotional burnout syndrome.

Burnout syndrome is most often recorded in individuals whose activities are associated with a large social circle. At risk: middle managers, social service workers, medical staff, teachers, representatives of the service industry.

Housewives who perform monotonous activities every day, do not have exciting hobbies, or experience a lack of communication are not immune from burnout syndrome. This disorder is especially difficult for those women who are convinced of the futility of their work.

Those who are forced to communicate with psychologically difficult people are susceptible to burnout syndrome. This group is represented by: professionals working with seriously ill patients, psychologists at crisis centers, correctional officers, sales workers dealing with conflicting clients. The same unpleasant symptoms can occur in a person who is valiantly caring for a relative with an incurable illness. Although in such a situation the person understands that caring for the patient is his duty, over time he is overcome by a feeling of hopelessness and indignation.

Burnout syndrome can occur in a person who is forced to work outside of his calling., however, he cannot refuse the disgusting work due to a number of objective reasons.

Quite often, emotional burnout syndrome is recorded in people of creative professions: writers, artists, actors. The reasons for the decline in activity, as a rule, lie in the lack of recognition of their talent by society, in negative criticism of their works, which leads to a decrease in self-esteem.

It has been established that the formation of emotional burnout syndrome is facilitated by the lack of coordination of actions in the team and the presence of fierce competition. An unfavorable psychological climate and poor organization of work in a team can also lead to frustration: unclear planning of employee functions, unclear formation of goals, poor material resources, bureaucratic obstacles. The lack of appropriate material and moral rewards for the work done contributes to the formation of emotional burnout syndrome.

Treatment of burnout syndrome

Unfortunately, burnout syndrome is a condition that is not given due attention and is not treated in a timely manner. The main mistake: a person prefers to “strain” his strength and perform suspended work, rather than restore strength after overwork and overcome the mental “storm”.

To prevent further intensification of burnout syndrome, psychologists advise starting treatment by looking “fear in the eye”: recognizing the fact of the disorder. You need to promise yourself that soon a new powerful incentive for action will definitely appear, a fresh source of inspiration will arise.

Good habit: give up in time the endless pursuit of often absolutely useless things, which leads to complete physical and mental exhaustion.

Treating burnout involves an important but simple step: slowing down. Allow yourself to do half as much work today as you try to do every day. Give yourself a ten-minute rest break every hour. Take time to slowly contemplate the wonderful results you have achieved.

Treatment of burnout syndrome is impossible without changing your low self-esteem. Be sure to note your positive character traits, praise even for tiny feats, thank you for your hard work and diligence. Make it a rule: be sure to reward yourself for achieving small results on the path to enormous success.

Sometimes treatment for burnout syndrome should be radical: quit your hated organization and get a job in a new, albeit less “heated” place. A good way to overcome burnout syndrome: acquire new knowledge, for example: by enrolling in a foreign language course, studying the intricacies of complex computer programs or discovering your vocal potential. Try yourself in new guises, discover your hidden talents, do not be afraid to experiment in previously unknown areas.

Treatment with “green pharmacy” products includes long-term use of natural stimulants: tinctures of ginseng, eleutherococcus, and lemongrass. In the evening hours, to get rid of insomnia, you should give preference to sedatives: a decoction of motherwort, mint, lemon balm, valerian.

Psychotherapeutic treatment becomes an excellent alternative to drug therapy in difficult situations with burnout syndrome. Communication with a specialist in a comfortable environment will help you determine the cause of the deterioration of your condition, develop the right motivation and protect yourself from prolonged depression.

When emotional burnout syndrome takes a life-threatening turn, pharmacological treatment will help cope with the disorder, the regimen of which is selected individually, taking into account the characteristics of the disease and clinical symptoms.

Preventive measures

Prevention of burnout syndrome involves carrying out activities aimed at improving health, resolving difficult situations and preventing nervous breakdowns. A few rules:

• A balanced, nutritious diet with minimal fat, but an abundance of vitamins, minerals, and proteins.
• Regular physical activity.
• Daily exposure to fresh air and communication with nature.
• Get enough sleep at night.
• The golden rule: work exclusively during working hours, unfinishing the “tails” at home.
• Mandatory day off with a radical change in activity.
• Minimum two weeks vacation once a year.
• Daily “cleansing” of thoughts through meditation and auto-training.
• Clearly setting and maintaining priorities in business.
• High-quality varied leisure time in your free time: attending entertainment events, friendly meetings, traveling, hobbies.

Article evaluation.

The well-known expression “burned out at work” is not a fiction, but a very real phenomenon, which in psychology is called emotional burnout (mental burnout syndrome, combustion, professional burnout). This is an independent condition (not a symptom of some disorder), characterized by chronic fatigue, indifference to work, oneself and other people, a feeling of emptiness that arose against the background of the persistent stressful influence of work.

The first studies and notes on a decrease in psychological stability and performance, refusal to perform actions in demanding situations caused by prolonged exposure to stress, belong to the American psychologist Richard Lazarus and the Canadian doctor Hans Selye.

The terms “burnout” and “mental burnout” were introduced by the American psychiatrist Herbert Freudenberger in 1974. Then the author thus characterized all employees experiencing chronic stress, provoked by abundant and highly emotional communication with clients, or in areas with increased emotional stress and responsibility.

At the same time, only doctors and social workers were classified as such professions, but soon this list became much wider:

• policemen,
• prison guards,
• security guards,
• military,
• doctors,
• social workers,
• politicians,
• lawyers,
• managers,
• sellers.

Thus, emotional burnout refers to the depletion of physical, psychological (emotional) and intellectual strength. And in modern thinking, the risk group includes all professions where you have daily contact with many other people:

• teachers of all spheres and levels of education;
• doctors and medical staff;
• psychologists and psychiatrists;
• social workers;
• veterinarians;
• employees of law enforcement agencies and the penitentiary system;
• trainers;
• judges;
• employees of the Ministry of Emergency Situations;
• security guards;
• customs officers;
• managers and agents;
• athletes;
• operators;
• drivers;
• pharmacists;
• artists;
• other professions of the “person-to-person” type.

The structure of emotional burnout

Emotional burnout includes 3 components: emotional exhaustion, cynicism and simplification of achievements (personal and professional). Let's look at each element in more detail.

Emotional exhaustion

This feeling:

• eternal fatigue;
• dissatisfaction;
• emptiness in relation to work and, as a rule, other areas of life.

If work takes up the bulk of an adult’s time, then it is logical that it is the fundamental basis of a person’s relationship to the whole world. If , then it disappears in other areas as well. Over time, complete apathy and, of course, cynicism develop.

Cynicism

Depersonalization, or a cynical attitude towards everything that happens, is another characteristic element of emotional burnout. If we say that burnout is more common in social professions, then in this context cynicism implies:

• immoral, inhumane, indifferent attitude towards clients;
• transfer of relations from subject-subject to subject-object.

Suffice it to recall the angry women sitting in the windows of public service institutions, doctors who always have no time and “they gave a prescription, what else is needed.” All these are signs of emotional burnout and, one might say, hatred of work.

Reduction of achievements

Reduction – simplification (from complex to simple). But this is not so much about a decrease in productivity, but about personal and professional depreciation. The specialist does not feel his competence, but feels failure in the professional field. This reduces self-esteem.

Modern consideration of the problem

Although it is still customary to primarily consider burnout in the social sphere, science has proven that this can happen in any profession, although “person-to-person” work remains the main risk group.

In modern thinking, emotional burnout is interpreted as a professional crisis in any work activity. It is connected with the person himself, and not with interpersonal relationships within the framework of work.

Then the components of the burnout structure change:

• exhaustion remains the same, but the risk is greater;
• cynicism extends to the attitude towards the activity itself, its product (quality suffers);
• reduction is replaced by professional efficiency (the performance of work is simplified).

Signs of burnout

Professional mental burnout makes itself felt through:

• increasing negative attitudes of a person towards work, himself and colleagues (clients);
• decreased self-esteem (personal and professional);
• feelings of inadequacy;
• loss of valuables;
• formalities in relations with clients and colleagues;
• cruelty towards clients (colleagues), which first manifests itself in internal irritation, hostility, hidden, but gradually comes out through immoral acts and open aggression.

The leading symptom is a feeling of exhaustion, which first makes itself felt by fatigue, deterioration of health (frequent illnesses or fever are possible), but gradually exhaustion causes worry and tension throughout the body and makes itself felt in several directions:

• somatics (weakness, decreased immunity, sleep disturbances, stool disorders, headaches, other individual reactions);
• psyche (irritability and apathy, loss of desires, interests and inability to rejoice);
• the highest level, or noetic (devaluation of oneself and the world, withdrawal from communication, work, reality).

The long-term influence of these emotions causes a general depressed emotional background. Then he begins to dictate the rules of life (perception of the world and himself). A person is overtaken by an existential (mental) crisis and emptiness (frustration). The feeling of meaninglessness grows like a weed: it creeps from work to everyday life, leisure, family, and personal life.

As a result, if the condition is not corrected, the person will be lost and thrown overboard of life. It will exist, complexes, syndromes and grow. They often join. In order not to bring the situation to such a peak, it is important to identify combustion syndrome in time and begin to correct it and further prevent it.

Joseph Greenberg developed a theory of burnout progression based on symptom severity. There are 5 stages in total:

1. "Honeymoon". No matter how stressful the job, a person is driven by enthusiasm. But the longer a person works under such conditions, the lower his energy reserve becomes. Gradually interest and passion disappear.
2. "Lack of fuel." The first signs of exhaustion appear: apathy, fatigue, sleep disturbances. If there are no additional incentives and motives, then a person will very soon completely lose interest in work. Efficiency and productivity decrease, violations of discipline or failure to fulfill duties are noted. If there are additional incentives, then the person will continue to work with the same productivity, but internally this will affect his well-being and health.
3. "Chronic symptoms." Irritability, anger, depression, fatigue, pain are the consequences of workaholism and stressful work. Often a person at this stage feels as if he is “in a cage” and suffers from a lack of time and energy.
4. "Crisis". Dissatisfaction with oneself and life intensifies (as do other symptoms), health noticeably weakens, and diseases arise that limit performance.
5. "Breaking through the wall." In the life of a burnt person, many problems accumulate in various areas, and life-threatening diseases often arise. If a person consciously cannot leave a job that is killing him, then the subconscious will make it so that he cannot physically work there.

T. I. Ronginskaya, who devoted a lot of research to the issue of burnout, identified 6 phases of symptom development:

1. Feeling tired and insomnia, preceded by excessive activity and a feeling of being indispensable at work.
2. Reduced personal involvement in relationships with colleagues and clients with increased demands on others.
3. The emergence of signs of depression or aggression.
4. Destructive and noticeable changes (decreased concentration and rigidity of thinking, weakness of imagination), motivation (lack of initiative), (avoidance and passivity).
5. Any and addictions (dependence).
6. Despair and disappointment in life, a feeling of helplessness.

Psychologist Viktor Boyko considered symptoms in 3 stages: tension, resistance, exhaustion.

1. At the stage of nervous tension, there is anxiety, dissatisfaction with oneself, a feeling of being “caged,” anxiety and depression.
2. At the stage of resistance, there is an inadequate selective emotional response (perceived from the outside as disrespect), emotional and moral confusion, expansion of the zone of emotional economy (a person is restrained in emotions not only at work, but also at home), reduction (avoidance of responsibilities that require high emotional dedication) .
3. Exhaustion is manifested by a feeling of emotional deficiency (a person himself does not feel able to empathize, to enter into someone else’s position), complete emotional indifference (neither positive nor negative events affect him), weakened mental and physical health, psychosomatics and depersonalization.

Turning into a “robot” is the most dangerous and striking symptom of burnout, and it is also a sign of professional personality deformations. And this is not even a violation, but taken to the point of absurdity.

Types of burnout

There are 4 types of burnout according to their structure: one-factor, two-factor, three-factor, four-factor.

Single factor burnout

The main factor is exhaustion (emotional, cognitive, physical). The remaining components (depersonalization and reduction) are a consequence. All professions are susceptible to this type of burnout, not just social ones.

Two-factor burnout

The influence is exerted by exhaustion (affective factor) and depersonalization (attitude factor). This type is more typical of social professions, but not necessarily (if depersonalization occurs in relation to the person himself, and not others).

Three-factor burnout

All three factors have an influence (exhaustion, depersonalization, devaluation). Exhaustion is manifested by a reduced emotional background, oversaturation of contacts or indifference. Depersonalization can manifest itself in two ways: dependency in relationships or negativism and cynicism. Devaluation affects either professional self-esteem or personal self-esteem. This type of burnout is typical of social professions.

Four-factor burnout

With this type, any factor (exhaustion, depersonalization, reduction) is divided into two more. For example, there is an immediate devaluation of the subject of labor and clients.

Afterword

Mental burnout is a long process, at the beginning of which a person strives to “squeeze all the juices out of himself” and find new resources. But in fact, irritation, dissatisfaction, anxiety, frustration, depression only increase, and then exhaustion, depersonalization and reduction come.

Interestingly, not only personality traits influence the development of burnout, but burnout also causes changes in personality. Due to the adaptive, but different from social norms, behavior of a burnt-out person, professional deformations arise. This is a variant of self-justification of the individual, resolution of the existing contradiction. Professional deformations are the result of restructuring and the appearance of neoplasms.

Read more about deformations in the article. And about the causes of emotional burnout in the article.

professional emotional social combustion

Emotional burnout syndrome (EFS) is caused by disorders and difficulties that arise in the human body during his professional activities. This is the body's response to a situation that causes constant, prolonged stress.

SES is characterized as a state of mental fatigue and disappointment and most often occurs in people in the so-called helping professions. This condition is accompanied by emotional exhaustion, depersonalization, and decreased performance.

The symptoms accompanying emotional burnout syndrome can be divided into three groups: those associated with the physical condition of a person, those associated with his social relationships, and the person’s intrapersonal experiences.

Symptoms associated with a physical condition indicate that certain processes are occurring in the human body that can cause a deterioration in health. These symptoms include:

Increased fatigue, apathy;

Physical malaise, frequent colds, nausea, headache;

Heart pain, high or low blood pressure;

Abdominal pain, loss of appetite and diet;

Attacks of suffocation, asthmatic symptoms;

Increased sweating;

Tingling behind the sternum, muscle pain;

Sleep disorders, insomnia.

Symptoms associated with social relationships appear when a person has contact with others: colleagues, clients, loved ones and relatives. These include:

The appearance of anxiety in situations where it did not arise before;

Irritability and aggressiveness in communicating with others; a cynical attitude towards clients, towards the ideas of the common cause, towards one’s work;

Reluctance to work, shifting responsibility;

Lack of contact with clients and/or unwillingness to improve the quality of work;

Formalism in work, stereotypical behavior, resistance to change, active rejection of any creativity;

Food aversion or overeating;

Abuse of mind-altering chemicals (alcohol, smoking, pills, etc.);

Involvement in gambling (casinos, slot machines).

Intrapersonal symptoms relate to processes occurring within a person and caused by changes in his attitude towards himself, his actions, thoughts and feelings. These include:

Increased feelings of self-pity;

Feeling of one’s own lack of demand;

Guilt;

Anxiety, fear, feeling trapped;

Low self-esteem;

A feeling of one’s own oppression and the meaninglessness of everything that happens, pessimism;

Destructive self-examination, replaying in the head situations associated with strong negative emotions;

Mental exhaustion;

Doubt about work efficiency.

Each person experiences combustion syndrome with varying degrees of symptom severity. The initial assumption that the most vulnerable to burnout syndrome are people who have worked for many years in helping professions is not always true; as it turned out, over time, many of them adapt to the profession and develop their own ways of preventing burnout syndrome. Much more cases of SES occur among young professionals.

The most common model of professional burnout syndrome is the three-component model, according to which professional burnout syndrome includes three components: emotional exhaustion, depersonalization and reduction of personal achievements.

The development of emotional burnout syndrome is preceded by a period of increased activity, when a person is completely absorbed in work, to the detriment of his needs in other areas of life. This leads to the development of the first sign of burnout syndrome-emotional exhaustion. Emotional exhaustion is expressed in the appearance of emotional emptiness and a feeling of fatigue caused by work. The feeling of fatigue does not go away after a night's sleep. After a period of rest (weekends, vacations), it becomes smaller, but upon returning to the usual work situation it resumes with the same force. Emotional overload and the inability to replenish energy lead to an attempt at self-preservation through detachment and alienation. A person is no longer able to do his work with the same energy. The work is carried out mainly formally. Emotional exhaustion is a major symptom of professional burnout.

In the social sphere, depersonalization involves an insensitive, inhumane and cynical attitude towards a client seeking treatment, consultation, educational and other services. The client is perceived as an impersonal object. The consultant may have the illusion that all the client’s problems and troubles are given to him for his good. A negative attitude manifests itself in expecting the worst, unwillingness to communicate, and ignoring the client. Among his colleagues, the “burning out” specialist talks about him with hostility and disdain. At first, he can still partially restrain his feelings, but gradually it becomes more and more difficult for him to do this, and in the end they begin to literally spill out. The victim of a negative attitude is an innocent person who turned to a professional for help and hoped, first of all, for a humane attitude.

The reduction or belittlement of personal achievements is accompanied by a decrease in the consultant’s self-esteem. The main manifestations of this symptom are:

Tendency to negatively evaluate oneself, one's professional achievements and successes;

Negativity towards job responsibilities, decreased professional motivation, shifting responsibility to others.

The consultant loses vision of the prospects of his professional activity, receives less satisfaction from work, loses faith in his own professional capabilities, and as a result he develops a feeling of incompetence and doomed to failure.

In this case, we can already talk about the complete combustion of the specialist. The man still retains a certain aplomb and outward respectability, but if you look closely, his “empty gaze” and “cold heart” will become obvious: as if the whole world has become indifferent to him.

Paradoxically, combustion syndrome is a protective mechanism of our body, since it forces us to dose and use energy resources sparingly. At the same time, this statement turns out to be true only in the case when we are talking about the very beginning of the formation of this state. In later stages, “burnout” negatively affects the performance of professional duties and relationships with others. The “burning” person may not be aware of the reasons for the processes occurring in him. To protect himself, he stops perceiving his own feelings related to work. Formalism, harsh intonations and cold looks, to which we are almost accustomed in clinics, schools, and other administrative organizations, in most cases are manifestations of emotional burnout syndrome.

There are two main groups of reasons that play a key role in the formation and development of professional burnout syndrome: internal and external reasons.

Reasons of an internal nature are related to the individual characteristics of a person: age, high expectations, self-criticism, dedication, readiness for hard work, the need to prove one’s worth.

Reasons of an external nature are related to the characteristics of professional activity: a “difficult” contingent, emotionally intense work, difficult working conditions, increased demands from management, an unfavorable psychological atmosphere in the team.

Professional activity undergoes significant changes in particularly unfavorable and extreme working conditions. Social workers, who by the nature of their work are involved in long-term intense communication with other people, are prone, like other specialists in the “person-to-person” system, to have an occupational disease called “emotional burnout” syndrome. This is due to the fact that in his work, a social worker, in addition to professional knowledge, abilities and skills, largely uses his personality, being a kind of “emotional donor”, ​​which also refers to professional risk factors.

The term “emotional burnout” was introduced by one of the American psychiatrists in 1974 to characterize the psychological state of healthy people who are in intense and close communication with clients and patients in an emotionally charged atmosphere when providing professional assistance. At first, this term denoted a state of exhaustion, exhaustion, associated with a feeling of one’s own uselessness. The essence of this disease has been studied by many scientists.

Burnout syndrome

Pavel Sidorov

Doctor's note

Emotional burnout syndrome (EBS) is a reaction of the body that occurs as a result of prolonged exposure to moderate-intensity professional stress. The WHO European Conference (2005) noted that work-related stress is an important problem for approximately one third of workers in the European Union and the cost of addressing mental health problems in this regard amounts to an average of 3-4% of gross national income .

SEW is a process of gradual loss of emotional, cognitive and physical energy, manifested in symptoms of emotional, mental exhaustion, physical fatigue, personal withdrawal and decreased job satisfaction. In the literature, the term “mental burnout syndrome” is used as a synonym for emotional burnout syndrome.

SEV is a psychological defense mechanism developed by an individual in the form of complete or partial exclusion of emotions in response to selected psychotraumatic influences. This is an acquired stereotype of emotional, most often professional, behavior. “Burnout” is partly a functional stereotype, since it allows you to dose and use energy resources sparingly. At the same time, its dysfunctional consequences may arise when “burnout” negatively affects the performance of professional activities and relationships with partners. Sometimes CMEA (in foreign literature - "burnout") is designated by the concept of "professional burnout", which allows us to consider this phenomenon in the aspect of personal deformation under the influence of professional stress.

The first works on this problem appeared in the USA. American psychiatrist H. Frendenberger in 1974 described the phenomenon and gave it the name “burnout” to characterize the psychological state of healthy people who are in intensive and close communication with patients (clients) in an emotionally charged atmosphere when providing professional assistance. Social psychologist K. Maslac (1976) defined this condition as a syndrome of physical and emotional exhaustion, including the development of negative self-esteem, negative attitudes towards work, loss of understanding and empathy towards clients or patients. Initially, SEW meant a state of exhaustion with a feeling of one’s own uselessness. Later, the symptoms of this syndrome expanded significantly due to the psychosomatic component. Researchers increasingly associated the syndrome with psychosomatic well-being, classifying it as a pre-disease condition. In the International Classification of Diseases (ICD-X), CMEA is classified under the heading Z73 - “Stress associated with difficulties in maintaining a normal lifestyle.”

Prevalence of burnout syndrome

Among the professions in which CMEA occurs most often (from 30 to 90% of workers), we should note doctors, teachers, psychologists, social workers, rescuers, and law enforcement officers. Almost 80% of psychiatrists, psychotherapists, psychiatrists and narcologists have signs of burnout syndrome of varying degrees of severity; 7.8% - a pronounced syndrome leading to psychosomatic and psychovegetative disorders. According to other data, among psychologists-consultants and psychotherapists, signs of SEV of varying severity are detected in 73% of cases; in 5%, a pronounced phase of exhaustion is determined, which is manifested by emotional exhaustion, psychosomatic and psychovegetative disorders.

Among nurses in psychiatric departments, signs of SEV were found in 62.9% of respondents. The resistance phase dominates the picture of the syndrome in 55.9%; a pronounced phase of “exhaustion” is determined in 8.8% of respondents aged 51-60 years and with more than 10 years of experience in psychiatry.

85% of social workers have some symptoms of burnout. The existing syndrome is observed in 19% of respondents, in the formative phase - in 66%.

According to English researchers, among general practitioners a high level of anxiety is found in 41% of cases, clinically significant depression in 26% of cases. A third of doctors use medications to correct emotional stress; the amount of alcohol consumed exceeds the average level. In a study conducted in our country, 26% of therapists had high levels of anxiety, and 37% had subclinical depression. Signs of SEV are detected in 61.8% of dentists, with 8.1% having the syndrome in the “exhaustion” phase.

SEV is found in a third of employees of the penitentiary system who directly communicate with convicts, and in a third of law enforcement officers.

Etiology

The main cause of SEV is considered to be psychological, mental fatigue. When demands (internal and external) prevail over resources (internal and external) for a long time, a person’s state of balance is disturbed, which inevitably leads to SEW.

A connection has been established between the identified changes and the nature of professional activities associated with responsibility for the fate, health, and lives of people. These changes are regarded as a result of exposure to prolonged occupational stress. Among the professional stressors that contribute to the development of SEW, the obligatory nature of work in a strictly established daily routine and the great emotional intensity of acts of interaction are noted. For a number of specialists, the stressfulness of interaction is due to the fact that communication lasts for hours, is repeated for many years, and the recipients are patients with a difficult fate, disadvantaged children and adolescents, criminals and victims of disasters, who talk about their secrets, suffering, fears, and hatred.

Stress in the workplace - the discrepancy between the individual and the demands placed on him - is a key component of CMEA. The main organizational factors that contribute to burnout include: high workload; absence or lack of social support from colleagues and management; insufficient remuneration for work; high degree of uncertainty in assessing the work performed; inability to influence decision making; ambiguous, ambiguous job requirements; constant risk of penalties; monotonous, monotonous and unpromising activity; the need to outwardly show emotions that do not correspond to reality; lack of days off, vacations and interests outside of work.

Occupational risk factors include “helping”, altruistic professions (doctors, nurses, teachers, social workers, psychologists, clergy). Working with seriously ill patients (gerontological, oncological patients, aggressive and suicidal patients, patients with addictions.) is highly predisposing to burnout. Recently, burnout syndrome has also been identified among specialists for whom contact with people is not typical (programmers).

The development of CMEA is facilitated by personal characteristics: a high level of emotional lability; high self-control, especially with volitional suppression of negative emotions; rationalization of the motives of one’s behavior; tendency to increased anxiety and depressive reactions associated with the unattainability of the “internal standard” and blocking negative experiences; rigid personality structure.

A person’s personality is a fairly holistic and stable structure, and it tends to look for ways to protect itself from deformation. One of the ways of such psychological protection is emotional burnout syndrome. The main reason for the development of CMEA is the discrepancy between personality and work, between the increased requirements of the manager for the employee and the real capabilities of the latter. Often, SEV is caused by a discrepancy between the desire of workers to have a greater degree of independence in work, to look for ways and means to achieve the results for which they are responsible, and the rigid, irrational policy of the administration in organizing work activity and monitoring it. The result of such control is the emergence of feelings of futility of one’s activities and a lack of responsibility.

The lack of proper remuneration for work is experienced by the employee as lack of recognition of his work, which can also lead to emotional apathy, decreased emotional involvement in the affairs of the team, a feeling of unfair treatment and, accordingly, burnout.

Burnout syndrome is a special condition of a person in which he regularly feels depressed and tired. The patient is exhausted morally and physically, does not want to engage in any work, and is unable to perform his professional duties efficiently. For such a person, the working day seems like real torture, and even favorite activities cease to bring joy.

As a rule, people with the syndrome do not immediately understand what is happening to them. At first, the disease resembles seasonal blues. Patients become suspicious, hot-tempered and touchy. They give up at any slightest defeat. Ultimately, the disease can lead to emotional breakdown and severe depression. General health also worsens: insomnia, anxiety, causeless feelings of guilt and irritability appear.

The pathology can affect anyone, but most often it occurs in workers whose professions involve daily interaction with other people. These include doctors, teachers, psychologists, and consultants.

Burnout syndrome develops due to the fact that helping others begins to exceed one’s own needs and interests. This is also facilitated by increased activity in the workplace, regular overwork, conflicts with colleagues and superiors.

Pathogenesis

Many scientists believe that the syndrome appears due to problems that have recently arisen in professional activities. Regular conflicts, negativity from other people and their inappropriate behavior can undermine even the most stable psyche.

Statistics show that the disease mainly affects those whose professions involve daily contact with other people, namely:

• Teachers and educators;
• Medical workers, social service employees;
• Bank and service sector employees, operators.

Scientists have identified several stages of increasing emotional stress, which are associated with the professions of patients:

1. A person is completely satisfied with his work, but minor conflicts and stress gradually begin to darken his life.
2. The first signs of pathology appear: irritability, chronic fatigue, insomnia, loss of appetite.
3. It becomes difficult for the patient to concentrate on his direct responsibilities, as well as to perform them efficiently. He stops having time to do everything that was planned, so he often stays at his workplace until the night.
4. Lack of sleep and fatigue significantly harm your health. The patient's immunity decreases, which leads to the development of various diseases and exacerbations of chronic diseases. At the same time, people with burnout syndrome cease to be satisfied with themselves and the colleagues around them.
5. Apathy, irritability and short temper, mood swings and exacerbation of many pathologies are the main signs of stage 5 of the syndrome. The condition requires immediate help from a specialist, as the risk of developing deep depression rapidly increases.

Causes of pathology

Mental burnout syndrome in most cases develops precisely because of regular stressful situations in the workplace. But there are other factors that influence the emotional state of the patient:

• Intense rhythm of life;
• The so-called “Groundhog Day”;
• Regular criticism from your boss or colleagues;
• Insufficient incentives for work;
• Feeling of uselessness.

The risk of pathology increases in people with the following character traits:

1. Maximalists who always try to do their job perfectly;
2. Overly responsible and obligatory;
3. Dreamers whose self-esteem is often inadequate.

The syndrome often worries patients who suffer from alcohol or drug addiction, as well as people who smoke. With such bad habits they try to get rid of stress, thereby increasing their performance. But in fact, such methods of solving problems in professional activities only harm a person. His body is depleted, new diseases appear.

The disease does not always occur only in working citizens. The disease can even affect a housewife, especially if her work goes unnoticed and unappreciated. People caring for a sick relative experience similar feelings. Over time, a whole lump of hopelessness and injustice accumulates inside them.

People of creative professions are also susceptible to pathology: artists, writers and actors. Often the syndrome arises as a result of one’s own insecurity, especially if one’s talent is not recognized.

Essence and types of syndrome

Pathology usually occurs as a result of accumulated negative emotions that are associated with a person’s profession. The main reason for the development of the syndrome is the need to help other people. As a result, for example, doctors, psychologists and teachers simply do not have enough time to take care of themselves. They perceive every negative event and failure in the life of their ward as their own defeats. Ultimately, frequent stressful situations lead to the appearance of the disorder.

The pathology is considered dangerous because over time it causes real depression in the patient. A person feels like an outcast, he cannot realize himself due to enormous self-doubt, he loses his job and people close to him, and all prospects for the future completely disappear. As a result, the patient loses interest in life and may have thoughts of suicide.

Burnout syndrome in medical workers

Since the work of medical employees involves regular communication with patients, the syndrome of professional emotional burnout threatens them to a greater extent than people of other professions. That is why it is important for specialists to undergo all kinds of examinations in a timely manner and correct their own behavior.

The work of a doctor is characterized by increased mental stress, frequent conflict and stressful situations. All the time, the doctor is under the gun of other people’s negative emotions, which in any case will affect his state of mind. As a result, in order to protect itself from stress, the body builds a certain barrier, as a result of which the doctor becomes less emotional and susceptible to other people's problems.

Professional burnout syndrome among teachers

A teacher at an institute or a teacher at a school constantly has to interact and communicate with people - colleagues, students, parents.

In this case, burnout syndrome may appear due to frequent psycho-emotional stress, regular noise and insufficient work organization. At the same time, the teacher constantly experiences a sense of increased responsibility and takes everything too personally. To return to normal life, experts recommend that teachers seek help from a psychotherapist, who will not only conduct a relaxing conversation, but also prescribe appropriate medication.

Burnout syndrome among psychologists

The work of psychologists also involves regular interaction with other people. The psychotherapist regularly encounters anger, irritation and temper. Moreover, he goes through every problem of the patient through himself in order to find a truly correct way out of the current situation. In this case, even a strong and self-confident person cannot always withstand the load that has fallen on his shoulders. That is why sometimes psychologists need the help of experienced specialists.

Personal burnout syndrome

A striking example of personality burnout syndrome can be the detached, indifferent behavior of a person. In this state, the patient changes his attitude towards friends and close people, relatives; he can no longer cope with the stress that arises in the workplace. The patient believes that he is no longer competent in his specialty. A person loses the meaning of life, since he does not receive joy or satisfaction from his own achievements. There is a need for loneliness and solitude. His memory deteriorates and his concentration decreases.

People with burnout syndrome can also negatively affect their colleagues, friends, and family. Patients constantly break down and make scandals, causing pain to others. It is impossible to help such people without consulting a psychotherapist.

Symptoms

Mental burnout syndrome develops slowly and gradually. At first the patient feels slightly tired, but later he loses the desire to work and do his favorite things. This condition occurs due to decreased concentration. Along with this, apathy, causeless temper and irritability appear.

Scientists divide the signs of the disease into three groups:

1.Physical manifestations, which are characterized by the following symptoms:

• General weakness;
• Fatigue;
• Joint pain;
• Decreased immune defense of the body;
• Regular headaches;
• Hyperhidrosis;
• Lack of appetite;
• Change in weight;
• Frequent dizziness;
• Insomnia.

2. Socio-behavioral signs:

• Irritability and anger towards everything that happens;
• Complaints about one’s own work and the team;
• The desire to find someone to blame for all your failures among other people;
• Pessimistic mood, only gloomy forecasts for the future;
• Avoidance of responsibility;
• The desire to be alone as often as possible.

Sometimes a patient may begin to abuse alcohol or drugs in order to drown out absolutely all the problems at once. As a rule, this does not lead to anything good.

3. Psycho-emotional signs:

• Indifference to events occurring in one’s own life;
• Self-doubt;
• Loss of interest in work;
• Conflicts with loved ones, family;
• Bad mood for a long time.

Burnout syndrome, in its clinical manifestations, is very similar to deep depression. The patient always feels that absolutely no one, including his family, needs him anymore. He feels doomed and depressed, and it is also difficult for him to concentrate on any important matters.

Diagnosis of the syndrome

It is estimated that the pathology has about 100 different signs. As burnout syndrome develops, the patient increasingly complains of constant fatigue, aching pain in the joints, insomnia, forgetfulness, irascibility, decreased mental performance, and loss of concentration.

Doctors distinguish several main periods of development of the syndrome:

1. The previous stage is characterized by excessive activity of the patient in the professional sphere. At the same time, the patient is not interested in anything other than job responsibilities.
2. The next stage is called the period of exhaustion. Its duration has no clear boundaries. The patient experiences chronic weakness that does not disappear even after sleep.
3. Personal detachment is a new stage in the development of the disease. A person loses interest in his own professional responsibilities. The patient's self-esteem drops, and a feeling of loneliness and doom appears.

To identify the disease, a special test was developed that determines the degree of development of the pathology. In addition, there are 5 most striking manifestations of the disorder, which help to distinguish it from similar mental illnesses:

• Emotional: pessimism, indifference, callousness towards other people, cynicism.
• Behavioral: attacks of aggression, lack of appetite.
• Physical: fatigue, apathy, overwork, insomnia, high or low blood pressure, heart disease, panic attacks, skin rashes, increased sweating.
• Social: social activity decreases, the patient prefers loneliness, and limits contact even with family.
• Intellectual: concentration and memory deteriorate, refusal to participate in developmental programs is observed, and patterned behavior arises.

Treatment

The main problem in the treatment of the syndrome is the non-serious attitude of patients towards this pathology. They believe that to improve their condition, they simply need to overcome themselves and fulfill all professional obligations, even despite the lack of desire and overwork. But such an opinion is wrong.

To cope with the disease, first of all, you need to slow down the pace of life. This does not mean that you should quit your job and abandon all responsibilities. You just need to take care of yourself and, at least a little, rest.

For example, psychologists recommend that housewives alternate household chores with something pleasant that will help them distract themselves and relax: let them watch an episode of their favorite TV series after cooking or read an interesting book after cleaning the house. Such encouragement will not only help you cope with household chores faster, but will also increase your interest in life.

If the syndrome occurs in an office worker, then the best treatment option would be extraordinary leave or sick leave. Usually this period is enough for a person to rest and return to a normal, happy life.

Also, one of the most important places in the treatment of pathology is the analysis of the reasons that led to the development of the syndrome. These factors can be outlined to a friend or written on a piece of paper and then burned. It has been proven that such an outburst of emotions helps improve a person’s moral and physical condition.

Professional burnout syndrome must begin to be treated as soon as its first symptoms appear. Usually, in such a case, getting rid of the disease is quite simple. You should take a break from pressing problems, do what you love and relax. You also need to learn to cope with negative emotions, for example, through regular exercise.

Prevention

To prevent the disease, experts recommend conducting classes that help improve personal qualities and increase the level of resistance to various stressful situations. To do this, the patient himself must take a direct part in the treatment of the syndrome. He needs to know what this pathology is, how to get rid of it and how to prevent relapse. In this case, the main thing is to provide the patient with proper rest and isolate him from his usual work environment. The help of a psychotherapist is also often required.

Typically, emotional and psychological burnout is a consequence of mental and physical exhaustion. Therefore, to prevent the occurrence and development of pathology, the following preventive measures can be taken:

1. Do some kind of sport, take a walk in the evenings before going to bed. Such activities promote a good mood and the release of all negative emotions. You can choose the type of physical activity depending on your own preferences, for example, running, dancing, volleyball or even figure skating.
2. Maintain a proper healthy diet, increase your intake of vitamins, minerals and fiber. At the same time, you should avoid products with high caffeine content, as it contributes to stress. It has been proven that within 3 weeks after completely stopping its use, the level of anxiety and worry decreases sharply.
3. Maintain a positive atmosphere in the workplace. Psychotherapists advise regularly taking at least short but frequent breaks.
4. Sleep at least 8 hours. Scientists have proven that night rest helps the patient cope with all negative emotions in a shorter time. It is believed that a person is truly awake only when he easily wakes up at the first ringing of the alarm clock.
5. Find your favorite activity, hobby. There is a moment in everyone's life when it is necessary to quickly reduce emotional stress. It is in this case that your favorite hobby helps. For example, painting or making clay sculptures will help relax the nervous system.
6. Conduct auto-training, meditation and aromatherapy. In addition, psychologists advise not to take the problems that happen in life too personally. It is important to learn to look your fears in the eye and be able to overcome them.

Burnout syndrome is the body’s cry that it needs rest. Therefore, already at the first manifestations of the disease, you should take at least a few days off and just relax. Traveling, meeting with friends, playing sports, psychological training and other relaxing techniques can reduce the risk of illness and cope with existing illnesses.

Forecast

Burnout syndrome is the result of severe and prolonged stress. At the same time, pathology can disturb absolutely any person. To avoid such a situation, you should get rid of all negative emotions and experiences as quickly as possible. Otherwise, the appearance and development of pathology becomes inevitable. Typically, the disease leads to loss of strength, increased anxiety and anger, and without proper timely treatment, to emotional breakdowns and deep depression. In this case, it is especially difficult to do without the help of a qualified specialist.

Video: specialist on burnout syndrome