Understanding Burnout

by Dr Amy Pelletier

It’s been a long year and more and more I’m hearing patients talk about feelings of exhaustion, both emotional and physical. Long periods of chronic stress can leave us feeling burnt-out, drained, and unable to tackle the unavoidable stressors of life. Is this a normal stress response or is this burnout? And what is burnout anyway?!

Burnout is a state of physical, mental, and emotional depletion that follows a period of chronic stress or overwork. The World Health Organization (WHO) considers workplace burnout as an occupational phenomenon with three key features:

  • Feelings of energy depletion or exhaustion
  • Increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job
  • Reduced professional efficacy

The WHO makes a point of stating that it does not classify burnout as a medical condition and only applies to chronic workplace stress, though I would argue that burnout affects us in far more ways than just professionally, and the ramifications can touch every aspect of our lives. As our work and home lives merge more and more (especially this past year!), compartmentalizing the effects of burnout to an occupational context only is not realistic. So let’s break down the symptoms included in the WHO’s definition of burnout.

Energy Depletion or Exhaustion

Everyone can feel exhausted and depleted sometimes, but for individuals suffering from burnout, these feelings are experienced most of the time and don’t necessarily get better with sporadic days off or a reduction in workload. These strategies of short breaks can help when we start to see the warning signs of burnout, but will not reverse months or years of chronic stress. Notably, the onset of burnout is gradual and insidious. For many people, they may feel busy and overwhelmed but insist they can handle it—which they probably can in the short term—but after many months or even years, they realize they can no longer maintain that level of energy output, and probably haven’t been coping for some time.

Burnout also takes a physical toll; people may experience reduced immune function, irritable bowel syndrome (IBS)-like symptoms with chronic gastrointestinal upset and a change in bowel function, and/or poor sleep, among other symptoms. Ironically, when we’re so depleted and exhausted, we may not be able to fall asleep or stay asleep. One of the culprits of these physical manifestations of chronic stress is cortisol, the “stress hormone”. When operating properly, cortisol is an essential hormone, involved in blood sugar and blood pressure regulation, as well as inflammation reduction. Simultaneously, it suppresses what are deemed non-essential survival functions like digestion and reproduction. We can’t live without cortisol, but we’re not meant to stay in a state of elevated stress for long.

Increased Mental Distance, Negativism, or Cynicism

Feelings of withdrawal, numbness, or alienation can be the first warning signs of burnout, particularly for anyone who normally prioritizes relationship-building and loves being surrounded by friends and family. This may present as feeling defeated at work, as if nothing you do matters, or the sense that accomplishments aren’t significant and don’t deserve to be celebrated. I have seen this in particular with overburdened and exhausted students, overworked young adults, and new parents. These individuals have full lives with events worthy of celebration, but they feel unable to celebrate milestones because of the next task they see coming over the horizon. There may also be an increased sense of irritability that results in conflicts with loved ones, coworkers, or strangers.

Reduced Efficacy

This feature of burnout is particularly important to discuss because it doesn’t necessarily mean you’re not able to fulfill the tasks of your job. For some people, the lack of motivation will present as a reduction in capacity for completing tasks and their work will suffer. However, for others, it can continue to look they are high functioning, but they may be finding themselves completely unable to complete small everyday tasks in their personal life, errand paralysis.

Am I just stressed? Or could it be something else?

Stress and burnout do have some similarities but they are not the same: stress is a state of heightened emotionality, while burnout is dampened emotionality. Stress can make you feel agitated and wired, while burnout leaves you feeling depleted and empty.

When I treat patients who present with these key features of burnout I also want to make sure that we’re looking at other possible root causes. A few examples of conditions I would consider include: anemia, hypothyroid, nutrient deficiencies, depression, anxiety, chronic fatigue syndrome, or an infection (especially a chronic infection). These, among others, could present similarly but would have different treatments.

If these symptoms sound familiar and you’d like to start investigating burnout management, give me a call. I would love to partner with you in your healthcare! Book a visit

Stay tuned for a discussion on some of the treatments and strategies available to prevent burnout, change course when you see the warning signs, and speed recovery.

In health,

Dr. Amy Pelletier, ND

Dr. Amy Pelletier is a Naturopathic Doctor and offers appointments at Local Health Integrative Clinic Sundays and Tuesdays. Click here to book an appointment with Dr. Amy.

 

This content is not intended to be substituted or interpreted as medical advice and should not be used to diagnose, treat, or prevent any disease or health concern. Please book a consultation with me or a qualified healthcare professional before acting on any information presented here.

References

  • N.A. “Burn-out an “occupational phenomenon”: International Classification of Diseases.” World Health Organization, https://www.who.int/mental_health/evidence/burn-out/en/.
  • Golonka, K., Gawlowska, M., Mojsa-Kaja, J., & Marek, T. (2019). Psychophysiological characteristics of burnout syndrome: resting-state EEG analysis. Biomed Res Int., doi: 10.1155/2019/3764354
  • Privitera, M. (2018). Is burnout a form of depression? It’s not that simple. Medscape. https://www.medscape.com/viewarticle/896537#vp_4