Exhaustion, fatigue and burnout


Sir, – Your series on burnout is excellent and necessary.

Patrick Freyne rightly notes that “burnout is nothing new” (“Burnout: a potted history”, Magazine, September 16th).

Well over a century ago, in 1875, Irish asylum-doctor James Foulis Duncan warned that “a striking feature of the present age is that it is one of incessant mental activity. All is hurry, bustle, and excitement”.

Previously, people “had no real ambition; none of that feeling of discontent with present things which lies at the basis of all improvements. They did not hatch eggs by steam, or make calculations by a machine . . . Is it necessary to prove that the greater the activity of the brain the greater must be its liability to disease?”

Like many commentators today, Duncan felt there was “an amount of brain work going on in the present age far different in kind from, and far greater in degree than, any that was ever known before”.

Jennifer O’Connell is correct that the contribution of technology to burnout stems not from technology itself but from how we use it (“Burnout left me on the floor, unable to move”, Magazine, September 16th).

Duncan, too, made this point in the Journal of Mental Science in 1875: “We can no more change the mechanical and commercial character of the age than we can arrest the sun in his course, or put back the hands upon the dial plate of time. Nor, even if it were possible for the world to return to the condition it was in a century ago, would any of us be willing to give up the advantages of our present state to secure such a result.

“It must not be forgotten that the evil complained of arises, not from mechanical contrivances in the abstract, but from the abuses connected with their working and incidental to their introduction”. – Yours, etc,


Professor of Psychiatry,

Trinity College Dublin,

Dublin 2.