If you are exposed to stress for a prolonged period of time, longer than the body can handle, the energy reserves run out. You get very tired, have issues with sleep and become unusually sensitive to stress. In order for a doctor to diagnose burnout, you must meet the following criteria: Physical and mental signs of fatigue that have lasted for at least two weeks and have been preceded by at least six months of unusually high stress levels. Decreased mental energy: increased difficulty to get started with things, poorer ability to concentrate and need for more rest after mental exertion.
At least four of the following symptoms of burnout should have occurred almost every day for the past two weeks:
Concentration difficulties / memory problems
Difficulty managing demands and doing things under time pressure
Emotional instability or irritation
Physical fatigue / weakness
Physical ailments such as stomach problems, sensitivity to sound, dizziness, chest pain or palpitations
What happens in the body during burnout?
When we are exposed to prolonged stress, the brain responds by ordering the adrenal glands (two small glands located on top of the kidneys) to produce more cortisol. Cortisol is a stress hormone that makes us awake, alert and energetic, but if levels remain high for a long time it gets negative health consequences.The stress hormones are regulated by a system called the HPA axis, which includes the hypothalamus, the pineal gland and the adrenal glands. Over time, the HPA axis begins to deteriorate due to constant activation. For example, you may experience circadian rhythm issues such as feeling tired during the day but alert at night. Finally, the brain responds by lowering the production of cortisol throughout the day to protect the body from its harmful effects. Consequently we become exhausted. Growth hormones and sex hormones such as testosterone and estrogen may also decrease, which affects physique, well-being and sex drive.
Causes of prolonged stress
When thinking of burnout it is important to examine your current working environment. Stress has been closely related to adverse working conditions. Nevertheless stress can also be attributable to different factors.
For example, you may be in a destructive relationship, making unreasonable performance demands on yourself, experience undetected ADHD or other neuropsychiatric functional variations, suffering from anxiety or sleep problems, deaths in the family, and so on. All of this can lead to harmful stress, even if you are in a good working environment.
More severe causes of exhaustion can be war, rape or car accidents. In these situations, the condition is called PTSD, post-traumatic stress disorder, but the body’s response to hormone levels is the same as in burnout. One should therefore not focus solely on the workplace as the only source of fatigue. Life consists of more than work, and stress can be everywhere where the demands are greater than our energy resources.
Recovery and rehabilitation
If you have suffered from burnout, you may require full-time or part-time sick leave in order to facilitate your recovery. Treatment may consist of psychoeducation (information about how stress works and strategies for dealing with it), CBT, physiotherapy and relaxation exercises such as mindfulness, medical yoga and basic body awareness. Sometimes they also examine how the workplace can be adapted to make it easier for you to get back to work. Medication can be used if you also have problems with such things as Depression, anxiety and difficulty sleeping, but there is currently no prescription medication used to cure burnout itself. It is important to have a lot of rest and low demands at the beginning, but eventually it is good to have some kind of active recovery, for example by courses in relaxation and stress management, support group discussions or psychotherapy. When you have become a little healthier, your doctor may encourage you to try part-time work. Some people who become exhausted can develop a phobia of the workplace, because they associate it with stress and discomfort. If you gradually get used to starting work in calmer conditions, that connection is weakened, so that you get a more positive perspective of your work. As you start to feel better, you can then slowly increase your working hours with the goal of finally working full time again. This process is fairly fast for some, but for others it can take several years. It is therefore important that you have patience with yourself.