Sufferers complain initially of feeling “overwhelmed,” “frustrated,” “blocked by insurmountable circumstances,” or “unable to cope.” Eventually, they feel “drained of energy,” “used up”, “having noting more to give.” This, in turn, gives rise to a calloused cynicism a “don’t knock yourself out for anymore” attitude and, finally, to a sense of personal powerlessness – that the situation is beyond their control – which tends to become a self fulfilling prophesy.