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Fatigue or Exhaustion? How to Recognize the Difference Between Stress-Related Tiredness and Chronic Exhaustion
If an employee appears tired for a short period, it is rarely a cause for concern. However, when fatigue becomes a permanent state that cannot be resolved through rest, it is time to react. Statistics from the Swedish Social Insurance Agency show that psychiatric diagnoses are now the most common reason for sick leave among individuals aged 30–39.
By the end of 2024, nearly half of all ongoing sick leave cases were due to psychiatric diagnoses, with exhaustion disorder accounting for a significant share. What makes these cases particularly challenging for employers is their duration. Individuals affected by these diagnoses are, on average, on sick leave considerably longer than those with physical conditions. This is not about temporary tiredness, but long-term absence that often requires extensive rehabilitation measures.
To act proactively, we must first define what we are looking for. The difference is not about the degree of tiredness, but about the body’s ability to recover.
1. Normal Fatigue (Reversible)
Fatigue is the body’s natural signal that energy has been depleted. It is a linear process: you work hard, become tired, sleep, and wake up feeling rested.
- Characteristics: Can be “rested away” over a weekend.
- Cognitive function: Intact. You may feel sluggish, but logic and memory still function.
2. Exhaustion (System Failure)
Exhaustion disorder is the result of prolonged stress without adequate recovery. In this state, the body’s stress system (the HPA axis) has become dysregulated. It is no longer a matter of energy depletion, but of a biological shutdown.
- Characteristics: Rest does not restore energy. You wake up just as tired as when you went to bed.
- Cognitive function: Significantly impaired. “Brain fog,” difficulty concentrating, and memory disturbances are common.
How Exhaustion Affects the Employee
As an employee approaches exhaustion, changes occur in the brain’s prefrontal cortex – the area responsible for logic, impulse control, and planning.
- Decision-making: A previously decisive person may become ambivalent. Small decisions, such as choosing lunch or scheduling meetings, can feel overwhelming.
- Social friction: Empathy requires energy. An exhausted person may become more irritable, cynical, or withdraw from social interaction at work.
- Declining quality: What appears to be carelessness is often a sign that working memory is overloaded. The person may lose track in conversations or forget agreements.
Checklist for Early Signs
As an employer, you often notice the signs long before the employee understands the seriousness of the situation. Be attentive to the following behavioral changes:
| Area | Early signs (warning) | Acute signs (risk of sick leave) |
|---|---|---|
| Work patterns | Begins working overtime more than usual to “catch up.” | Responds to emails at unusual hours, loses sense of time. |
| Efficiency | Seems to be “spinning wheels,” accomplishing less despite longer hours. | Misses deadlines or completely forgets important meetings. |
| Emotional state | Increased irony or a new form of pessimism. | Prone to tears, strong irritability, or emotional detachment. |
| Physical | Recurring headaches or frequent minor infections. | Sensitivity to light and sound, dizziness, or heart palpitations. |
How to Detect It Early
To identify exhaustion before it leads to sick leave, we need to look at two levels simultaneously: the software, meaning how the employee behaves and feels mentally, and the hardware, which includes the physical and biological warning signs.
- Active listening: In one-on-one conversations, avoid asking “How are you?” – the answer is almost always “Fine, just a lot going on.” Instead, ask: “How is your recovery functioning right now?” or “When was the last time you felt completely free from work-related thoughts?”
- Medical screening: Many signs of fatigue are diffuse. By offering medical assessments, physiological causes such as vitamin deficiencies, thyroid dysfunction, or persistently low or elevated biomarkers can be ruled out or confirmed.
- Workload analysis: Look at the data. Has the employee taken their vacation? What does the overtime trend look like over the past six months?
An Investment in Sustainable Performance
Distinguishing between normal fatigue and emerging
