How to recognise the physical symptoms of work-related stress

Burnout can lead to physical symptoms like headaches. Photo / 123RF

Dr. Jessi Gold, a psychiatrist at Washington University in St. Louis, knows she's edging toward burnout when she wakes up, feels instantly angry at her email inbox and doesn't want to get out of bed. It's perhaps not surprising that a mental health professional who is trying to stem the rising tide of burnout could burn out sometimes, too. After all, the phenomenon has practically become ubiquitous in our culture.

In a 2021 survey of 1,500 US workers, more than half said they were feeling burned out as a result of their job demands, and a whopping 4.3 million Americans quit their jobs in December in what has come to be known as the "great resignation." When people think of burnout, mental and emotional symptoms such as feelings of helplessness and cynicism often come to mind. But burnout can lead to physical symptoms as well, and experts say it can be wise to look out for the signs and take steps when you notice them.

Burnout, as it is defined, is not a medical condition — it's "a manifestation of chronic unmitigated stress," explained Dr. Lotte Dyrbye, a physician scientist who studies burnout at the Mayo Clinic. The World Health Organisation describes burnout as a workplace phenomenon characterised by feelings of exhaustion, cynicism and reduced efficacy.

"You start not functioning as well, you're missing deadlines, you're frustrated, you're maybe irritable with your colleagues," said Jeanette M. Bennett, a researcher who studies the effects of stress on health at the University of North Carolina, Charlotte.

But stress can have wear and tear effects on the body, especially when it doesn't ease up after a while — so it makes sense that it can incite physical symptoms, too, Dr. Bennett said. When people are under stress, their bodies undergo changes that include making higher than normal levels of stress hormones such as cortisol, adrenaline, epinephrine and norepinephrine. These changes are helpful in the short term — they give us the energy to power through difficult situations — but over time, they start harming the body.

Our bodies were "not designed for the kinds of stressors that we face today," said Christina Maslach, a social psychologist at the University of California, Berkeley, who has spent her career studying burnout.

Here's how to recognise burnout in your body and what to do about it.

What to look out for

One common burnout symptom is insomnia, Dr. Dyrbye said. When researchers in Italy surveyed frontline health care workers with burnout during the first peak of the pandemic, they found that 55 per cent reported having difficulty falling asleep, while nearly 40 per cent had nightmares.

Research suggests that chronic stress interferes with the complicated neurological and hormonal system that regulates sleep. It's a vicious cycle, because not sleeping throws this system even more out of whack. If you've noticed you're unable to sleep at night, that could be a sign that you're experiencing burnout, Dr. Dyrbye said — and your sleeplessness could exacerbate the problem.

Physical exhaustion is another common sign. Dr. Gold said that one of her key symptoms of burnout was fatigue. "I realised I was sleeping every day after work — and I was like, 'What is wrong with me?' but it was actually burnout," she said.

Changes in eating habits — either eating more or less than usual — can also be a sign of burnout: In the study of Italian health care workers, 56 per cent reported changes in food habits. People might eat less because they're too busy or distracted, or they might find themselves craving "those comfort foods that we all like to go to when we need something to make us feel better," Dr. Bennett said. Research suggests, too, that stress hormones can affect appetite, making people feel less hungry than usual when they're under a lot of stress, and more hungry than usual when that stress alleviates.

Headaches and stomachaches can also be incited by burnout, Dr. Gold said. One study of people in Sweden suffering from exhaustion disorder — a medical condition similar to burnout — found that 67 per cent reported experiencing nausea, gas or indigestion, and that 65 per cent had headaches. It's also important to note that burnout can develop alongside depression or anxiety, both of which can cause physical symptoms. Depression can cause muscle aches, stomachaches, sleep issues and appetite changes. Anxiety is linked to headaches, nausea and shortness of breath.

What to do

If you're experiencing physical symptoms that could be indicative of burnout, consider seeing your primary care doctor or a mental health professional to determine whether they are driven by stress or rooted in other physical conditions, Dr. Dyrbye said. Don't just ignore the symptoms and assume they don't matter.

"It's really easy to blow off your own symptoms, especially in our culture, where we're taught to work hard," Dr. Gold said.

If it is burnout, then the best solution is to address the root of the problem. Burnout is typically recognised when it is job-driven, but chronic stress can have a variety of causes — financial problems, relationship woes, and caregiving burdens, among other things. Think about "the pebbles in your shoe all the time that you have to deal with," Dr. Maslach said, and brainstorm ways to remove some of them, at least some of the time. Perhaps you can ask your partner to help more with your toddler's bedtime routine, or get takeout when you're especially busy so you don't have to plan dinner, too.

Despite popular culture coverage of the issue, burnout can't be "fixed" with better self care, Dr. Maslach said — in fact, this implication only worsens the problem, because it lays the blame and responsibility on those with burnout and implies that they should do more to feel better, which is not the case, she said. However, some lifestyle choices can make burnout less likely. Social support, for instance, can help, Dr. Gold said. This could include talking to a therapist or meeting with friends (even if over Zoom). It may also help to take advantage of mental health or exercise benefits offered by your employer. Sleeping more can help too — so if you're suffering from insomnia, talk to a doctor about possible treatments, Dr. Bennett suggested.

When burnout stems from job-related woes, it may help to request better working conditions. Dr. Maslach suggested brainstorming with co-workers and presenting your employer with ideas that would help — like providing quiet areas for breaks and personal phone calls, creating "no meeting" days so that employees can have more time to focus, or ensuring that there's always coffee in the break room. Even small changes like these can make a dent in the risk for burnout if they fix a problem people face at work every day. "It's the chronic job stressors that drive people really nuts after a while — they don't have the right equipment, they don't have the things they need, they don't have enough people to do the work," Dr. Maslach said.

Taking time off work could also help, but it's likely only a temporary Band-Aid, Dr. Gold said. She compares it to using a bucket to empty water out of a sinking ship. "It's still sinking, right? You have to do more than just occasionally take the water out," she said. Still, it is important to take time off regularly, Dr. Dyrbye said.

Ultimately, you want to ensure you have some freedom and autonomy in your job, Dr. Gold said. "Anything you can do to regain an element of control can be really helpful," she said. That could mean doing your least favourite work activity right before your break, so you have something to look forward to during the task and time to recover from it afterward. Or it could be trading a dreaded task with a co-worker and, in return, picking up their most hated task, which might not be so difficult for you.

Finally, while you may not want to add more to your plate, try to make a bit of time each day for something you love, Dr. Dyrbye said. Her work has found that surgeons who make time for hobbies and recreation — even just 15 to 20 minutes a day — are less likely to experience burnout than surgeons who don't.

"You have to have something outside of work that helps you de-stress, that helps you focus and helps you relax," she said.

Written by: Melinda Wenner Moyer
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