Article Highlight: Your Brain on Burnout

Burnout is a serious medical condition associated with the experience of chronic work stress. I recently read an article linking this all-too-common condition to deficits in brain function. It was an eye-opening and slightly terrifying article.

In her article, entitled “Burnout and the Brain,” Alexandra Michel discusses our instrument, the Maslach Burnout Inventory™ (MBI), and summarizes some key research regarding the neurological consequences of burnout. The information she presents highlights the need for vigilance in managing job stress and preventing burnout.

Read the full article here.

What is Burnout?
As a graduate student and former human service provider, I am no stranger to burnout. Whether experiencing it myself or seeing the painfully obvious signs of it in others, burnout is a widespread phenomenon that appears to be increasingly affecting adults in all sectors of the workforce.

If I were to explain burnout from my own personal experience, I would describe it as a lasting state of frustration, disengagement from my work, and increasing inability to cope with the demands of my job. This isn’t far off from Herbert Freudenberger’s original definition, which identifies burnout as a loss of motivation, growing sense of emotional depletion, and cynicism associated with one’s job.1

Christina Maslach, one of the most preeminent researchers on burnout and the author of the Maslach Burnout Inventory (MBI), worked with colleagues to identify six aspects of the work environment that contribute to the onset of burnout. These six aspects are:

These six aspects are measured by one of our instruments, the Areas of Worklife Survey.

Burnout typically emerges when there is a continual conflict between you and your job in one or more of these six areas.3 Richard Gunderman, a physician and professor quoted in the article, describes burnout as resulting from “the accumulation of hundreds or thousands of tiny disappointments, each one hardly noticeable on its own.”4 Speaking from experience, this is exactly what burnout feels like.

Burnout is accompanied by a host of organizational and mental health costs. Employers experience diminished job commitment and higher turnover rates from their employees,5 while employees themselves suffer extreme fatigue, a loss of passion, and increases in cynicism and negativity toward their work.6

Burnout and Your Brain
As it turns out, burnout doesn’t just affect your employer’s bottom line and your sanity, it also has a profound impact on your brain. Chronic stress, as experienced in burnout, is associated with a host of changes in brain matter and hormonal functioning, which in turn are associated with cognitive impairment and even heart disease.

Research suggests that people who are experiencing burnout show difficulties with emotion regulation.7 In particular, they have trouble attenuating the strength of their negative emotional reactions, which is mirrored by stronger physical reactions to negative stimuli.8

When compared with healthy controls, the average burned out individual tended to have a larger amygdala (the region of the brain associated with the processing of emotions).9 In addition to a larger amygdala, those experiencing burnout also showed weaker connectivity between the amygdala and brain regions associated with emotional distress (anterior cingulate cortex) and executive control (medial prefrontal cortex).10 The medial prefrontal cortex naturally thins with age, but burned out individuals showed more pronounced signs of aging in the cortex than did healthy controls.11

Decreased connectivity between these brain regions is associated with the emotion regulation difficulties described above.12 Ivanka Savic, a neurological researcher at the Karolinska Institutet, believes that overactivation in the amygdala due to chronic job stress leads to difficulty modulating the brain region associated with executive control, which is linked to attention and memory.13 Impairment in this brain region may lead to further difficulty regulating emotions and overactivity in the amygdala, and in turn, even more difficulty with executive control.14 Over time, this vicious cycle can spiral out of control and worsen the emotional, attentional, and memory difficulties associated with burnout.15

In addition to changes in neural connectivity, burned out individuals also show abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis -- the seat of the stress hormone cortisol. Under normal circumstances, cortisol is released when our “fight or flight” response is activated by a potential threat, such as a looming work deadline or a particularly difficult supervisor. Cortisol triggers changes throughout the body that prepare you to deal with the impending threat, thereby producing a state of heightened arousal.

The body continues to produce cortisol and the state of arousal persists as long as the perceived threat remains present. If the stress continues for too long, however, the HPA axis switches from producing high amounts of cortisol in response to a stressor to abnormally low amounts, almost reflecting a “burnout” of the body’s stress response itself.16 This “burnout” of the body’s stress response has been observed in individuals with burnout, and causes mild inflammation throughout the body.17 This inflammation can lead to severe heart problems by contributing to the accumulation of plaque in the arteries.18 No wonder they say stress kills.

What to Do About Burnout
Fortunately, there is some evidence that the effects of burnout can be reversed. In a study focusing on medical students, highly stressed students studying for their licensing exam exhibited the same kinds of brain matter changes as burned out individuals.19 Luckily, a 4-week period of recovery following the cessation of the exam stressor led to a return to normal brain functioning.20

Although the stress associated with medical school exams is not as chronic as the stress many burned out individuals face at their jobs, evidence from this study gives us hope that people experiencing burnout can, indeed, achieve some degree of neural repair.

As with any medical condition, the best treatment is prevention. Clearly, I'd like to avoid brain damage, so this article highlighted the importance of screening myself for early signs of burnout to prevent the associated neural and cognitive deficits from arising. Fortunately, here at Mind Garden, we publish the premier screening instrument for burnout, developed by Christina Maslach herself: the Maslach Burnout Inventory (MBI). As previously mentioned, we also publish the Areas of Worklife Survey (AWS), which assesses the causes of burnout.

If you think you may be experiencing burnout and want to learn more, I would emphatically encourage you to check out one or both of these assessments.

References

1 Schaufeli, W.B., Leiter, M.P., & Maslach, C. (2009). Burnout 35 years of research and practice. Career Development International, 14, 204 - 220. doi: 10.1108/13620430910966406

2, 3 Maslach, C. & Jackson, S.E. (1981) The measurement of experienced burnout. Journal of Occupational Behavior, 2, 99 - 113. doi: 10.1002/job.4030020205

4 Gunderman, R. (2014, February 21). For the young doctor about to burn out. The Atlantic. Retrieved from http://www.theatlantic.com/health/archive/2014/02/for-th0e-young-doctor-about-to-burn-out/284005

5 Maslach, C., Jackson, S.E., & Leiter, M.P. (1996). Maslach Burnout Inventory Manual (3rd ed.).

6 Maslach, C. & Leiter, M.P. (Eds.). (2015). It's time to take action on burnout. Burnout Research, 2, iv - v. doi:10.1016/j.burn.2015.05.002

7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 Michel, A. (2016). Burnout and the brain. Association for Psychological Science. Retrieved from http://www.psychologicalscience.org/index.php/publications/observer/2016/february-16/burnout-and-the-brain.html