Table 1.

Twelve phases of burnout syndrome by Freudenberger and North.

1. The Compulsion to Prove Oneself; demonstrating self-worth obsessively; showing enthusiasm; accepting responsibility easily. 2. Working Harder; reinforced efforts; an inability to switch off and relax from work. 3. Neglecting Needs; problems with sleep; eating disorders; lower level of social interaction. 4. Displacement of Conflicts; problems are repressed; feelings of threat, panic and nervousness. 5. Revision of Values; values are reinterpreted; friends and family neglected; hobbies seem irrelevant; work is the only focus. 6. Denial of Emerging Problems; intolerance; perceiving collaborators as stupid, lazy, demanding or undisciplined; social contacts harder; signs of cynicism and aggression; problems are viewed as caused by time pressure and work, not because of life changes. 7. Withdrawal; social life very small or nonexistent; need to feel relief from stress; abuse of alcohol/drugs. 8. Odd Behavioral Changes; visible changes in behavior; friends and family concerned. 9. Depersonalization; seeing neither self nor others as valuable; not being able to perceive own needs. 10. Inner Emptiness; feeling empty inside and to overcome this, look for activity such as overeating, sex, alcohol or drugs; activities are often exaggerated. 11. Depression; feeling lost and unsure, exhausted; future feels bleak and dark. 12. Burnout; can include total mental and physical collapse; time for full medical attention.