A few years ago, Anna Katharina Schaffner became the latest victim of the exhaustion ‘epidemic.’ It began with a kind of mental and physical inertia – as she put it, a “sense of heaviness” in all that she did. Even the most mundane tasks would sap her of all her energy, and concentrating on her work became increasingly difficult.
If the media are to be believed, it is a purely modern ailment; almost every time Schaffner turned on the TV, she would see a debate on the trials we face in our 24/7 culture. “All the commentators represented our age as the most terrible one out there – that it’s the absolute apocalypse for our energy reserves,” she says.
But can that really be true?
A literary critic and medical historian at the University of Kent in the UK, Schaffner decided to investigate further. The result is her new book, Exhaustion: A History, a fascinating study of the ways in which doctors and philosophers have understood the limits of the human mind, body – and energy.
Men are more likely to take extended sick leave than women for experiencing exhaustion and burnout.
A study of German doctors found that nearly 50% of physicians appeared to be suffering ‘burnout,’ reporting, for instance, that they feel tired during every single hour of the day and that the mere thought of work in the morning left them feeling exhausted. Interestingly, men and women seem to deal with burnout in different ways: one recent Finnish survey found that male employees reporting exhaustion were far more likely to take extended sick leave than burned out women, for instance.
In her book, Schaffner quotes one German newspaper article that claimed burnout is just a “luxury version” of depression for high-flying professionals. “Only losers become depressive,” the article continued. “Burnout is a diagnosis for winners, or, more specifically, for former winners.”
Is exhaustion really a purely modern ailment?
“Theorists generally agree that depression entails a loss of self-confidence, or even self-hatred or self-contempt, which is not the case for burnout, where the image of the self often remains intact,” Schaffner says.
“Anger in burnout is generally not turned against the self but rather against the organization for which one works, or the clients with whom one works, or the wider socio-political or economic system.”
Nor should burnout be confused with chronic fatigue syndrome (CFS), which involves prolonged periods of excruciating physical and mental exhaustion for at least six months, with many patients reporting physical pain at the slightest activity.
According to one argument, our brains are simply ill evolved to deal with the modern working environment. The increasing emphasis on productivity – and the emotional need to prove one’s worth through one’s job – leaves workers in a permanent state of ‘fight or flight.’
For many, moreover, the pressure does not end with work. Cities (and technological devices) are always buzzing with life, and this ‘24/7 culture' can make it difficult to rest at any hour of the day or night. With no chance to recharge our minds and bodies, our batteries are constantly running dangerously low.
That, at least, is the theory.
When Schaffner explored the historic literature, however, she found that people did suffer from extreme fatigue long before the rise of the modern workplace. One of the earliest discussions of exhaustion was written by the Roman physician Galen.
With the birth of modern medicine, doctors began diagnosing symptoms of fatigue as ‘neurasthenia.’
Religious and astrological explanations continued abound until the birth of modern medicine when doctors began diagnosing symptoms of fatigue as ‘neurasthenia.’ Physicians now understood nerves transmitted electrical signals, and they believed that someone with weak nerves may, therefore, dissipate energy like a badly insulated wire. Intellectual figures from Oscar Wilde to Charles Darwin, Thomas Mann, and Virginia Woolf were all diagnosed with neurasthenia.
Although few countries tend to diagnosis neurasthenia today, the term is often used by doctors in China and Japan – again, with the occasional accusation that it is an alternative, stigma-free way of labeling depression.
Clearly, many people throughout history have felt just as tired as we do, suggesting that fatigue and exhaustion may just be part of the human condition. “Exhaustion has always been with us,” Schaffner says. “What changes through history are the causes and effects that are aligned with exhaustion.”
Physical and mental reasons
In reality, we still don’t really understand what gives us that feeling of ‘energy’ and how it can dissipate so rapidly without physical exertion. We don’t know whether the symptoms originate in the body or the mind, whether they are the result of society or created by our own behavior.
Perhaps the truth is a little of all of these: a growing understanding of the mind-body connection has shown that our feelings and beliefs can have a profound influence on our physiology. We know that emotional distress can increase inflammation and exacerbate pain, for instance – and in some cases, it can even bring about seizures and blindness.
"It’s really hard to say that an illness is purely physical, or purely mental, because often it is both at the same time."
“It’s really hard to say that an illness is purely physical, or purely mental because often it is both at the same time,” Schaffner says. In this light, it’s not surprising that our circumstances could cloud our minds and nearly paralyze the body with lethargy. And this fact should in no way suggest the symptoms are imaginary or made up – they may be just as ‘real’ as the fever that comes with the flu.
Schaffner doesn’t deny the stresses of modern life. She thinks that it comes, in part, from our greater autonomy, since more and more jobs have given us the freedom to manage our own activities. Without clearly defined boundaries, many people over-stretch themselves.
If history has taught us anything, it is that there is no easy cure for this malaise. In the past, patients with neurasthenia might have been prescribed prolonged bed rest – but the boredom often only exacerbated the distress. Today, people suffering from burnout can receive cognitive behavioral therapy to help them manage their emotional exhaustion and identify ways of recharging.
“The cures for exhaustion are subject specific. You have to know yourself what costs you energy and what restores your energy,” Schaffner says. Some people might need stimulation from extreme sports, while others may prefer reading a book. “What’s important is to draw boundaries between work and leisure,” she says. “These are certainly under threat.”
There is something very reassuring to learn that one is not alone in the way one feels, that others have felt the same – although in different circumstances.
You can read the original BBC article through this link.