Experiences of returning to work after sick leave due to exhaustion disorder: a qualitative content analysis

Non-traumatic stress-related illnesses are associated with considerable functional impairment and costs for both individuals and societies. In Sweden, the national diagnose Exhaustion disorder (ED) is one of the most frequently diagnosed disorders in this category. Despite the major negative consequences of illnesses such as ED, there is no clear evidence on successful treatments or effective interventions to enhance return to work outcomes for this population. Therefore, the aim of this study was to explore how individuals who had returned to work after sick leave due to ED experienced the process of returning to work, including facilitating factors, significant challenges and needs of further support.

Participants were recruited from three clinics in Stockholm specialized in rehabilitation for Exhaustion Disorder. Semi-structured interviews were conducted with 15 participants and the transcribed interviews were analyzed using qualitative content analysis.

The results yielded three themes - Struggling to adapt sustainably to change, Being supported or hindered by the context and Being part of a larger societal system. The first theme revolves around individual processes of change, such as gaining insight in one's own behavior, and rethinking one's perceived identity. The second theme focuses on how practical and emotional support, or lack thereof, affect the experience of returning to work. The third theme addresses hindering or facilitating factors on a more societal level, such as social norms or conditions of the social welfare system.

The results indicate the relevance of further and prolonged support for individuals returning to work after sick leave due to ED. The workplace and overall organization plays an important role in providing this support. In a clinical individual context, the support given may include programs designed to facilitate behavioral maintenance, sustainable psychological flexibility and renegotiation of values. However, further research is needed on how such programs should be best designed and delivered.

Not applicable.