Burnout is a psychological syndrome involving long-term exhaustion, feelings of cynicism and reduced personal accomplishment from one's work. It is not the same as stress and can develop over time from a buildup of stressors without relief. Signs include emotional exhaustion, depersonalization of others, and a reduced sense of personal achievement. Those at highest risk include health workers, teachers, social workers and police due to high workload, responsibility and lack of support. Prevention focuses on reducing stressors individually through relaxation, and organizationally by increasing job resources, support, and participation in decision making. Treatment involves counseling, skills training, social support and modifying work conditions.

2. Try to imagine yourself and your work situationDo you feel overwhelmed with your work demands?

3. Do you seem not to receive enough support from the organization?

4. Do you seem physically exhausted and “wiped out”?

5. Do you seem tired all the time?

6. Do you seem careless in relationship to service recipients / patients?

7. Do you report feelings of incompetence when doing work tasks?

8. Do you seem frustrated because of the work?

9. Do you seem to have lost your enthusiasm for the job? People that are burned out report the followingIf you report the following“I’m frustrated. It’s getting impossible to do a good job, and the situation just keeps getting worse.”

10. “I have lost my enthusiasm for work I really liked.”

11. “I’m feeling overwhelmed, overloaded, overworked and trapped. There’s no way out.”You might susceptible for or might even experience

12. Burnout SyndromeBy Mohamed AbdelghaniSpecialist Of Psychiatry

14. DefinitionA psychological complex phenomenon related to stressful working environment, long-term exhaustion and diminished interest. First coined by Herbert Freudenbergerin his 1974 Staff burnout, based on the 1960 novel A Burnt-Out Caseby Graham Greene.According to Maslach; Burnout syndrome is characterized by three dimensions: 1) Emotional exhaustion (depletion of emotional resources to contact with other people, feelings of frustration, anger and dissatisfaction). 2) Depersonalization (negative feelings and dehumanization of the relationships with the persons who expect personal “investment”). 3) Reduced personal accomplishment (a tendency to evaluate oneself negatively, particularly with regard to work).

15. Outcome of Burnout SyndromeOn organizational level:Reduced job performance and organizational commitment. Higher intention to leave the job.On individual level: Health related outcomes (increases in stress hormones, coronary heart disease, circulatory issues). Mental health problems (depression, etc.).Excessive absenteeism, inordinate use of sick leave, wish to leave the job and decrease to overall well-being.

17. How does burnout develop?Herbert Freudenberger “12 phases” theoryA compulsion to prove oneself.Working harder. Neglecting one's own needs.Displacement of conflicts (person does not realize the root of the distress).Revision of values (friends or hobbies are completely dismissed).Denial of emerging problems (cynicism and aggression become apparent).Withdrawal (reducing social contacts to a minimum; alcohol or other substance abuse may occur).Behavioral changes become obvious to others.Depersonalization (life becomes a series of mechanical functions).Inner emptiness.Depression.Burnout syndrome.

18. Biological aspect:HPA axis dysfunction:Some studies found elevated levels of cortisol after awakening in burnout participants.However, results have so far been inconclusive.Failure of adult hippocampal neurogenesis: Elevated HPA-axis activityin reaction to stress can lead to the suppression of hippocampal neurogenesis, which is assumed to be one of the pathways for depression and other neuropsychiatric disorders. Brain-derived neurotrophic factor “BDNF”:Neurotrophic factors are critical regulators of the formation and plasticity of neuronal networksStress reduces BDNF gene expression in the hippocampus and this reduction can also be prevented by antidepressant drug treatment.Also more recently Mitoma et al. (2007) found a negative correlation between job stress levels and sBDNF levels.

20. Signs & SymptomsThe burnout process can be resumed in the following stage: Stage 1: High workload, high level of job stress, high job expectations Job demands exceed job resources. The job does not fulfill one’s expectations. Stage 2: Physical / emotional exhaustion Chronic exhaustion, sleep disturbances, susceptibility to physical pain. Emotional exhaustion; fatigue even when work comes only back to mind Stage 3: Depersonalization / Cynicism / Indifference Apathy, depression, boredom A negative attitude toward the job, the colleagues and service recipients .Withdrawal from the job, the problems; a reduced work effort Stage 4: Despair / Helplessness / Aversion Aversion to oneself, to other people, to everything Feelings of guilt and insufficiency

21. What is not burnout? Stress:Can intensify burnout but is not the main cause.Symptoms may be more physical rather than emotional.Produces urgency and hyperactivity, while, Burnout produces helplessness.Emotions associated with stress are over-reactive, those of burnout are more blunted. Depression:Extends to every life domain (e.g., work, family, leisure), while, Burnout is specific to work context.Post traumatic stress disorder (PTSD): Caused by the exposure to a traumatic event or extreme stressor.

23. High risk individualsProfessional groups who work with the public that include:

24. Teachers

25. Health professionals "mostly; general practitioners and nurses".

26. Social workers

27. Policemen

28. Judges

29. Working environment that involves:

30. Extreme or hazardous responsibility.

31. Severe consequences, shift work.

32. Workload, time pressure.

33. Role conflict and role ambiguity.

34. Lack of social support and job autonomy .Example: Nurses working in hospitals are at the highest risk of burnoutWhy?The demands of patients, possible hazards in nursing care.The constant fear of error in medicine administration.The heavy workload or time-pressure in trying to provide care for many patients during a work shift.The lack of respect from the public. The dislike of the traditional domination of physicians in the health care system. Frequent and unpredictable aggression or violence from patients while on duty. The lack of role clarity. Understaffing and lack of support at working environment.

36. Prevention of Burnout syndromeAt the organizational level:Eliminating, reducing or counteracting stress factors of working environment.Development of values in organizational culture. Development of attitudes and rewarding relationships. Development of effective social support. Modeling, programming and resource planning. Consultation with employees. Employee participation in decisions making concerning changes. Custom fitting and comfortable workplace.

37. Prevention of Burnout syndrome “cont.”Prevention of Burnout syndrome “Cont.”At the individual level:Relaxation techniques.Cognitive restructuring. Social skills training, Didactical stress management. Attitude change.

38. Intervention programs on Burnout SyndromePerson directed intervention programs :Psychotherapy: “cognitive-behavioral measures”.Counseling Adaptive skill training. Communication skill training. Social support.Exercises for relaxation.

39. Intervention programs on burnout syndrome “cont.”:Intervention programs on Burnout Syndrome “Cont.”Organization directed intervention programs :Work evaluation:Decreasing job demands.

40. Increasing job control.

41. Change shift work systems & introduce vacations.Increasing participation on making decisions.Training supervisors & managers.Training for better coping “stress management intervention”.Counseling & therapy.