The revelation by the Tanaiste, Mary Harney, that she suffered from "burnout" during the summer months is yet another example of the stress of working life. She told Marion Finucane on RTE radio: "In the beginning of summer, I was suffering from burnout. It was a question of so many things coming together."
What is burnout? It is a specific form of occupational stress which usually occurs after many years of high-quality performance. It does not suddenly emerge, but progresses slowly throughout a person's working life. Because individuals prone to burnout often start out as enthusiastic over-achievers, the organisations they work for tend to heap more and more responsibilities on them. The result is a cycle of constant over-achievement leading to burnout.
To the outsider, people affected by the condition seem suddenly unable to perform their work. They appear less efficient, have a diminished interest and are unable to maintain performance.
The burnout victims themselves will experience extreme tiredness, sleeplessness, irritability and even full-blown depression. They may suffer from tummy trouble, shortness of breath and palpitations. People with burnout feel helpless and easily become frustrated. Increased risk-taking is another feature of the condition.
The Tanaiste is not alone in experiencing work-related stress. A recent survey of patients attending the Dublin County Stress Clinic showed that 80 per cent of them had an occupational component to their stress. When they were assessed for signs of clinical depression, 45 per cent of males and 52 per cent of females were rated as having moderate to severe depression. Another striking feature of the survey was the number of senior business people affected, including directors, business owners and senior managers.
Dr Abbie Lane, consultant psychiatrist at the Dublin County Stress Clinic says that, at a personal level, the individual cost is high. "People feel uncomfortable, unproductive, are very aware of not performing, as well as other health effects which flow from being stressed."
Her survey also found that those with occupational stress showed poor coping abilities. Recreation and self-care were low on their lists of priorities. The ability of those studied to process stressful situations and to use coping and cognitive skills to appraise and deal with their situations was extremely low.
This latter finding is probably related to the effect of the long-term release of the stress hormone, cortisol. The constant release of cortisol is known to cause mood changes and can lead to actual physical changes taking place in certain parts of the brain.
By speaking openly about her problem, Mary Harney has undoubtedly increased awareness of burnout. According to a recent health policy seminar in the US, public awareness of a disorder usually increases dramatically when a celebrity develops it. Dr George Lundberg, editor-in-chief of Medscape.com, told the conference that when celebrities were open about their illnesses, it often educated the public.
Betty Ford, wife of President Gerald Ford, did a great deal to raise awareness of breast cancer in 1974 when she spoke out about her own experience of it. Detection rates rose immediately in a phenomenon that became known as the "Betty Ford blip".
However, the conference was also told that public campaigns which spring up in the wake of celebrity publicity can sometimes lead to misunderstandings about what can be done to prevent a particular disease.
Which brings us back to the question: "How can burnout be prevented?" A dual approach to stress is undoubtedly the best one, combining interventions at both the personal and workplace levels.
Specific interventions that have been shown to be effective include changes to workplace design, management style, work schedules and training. At a personal level, the active promotion of a healthy lifestyle seems to show beneficial results.
Reactive, short-term strategies or "off-the-shelf" solutions for existing workplace stress do not work, according to Prof Michael Kompier of the University of Nijmegen in the Netherlands. He advocates a pro-active and personalised approach which has been shown to improve employees' general health and wellbeing.
Recent pictures of, and interviews with, the Tanaiste suggest that she has benefited from just such an approach during her "time out" during the summer.
Dr Muiris Houston, Medical Correspondent, can be contacted at mhouston@irish-times.ie or by leaving messages at tel 01-6707711, ext 8511. He regrets he is unable to reply to individual medical problems.