Burnout

Burnout is a word most people know, and many people use it to describe a deep, wearing exhaustion. The exhaustion is real, and it’s worth getting help with. At the same time, burnout isn’t a medical diagnosis. Understanding what the word means, how it relates to depression, and how it’s classified helps make sense of what you’re feeling and where to look for support.

What burnout is

The World Health Organization’s International Classification of Diseases describes burnout as a result of long-running stress at work that hasn’t been successfully managed (World Health Organization, 2019).

The classification lists three main features: feeling drained of energy or exhausted; feeling more distant from your job, or negative and cynical about it; and getting less done, or feeling less effective, at work.

It says burnout isn’t a medical condition. That’s a statement about how it’s classified, not about how much it affects you. It also ties the term to work, rather than to other parts of life. Burnout isn’t listed in the Diagnostic and Statistical Manual of Mental Disorders either.

When it isn’t about work

While the official classification limits burnout to work, people use the word for exhaustion from caring for someone, or from parenting, too. What people describe from caring and parenting is often very similar, and looking at what helps is still worth doing, wherever the load comes from.

Burnout and depression

Burnout and depression are closely related, and researchers disagree about how separate they really are. In a review pooling dozens of studies, researchers found that people with more burnout tend to have more symptoms of depression and anxiety. The authors concluded burnout is related to both but is a different thing (Koutsimani and colleagues, 2019). Other researchers argue the line between burnout and depression is thin, and that some of what gets called burnout is depression.

Whichever side is right, the practical question is the same: if you’re exhausted and low, it’s worth a GPGP (general practitioner) For most people, where getting help starts. A GP can write a Mental Health Treatment Plan, prescribe medication and refer you on, and some are trained to deliver a small number of structured therapy sessions themselves. More in the jargon decoder Close checking for depression, because depression has treatments with good evidence behind them. Is it depression or burnout? looks at how the two compare, and depression has more on what helps with it.

What helps

The evidence points towards changing the work, rather than relying on individual coping skills alone. In a review of programs to reduce burnout among doctors, the programs helped a little on average, and changes to how the work was organised helped more than programs aimed at the individual doctor (Panagioti and colleagues, 2017). That research was on doctors, and the finding may not hold the same way in every job. In Australia, employers have a legal duty to manage risks to mental health at work, including unmanageable workloads, bullying, poor support and little control over your work. If your workplace is part of the problem, your union, if you have one, or the work health and safety regulator in your state or territory are the places to take it. For bullying, the Fair Work Ombudsman sets out where you can go.

Research on treating burnout itself is thin, and researchers put part of that down to there being no agreed definition to measure. Psychological therapy is well supported for depression and anxiety, which often come with burnout. Therapy can also give you a place to work out what needs to change, and support you while those changes happen.

Getting help

If you’re exhausted and nothing in your life explains it, see your GP. Thyroid trouble, low iron, sleep problems and other physical causes can feel the same from the inside. When it isn’t therapy you need covers physical causes and other things worth ruling out.

If you decide to seek professional support, how you pay depends on the route you use. A Mental Health Treatment PlanMental Health Treatment Plan A document your GP writes with you. It makes you eligible for a Medicare rebate on up to ten individual sessions a calendar year: six, then a review with your GP, then the remaining four. The plan itself isn't therapy. More in the jargon decoder Close needs a GP to diagnose a mental disorder, and burnout on its own isn’t classed as one. Whether a plan is possible depends on what your GP finds.

Options for getting care include:

• Full fee. Seeing a private psychologistPsychologist Someone trained to assess mental health problems and treat them with therapy. It takes at least six years of study and supervised practice, and they're registered with Ahpra, the national regulator. Psychologists can't prescribe medication. More in the jargon decoder Close, counsellorCounsellor Someone trained to help people talk through and work on difficulties. The title isn't protected in Australia, so it's worth checking a counsellor's training and registration. Medicare doesn't give a rebate for counsellors. More in the jargon decoder Close or psychotherapistPsychotherapist Someone trained in therapy, often for longer-standing patterns. Like counsellor, the title isn't protected in Australia, and Medicare doesn't give a rebate for psychotherapists. More in the jargon decoder Close. MedicareMedicare Australia's public health insurance scheme. For mental health, it gives rebates on sessions with psychologists and some other professionals, usually through a Mental Health Treatment Plan. More in the jargon decoder Close doesn’t cover counsellors or psychotherapists.
• Workplace programs. Free, short-term counselling through an employee assistance program, if your employer provides one.
• Community services. Local health centres or non-profit organisations offering subsidised or low-cost sessions.
• headspaceheadspace A national youth mental health service for anyone aged 12 to 25, with centres around Australia and support online and by phone. It's free or close to it, you don't need a referral or a parent, and you can book it yourself. More in the jargon decoder Close. Free or low-cost support for young people aged 12 to 25.
• Groups. Skills or support groups, which usually cost less per session.
• A Mental Health Treatment Plan. Where your GP writes one, it gives you a Medicare rebateRebate The amount Medicare pays back towards a session. It comes back to you after you've paid, so what you pay yourself is the fee minus the rebate. More in the jargon decoder Close on up to ten sessions a calendar year.

Getting a diagnosis covers what an assessment involves, and free and low-cost options has more on each of these.

If things are difficult right now, Lifeline is on 13 11 14, the Suicide Call Back Service is on 1300 659 467, and Kids Helpline is on 1800 55 1800 for anyone aged 5 to 25. In an emergency, call 000. Crisis and emergency support has the full list.

Where next

Why who you see matters more than what they do explains why the relationship with your therapist matters so much, whichever approachApproach (modality) The kind of therapy someone uses, such as CBT or psychodynamic therapy. You'll also see it called a modality. More in the jargon decoder Close they use.