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Understanding burnout and ways to tackle it

Understanding burnout and ways to tackle it

That feeling of a candle burning at both ends ⁠— burnout is just that.
Representational image | Shutterstock

Symptoms associated with burnout are usually dismissed as hypersensitivity to stress, or as office slang for being tired or bored of work. However, burnout is an occupational phenomenon recognised by World Health Organization and defined as “a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed.”

“I started feeling extremely tired and had frequent headaches, digestion problems and just couldn’t sleep. My psychologist told me it could be due to work stress, and I was indeed working long hours. One week after I quit my job, all of these [symptoms] magically disappeared,” says Malavica Chengappa, a former copywriter.

Problems such as Chengappa’s have been directly associated with burnout, a phenomenon affecting not only the professionals but also the student community which is under constant and tremendous pressure to excel.

“The COVID-19 pandemic has seen an uptick of stress-related issues among the working population when they were forced to sit at home and work long hours. Restricted physical activity and limited social interaction with the outside world do tend to cause burnout along with other physiological and mental issues,” says Dr Gururaj G P, Professor of Psychiatry at East Point College of Medical Sciences and Research Centre, Bengaluru.

Cause of health issues

Studies have found a direct link between long-term burnout and physiological health issues such as blood pressure, Type-2 Diabetes, arrhythmia (irregular heartbeat) and even early death.

One of the primary symptoms of burnout is disturbed sleep. A 2009 study that explored a correlation between burnout, symptoms of depression, satisfaction (or otherwise) in life and sleep complaints among 2,231 participants, found that the emotional and physical exhaustion stemming from a burnout led to sleep issues.

Another similar study in 2018 concluded that the study group with burnout “had significantly higher insomnia troubles, sleep fragmentation, and non-restorative sleep than the control group”.

The link between burnout and Type-2 Diabetes was also researched in a 2006 paper, where 677 employees were screened for the onset of Type-2 Diabetes for periods ranging from three to five years. It investigated parameters such as emotional exhaustion, physical fatigue and cognitive weariness.

It found that burnout were associated with a 1.84-fold increase in the risk of diabetes. For a smaller sub-sample where blood pressure levels were monitored, the odds ratio shot up to 4.32, which in simple terms means that individuals with chronic burnout were 4.32 times more susceptible to developing Type-2 Diabetes later.

Rise in mortality rate

Burnout is generally associated with a pervasive feeling of low quality of life, but, in its chronic form, it can apparently also increase the morality rate.

A 2010 study on over 15,000 forest industry workers, conducted over a span of 10 years, concluded that individuals who experienced burnout symptoms had 35 per cent higher chances of succumbing to early death than those who did not have the symptoms.

The study also showed that 26 per cent reported higher exhaustion levels, 29 per cent were more cynical than before, and 22 per cent experienced diminished interest and efficiency at work.

Cardiovascular disease is a side-effect

Alarmingly, cardiovascular disease is one of the most frequently reported causes of absenteeism by workers who are going through burnout.

Scientists relate cardiovascular stress due to the overworking of the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal axis (HPA). The HPA is responsible for the functions of releasing the hormones thyroid and adrenaline.

“When these systems overwork, they place a tremendous amount of stress on heart rate and blood pressure. This, in turn, leads to metabolism being affected as well as immunity,” says Vellore-based cardiologist Dr K Sabapathy. This can be mitigated with regular exercise, and cutting smoking, he says.

A small study in 2008 backs the claim on the importance of physical activity, smoking and burnout.

Additionally, individuals who already have cardiac complications could worsen their health condition with overwork. According to a 2021 paper, a working population with a high burnout after going through an acute coronary syndrome showed reduced parameters of heart rate variability, a critical factor used to measure the functioning of the heart and nervous systems.

Ways to beat the syndrome

People suffering from burnout often report feeling like a candle being burnt at both the ends. For such people, identifying the symptoms is usually not the problem. Signs such as losing interest in work, feeling disconnected from friends and family, and the intense desire to set oneself free from the causes of stress are easily perceptible. An inability to figure out a way out of it without losing out on opportunities turns burnout into a chronic situation.

In an article titled ‘Beating Burnout’ published in the Harvard Book Review, Monique Valcour, an executive coach, and management professor, lists a few ways of reducing burnout:

Giving priority to self-care; changing one’s perceptions to differentiate between critical and non-critical tasks; resetting ground rules at work to reduce work related stress; and seeking out rich and fulfilling interactions with people both at work and in personal life.

WHO in 2020 published a self-help booklet titled “Doing What Matters in Times of Stress”. It discusses potential causes of stress and offers tips, strategies and exercises that one can adopt to mitigate the effects of stress factors.

At the end of the day, however, it is the person who must first make the appropriate choices as that is the only way to bring harmony back in one’s life.

The Utrecht Burn-out scale is one of the popular research methodologies to assess burnout. It measures exhaustion, cynicism, and professional efficacy.

The Maslach Burnout Inventory (MBI) is another popular tool much used since 1981.

The first signs

WHO, in its 11th edition of the International Classification of Diseases (ICD-11), names three dimensions which could point towards a person going through a burnout.

  • If a person feels that his or her energy is depleted and constantly feels exhausted
  • Increased negativity and cynicism towards work
  • A deep sense of ineffectiveness or a lack of accomplishment

Physiological symptoms of burnout may include:

  • Headache and body ache
  • Muscle fatigue
  • Frequently falling sick
  • nausea
  • Problems with digestion

Behavioural symptoms of burnout may include:

  • Withdrawing from social interactions
  • Erratic work timings
  • Procrastinating with deadlines
  • Low empathy toward others, and
  • Easily irritated by colleagues, children
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