Burnout: What is it and How do we fix it?
Ever felt overwhelmed, exhausted, emotionally drained or just too tired to even figure out how to feel better and face the continuous demands that life puts on us? Almost all of us have, at some time or another, felt overworked, overtired or overextended. In fact, it seems unavoidable in our modern lives that we wouldn’t experience this in varying degrees at some point in time. This, in some shape or form, is known as BURNOUT!
Even if you’re not necessarily feeling tired, this may be because you associate that feeling with what is “normal”, or the burnout is being experienced physically in the form of headaches, muscle soreness, gastrointestinal issues or poor sleep (for example because your brain is always feeling like it’s “on fire”!). But burnout is real.
What Does Burnout Look Like?
As you’ll shortly see, burnout affects literally every part of our bodies and therefore our overall health in a very real way. Suffering from burnout manifests itself both physically and physiologically, and includes things like chronic fatigue, anxiety, hormone dysregulation (think cortisol, hypothyroidism, low testosterone for men and women, irregular menstrual cycles), poor digestive health, obesity, diabetes, cardiovascular problems, brain problems and poor sleep. There really is no part of our systems that is untouched by the impact that stress and burnout has on the body.
Sadly, feeling overworked, overtired and overstressed is something that impacts millions of people every day. However, when we go to a doctor for a solution, blood work can often show that everything is fine, or even if something is found and addressed, we are still left feeling just so damn tired. We often hear it’s because we’re getting older or that it’s “normal” to feel this way because we work hard or have challenging relationships.
More and more people appear to be suffering from an epidemic of fatigue and burnout due to an inability to manage the pressure that we put on ourselves to perform both personally and professionally. And then just assume that it’s an inevitable part of life. The truth is that it shouldn’t be normal.
What you may have heard referred to as burnout or adrenal fatigue (a term that some people scoff at) is more properly known as HPA Dysfunction (“HPAD”). HPA is the hypothalamic-pituitary-adrenal (HPA) axis, which is an intricate system of endocrine (hormonal) pathways and a mechanism in our bodies that is designed to regulate a number of physiological processes, including metabolism, our immune response, our stress response etc.
HPA axis dysfunction then (or adrenal fatigue) is what happens when our stress response is always on. There are generally four things that people experience in their lives that can cause HPAD:
1. Perceived stress
Let’s look at it this way. As humans, we were originally designed for short bursts of stress. You’re out looking for food in nature and out jumps a lion, ready to maul you because that lion is hungry or may have some cubs to feed.
Our bodies are very cleverly designed: an immediate stress response is triggered which turns ON important functions (energy mobilisation from muscles, fat stores and the liver so that muscles are activated to allow us to run away, heart rate and blood pressure speed up so that we can respond in 2 seconds rather than in 5 seconds, our brain is turned on high alert so that we can think quickly to avoid danger and our immune system is turned on so that we can immediately fight off pathogens in case we get injured). In the same way that these bodily functions are turned on, some bodily functions are turned OFF when faced with an immediate stressor. These include reproduction, digestion, growth etc. which aren’t needed when running away from a hungry lion.
This is all normal and short-term stress is very good for us because it allows the above process to occur, i.e. turning on what you need immediately and turning off what you don’t need so that your stress response can be optimal.
What does become problematic is when you’re going through that process over and over. With perceived stress, we’re planning for the lion to attack us right now, later, tomorrow and next week. Our modern lives often leave us in a state of hyper alertness and ongoing stress about life and this is like non-stop experiencing an attack from a lion. Imagine constantly mobilising your muscles due to stress. This actually causes muscles to waste away (muscle catabolism) which results in sarcopenia (muscle loss), a leading cause of death in the elderly.
Similarly, putting energy into your blood as if running from a lion results in chronically elevated blood sugar which eventually results in insulin resistance, increasing the risk of obesity and diabetes. Ever notice how you can’t lose weight when you’re stressed? It’s physically impossible because of the cortisol and blood sugar dysregulation that occurs when we’re perpetually stressed.
Blood pressure too high for extended periods of time, for example from just walking into your office? Chronically elevated blood pressure will eventually remodel the heart and arteries, increasing your chances of having a heart attack.
When your immune system is turned on long term from continuing stress instead of just for short bursts of time, the immune system’s response is either to go into overdrive or to slow down completely, both of which are dangerous to our health.
Finally, and scariest of all is that the brain can be remodelled. Dopamine, a happy brain chemical, should only be released in the short term. When this is interrupted due to constant stress which requires a constant release, we eventually run out of dopamine, which is the joylessness which we associate with depression. The hippocampus in the brain, which is responsible for memory and learning, shuts down, and our ability to grow new neurons is inhibited. Not only do we experience memory problems and brain fog, but the fear response that is associated with anxiety doesn’t switch off properly. Basically, our brains become a mess and cannot regenerate.
The above all relates to bodily functions that are turned on in stress. Those that are turned off (digestion, reproduction) remain turned off, resulting in digestive havoc, infertility, low testosterone, PCOS in women, growth hormone issues and thyroid disease. Clearly, a recipe for disaster.
To summarise, perceived stress is a major cause of HPAD. It is this feeling of being chased by a lion, all of the time and it is caused by our daily life stressors and the problem is when it becomes chronic. Here are some other causes of HPAD that are more physiologically based:
2. Blood sugar dysregulation
When we eat inappropriate amounts of carbohydrates or we eat sugar, our blood sugar spikes. If this happens chronically, our insulin response starts to malfunction, and this is a big contributor to HPAD. What we eat matters for stress management!
3. Circadian disruption
When we are exposed to too much artificial light at night, our bodies don’t know that it’s nighttime (because artificial blue light mimics sunlight). When we don’t sleep and wake in a regular cycle that is linked to the sun, HPAD flourishes!
The fourth cause of HPAD is inflammation, which is when you get right down to it, the basis of all chronic disease. This can be caused by too much high intensity exercise, chronic cardio, an inflammatory diet or again, stress!
What to do about HPAD
We know that in the brain, HPAD causes depression, anxiety, PTSD, chronic fatigue, memory problems etc. In the gut, it causes IBS and dysbiosis (when the good and bad bacteria are imbalanced). Metabolically, it causes heart disease, diabetes and obesity. In the reproductive organs, it causes infertility, low testosterone and irregular cycles. All of these can be linked back to HPAD, which we know is largely caused by perceived, ongoing and chronic stress.
Having a stressor or two is fine and perfectly healthy. These come in peaks and troughs and that’s fine because when it comes up, it goes back down again. But because we are bombarded by so many stressors, there are too many peaks and cortisol remains chronically elevated. Your body becomes so tired of regulating the cortisol up and down that it decides to just leave it on “high”. Sometimes, it thinks you’re crying wolf so what results is a chronic under response to stressors. Both leaving you utterly fatigued and burnt out!
So, what can we do to fix things when they start getting broken?
First of all, and most importantly, is to manage your stress. Realistically, we can’t just remove jobs, stressful relationships, commutes, financial worries etc from our lives. Nor modern day stressors like processed food, artificial light and other pollutants. What we can address though is how we respond to those stressors. Meditation is a wonderful tool to reduce stress. At work, delegate tasks where possible. If social media or the news stresses you out, limit how you consume it. Increase a feel-good hormone called oxytocin through lots of physical touch, time spent with loved ones, sex, playing with kids or animals and connection. Avoid pointless arguments and schedule time if you need to for relaxing activities. So many people have come to a point where we wear burnout and stress as a badge of honour and when you do something enjoyable or relaxing, we view it as lazy or unmotivated. That is an attitude that needs to stop because it is making us sick.
- Sometimes, fatigue can have medical reasons, like iron deficiency, low vitamin B12 levels or thyroid issues. If you are worried that you’re facing burnout / HPAD, then it’s always a good idea to get a panel of bloodwork done. If it comes back normal it doesn’t mean it’s all in your head, but it might help you identify what is going on. I’m also a big believer in seeing an endocrinologist to look at hormone levels from a young age!
- Soft interventions: I’ve had periods of stress and all we want in that moment is a magic pill that takes the nauseousness out of your tummy and slows your heart down or lifts your depression. Unfortunately, this is simply not how it works. Things like breathing techniques, mindfulness and meditation can have a very real and tangible effect on symptoms of burnout. My favourite stress-reliever is exhaling for longer than you inhale on each breath, which stimulates a relaxing effect in as little as five minutes!
- Address circadian dysfunction. If you can, avoid bright lights at night, use blue light blocking glasses and prioritise getting sunshine in your eyes in the first 30 minutes of waking in the morning.
- Diet: because inflammation is often caused by the food we eat, following an anti-inflammatory diet could be highly useful! That being said, sometimes people who eat perfectly are still inflamed, purely due to stress! So, it’s important to address stress management before diet, but if you’re eating foods that are inflammatory (processed food, histamine-containing food if you’re intolerant, gluten etc), then you’re definitely going to make symptoms of burnout worse! Most important tip: optimise (increase) your protein intake! Also, eat slowly and with mindfulness. Rushing a meal down in the car or in front of the television has a negative impact on how we digest food!
Exercise: this might actually be one of the reasons why you’re suffering from burnout and is often brought on by excessive high-intensity exercise or too much cardio. While you are healing, you want to focus on walking, yoga, low intensity resistance training and gentle movement, rather than anything remotely intense. People who are addicted to high intensity exercise or strenuous cardio are often people who suffer from elevated cortisol the most, so we need to be mindful of how we are exercising for our health.
- Adaptogens: these are natural plants that literally balance our systems. My favourite is PrimeSelf’s Adaptogen Complex, a cleverly formulated and very effective product for bringing a stressed system back into balance.
I really enjoyed a book by Dr Amy Shah called “I'm So Effing Tired: A Proven Plan to Beat Burnout, Boost Your Energy, and Reclaim Your Life” in which she speaks about how we can’t remove stress from our life, but we CAN manage how we ADDRESS that stress. It’s a really great book if you think that you’re suffering from burnout and gives really good advice on how to deal with it!
It’s important to recognise that feeling tired is not normal and that you can feel better! If you have any of the symptoms mentioned, put yourself and your health first and identify what you can change and what interventions you can make in your own life. Given how pervasively burnout affects our physical and mental health, this could be one of the most important investments you make in yourself!
- Thea is the founder of Neolaia – Biohacking SA and passionate about all things biohacking, functional medicine, holistic and ancestral wellness. She enjoys the occasional triathlon, is fanatic about yoga and the gym and loves n=1 biohacking experiments more than anything else! Learning about the latest in scientific research for health and wellness and applying this knowledge is what makes her happiest!
This information does not serve as medical advice, diagnosis, or treatment. This content is for informational purposes only and does not provide a comprehensive explanation of the different compounds. Always consult your doctor first when making any changes to medication or supplementation.