Just consider these figures. Almost 45% of the employees in India report difficulty concentrating on their work. Up to 52% end the workday feeling mentally and/or physically exhausted and 53% say their mental health is also negatively impacting work productivity, as per the ‘2023 Asia Mental Health Index’, a collaborative research report released by global HR consulting firm Aon and global health and wellbeing provider TELUS Health to explore how employees are feeling and the status of their mental health.

According to another study conducted by global consulting firm McKinsey in 2022, four in 10 Indian workers reported symptoms of burnout, distress, anxiety and depression. Among associated factors, toxic workplace behaviour was dominant, accounting for approximately 90% of explained variance for each outcome. “Such behaviour also accounts for 90% of explained variance in intent to leave, with employees reporting a desire to leave their job at a level approximately 60% greater than the global average,” the report adds.

Whatever be the cause, burnout—a special type of work-related stress—is increasingly affecting physical and mental health. So much so that in 2019, the World Health Organization (WHO) declared burnout a legitimate medical diagnosis, listing it in the International Classification of Diseases, or the ICD-11, the world health body’s handbook that guides medical providers in diagnosing diseases.

Cases of burnout had increased during the Covid-19 pandemic, but what’s concerning is that, over three years on, there are few signs of it abating. In fact, cases continue to rise. So, what is going wrong? “Stressful life, daily hassles, low resilience, low family support, disturbed lifestyle including disturbed sleep wake schedule, excessive mobile use, less time for relaxation or to pursue one’s creative hobbies, hardly any physical exercise/ sport activity, excessive caffeine intake/ substance misuse all add to the distress and burnout,” says Dr Sameer Malhotra, director and head—department of mental health and behavioural sciences, Max Multi Speciality Centre, Panchsheel Park, New Delhi.

Pandemic & beyond

The pandemic has resulted in the increased use of digital technology, remote work, work from home and hybrid work models. While convenient, it has led to increased workload, blurring of work-life boundaries, difficulty in adapting to a combination of in-person and remote work. “The pandemic has resulted in significant lingering health issues— mental and physical, which in turn increase susceptibility to burnout. Economic uncertainty, continuing job insecurity, reentry into the job market after job loss, changing roles into unfamiliar ones, uncertainty regarding future can also be the cause for increasing burnout rates. Lingering grief due to pandemic-related losses and change fatigue due constantly having to adapt to changing, uncertain circumstances may also have contributed to increasing burnout rates,” says Dr Aparna Ramakrishnan, consultant, psychiatry, Kokilaben Dhirubhai Ambani Hospital, Mumbai.

Dr Samir Parikh, chairperson, Fortis National Mental Health Programme, however, says burnout was an issue even before the Covid-19 pandemic. “The key reasons for burnout have been chronic stress, poor work-life balance, our approach to life, the pressures, and how they end up having an impact on our psychological functioning, productivity, physical health, and so on,” he explains.

“So, Covid-19 had its own kind of stress, but when it comes to our approach to work, lifestyle and support systems, we are vulnerable to burnout because somehow we push for those extra hours. We are okay with binging shows and all-nighters. We don’t encourage people to take a break, we only encourage them to push harder. These are some of the factors which have their own role to play,” Dr Parikh adds.

Warning signs

Signs and symptoms of burnout can be physical as well as emotional. In terms of physical conditions, you may be suffering from burnout if you have unexplained body aches and pains, headache, eye ache, fatigue, irritable bowel, disturbed digestion, acidity, disturbed immunity and frequent infections, or even blood pressure (BP) fluctuations. “Emotional or behavioural symptoms can range from sadness to lack of interest, significant anxiety and irritability, frustration, apathetic feeling, detachment from work/ goals, dissatisfaction, low motivation, etc,” adds Dr Malhotra of Max Multi Speciality Centre.

Physically, you will feel more fatigued, tired, insomnia, body aches, headaches, the psychosomatic spectrum of illnesses; emotionally, you will be more irritable, you may not feel more jovial or cheerful, you will become more reactive. “You may feel disengaged at work, you may feel that loss of vitality in a way loss of energy, you may actually end up having cognitive I mean that your thoughts may be impacted, for example, being more pessimistic feeling like learned helplessness, and then your behaviour it may come whether increased substance use or your absenteeism at workplace, in your social interactions, you become irritable or you become withdrawn. All of this can have an impact because of burnout,” explains Dr Parikh of Fortis.

Identifying the warning signs of burnout is critical for early intervention. “Recognising them provides individuals with the insight to assess their mental health and take steps to address potential burnout proactively,” says Shristi Sharma, senior psychologist at PeakMind, a Bengaluru-based, digital platform that aims to empower teenagers by making them competitive, performance driven, optimistic, mindful and mentally strong for success and holistic development.

Stressed out?

While we have all heard of stress—many of us are even dealing with it almost on a regular basis—burnout turns out to be a relatively new word. They are related concepts but indicate different stages and responses to prolonged stressors and excessive demands.

“Stress is a natural and often short-term, temporary response to a challenging situation/ specific stressor. It can be positive (eustress) or negative (distress). Both burnout and stress can manifest in several physical, emotional and behavioural symptoms, which in case of the latter, usually abate when the stressor is removed or managed. Stress management techniques, addressing specific stressors, social support are some of the adaptive changes an individual can and make to deal effectively with stress,” explains Dr Ramakrishnan of Kokilaben Dhirubhai Ambani Hospital.

Not all stress is bad but if it gets excessive and one finds it hard to cope with, it can lead to significant distress and dysfunction, feeling emotionally and physically drained, adds Dr Malhotra of Max Multi Speciality Centre.

Burnout, on the other hand, is more severe and chronic and develops due to prolonged unmanaged stress and involvement in emotionally demanding situations. “There is a persistent sense of being overwhelmed and emotionally exhausted, detached and a sense of depersonalisation. There is often a sense of helplessness and individuals are not able to figure out or implement effective coping strategies. More comprehensive interventions like help and support from mental health professionals, significant lifestyle alterations are required for management of burnout,” offers Dr Ramakrishnan.

Dealing with it

Dealing with burnout involves a multi-faceted approach. Individuals can benefit from setting boundaries between work and personal life, seeking social support, and practising stress management techniques like mindfulness or exercise. “Organisations play a pivotal role in preventing burnout by promoting a healthy work-life balance, providing mental health resources, and addressing systemic issues contributing to burnout. While there is no one-size-fits-all treatment for burnout, a combination of self-care, organisational support, and, in some cases, professional counselling can help individuals recover and prevent its recurrence,” says Sharma of PeakMind.

Medications help in correcting the underlying neurochemical imbalance. “Psychotherapy helps in achieving ventilation and catharsis and encouraging positive thinking patterns and healthier coping styles,” adds Dr Malhotra of Max Multi Speciality Centre.

We need to know and learn to listen to the cues that our body and mind give us to understand the importance of breaks, be okay with seeking help, making sure our lifestyle is adequate, whether it’s ‘me’ time, ‘friends’ time and our ‘hobby’ time, feels Dr Parikh of Fortis. “It’s also important that this is in sync with our organisation. One has to discourage people from working overtime, encourage taking breaks, and focus on encouraging people to have the positive mental health approach, the right guidance, the right education, in terms of being mental health aware. I don’t think it needs to be looked at as a treatment, but less intervention can be done,” he adds.

Strategies to prevent burnout

  • Set clear, realistic and achievable goals in personal as well as professional life
  • Set healthy boundaries; be assertive
  • Establish and maintain support systems at work and in life
  • Take good care of yourself; have adequate sleep, regular healthy meals, exercise and physical activity
  • Consistently use relaxation and stress management techniques; build up healthy coping skills
  • Improve job satisfaction by skill addition; contribute to a positive work environment
  • Manage time; prioritise tasks
  • Incorporate clear & healthy communication strategies and attitude at work and outside of work
  • Go for regular mental health check-ups and evaluation to catch the early signs and symptoms of burnout and stress
  • Take regular breaks; schedule time for rest and relaxation
  • Dr Aparna Ramakrishnan, consultant, psychiatry, Kokilaben Dhirubhai Ambani Hospital, Mumbai

How employers can support

  • Give employees peace of mind that sick leave may be used to access respite
  • Encourage employees to take adequate time off for their recovery
  • Develop a suitable return-to-work protocol
  • Keep the barriers to care seeking in mind
  • It is critical for employers to build support systems and signposts to make it fast and easy for employees to access helpful resources