Are You Rundown with Burnout? How Relentless Stress Damages Our Health and What to Do About It

There was an article in the New York Times earlier this year about how the pandemic did something unexpected to a lot of people—it put them in a state of languishing. Sadly, instead of flourishing or being at the peak of well-being or thriving, people feel joyless, unmotivated, stagnating and empty. It’s better known as burnout.

There has never been another time in my 35-year career when I felt more people under so much stress for longer periods of time. Even before Covid-19 hit our communities, these last years of constant access to work, social media, the news cycle, and issues of climate and environmental change created a backdrop of vulnerabilities that allowed Covid to reveal or exacerbate imbalances and illnesses across our physical, emotional, and cognitive landscape.

This made me think about the role of stress—and especially chronic stress—on the health of my patients. For many people, both those who’ve had Covid-19 and those who haven’t, negative health outcomes from pandemic stress continue. And when you add grief over loss of loved ones, the inability to be with family and friends because of varying degrees of Covid-19 restrictions, loss of work and income, and changes in school and other routines, the level of anxiety rises even higher, reaching burnout levels.

Stress, Burnout, and Bounceback

With unrelenting stress, our capacity for adaptation is compromised. We’re not bouncing back like we used to because we haven’t had the chance to heal. Chronic stress leads the hypothalamus gland to stimulate the adrenal glands, which generate and release adrenaline and cortisol. These hormones raise heart rate, blood pressure, respiratory rate, and glucose, and lower immune function—all of which create risk factors for numerous ailments.  Some people use the term adrenal burnout, which isn’t an accepted concept in the conventional medical world, but sure does seem to sum up how many people are feeling.

It’s important to underscore that the way stress impacts any individual relates to their susceptibility, which is influenced by many factors including genetics, coping skills, personality, racism, and access to support systems. Some stress can be good, for instance stimulating immune function, or sharpening focus, but too much has the opposite effect. Studies show that chronic stress may also lead to the release of histamine, which can cause allergy symptoms and asthma and rashes.

Psychological stress and burnout also alter insulin metabolism and sensitivity, one risk factor for developing diabetes. Stress also affects stomach acids, which can lead to all manner of digestive complaints. It’s also known that ongoing stress contributes to arterial plaque buildup worsened by a high-saturated fat diet and being sedentary This is also known as the Standard American Diet (SAD), which research show is associated with long-term stress that suppresses natural killer (NK) cells, and are important for many reasons, key among them, to prevent cancer metastasis.

Beyond physical ailments, we know that unmitigated and ongoing stress is a contributing or aggravating factor for depression, anxiety, irritability, and insomnia. All elements of our health are intertwined, that’s why whole person, natural medicine approaches are key to healing, especially now. They offer a fresh perspective on the treatment of stress and how it relates and impacts the human condition.

You Can Overcome Stress and Burnout

In their book, Burnout—The Secret to Unlocking the Stress Cycle Emily and Amelia Nagoski do a wonderful job describing the neurobiology of the stress cycle. They write about how every emotion has a beginning, a middle, and an end. You have to feel your emotion and get through it in order to move on. The authors suggest (and I concur entirely) that there are many ways to process emotions including talking about them, having a good cry, doing regular deep breathing exercises, sharing a caring hug, having a deep belly laugh, getting physical exercise, doing something creative, and connecting with family and friends.

I would add to this, the importance of spending time outdoors, in greenspaces at parks or in the woods. The more we study the need for time outdoors, the more we see its positive impact in alleviating stress and burnout. Television, computers, the internet, and video games have become a fallback activity for many children and adults, and we’re missing out on the essential role of sunshine, greenspace, and time away from screens. For more about the healing power of time spent outdoors, download our free eBook Nature’s Own Healing: The Art & Science of Forest Bathing.

Nine Natural Necessities to Address Burnout

1.   A healing, anti-inflammatory diet is often key, while addressing any nutritional deficiencies or potential food sensitivities. Work toward balancing blood sugar levels as you are able, by reducing frequent snacking and cutting down on or eliminating refined sugars, refined carbohydrates, and alcohol.

2.   Adequate hydration helps alleviate burnout—and it’s easier for some people than others. For my under-hydrated patients, I ask them to set out four small juice glasses of water as a starting goal and we work up from there. We’re aiming for half a person’s weight in ounces. It’s amazing how being adequately hydrated can help many people feel better. I recommend herbal teas or diluted fruit juice, or lemon or lime in water as ways to make water a bit more inviting for those who are not big fans.

3.   Sufficient, regular and restful sleep, which is just a handful of words to write but an enormous mountain of a challenge for some. Naturopathic doctors have a broad range of recommendations to help you sleep better.

4.   Exercise as tolerable and I would say for most people more is better. It’s one of the best ways to blow off steam, clear the mind, sweat out natural toxins related to typical metabolism, improve sex drive, improve sleep, and mitigate burnout. Research also shows that it improves quality of life and delays the onset of more than 40 chronic ailments!

5.   Individualized nutritional supplementation or botanical medicines may be called for to address specific or synergistic biochemical issues. The main ones here include:

• Vitamin C for its many roles related to improving energy and reducing overall inflammation
• Vitamin B complex for its roles related to stress and cognition
• Adaptogenic herbs like ashwagandha and rhodiola. Each address both mental and physical fatigue.
• Licorice root (Glycyrrhiza glabra) is another wonderful plant-based medicine that, among many of its biological activities, supports adrenal function.
• Curcumin (Curcuma longa), one of the bioactive compounds in turmeric, has many positive attributes as a culinary and medicinal herb from being anti-inflammatory to carrying anti-oxidant impact. Studies show it also improves overall quality of life.

6.   Body-mind approaches to help normalize an activated stress response are often in order to combat burnout. Think here about breathing techniques, mindfulness meditation, Qigong, yoga, and hobbies such as art, music, and even building model airplanes. Anything really that helps you relax.

7.    Simplifying your home and work space a la Marie Kondo. From her website: “Discard items that have outlived their purpose; thank them for their service—then let them go. People around the world have been drawn to this philosophy not only due to its effectiveness, but also because it places great importance on being mindful, introspective, and forward-looking.”

8.    Think about what you’re trying to accomplish on any given day. Sometimes we get burned out just by putting too much pressure on ourselves to get through the to-do lists, to produce, to be productive, as if we were human doings instead of human beings! A tremendous amount of stress can be alleviated by literally doing less.

9.   There are older, whole person medicines to consider in homeopathy and acupuncture for addressing the oftentimes complex complaints associated with being burned out or feeling overly stressed. For most patients, the experiences of working with a homeopathic practitioner or receiving an acupuncture treatment are both interesting and relaxing. Look for an experienced provider for either of these approaches.

I welcome conversations with patients to help identify what the most stressful things are in their lives and to appreciate that there’s the stress and then there’s the stress response.  I invite you to work with both ends of this equation. Firstly, to think about ways you might actually reduce your stress, whether letting go of a difficult relative, shifting the work schedule, or adjusting expectations from family members. Then there are all the approaches listed above to help let go and process the stress response. Addressing both is the only way to effectively battle burnout.

We also need to address any underlying chronic disease states and do our best to mitigate or perhaps reverse those ailments. Depression, overwhelm, and burnout are not uncommon side effects of chronic disease but it’s circular too, as stress and depression put us more at risk for certain ailments.

For many patients who are languishing or burned out or have what they consider adrenal fatigue, it will be a long unwinding back to health. But whole-person natural medicines that address the root cause(s), stimulate the body’s inherent healing capacity, and work to reverse the role of chronic stress, can all help. Taking stock and welcoming change plays a role here too, to help people feel better and handle stress without all its undue impacts.

From the Institute for Natural Medicine