Larisa: Hello, and welcome to the Mental Health for Romania podcast! I’m Larisa, a Research Assistant in Psychiatry, and today I’m joined by Rodica.
Rodica: Hello! I’m Rodica, a Personal Development Counsellor and a trainee psychotherapist. In today’s episode, we’ll be talking about burnout syndrome. We’ll cover what burnout is, the factors that contribute to its development, its main symptoms, available treatment options, and we’ll finish by answering some of the questions we’ve received from our followers.
Larisa: Great! Let’s get started. As Rodica mentioned, we’ll begin by defining burnout. I think we’ve all heard the term at some point, whether or not we’ve fully understood what it means. You’re even more likely to have come across it if you’ve already started your working life, as burnout is closely linked to occupational or work-related stress.
Rodica: Mhm.
Larisa: But what exactly is burnout? You might be wondering. Well, we can define it as a psychological process that develops as a result of prolonged exposure to work-related stress that hasn’t been managed effectively. Broadly speaking, it’s characterised by three key features: first, a lack of energy or emotional exhaustion; second, becoming detached from work or developing negative, cynical feelings towards your job; and third, reduced professional effectiveness or a decline in productivity. The term “burnout” isn’t new—it was first introduced in the 1970s in the United States to describe the consequences of chronic workplace stress, particularly in caring professions such as healthcare.
Since then, the concept has been broadened, as we now know that anyone can experience burnout—from employees to entrepreneurs, regardless of their profession. I’d also like to add that burnout has increasingly been recognised among parents and people who care for dependent family members.
Rodica: That’s a really interesting perspective. Larisa, could you tell us a bit more about why it’s so relevant for us to be talking about burnout right now here at Mental Health for Romania?
Larisa: Of course! That’s a great question. I think it’s important to talk about burnout for several reasons. First of all, many young people—particularly younger Millennials and older members of Generation Z—are just beginning their careers. As you know, our organisation’s mission is to raise awareness of mental health among young people, and we believe this is a particularly relevant topic for those entering the workforce today. At the same time, workplaces have become much more demanding than they were back in the 1970s, when burnout was first identified. The careers we choose often become an important part of our identity, which means it’s increasingly common for work-related concerns to follow us home.
Rodica: Mhm!
Larisa: Another reason is that burnout comes with enormous costs—not only for the individual, but also for the organisation they work for and for society as a whole. In 2010, the prevalence of burnout in Europe was estimated at around 13%, and by 2013 the costs associated with reduced productivity due to mental health problems, including burnout, were estimated at approximately €620 billion per year. These costs include lower productivity and reduced employee engagement, absenteeism, staff turnover, and the expenses involved in recruiting and training new employees. So I think it’s an important topic to bring to our listeners’ attention.
Rodica: That’s right.
Larisa: Now, Rodica, could you tell us a bit more about the factors that contribute to the development of burnout?
Rodica: Sure, I think this is a really important topic. Now that you’ve introduced the definition of burnout, I think there are several different perspectives we need to consider in order to answer this question. For example, if we look at today’s workplaces, we can see a strong emphasis on productivity and efficiency, with increasingly high expectations placed on employees. This includes expectations around competence, commitment, independence, flexibility, and ultimately being constantly available. Although we’re also seeing a growing focus on relaxation and improving employee wellbeing within organisations, there’s still a great deal of work to be done to implement practices that create a genuine cultural shift in the way people think about productivity and rest.
We can also see that, socially and culturally, many of us are still influenced by beliefs such as, “If I don’t do it, who will?”, “I have to get everything done if I want to fit in or be promoted,” or “I need to prove that I’m good at my job and capable of handling a heavy workload.” Many of us have probably come across beliefs like these. They are often reinforced by organisational leadership and workplace culture, but they’re also beliefs we’ve grown up with and gradually internalised over the course of our lives.
Among the workplace-specific factors we mentioned earlier, there are several that can contribute to the development of burnout. These include a lack of employee autonomy, role ambiguity—when an employee’s responsibilities are not clearly defined and they aren’t sure exactly what they’re expected to do or how to manage their workload—and fear-based management. Other contributing factors include excessive workloads, the high demands we mentioned earlier from managers and employers, and staff shortages in certain organisations. Burnout can also be fuelled by a lack of support from employers, low pay, and many other workplace-related factors that may trigger or contribute to its development.
At the same time, what we know about burnout is that it tends to arise from an imbalance between two sides. On the one hand, there are the demands placed on us by our work environment and organisation, along with the opportunities and resources available to us. On the other hand, there are our own abilities and expectations as employees. Burnout appears to develop when there’s a mismatch between these two. When we’re unable to cope effectively with the demands placed upon us, we can become emotionally exhausted and begin relying on coping strategies that help us avoid those intense emotions. Over time, this may even lead us to avoid work tasks altogether. The coping strategies we rely on can themselves become a risk factor for burnout. At the same time, certain individual characteristics can make it more difficult for us to find the resources we need to cope with stress and the high demands of the workplace.
And when I talk about individual factors, I’m referring to things like limited professional experience, unrealistic expectations about the job, struggling with profound feelings of loneliness, a lack of autonomy, feelings of helplessness or a weak sense of identity, and even difficulties setting personal boundaries. And, of course, this is where the beliefs we mentioned earlier also come into play—beliefs that are often reinforced by society as well.
It’s important to consider both categories of factors when working with people experiencing burnout, so that prevention and intervention strategies can be tailored accordingly. Addressing workplace-related influences is just as essential as understanding the individual vulnerabilities rooted in a person’s life experiences that may contribute to burnout. It seems that it’s the combination of these two sets of factors that makes the development of burnout symptoms more likely. Speaking of symptoms, Larisa, could you tell us a bit more about that?
Larisa: Of course. First of all, I just wanted to say that I found what you shared really interesting. Ultimately, burnout isn’t caused solely by individual factors—organisations also have a responsibility to create an environment in which employees can thrive. I think that’s a really important point to keep in mind when we think about treatment and prevention strategies, which I believe you’ll be talking about shortly.
But, as you said, let’s talk a bit about the symptoms of burnout. As we mentioned when defining it, the main symptoms of burnout are psychological exhaustion and, on the physical side, headaches or gastrointestinal problems; emotional detachment from work, often accompanied by cynicism, stress, or frustration about the workplace, sometimes to the point of indifference; and reduced performance at work, including difficulty concentrating, a lack of creativity, and generally negative feelings towards the tasks we need to carry out.
Burnout has also been included in the ICD-11, the International Classification of Diseases developed by the World Health Organization, which came into effect in January 2022. We see this as a very positive step, as the WHO’s decision to include burnout in this classification allows us to better understand, identify, and treat the syndrome, which is extremely important. Burnout was also mentioned in the previous edition, but it was described simply as a state of exhaustion and lacked a clear definition, making it more difficult to recognise and address effectively. That said, it’s important to point out that the World Health Organization classifies burnout as an occupational phenomenon rather than a medical condition, and I think that’s an important distinction, particularly when it comes to treatment. The WHO also clarifies that burnout occurs specifically within an occupational context. As we mentioned earlier, however, this isn’t always the case. Burnout can also affect parents and people caring for dependent family members. Even so, by definition, burnout remains a syndrome that is primarily associated with the workplace.
Also, now that we’re talking about symptoms, I’d like to make a distinction between burnout and depression, because I know many people tend to confuse the two—and understandably so, as they do share several similarities, such as exhaustion, a persistently low mood, and reduced performance. The key difference, however, is that with burnout, most of the difficulties are specifically related to the work environment, whereas in depression, negative thoughts and emotions tend to affect every aspect of a person’s life. In addition, depression is often associated with low self-esteem, feelings of hopelessness, and even suicidal thoughts, which are not considered characteristic features of burnout. So I think these are useful criteria for distinguishing between the two.
I’d also like to mention, while we’re talking about symptoms—and I know Rodica will go into this in more detail in a moment—that if we’re unable to manage these feelings on our own, it’s really important to seek support from a mental health professional to make sure we receive the right kind of help. I’d also like to briefly point out that a recent meta-analysis of longitudinal studies found that burnout is associated with a range of negative psychological outcomes, including symptoms of depression and insomnia. So, although burnout and depression are not the same thing, they can certainly occur together.
Now that we know what burnout is, why it develops, and what it looks like, Rodica, could you tell us a bit more about the treatment options available and the strategies we can use to prevent and manage burnout?
Rodica: Sure! Thank you, Larisa, for clarifying the symptoms. I think this is a really important point, because once we’ve identified the causes, we have a much better foundation for therapeutic or counselling interventions. As I mentioned earlier, when we talk about treating burnout, it’s important to consider both the individual and the organisational perspective, so that interventions can address both. From an organisational point of view, there are several protective factors that can help prevent burnout. These include fostering an open workplace culture where people feel able to give and receive feedback, investing in ongoing staff development through training and educational programmes, providing regular performance reviews, and implementing clear and effective ways of working. A healthy organisational environment can help restore the balance between workplace demands and the coping resources employees have available to them.
Workload, autonomy, professional recognition, pay, workplace community, fairness, and conflicts between personal and organisational values are six key dimensions that help create a safety net for individuals at risk of developing burnout. One of the most important aspects of prevention is recognising the problem early. When the first signs of burnout begin to appear, it’s essential for each of us to reflect on the coping strategies we’re using and the personal beliefs that may be influencing the way we respond, so that we can address them in the healthiest way possible. Maintaining good sleep hygiene, eating a balanced diet, and engaging in regular physical activity are all habits that can help protect against burnout. External sources of support are important too. Support groups with colleagues facing similar challenges, as well as open communication with managers about both our workload and any difficulties we’re experiencing, can also play an important role in preventing burnout symptoms.
There’s another important aspect worth mentioning here, namely self-care. Spending time outside of work, engaging in relaxing activities either on your own or with loved ones, and investing your free time in pursuits that have nothing to do with your job can all help reduce the risk of burnout. These habits are not only worth highlighting but are also important to cultivate as part of a healthy lifestyle.
Larisa: Mhm!
Rodica: This is also where psychoeducation comes in, particularly by helping us become more aware of and regularly monitor our thoughts, as well as our emotional and physical wellbeing. This builds on the importance of recognising the problem, which I mentioned earlier. Psychoeducation helps us become more aware of how we can manage challenges as they arise.
Among the more targeted psychotherapeutic and counselling interventions, mindfulness-based programmes have been shown to be effective in helping people cope with burnout, as has cognitive behavioural therapy, or CBT, as it’s commonly referred to in the literature. These approaches include components such as time management, relaxation techniques, developing and practising coping strategies that are appropriate to the situation we’re facing, communication skills, and challenging unhelpful beliefs. Of course, these interventions tend to be even more effective when they’re combined with organisational initiatives, such as psychoeducation, workshops, and targeted group-based programmes within the workplace.
I’d also like to add something about interventions that go beyond the specific issues related to burnout. Earlier, when discussing risk factors, I mentioned difficulties with setting boundaries and feelings of loneliness. It’s important that, within the field of mental health, we also address these underlying challenges. Burnout can recur naturally when these vulnerabilities are present. Perfectionism, a constant fear of failure, and defining ourselves solely through our role as employees can often make sense when we look at our personal life stories. Addressing past wounds over time, through healthy relationships and a balanced lifestyle, can be incredibly helpful. These are not quick fixes and require a lot of work, and in many cases, having a psychologist as a companion on this journey can make a real difference.
Larisa: Thank you so much, Rodica, that’s really, really interesting. And, just as you mentioned earlier, the causes of burnout are complex and involve both individual and organisational factors. In the same way, the treatments and strategies for managing burnout can be applied at both an individual and organisational level. I also think it’s really important that you highlighted the importance of taking care of ourselves, of self-care, but also the role of psychotherapy or counselling interventions when needed.
Now that we’ve talked about burnout, defined it, and discussed different symptoms and treatment options, I think we’re ready to answer some questions from our Instagram followers. The first question is: how do we recognise that we’re experiencing burnout, and how do we get through it? Rodica, would you like to tell us more?
Rodica: Sure. I would answer this question by saying that, ideally, we should recognise when we are at risk of developing burnout, so that we can try to prevent the symptoms you described earlier, Larisa. To become aware of our own emotional states, we need that ongoing monitoring of our emotions, thoughts, and physical sensations that we also mentioned earlier when discussing prevention. This allows us to identify when symptoms begin to appear. Some warning signs or “red flags” we can look out for include noticing changes in the way we behave, react, or feel. These can include constantly putting off tasks that we would normally complete, a decline in our performance on tasks we’re usually comfortable with, difficulties concentrating or remembering everyday things, feeling exhausted, struggling to prioritise tasks, and experiencing feelings of guilt or shame because we’ve left colleagues in a difficult position by not completing important tasks. This may eventually lead to avoiding interactions or meetings with them. However, whenever we realise that we’re struggling with these kinds of difficulties, the main recommendation would be to ask for help. This could range from opening up to someone close to us or a colleague, to having a serious conversation with a manager about the challenges we’re facing, or even seeking support from a psychologist or another mental health professional. All of these steps involve reaching out for support, and I think that, especially in Romania at the moment, we need to stop viewing either emotional sharing or seeking psychological support as something unusual or shameful. Psychological difficulties—particularly the ones we’re discussing today, such as burnout—affect a large proportion of people. The support we receive, both throughout the development of a burnout episode and when symptoms become more severe, can guide us towards the resources we need to overcome it. This can include relaxation techniques, communication and boundary-setting skills, challenging and changing unhelpful thoughts, and developing coping strategies for stress that are effective and appropriate.
If we look at the next question from our followers, it relates to how long a burnout episode can last. How long can we experience an episode of burnout, and can these difficulties still occur when we’re working in a field that we are passionate about and genuinely enjoy? Larisa, would you like to answer this one?
Larisa: Sure. To start with the first question—how long an episode can last—the short answer is that there is no fixed timeframe that determines when a burnout episode ends. As Rodica explained earlier, there are various treatments and strategies for managing burnout that we can use to help reduce the duration of such an episode. However, we can’t define the length of an episode from the outset, as it depends on the interventions the person chooses to pursue, as well as the changes made within the organisation they work for. Most often, it is likely a combination of these factors, as we discussed earlier.
As for the second question—whether burnout can occur even when we are working in a field we are passionate about—the answer is yes. Unfortunately, it can happen even when we love our work, if we are exposed to high levels of stress for a prolonged period of time. Passion for our work and the dedication we feel when we love what we do can sometimes turn into working long hours, staying late, neglecting rest and holidays, until we reach a point where our productivity decreases and we begin to feel cynical about our work. We may feel constantly exhausted and start to emotionally distance ourselves because we have been under such prolonged stress. To prevent burnout in a job we enjoy, in a field we are passionate about, it is important to prioritise rest, enjoyable activities outside working hours, and to remind ourselves that we are more than our profession. To give an example—although this applies to any profession or workplace—if you work in law and you love your career, remember that you are more than just a lawyer. You may be a parent, a sister, a brother, a friend; you may enjoy cooking, have hobbies, enjoy hiking in the mountains, learning a foreign language after work, or travelling. Your identity is much broader than simply being an employee, as Rodica also mentioned earlier.
Okay, I think that covers what I wanted to say in response to that question. The next question from our followers is: “How can we overcome burnout as quickly as possible?” And Rodica, I think you could tell us a bit more about this.
Rodica: As you mentioned earlier, Larisa, psychological interventions, the support we receive from loved ones, and making lifestyle changes towards healthier habits can indeed help reduce the duration of a burnout episode. Once again, I want to emphasise the importance of interventions focused on preventing these episodes from happening again. This is because they can help us reduce personal risk factors, but they also teach us to recognise early signs of distress related to burnout and identify when similar difficulties begin to appear again.
There is one more aspect that our followers asked us to address, namely the physical and psychological consequences of burnout. Could you clarify this for us a little towards the end, Larisa?
Larisa: Sure. As I mentioned earlier when we were discussing symptoms, burnout can unfortunately have consequences for both our physical and psychological health. Physically, it is often accompanied by headaches, gastrointestinal problems, insomnia, or changes in appetite. Psychologically, burnout is frequently associated with depression and sleep difficulties, as we mentioned earlier. In addition, a 10-year study conducted in Finland found that burnout was associated with an increased risk of hospitalisation for various mental health conditions and even cardiovascular diseases. So, I think this highlights why it is so important to address burnout, perhaps even more than we currently do, because it doesn’t only have short-term physical and psychological consequences. If left unaddressed, it can also have negative long-term effects.
Rodica: That’s right.
Larisa: I think that’s everything we wanted to discuss today. Rodica, is there anything else you’d like to add?
Rodica: I don’t think there’s anything else to add. I’m glad we had the opportunity to talk about such a relevant topic in today’s world, and I think it’s important that we discuss the aspects we’ve covered.
Larisa: If you’ve listened to us all the way to the end, thank you, and we look forward to welcoming you back for our next episode! Until then, take care of yourselves and your mental health. Bye!
