Burnout Syndrome

Symptoms

The symptoms of emotional burnout can be divided into groups:
1.    Physical - these are symptoms that are felt by a person as painful, he is forced to turn to specialists, thinking that he is seriously ill. Often the patient goes from one doctor to another, undergoes a complete examination, but the causes of poor health are not identified. Such complaints include insomnia, physical fatigue, weakness, nausea, dizziness, headaches, shortness of breath, high blood pressure.

2.    Emotional - this is either emotional rigidity (lack of emotional manifestations, a feeling of loneliness), or vivid emotional manifestations (tantrums, aggression, "mental suffering", increased anxiety even for minor reasons). Manifestations depend on the type of human temperament - an introvert, most likely, will withdraw into himself, and become isolated. If the client is a pronounced extrovert, then the manifestation of emotions will be vivid, even excessive. There is a direct relationship between temperament types and the degree of emotional burnout. People with choleric and melancholic types of temperament are more prone to this syndrome than sanguine and phlegmatic people.

3.    Behavioral is a change in human behavior that is noticeable to others. Behavioral symptoms include refusal to eat, excessive use of alcohol, drugs, tobacco, the appearance of fatigue during the working day (even at the beginning of work and with a light workload), provoking accidents at work, impulsive behavior at work and at home.

4.    Intellectual - these are symptoms that manifest themselves in the loss of interest in everything new, in self-development, in what was previously interesting, in communication, in participation in training seminars and trainings.

5.    Social - symptoms that indicate the isolation of the employee from the team, loss of interest in his hobby. A person feels that he is not understood and supported by close people, stops communicating with friends and relatives.

Thus, the burnout syndrome affects all spheres of human life and is manifested by a combination of symptoms in the somatic, mental and social areas.

Causes

Increased workload;
•    Monotonous activity;
•    Conflicting demands of managers;
•    Lack of a common goal in the team;
•    Employee disengagement;
•    Lack of remuneration;
•    Discrepancy between wages and work performed.
•    Poor team leadership can lead to burnout of entire departments and teams.
Signs of emotional burnout in a team:
•    "Sameness" of employees;
•    General apathy in relation to what is happening;
•    Frequent smoke breaks and tea drinking;
•    Lack of a clear understanding of the goals of the organization among employees;
•    High staff turnover;
•    The inability and unwillingness of the manager and his employees to take responsibility for what is happening and the work done.
It is important to point out that working conditions such as irregular working hours, lack of a well-equipped workplace and a clearly defined lunch break are often the cause of chronic fatigue syndrome, which is a harbinger of emotional burnout.
But even if the working conditions are good, and the boss is attentive, a person can still burn out due to personal characteristics. This condition develops in people with a highly developed sense of empathy, prone to sympathy and dreams, idealizing their work, obsessed with obsessions, as well as introverts, people with low self-esteem and increased conflict.
Burnout syndrome is more common among "social" professions (social workers, medical personnel, teachers, psychologists, educators, etc.) and "communicative" (managers, leaders, lawyers, lawyers, investigators, etc.). 
Housewives are also quite often prone to burnout syndrome, especially if a spouse or close relatives do not help care for the children and do not take on some of the household chores. The reason for burnout is that a woman is forced to perform monotonous work every day, her work is invisible and not properly evaluated.

Treatment

Self-regulation techniques.  Self-regulation is the management of one's psycho-emotional state, which is achieved by a person's influence on himself with the help of words, mental images, control of muscle tone and breathing. With the help of these techniques, the effect of calming, restoring and activating is achieved. Ways of self-regulation include laughter and humor, thinking about good things, relaxation exercises, looking at pleasant landscapes, photographs, paintings, walking in the fresh air, reading poetry, listening to music, etc.
•    Breathing exercises.  Breath control is an effective means of influencing muscle tone and the emotional centers of the brain. Slow and deep breathing (with the participation of the abdominal muscles) lowers the excitability of the nerve centers and promotes muscle relaxation. Frequent (thoracic) breathing, on the contrary, provides a high level of activity of the body, maintains neuropsychic tension. An example of an exercise: imagine that a fluff is hanging in front of the nose at a distance of 10–15 cm. Breathe only through your nose so smoothly that the fluff does not move. This exercise allows you to quickly calm down.

•    Body Oriented Therapy.  Under the influence of mental stress, tension and muscle clamps arise. The ability to relax allows you to relieve neuropsychic tension and quickly restore strength. Meditation and relaxation techniques will help with this.

•    Logotherapy (word therapy).  Verbal influence activates the conscious mechanism of self-hypnosis. Self-hypnosis formulations are built in the form of simple and brief positive statements (without the “not” particle).

•    Hypnotherapy is a form of psychotherapy that uses relaxation and intense attention to help deal with a variety of problems.

•    Visualization techniques.  Visualization is a mental representation, playing and seeing yourself in a situation that has not yet happened. Man imagines himself doing (or having) what he aspires to. Do 10 minutes before bed and 10 minutes in the morning.
The patient needs to remember that denial of the feelings he is experiencing and reluctance to seek medical attention can lead to the fact that the recovery will take much longer in the end.
If a person is at an advanced stage of emotional burnout, then it is necessary to involve specialists of other profiles and use pharmacological treatment in parallel with psychotherapeutic work. In more serious cases, with a threat to life, the help of a psychiatrist is required, who can choose drug therapy (antidepressants). Only joint competent work of specialists will be able to quickly help the patient.

Tests Required for Diagnosis

If a client comes to an appointment with a specialist complaining of overwork, weakness, emotional disturbances, depression, sleep disturbances, headache and other symptoms described above (they can appear both in combination and separately), then it is necessary to collect a complete history .
To do this, the patient specifies:
•    How his behavior has changed recently, whether he has become more irritable, whether aggression appears for minor reasons, whether he is interested in something new, how his habits have changed;
•    Whether he feels that the workload is increasing, whether there is a feeling that he chronically does not have time for anything, and the management makes increased demands;
•    Whether sleep is disturbed (poor falling asleep in the evening and difficult awakening in the morning, frequent waking up at night and insomnia);
•    Whether eating behavior is disturbed;
•    Whether there was an addiction to smoking, alcohol, drugs;
•    What are the health complaints?
•    Whether there was a feeling of chronic fatigue and apathy.
If a person answers positively to most of the questions, then this indicates that he is at one of the stages of emotional burnout, but which one can be determined using Victor Boyko's "Research of emotional burnout" method. The methodology consists of a questionnaire with 84 statements. Points are calculated using the key, and the result is a final value - the sum of the indicators of all the symptoms of emotional burnout.
To exclude other diseases, it is necessary to refer the patient to narrow specialists (neurologist, psychiatrist, therapist), who will prescribe additional laboratory tests.
 

Useful info

Pathogenesis:
Most often, burnout syndrome affects people working in the "person-to-person" system, primarily doctors, psychologists, teachers, educators, managers, administrators, and journalists. The draft International Classification of Diseases (ICD-11) defines burnout as "the result of chronic workplace stress that has not been successfully managed."
If a person constantly experiences stress at work, then in the end he is overtaken by emotional burnout. Stress is a powerful release of energy from the body, which is spent on solving problems that have arisen. Most often, a person in stressful situations withdraws into himself and tries to direct all his strength to overcome difficulties, the body tries to generate additional energy. But when the resources run out, a person will experience psycho-emotional and physical exhaustion - this is how the body gives him a signal about the need for rest and recovery. And if such states are repeated regularly, then a person spends his resources faster, and periods of exhaustion lengthen. In the future, if adequate measures are not taken to regulate the physiological state of the body, psychosomatic diseases and depressive disorders develop.
 
The development of the syndrome of emotional burnout takes place in several stages:
1.    The patient develops fatigue, weakness and sleep disturbances (either falls asleep for a long time and wakes up hard in the morning, or falls asleep earlier than usual in the evening, but wakes up at night and cannot fall asleep for a long time). Headaches, diarrhea, tachycardia, arrhythmia, hypertension, decreased memory and attention (especially its switching and concentration) are possible. Not passing pain in the throat, perspiration and hoarseness are quite frequent, but with a thorough examination by ENT doctors, the diagnoses are not confirmed.

2.    Then psychological symptoms appear, namely personality changes - anxiety increases, depressive disorders develop, mood often changes, uncontrollable emotions arise. At advanced stages, addictions are formed: nicotine, food, alcohol and even drugs.

3.    The extreme degree of manifestation is parasuicide (causing deliberate harm to one's health, for example, taking a large dose of sleeping pills, but without the goal of bringing oneself to death) or even suicide.

Somatic symptoms appear as the final link in the scheme of psychosomatic disorders. The most unprotected organs, weakened by previously transferred diseases, suffer. There is an opinion that there is a psychosomatic cycle, when mental and somatic disorders exist as a single process (the so-called vicious circle).
Thus, emotional burnout is first felt by the patient as a manifestation of somatic symptoms, and psychological disorders appear later. This can lead to erroneous conclusions of doctors and loss of time for treatment [20] . Therefore, it is important at the initial stage, along with the collection of an anamnesis and a detailed physical examination, to diagnose the psychological state of the patient.
Classification and stages of development of emotional burnout
In the scientific literature, you can find several theories describing the stages of emotional burnout. Despite external differences, they are quite similar.
The most complete theory belongs to Joseph Greenberg, where he describes a five-step model of emotional burnout:
1.    "Honeymoon". At this stage, the employee is happy to get to work and full of determination. But as the tasks become more complicated and the workload increases, they lose interest in professional activities, work ceases to bring pleasure.

2.    "lack of fuel". At the second stage, fatigue, detachment, sleep disturbance and appetite appear. Labor discipline is often violated - the employee is late, leaves earlier for no reason, there are frequent smoke breaks or tea parties.

3.    "Chronic symptoms". Irritability, aggression appear, the employee becomes exhausted, ceases to monitor his appearance (this is especially noticeable in women who are more likely to burn out). The employee often complains about the chronic lack of time.

4.    "A crisis". It is at this stage that chronic diseases begin to develop, as a result of which the employee may partially, and in severe cases, completely lose his ability to work. A person's self-esteem drops dramatically and, in his opinion, the quality of life deteriorates significantly.

5.    "Punching through the wall". Physical and psychological problems worsen, and there is a risk of developing life-threatening diseases.

There is also a dynamic model by B. Perlman and Heinz Hartman, which describes four stages of emotional burnout:
•    The first stage is tension associated with additional efforts to adapt to situational work requirements.

•    The second stage is a strong experience of stress.

•    The third stage is the reactions of three classes (physiological, affective-cognitive, behavioral) in individual variations.

•    The fourth stage is the experience of chronic stress. This stage is comparable to "extinguishing of combustion in the absence of the necessary fuel".