If you live and work in the Netherlands, chances are you know someone who is currently overspannen. The word means something like acute stress — and in the Netherlands, it carries real medical and legal weight. It is also the stage that precedes burnout: when it persists beyond six months, that is when burnout is the diagnosis. What makes the Netherlands unusual is not that burnout is especially prevalent here compared to other countries, but that the system takes it seriously: formal diagnoses, legal obligations, real consequences for employers and employees alike.

Burnout rarely has a single cause. Doctors typically look for a combination of factors: workload, lack of autonomy, personal circumstances. But one factor that research consistently identifies as a significant driver tends to receive less attention than it deserves: conflict. It is often the last thing named — by the employee, by the employer, sometimes even by the doctor. Interpersonal conflict at work — with a colleague, a manager, a business partner — produces sustained stress with real health consequences: disrupted sleep, fatigue, difficulty concentrating, and over time, elevated blood pressure and increased cardiovascular risk.

Something I have come across more than once: it is the company doctor (bedrijfsarts) who, after a period of sick leave, proposes mediation. By the time that recommendation comes, several things are typically true. The sick leave has already gone on for some time. The doctor has learned that conflict is in the background. And the doctor believes that addressing it — not just the symptoms, but the underlying relational dynamic — is part of what recovery requires.

I value that recognition. But it also raises a question I find hard to let go of: what if the conflict had been addressed earlier? Before the exhaustion set in, the burnout, the months away from work?

Morly Frishman