Fired Up, Worn Down, Burnt Out.

The Near Unescapable Trap Of Burnout In The Modern Age…

and what to do when you find yourself there.

Let’s start this month’s newsletter with an excerpt from Anne Peterson’s latest book, Can't Even: How Millennials Became The Burnt Out Generation.

. . .

“The only way to make it all work is to employ relentless focus – to never, ever stop moving. But at some point, something’s going to give. It’s the student debt, but it's more. It’s the economic downturn, but it's more. It’s the lack of good jobs, but it's more. It’s the overarching feeling that you’re trying to build a solid foundation on quicksand… It feels like it’s harder than ever to keep our lives – and our family’s lives – in order, financially solvent, and prepared for the future, especially as we’re asked to adhere to exacting, and often contradictory expectations. We should work hard but exude “work/life balance.” We should be incredibly attentive mothers, but not helicopter ones. We should maintain equal partnership with our wives, but still maintain our masculinity. We should build our brands on social media, but live our lives authentically. We should be current, conversant, and opinionated about the breakneck news cycle, but somehow not let the reality of it affect our ability to do any of the above tasks…”

. . .

Peterson’s words ring true not just for Millennials, but for all of us trying to make a living in the modern age. For Boomers, X’ers, and Millennials alike, accessibility has become foundational for success, with intrusions accepted, and expected, at the most vulnerable of times. It’s not enough to simply be available though, we also have to out-perform our peers – which, by the way, have gone from intergenerational to intragenerational – and lest we forget, on top of both prior requirements for successes, we also must maintain “promotable” personalities in this new age of 24-hour access. On top of working as hard as we can, we’re grappling with how our personal and professional personalities (and entire industries, for that matter) are being represented on Facebook, Twitter, and LinkedIn, all while acknowledging that this digital space in no way represents our actual lived experience. When was the last time in history we had to erroneously but successfully manage two, or even three, identities at the same time? At the end of the day, anyone participating in this modern conundrum (including and especially our kids) is hopelessly and unequivocally exhausted. Burnt through, used up, and burnt out. We seem to be willfully ignoring the fact that our energy, attention, and time, is limited - and the more we pretend that it isn’t, the sicker we get.

If you’ve been following along with our newsletters you’ll remember that in August we wrote about our addiction to i-tech, and how we can’t seem to shake the near magnetic pull and false relational promise of our beloved devices. Last month we talked about sleep and our nervous systems, and how the two often get completely misaligned and inflamed by our rest-less modern lifestyle, leading to disastrous consequences in our physical, cognitive, and emotional lives… This month, October, we’re talking about exhaustion - the culmination of our dysregulated priorities, routines, and circumstances. This topic involves i-tech, sleep restriction, and is intricately intertwined with our autonomic nervous system response to stress. In many ways, the topic of exhaustion is continuing and building on the themes we’ve been discussing since we re-launched this newsletter. Themes that try to illuminate the slippery and often overlooked aspects that keep us in need of more coping, more medications, and more mental health interventions.

The term ‘burnout,’ also known as Exhaustion Disorder, was coined by psychologist Herbert Freudenberger in 1974. Freudenberger defined the condition as a “state of mental and physical exhaustion caused by one's professional life.” The phenomenon of burnout, however, is nothing new. As early as the fourth century AD, the term ‘acedia’ has been used to describe a state of listlessness and torpor - a lack of care or concern with one’s place in the world. In 1976, social psychologist Christina Maslach formally defined burnout as a syndrome with three domains: 1) exhaustion, 2) depersonalization, and 3) a reduced sense of professional accomplishment. Burnout has become a hot topic in the workplace, as it has been identified as a major factor in job dissatisfaction, decreases in job performance, absenteeism, and employee turnover. In many cases, burnout can lead people to abandon their careers, and even leave their field or profession entirely. Outside of the workplace, burnout makes us less connected, less content, and is associated with a cavalcade of negative health outcomes. 

As burnout has become more prevalent in our personal and professional worlds, researchers have attempted to identify the physiological mechanisms that underlie the syndrome, a task that has proved challenging given the wide variety of symptoms associated with burnout. What we do know is that burnout is a result of prolonged stress, and there are two main systems in the body that respond to stressors: the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis. When we encounter a stressor, the ANS responds immediately, triggering a sympathetic response that causes our heart rate and blood pressure to elevate. This ‘fight-or-flight’ state is an adaptive survival mechanism meant to be engaged only as long as a threat is present. But, as we discussed in last month’s newsletter, repeated activation of the sympathetic nervous system or prolonged exposure to stressors can actually keep us from returning to homeostasis. 

Acute stressors also activate the amygdala and hippocampus, which triggers the HPA axis to release cortisol into the bloodstream from the adrenal cortex. You’ve likely heard about cortisol, a hormone that plays a role in regulating metabolism and blood pressure and boosts our energy to help us respond to stress. Typically, cortisol levels peak when we wake up and decrease throughout the day, but prolonged exposure to stress can change this cortisol awakening response (CAR). In groups with clinical burnout, researchers have observed both heightened and suppressed cortisol responses. While science has yet to identify the exact causal relationships between these biological processes and burnout, we nonetheless have established that they are intimately intertwined.

Burnout can even impact the physical structures of our brains. In animal trials, researchers have found that neurogenesis - the process by which our brains create new neurons - is impaired in response to stressful events, particularly in the hippocampus and some frontal areas of the brain. These structures help regulate the HPA axis; if damaged, the body’s cortisol response may be elevated. This stress response may lead to further neuronal cell death, creating a feedback loop that continues to impede the ability of the brain to repair itself. Imaging studies have shown reduced grey matter volume in key frontal and limbic structures of the brain in individuals with chronic occupational stress. Other studies of burned-out individuals show a reduced functional connection between the amygdala and areas of the prefrontal cortex, a part of the brain associated with emotional regulation.

This disconnect means that people experiencing burnout have a much harder time regulating their response to emotional stress and returning to a neutral state once the stressor is gone. As a result of these structural and functional changes in the brain, burned-out individuals often show changes in cognitive ability. Studies on clinical burnout groups have demonstrated deficits in attention, episodic and working memory, and aspects of executive function, likely due in part to reduced neuroplasticity in the hippocampus and frontal lobe.

While the main symptoms of burnout and its impact in the workplace are well known, less frequently discussed are the long-term impacts of burnout on the body. For example, people working in more stressful jobs have shown signs of accelerated skin aging as well as shortening of our DNA’s telomere length, essentially increasing the biological age of our body’s cells. Burnout is a risk factor for many types of infectious disease, as it is associated with a suppressed immune response and higher levels of inflammation in the body. 

Even low levels of burnout among supposedly healthy workers is associated with an increased risk of heart disease, and that risk increases as levels of burnout rise. Burned-out individuals are 4.3 times more likely to develop type II diabetes than their healthy counterparts. In general, burnout has been shown to be related to all-cause mortality in people under 45 years of age. The Japanese even have a word for this - 過労死, or karoshi, literally meaning “overwork death,” to describe occupational sudden mortality often due to heart attack, stroke, or suicide. Burnout and depression are also highly correlated, as the two share overlapping symptoms and similar biological markers in the brain.

Clearly, burnout is a complex beast to tackle, both from an emotional and biological perspective.

So how do we combat the constant stressors that lead to burnout, or recover if we are already at the end of our proverbial rope?

Here are a few action steps, interventions, and resources to help you kick burnout to the curb.

Action Steps

• Put the Phone Down: Do you find yourself answering emails after hours or responding to work-related texts on the weekends? Using our smartphones for personal and work purposes causes “work-home interference,” which can lead to, and prevent us from recovering from, burnout. Apps like Space can help break that habit by creating healthy boundaries around phone use.
• Leave Work at Work: If you have trouble disconnecting when you go home from the office, create an end-of-day routine that helps you transition out of work mode. Close work-related browser tabs on your devices. Tidy up your desk. Set your Slack status to ‘Away.’ Listen to music or a podcast during your commute to keep your mind off work-related thoughts. A shutdown ritual takes practice, but can be a great start to establishing better work/life balance.
• Take a Walk: Cardiovascular fitness is associated with decreased symptoms of burnout and an increased sense of well-being. Make space in your day for exercise, which can boost your mood and energy level.
• Prioritize self-care: It may sound trite considering how often we hear about it, but establishing a self-care plan is a huge step towards beating burnout. Creating good habits around sleep, nutrition, social connection, and practices like meditation, journaling, and calm hobbies can help replenish the parts of us that feel totally drained by our professional lives.

Interventions

• Using individualized, non-invasive neuromodulation, Aspen has had success helping overstressed people sleep better, have more energy during the day, and return the nervous system to homeostasis. If you are noticing warning signs of burnout or are coping with chronic stress, our process can help you recover. 
• Burnout is correlated with insomnia, wakefulness throughout the night, reduced REM sleep, and feeling tired when you wake up. Adding in a magnesium supplement to support sleep quality and stress management can sometimes be enough to keep burnout at the door. Using magnesium l-threonate, the first type of magnesium proven to cross the blood brain barrier, OptiMag Neuro is neuroprotective, meaning that it helps to prevent neuronal cell death (one of the consequences of burnout!). If you are struggling with sleep as a result of chronic stress, contact us to see if OptiMag Neuro would be a good fit for you.

(look to the bottom of this newsletter for more information on how to begin this process)

Resources

• Celeste Headlee’s Do Nothing: How to Break Away from Overworking, Overdoing, and Underliving covers the history of work and the pitfalls of our modern day “cult of efficiency.” Headlee offers “life-back” tips for reclaiming your time and energy in a world that is always demanding more. 
• Last month, we recommended an episode of the Huberman Lab Podcast about sleep. Dr. Huberman also has a great episode about managing stress and anxiety, breaking down tons of scientific literature and offering evidence-based tools for coping with long-term stress and preventing burnout.

Overcoming burnout can feel insurmountable or out of reach, especially if you are fighting it alone.

Action steps like taking a walk or prioritizing self care can be amazing tools to begin the process of getting better sleep, but sometimes we need more neurological, cognitive, and therapeutic support to have real success. Our faculty of seasoned neuro and talk therapists specialize in helping people with stress reduction,  insomnia, sympathetic activation, depression, trauma & grief, and much more. Our human experience is so complex and stressful, and especially during times like these, it is helpful to have a treatment team that can come alongside you.  

To schedule your appointment and get more information, call us today at (970) 281-7872 or visit aspenneurofeedback.com to get started. 

John VanDeGrift

Director of Neurotherapy, Aspen Neurofeedback