Burnout symptoms: which complaints are part of it and what a questionnaire can and cannot say

You sleep badly, you are irritable, your concentration is gone and every week feels like the one before. You no longer know yourself: is this still busyness, or are these symptoms of burnout? Which complaints are part of it, what a questionnaire can and cannot say about them, and what the GP does instead of a test, is all below. The stress scan from BioProfile measures how much these complaints trouble you, and gives you an indication of where you stand today in this area, as the first of the 11 health areas the full scan assesses. This is not a diagnosis. It is insight, to see where you stand today. And to help you make better choices in your food and lifestyle. What this scan does not do: identify burnout or make a diagnosis. Only a doctor can do that.

Burnout symptoms: what the well-known questionnaires measure

Most online tests descend from one of three instruments. The oldest is the Maslach Burnout Inventory from 1981, built for research among people in caring professions. It measures three things: emotional exhaustion, distance from the work and the people in it, and the feeling of achieving less.⁠³ The newest is the Burnout Assessment Tool from KU Leuven, tested with 1,500 Flemish employees. It measures four core dimensions, exhaustion, mental distance, and reduced emotional and cognitive control, which together form a general burnout factor.⁠⁴

The third one is Dutch and sits in general practice: the Vierdimensionale Klachtenlijst, developed to tell general tension apart from depression, anxiety and physical complaints caused by tension. Across ten studies in general practice, the tension scale pointed to a psychosocial problem with an accuracy of 0.79; it is the most general expression of psychological complaints, and that is exactly why a high score is not a label.⁠⁵

Why no test establishes a burn-out

Because nobody agrees on what should be measured. A review of 182 studies among 109,628 doctors in 45 countries found that 86 per cent of the studies used the Maslach questionnaire, and that in doing so they applied at least 142 different definitions of burn-out. The percentages found therefore ranged from 0 to 80.5 per cent, and the researchers could not make a reliable statement about how often it occurs.⁠² A second review of 92 studies reached the same conclusion from the other side: in research the line between a burn-out and a depression is thin, and there are no agreed criteria for drawing it.⁠⁶

Thuisarts puts it plainly: there is no test. Your GP can recognise over one or more conversations whether this is the case for you, a questionnaire can help with that, and so can what the people close to you say. If you have had complaints for longer than six months and you are mainly tired and exhausted, a burn-out is possible.⁠¹ If the complaints last a shorter time, your GP is more likely to speak of overstrain, and you usually recover from that in about three months, in three steps: understanding and accepting what is there, working out which problems are causing the tension, and solving them.⁠⁷

What a stress scan measures

The stress scan asks five questions about the past two weeks: your sense of control, things piling up, your confidence that you can handle your problems, things going the way you want, and switching off at the end of the day. Each question is given points, the points are added up and converted into a stress score from 0 to 100, with the reading band it falls into. Higher is better.

The questions are modelled on the Perceived Stress Scale, since 1983 the most widely used scale for perceived stress. It measures how unpredictable, uncontrollable and overloading life feels, and its makers deliberately published no clinical cut-off value.⁠⁸ That is why we give you a position on the scale and not a label. Our questions are worded by us, not a copy, so the score is not a validated clinical score. Self-reporting is the right method here: with perceived stress, the experience itself is the thing being measured.

What a stress scan does not measure

A stress scan is not a burnout test. It does not measure cortisol or any other stress hormone, it cannot identify an anxiety disorder or any other condition, and it does not make a diagnosis. A low score is not a judgement about your mental health; it is a baseline. If worrying or a low mood affects your daily life, that calls for a conversation with a doctor, not a number to work on. And if you have been mainly tired and exhausted for longer than six months, the GP is the place where the question “is this burnout?” belongs.⁠¹

What you do with your score

Today’s score is your baseline. Repeat the scan in two weeks, with the same questions, and you have two numbers instead of a feeling about a period in which your memory cannot be trusted anyway. If you want to do something in those weeks, start with the first step from Thuisarts: acknowledging what is there, and talking about it with someone you trust or with your GP.⁠⁷ There is no medicine that makes you better from this; the work is finding out what causes the tension, and that starts with knowing where you stand.⁠¹