Burnout

Burnout describes a state of profound exhaustion following prolonged stress. Those affected feel empty, powerless, and burned out. For parents, this condition often stems from the constant care of a child with mental health challenges: doctor’s appointments, crises in the evening, and constant vigilance.

The World Health Organization lists burnout in the ICD-10 under code Z73.0 (burnout). The Z codes identify stressors that affect health. Z73.0 is not considered a standalone medical diagnosis. Doctors use the code as an additional code to document a state of exhaustion. The IQWiG health portal emphasizes that burnout is not recognized as a distinct clinical condition in the medical community.

The term originated in the 1970s and initially referred to helping professions such as nursing and medicine. Today, it also includes caregiving for a sick family member.

Experts describe three key areas. First, emotional exhaustion: You’re already running on empty by the time morning rolls around. Second, a growing sense of detachment—sometimes irritability or indifference—toward tasks that used to be important. Third, the feeling that you’re getting less done than usual.

In parents’ daily lives, this often manifests as:

• Sleep problems despite extreme tiredness
• concentration wanes; even small decisions feel overwhelming
• Withdrawal from friends; the phone remains silent
• physical complaints such as headaches, backaches, or gastrointestinal problems
• the feeling of no longer being able to meet anyone’s expectations

Anyone who has barely any energy for weeks on end and feels emotionally numb should take this seriously. Persistent exhaustion can be a sign of other health conditions.

Burnout and depression share symptoms such as exhaustion, sleep disturbances, and a lack of motivation. One distinguishing feature helps differentiate between them: Burnout symptoms are usually linked to a specific source of stress—such as worry about a child—and subside when that stress is genuinely alleviated.

A depressive episode has a broader impact. The low mood, lack of joy, and negative thoughts overshadow all areas of life and last for at least two weeks, often regardless of external circumstances. Feelings of guilt, hopelessness, and low self-esteem are typical.

The line between the two is blurred. Persistent burnout can develop into depression. Therefore, prolonged exhaustion should be evaluated by a professional.

Parental burnout develops gradually. Caring for a child with mental health issues creates a strain that rarely lets up. Nights become short because the child can’t settle down. Your mind stays on high alert, even when things are calm.

Several factors reinforce one another:

• Constant vigilance over months, without any real periods of rest
• a lack of support when one person bears the brunt of the burden
• Waiting times for therapy slots, which prolong the stress
• the pressure to do everything right

Sleep deprivation over weeks further depletes one’s reserves. In this situation, burnout is an understandable reaction to being overwhelmed for too long. Parents are not to blame for this.

The first step is to acknowledge your own exhaustion and not push it aside. Self-care may sound like a luxury, but it actually involves small, manageable things: an hour free of responsibilities, a walk, a phone call to someone who will listen.

Several approaches have proven effective against chronic stress:

• Delegate tasks and accept help instead of trying to handle everything on your own
• Schedule time for rest and don’t just hope for it later in the day
• Reevaluate your expectations, because not everything has to be perfect
• Relaxation techniques such as progressive muscle relaxation or mindfulness
• Exercise, which physically relieves stress

Taking early action helps preserve your energy reserves longer. If you take breaks in a timely manner, you’re less likely to experience severe exhaustion. For more information, see “Burnout Prevention for Parents.”

If exhaustion persists for weeks, sleep is no longer restful, or dark thoughts arise, it’s time to seek medical help. The first place to turn is your family doctor’s office. They will rule out any physical causes and, if necessary, refer you to a psychotherapist or psychiatrist.

Rückenwind Janike, a social worker and parent coach currently training to become a child and adolescent psychotherapist (not yet licensed), provides support and relief to parents. Rückenwind does not make diagnoses and is not a substitute for treatment. The assessment of burnout, depression, or stress in a child should be handled by a medical or psychotherapeutic specialist. For the child, child and adolescent psychiatry (KJP) is the appropriate place to go.