You have a demanding job requiring many hours, or you have several jobs that you need to run between. You also have a partner and maybe a couple of children (very reasonably) all who want some piece of your time. Your parents, who are still living in the family home, are starting to display possible signs of dementia and you are trying to work out how to get your father to stop driving before he kills someone – like your mother.

Your sleeping is affected, and you are propping yourself up with too much alcohol or other sugary stimulants. You’ve not made it to a morning run or bike ride for months. After another fight with your spouse, you finally get to see a psychologist saying “I am stressed. Burnout. So anxious.”

The job of a psychologist like me is to work out which one it is – Stress, or Anxiety or Burnout? They are all different concepts with different (and some overlapping) causes and treatments.

While researchers need very sharp definitions, the moment terms like Stress, Anxiety or Burnout get used away from pure research, even only as far as a psychology clinic the definitions start to get a little blurry. By the time Stress, Anxiety or Burnout hit the street they can easily mean anything the speaker thinks they mean!


Stress comes from external sources – the parents, the children, the spouse, the job, etc, etc. Stress is the general experience of physical, mental, emotional and relational factors that cause the person and their nervous system to feel overwhelmed. It is typically short term in nature, and ideally … once the stressor is removed, then not too long after that, the stress symptoms can noticeably decrease.

Stressed clients are likely to say, “I have a lot going on right now,”

The symptoms of stress can come on without warning, which is consistent with resilient systems that demonstrate a capacity to cope until they suddenly are unable to cope.

Anxiety comes from internal sources – inherited tendencies as well as from internal attributions eg the “I am not good enough”, and other not very useful thoughts.

An anxious client might say, “I have a lot going on right now, and I don’t know how I’m going to handle it.” 

Most clients displaying anxiety report a history of anxiety often back into childhood. What usually drives them to seek treatment is a failure of the past coping strategies to work with the current situations. For example – the person who previously used large amounts of physical activity to manage their anxiety. With changing circumstances (injury, age, less time to exercise) they now need to develop new anxiety-management strategies.

Burnout is a concept developed by Professor Christina Maslach in the 1970s exploring the occupational psychological hazards endured by people working in human services and caregiving professions. The dimensions of Burnout were considered to be

  1. Exhaustion Dimension: wearing out, loss of energy, depletion, debilitation, and fatigue
  2. Cynicism Dimension: negative attitudes toward clients, irritability, loss of idealism, and withdrawal from professional obligations
  3. Inefficiency Dimension: reduced productivity, low morale, and inability to cope

Role of the organisation in reducing stress and Burnout

There are valid criticisms of the original burnout concept that it is entirely focused on the individual (victim-blaming), and not the organisation. To avoid this, it is more useful to start looking top down in your organisation to reduce the workplace stressors leading to burnout of staff, rather than see burnout as individual failures or problems.

  1. Organisational level – strong values and culture, recognition of the potential for vicarious trauma in the work, effective induction and training processes, courageous human resources processes, etc
  2. Team/Manager level – respectful leadership, useful performance management, etc. You can have great culture and values that are undermined by poor managers. Alternatively great managers unsupported by timid corporate services.
  3. Individual – appropriate supervision and monitoring of individual performance, and behaviour.

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