“Burn-out” As A Medical Condition

Every few years, the World Health Organization produces a new version of the International Classification of Diseases, a catalog of acknowledged medical conditions that is used as a diagnostic guide by health care providers.  With every new version of the ICD, there seems to be some controversy about whether or not a particular ailment or complaint should be recognized.

burnoutThis year, the “should it be included or not” controversy swirls around “burn-out.”  Apparently there has been a long, ongoing debate about whether “burn-out” should be recognized as a medical condition, and the WHO has now weighed in with a “yes”:  the ICD-11 lists “burn-out” and defines it as “a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed.”  According to the WHO, “burn-out” syndrome is characterized by “1) feelings of energy depletion or exhaustion; 2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and 3) reduced professional efficacy.”  Notably, the ICD-11 tries to draw a kind of line in the sand by stating that “burn-out” “refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”

My guess is that many — if not all — workers have, at some particular point or another in their careers, experienced “burn-out” as defined by the WHO.  Jobs typically involve stress, and it’s almost inevitable that there will be periods where multiple obligations pile on top of each other, leaving the worker feeling overwhelmed, exhausted, and dissatisfied.  But . . . should “burn-out” be viewed as a medical condition?  What, exactly, is a doctor supposed to do for a patient who presents with classic “burn-out” symptoms — prescribe a three-month vacation, or a new job, or new job responsibilities, or a change in the patient’s workplace manager?  Will employers be required to allow leaves of absence, beyond their designated vacation periods, for employees whose doctors diagnose them with “burn-out,” and will health insurers be required to pay for vacations as a form of treatment?  By classifying “burn-out” as a diagnosable health condition, aren’t we really going far down the road of “medicalizing” common aspects of our daily lives?

And can “burn-out” really be limited to the “occupational context,” as the ICD-11 instructs, or will the same concepts underlying workplace “burn-out” ultimately be recognized in other areas, like family or marital or college “burn-out”?  Here’s a possible answer to that question:  the ICD-11 now recognizes video gaming, with cocaine, and alcohol, and gambling, as a potential source of addiction.

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