Burnout: what it is, how it differs from depression and how recovery works

Burnout is not a term that comes from a single test or a single clinic; it describes a pattern. The World Health Organization defines burn-out in the 11th revision of the International Classification of Diseases as a syndrome resulting from chronic workplace stress that has not been successfully managed. It names three dimensions: feelings of energy depletion or exhaustion, increased mental distance from your job or feelings of negativism or cynicism about it, and reduced professional efficacy.

WHO is explicit about the limits. It places burn-out in the chapter on factors influencing health status, which covers reasons people contact health services but that are not classed as illnesses, and it says the term refers specifically to the occupational context and should not be applied to experiences in other areas of life. In other words, burnout is a recognised pattern of work-related exhaustion, not a separate disease with its own treatment pathway.

The NHS Every Mind Matters pages describe a related idea: long-term or severe stress can lead to physical, mental and emotional exhaustion, often called burnout. That is why most UK advice on burnout is really advice on stress and mental wellbeing.

The NHS says stress can cause physical symptoms such as headaches or dizziness, muscle tension or pain, stomach problems, chest pain or a faster heartbeat, and sexual problems. Mental symptoms include difficulty concentrating, struggling to make decisions, feeling overwhelmed, constantly worrying and being forgetful. Behaviour may change too: being irritable and snappy, sleeping or eating too much or too little, avoiding certain places or people, and drinking or smoking more.

The Health and Safety Executive, writing for managers, lists changes that may signal work-related stress in a worker: taking more time off, arriving later, being more twitchy or nervous, mood swings, being withdrawn, loss of motivation, commitment and confidence, and more emotional reactions such as being tearful, sensitive or aggressive. It notes that these signs can be symptoms of other conditions. They map closely onto the WHO dimensions of exhaustion, detachment and reduced effectiveness.

NHS Every Mind Matters says stressful feelings typically arise when we feel we do not have the resources to manage the challenges we face, and lists pressure at work, school or home among the causes. The NHS stress page names work pressure, unemployment or retirement among work-related triggers, with family, financial and health pressures alongside them. The Mental Health Foundation says stress is often triggered when we feel we have little control over a situation, and that work-related stress can affect mental health.

Because burnout is defined by unmanaged workplace stress, the useful question is rarely only what you can do differently. HSE states that employers must assess the risks of work-related stress in the workplace and take action to protect workers, and that managers should look out for signs in teams, such as arguments, higher staff turnover, more sickness absence and decreased performance. Recovery often involves both personal steps and changes at work.

These states overlap and one can lead into another. The NHS says depression is more than feeling unhappy or fed up for a few days: when you are depressed you feel persistently sad for weeks or months. Symptoms can include lasting unhappiness and hopelessness, losing interest in things you used to enjoy, feeling very tearful, constant tiredness, sleeping badly, no appetite or sex drive and aches and pains. At its most severe, depression can make you feel suicidal.

The NHS also says a low mood after a difficult period may improve after a short time rather than being a sign of depression, and that it is important to see a GP if you think you may be depressed. If exhaustion comes with persistent low mood, hopelessness or thoughts that life is not worth living, treat that as more than burnout and ask for help promptly; a clinician can then decide whether depression, anxiety or another problem is present.

NHS pages on stress suggest a range of practical steps, none of which replaces changing an unsustainable workload:

• talk about your feelings to a friend, family member or health professional

• use simple time-management techniques and plan ahead for stressful days or events

• split big tasks into smaller, manageable chunks and give yourself credit when you finish one

• try breathing exercises, and be active regularly, which NHS Every Mind Matters says can help burn off nervous energy

• set small targets you can easily achieve rather than trying to do everything at once

• try not to use alcohol, cigarettes, gambling or drugs to relieve stress, because these can contribute to poor mental health

• try self-help cognitive behavioural therapy (CBT) techniques, which the NHS says can help with stress and worry

The NHS says to see a GP if you are struggling to cope with stress, if things you are trying yourself are not helping, or if you would prefer a referral from a GP. It also says NHS talking therapies for anxiety and depression may be able to help with stress, and that if you are 18 or over (or 16 or over in some areas) you can refer yourself directly without talking to a GP. Talking therapies involve talking to a trained professional about your thoughts, feelings and behaviours.

For depression, the NHS says treatment can involve lifestyle changes, talking therapies and medicine, depending on severity, and that most people with depression can make a full recovery with the right treatment and support. A GP can also talk through time off work; this guide does not give employment-law advice, and the HSE pages are a starting point for what employers must do about work-related stress.

The NHS says to call NHS 111 or ask for an urgent GP appointment if you need help urgently but it is not an emergency. It says to call 999 or go to A&E now if you or someone you know needs immediate help, or if you have seriously harmed yourself, for example by taking an overdose, and that a mental health emergency should be taken as seriously as a physical one. Do not drive yourself to A&E; ask someone to take you or call 999.