Facing a blind alley - Experiences of stress-related exhaustion: a qualitative study

Abstract

IntroductionMental illness is a major concern in many countries. In Sweden, stress-related mental illness is currently the most frequent reason for sick leave.ObjectiveThis study aimed to explore patients’ experiences of stress-related exhaustion.DesignA qualitative study with interview data analysed using a phenomenological hermeneutic method.SettingParticipants were selected from public primary healthcare centres in a larger city in western Sweden.ParticipantsSeven women and five men on sick leave from work due to stress-related exhaustion were included in the study.FindingsStress-related exhaustion was experienced as a loss of access to oneself and one’s context and feelings of being trapped and lost in life. The condition had a significant impact on personal identity, raised existential issues and was interpreted as facing a blind alley. Participants described a mistaken direction in life, being forced to stop, change direction and act differently.ConclusionStress-related exhaustion is a challenging, life-changing existential experience that involves a crisis with an opportunity for new insights. Careful consideration of patients’ narratives together with the expertise of healthcare professionals can be combined to improve health and optimise recovery based on individual’s situation.

Exhaustion disorder: scoping review of research on a recently introduced stress-related diagnosis

“…Of the nine studies that qualitatively investigated lived experience of exhaustion disorder, six were conducted in Sweden and three were conducted in Norway using Norwegian participants who were diagnosed according to exhaustion disorder diagnostic criteria. [14][15][16] One study interviewed co-workers of individuals with exhaustion disorder using thematic analysis; 17 the other studies investigated exhaustion disorder samples, four using a phenomenological approach, [14][15][16]18 three using a hermeneutic phenomenological approach 12,13,19 and one using grounded theory. 20 All of these studies collected data through face-to-face interviews, with some complementary sources: diaries, [14][15][16] photographs, 18 telephone interviews and email dialogues.…”

“…17 This collapse was also described as a 'cross-roads' for identifying new personal values and/or a new direction in life. 12,13,19 To recover from exhaustion disorder, some participants described a period relieved of demands as essential. 13,18 Aspects such as balancing energy, 13,16,18 performing self-chosen creative activities, 13 having joyful moments 16 and a supportive environment 13,18,20 were also described as important to aid recovery.…”

“Who I Am Now, Is More Me.” An Interview Study of Patients’ Reflections 10 Years After Exhaustion Disorder

“…Previous studies describing patients’ experience of ED show that the road to ED is outlined as a struggle between demands and resources that finds its crescendo in an existential collapse with physical, mental, and social dimensions, giving rise to a series of negative emotions ( Alsén et al, 2020 ). Feelings of guilt and shame, loss of access to oneself and one’s context, and fear of not being able to live up to demands and responsibilities are described in many interview studies among patients with ED ( Bernier, 1998 ; Ekstedt and Fagerberg, 2005 ; Håkansson et al, 2006 ; Salminen et al, 2015 ; Alsén et al, 2020 ). The process toward recovery follows different phases or steps, resembling those seen in a crisis, for example, a family loss ( Norlund et al, 2013 ).…”

“…The process toward recovery follows different phases or steps, resembling those seen in a crisis, for example, a family loss ( Norlund et al, 2013 ). It often includes stages such as frustration, acceptance, and self-awareness, and successful rehabilitation leads to changed coping strategies and behaviors which result in a feeling of regaining control over one’s life ( Bernier, 1998 ; Salminen et al, 2015 ; Sonntag-Öström et al, 2015 ; Alsén et al, 2020 ; Hörberg et al, 2020 ). Both internal factors, such as new insights and coping strategies, and external factors, such as balance and structure in everyday activities, are emphasized in the rehabilitation process ( Bernier, 1998 ; Glise, 2014 ; Salminen et al, 2015 ; Hörberg et al, 2020 ).…”

“…Both internal factors, such as new insights and coping strategies, and external factors, such as balance and structure in everyday activities, are emphasized in the rehabilitation process ( Bernier, 1998 ; Glise, 2014 ; Salminen et al, 2015 ; Hörberg et al, 2020 ). Several studies also highlight the need for support from professionals, patient groups, and family ( Bernier, 1998 ; Sonntag-Öström et al, 2015 ; Alsén et al, 2020 ).…”