The impact of chronic stress is being felt the world over – experts share advice on recognising burnout and keeping it at bay. Photo / Getty Images
Burnout is something that can creep up on us unnoticed. But what does the term mean? Many people confuse it solely with the fallout from pressure and stress that we all experience in our daily lives from time to time, but burnout is a distinct health condition and can have a range of problematic health and psychological consequences.
According to the most recent Mental Health UK’s Burnout Report, burnout affects a fifth of UK employees, with one in five working adults needing time off work in the past year for it. It wasn’t until 2019 that the World Health Organisation defined it as an occupational syndrome that arises as a result of unsuccessfully managed stress at work.
Dr Claire Ashley, a GP, neuroscientist and burnout specialist, describes the three components of burnout syndrome as detachment from your work, emotional exhaustion and reduced performance. The ways in which these components affect your overall health are complex. Read on to find out why – and how to manage the symptoms.
Feelings of energy depletion and exhaustion are a common symptom of burnout. “While you may feel worn out after a stressful experience, burnout involves a deeper level of emotional and mental exhaustion and detachment that goes beyond the typical stress response. Burnout is both not having the ability to work due to exhaustion but also not having the willingness to work,” says chartered occupational psychologist Rachel Austen.
Lower immunity
Stress can set off the body’s inflammatory response, and chronic inflammation can compromise the immune system. “In the long run, if you have constantly elevated cortisol, it dampens down your immune system, meaning you’re more likely to get colds and minor illnesses and just feel really rundown,” says Dr Ashley.
Tension headaches are a common symptom of burnout, and these are exacerbated by sleep deprivation and insomnia, which are also side effects.
Change in appetite
While some find they lose their appetite, others take comfort in emotional eating and often make unhealthy food choices. Gastrointestinal issues are also common.
Insomnia
Mental Health UK’s report suggests that the UK is a nation of insomniacs, with six in 10 saying poor sleep is contributing to stress and burnout. “With insomnia, I’m not sure if that’s a physical symptom or more about the kind of interplay between emotional symptoms,” says Dr Ashley.
Muscle pain
Aches and pains in your shoulders, back, neck and head can also be a physical sign of burnout, due to your muscles automatically tensing up to guard the body against pain and injury. Chronic stress causes the body to hold on to the tension.
Serious health risks
Burnout also carries more serious health risks, says Dr Ashley. “The prolonged elevation of stress hormones causes low-grade inflammation throughout the body. This increases the cardiovascular risk, making you more likely to end up with cardiovascular complications.” And you’re also more likely to have a serious accident. “With burnout you may experience difficulty with focus and concentration and are more likely to trip over or crash your car, especially if you’re sleep-deprived.”
Adrenal fatigue is sometimes cited by alternative medicine providers as a symptom of burnout, suggesting that exhausted adrenal glands are unable to produce adequate quantities of hormones due to chronic stress, but Dr Ashley says there is no scientific basis for this. “But interestingly, a small group of people in burnout do undergo some sort of drop in their stress hormones after a period of prolonged stress, increasing their health risks.”
Emotional symptoms
Detachment
In burnout people withdraw, feeling a sense of “numbness” or of being disconnected from their own emotions and the emotions of others.
Cynicism
“Negative and cynical attitudes – mentally distancing yourself from your job and becoming increasingly negative about work – are a common sign of burnout,” says Austen. When we’re under chronic stress, our brains and bodies adapt to cope and get back to equilibrium. Cynicism can act as a defence mechanism.
“A key sign of burnout is withdrawal from life, hobbies, exercise, people, relationships, social activities and all the things you used to love doing,” says Kelly Swingler, a burnout coach with a background in organisational health and wellbeing.
Anger or irritability
In burnout people become increasingly irritable and lose empathy for others. “They become overly focused on the negative aspects of their work which leads to feelings of resentment,” says Austen. Emotional dysregulation is a hallmark symptom of burnout, says Dr Ashley.
Sense of failure and self-doubt
Burnout can lead to a loss of confidence in your ability to do your job, and feelings of self-doubt. “This can then lead to feeling a strong need to prove yourself, working harder and over-extending yourself,” says Austen.
“My research with individuals who have experienced burnout showed that many start questioning the meaning and purpose of their work and life. They lose a sense of self, and feel disconnected from what’s important to them,” says Austen.
Behavioural signs
Indecisiveness
“Burnout has the same impact on our brain as trauma and can hinder our decision-making abilities, self-esteem, judgment, and confidence,” says Swingler.
Concentration issues
Chronic exposure to stress hormones can lead to cognitive deficits. It can damage the hippocampus area of our brain, leading to impaired memory and learning difficulties. “Research also shows reduced connectivity to the ‘prefrontal cortex’ - the area responsible for thinking, planning and rational decision making, impairing these cognitive functions,” says Austen.
With the decline in motivation and enthusiasm that comes with burnout, the urge to quit your job can become strong. “Staff who are burnt out can’t be creative and innovative, they are in a fight for survival, then it’s ‘survival of the fittest’ and in a workplace context, this creates toxicity,” says Swingler.
Isolating yourself
People with burnout tend to feel overwhelmed and may stop socialising and confiding in friends, family members and co-workers.
Using alcohol to cope
“It may help with stress temporarily, but overall over-drinking makes you feel more depressed and anxious as well as disrupting sleep, which is already disrupted in burnout, so it’s just fuelling that burnout cycle,” says Dr Ashley.
The same goes for drugs, food or other addictions that momentarily relieve stress.
Our brains and bodies are expertly designed to manage “acute” or “short-term” stress, triggered when we come across a perceived threat. “But when this acute response is over, we need to recalibrate, otherwise it starts to have a damaging impact and eventually leads to burnout. The problem is, we are surrounded by small things that trigger the stress response and put us in this activated state (called ‘micro-stressors’) like work deadlines, a news headline or even the fast-changing images and noise of a mobile device,” says Austen. “Stress has become a normal part of the way we function, so we don’t notice when we’ve reached unhealthy levels – until we’re far down the path to burnout.”
Lack of control
Lacking autonomy may lead to feelings of having little control over your work and performance. The helplessness this causes can contribute to your emotional exhaustion, a key component of burnout. “In workplaces, there’s so much uncertainty, job insecurity, low levels of trust and unapproachable managers that people don’t feel comfortable asking for help, instead ‘bottling it up’. This is not helpful,” says Austen.
Heavy workload
Mental Health UK’s research found factors contributing to burnout include a high or increased workload or volume of tasks (54%), working unpaid overtime beyond contracted hours (45%) and feeling isolated at work (42%).
Having difficult work relationships and feeling undervalued and unsupported by your employer, line manager, colleagues or clients can contribute to a toxic work environment and increase the likelihood of burnout.
Being on high alert
Back when we were hunters and gatherers, we’d have needed to be on red alert at all times to stay alive and to gather food for our community, says Swingler. “The modern day equivalent is staying on red alert, thinking that the next email or phone call is the one that means we need to fight for survival. Slowing down or resting might mean we miss the big deal, or that important email.”
Social media
“Once you’re in burnout, the dopamine ‘hit’ of social media ‘likes’ can become very addictive,” says Dr Ashley. “Because you’re so stressed and feeling low, you’re looking for any way to feel good about yourself. Social media is an easy way of getting dopamine hits. If you’re running a business, it’s very easy to fall into a ‘scroll-hole’ of content posts and getting into a cycle of comparing yourself to others and feeling more negative about yourself.”
Professions that are most at risk of burnout include people with very stressful jobs like lawyers, those who work in finance, doctors and healthcare workers. “But there are certain demographics as well. While men do suffer from burnout, women are more at risk than men, particularly mothers who are dealing with more stress outside of work in terms of managing the household and the mental load of the family,” says Dr Ashley.
Entrepreneurs and the self-employed can find it difficult to have professional boundaries because of the pressure to be “on” all the time so you never lose an opportunity to make income. “It’s very easy to overcommit to work and I think for many that’s the start of the burnout cycle,” says Dr Ashley.
Certain aspects of personality can also put people at risk, she adds. “If you’re an introvert working in an extrovert job, or if you’re neurodiverse, in particular if you’ve got ADHD, you may have very rapid burnout cycles.”
Overcoming burnout
1. Accept
“Accept that you are at burnout. This doesn’t mean there is anything wrong with you. You’ve just been pushing too hard, for too long, and now you need some recovery time,” says Swingler.
“Recovery involves spending more time sleeping and engaging in activities that are not outcome-driven and have a low cost in terms of energy,” says Dr Ashley. “You need to give yourself permission to rest because people that go into burnout tend to be high achievers who are really hard on themselves,” adds Ashley.
3. Wellness
Incorporate good habits into your day, getting regular exercise, prioritising rest and following a healthy diet. “Physically, you need to release some of the stress and for this, somatic exercises, walking, breathwork and yoga are great. Running, weights and cardio can just keep your body in a state of stress,” says Swingler. “A common myth is that you need to take sick leave to get better but actually most people carry on working during their burnout and they do get better,” says Dr Ashley.
4. Take control
“Another myth is that you need to make drastic changes and leave your job, but in fact the evidence-based factors that matter in burnout recovery is believing you’re in control of your work and your wellbeing and having supportive relationships,” says Dr Ashley.
“About 60% of people with burnout will have mental health problems, depression or anxiety,” says Dr Ashley. “Antidepressants don’t work with burnout but if you’ve got depression alongside it, then therapy can help give you different coping strategies, helping you manage your stress and the way you’re thinking.”