Abstract
Aim: To achieve a deeper understanding of the patient’s perception regarding individual aspects related to the development of exhaustion, hindering and supporting factors in the recovery process, and potential remaining consequences, 7–12 years after receiving an exhaustion disorder diagnosis.Participants and Methods: Twenty patients previously diagnosed with and treated for exhaustion disorder were interviewed 7–12 years after onset of the disease. The semi-structured interviews were transcribed verbatim and analyzed with inductive content analysis.Results: Three main themes with patterns of shared meaning resulted from the analysis: “it’s about who I am,” “becoming a more authentic me,” and “the struggle never ends.” The interviewees described rehabilitation from exhaustion disorder as the start of an important personal development toward a truer and more authentic self-image. They perceived this as an ongoing long-lasting process where learned behavior and thought patterns related to overcommitment and overcompliance needed to be re-evaluated. The results also convey long-term consequences such as cognitive difficulties and reduces energy, uncertainty about one’s own health, and the need to prioritize among one’s relationships.Conclusion: Patients with exhaustion disorder are still struggling with dysfunctional strategies and functional impairments such as cognitive problems which limit their lives, 10 years after receiving their exhaustion disorder diagnosis. While informants describe some positive consequences of ED, the results also emphasize the importance of acknowledging that the patients are embedded in systems of relationships, in working life as well as in family life. This needs to be considered, together with other aspects, when working toward prevention of stress-related mental health problems.
Highlights
During the last decade, many countries including Sweden have seen an increase in the number of people requiring sick leave due to psychiatric diagnoses (Försäkringskassan, 2020)
The themes are organized in a temporal continuity conveying how the participants’ experience with exhaustion disorder (ED) has developed over time. It reflects the relationship between ED and their own personality, what was important in the process of recovery, and what remained as an ongoing journey toward an alluring perception of balance
Other factors that were perceived as contributing to the ED were control needs, compulsion, and perfectionism
Summary
Many countries including Sweden have seen an increase in the number of people requiring sick leave due to psychiatric diagnoses (Försäkringskassan, 2020). Exposure to psychosocial stressors at work is associated with an increased risk of sick leave due to a diagnosed mental disorder (Duchaine et al, 2020). Many patients seeking care for stress-related problems suffer from extreme fatigue, sleep disturbance, and cognitive impairments. These clinical attributes go beyond the original definition of the psychological term “burnout,” used to describe exhaustion due to work-related stress exposure. In the Netherlands, clinical burnout has been suggested as a diagnosis, using diagnostic criteria such as neurasthenia and adding the component that the problem should be workrelated (Schaufeli et al, 2001). In Sweden, a criteria-based diagnosis known as exhaustion disorder (ED) was developed, serving as a clinical manifestation of burnout. An important distinction between ED and burnout is that burnout is considered an occupationally specific dysphoria, primarily associated with work-related stress, while ED refers to work-related stressors and to stressors from private life (Hasselberg et al, 2014)
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