Recognizing Burnout

Road to wellness

Identifying & addressing signs of physician & medical student burnout

Burnout, which often begins in medical school, can deepen into depression if left untreated. Learn how to recognize the signs early on.

The World Health Organization has defined burnout as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.” It is characterized by three dimensions:

Feelings of energy depletion or exhaustion.
Increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job.
Reduced professional efficacy.

Source: Burn-out an “occupational phenomenon:” International Classification of Diseases

Signs of physical and emotional exhaustion – “I feel burned out from my work”

Chronic fatigue includes lack of energy, feeling tired most of the time leading to emotional exhaustion, feeling drained and depleted.
Insomnia, in its early stages, is having trouble falling asleep or staying asleep, leading to a continual nightly ordeal.
Forgetfulness/impaired concentration and attention includes lack of focus and mild forgetfulness leading to the inability to get work done, resulting in a pile-up of tasks and responsibilities.
Physical symptoms include chest pain, heart palpitations, gastrointestinal pain, dizziness, fainting, and/or headaches.
Increased illnesses arise when the body is drained, which causes the immune system to weaken, making one more vulnerable to infections, colds, flu, and other immune-related medical problems.
Loss of appetite, starting as not feeling hungry to skipping a few meals and advancing to loss of appetite and significant weight loss.
Anxiety begins with early mild symptoms of tension, worry, and edginess which advances to serious anxiety that interferes with working productively and causes problems in personal life.
Early stages of depression include feeling mildly sad, occasional hopelessness, and feelings of guilt and worthlessness that advance to feeling trapped and severely depressed.
Anger initially begins with interpersonal tension and irritability and later results in outbursts and serious arguments at home and in the workplace.

There are many signs of burnout. Listed below are just a few that will help you begin to recognize if you are approaching or have approached that “burnout” threshold.

Signs of cynicism and detachment (depersonalization) – “I really don’t care what happens to my patients”

Loss of enjoyment initially seems mild, such as not wanting to go to work or being eager to leave, and extends to all areas of life, including time spent with family and friends.
Pessimism first presents as negative self-talk and/or moving from glass half-full to glass half-empty and advances to trust issues with coworkers and family members.
Isolation initially begins as mild resistance to socializing (i.e., not wanting to go out to lunch) and advances to becoming angry when someone speaks to you.
Detachment is a general sense of feeling disconnected from others or one’s environment and advances to removing oneself emotionally and physically from the job and other responsibilities.

Signs of ineffectiveness & lack of accomplishment: “I have not accomplished many worthwhile things in this job”

Feelings of apathy and hopelessness are similar to depression and pessimism listed above, present as a general sense that nothing is going right and worsening to the feeling of “what is the point?”
Increased irritability often stems from feeling ineffective, unimportant, and useless and an increasing sense that one cannot do things efficiently or effectively as once done, which can initially destroy relationships and eventually careers.
Lack of productivity and poor performance occur when, despite long hours, chronic stress prevents one from being as productive as once was, leading to incomplete projects and an ever-growing to-do list.