Burnout: Our Civilization’s Disease

Belgian philosopher Pascal Chabot calls burnout “civilization’s disease.” It’s certainly symptomatic of our modern age. “It is not only an individual disorder that affects some who are ill- suited to the system, or too committed, or who don’t know how to put limits to their professional lives,” he writes. “It is also a disorder that, like a mirror, reflects some excessive values of our society.”

Marie Asberg, professor at the Karolinska Institutet in Stockholm, describes burnout as an “exhaustion funnel” we slip down as we give up things we don’t think are important. “Often, the very first things we give up are those that nourish us the most but seem ‘optional,’ ” write Mark Williams and Danny Penman in Mindfulness: An Eight-Week Plan for Finding Peace in a Frantic World. “The result is that we are increasingly left with only work or other stressors that often deplete our resources, and nothing to replenish or nourish us — and exhaustion is the result.”

Another result of our current toxic defi nition of success is an epidemic of addiction. More than twenty- two million people in the United States are using illegal drugs, more than twelve million are using prescription painkillers with out a medical reason, and almost nine million need prescription sleep aids to go to sleep. And the percentage of adults taking antidepressants has gone up 400 percent since 1988.

Burnout, stress, and depression have become worldwide epidemics. And as we found out when we held a Third Metric conference in London in the summer of 2013, and then one in Munich in the fall, the need to redefi ne success is a global need. In the United Kingdom, prescriptions for antidepressants have gone up 495 percent since 1991. In Europe, from 1995 to 2009, the use of antidepressants went up by nearly 20 percent per year. And the health consequences of stress are increasingly documented around the world. According to a Danish study, women who described workrelated pressures as “a little too high” faced a 25 percent increased risk of heart disease. As June Davison, a nurse at the British Heart Foundation, cautioned, “Feeling under pressure at work means stressed employees may pick up some unhealthy bad habits and add to their risk of developing heart problems.”

In Germany, more than 40 percent of workers say that their jobs have become more stressful in the past two years. Germany lost fi fty- nine million workdays to psychological illness in 2011, up over 80 percent in fi fteen years. When she was the German Labour Minister, Ursula von der Leyen, now Germany’s defense minister, estimated that burnout is costing the country up to ten billion euros per year. “Nothing is more expensive than sending a good worker into retirement in their mid- forties because they’re burned out,” she said. “These cases are no longer just the exception. It’s a trend that we have to do something about.”

In China, according to a 2012 survey, 75 percent of Chinese workers said their stress levels have risen in the previous year (versus a global average of 48 percent).

According to a Harvard Medical School study, an astounding 96 percent of leaders said they felt burned out. In fact, one of the legal defenses offered by Steve Cohen, CEO of SAC Capital, the hedge fund that was indicted in 2013 and agreed to a record $1.2 billion fi ne, was that he missed a warning about insider trading because of the one thousand emails he gets every day. There is a price to pay for that kind of daily deluge. After less than a year as CEO of Lloyds Banking Group, António Horta- Osório took a two- month leave in 2011. Lloyds’s chairman Sir Winfried Bischoff blamed “overwork, lack of sleep.” Upon his return, Horta- Osório said, “With the benefit of hindsight I should have gone a bit slower.” And in October 2013, Hector Sants, head of compliance at Barclays, took a leave of absence. A month later he quit his job entirely, after being diagnosed with exhaustion and stress.

The word “stress” was first used in its modern sense in 1936 by physician Hans Selye. It means “the body’s nonspecific response to an external demand,” as immunologist Esther Sternberg put it in her book Healing Spaces: The ancient Romans used a word with a similar meaning — stringere, “to squeeze tight,” “graze,” “touch,” or “injure.” When the word entered the English language in the fourteenth century, it continued to refer to physical hardships of the environment. By the nineteenth century, the word had begun to take on a meaning combining the environment’s physical effects with the body’s responses to them. Then, in 1934, physiologist Walter B. Cannon showed that animals produce adrenaline in response to such stressors. This was indeed the fi rst proof that the physical environment could trigger a bodily response. Selye took the concept one step further, showing that many other hormones were produced in response to stress, and that these could have lasting physical consequences on the body.”

What produces stress in our bodies is deeply subjective. It’s as if stress is always fl oating around looking for something — or someone — to land on. And it often lands on completely trivial and insignifi cant things. We only realize how trivial and insignificant they are — and unworthy of our attention, let alone our stress over them — when something truly signifi cant intrudes upon our routine: the loss of a loved one, sickness, a health scare.

I remember when we had just moved to Washington. I was completely preoccupied with decorating our new home, getting our two young children into new schools, responding to my editor’s queries on a manuscript I had just sent in, and organizing a birthday dinner. In the middle of all this, I drove to Georgetown hospital for a routine physical exam. When I arrived at the hospital I moved mindlessly through my exam, silently processing my to- do list while a nurse took my blood pressure. The doctor was in, then out, then in again. At some point it occurred to me that she was speaking with unusual seriousness. I think she caught my attention with the word “lump.” It needed to “come out as soon as possible.”

One of the problems with my philosophy of assuming the best until told the worst is that when I had first noticed the lump at home I assumed it was just a harmless cyst. It had happened before. No problem. But now the doctor was using words such as “biopsy” and “surgery,” and telling me the lump would not “aspirate” — that she could get no fl uid from it and wanted to get it out right away. I felt myself beginning to black out, and I asked if I could lie on the examination table while she explained what this meant. As if through a thick fog, I heard the doctor talking about how long it takes to “get lab results after surgery” and that she always likes her patients to come to her office to review the results and discuss alternatives in person. In an instant, deadlines were disappearing and priorities recalculated.

A week after my surgery we got the results. The lump was benign. It had been a long week full of “what- ifs,” a week that brought home one great truth about life: the ease with which the big crises can wipe out the small ones that seemed so critical just a moment before. All of our small anxieties and trivial preoccupations evaporate with the sudden recognition of what really matters. We are reminded of the impermanence of much that we assume is forever and the value of so much we take for granted.

Again and again, all around the world, it often takes a personal health crisis to get us to pay attention. That moment came for the former president of Google China, Lee Kai- Fu, in the fall of 2013 when he was diagnosed with cancer. Lee told his fifty million followers on Sina Weibo (a Chinese social media network) that he had decided to change his life: “I naively used to compete with others to see who could sleep less. I made ‘fighting to the death’ a personal motto. . . . It’s only now, when I’m suddenly faced with possibly losing 30 years of life, that I’ve been able to calm down and reconsider. That sort of persistence may have been a mistake.” His new plan: “Sleep enough, adjust my diet and start exercising again.”

Excerpt from Thrive pp. 28–34