Why people burn out and how to recover
Burnout has been a controversial topic, especially the last decade or so. For a long time — and still — many people deny that such a thing even exists. Some people go as far to criticise those who burn out for easily giving up, not trying hard enough or being weak. Such harsh judgments reflect a serious PR issue around burnout.
Contrary to what many people believe, burnout has been well researched — but as with anything that involves health and money, there is a lot of junk information floating around. Let’s look a the basics of burnout and what researchers say about it.
Definitions and dimensions of a burnout
I first want to share with you some information that helps to better understand burnout. Once we have that on board, we can look into what’s actually going on ‘under water’ in your body and mind when you’re burning out.
Three assessment criteria [1]
Researchers identify three dimensions that help assess people going through a burnout:
- Overwhelming exhaustion (physically, emotionally and mentally)
- Feelings of cynicism and detachment from the job
- A sense of ineffectiveness and lack of accomplishment
Other descriptions have also been used, generally focusing on similar experiences of energy loss, fatigue, irritability, reduced productivity, etc. Although these criteria might seem somewhat subjective, they are clearly observable on the outside. It is not uncommon that initially the people close to the person burning out will start asking questions like ‘are you doing okay?’. Most people on their way to exhaustion will keep answering that they’re doing fine — since many of them are so used to pushing through and suppressing the signals that their body is giving them.
Organizational factors [1,2,3]
Since burnout is so strongly related to work, researchers have also looked into the key causative factors in organizations. According to recent research, it seems pretty clear that high job demands are key to the development of burnout and exhaustion. Other factors that increase burnout risk are: low job control, high workload, low reward and job insecurity.
Although most of the research focuses on established and mature organizations, it seems quite obvious that many of these risk factors are abundant in the work environment of entrepreneurs and startup teams. Unsurprisingly, I personally encounter many entrepreneurs who are either on their way to a burnout or who already have hit the end station of total exhaustion.
Becoming adrenaline junkies
We’ve now seen that the road to burnout almost always starts with people working too much, under too much pressure and under adverse conditions (low control, rewards and security). Although many people don’t think they work that hard or are that stressed, their biology would beg to differ. Let us now take a look at what’s happening inside people that are burning out.
Subconsciously, their biology is involved in a process called allostasis: a short term adaptation of different body systems to maintain the organism and ensure survival. This is more complex and dynamic than homeostasis, a term you might remember from your biology class. Homeostasis involves balancing single variables in the body, like keeping blood glucose or blood pH constant. [4]
All things going on in your life right now contribute to allostatic load, including the stress from your work, finances, relationships, sickness, working out, and so on.
What most people do not know is that the body is handling all kinds of stressors through this allostatic process, the sum of which is also called allostatic load. All things going on in your life right now contribute to this load, including the stress from your work, finances, relationships, sickness, working out, and so on. The most important way that your body responds to these stresses is through the so-called HPA axis (hypothalamic–pituitary–adrenal axis) which results in the secretion of adrenaline and cortisol, the major stress hormones.
These hormones give an immediate boost to the system, preparing it for (intense) action and fight-flight behavior. In other words, when the HPA-axis kicks in you’re running on survival energy. This is great when you’re in acute danger, like escaping from threat or fighting of attackers. But it is unnecessary during normal daily living. And it can even become damaging when you’re functioning from your survival energy supply 24/7. Nevermind the fact that it is possible to get addicted to these and other related hormones and neurotransmitters — indeed, I wasn’t joking with the adrenaline junkie title!
In the first phase towards burnout people overwork (and/or overtrain) themselves, remaining unaware or even actively ignoring the warning signals of their body. On a conscious level people often experience chaos, fatigue, overwhelm, irritability, worrying and anxiety. Their sleep is starting to become problematic, digestion starts derailing and they have trouble with their thinking and focus.
Since these symptoms are so general or nonspecific, internet searching and doctor visits often do not yield great results other than some oversimplified lifestyle suggestion or pill prescription.
People that are in this mode of living often believe that if they were to truly take a break or give in to the fatigue, they wouldn’t be able to get up and go on anymore. I notice that with clients in this phase it seems that taking a break actually feels more dangerous than continuing on their current rollercoaster. One reason for this is that their biology gives signals there is deep restoration and recovery work to be done inside, which would require shutting down activity for some time.
Running out of your supply [4,7]
When the previous phase continues for too long — without adequate rest and recovery — people increasingly become overwhelmed (having thoughts like “I can’t …”). The fatigue becomes ever present and often people experience pain and tightness in muscles, often in the shoulders, neck, mid- and lower back. The irritability can become more extreme, like a hypervigilance with frequent outbursts of either anger or panic. Simultaneously, the mental clarity and focus keep diminishing, sometimes accompanied by memory loss and disorientation.
Ultimately, this phase is the actual burnout phase, where complete exhaustion and possibly severe illness enter the stage. The allostatic load with its excessive adrenaline and cortisol levels will have damaged many body systems and several of the following symptoms will start showing:
- Memory problems (because prolonged cortisol exposure damages the hippocampus)
- Declined executive function and mental capacity (due to constriction of blood vessels in the forebrain)
- Reduced immune function, possibly even auto-immune disease (cortisol dampens immune function since the body experiences ‘acute danger’ in the fight/flight mode and more long-term immune protection is not a priority)
- Serious digestive issues (for example Irritable Bowel Syndrome)
- Reduced cardiovascular function (due to high blood pressure from the excessive adrenaline)
- On a mental and emotional level, depression, numbness and complete fatigue ensue (sometimes alternated with extreme emotionality like panic and helplessness).
- Increased aging and adverse epigenetic changes [5]
In the final stages of burning out, people experience complete exhaustion and possibly immobility for a short time. For example, people in this stage sometimes cannot get out of bed all of a sudden.
This may be the result of their nervous system moving beyond the fight-flight response into a freeze response, which immobilizes the body and greatly reduces metabolism. You can think of this as the ultimate handbrake that your (autonomic) nervous system pulls when there is not only danger but actual life threat. This is kind of accurate at this point, since vital body systems are being (severely) damaged and bodily resources are utterly depleted. The freeze response is a primitive, time-limited strategy for shutting down a great deal of bodily activity to increase chances of survival.
The graphic below shows the three different states from your autonomic nervous system in the stress response: social engagement, fight-flight and freeze.
Recovery from a full-blown burnout will take a lot of time, especially when people have come to the point of collapse in the freeze response. From there, they will be unable to get back to work for at least some extended period of time. This creates all sorts of problems for the employer, team and other stakeholders who will have to redistribute work — or even terminate activities to some extent in entrepreneurial cases.
Now, maybe take a pause and deep breath here, since it can be somewhat intense to take this all in. Let’s leave this part of the burnout story and take a look at what might help to prevent or reverse all of this.
What you can do to reverse the downward spiral
Obviously there is too much to share on the subject of preventing and recovering from burnout. What I want to do is walk you through some of the essential pieces of the puzzle.
Adequate rest and recovery
This is a no-brainer, but at the same time also the hardest piece for most people. Because of the strong biological survival imperative that comes with functioning from the fight-flight mode, it will be very hard to cross the threshold to true, deep restoration.
The recommendation here is quite simple: get rest. Sleep at least 8 hours, although you probably need way more to settle your so called ‘sleep debt’ at this point. Taking naps in the afternoon can also help getting good rest throughout the day.
Also, if you can take some time off that will be great. Getting back to low-intensity, relaxing activities like reading, playing music, cooking food, etc. may also be helpful.
Safely discharging accumulated stress and rewiring the nervous system
Another important piece to the puzzle is rewiring how the nervous system handles stress. Many people have nervous system tuned to higher levels of stress because of their histories that include sub-optimal family life, traumatic experiences, the daily chronic stress, and so on.
Although you take some steps in this on your own, this process often requires the experienced guidance of some coach or therapist who knows how to work on this subject. I can recommend coaches or therapist trained in somatic and psychobiological methodologies like Somatic Experiencing, a method I’m training in myself.
Noticing and responding to biological signals
It will also be essential to get back in touch with the signals that your biology are giving you throughout the day. When we overwork we often ignore basic needs like eating, drinking, eliminating and so on.
One tool that can help here is a body scan or other somatic exercise that helps you reconnect with your interoception: the capacity to perceive bodily sensations coming from your internal milieu. If at work, you can set a simple reminder for every 30 or 60 minutes or so to take a mini-break and check in with what’s going on inside yourself.
Social support
A great antidote to the stress response comes from the opposite of the fight-flight system, the so called ‘social engagement system’. Activating the social engagement system puts a break on the stress response and activates the ‘rest & digest’ branch of your autonomic nervous system. As the name implies, a good way to trigger this system is by being socially engaged.
This means that it is very beneficial to spend time with close friends, loved ones, family, pets or groups where you feel safety, trust and connectedness. As a matter of fact, simply meditating on the people or animals in your life that you feel affection for can activate the social engagement system and calm the stress response.
Mild activity and play
Depending on how much wear-and-tear your body has gone through due to chronic stress, it will be helpful to engage in non-intense activity. The goal here is not to stimulate your body for maximum strength or muscle growth, but to simply get blood flowing and reduce patterns of tension and constriction.
Options include going for walks (preferably in nature), tai chi, light yoga, swimming or rediscovering how to play! As mammals, we are made for play [6] and this need is often chronically unmet when we have been overworking and burning out.
What organizations can do [2,3]
When it comes to organizing teams and workplaces, a few recommendations were made by researchers investigating burnout risk. What they’ve found is that high levels of job support, balanced job demands and workplace justice were protective for burnout and emotional exhaustion. An important other factor is the possibility to exert control over your work, meaning that leaders and managers can mitigate burnout risk by refraining from top-down authoritarian goal and task setting.
The caveat here is that many people do not experience a strong sense of agency or internal locus of control. This means that even if there is the possibility to make changes and exert control over their work, the internal lack of agency will prevent them from perceiving these options and create an experience of being powerless or helpless against the demands, pressures and injustices at work. For this group of people it will be very beneficial to resolve internal conflicts, often in the form of stuck patterns of thinking, feeling and behaving, that keep them from making the changes that can improve their working conditions and prevent burnout.
The non-burnout experience [1]
Before we end, I want to also point to the necessity of defining the opposite of burnout. Sadly, in many medical and scientific literature pathology prevails. We know very well what sickness and dis-ease look like, but what about the opposite? What’s it like to notbe burning out?
Luckily there has been more appreciation of the positive side of things in science recently. Research into positive psychology, positive emotions and well-being has been emerging for at least a few decades now. According to some burnout researchers, we could say that engagement is the total opposite of burnout, including states of high energy, strong involvement and a sense of efficacy or agency. This is close to the concept of flow developed by (positive) psychologist Mihaly Csikszentmihalyi, which is a moment-to-moment experience of being engaged with what you’re doing — whether that’s work or any other activity.
I want to leave you with the thought that although we often are so concerned what we don’t want, that we tend to forget what we do want. Therefore another important piece to prevent or recover from burning out involves this: taking the time to pause and reflect on what it is that you want most out of your life, what you’re attracted to.
This will help you reconnect with a different source of energy — from the addictive survival energy to the life-giving force of intrinsic motivation and meaning.
Sources
- Understanding the burnout experience: recent research and its implications for psychiatry. — https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911781/
- A systematic review including meta-analysis of work environment and burnout symptoms. — https://www.ncbi.nlm.nih.gov/pubmed/28302088
- The role of psychosocial working conditions on burnout and its core component emotional exhaustion — a systematic review. — https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4233644/
- Why Zebra’s Don’t Get Ulcers — Robert Sapolsky
- Preclinical and Clinical Evidence of DNA Methylation Changes in Response to Trauma and Chronic Stress. — http://journals.sagepub.com/doi/full/10.1177/2470547017710764
- The PLAY circuit was discovered by Jaap Panksepp, more on this here: https://www.psychologytoday.com/blog/play-in-mind/201705/jaak-panksepp-archaeologist-the-mind
- When The Body Says No — Gabor Mate
