Are you exhausted from excessive demands at work?
Be careful… You could be hurtling towards a burnout without even knowing it.
This is a two-part post. Once you’re finished with this one, be sure to click here for part 2!
Much like adrenal fatigue, burnout and chronic fatigue syndrome have a lot of overlap. And the symptoms you experience in each condition will probably look a lot alike. But the treatment pathways for each condition are very different.
Proper treatment depends on proper diagnosis. But there’s no blood test for either chronic fatigue, adrenal fatigue, or burnout.
How do you know which condition you’re dealing with?
And how do you properly treat it?
I’ll show you how in today’s post!
Is burnout actually a medical condition?
If you feel you’re suffering from burnout, don’t hope to get a lot of support from your family doctor. The bible followed by medical professionals in the world of mental health is called the Diagnostic & Statistical Manual of Mental Disorders (DSM). The DSM does not list burnout as a medical condition. (1)
Now, the DSM is published by the American Psychiatric Association (APA). It is not necessarily the standard followed by the rest of the world. In fact, the World Health Organization (WHO) does list burnout in their classification of diseases. (2) But burnout is not listed as a disorder unto itself. Instead, the WHO interprets burnout to fall under the category of problems related to life management.
As you’ll learn later on in this post, burnout is more likely associated with other medical conditions. What makes burnout unique is that the symptoms often present as a result of a high-stress work environment.
What Are The Signs & Symptoms Of Burnout?
The signs and symptoms of burnout are so commonplace in the developed world that you might even mistake them for normal. Here’s an incomplete list of some of the more common burnout symptoms: (3, 4)
- Physical and/or mental fatigue and/or exhaustion
- Emotional exhaustion
- Treating colleagues in a cynical way
- Disengagement at work
- Reduced feelings of personal or work-related accomplishment
A symptom list like this is known as non-specific symptoms. Non-specific symptoms are, well, not very specific. Thus, they can’t be used to diagnose a disease or illness.
Take fatigue – fatigue is the perfect example of a non-specific symptom. Fatigue is a symptom experienced with almost every ailment. If your main symptom is fatigue, doctors can’t look to a specific condition to diagnose you with. Whereas an itchy rash that turns into fluid-filled blisters is a specific symptom. It’s unique to chickenpox.
The signs and symptoms of burnout are non-specific. This makes diagnosis challenging. So, be patient with your doctor. There’s no blood test for burnout. She’s doing her best with the information she has.
What I find fascinating about this symptom list is how closely it tracks with the symptoms of mitochondrial decline. For those of you unfamiliar with mitochondria, they are the powerplants of your body. It’s your mitochondria that give you the energy to power through your day. When your mitochondrial function starts to decline, you start to experience symptoms just like the ones mentioned above.
Are you burnt out? Or, are you depressed?
You think you’re burnt out. But your doctor thinks you’re depressed. Are depression and burnout two sides of the same coin?
This becomes a challenging question to answer because so many of the symptoms overlap. Confounded by the fact burnout is not recognized as a legitimate medical condition. In all likelihood, your doctor will probably offer you an antidepressant. But depending on the actual cause of your burnout, antidepressant medication could offer little benefit and actually be dangerous.
Don’t think for a minute that this won’t happen to you. There’s no shortage of evidence that burnout is really just depression masquerading in a different outfit (and at the office). (6, 7, 8, 9, 10) One study even found that burnout shared eight of the nine clinical features of depression. (11)
And there are now multiple studies pushing for burnout to be rebranded as depression. (12, 13, 14) But before you go searching out antidepressant therapies, please please please finish reading this post. You’ll learn that burnout isn’t as cut and dried as researchers may think it is.
That burnout (or depression – whatever you want to call it) of yours may actually be a symptom of something else. I’ll get into just what that may be below!
Are you hurtling towards a burnout?
Now that you know those depression-like symptoms you’ve been experiencing could actually be burnout, let’s discuss who’s at the highest risk. Research suggests that there are six risk factors for burnout. These include: (15)
- A mismatch in workload
- A mismatch in control
- Lack of appropriate awards
- Loss of a sense of positive connection with others in the workplace
- Perceived lack of fairness
- A Conflict between your values
The textbook example of these risk factors would be an employee who recently survived a round of layoffs in her office. Now, she has to complete her previous workload and the workload of her three colleagues that were recently laid-off. This is both a mismatch in workload (far too much) and a mismatch in control (she has no choice but to complete the work if she wants to keep her job). Her increased workload is now an expectation – she is not rewarded (financially or otherwise) for the increase in her workload.
Since she’s now so busy trying to complete the work of four people, there’s no time to connect with her colleagues (plus, the moral at work is awful since the layoffs). The new workplace is not at all fair. And it conflicts with her values of connecting with her family – there’s just not enough hours in the day to be present with your kids AND finish all the work. This is a woman (or man) hurtling towards burnout.
Another way to identify if work-related stressors are pushing you towards burnout is through the acronym NUTS. The types of stress most likely to lead to burnout are NUTS. These include:
N – Novelty of the event; New or unknown stresses are more challenging to overcome than situations/circumstances you’ve navigated in the past.
U – Unpredictability; Being able to prepare for a stressful event is more comfortable and easier to manage than an unpredictable stressful event.
T – Threat to your ego; This is all about your sense of self. If the person you perceive yourself to be is threatened, the level of stress goes way up.
S – Sense of control; If you feel that no matter what action you take, you can’t affect the outcome, you don’t have control. The less control you have over an event, the more stressful the event.
I’ve spoken almost exclusively about burnout occurring in the context of an office job. Burnout is not unique to the office cubicle. Burnout can happen in just about any environment. I’ll elaborate on whether your workplace is putting you at risk of burnout below!
Can you experience burnout away from the office?
Descriptions of burnout are almost exclusively related to office work. But this is a generic, narrow perspective of the condition. Burnout can happen in any field – not just the office cubicle. (16)
Take healthcare professions – nursing for example. A 2017 survey showed that half of all nurses surveyed were considering finding a new job. (17) In healthcare, you deal with the burnout risk factors I listed above combined with compassion fatigue. Compassion fatigue is a set of symptoms quite similar to burnout that results when you consistently deal with trauma or illness.
And it’s no better for doctors – nearly 50% of doctors are experiencing burnout and/or compassion fatigue! (18) If you’re a veterinarian, things are even worse. Vets are thoughts to be 4-8x more likely to die from suicide compared to the general population. (19, 20)
Burnout is not unique to the office. It can be found in nearly every industry – even parenting. Nearly 13% of parents experience burnout. (21) If you’re suffering from any of the symptoms I listed, take them seriously. They’re not in your head. Your symptoms are real. They need to be addressed.
Next, I’ll show you a functional medicine approach to burnout – how it’s diagnosed and the best treatment strategies.
Burnout through the lens of functional medicine
You can’t draw blood and run a test that measures your degree of burnout. While that would be incredibly helpful, there is not a burnout marker in your blood. That means your diagnosis will likely be made entirely based on your symptoms. In my opinion, this is not the best approach. Fortunately, functional medicine offers a unique point of view.
Have you heard of adrenal fatigue?
Adrenal fatigue and burnout match symptoms even better than depression and burnout. But before you rush off to your doctor’s office and tell him that your adrenals are fatigued, know that adrenal fatigue is not considered a real medical condition. What is a real condition is something known as hypothalamic-pituitary-adrenal axis dysfunction or, HPA-D.
HPA-D describes a condition where your body struggles to maintain homeostasis. This comes about when you’re placed under an intense or chronic stressor.
Each of you has something called metabolic reserve. Think of metabolic reserve as your stress bucket. Each stressor in your life is a rock placed in your bucket. So long as your bucket does not overflow, your body is able to manage/tolerate the stresses of life.
Now, there’s also something to be said about the intensity of stress. Bigger rocks take up more room in your bucket. A term known as allostatic load describes the severity of your stress. Getting caught in rush-hour traffic, that’s frustrating. But it’s a relatively small stressor. Thus, traffic jams are a small rock in your bucket. But getting in a motor vehicle accident, that’s a much bigger stressor – it will take up a lot more room in your bucket.
Your HPA axis struggles to maintain balance when your bucket is full. So, measuring your HPA axis is an incredible, objective means of assessing burnout. There is a lab test to determine whether or not you’re suffering from burnout!
But how do you treat it? Is there a cure for burnout?
How to treat burnout
First, you need to objectively evaluate the functioning of your HPA axis. I go through how to properly test for adrenal fatigue/burnout here. Please don’t skip this step.
Burnout can result from either high or low levels of cortisol. But the treatment plan for high cortisol is very different from low cortisol. So, make sure you know what you’re dealing with before starting a treatment plan. It’s not as simple as taking some herbs known to help with stress.
You know that work is contributing to your symptoms. But a lot of the time there’s not much you can do to change your work environment. If your company’s restructuring, there’s not much you can do to lower your stress at work – it’s a tense time until the restructuring is complete.
Instead of focusing on parts of life that are beyond your control, focus your effort and energy on aspects you can control. I’ve found that there are three hidden stresses that continually contribute towards burnout:
Blood sugar imbalances
Out of the three hidden stresses, blood sugar imbalances is the most common. More than a quarter of the North American population has prediabetes. (22) And another quarter of the American population has full-blown diabetes. (23) That’s half of the general population dealing with blood sugar disorders!
And that doesn’t even include those with blood sugar imbalances that haven’t been diagnosed. Almost of a quarter of those with diabetes have not been diagnosed. (24) Those with prediabetes and/or diabetes make up nearly half of the entire population! Odds are pretty good that you too have a blood sugar imbalance.
To assist you in recovering from burnout, you need to ensure your blood sugar is perfect. I show you how to do just that without radical diet changes in my new program, Stop Feeding Fatigue. Keep in mind that just because your family doctor says your blood sugar is fine does not mean that you’ve got healthy blood sugar readings.
To overcome burnout, you need your blood sugar balance to be perfect.
Sleep disturbances
One of the more frustrating aspects of stress is that it interrupts sleep. The mind likes to solve the problem(s) that are causing stress. Unfortunately, the only time it has to solve these problems is when you lay down to sleep. The rest of your day is likely too stimulating.
To improve your sleep, try setting aside a specific time of the day where you troubleshoot and problem solve. Personally, I’ve found a great practice to be writing out everything I need to do the next day. This allows my mind the space to settle – it’s no longer worrying about what needs to be done tomorrow.
Another way to dramatically improve your sleep is through blackout blinds. Light suppresses melatonin production. To improve your sleep, you’re going to want to avoid light sources at night. This includes your television.
Please, do not put a TV in your bedroom. You need your brain to associate your bedroom with sleeping. Not watching tv. Do your television watching in a different room in your house.
If you still struggle to fall or stay asleep, try taking 200-400mg of magnesium glycinate before bed. Magnesium can help to calm your nervous system. A dose before bed can help better prepare your body and mind for bed. If you want more information on how to sleep like a pro, check out my previous post.
Inflammation
Like blood sugar imbalances, inflammation sneaks up on you. Mild levels of inflammation can go unnoticed when you’re healthy. But when you’re nearing burnout, even mild sources of inflammation can exacerbate your symptoms.
I see two hidden causes of inflammation more often than anything else. The first is through unidentified food allergies or sensitivities. The second is via an unhealthy gut.
If you’re like a lot of my patients, every time you eat gluten you don’t feel great. Your symptoms are mild – maybe a slight bout of brain fog and or a little abdominal bloating. This phenomenon is not unique to gluten. You could have a food sensitivity or allergy to just about any food. Gluten is just more likely than most others!
Each time you consume food you react to, your body will experience a mild inflammatory response. When you’re healthy, these inflammatory responses are generally well tolerated. So you can eat your sandwich and not notice much in the way of ill effects.
But when your HPA axis is at redline, any little stress – including the food you eat – can have serious, unwanted effects. In general, food sensitivities worsen burnout symptoms.
The same goes for gut infections. If you have an unidentified gut infection – like SIBO – you’re going to be experiencing unwanted levels of inflammation. And this will most certainly make your signs and symptoms of burnout worse.
Burnout in a nutshell
If you read nothing else in this post, keep your eyes glued to this section. Below are the five key takeaways of this post:
- Burnout is not recognized as a medical condition.
- But that doesn’t mean it isn’t real. It is real.
- Pay close attention to the signs and symptoms of burnout.
- You could – unknowingly – be headed in that direction.
- Burnout is not unique to the office.
- It happens in nearly every profession. Including parenting.
- Burnout is closely related to adrenal fatigue or HPA axis dysfunction.
- Proper testing is essential!
- There are three hidden causes you need to address if you want to treat burnout
- Blood sugar imbalances
- Sleep disturbances
- Hidden sources of inflammation
Now, your an expert in burnout.
But what about chronic fatigue syndrome…
How does CFS tie into burnout?
In part II of this post, I’ll help demystify the differences between chronic fatigue and burnout. Treatment for these two conditions varies greatly. Before starting treatment for either, you need to be 100% sure which condition you’re dealing with. Otherwise, you’re going to end up spending tons of your time, energy, and money on the wrong condition.
