Summary: This questionnaire is designed to help you self-assess your level of burnout. It does not replace the need for professional assessment or support.

Directions: Place a check beside any of the following symptoms you’re experiencing. If at the end of the questionnaire you find you’ve made many checkmarks, please consider additional support.

• I am constantly exhausted, tired, fatigued, or overwhelmed.
• I am becoming increasingly irritable. My fuse is getting shorter.
• I feel a sense of hopelessness, like “Why bother?” or “Who cares anyway?”
• I experience regular sleep disturbance; I feel like I never sleep enough.
• I am always sleepy and sleep as much as I can. I have trouble doing my daily activities.
• I have experienced a significant change in appetite, up or down.
• I feel unappreciated most of the time.
• I notice that I have become overly dogmatic, inflexible, or rigid.
• I worry I am losing a clear perspective on work or life.
• I feel I would let everyone down or let things fall through the cracks if I take a break.
• I have noticed myself becoming more cynical, pessimistic, or hyper-critical.
• I have difficulty making decisions or feel I am making poor decisions.
• I have spent less time with / am avoiding spending time with my friends and family.
• I have engaged less rather than more in activities that used to bring me pleasure.
• I have more trouble concentrating and/or my brain feels foggy.
• I feel I look after certain people impersonally, as if they are objects.
• I feel apathetic or bored.
• I have the impression that people often make me responsible for their problems.
• I feel like many tasks require a great deal of effort.
• I feel like no progress has been made, and I am unable to make progress.