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To be burned out - causes, symptoms and treatment

To be burned out - causes, symptoms and treatment


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Burned Out Strategies to Beat Burnout Syndrome

The topic of being burned out is very topical in our day and age. We want to be perfect in all areas of life - at work, in private life and also in our free time. We can hardly forgive ourselves for poor performance, we keep going, we do our best - until we get to a point where nothing seems to work properly and we feel burned out, aimless and exhausted. In medical terms, this condition is also known as burn-out syndrome if the state of exhaustion and overload persists over a longer period of time and there is no improvement even after long periods of rest. However, the actual development to burn-out begins much earlier, which is why it is important to interpret the first signs in good time in order to prevent serious progress.

Burn-out - what is it?

The term "burnt out" is no coincidence. Because, for example, like an oil lamp that relies on fuel in the form of oil to light up, our body needs energy to function. However, if the body lacks this energy, for example due to chronic overwork, which consumes the body's energy reserves, it leads to people feeling burned out and the burn-out syndrome developing.

To date, burn-out is not an official medical term, although it was first described in the 1970s by the German-American psychologist Herbert Freudenberger. According to his own statements, he suffered from the syndrome after years of long-term revision and finally worked as a volunteer for a rehab clinic. Working with addicts, like many other professions in the nursing and care sector, is known to be one of the most strenuous activities and it is not surprising that Freudenberger also repeatedly observed signs of being burned out on his colleagues. It also happened that burn-out was initially seen as a kind of "occupational disease" of nursing staff and specialists from the social sector.

However, both the description of the burn-out as an illness and the assumption that only people working in the social or care sector could suffer from being burned out are wrong. Especially in our modern world of work, people from other professions are increasingly suffering from this insidious complaint. Especially in fields of work that are associated with a high degree of stress, the number of those who have had to deal with burn-out at least once during their professional life is very large.

However, burn-out is not an independent clinical picture, or is not (yet) defined as such. Rather, it is a complex of symptoms and thus a syndrome, which is characterized by complaints such as listlessness, lack of motivation and a feeling of senselessness and emptiness. Since corresponding symptoms can also be found in depressed people, some doctors assume that burn-out could be a special form of depression. At least every sixth patient who comes to the doctor for burn-out can also attest to depressive tendencies.

Causes

How exactly the burn-out syndrome comes about is still not fully understood. One concept that experts repeatedly use to explain the burnout phenomenon is the so-called effort reward imbalance model (ERI) by the Swiss medical sociologist and university lecturer Johannes Siegrist. He assumed that patients with burn-out felt a strong imbalance between their own performance and the recognition they received. However, the symptoms cannot be reduced to this feeling alone, because there are also other aspects involved in being burned out. These can be roughly divided into three general terms:

  • Everyday factors,
  • personal factors
  • and nutrient factors.

Everyday stress

As already mentioned, a stressful working life is one of the most important risk factors for the development of a burn-out syndrome. In addition to nursing professions, some other occupations also stand out clearly among the risk groups. Burnout, for example, is also increasing among people in management positions and among office workers. The constant juggling with appointments, coordinative work steps, customer correspondence and other demanding professional aspects obviously contributes to the fact that persistent exhaustion spreads.

There are also professions that require a high degree of mental work and thus increase the mental stress level. This is the case, for example, with academics, architects, but also with typists and teachers. With regard to the latter field of activity, a risk aspect should also be mentioned, which increases the risk of burnout drastically in the care sector: the professional dealings with groups of people to be cared for.

Where the care of patients in need of health for the elderly or nursing staff favors professional stress, the care of children and adolescents holds great stress potential for teachers as well as for nanny, educators and social pedagogues. These, including their family background, can sometimes be very "exhausting little customers" and can drain the nerves and energy reserves of the social service provider.

Speaking of services, including call center employees, service personnel and large parts of the catering trade are among the risk groups in burn-out. In addition, work-independent stress in everyday life should not be underestimated as a source of a burgeoning burnout. Because private life also has countless situations ready, which can be the cause of being burnt out. In general, the following everyday factors can be identified as possible causes:

  • enormous deadline or performance pressure,
  • demanding job,
  • special mental challenges in the workplace,
  • Conflict situations in the workplace (e.g. bullying or stress with customers),
  • Conflict situations in private life (e.g. divorce or illness in the family)
  • and problems in reconciling work and family.

By the way: The pressure to perform in modern times is increasingly reaching the youngest in society. With increasing concern, doctors are observing the trend of the so-called burnout kids, who can no longer cope with the increasing performance requirements in the school sector. Burn-out is no longer a health problem that only affects adults.

Personal factors

Another important point that plays a role in the development of burn-out are certain personality traits. For example, people are often affected who are very perfectionist and therefore always want to give 100 percent. Such people usually also tend to show generally more willingness to perform than others. Behavior that is used on the one hand by fellow human beings and thereby strengthened, but on the other hand also leads to the fact that those affected can often no longer realistically assess their performance limits. For this reason, at the beginning they often do not even notice that their bodies can no longer cope with the demanding workload for long. However, this point only addresses one possible personality trait that can promote burnout. Overall, the following are to be rated as risky in this cause field:

  • Idealism,
  • Perfectionism,
  • Workaholic behavior,
  • Frustration and disappointments,
  • Insults and mental injuries,
  • low self-esteem,
  • lack of balance between work and relaxation
  • and performance-oriented conditioning in childhood.

Imbalanced nutrient balance

The aspect of the body's own nutrient supply is greatly underestimated when burned out occurs. If we look back at our comparison with the oil lamp, which has a certain amount of lamp oil in stock, the human organism also has energy reserves from which energy is provided for daily challenges if necessary. The main substrates for energy generation are here

  • Glucose,
  • Glycogen,
  • Fats (mainly in the form of triglycerides)
  • and proteins (mainly in the form of amino acids).

In order to ensure a trouble-free energy balance, adequate nutrients should be supplied to the body in sufficient quantities. When it comes to being burnt out in combination with an unfavorable mood or even depressive moods, a few other substrates play an important role, including a number of vitamins:

  • Vitamin B: Vitamin B is one of those vital substances that can be stored very poorly by the body. However, the different variants of this vitamin play an essential role in energy metabolism. For example, they are involved in the energy supply to the body's cells and are required for the production of energy from fats and proteins. A vitamin B deficiency inevitably leads to symptoms of exhaustion and fatigue. Vitamin B is also important to avoid disturbances in the neural network of the brain. These can contribute to psychological problems such as depression and sleep disorders. In this context, the most important vitamin B components include:
    • Vitamin B1 (thiamine),
    • Vitamin B2 (riboflavin),
    • Vitamin B3 (niacin),
    • Vitamin B6 (pyridoxine),
    • Vitamin B9 (folic acid)
    • and vitamin B12 (cobalamin).
  • Vitamin C: When it comes to mental and psychological well-being, vitamin C also plays an important role. In the body, this is jointly responsible for the production of serotonin, the famous happiness hormone. It serves as a neurotransmitter for the nervous system and is specifically responsible for feelings such as serenity, inner balance and satisfaction. With serotonin deficiency, on the other hand, there is a risk of increased irritability, depression and dissatisfaction. In addition, serotonin also influences the cardiovascular system and thus the performance of the body. If it cannot be produced adequately due to an insufficient supply of vitamin C, there is a risk of a drop in performance in addition to depressive moods, which is then noticeable through tiredness and fatigue.
  • Vitamin D: Vitamin D also affects a person's performance (especially brain performance) and mood. Like vitamin C, it is involved in the biosynthesis of serotonin and is therefore essential to prevent depression and loss of performance. The problem with this, however, is that vitamin D can often only be built up by sufficient sunlight in the body. Especially in the autumn and winter months, the seasonal lack of sun also causes a lack of vitamin D for many and thus the notorious autumn or winter blues. And the annual burn-out season can also be located in the second, low-light half of the year.
  • Iron: With iron, the body is given a mineral that can control the oxygen conduction in the blood and cells. Since iron binds oxygen, it can be easily channeled through the bloodstream into all areas of the body thanks to iron molecules. If, on the other hand, there is an iron deficiency, it is not only the blood that becomes low in oxygen. In addition, the cells, organs and especially the nerves also lack oxygen, which is urgently needed to generate energy. In addition, iron also regulates the production of neurotransmitters, which in turn is decisive for the mood and the feeling.
  • Magnesium: As a mineral, magnesium is just as important for the body as iron. Magnesium deficiency can also lead to symptoms similar to iron deficiency. The cardinal symptoms in this regard include exhaustion, inner restlessness, easy irritability and tiredness, i.e. exactly those symptoms that are also typical for being burned out. Even severe depression and even schizophrenic psychoses are not excluded in the case of magnesium deficiency. It is hardly surprising when you consider that magnesium plays a major role in the functionality of energy metabolism, the nervous system, the cardiovascular system and even the immune system.
  • Trace elements: relatively small particles of minerals are defined as trace elements, but this does not mean that they are less important for the body. On the contrary, it is particularly evident in the case of complaints of exhaustion and depression how much trace elements can influence health. Above all, the functioning of the neurotransmitters as transmitters of any nerve signals, as well as the signal line in the energy balance, are decisively shaped by trace elements. The most important trace elements for this are:
    • Copper,
    • selenium
    • and zinc.

Interesting: The fact that a lack of nutrients and the associated malfunctions in the area of ​​energy metabolism and the nervous system can lead to permanent exhaustion with depressive symptoms can also be seen in the chronic fatigue syndrome. In contrast to the burn-out syndrome, this is in fact an independent clinical picture that, in view of the almost identical symptoms, must be distinguished from the burn-out by careful diagnosis of exclusion. Because the chronic fatigue symptom is usually not caused by psychological factors, but there is a tangible dysregulation of the nervous, immune and hormonal systems.

Symptoms

As shown, the phenomenon of burn-out mostly arises as a result of a combination of various causal factors and can manifest itself in very varied symptoms. These can manifest themselves both on a physical level and in changes in perception and experience, i.e. on a psychological level.

The symptom complex, which is usually noticed first, naturally includes the body's energy balance. Those affected have to struggle with falling asleep and staying asleep, which means they lack the necessary regeneration breaks to counteract persistent exhaustion. Understandably, they therefore feel little rested in the morning, wake up sleepy and lack the necessary energy reserves at the beginning of the day to be able to complete their daily tasks. This quickly results in a feeling of torturing yourself only through the requirements and obligations to be met. The sleep disorders can have very different forms:

  • Problems falling asleep (e.g. very late falling asleep despite adequate bedtime),
  • Problems sleeping through (e.g. waking up frequently after short sleep phases),
  • Sleep phases that are permanently planned too short (e.g. permanent power napping to meet all tasks and requirements),
  • and sleep disorders that have physical illness values ​​(e.g. breathing difficulties, restless leg syndrome, circadian sleep rhythm disorders).

A study conducted by Harvard University under the direction of Thomas Scammell has recently shown in detail that persistent sleep deficits also increase sensitivity to pain. People with burn-out are very often plagued by pain of any kind. The locations of the pain and discomfort can be very different and can also occur in several places at the same time. Cause and effect are not always clearly differentiated. For example, sufferers very often report back and neck problems that can result from muscle tension and can also lead to permanent headaches. However, headaches can also be caused by a lack of fluids and nutrients, since those affected often eat and drink irregularly and unhealthily. This behavior in turn favors gastric and intestinal complaints in the short term and even cardiovascular complaints in the long term and an increased tendency to infections.

In the area of ​​hormone regulation, burnout also has undesirable effects. You can enter here, among other things:

  • Cycle disorders,
  • Erectile dysfunction
  • and loss of libido.

Even with these symptoms, cause and effect can rarely be clearly defined. In all likelihood, it is more of a gear phenomenon, in which an effect of being burned out (e.g. unhealthy or insufficient nutrition) favors the development of another symptom, such as cycle disorders.

In addition to the physical complaints of burn-out, there are now enormous psychological consequences. Unfortunately, people tend to perceive physical complaints earlier and, above all, to recognize them as signs of illness rather than psychological symptoms. But especially in the context of the feeling of being burnt out, the psychological symptoms become all the more relevant, since early detection often allows the problem to be alleviated. Unfortunately, affected people perceive corresponding health complaints in a large number of cases as a temporary and one-off matter, instead of evaluating them as a serious warning signal. Often, those affected are only shaken awake and admit that they need medical support if the body clearly shows that it is reaching its limits.

In the anamnesis discussion through specifically asked questions of the doctor, those affected mostly become aware that their current condition has not been an acute event in the past few weeks, but that the first signs were there much earlier, but were successfully suppressed. These psychological changes in the area of ​​perception and experience of those affected, typical of the state of being burnt out, include:

  • Unusual low motivation,
  • Impaired concentration over a long period of time,
  • Listlessness,
  • Lack of motivation for things that used to bring joy and satisfaction,
  • Joylessness and discontent,
  • Tendency to mood swings and lust for argument,
  • increased aggression potential,
  • Resignation,
  • Inability to accept criticism
  • Isolation,
  • Perception of fear of failure
  • and feelings of senselessness and helplessness.

The psychological symptoms listed above are not uncommon and far from being to be regarded as key symptoms. Just because it is difficult to motivate yourself to work for a few days does not mean that you are about to burn out. Rather, those affected should always consider the context and not immediately fear the worst. Maybe the tasks to be done just don't create an inviting atmosphere because they have to be done or are a tedious preparation or rework of a completed project. However, if the symptoms persist over a longer period of time and do not improve after a period of rest (such as a free weekend) or if the symptoms also shift to the private environment, it is very likely that it is not just a temporary condition.

Diagnosis

Before the diagnosis of burn-out can be tackled at all, those affected themselves must have a sufficient degree of insight into the illness. You should be honest with yourself and reflect on whether it would be necessary and helpful to get help. Close relatives, friends and acquaintances can also be a helpful tool here, since they can observe much more objectively and for this reason often develop the feeling much earlier that something could be wrong. Here, an open discussion in a relaxed atmosphere, without reproaches and hostility, can help to trigger an honest view of their situation. Once the decision for professional help has been made, the first way is through the family doctor. Although he cannot treat the underlying causes of being burnt out, he is able to give the person concerned a first break (preferably one to two weeks' incapacity to work) in order to then create another treatment plan together.

However, the complexity of the psychological and physical symptoms does not make it easy to make a diagnosis in conversation with the doctor treating you, because they can also be an indication of other diseases. It is therefore all the more important to have a detailed anamnesis discussion with those affected in a calm and relaxed atmosphere in order to gain clues as to whether the symptoms are a temporary state of being burned out or whether there are other diseases behind them. The following diseases are also considered for differential diagnosis:

  • chronic fatigue syndrome,
  • Fatigue syndrome,
  • Depression,
  • Underactive thyroid gland,
  • Adrenal fatigue
  • and vitamin D deficiency.

Various tests are available to the doctor to narrow down this wide range of possible diagnoses. In order to rule out physical causes, for example hormone imbalances due to damaged organs (e.g. thyroid or adrenal gland), it is advisable to have laboratory blood tests performed. The following parameters should be determined here:

  • Differential blood count,
  • Thyroid hormones,
  • Ferritin,
  • Cortisol,
  • various antibodies
  • and vitamin and mineral levels.

In order to be able to narrow down the various mental illnesses in question, the doctor can use various questionnaires as an instrument. In these, the people concerned are asked specific and trend-setting questions that, after evaluation, make a distinction possible.

Therapy

In order to successfully get burnt out, it is important to set specific therapy goals. The goals of the treatment can be formulated as follows:

  • Development of measures for coping with stress,
  • Learning relaxation techniques,
  • Optimization of time management
  • and rethinking personal priorities.

Based on the different symptoms and the different therapy goals, it can be seen that there can be no standard therapy for the treatment. Rather, in terms of lasting compliance (cooperation of the person concerned), it must fit him, his life plans and his life situation.

Behavioral therapy

An important pillar in the treatment of states of exhaustion is the change in one's own behavior, which ultimately led to the state in the first place. Here, self-help guides, group meetings with other people affected or even mindfulness seminars can provide the necessary food for thought, provided that the state of exhaustion has not yet reached uncontrollable proportions. Those affected should also not be afraid to consult a suitable psychotherapist. In a one-on-one interview, the underlying causes can be identified and processed. The goals of working on your own behavior and thinking are:

  • Development of strategies for dealing with personal and professional stress (conflict and stress management),
  • Strengthening self-confidence,
  • Perceive warning signals earlier
  • and adapt perspectives and your own requirements to the living situation.

Nutritional measures

In order to ensure a trouble-free energy balance in addition to a regular everyday life and the avoidance of stress, the right nutrition is essential. In particular, vitamins B, C, D and the minerals iron and magnesium must be supplied to the body in sufficient quantities. A balanced diet with plenty of fruit and vegetables to cover the vitamin requirement is ideal for this. In addition to walks in the sun, the need for vitamin D in particular can also be met through the regular consumption of fresh fish. There is also plenty of iron and magnesium in fish. The minerals are also found in cereals and dairy products.

Medicinal herbs

Many herbs are known especially from Ayurvedic and Traditional Chinese Medicine, which are considered vitalizing, invigorating and energizing. They can also be used as supportive therapeutic measures during the treatment of burn-out and taken, for example, as tea. And also in the Western herbalism there are some medicinal plants that are used as standard for the therapy of exhaustion. Corresponding examples are:

  • Valerian,
  • Damiana,
  • Ginseng,
  • Hop,
  • Jiaogulan,
  • Johannis herbs,
  • Lavender,
  • Lemon balm,
  • Passion flower,
  • rosemary
  • and taiga root.

Alternative medical treatments

Treatment measures such as acupuncture or the tuni massage to eliminate burn-out also originate from the TCM. Those affected can also think about special courses such as yoga, Qi Gong or autogenic training to bring their body back into a balanced state. (ma)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • Matthias Burisch: Das Burnout-Syndrom, Springer Verlag, 5th edition, 2014
  • Wu Guangdong et al .: Job Burnout, Work-Family Conflict and Project Performance for Construction Professionals: The Moderating Role of Organizational Support, International Journal of Environmental Research and Public Health, (accessed August 15, 2019), PubMed
  • Wolfgang P. Kaschka, Dieter Korczak, Karl Broich: Burnout: a Fashionable Diagnosis, Deutsches Ärzteblatt International, (accessed August 15, 2019), PubMed
  • Ingrid Kollak: Burnout and Stress, Springer Verlag, 2008
  • Klaus Michael Ratheiser et al .: Burnout and Prevention, Springer Verlag, 2011
  • Stephen Gluckman: Chronic Fatigue Syndrome, MSD Manual, (accessed Aug 15, 2019), MSD

ICD codes for this disease: Z73ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.


Video: How to notice the signs of career burnout (November 2022).