A Brief History of Burnout (Part 1)
Elijah, Moses, and the Ancient Tales of Exhaustion
The timeless struggle
Burnout is nothing new. While the word ‘burnout’ didn’t enter the zeitgeist until the last century, physical and emotional exhaustion is as old as our pursuit for success. This is illustrated metaphorically in the famous Greek story of Icarus. Both Icarus and his father Daedelus, a skilled craftsman, are imprisoned on the island of Crete. In an attempt to escape, they fashion wings made of feathers and wax and then escape into the sky.
“Let me warn you, Icarus,” said his father in a serious tone, “take the middle way, in case the moisture weighs down your wings, if you fly too low, or if you go too high, the sun scorches them. Travel between the extremes.” What solid advice. But Icarus didn’t listen. As he took to the sky, he felt an insatiable urge to ascend as far as he could into the heavens. He flew higher and higher until his wings melted and he screamed his father’s name and came tumbling to his demise. Icarus perished from burnout due to excessive ambition.
In the Bible, the prophet Elijah has a successful streak of performing miracles and victories, but then breaks down in despair and exhaustion in front of God. This became known as “Elijah’s fatigue,” which included symptoms like disengagement, physical and emotional exhaustion and disappointment in one’s pursuit of a cause.
In the story of Moses, he feels like he’s given so much of himself during the exodus from Egypt, but has received little in return. Both Elijah and Moses never had a salary – but certainly the scrutiny of a big boss upstairs – and yet their descriptions feel very similar to our modern definitions of burnout.
Burnout in the medieval ages
The first time the word burnout was referenced in an emotional context seems to be in 1599. William Shakespeare wrote about exhaustion in terms of love in his poem The Passionate Pilgrim, where he says,
She burn’d with love, as straw with fire flameth
She burn’d out love, as soon as straw outburneth
In the medieval ages, there was a word for feeling numb and depleted. It was called acedia and can be traced back to the Greek word "akēdeia," which means "carelessness" or "negligence." It was often used to describe monks in religious communities who were so bored of their spiritual practice and spent time agitated, distracted and killing time with aimless activities. Instead of whole-heartedly devoting themselves to prayer and their church responsibilities, they’d be chatting up visitors, snacking on cheese curds and mindlessly moving around chairs, pretending to be productive.
This reminds me of myself, scrolling through my emails, pumping myself with the coffee drip and mechanically going through the motions of productivity. These monks were disconnected and disengaged, similar to many of us today who are worn out or not challenged enough. While the monks weren’t striving like Icarus or the over-achiever with three side-hustles, they still represent another form of burnout.
Burnout in other cultures
This wasn’t purely a Western idea or phenomenon. One burnout researcher, Ida Rösing, says the core symptom of burnout is emotional exhaustion, and argues that it occurs universally. For example, the Quechua and Aymara Indians from the Andes (Bolivia) and Ladakhis in the Himalayas (Tibet) describe it as a 'loss of soul.' It involves a combination of exhaustion, feelings of meaninglessness, and emptiness.
According to Aymara cosmology of Bolivia, the soul or "ajayu" is considered an essential life force that sustains a person’s wellbeing. They believe that trauma, extreme stress, or prolonged disconnection from their cultural roots and natural environment, can lead to the separation or loss of one's soul. This sounds a lot like burnout to me. Their solution is to provide rituals, ceremonies, community activities, and to reconnect with nature until the person’s ajayu has returned.
The archaeological evidence backs up the notion that we’ve been getting burned out for a long time. In one remarkable investigation led by Stephen Webb, Australian Aborigines from prehistoric times were examined. By analyzing skeletal stress markers and disease indicators, the researchers unveiled evidence of chronic stress among a hunter-gatherer population in southeastern Australia.
Traveling to Peru, paleopathological studies provide further intriguing insights. The analysis of archaeological hair revealed cortisol levels that suggest a regular experience of heightened stress in the pre-modern period. Our ancestors didn’t have social media, cars and bosses, so it’s true that we have a lot more stressors nowadays. But these studies suggest that high amounts of chronic stress and the resulting physical and emotional collapse from burnout aren’t just modern issues. There are countless stories and examples like this throughout history.
All that said, your inclination to burnout may not solely be influenced by external factors – it could also be in your genes.
Inherited strain
Could it really be that some of us are genetically predisposed to getting burned out? In a fascinating study by Kenneth Kidd of Yale, he and his team measured the distribution of certain genetic markers related to a dopamine gene variant called 7R. Research suggests that individuals carrying the 7R gene variant may exhibit a greater inclination towards novelty-seeking, risk-taking, and exploratory behaviors. Interestingly, the gene variant seemed to have a correlation with populations who migrated the farthest in history. Risk-taking behavior indeed! It’s been called the “wanderlust gene” or the “restless gene”.
In his book Behave, Stanford professor Robert Sapolsky vividly illustrates the prevalence of the 7R gene variant among the descendants of intrepid individuals who journeyed to the remote reaches of the Amazon Basin. Astonishingly, Sapolsky reveals that a remarkable 70% of these descendants possess this gene variant—a genetic inheritance that can be traced back to the courageous souls who, having reached the bustling metropolis of future downtown Anchorage, felt an urge to continue their expedition for another six thousand miles! (It reminds me of that dude who did 50 ironmans in a row.)
This risk-taking and novelty-seeking gene predisposes us to push harder and further beyond our limits, whether that’s traveling across continents or staying up late to finish a report, proving ourselves at work, and taking on more on our plate. And it’s possible that perhaps those of us who have this gene, or group of genes (higher in European and Middle Eastern population), are more likely to burnout.
Interestingly, Asian populations in particular Japanese, Korean and Cambodian have the lowest prevalence of the 7R gene, and fascinatingly some studies suggest that Asian physicians are less likely to get burnout compared to their white counterparts. A Swedish twin study even found that genetic factors explained 33% of the individual differences in burnout symptoms. This all suggests that there could be a genetic component.
That said, it’s very likely that both nature and nurture play their roles and that your upbringing matters. In the same Swedish study above, they state that environmental factors explained a substantial part of the variation as well, not just genetic makeup. The impact of the environment on an individual's stress response system begins early on, even before birth. When a pregnant mother faces tough times or high-stress situations, it can affect the production of hormones called adrenal glucocorticoids, which play a role in how we handle stress.
These hormone levels can actually impact the growth and development of the growing baby. On top of that, the environment the mother experiences can also influence her own physiology and behavior. And guess what? These changes in the mother can then affect how the stress response system of the child develops. It's like the child's stress response gets "programmed" based on what the mother goes through.
So, in a nutshell, it’s very likely that your early experiences and environment really do have a significant impact on your stress response system, along with your genes, and how likely you are to get burned out.
Neurasthenia, the modern malady
Fast-forward to the early 19th century. The Industrial revolution, capitalism, mass transportation, and technology began to create a more frazzled and frenetic society that was constantly on the move, full of people valuing hard work and all looking to fulfill their passions.
In Japan (where I currently live), a society that is known for being the epitome of punctuality where high-speed bullet trains are never late, wasn’t that way until recently. A Dutchman who lived in Japan in the late 1800’s wrote in his diary that “Japanese people are never on time for anything!” It wasn’t until after WWII with the introduction of cheap quartz watches, timekeepers and a greater abundance of trains that Japanese people started to become more punctual.
Emotional and physical exhaustion – still not called ‘burnout’ yet – became more and more prevalent with the advent of sweatshops, factories and production lines. Build more stuff! Be more efficient! Work hard! And then the modern precursor to burnout finally got a name. It was a syndrome called neurasthenia, marked by frantic busyness and juggling too much. It appeared in the late 1800's and was popularized by neurologist George Miller Beard. He described it as "severe debilitating mental and physical fatigue arising after even minimal effort." The reason, he said, was due to the fast pace of change in modern society.
As more people moved to cities, Beard thought that our accelerated modern life and stressful jobs put excessive demands on peoples’ brains. This weakened and depleted their nervous system and caused exhaustion, anxiety, despair, insomnia, indigestion, palpitations, and migraines. He even wrote about the increasing use of clocks, timetables and how this created time pressure. In the good ol' days, he said, there was a wider margin of error to get to appointments. Now you had to be exactly on time, not a second late, which created more stress and "affected your pulse." If Beard were alive and working today, he'd hate it.
Like our modern idea of burnout, there was an entire self-help market for neurasthenia — from books, courses and people peddling the cure. There were even belts that would electrocute you, although I’m not sure how effective that was. Before you could wear the ‘electropathic belt’, the doctor would ask you a series of questions to confirm your diagnosis, like, “are you nervous, timid or indecisive? Are you wanting in will power? Do you crave stimulants and alcohol? Are you restless or sleepy? Do you blush easily?” If you answered yes to any of these, they would happily give you the electric treatment. Oh, and another popular cure was the “rest cure,” which required patients to stay in bed for 4-6 weeks without getting up.
Neurasthenia was, for the most part, seen as a modern malady. It’s strikingly similar to burnout, which is often seen as the product of the social and cultural shift into a more service-oriented society (the first people to report burnout were physicians and nurses, those who suffered from empathy fatigue). Our more recent predicament — always-on, glued to your phone and being stuck indoors for two years during the pandemic — has exacerbated that trend. Now everyone seems to be burned out.
So, what happened to neurasthenia? Physicians agreed that modern society was causing all sorts of issues. But neurasthenia seemed to cover too many symptoms, and was really hard to test with any single diagnostic tool. Neurasthenia eventually fell out of use because the definition was too vague. By the mid 1900's, the term had all but disappeared.
But after some time, the resurgence of burnout inevitably returned to the scene.
To be continued…
Great post, that's really interesting about the genes.
Speaking of burning yourself out, I'm waiting for your book on burnout