The Wellness Scoop - The Extra Scoop: What is Burnout?

Episode Date: April 3, 2025

Burnout is a growing concern, dominating workplace discussions and social media. But what does it actually mean? Is it just a buzzword or a real issue we need to take seriously? In this episode, we explore what burnout is, why it’s such a big deal right now, and what you can do to protect yourself. To help us unpack all of this, we’re joined by Dr. Claire Ashley, neuroscientist and clinician, who has 15 years of experience helping individuals and organisations prevent and recover from burnout using evidence-based strategies. In This Episode, We Cover: What burnout actually means and how to recognise it Burnout versus day-to-day stress, what's the difference? The most effective ways to prevent and recover from burnout Simple steps to reduce stress and avoid burnout Dr. Claire Ashley is the author of The Burnout Doctor: Your 6-step recovery plan Get your tickets for The Wellness Scoop Live here: https://cadoganhall.com/whats-on/the-wellness-scoop-with-ella-mills-and-rhiannon-lambert/ Learn more about your ad choices. Visit podcastchoices.com/adchoices

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As our listeners probably know by now, our Extra Scoop episode is all about taking those topics that everyone's talking about and just quickly breaking them down for you so that you have expert-led insights that leave you feeling informed and very empowered when it comes to your health and well-being. And with nearly 90% of UK employees experiencing some level of burnout in the last two years and the third reporting frequent physical and mental exhaustion due to workplace pressures, burnout just feels like this widespread issue. I know for sure both of us keep seeing it everywhere, lots and lots of headlines. It feels incredibly relevant. Lots of us also just feeling constantly

exhausted, overwhelmed, like we're running on empty. But the question Rhi and I have been having is what does burnout actually mean? Why is it gaining so much attention at the moment? And obviously, most importantly, what can we all be doing to prevent it? So to help us unpack burnout, we are joined by neuroscientist and clinician Dr. Claire Ashley, who's got 15 years of experience helping individuals and organizations prevent and recover from burnout with evidence-based strategies. So welcome, Claire. Thank you for joining us today. Thank you so much for having me. Oh, it's our pleasure, Claire. Honestly, when we saw your impressive CV and the work you've done around this area, we were like, we have to get her on for an extra scoop. So let's

break it down, Claire. What is burnout really? How do we even define this? What's the clinical difference, I guess, between just being tired and run down all the time versus actually being burned out? Yeah. So there is a key differentiator between regular stress, which everyone experiences and is something that we all go through periods of stress throughout our lives, both at home and at work. And that's not to be pathologised. It's part of the normal human experience.

And it's something that we all have to learn coping strategies to manage and to get over it successfully, right? But burnout is something completely different to regular stress, and it's really important to make the distinction between the two. Burnout has an official definition. It wasn't actually officially recognized until 2019 when the World Health Organization gave it an official definition.

That definition is that burnout is an occupational syndrome, so they only recognize it as happening in the context of work, which is debatable, but that's the official definition. That definition is that burnout is an occupational syndrome, so they only recognize it as happening in the context of work, which is debatable, but that's the official definition that arises as the result of workplace stress that has not been successfully managed. There are three parts to it. Without these three parts, then technically you don't have a diagnosis of burnout. Those three parts are, one, depersonalization. So that's kind of the posh medical term for lack of caring, feeling really detached from your work and a lot of apathy, cynicism. The second component is emotional exhaustion.

And emotional exhaustion is something that I think a lot of people that experience stress identify with. So that's the fatigue of caring for too much for too long. And the third component is reduced performance at work. To have an official diagnosis of burnout, then you have to take all of those boxes in the context of prolonged stress at work. Now, I personally slightly disagree with this definition. I think that it ignores the fact that people that do unpaid work can get burnout.

I'm thinking about parents. I'm thinking about caregivers. It also ignores demographics of people that are at risk of burnout, where the burnout has not necessarily been driven by the work. Particularly people that are neurodivergent, so people with ADHD and autism, are also at really high risk of burnout that isn't necessarily purely fueled by work. The thing about burnout is that it starts off as stress. You go through a process where the stress is affecting you maybe a little bit and maybe that some days are harder than others, but

you're taking it in your stride and you're managing it. Then it gradually gets worse and worse and worse and you develop a whole myriad of symptoms that are emotional, that are physical before you end up in full-blown burnout. That slide into burnout is difficult to recognize, but it's really important because if you end up in full-blown burnout, then most people need an average of three and a half months off work sick. It's a one to three-year average recovery period. That is very different from regular stress, which a lot of people can handle through strategies, through having some time out,

having a nice weekend away or spending some time with their friends. Burnout isn't like that. It requires so much more than just taking a couple of days off. It also carries, unfortunately, a whole raft of problems alongside the symptoms that you get along with it, including health problems such as an increased risk of cardiovascular disease, diabetes, increased risk of accidents. And actually, if you are under the age of 45, then your risk of dying from any cause goes up significantly. So burnout is very different from regular stress.

That was such a helpful differentiator, because as I said, certainly where I sit, I feel I keep saying the word burnout everywhere. Totally guilty of overusing it as well myself, When we say I have been feeling really burnt out, but actually what we mean is we feel overwhelmed for a little bit too long. We feel a bit too much stress versus what we feel we can handle over a prolonged period, but it's not that clinical diagnosis. And I think what you said, there's something I wanted to pick up on there, which I personally thought was really interesting, is this idea of stress as a normal human

experience. And where I say again, I feel, at the moment, with a lot of conversations in the world of health and wellness, it's almost like we're trying to eradicate stress or eradicate difficult things, which doesn't feel like a plausible way to live life. Life can't be kind of Instagram perfect. It ebbs, it flows, you have stress and it's learning to live with that and feel like that's very normal. It's normal to feel overwhelmed at times. You're not doing anything wrong. Is that something you see or agree with? Oh, yeah, I completely agree with what you've just said. And I think that it comes from a number of things actually. So I think first of all, social media definitely plays a part in this. You

mentioned the Instagram aesthetic, the picture perfect lifestyle. I think it's really difficult when you're on social media to remind yourself that actually you are just seeing someone's highlights real. Actually, even if they're sharing difficulties, then what they're sharing is very curated as well and isn't necessarily real life. It's difficult if you're constantly on social media, which a lot of us are, to kind of have that realization, especially when things are difficult for yourself. I think that modern work is really difficult as well. And I think that people are experiencing stress more

these days and in different ways at work as well. And different groups are experiencing it in different ways and some groups are more at risk than others. So when we look at the scientific literature, we see that there are groups that are experiencing stress more and you'll probably see this in your own practice as well. It's largely younger people compared to older people. It's women compared to men. And then within women that are suffering from stress overwhelmed burnout, it's mothers in particular. And then within that group, it's black, Asian and Latina mothers.

You can understand that because at every point, they're experiencing more stress and more layers of complexity when it comes to work and their home life. As a woman, you might be even in equal relationships, cis-eterosexual relationships, then you're likely to be paying the childcare bill, which as we know is very, very expensive in this country. You're likely to be taking on more of the mental and domestic load in the household. That adds on an extra layer of stress in addition to your work stress as well. Then obviously if you're Black, Asian, Latina, or any other marginalized group, then you are going to be subject to microaggressions and bias and discrimination, which also adds

on that extra layer of stress. I think really difficult and complex lives. I think that's why people are also struggling with it at this particular present point in time. The world of work has changed as well. We can't forget that. We are working in very different ways now with remote working, hybrid working, the return to office culture. We're working in a cost of living crisis and a difficult economic climate, which means that there's more pressure to perform at work, but also your money isn't going as far outside of work, and that also creates the perfect storm for stress and overwhelming burnout. It makes perfect sense. And one thing you mentioned in the definition at the start,

so first of all, I'm sure a lot of people didn't know that it was actually clinically defined in 2019, but you mentioned one of the criteria being in the workplace. How does this impact, I can imagine you said mothers are obviously high up, but how does this impact women that perhaps their work is that they're a mother every day? They have no definition. How do they then get diagnosed with something when a stay at home mum still isn't really seen, I think, in the larger context as a job perhaps?

Yeah, I completely agree with your take on that. And that's why I personally disagree with that definition. The reason why the World Health Organization only recognises it as a workplace problem is because they very much view it as the endpoint of prolonged workplace stress. It's a normal physiological reaction to end up in that position when you've been subject to prolonged workplace stress. But they don't feel it's the fault of the individual, and they very much feel like it's a workplace culture issue. With the definition, they were very clear that they wanted workplaces to be responsible for making changes so that their employees didn't burn out. They didn't

feel like it was something that individuals could control particularly. And certainly within the scientific community, this is a very strong feeling as well. And I totally understand that. But you're right. It excludes people, particularly parents, mothers and other caregivers. I'm thinking about people who might look after elderly relatives, for instance, or people, children with special educational needs or disabilities or whatnot. It excludes them from that definition. It is my personal belief as a clinician that anything that causes prolonged stress can end you up in burnout.

The difficulty for women, and particularly mothers, is that when it comes to managing your work stress, you can possibly, potentially if it's available to you, take some time out and have some therapy or be supported to develop new coping strategies to manage that stress and tackle the root cause of your stress. But when you're a mother, obviously as your child grows, the stress has changed slightly. My kids are slightly older now, so I don't have to worry about a toddler running into the middle of the road and killing themselves or sticking their fingers in a plug socket. My challenges now with my children are very different.

They're largely centered around emotional stresses and bodily changes and puberty and all of that sort of stuff. That's still difficult. It's still stressful. I still have to be there for them. But that's still difficult. It's still stressful. I still have to be there for them, but that's still stress. And I can't remove myself from that situation because I've chosen to be there. And the other thing is it's complicated by the fact that you love your children. But modern parenting is hard. And I do feel like women are being not necessarily

excluded by the official definition, but I think they are still at risk and are a group that definitely need help in this area because it's hard being a working mom, it's so difficult. And even if you're not working, being a mom is difficult as well. Absolutely. I think there'll be a lot of nodding heads. But as you said, for caregivers on the whole as well. And so if you are thinking about this, you put it really brilliantly, Claire, this kind of sliding scale from normal stress, which is that that exists, that's part of life to prolonged stress that begins to overwhelm you for a period of

time, and then you slide down that ramp into eventually a kind of clinical definition of burnout. What are the biggest steps when you're getting to that? In my mind, I think the interesting bit that people will be really relating to is that moment where you feel you can't cope with the stress, where it's becoming overwhelming or it's gone on a bit too long, and you're really starting to kind of feel it in your body. And I think even if you, most of us listening to this, haven't necessarily had a kind of

a clinical definition or diagnosis of burnout, can probably all relate to that moment where you feel that kind of depersonalization, as you said, that ability that you just can't cope with the smallest things because you're so overstimulated, so overwhelmed for a prolonged period of time. What do you do at that point? Yeah, so you're absolutely spot on. There is a stepwise slide into burnout where, unfortunately, there's a whole raft of things that conspire to prevent you from recognizing it until you get to that point where you realize that you're in over your head.

So I'll just briefly talk you through those stages and then what you need to do when you realize that you're in over your head. So the first stage of burnout is called the honeymoon period. And this is characterized by enthusiasm for your work. I'm sure we've all experienced this when you're undertaking a new job, a new role, a new task, a new initiative, and you're undertaking a new job, a new role, a new task, a new initiative, and you're full of enthusiasm. You absolutely love what you're doing.

You take a lot of joy and meaning and satisfaction from your work, and you're very productive. This can feel wonderful, but the danger with this stage is that if you don't adopt strategies to wind down and be boundaried about what you take on, then you can progress to feeling stressed. The second stage of burnout is the onset of stress. This is when some days are more stressful than others. This is when you start to overcommit your work. You start to maybe neglect your hobbies and your personal needs, start to see your family and your friends less, and you feel like your job is the most important thing in your life. What you're trying to do really with overcommitting to your work is trying to feel less stressed and to manage your stress.

In this stage as well, you might start to notice the onset of some physical symptoms. So burn up is very physical thing to experience. And the most commonly reported symptom is muscle pain in fact. But there's a whole raft of things you can get with it ranging from headaches, shortness of breath, chest pains, stomach aches,

palpitations, and also psychological symptoms including difficulty focusing and concentrating on memory issues as well. Now, if you then progress to the next stage, which is chronic stress, and this is when more days are stressful than not, and all of the symptoms that you might have started to develop in the second stage start to become worse and more significant. So your problem-solving skills and your performance starts to drop off. Your productivity decreases.

You might start to feel very guilty because you're not performing very well at your job and you realize this and there's a profound sense of failure that comes with that. And you know, the other symptoms might start to get worse. And one of the hallmark features actually of burnout is this thing called emotional dysregulation. So you might find yourself crying lots and bursting into tears over things that you might have been able to manage calmly and in your stride prior to feeling really stressed. Some people might even start to self-medicate with alcohol, drugs, or other substances in this particular

stage. The really sneaky thing about burnout is that you could be having really significant symptoms in that third stage of burnout, but still not really realize what's happening to you, partly because that denial is another core feature of burnout, but also because people don't necessarily have the education, the knowledge, the skills to be able to recognize it in themselves. But up until this particular point, then you've got that opportunity to avoid full-blown burnout and that one to three year recovery period. Then the fourth stage of burnout is burnout itself, and that's where you reach critical exhaustion levels that not just affect your work, but affecting your daily life as well.

This is when you kind of tick all of those boxes of the definition of burnout, and apathy really is the key emotion and characteristic of that particular stage. And then there is a fifth stage, which is habitual burnout, which is when what you're experiencing is habitualised and you need external help to be able to get over your burnout. And depression really characterises that particular stage as well. When you realise that you're in burnout, my advice to people is actually to stop. It's actually really hard to recognize that it's happening to you, but when you're there, to stop if you can to take time off work because your work stress is the thing that is fueling your symptoms. It's helpful

to have some time out. I realize that sick leave isn't necessarily appropriate or accessible to everyone. If you're not able to take sick leave, then that's fine. It might be that you could have some adjustments made at work to allow you, or if you're experiencing it in the home, for instance, if you're a mother, to get some extra help so that you don't have to take on so much of the physical and the emotional workload. And then also to start thinking about the recovery process.

And I would encourage anyone that identifies with being burnt out to speak to their doctor or a therapist so that they can kick start that recovery process. Wow. So it is something then that would be recognized if you went to your GP, because I think a lot of people will be thinking, well, what can I do right now to either prevent or getting to one of those first stages of recovery? And you mentioned it can take one to three years. It sounds very daunting I think for lots of people to think, wow it's going to take me you know one to three years to recover from this.

What would be something now we can actively do? And then the second caveat was the GPs, are they receptive to this conversation? Yeah it is daunting actually to think when you're in the pit of burnout and I understand this because I've been there myself, and I understand how vulnerable you're in emotionally when you're in that position and how just the state of despair and disillusionment that people experience when they're in the full-blown pit of burnout is not a great place to be. It's really hard to help yourself when you're in that situation. I actually found it helpful because to know that it's a one to three year recovery period when I started doing a deep dive into the scientific literature around it, because what

it did is because that recovery was so hard and I really berated myself because I was like, why aren't I getting better quicker? This should be easy. You know, I'm a doctor. I can do this. I should be able to do this really easy. I know what I need to do to get myself better. Why isn't it happening? Actually, when I understood the pathology of it and how your body and your brain changes

with burnout and that it wasn't in my head and it wasn't my fault, it actually took a weight off my shoulders to know, actually, this is completely normal. It gave me that permission to be kind to myself and to be compassionate to myself. Yes, it does feel daunting and overwhelming, but actually, it's a reminder to be kind to yourself and to make sure that your recovery is done slowly and not to rush yourself too much because then you'll just end up risking going back to where you were in the first place. That conversation about GPs is a really interesting one

because obviously I'm a GP myself. And when I burnt out, I didn't know what burnout was. My colleagues didn't know what burnout was. It was never something that we talked about in medical school. We'd never been taught it at all in medical school, in my postgraduate training. I remember having in my GP training one conversation,

one teaching session on how to manage your workload if you're feeling overwhelmed. It was basically come in earlier and go home late. That was it. It wasn't really on the agenda, but things are definitely changing. I know that there is now changes that are happening at medical schools to help medical students to have these conversations with patients, but also themselves and their colleagues, their peers, which is great. I also know that doctors now are talking about it more openly because doctors are burning out at a crazy rate. There is actually now, people might not be aware

of this, there is actually a healthcare service for doctors who are struggling with their mental health. It's called NHS Practitioner Health. I've been a patient of theirs during my own burnout. They saved my life. They're overwhelmed with doctors needing help. This is a conversation that more and more doctors are having amongst themselves. As a result, they are helping patients, I think, to recognize burnout. Someone messaged me on Instagram the other day and they said, my GP actually recommended your book to me. I've written a book called The Burnout Doctor that explains how to effectively prevent burnout, how to recover from it's all evidence based.

And I just thought, oh, my goodness, the fact that GPs are now recommending this book, I was like, it means they understand they get it and they're having those conversations with patients. I was absolutely made up. That's brilliant. Well, congratulations on that. And Claire, for people listening, I think exactly what you just said is so important, because everyone has stress in their life, everyone has overwhelmed. Well, I think most people, probably everyone listening, because they're all looking for these kind of simple tools. What are those day-to-day

tools that we can all start to try and implement in our lives to just better manage the reality of stress. And I almost I quite like the idea that better acknowledging that stress is part of our life, as you said at the beginning, like it's part of human nature, it's part of our lifestyles, there's no way of getting around it. But what should we all be trying to do to have better mechanisms, tools in place to deal with the reality of life stresses more effectively? I mean, my answer to that, and I realize it's not accessible to everyone, is that everyone should be having therapy and or coaching because those things teach you the skills to be able to manage your stress really effectively. But I know it's not accessible to everyone

and not everyone is able to access a therapist. So I think in lieu of that, I think it's about implementing small, achievable, realistic changes into your daily life that allow you to manage your work stress, in particular if we're thinking about workplace burnout, more effectively. When you look at the evidence around effective burnout prevention and effective burnout recovery, there are some common themes. I think these are the things that people really need to concentrate on when it comes to handling stress effectively. The first thing is that control over your work stress and control over your wellbeing is really crucial when it comes to managing your stress effectively. Actually,

what's really interesting in the literature when it comes to burnout is that it doesn't matter what you have control over because it might not be that you can control the big things that are causing you to feel stress. It's okay to have control over smaller things because the people that have control over the smaller things or even that they believe that they have control over them, this mindset shift allows them to then go and make changes to how they cope at work that then basically help them to be buffered and protected against burnout. Those things really matter. How do you identify what you can reasonably control and what you can't? There is an exercise called the Circle of Control exercise that was developed by someone called Stephen Covey.

Feel free to go and Google it or it's all detailed in the book as well. And what it does is it allows you to work through what it is that you can realistically control in work or in your life. And you basically put that in a small circle and then in a bigger circle you write down all the things that you can't control. So to give an example, for instance, when I was burning out as a GP, I couldn't control the fact that I had to see 50 plus patients a day. I couldn't control what they were coming in and seeing me about the fact

that they were really complicated and had huge need. There was nothing I could do about that. What I could control is how I organized my day, how much time I spent with those patients, and how I looked after myself during my working day. Was I taking my breaks? I wasn't. Was I making sure that I was eating nutritious and hydrated?

No, I wasn't. Those things fell by the wayside because I was so committed to looking after them. Actually, had I done this exercise, I could have realized that was something that I could control and I could look after myself. You can also do that for your wellbeing as well. How are you looking after yourself on a day-to-day basis? Things like taking short regular breaks, those things are really important in burnout prevention and burnout recovery as well, much more so than taking one long lunch break or one long holiday every year, long summer holiday. It's better to have regular short breaks. The other thing that really matters when it comes to both prevention and recovery is community

and having a network. What you need is a network, whether it's at work or whether it's outside of work, doesn't matter, where you can share your trials, your tribulations, your difficulties, but also have fun and be your authentic self without fear of judgment, without fear of retribution or consequences. This could be in real life, it could be online, it could be at work, it could be outside of work, but then you need to use your network as well. So when we look at the scientific literature, you don't necessarily have to share your problems with your network in order to get the benefits

of spending time with them and the stress-reducing and buffering effects. You can get stress reduction benefits from sharing successes and good things that have happened to you. There's a lot of evidence around gratitude and shared gratitude. Also, simply socializing together, those things have huge buffering effects on the neurobiological effects of stress on the body. It calms down your nervous system. And I think that these things are all really small but achievable things that people can do right now to help manage their stress levels.

Oh, Claire, I mean, they absolutely are. But equally, I think what you've really shone a light on in this episode today is the fact that burnout is far more complicated than just a buzzword. Burnout does have this definition now and we do all experience overwhelm and stress as Ella said, you know, it's how we manage it and it's interesting you mentioned social community there at the end and what we can actually control because we had an episode on happiness actually and one of the big parts of being happy was being able to give something to another or chat to somebody else and experience gratitude. And I just think this is incredibly helpful for our listeners because burnout can hit everybody in a different way, shape or form. But equally, it's not just the buzzword I think we're seeing. This is actually

a very serious thing and there are things we can do. Ella, do you have anything else to add to that? I think it just comes back to what we're, I think probably a shared passion, which is that these tools that can have such a huge impact on our wellbeing, day to day and long term and prevent conditions such as burnout in this example, actually often, I'm not saying it's simple necessarily to do because you often feel overwhelmed, but there's simple things like stopping to, as you said Claire, make sure you've taken a 10 minute break here, gone outside for 15 minutes there, taken a day off every now and again to just relax. It's making active decisions

to spend time with other people. Again, it could be that 15-minute coffee break walk with a colleague. It doesn't need to be huge, big plans, but these simple day-to-day things are evidence-based ways to improve your health and your wellbeing. In a world of buzzwords and a world of very clever marketing and hype and complicated expensive gadgets and gizmos, which we're really trying to kind of break down for you so you know what's worth your time and money and what's not necessarily a requirement. I think what's interesting to me is that,

just like you're saying, Claire, we come to expert after expert, and the advice is, spend time with friends, do things that are in your control, like go for a walk on your lunch break or make time to drink water during the day. You know, they sound simple, but they add up in they're very evidence based. And I think it's just, for me, it's really reassuring these themes coming up again and again, which is that it's not necessarily easy to implement those habits as we can all attest to, but it is possible

more times than not, and they make a massive difference. Before you get to the depression state or that level, which is when I guess you need the GP intervention, I suppose. Yeah, exactly. Well, Claire, thank you so much for your time today. We so appreciate it. It's been an absolute pleasure. Thank you so much for having me. Thank you guys so much for listening to us on the Extra Scoop. We are a community based podcast. We want this to be helpful for you. So any requests, we want to hear it. Absolutely, let us know which experts that you want on the Extra Scoop and we will see you on Monday. Can't wait!