Burnout may be changing your brain. Here's what to do

By Sandee LaMotte, CNN

    (CNN) -- Are you burned out?

If these three symptoms apply to you -- a total lack of energy, a decline in your sense of belonging and a plummeting self-esteem -- you could be a victim of burnout, experts say.

After two years of living in a simmering pool of pandemic stress, you could feel stretched to the max. Stay in that state long enough -- or at a level of intensity such as that facing doctors and nurses working with the dying in Covid-19 wards -- and it may even change your brain.

"You notice things like being more irritable, more destructive, less motivated, less hopeful," said Amy Arnsten, a professor of neuroscience at Yale School of Medicinewho studies the neural mechanisms of burnout.

Understanding how your brain reacts to burnout can be helpful, as it shows people many of their reactions are part of a "natural phenomenon," Arnsten said.

"I am not a bad person -- this is just how the brain changes with chronic stress. It's doing it to try to protect me, even though in this situation, it's making it worse," she said.

"Having that kind of insight and perspective can break the vicious cycle where you're blaming yourself for not being better."

Your brain on burnout

Chronic stress has long been known to contribute to mental and physical diseases, and now researchers are able to capture what happens to the brain.

"One of the most striking (effects) is thinning of the gray matter of an area of the brain called the prefrontal cortex," Arnsten said. "It helps us to act appropriately. It gives us insight about ourselves and others. It gives us perspective. It allows us to do complex decision-makingand tobe able to have thoughtful, abstract reasoning rather than concrete or habitual responses."

By weakening that area, experts say burnout can impact our ability to pay attention and retain memories, making it harder to learn new things and increasing the risk for mistakes.

That's not all. Burnout can enlarge the amygdala, which is the part of the brain responsible for our "fight-or-flight" response when in danger, researchers have discovered.

"It's a double whammy. At the same time the prefrontal cortex is getting weaker and more primitive, the brain circuits that generate emotion like fear are getting stronger," Arnsten said. "You start seeing the world as harmful even when it's not."

Can you reverse these changes in the brain once they occur? Studies in mice show it's possible, and a 2018 study in people found cognitive behavioral therapy for burnout reduced the size of the amygdala and returned the prefrontal cortex to pre-stress levels.

Research in people also shows we can keep the damage from occurring in the first place -- if we feel we are in charge.

"If you feel like you're in control of the stressor, then there aren't these toxic brain changes," Arnsten said. "If you feel out of control it leads to chemical changes in the prefrontal cortex that weakens the connections, and over time actually erode those connections away."

What is burnout?

Burnout presents with three major symptoms that can intertwine in unique ways for each person, experts say.

"One of them gets most of the attention. It's exhaustion," said Kira Schabram, an assistant professor of management in the Foster School of Business at the University of Washington.

"You wake up in the morning and you say, 'How am I going to get out of bed and go to work?'"

Many employers attempt to fix workplace burnout by offering employees time off to rest and rejuvenate. While that's absolutely necessary for recovery, Schabram said, it may not be enough.

"The problem is there's two other dimensions," she said. "Inefficacy, or feeling like you're not really accomplishing things anymore, and cynicism, or a sense of alienation, either from the work itself or from other people."

Sending employees home to rest without giving them tools to address the other two symptoms may be ineffective, Arnsten said

"The problem is cynicism as a sense of alienation," she said. "Now I'm sending you home. You're spending even less time feeling like you're connecting to your patients or your coworkers. So that's where it gets tricky."

You are resilient

The good news is that studies show you can recover from burnout, experts say. First, give yourself grace.

"If it's exhaustion, give yourself permission to engage in self-care, right? Take a nap. Take a day off. Call in sick," Schabram said.

Try to do healthy activities as part of that self-care, such as "trying to get to sleep and eatinghealthyfoods not high in sugar," Arnsten said.

"Alcohol is what people often reach for to relieve the stress, but it actually makes you feel worse the next day ... and the same thing with benzodiazepines like Valium. But the healthier physiological activities (like) exercising and meditation that give you perspective can be really helpful," Arnsten said.

When it comes to addressing the sense of alienation that comes with burnout, Schabram said the solution may seem counterintuitive.

"What we find is having compassion towards others helps restore that sense of belonging," she said. "Become someone's mentor. Start volunteering. What we find is that those acts of doing something kind for someone else really pulls you out of that sense of alienation."

And don't forget to be compassionate to yourself, Schabram added: "We found both other-compassion and self-compassion help with burnout."

Self-care and doing for others can also help with feelings of self-worth, by boosting your sense of accomplishment: "I took a cooking class or I picked up yoga for myself or I mentored someone else," Schabram said.

And studies show those activities don't need to be massive or time-consuming to reduce feelings of burnout, she added.

"Even really small gestures had an effect the next day," she said. "Giving someone a compliment, taking them out for a five-minute walk to get a coffee, we see that that pushes the dial on next day burnout."

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