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Occupational Burnout – Part 2: A Cumulative Trauma Disorder

  • Published
  • 21 June 2019
  • Category
  • WorkCare Upates

This is the second part of a two-part blog post by WorkCare Associate Medical Director Brittany Busse, M.D.

In Part 1 of this post, I promised to explain how I reached the conclusion that occupational stress is a cumulative trauma injury. Allow me to walk you through three related inherent truths.

Health at Work

The first truth is that a positive state of health occurs when a person has a balanced sense of physical, mental and social well-being. Without this balance at work, employees cannot achieve whole health. Work is important because it occupies so much of our time, helps defines us, makes us part of a larger community and gives us purpose.

Meanwhile, in many professions health status is strongly influenced by the expectations of and interactions with peers and superiors. In addition to following clearly defined rules, many employees feel obligated to comply with unspoken expectations of conduct, such as being virtually available 24/7, performing jobs outside of their skill set to cover for others or doing personal tasks for their boss.

Studies show that expectations of availability, even if only perceived by the employee and not directly stated, lead to symptoms of burnout and have a direct impact on health balance.


The second truth is that all aspects of health are interdependent. Consequently, a dysfunction in one aspect will affect functioning in other aspects. Here’s an example:

An employee is suffering from a higher level of social stress than he is capable of processing. His emotional distress stimulates neurotransmitters and hormones that affect his physical health. The employee experiences an immune system response that makes him susceptible to illness. When he gets sick and has to take time off work to recover, he loses income and a sense of connection, in turn creating rather than relieving stress, which in turn impacts his health.

Baseline Variances

The third truth is that baseline levels of health, abilities and thresholds for reaching a level of dysfunction vary by individual. The physical health threshold is easily recognized and acknowledged. For instance, an employer may make adjustments to match a worker’s physical capabilities or modify repetitive tasks.

But mental and social health baseline measures are not as readily apparent. In most cases, workplace stress management strategies focus on the individual employee’s responsibility to improve his or her own resiliency and coping mechanisms rather than changing the circumstances that cause stress. Employees are told to get more and better-quality sleep, meditate or get regular exercise. The employee is left with little to no agency in requesting that accommodations be made.

When we acknowledge these three truths, we can then work together to devise effective solutions for occupational burnout. As with other cumulative trauma syndromes, it is important for the employee to recognize his or her own abilities, baseline and threshold for dysfunction, and feel empowered to communicate this information to their employer without fear of retaliation or judgment

This will likely require a cultural change in workplaces where a lack of mental and emotional resilience is seen as a character defect. With an understanding of individual capabilities, the employer can make adjustments to help the employee achieve physical, emotional and social health balance. For example, more employees may be hired to help relieve 24/7 expectations.

An effective burnout prevention and treatment plan focuses on both responsibility and empowerment. Employees must feel free to speak up without fear of retaliation or shame in the workplace, while employers must be prepared to listen with compassion and without judgment.

When efforts are made to keep the employee health triad in balance, then we will be much better equipped to take these necessary steps forward together.