Burnout – how to recognize the symptoms!

The burnout syndrome, often called burnout, describes a state of extreme mental and physical exhaustion. In addition to the feeling of “being burned out” with reduced performance and chronic fatigue, there are a wide variety of symptoms, which all have in common that they are caused by excessive stress – in most cases due to work overload, but caring for relatives can also lead to this “burn out” people. The symptoms in men and women are mainly identical. How does burnout manifest itself physically, and how can the psychological signs of burnout syndrome be identified? How do we recognize the warning signs of depression demarcate? This series of photos will teach you which symptoms should make you think of burnout.

Exhaustion and tiredness as a burnout symptom

 There are many signs of burnout . Work-related stress typically leads to a persistent feeling of exhaustion and tiredness. Those affected feel overburdened by their work and often no longer feel up to the professional demands. In everyday life, too, they increasingly feel that they are overwhelmed by the tasks that arise every day. The need for breaks increases, but sufficient rest is no longer possible, even in rest phases.

Sleep disorders in burnout syndrome

Despite the permanent tiredness, those affected cannot fall asleep in the evening and often wake up too early. Disturbed sleep behaviour means that the much-needed recovery cannot begin, and the symptoms of exhaustion continue to develop—elevated levels of the stress hormone cortisol lead to persistent states of alertness. In addition, fewer growth hormones are released, which ensures restful deep sleep. The altered hormonal balance essentially robs the body of its ability to compensate for the stress at work.

Loss of meaning in life and resignation as warning signs

While those affected initially see great importance in their work and immerse themselves in it with enthusiasm, this enthusiasm often gives way to dissatisfaction and a feeling of insufficient appreciation or recognition. Eventually, a certain indifference and inner emptiness arise. They lose all joy in their work and can no longer find the lost zest for life in their free time. Everything is perceived as exhausting and stressful; hopelessness and cynicism determine the thinking of those affected.

Reduced performance as a sign

People with high demands on themselves and their performance tend not to know their limits and develop burnout syndrome. High expectations, perfectionism and a hunger for recognition gradually lead to the feeling of having to do more and more and finally to “burning out” of one’s strength. This also reduces physical and mental performance: the error rate increases, concentration and memory problems arise, complex activities become more and more complicated and decision-making difficulties become noticeable.

Restriction of social contacts and loneliness

Due to the increasing feeling of insignificance, the loss of former interests and the characteristic exhaustion, those affected by burnout withdraw more and more. Family, circle of friends and partner are neglected, and hobbies are given up due to lack of drive. Inner distancing and depersonalization mean those affected appear dull and disinterested to others; sometimes, they react irritably, suspiciously or aggressively. People often do not explain themselves and react closed to questions so caregivers can confuse the psychological symptoms with classic depression.

Psychosomatic symptoms of burnout syndrome

As a result of the mental problems, there are usually other psychosomatic symptoms in addition to sleep disorders. This refers to complaints that cannot be explained organically and are consequently attributed to psychological causes. Examples are physical symptoms such as:

• Back and headaches, tension
• dizziness
• Abnormal sensations (“tingling”)
• indigestion
• sexual problems such as erectile dysfunction or sexual reluctance

In addition, the body’s defence system can suffer from burnout, and infections such as colds occur more frequently.

Substance abuse and addictions

Similar to non-occupational depression, those affected by burnout also tend to consume more alcohol and tobacco products. The abuse of other addictive substances and drugs is also significantly higher among them.

Addiction and subsequent physical damage can make it much more challenging to return to everyday life and represent an enormous hurdle for a healthy lifestyle. Statistics also show that the accident rates among those affected with a tendency to dependency are significantly higher than among the rest of the population. Men are affected significantly more often than women.

Late effects and permanent damage

Burnout is often not recognized in time and, therefore, not treated. Then depression can develop in the long term – this is the most common consequence of burnout. Lack of drive, tiring quickly, and loss of interest, as well as depressive mood and hopelessness, develop in the long term.

In addition, many sufferers develop anxiety disorders, usually in the form of panic reactions and somatoform diseases. This refers to physical complaints that are insufficiently attributable to organic diseases. Addiction disorders that arose during the active burnout phase (e.g. alcohol, drugs, gambling) often last for life and, in turn, require therapy.

Diabetes mellitus and cardiovascular diseases, which result from lack of exercise and an unhealthy diet, are also possible long-term consequences.

Damaged heart as a result of burnout

The burnout syndrome not only affects people mentally but also causes physical damage. The heart is particularly affected. While perceived stress and depressive moods lead to a lack of exercise and an unhealthy lifestyle, stress also has a direct effect on the vegetative nervous system.

Stress hormones such as adrenaline and noradrenaline can contribute to premature ageing of the cardiovascular system and damage the heart muscle and coronary arteries. Increased blood pressure, as a result, puts a strain on the cardiovascular system and can lead to acute heart problems and even life-threatening cardiac arrhythmias, heart attacks or sudden heart failure. Stress is thus considered a significant risk factor for cardiovascular deaths.

Burnout syndrome: challenging to diagnose

Burnout syndrome is not considered an independent disease. Instead, it can be seen as a particular form or even a preliminary stage of stress-related depression.

An exact diagnosis is often challenging and requires in-depth psychiatric and psychomotor diagnostics. Since there are no clear diagnostic criteria, the “Maslach Burnout Inventory” (MBI) test, which consists of 22 questions and three criteria based on a point system, is sometimes used. However, this needs to be clinically validated and is only of limited significance.

Internal and neurological examinations are also required to rule out other causes that can lead to severe exhaustion. Numerous diseases are possible here, for example, diabetes, multiple sclerosis, kidney or thyroid diseases.

Burnout or Depression?

It is usually challenging to make an exact distinction between burnout and depression since meaningful classification systems are only available for depression. In both cases, the diagnosis is solely based on identical symptoms.

Therefore, the focus is on where the feeling of “being burned out” comes from. While depression can have numerous causes, the exact elaboration of which often takes years, the professional context (or rarely also the care of relatives) is decisive in the case of burnout. According to a revision of the diagnostic catalogue published by the World Health Organization (WHO) in 2022, one can speak of burnout when the exhaustion is the result of “chronic stress at work (…) that has not been successfully managed”.

A professional and detailed anamnesis is of the utmost importance for the diagnosis. This can only be provided by qualified doctors and psychotherapists. A burnout that is not recognized and treated carries a high risk of turning into depression and, therefore, requires early and appropriate therapy.