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Burn-Out Has Officially Become A Medical Condition

Can the World Health Organisation classification help increase awareness of the fact that stress from overworking may lead to death?

by Edoardo Liotta and Shamani Joshi
29 May 2019, 5:23am

Photos from Unsplash.

Update as of May 30: The World Health Organisation has released a statement clarifying their position, saying "burn-out is not classified as a medical condition." According to this media release burn-out is now classified as "an occupational phenomenon."

Do you remember the Mean Girls character Janis Ians breaking down the various cafeteria cliques to Cady Heron? ICYMI, the scene mentions a table of ‘burnouts’, who basically make for the stoner squad on a constant quest for motivation and munchies. Urban Dictionary describes being burnt out as the stupid or demotivated feeling one has when coming down from a marijuana high. But burn-out is actually a serious medical issue that causes complete physical and mental exhaustion from prolonged stress at work, to the point where you just DGAF about anything.

Now, the World Health Organisation (WHO) has added it to its list of diseases or International Classification of Diseases (ICD-11), along with gaming disorders. This declaration was made last weekend at the World Health Assembly in Geneva, an event where the WHO’s 194 member countries came together from May 20 to 28 for the 11th revision to the health handbook.

The WHO defines burn-out as being “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.” The organisation divided it into three dimensions: “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.” Which means, being burnt out is more than Monday blues or wanting to bang your head against the wall every time you think about your deadlines and deliverables.

Hopefully, this addition to the WHO’s ICD can influence legislation in countries like Japan, China, South Korea and India, where zealous overworking is causing serious social harm.

In Japan, it is completely normal to work 60-hour weeks, with some people clocking in 100 hours of overtime. And that’s not only causing businessmen to fall asleep all around major cities, but also an increased rate of heart failure, suicide and literally, death by overwork.

Similarly in South Korea, a country so stressed that the New York Times said it was “on the verge of a national nervous breakdown,” yearly competitions to see who can do nothing for the longest time are being held to remind people to take time off. While in China, work schedules are not called nine to five anymore, but “996”, meaning working from 9 a.m. to 9 p.m., six days a week. Even Indians are pretty prone to burn-out because of the ‘Always On’ work culture in the country that demands they work longer hours for better financial gains.

The Asian culture is largely such that we’re always told by our parents or authority figures that we need to push ourselves to our limits if we truly want to achieve something. In fact, pop culture even portrays Asians as the stereotypical supernerds who are always working hard instead of getting hard.

“In burn-out most people are irrational because they’re not slowing down,” says clinical psychologist and author Seema Hingorrany. “It’s been told to us to not be lazy and there are demands from even our parents because they’ve worked very hard. So then the competition in our mind sets in and we push ourselves because we think our cousin or neighbour is doing well. Many of my patients even feel ashamed for taking a sabbatical because they have been so judged by their family members. I have patients who come to me saying they have anxiety or depression and are then diagnosed with burn-out. If it is declared as a medical diagnosis then people will at least understand the concept of burn-out.”

With the medical classification of the ICD comes the hope that businesses worldwide will be more cognisant of staff welfare, and be less dogmatic about long hours. And even if that doesn’t happen, at the very least, we can warn friends and family if we notice signs of burn-out, and become more empowered to say no to excessive work if we find ourselves at risk.

Another major move worth mentioning was the WHO’s classification of video game addiction as a disorder. However, this has met opposition from many players in the global gaming industry. There’s even a statement signed by trade bodies from the UK, Europe, United States, Canada, Australia, New Zealand, South Korea, South Africa and Brazil that says stuff like parental controls can manage play time, urging the WHO to rethink its decision. On Sunday, 88 local Korean gaming related organisations issued a joint statement in opposition of the new ICD. And reports say that if adopted, this recommendation could lead to stricter regulations on the gaming industry, which can negatively impact their sales.

“It’s not that gaming isn’t good; that’s like saying watching TV is not good,” says Manoj Chandran, the CEO of White Swan Foundation, an Indian not-for-profit organisation researching mental health issues and finding ways to cope with addiction. “But now that it’s been classified by the WHO as a disease, people have the knowledge that it can be a problem and once you have this knowledge, you can shape yourself and your capabilities towards not becoming addicted and affecting your loved ones.”

On a more positive note, gender identity disorder is no longer classified as a mental health concern. Gender nonconformity will now be seen as something to address in the sexual health category, which is a massive victory for transgender activists who have been fighting for the desire to identify yourself in a different gender from the one you were born as to be recognised as totally normal and natural.

The WHO was set up in 1948 to combat communicable diseases like tuberculosis and small-pox back in the day. So while antibiotic-resistant bacteria, Ebola and HIV are still major health concerns, it’s good to see it broadening its health horizons to account for relevant manmade malaises and socio-culturally developed trends like vaccine hesitancy and climate change. It acknowledges that even things that don’t have tangible symptoms like a fever or cold don’t deserve to be dissed as diseases.

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