The oft-bemoaned experience of work-related burnout has a whole new meaning. Too often, people tell themselves to (literally) work through that spiraling sense of a lack of control, apathy, and sheer dread at the mere idea of work, because it's not "that serious" or it's "just work." But now, according to the World Health Organization (WHO), burnout is an actual medical diagnosis.
Six months after a viral BuzzFeed article called burnout the "millennial condition," WHO’s inclusion of burnout as a medical diagnosis reminds us that yes, burnout is actually serious and needs to be taken care of. Years of research summarized in a 2017 review showed that the work-related stress, exhaustion, and fatigue that characterize burnout span across a wide variety of occupations. The study hypothesized that, even though research on burnout has been on the rise for the last 40 years, the syndrome had not reached medical diagnosis status sooner because most studies lacked attempts to identify diagnostic criteria.
Those diagnostic criteria have arrived. This medical language change occurred in the latest 2019 International Classification of Diseases (ICD), which is WHO’s diagnostic handbook for medical providers. The handbook has its own dedicated section for “problems associated with employment or unemployment”, which is where you can find “burn-out [sic].”
But what is burnout, exactly? According to the ICD-11, "Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed." Burnout is characterized by "feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy."
These experiences are widespread in a work-to-live and live-to-work culture like ours, where there are both rising costs of living and increasing fetishization of the #hustle. This combination makes it especially important for burnout to become a medically-recognized condition. The medical seal of legitimacy can expand treatment options for people experiencing burnout; if burnout is a diagnosis, it can be coded as something insurance should cover for treatment.
While people with any mental health experience can also endure burnout from work, the medical diagnosis of burnout outlined in the ICD-11 specifically excludes people with the following diagnoses:
- Adjustment disorder
- Disorders specifically associated with stress
- Anxiety or fear-related disorders
- Mood disorders
The logic here is that these disorders are going to produce burnout-like symptoms regardless of work situation and work-related stress. The ICD-11 specifies that burnout only applies "specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life."
The new status of burnout as a medical diagnosis might be especially significant for people who have multiple marginalized identities. A 2019 study in the journal Stress & Health suggests that political dissimilarities with colleagues and incivilities experienced at work lead to increased burnout. And a 2010 study published in the Journal of Applied Psychology found that incivility based on ethnicity or gender had concurrent impacts on women of color’s experience of feeling burnt out and actively harmed at work. Similarly, lesbians experience a great deal of minority stress in the workplace, according to a 2019 Journal of Lesbian Studies article.
The medical definition of burnout as exhaustion with one’s job as well as "increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job" is especially relevant when it's not "just work" impacting the work experience. These minority stresses at work conceivably impact experiences of burnout in people of color and other marginalized communities.
Moving forward, it will be the responsibility of health care providers to validate and treat these real mental health concerns resulting from toxic work cultures. Perhaps, with the advent of this new diagnosis, burnout will be taken seriously as a mental health condition that can’t simply be treated with a single day off here and there, or more vacation time. In this work-first live-second culture, one can hope.