Among patients receiving compensation from the Swedish Social Insurance Agency for more than 90 days, it is the most common diagnosis and women are at higher risk than men.

[5] Exposure to stress is a part of life that generates a host of different responses, some of them akin to signs of illness without constituting or resulting in disease.

[6] How to differentiate between benign and maladaptive responses to stress is not necessarily evident, and from a dimensional rather than categorical perspective there is no sharp line dividing normality and illness.

[17] At risk individuals experience a gradual onset of symptoms over a prolonged period of time, followed by a sudden deterioration and a long recovery, with pronounced exhaustion and reduced cognitive capacity.

[18] The initial phase can last several years and various complaints such as fatigue, headaches, anxiety, sleeplessness, irritability, dizziness or bowel issues may erupt.

At the peak of distress some are compelled to seek emergency care due to panic or chest pain, where the resulting examination fails to identify any physical cause.

[26] Early on, a decreased sensitivity within the HPA axis was identified in small scientific studies, resulting in an attenuated release of cortisol in response to stimulation.

[27] Subsequent investigations into this abnormality have produced mixed results, and several later scientific reports found no difference compared to healthy controls.

[29] Exhaustion disorder is a clinical diagnosis made by a qualified health care professional based on the patient's recollection of the course of disease.

[33] Relevant physical alternative diagnoses are symptom dependent, but could include hypothyroidism, vitamin B12 deficiency, COPD, cardiovascular disease and diabetes.

[6] The 2024 Åsberg review recommends that the criteria be interpreted strictly to avoid medicalization, and emphasizes that a combination of fatigue and diminished cognitive capacity must be present for the diagnosis to be considered.

[51] The WHO Disability Assessment Schedule (WHODAS 2.0) has been studied as a means to distinguish between exhaustion and the less severe adjustment disorder,[48] but no currently available scales or questionnaires are properly validated for use in differential diagnostics.

[56] Before return to work a joint-appointment (Swedish: avstämningsmöte) between the patient, employer, care provider and the Social Insurance Agency is sometimes called for to agree on common terms for a gradual increase in workload.

Since exhaustion disorder results in a long-lasting and severe loss of function, usually brought on by work-related stress, time until "return to work" is considered the most important end-point when evaluating the effectiveness of various treatments.

There is limited evidence concerning the efficacy of treatments in terms of return to work, primary research studies on the topic are wrought with generally low numbers of participants, and show marginal or no effect.

[60][61] Therapeutic approaches like CBT and ACT reduce stress-induced symptoms in the short term, and have been found cost-efficient in health-economic studies, but there is limited or no evidence for any effect on return to work.

[64] Due to limitations in study design and size, the effects of physical exercise in fully developed exhaustion disorder is unknown.

[63] Due to the limited efficacy of currently available treatment options, the need to focus on preventative measures has been highlighted as the most important intervention in order to mitigate stress-induced sickness.

Still, at the time of long term follow-up 7–10 years later, almost half of the participants experienced fatigue and a majority reported a lasting reduction in stress tolerance.

In smaller questionnaire-based studies symptoms of exhaustion have been approximated to occur in 15% of the general Swedish population, 15% of healthcare workers and 30% of primary care patients.

[77] Among patients receiving compensation from the Swedish Social Insurance Agency for more than 90 days, exhaustion disorder is the most common diagnosis and the ratio of women to men is 4 to 1.

Beard believed that the condition was brought on by the woes of modern life — express trains, and a fixation with time and especially measuring it — that subjected the human psyche to overload.

The most disseminated version of burnout was developed by Christina Maslach, and is defined by the triad of emotional exhaustion, cynicism and an experience of reduced professional capacity.

[91] The description of the condition has shifted over time and between different scholars, which has contributed to burnout never attaining the status of a medical diagnosis in either the ICD or the DSM, with fixed diagnostic criteria.

In occupational medicine the initial focus on physical ergonomics and toxicology has been complemented by an awareness of psycho-social stress as an inducer of illness and premature death.

[6][93] Overarching socio-cultural and workplace related developments since the 1980s, including increased information density and exchange, and both parents working full-time while raising children, have also been emphasized as contributors.

[94][95] Efforts to formulate the diagnosis were sparked by an increase in sick leave numbers attributed to depression, for customers served by one of the larger Swedish insurance agencies.

In 2002 she was authorized by Kerstin Wigzell, Director-General of the Swedish National Board of Health and Welfare, to investigate the condition and conduct a scientific review.

The first edition of guidelines was published by the Board of Health and Welfare in 2008, delayed by roughly half a year due to "disagreements in the medical corps.

[17] Another group led by psychiatrist Christian Rück published a scoping review on the condition in 2022, questioning its validity and reliability as a medical diagnosis.