How to manage stress and recover from burnout

Recently, I had an interview with CNM (College of Naturopathic Medicine) about burnout from stress. I talked about how how stress affects your emotional and physical wellbeing and the signs and symptoms to look out for when you’re burnt out. I also shared my health coaching tips and advice on how to recover from burnout through diet and lifestyle.

Listen to the full podcast of the interview here or read it below...

What you’ll learn:

• What a Health Coach is and how they work.

• How burnout affects the body and the key signs and symptoms to look out for.

• The causes of burnout and the dietary and lifestyle factors that exacerbate symptoms.

• An overview of the stress response and what happens in the body when you get stressed.

• The long-term health complications of burnout.

• How to address burnout with health coaching strategies.

• Dietary and lifestyle tips to help you recover from burnout.

• Daily practices to assist with burnout.

Stress and burnout: what are the key differences and how can we manage them more effectively?

What is stress?

When we use the word “stress” we are often using the word as a short cut to describe a host of underlying feelings and physical symptoms that are hard for us to describe in that moment of acute stress. If we were to take a step back and think a little more deeply about what we really mean, we would see that the word “stress” is used to cover a collection of feelings and physical symptoms. These can include overwhelm, anxiety, frustration, irritation, or a combination of these and more! It is usual to feel this way on an almost daily basis around all the common parts of work home balance, which can be very challenging to juggle. These conscious feelings of stress also manifest physically as:

• Faster breathing

• Muscle tension and increased blood flow to the muscles

• Increased sensation of a pounding heart due to increased heart rate and blood pressure

• Increased production of the hormone’s adrenaline and noradrenaline via the hypothalamic pituitary axis

• Reduced blood flow to the digestive system

• Release of natural endorphins – painkillers which can give us a natural boost of “feeling energetic” temporarily. This also helps us to temporarily numb physical pain.

This is known as the sympathetic or “fight or flight” state, an entirely biological state of our nervous system. We are hard wired to feel this way and adapt our bodily functions so that we have the strength and power to respond to an imminent threat. The commonly used example is of the Neolithic human running from a sabre-toothed tiger. In and of itself this can be a very useful function which our bodies perform automatically to give us the boost we need to perform well in a work presentation, to get the kids to school on time or respond to an accident or crisis. However, remaining in this stressed state was never supposed to be a sustained experience for our bodies and minds. If we compare our modern lives to those of our ancestors, we can immediately see that there is a missing link: our lives are not set up to bring us out of the sympathetic state naturally. With so many distractions from media, screens, work, and general busyness we are switched into the stressed state most of the time and this feels normal for our culture. Even our so-called relaxation efforts (coffee breaks, alcohol consumption and Netflix) are adding to this by pushing our bodies into metabolic stress caused by inflammatory lifestyle choices such as inflammatory foods or scrimping on rest, sleep, and daily movement.

If this chronic stress goes on for long enough to produce the symptoms of burnout (see below) then there will also be physical effects of chronic stress too. This is driven by chronic inflammation, free radical damage and destruction of our gut flora or microbiome, and happens because we are not allowing our bodies the time in the parasympathetic or “quiescent” rest and digest state for all the repair our cells and tissues need after a stressful episode in the sympathetic state. Due to the long-term lack of repair in our tissues we start to suffer with symptoms of chronic disease. For example, cardiovascular disease (eg increased blood pressure), chronic asthma, irritable bowel syndrome or skin conditions like eczema or psoriasis (not to mention poor immunity). This is why people suffering with long term unresolved work stress not only have the 3 components of burnout but also have symptoms of other chronic diseases as well – due to the physical effects of prolonged stress on the body.

What is burnout?

Burnout is a collection of three symptoms resulting from chronic workplace stress that has not been identified, acknowledged, and managed. It is characterised by three dimensions: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from your job, negative feelings or cynicism related to your job; and 3) a sense of ineffectiveness and lack of accomplishment. Burn-out refers specifically to work or occupational stresses and technically speaking should not be applied to describe experiences in other areas of life. (ICD-11) However, that’s not to say that there aren’t affects in other areas of life…

The feelings of complete exhaustion usually also manifest in a lack of energy and enthusiasm for homelife too, although the focus or driving factors are work related. The exhaustion spills over into homelife and relationships can become strained. All the tasks associated with making life happen can seem completely overwhelming and impossible due to physical and emotional pain experienced by the burnt-out person. An over reliance on caffeine and sugar to give us the energy we need to get through the day, can dominate our thoughts. Poor energy and therefore poor concentration ensue, with a real sense of brain fog and an inability to concentrate for more than a few moments. Sleeping can become a real problem with difficulties falling asleep, multiple awakenings during the night or an inability to get out of bed on days off work due to sheer exhaustion.

What are the driving factors pushing us towards burnout?

1. Unresolved or unrecognised stress.

2. Modern cultural factors – over working, never feeling good enough, or never feeling like the day’s work is finished.

3. Systems within working environments which don’t prioritise health and wellbeing or productivity – this is a sad fallacy because healthy workers, full of vitality, are more focused and productive.

4. Loss of an ability to read our bodies for early signs of stress and cultural norms which say or imply that resting is for weak people and a narrative of busyness being the goal in life eg “I’ll sleep when I’m dead” or “yes I’m doing well, keeping busy!”.

5. No natural time in our modern days where we naturally switch off, life is always “on”. We can work from anywhere with 24/7 access to email, messages, social media and information in general.

How the covid-19 pandemic has added to our stress levels

Two systematic reviews have investigated how the pandemic has affected our stress levels and mental health. The researchers looked at 58 separate studies in total, including people from various backgrounds, health care workers, the general public, adolescents and children (1,2). Their findings showed that increases in stress and reduced health and wellbeing indicators have been experienced with an increased frequency since the start of the pandemic. The pandemic has added to increased stress levels in various ways:

1. Anxiety provoking news and daily figures

2. Covid-19 has been an unknown threat – which continues to evolve

3. Isolation and the removal of our usual stress relieving factors

4. Relaxing of restrictions - once again a large change to something we had become accustomed to for a while

5. Constant uncertainty

6. Supporting research from meta-analyses shows us that the above factors are having a real effect on our over stress levels and resilience – ultimately affecting our immunity

How do we address the chronically stressed state?

It is true that burnout is caused by long term unresolved stress but that doesn’t mean that stress in and of itself is bad for us. It is the chronic nature of modern-day stress that does the damage. The stress response can be exhilarating when we need it, so that our bodies and minds can do incredible things under pressure. We can get a sense of accomplishment having been stressed to achieve a work-related goal, for example. There is however a very large BUT attached here! In the modern world we have lost the ability, cultural awareness and knowledge of the bodily cues that tell us about stress so that we can intentionally take ourselves out of the acutely stressed state. This is the reason that we are prone to burn-out. We have lost touch with the ability to enter the rest and digest or parasympathetic state on purpose where we repair and nourish our bodies, ready to take on the next acute episode of stress that is the next fight or flight state. There are so many things distracting us from listening to bodily cues, that we have become accustomed to living in a state of chronic stress permanently and have forgotten the art of intentionally entering the rest and digest state.

Thankfully there are lots of techniques and things you can try to intentionally move into your parasympathetic state. You can take charge of your stress levels by relearning your bodily cues and by starting to make positive intentional decisions to come out of the sympathetic state every day. Just be curious and start to believe in yourself that there are ways to turn your health around, here are my 8 main pointers when working with clients, to help them to balance their stress and bring it back under their own control.

1. The power of story and narrative over yourself – a belief in yourself to solve this. Start by taking a moment to think about and write down all the fixed stories you tell yourself about stress and your wider life. Are there intentional changes you can make here? Thank your brain for warning you of the potential threat but then consciously tell yourself a different story – one that is based in fact. For example, “my body and mind are physically capable of calm, I simply need to learn to tap into that physical process”.

2. A daily Self-compassion practice is proven to make us more resilient to life’s challenges, more compassionate and less stressed, with a greater capacity to learn and adapt to changing circumstances in life. The three components are: 1) acknowledgment of the stress, pain and suffering and feeling this; 2) recognising that we are not alone, this is an inherently human feeling regardless of the details of circumstances, we all feel stress, pain and suffering; 3) learn to attend to what you need to help and nourish yourself in that moment. Rather than relying on denial techniques or crutches like TV or sugar, ask yourself but what can I do to nourish and support myself, like a close friend would (4).

3. Understanding what you are feeling and start to look at the information this is giving you– this can be applied emotionally with tools of emotional intelligence and physically with relearning the concept embodiment.

For example, if you feel “stressed” – stop and ask yourself about what is underneath this feeling? Am I anxious about a comment from a colleague or a presentation or overwhelmed about workload or a new project or role I’m stepping into? Once you’ve identified this, you can use techniques like journaling, prioritising tasks or brain dumps to identify things you can do to help the situation. Just simply breaking the feeling down to see what’s beneath the initial feeling of stress can be hugely beneficial (5).

4. Learning how to intentionally enter the parasympathetic state (the calm, rest and digest state) – this is key to sustaining a period for recovery for the mind and body, but also for building resilience for the rest of life too. Different things work for different people get curious and find out what works for you.

• Breath work and abdominal breathing – try a 1 minute breathing exercise: lie on the floor with your knees bent and feet planted firmly on the floor. Place one hand on your chest and one on your belly. Breathing in through the nose and out slowly through the mouth notice which hand moves more, over the minute concentrate on breathing into the belly to make this hand move and keep the chest still. Notice how this slows the breath and the heart rate in just one minute. Over consecutive days try to keep this going for a little longer working up to several minutes.

• Engaging with nature: try wild swimming, take a 1 minute bare foot walking in grass, walking in nature in mini-breaks from work or in the evening.

• Digital curfew in the evening or longer detoxes – give yourself permission to tune out

• Bedtime routines – nourish yourself by creating a routine which helps you get to get a powerful nights sleep

• Mini-rituals around savouring moments in your day to return to the present, notice what you are eating, notice things to be grateful for in your day

• Mindfulness work – whether that be savouring moments in your day, meditation or the self-compassion work I noted in my first point, anything that will help us stop and come back to the present moment as much as we can.

• Crafts and artistic projects

• Playing and listening to music – the relaxation frequency 432Hz can help you to physically enter the parasympathetic state, and reduce anxiety (6,7)

5. Nourishing the body with the best quality whole foods that we can manage. Think about the timings of meals more intentionally and take time to eat calmly, chew food and savour it. Therefore, making sure that we are getting full digestion of the nutritional content from our food – which our bodies need especially when we are living in stressful circumstances.

Try moving to a more whole food diet, thinking about increasing the amount of fresh unpackaged foods from local sources, knowing that the nutritional content has not decomposed by the time it gets to our plate. Try taking note of the ingredients lists on the foods you buy and asking yourself – “Does this look like its full of real food, or lots of things that look like chemical names?” Try buying less of these foods and replacing them which whole foods. (8,9,10)

6. Get high quality and enough sleep every night – and realise the powerful healing quality of a great night’s sleep. This should be 7-9 hours of uninterrupted sleep. Getting a lovely relaxing sleep routine which gets you wound down and ready for sleep is the key here. Removing screens and technology for at least 1 hour before heading to bed is key to success (11).

7. Get active movement into every day, taking mini movement snacks or breaks. These can be tiny, even 2 minutes every hour can help. Finding the joy in this and realising that movement can be medicine, gentle stretching and walking can be anti-inflammatory for the body. Noticing and using the breath during movement can be a powerful way of putting us into the parasympathetic state.

8. Healthy nurturing relationships, spending quality time with loved ones can really boost our mood and our immunity, and lower stress levels. Learning some key relational and communication skills to help with tricky work relationships can be hugely beneficial and alleviate stress by helping you to feel like you have more agency in these tougher collegiate relationships (12,13).

A health coach can really help here, by helping identify barriers and help to build techniques for dealing with overwhelm or help with techniques to calm anxiety. We can also help people to find more specific support and counselling if anxiety is a more deep-seated issue and work alongside each other to help you learn sustainable strategies for stress management. If this blog has highlighted some key issues for you, please take heart and start to apply some small changes to your life or reach out for help and support by arranging a call with Joyce to discuss how a programme of health coaching could help you: www.drjoycereedhealthcoach.com

References

1. Vindegaard N, Benros M E Brain COVID-19 pandemic and mental health consequences: Systematic review of the current evidence Behav Immun. 2020 Oct

2. Meherali S, Punjani N et al Mental Health of Children and Adolescents Amidst COVID-19 and Past Pandemics: A Rapid Systematic Review Int J Environ Res Public Health. 2021 Mar

3. Dr Kristen Neff https://self-compassion.org/

4. Prof Marc Brackett https://www.marcbrackett.com/about/book-permission-to-feel/

5. Calamassi D, Pomponi GP. Music Tuned to 440 Hz Versus 432 Hz and the Health Effects: A Double-blind Cross-over Pilot Study. Explore (NY). 2019 Jul-Aug

6. Calamassi D, Lucicesare A, Pomponi GP, Bambi S. Music tuned to 432 Hz versus music tuned to 440 Hz for improving sleep in patients with spinal cord injuries: a double-blind cross-over pilot study. Acta Biomed. 2020 Nov

7. Kris-Etherton PM, Petersen KS, Hibbeln JR, Hurley D, Kolick V, Peoples S, Rodriguez N, Woodward-Lopez G. Nutrition and behavioral health disorders: depression and anxiety. Nutr Rev. 2021 Feb

8. Kris-Etherton PM, Petersen KS, Hibbeln JR, Hurley D, Kolick V, Peoples S, Rodriguez N, Woodward-Lopez G. Nutrition and behavioral health disorders: depression and anxiety. Nutr Rev. 2021 Feb

9. Kris-Etherton PM, Petersen KS, Hibbeln JR, Hurley D, Kolick V, Peoples S, Rodriguez N, Woodward-Lopez G. Nutrition and behavioral health disorders: depression and anxiety. Nutr Rev. 2021 Feb

10. Mathew Walker 2017 Why we sleep

11. Max Storm A life worth breathing

12. David Bradford and Carole Robin 2021 Connect: Building exceptional relationships with family friends and colleagues

13. Robin Dunbar 2021 Friends: understanding the power of our most important relationships