Quick answer: Burnout is an occupational phenomenon: the World Health Organization defines it in the ICD-11 as a syndrome resulting from chronic workplace stress that has not been successfully managed, with three dimensions – exhaustion, mental distance from the job, and reduced professional efficacy. Expats burn out faster because they are doing a second unpaid job on top of the first one: rebuilding a life in a system they cannot yet read.
Therapsy is a multilingual psychotherapy service in Italy that connects expats, international students and Italians with licensed therapists in their own language, online across the country and in person in 24 Italian cities.
Key takeaways
- The WHO definition is narrow on purpose: burnout refers to the occupational context and should not be used to describe experiences in other areas of life.
- Its three dimensions are exhaustion, cynicism or distance from the job, and the sense of being less effective at it.
- The expat version has a hidden second workload: bureaucracy, language, and a social life that has to be built from scratch after hours.
- Working all day in a second language is a real cognitive cost, and it is almost never counted as work.
- A holiday that fixes it for four days and loses it in three is a diagnostic sign, not a failure of the holiday.
- Therapsy works in 14 languages, with a free first conversation and a reply within 12 hours.
What is burnout, precisely?
How does the WHO define it?
In the ICD-11 the World Health Organization describes burn-out as an occupational phenomenon: “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed”, characterised by “feelings of energy depletion or exhaustion”, “increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job”, and “reduced professional efficacy”.
Is it a medical diagnosis?
It is classified as an occupational phenomenon rather than a medical condition, and the WHO is explicit that it “should not be applied to describe experiences in other areas of life”. That matters: parenting exhaustion, relocation exhaustion and grief are real, and calling all of them burnout sends you looking for the wrong solution.
How is it different from depression?
Burnout is tied to a context: it lifts, at least partly, when you are away from the work situation, and it is strongest in relation to the job. Depression travels with you, changes sleep, appetite and interest across the board, and does not lift on holiday. They overlap often enough that an assessment looks at both rather than choosing one in advance.
Why do expats burn out faster?
The second job nobody counts
Permesso di soggiorno, codice fiscale, a bank that wants a document you have never heard of, a landlord, a doctor, a school. Each is a small task and all of them land in the hours when someone at home would be resting. You are working a full job and administering a life at the same time, in a system whose rules are not written anywhere you can read them.
The language tax
Working all day in a second language costs attention continuously: understanding takes effort, speaking takes more, and the humour and nuance that make a workplace bearable arrive late or not at all. Most people register the tiredness and attribute it to the job rather than to the language, which is why they try to fix it by working differently.
No recovery infrastructure
Recovery is not only sleep. It is the friend you complain to, the routine that switches your head off, the family lunch that does not require planning. Relocation removes all of it at once, and it takes far longer to rebuild than the practical layer. So the load goes up and the recovery goes down in the same month.
The pressure to justify the move
If you chose to move, admitting that it is grinding you down feels like admitting a mistake, especially to the people who warned you. So it stays private, which removes the last thing that might have helped.
What are the signs?
What does the early phase look like?
Not collapse. Sunday evening dread, a shorter fuse with the people closest to you, work that takes twice as long, and a growing sense that nothing you produce is any good. Sleep goes first for many people, and physical symptoms with no obvious cause are common.
The holiday test
A useful, informal check: if a week off restores you for a few days and the state returns within three days of going back, the problem is the situation, not your stamina. People routinely read the quick relapse as proof that they are weak. It is the opposite: it is evidence that the load is structural.
When does it become urgent?
When exhaustion stops lifting at all, when sleep does not recover on days off, when you cannot remember the last time you enjoyed anything, or when thoughts turn to not wanting to be here. That last one is not burnout and it needs help now: in Italy, 112 is the emergency number.
What actually helps?
Fix the load before the attitude
Resilience training on top of an unchanged workload produces a more resilient person doing the same impossible job. The first useful conversation is about what can be removed, delegated, refused or renegotiated, and that is usually uncomfortable rather than complicated.
Count the language and the admin as work
Put them in the week honestly. People who schedule the bureaucracy into working hours, rather than into the evening, report the biggest change for the least effort. It is not a trick: it stops the day having two shifts.
Rebuild recovery deliberately
Since none of it happens by accident abroad, it has to be scheduled: one fixed thing a week with other people, one that switches your head off, and protected sleep. Boring, and it is the part that decides whether the load is survivable.
What does therapy add?
It separates what belongs to the job from what belongs to the move, which people cannot usually do alone because both are happening at once. Then it works on the rules that make refusing impossible, and on the self-criticism that makes a slower week feel like proof of inadequacy. At Therapsy the first conversation is free and happens with the Clinical Director, who proposes a therapist and explains why, with a reply within 12 hours.
How it works at Therapsy
Which language, and which format?
Your own, if the language is part of the load: an hour a week spent reaching for words is the opposite of recovery. Therapsy works in 14 languages, with sessions online across Italy and in person in 24 cities, and you can see the network on our therapists page.
What does it cost?
Individual sessions start from EUR 70, with the same fee online and in person; the pricing page lists the rest. Psychological care counts as a health expense in the Italian tax return, so keep the invoices.
Frequently asked questions
Is burnout a medical diagnosis?
No. The WHO classifies burn-out in the ICD-11 as an occupational phenomenon rather than a medical condition, and states that it should not be used to describe experiences outside the work context.
What are the three dimensions of burnout?
Energy depletion or exhaustion, increased mental distance from the job including cynicism or negativism about it, and reduced professional efficacy. All three refer to the occupational context.
How do I know if it is burnout or depression?
Burnout is tied to the work situation and eases at least partly when you are away from it, while depression persists across contexts and changes sleep, appetite and interest generally. The two often coexist, which is why an assessment looks at both.
Why do expats burn out faster?
Because the workload includes a second, uncounted job: bureaucracy, a second language all day, and a social life that has to be rebuilt after hours. The load rises while the usual means of recovery are gone.
Will a holiday fix burnout?
Usually not on its own. If the state returns within days of going back, the load is structural and the useful work is on the situation, not on your stamina.
Can I have therapy for burnout in my own language in Italy?
Yes. Therapsy works in 14 languages, online across Italy and in person in 24 cities, and the first conversation is free with a reply within 12 hours.
