The syndrome of emotional burnout is a process of gradual extinction of cognitive, emotional and physical energy, characterized by loss of strength, mental exhaustion, personal detachment and loss of satisfaction from the work done. These symptoms appear as a result of long-term chronic stress at work. And you cannot get rid of it, even while playing at PlayAmo or watching movies you enjoy. The emotional burnout syndrome is considered as an unfavorable outcome of stress resolution and is a stage of general adaptation syndrome exhaustion.
As a rule, development of this syndrome more often occurs in the sphere of “human-human” professions, where a high level of responsibility for one’s own decisions is required. Social workers, doctors, nurses, teachers, educators, lifeguards, and many others suffer from the emotional burnout syndrome. All employees focused on the client, his rights and desires. The service and therapeutic relationships required in these specialties require prolonged and extensive emotional contact.
Such work involves self-sacrifice, altruism, and the desire to do one’s best to solve a problem, carries with it a lot of anxiety, and is a cause of lingering stress. Moreover, politics, the social environment, and the problem of remuneration impose their own constraints, demanding great results, but limiting the resources for their realization.
Causes of Emotional Burnout Syndrome
The main reason for emotional burnout syndrome is a discrepancy between a person’s personality and requirements imposed on him/her. Persons with a high level of emotional lability, those prone to depression and anxiety, rationalizers, perfectionists and workaholics are predisposed to the emotional burnout syndrome.
There are also situational demands, such as “difficult” clients, unfairness, relationship inequality, lack of support from superiors and colleagues, conflicts within the team, high workload, long working hours, and lack of activity changes.
The risk of emotional burnout syndrome also increases due to high professional demands. These include searching for new solutions, cognitively difficult communication, a large amount of paperwork, bureaucracy, the need to constantly adapt to new conditions, and low pay.
Pathogenesis of Emotional Burnout Syndrome
Canadian endocrinologist Hans Sellier considered burnout syndrome as a kind of long-lasting stress, connected with work processes. He first introduced the term “distress”.
Distress is a negative type of stress, to which the organism cannot adapt. Often such stress is the cause of the manifestation of serious diseases. Within the theory of general adaptation syndrome and stress, burnout is equated to the last stage of stress – the exhaustion stage. There are 3 phases of stress development:
Phase 1 – the phase of tension. At this stage a person quotes strong worries about psychotraumatic circumstances, disappointment in oneself and one’s abilities, regret about the choice of profession, increased conscientiousness, responsibility and anxiety. Development of emotional burnout syndrome at this stage is preceded by a period of increased activity – a person is completely involved in work, works with maximal self-giving, forgetting about other spheres of life and their own needs.
Phase 2 – the phase of resistance. The person tries to ward off unpleasant emotions, limiting his or her reaction to what is going on, tries to reduce the pressure of external circumstances, and limits contacts at work. Emotional and moral disorientation is manifested.
Phase 3 – the phase of exhaustion. A deficit of positive emotions, cynicism, callousness, and professional deformation of the personality are observed. The person completely loses interest in the subject or object of his activity, loses compassion. The general energy and nervous system tone drops. A person changes his system of values and loses the sense of life.
Symptoms of Emotional Burnout
Emotional and mental exhaustion is a constant feeling of overstrain, lack of emotional and physical strength, a permanent feeling of fatigue. Usually it disappears after a rest or a change of activity, but it reappears when you return to your usual environment. The person feels tired from work, productivity decreases, and more effort has to be put in for quality results. Exhaustion is a basic symptom of emotional burnout.
Mental dysfunction – reduced concentration of attention, memory, loss of mental clarity, increased typos, mistakes.
Personal detachment – reduction of interest, development of cynicism and indifference, lack of desire to do the job perfectly. Preference for standardization of work, minimal personal investment in the process. Detachment affects not only attitudes toward work, but also relationships with colleagues and clients. People stop empathizing with those they are helping. They behave in relationships formally, indifferently. Team relations are toxic, disconnected.
Sense of loss of effectiveness – low self-esteem, humiliation of own achievements and work done, a sense of unfulfillment, absence of prospects and career growth.
Changes in physical well-being – malaise, sleep disorders, weight changes, nausea, dizziness, tremors, increased blood pressure.
Stages of Emotional Burnout Syndrome
At first, a person spends a lot of energy and feels great, but as the syndrome develops, he or she notes fatigue, which eventually changes to a feeling of frustration and decreased interest in work.
According to Burish’s 1994 classification, emotional burnout syndrome has 6 stages:
- The precautionary phase – can develop in two variants: either the so-called honeymoon phase, or exhaustion. In the first case, a person observes a rise in productivity, feels needed, appreciates his/her work, refuses to rest and communicates with his/her relatives. In the second case, insomnia, fatigue, impaired coordination, memory, and an unremitting feeling of fatigue are noted.
- Decrease in the level of participation – loss of communication with colleagues, patients, clients, negativism, absence of empathy, detachment, cynicism. In relation to professional activity – tardiness, deliberate reduction of the working day, absenteeism, unwillingness to perform the habitual work, dissatisfaction with the work itself and its payment.
- Emotional reactions – depending on the person, this can manifest itself as depression or aggression. When depressed, the person notes mood changes, apathy, decreased self-esteem, and a constant feeling of guilt. In the case of aggression, he or she blames others, shifts responsibility, ignores participation in his or her own failures and behaves in a conflicted and uncompromising way.
- Destructive behavior – decreased concentration, inability to solve habitual tasks, rigidity of thinking, lack of motivation to work, decreased efficiency. At this stage, changes in the emotional and social sphere are also noted, namely indifference, avoidance of communication with people, or strong attachment to one person, loneliness, refusal of hobbies and leisure activities.
- Psychosomatic manifestations – sleep disorders, sexual disorders, decreased immunity, tachycardia, increased blood pressure, tension headaches, digestive system disorders, development of dependence on alcohol, nicotine or drugs.
- Disappointment – a feeling of own helplessness, uselessness, lack of meaning in life, hopelessness.
Complications of an Emotional Burnout Syndrome
At its late stages, emotional burnout syndrome can favor development of somatic diseases. Prolonged stress increases the risk of ischemic heart disease, hypertension, stomach and duodenal ulcer, bronchial asthma and acute respiratory tract infections. Impaired adaptation also adversely affects the development of autoimmune diseases such as thyrotoxicosis, Hashimoto’s thyroiditis, psoriasis, systemic lupus erythematosus, rheumatoid arthritis.
Long-lasting emotional burnout syndrome can be complicated by a depressive or anxious state, can promote addiction to psychoactive substances, and in severe cases can even lead to suicide.
In the social sphere, the quality of work performance worsens, creative approach to problem solving is lost, relations with a collective and family worsen. Professional errors, tardiness and absenteeism appear. In the future change of a place of work and a profession.
Prophylaxis of professional burnout is an activity that is directed at the change of a person’s way of life and attitude towards work. The aim of psychological prevention of emotional burnout syndrome is to decrease the level of stress at work, to change one’s mindset in which a person lives to the fullest and gets satisfaction from work.
It’s necessary to develop coping skills, to remove one’s own psychological limiting beliefs, to make decisions confidently, to maintain social and interpersonal relationships and to realize one’s potential. First, it’s necessary to minimize stress factors at work, to maintain a work/rest balance, and to find a favorite activity outside the circle of duties. Exercise several times a week will also help in the fight against stress.
A positive and rational outlook on the situation, the ability to manage your own worries and restore your psycho-emotional potential are a powerful foundation in the fight against burnout syndrome.
Treatment of Burnout Syndrome
If the first symptoms of emotional burnout syndrome appear you need the help of a psychotherapist or a psychologist. The specialist will help to understand the causes of this condition and outline a clear plan of actions. Different kinds of psychotherapeutic help are used in the treatment of emotional burnout syndrome.
Self-regulation helps to cope with stress in a moment. This method includes managing one’s own psycho-emotional state with the help of words, thoughts, breathing, muscle relaxation, and meditations. These techniques promote relaxation and recovery. Memories, reflecting on good things, taking a walk in the air, a favorite activity reduces stress levels. Slow and deep breathing will help to oxygenate the brain, relieve tension and muscle tone.
Communication skills training, critical event discussion, positive situation assessment, frustration prevention, self-confidence training and many others are used to work with patients in individual or group therapy.
In therapy of an already developed emotional burnout syndrome, therapy – integrative, non-directive, cognitive-behavioral, relaxation techniques – is well recommended.
Pharmacological treatment is prescribed depending on the symptoms. For anxiety, somatomorphic disorders and nervous tension, benzodiazepine and non-benzodiazepine tranquilizers are prescribed. They should be used at the lowest effective dose possible, in short or intermittent courses with gradual withdrawal. These drugs can cause withdrawal syndrome and dependence, decrease concentration, speed of motor reactions, cause drowsiness and other side effects.
As a part of emotional burnout syndrome, sleeping pills – hypnotics – can be prescribed for sleep disorders. Pharmacological therapy of insomnia is conducted only after identifying and eliminating the underlying cause when insomnia leads to distress. It’s necessary to control the dose of the drug, to use intermittent courses with a change of drugs. Tranquilizers, non-benzodiazepine hypnotics are used.
Different groups of antidepressants can be used to treat depressive disorders: triceptic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors. Treatment should use an optimal dose regimen for at least 2-3 weeks until the thymoanaleptic effect develops, and after symptoms have resolved, for at least another 4-6 months. The choice of drug, dosage, and course are selected by the physician depending on the clinical picture. It’s most effective to treat simultaneously with antidepressants and psychotherapy.