Burnout syndrome: causes, consequences, prevention

Emotional burnout is directly related to work routine, regardless of profession and status. Both managers of large corporations and ordinary employees are susceptible to it. At the same time, the increase in the number of unemployed and the fear of losing a job also contribute to the emergence of symptoms of stress and burnout.

Burnout syndrome is characterized by a state of mental and emotional exhaustion, a feeling that “the batteries are low,” when a person is unable to recover in short periods of time. This syndrome is accompanied by a number of symptoms.

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Burnout has become a buzzword, so its true symptoms are often overlooked. If left untreated, burnout syndrome can lead to serious illnesses such as depression or medical illnesses.

Causes of burnout syndrome

It is generally accepted that teachers, as well as doctors and medical staff, are more susceptible to emotional burnout than others. However, even students, pensioners and housewives can suffer from it. After all, emotional exhaustion is not always associated with work; it can also be caused by too heavy a burden of personal obligations.

Let us conditionally divide the causes of this syndrome into personal and external.

Personal causes of burnout.
Individual resilience and coping skills certainly play a role, but just because a person is very resilient to stress doesn't mean they're immune to burnout. It can affect both people who lack self-confidence and those who are confident, determined and full of energy.
Here are some of the internal reasons:
perfectionism;
inability to say “no”;
difficulty expressing feelings;
Ignore your own needs and instead strive to meet the needs of others;
poor adaptability;
constant stress in your personal life;
lack of rest;
too high demands on yourself.
External causes of burnout.
Both the workplace and society can exert significant pressure. Likewise, a difficult life episode or any other major change can lead to burnout.
Some of the possible external causes are:
lack of incentive or overwork;
lack of recognition and support;
conflicts and bad atmosphere in the company;
discrimination or intimidation;
high competitive pressure;
too many responsibilities;
difficulty meeting deadlines;
lack or absence of autonomy.

Burnout often occurs as a result of a clash of personal factors and external causes. Over time, all of these stresses weaken the immune system and are considered triggers for chronic fatigue syndrome (CFS).

Why can’t the psyche stand it?

Because it faces loads that altogether exceed its processing capacity. This can be compared to a fracture - the bone cannot withstand the force of a blow or fall. Or, if a person sits in an uncomfortable position for many years, then at some point the back begins to hurt, and after some time the consequences are the same as in the case of an acute injury. The psyche works thanks to the integrity of neural chains that ensure the stability of emotional reactions, and if these chains are destroyed under the influence of stress, then a person loses his usual internal supports.

That is, emotional burnout is the result of accumulated tension, which for a long time (several months, and sometimes a year) does not receive release in the form of a pause in work, communication with loved ones, or spiritual nourishment in the form of a hobby.

Symptoms of emotional burnout

According to the WHO, burnout is a work-related phenomenon and is not considered a disease. Burnout or professional exhaustion is a syndrome that is considered to be the result of chronic work stress that is not properly managed.

Symptoms of burnout syndrome develop over a long period. And even during weekends and vacations, as a rule, a person does not get better.

How does burnout manifest? Although it is not officially considered a disease, some of its symptoms are similar to those of depression.

Let's look at the most common ones:

Emotional exhaustion. This is one of the main signs of burnout. A person suffers from an extreme lack of energy, it is difficult for him to start work and he feels exhausted. In general, the need for rest continues to grow, but a “burnt out” person is unable to fully rest. In addition, he feels increasingly depressed, believing that he cannot cope with his tasks and expectations.
Reduced work efficiency. Emotional and physical exhaustion affects professional activities. Typically, productivity decreases gradually, concentration decreases, and errors become more frequent.
Behavioral changes. One of the common symptoms of burnout is depersonalization, which manifests itself in some indifference and cynicism. Empathy and compassion for others, whether colleagues and clients, family and friends, are weakened. A burnt out person is too demanding of others and can even cause pain. As a result, his relationships with others may deteriorate sharply.
Psychosomatic symptoms. Burnout can have physical consequences. Typical symptoms include:
headache;
sleep disorders;
back pain and muscle tension;
cardiopalmus;
high blood pressure;
digestive problems (diarrhea, constipation and vomiting).

Sexual dysfunction may also occur. And if a person consumes too much alcohol, caffeine or nicotine, it can lead to other physical problems. Some of these symptoms are common to other conditions, such as chronic fatigue syndrome.

Other symptoms of burnout. Its symptoms may be different in men and women. Here are some of the possibilities:
anxiety and nervousness;
increased risk of accidents;
apathy;
feeling exploited;
feeling of helplessness and despondency;
feelings of worthlessness;
decreased creativity;
difficulty making decisions;
depression, even depressive attacks;
in some severe cases, suicidal thoughts.

Burnout is a multifactorial evil. In other words, people suffering from one of the symptoms are not necessarily experiencing burnout. On the other hand, if several of these signs appear at the same time, it may be time to be wary.

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Pathogenesis of emotional burnout

From an evolutionary and physiological perspective, humans are adapted to acute stress and respond to it with either flight or fight. This is the hereditary mechanism that has allowed the human species to survive.

The physiological response to stress occurs in three stages:

Alarm phase.
It implements the hypothalamic-sympathetic-adrenergic axis, which involves the hypothalamus (a region of the brain), the sympathetic nervous system (or activator) and the medullo-adrenal glands.
The sense organs (vision, hearing, smell, touch) perceive the stress factor and transmit information to the limbic system of the brain. The hypothalamus, a specific area of the brain, receives this information and triggers a range of responses that facilitate flight or fight. The first reaction is immediate and follows the path of the autonomic nervous system: it occurs automatically, not consciously.
The so-called sympathetic nervous system, a component of the autonomic nervous system, produces norepinephrine and activates the adrenal medulla (the central parts of the adrenal glands, the glands located above the kidneys), which in turn produce epinephrine and norepinephrine.
These two substances, called catecholamines, increase heart rate, pulmonary ventilation, alertness, sensory acuity (pupil dilation), and blood sugar levels. The muscles tense, and so do the smooth muscle cells of the artery walls, hence the increase in blood pressure.
The whole body is ready to fight or flee almost immediately. Everyone is familiar with the expression “adrenaline rush” and the sensations associated with it.
In addition, norepinephrine activates two other areas of the brain: the amygdala and hippocampus. The amygdala analyzes and evaluates the severity of a situation compared to past experiences. The hippocampus is responsible for remembering experienced events and recording new information.
Resistance phase.
It concerns the hypothalamic-pituitary-adrenal axis or corticotropic axis, in which the hypothalamus, pituitary gland and cortico-adrenal glands intervene.
If the stressor persists, the hypothalamus activates the pituitary gland by producing corticotropin-releasing hormone or corticoliberin. The pituitary gland, in turn, activates the adrenal cortex, which produces cortisol, also called hydrocortisone.
Cortisol is used to release energy from fats and carbohydrates to keep muscles working. In addition, cortisol, like the drug cortisone, has an anti-inflammatory effect: a person can run very fast or get injured, but does not feel pain at this moment.
Read also: How to set yourself up for a positive attitude (review of techniques and recommendations for changing attitudes)
Cortisol also tends to travel into the brain and activate the hippocampus, an area of the brain involved in memory and learning. In a physiological situation, the hippocampus slows down the hypothalamus. This is negative feedback control of the stress response.
During the resistance phase, the corticotropic axis remains active, with corticotropic hormone and cortisol levels increasing and remaining high. This phenomenon is called the burning phase.
Corticoliberin has a depressive and anxiety-producing effect, which explains the symptoms of people in a state of chronic stress: depression, anxiety.
Elevated cortisol levels are toxic to the hippocampus, which gradually loses its ability to slow down the hypothalamus and the ability to remember events. This explains the deterioration of immediate memory and learning ability.
In addition, levels of certain neurotransmitters fall in the central nervous system (brain and spinal cord). For example, dopamine (“the hormone of happiness”), associated with attention, initiative, pleasure, and serotonin (“the hormone of well-being”), associated with a feeling of completeness and satisfaction.
Exhaustion phase.
Under conditions of chronic occupational stress, modern man can neither run nor fight most of the time. He experiences repeated stress, sometimes for long periods of time.
When the burn-out state persists, the adrenal cortex becomes exhausted and cortisol production drops. Hypotension may be a sign of adrenal fatigue.
There comes a point when a person no longer has energy. He is in a situation of physical, mental and emotional exhaustion. He is depressed, deficient in dopamine and serotonin. This phenomenon is called the burnout phase.
The person becomes susceptible to infections. In people with burnout, there is a decrease in the activity of some immune defense cells, natural killer cells, and a decrease in the CD4 + / CD8 + ratio. CD4+ T cells are lymphocytes (white blood cells) that enhance the immune response.
CD8 are suppressor or cytotoxic lymphocytes: they are able to prevent certain reactions and kill abnormal cells. The normal ratio is 2:1. A decreased CD4+/CD8+ ratio suggests abnormal functioning of the immune system with possible immunodeficiency.
Burnout is associated with increased levels of proinflammatory cytokines, chemical mediators of inflammation, and reactive C protein, another marker of inflammation.
VEGF (Vascular Endothelial Growth Factor) increases blood circulation in people with burnout. VEGF causes the formation of new blood vessels (which is unfavorable in cancer) and increases microvascular permeability.
Conversely, the protein BDNF (brain-derived neurotrophic factor) reduces circulating levels. BDNF promotes the survival of existing neurons and the formation of new ones. It is present in the central and peripheral nervous system, with prominent activity in the hippocampus and cerebral cortex. Decreased BDNF levels suggest a decrease in the brain's ability to maintain and repair itself.

Stages of emotional burnout

This syndrome has several classifications. Let's consider one of them, which distinguishes 5 main stages.

Honeymoon phase.
It is characterized by not knowing that something is wrong. At this stage, it is only some dissatisfaction or concern that does not raise suspicions.
The honeymoon phase often happens when we change jobs or take on new challenges in an old workplace. At this moment, we are still full of energy and optimism and feel the need to show our best side.
The most common symptoms of burnout in the early stages are:
Sustainable energy levels;
Feeling that something is wrong, but ignoring it;
The desire to prove yourself and go beyond your own capabilities;
A state of constant vigilance;
Increased energy, as if you are on an adrenaline rush.
The onset of stress.
The second stage of burnout occurs with more obvious symptoms. This usually starts with recognizing that some days are harder than others. During these difficult days, employees typically find it difficult to concentrate, stay awake, feel sluggish, and worry about unfinished work. All of this begins to take a toll on their emotional and physical well-being, which only gets worse over time.
Here are some of the most common symptoms of stage 2 burnout:
Problems with decision making;
Change in appetite;
Fatigue;
Forgetfulness;
Rapid heartbeat and headaches;
Lack of sleep;
Irritability;
Problems with focusing.
Chronic stress.
If you are constantly in nervous tension, you gradually move into the stage of chronic stress. It impairs the ability to concentrate, which seriously reduces productivity and performance. In turn, you will begin to feel powerless and unworthy, losing control of everything you do. You will also feel pressured by daily tasks to the point where you will feel like you need to run away from your responsibilities. All of this can lead to feelings of incompetence.
Chronic stress can take a huge toll on mental and physical well-being as it deepens and intensifies the symptoms listed in stage two. However, unlike the second stage, you will not be able to manage your emotions as well, which can lead to sadness, resentment and aggressiveness.
Some of the symptoms of the chronic stress phase are:
Apathy;
Exhaustion;
Decreased sexual desire;
Increased alcohol/drug consumption;
Increased caffeine consumption;
Physical illness;
Touchiness;
Social isolation.
Burnout.
It occurs when all these symptoms become too frequent and even considered a normal part of life. However, these signs, if present over a long period, lead to physical and mental problems that impair our quality of life.
Read also: Types of emotional experiences and their characteristics.
Some of the most common symptoms of the burnout stage include:
Pessimistic outlook on work and life;
Physical symptoms worsen;
Diffidence;
Complete disregard for personal needs;
Wanting to leave work or friends/family;
Habitual burnout.
This is the last of the five stages and occurs when burnout becomes a part of life and all attempts to recover from the situation fail. Habitual burnout affects your career, your relationships, your health—every aspect of your life. Habitual burnout usually requires medical attention because it can be difficult to deal with alone.
Some of the common symptoms of habitual burnout include:
Depression;
Chronic physical and mental fatigue.

Who is most often affected?

In practice, there is a clear risk group, certain professions or stages of life, for which emotional burnout is more common. Among these categories of people are students, teachers, doctors, mothers.

Emotional burnout among students. Studenthood is a special stage in the life of every person, a time of increased activity, self-determination, and responsibility. The student is already an adult, but demands still continue to be placed on him. Instead of spending time with friends or a favorite hobby, the student is forced to prepare for an important session in order to continue studying and become a competent specialist. Responsibilities associated with preparing for classes are not the only activities of students - research work, creative and social associations, participation in conferences, forums, outdoor events, all these conditions create a favorable environment for the development of the syndrome. In this case, it is useful to seek the help of a teenage psychologist.
Emotional burnout among teachers. Educators encounter a variety of students of all ages and personalities every day. It is very difficult to find a common language with each of them, but within the framework of the educational process, an individual approach is a priority area of professional activity. The teacher feels direct responsibility for the quality of children’s preparation, the results of their intermediate and final certification, but at the same time, their inability to cope with such a volume of work alone. Over time, the profession ceases to bring pleasure, fatigue and lack of acceptance of one’s own competence appear. The situation develops especially quickly when working with difficult children, disobedient, self-willed, and lacking initiative.
Emotional burnout among doctors. Employees of medical institutions take on enormous responsibility for the health, and often the lives of patients. Constant work with negativity (complaints, poor health, unpleasant procedures, stress) invariably affects the mental state of doctors. All specialists are susceptible to burnout to one degree or another, primarily those caring for cancer patients, patients with immunodeficiencies, as well as workers in intensive care teams.
Emotional burnout in mothers. It would seem that the birth of a child is a happy, significant event in life that cannot lead to negative consequences. However, in practice, an increasing number of mothers complain of emotional burnout. The baby begins to take up all the time, attention, strength, and this will continue until he comes of age. You need to have enormous internal energy resources to overcome all crisis stages of a child’s development without consequences for your own mental health.

For those who study, work in a responsible position, interact with a large number of people every day, or are parents, it is especially important to pay attention to spending their own leisure time and organizing rest in order to prevent the onset of emotional burnout.

Consequences of emotional burnout

Ignoring burnout can have serious consequences. They can be like this:

Chronic fatigue;
Insomnia;
Alcohol or substance abuse;
Heart disease;
High blood pressure;
Diabetes mellitus type 2;
Vulnerability to disease.

Therefore, it is so important to diagnose this syndrome in time and try to correct it as soon as possible.

“Emotional burnout can lead to quite serious consequences. It's not just weight changes or sleep disturbances. A whole cascade of pathological reactions in the body is launched.
The menstrual cycle is disrupted, ovulation disappears, which can lead to infertility, PMS develops, and many develop benign tumor-like diseases - fibroids, cysts, mastopathy, endometriosis. Some women begin to bleed, while others may miss their periods. Memory and concentration decrease significantly, it becomes difficult to work, study, and absorb new information. The nervous system cannot adapt to what is happening and fails. For some, this can result in neurosis or aggression, for others - in depression. Depletion of the entire endocrine and immune system leads to the development of a variety of diseases against this background - from systemic to oncological. And it is very important to stop this process in time.”
Lyudmila Vladimirovna Mudragel
obstetrician-gynecologist, gynecologist-endocrinologist, ultrasound diagnostics doctor, specialist in aesthetic gynecology, doctor of integrative and anti-aging therapy
Experience: 23 years

Diagnosis of emotional burnout

Burnout is quite difficult to diagnose because it has no specific physical symptoms. However, its treatment is more effective when it begins after the first signs appear, which we described above.

You can seek help from a psychotherapist or an anti-aging doctor. The doctor will collect a family history, analyze working conditions and offer testing.

For this purpose, for example, there is the Maslach Burnout Inventory (MBI), which is used to assess the degree of emotional burnout and consists of 22 questions.

There are other questionnaires of the same focus: the Oldenburg Professional Burnout Questionnaire, the Copenhagen List, the Shirom-Melamed burnout indicator model and others. However, none of these tools provide a diagnosis that needs to be supplemented by clinical examination.

You will likely need to undergo laboratory tests to rule out underlying inflammation, infection or allergies, and analyze your eating habits to suggest any nutritional deficiencies.

“For a long time, we write everything off as fatigue or a difficult period in life. And only when problems arise at work, relationships in the family or with a partner deteriorate, or depression sets in, the question arises, where to go for help?
Since burnout leads to significant changes in hormonal levels, menstrual irregularities, decreased libido, weight changes, sleep disturbances, and the development of anxiety, such women turn to a neurologist, an endocrinologist, or a gynecologist for medical help.
But more often than not, the correct diagnosis is not made, and they do not receive effective therapy. That is why it is important to work with an integrative doctor who can understand the cause of what is happening and comprehensively influence the body, restoring all damaged links in this chain. Only an integrated approach to the treatment of such conditions can be successful.”
Lyudmila Vladimirovna Mudragel
obstetrician-gynecologist, gynecologist-endocrinologist, ultrasound diagnostics doctor, specialist in aesthetic gynecology, doctor of integrative and anti-aging therapy
Experience: 23 years

Who should I contact for help?

Veronica Pivkina explained what you should consider when choosing who to contact:

Find a specialist who is right for you. Usually, after 1-2 consultations, you can evaluate whether the recommendations help you, whether you like the approach to work, whether there is an effect, whether trust has emerged. If a specialist is not suitable for you and you do not like it, then effective therapy will not work - it is better to look for another one.
Assess the specialist's qualifications. Ask about education, advanced training, and techniques used by the specialist. Don’t be afraid to ask even what seems indecent, vulgar, or inconvenient to you: a normal specialist will not leave any questions unattended.

It is important to remember that no specialist can solve your problem unilaterally. A person will still have to understand himself, work through the problem and change what does not suit him. Each of us manages our own lives, and everyone can change something in it.

Treatment of emotional burnout

Treatment depends on the cause and must be individualized for each patient. Self-medication with sleeping pills is strictly not recommended, as it can lead to drug dependence.

If burnout is work-related, the doctor may recommend taking a vacation, as well as the following steps to correct the syndrome:

Psychotherapy. Cognitive behavioral therapy involves gradually exposing the patient to anxiety-provoking situations and helping them change their behavioral responses.

Medicines. In some cases, antidepressants (serotonin reuptake inhibitors) may be prescribed. Dopamine and norepinephrine reuptake inhibitors are sometimes combined. These substances aim to increase the concentration of these neurotransmitters in the intersynaptic spaces, the connection points between neurons.

There are also natural treatments for burnout:

Relaxation techniques. They reduce stress and improve heart function, even if you spend just a few minutes a day.

Hypnosis. It allows a person to mobilize their own resources to cope with burnout.

Yoga and tai chi. Their practice is associated with an increase in BDNF, a neuronal building factor and plasticity. Therefore, practicing yoga or tai chi can prevent burnout or improve the well-being of a person with this syndrome.

Changing your diet. In particular, a diet rich in magnesium may be recommended - its deficiency is involved in numerous mechanisms associated with stress and burnout. Taking magnesium helps prevent and recover from burnout.

At the same time, some products reduce the absorption of magnesium and increase its excretion in the urine:

caffeine found in coffee, some carbonated drinks and energy drinks;
excess phosphorus (dairy products, soft drinks enriched with phosphoric acid);
alcohol.

Foods rich in magnesium include seafood, sardines, Brazil nuts, nuts, hazelnuts, almonds, green leafy vegetables, buckwheat, legumes.

Other methods for correcting burnout syndrome include homeopathy and herbal medicine.

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Prevention

The most important prevention of emotional burnout is taking care of your health. An integral part of every person’s life should be walking or jogging, playing sports, eating right, and giving up bad habits.

Refusal from modern technologies is no less important for stabilizing the mental state. All kinds of gadgets have become firmly established in the life of every person - they serve not only as a means of communication, but as a tool for self-development, leisure time, vacation planning, and so on. Despite all this, numerous researchers insist that frequent use of smartphones contributes to the accumulation of nervous tension.

To prevent the development of the syndrome, one should master control over emotions. Relaxation techniques, relaxation, meditation will help cope with stress, which cannot be completely eliminated from life, but learning to respond to it is easier - quite.

Brief conclusions

Emotional burnout is directly related to work routine or heavy personal obligations.
It is not officially considered a disease, but the condition is accompanied by many different symptoms.
The stages of emotional burnout are conventionally divided into 5 stages.
Burnout can lead to serious health consequences if not diagnosed early.
For successful correction of the syndrome, it is recommended to contact doctors of integrative anti-aging medicine.