Topic letter 28
Burnout
The most dedicated workers are particularly prone to this and it can appear to be depression. But what actually is a burnout, how does it develop and what can we do about it? Those are the subjects of this blog..
Collapse
We have a whole lexicon to describe what happens when somebody collapses at work, like strained, overworked, exhausted, extinguished, depressed or suffering from burnout. Behind these words, there lies a dichotomy of symptoms. On the one hand we can see symptoms of a depressive nature and on the other side a burnout. Although they appear to be alike, they differ both in cause and in treatment.
Depressive symptoms
Breakdown due to depression is the result of alienation between what you do and what you would like to do. Work no longer brings you satisfaction and energy. You tire easily and over time you even lack the motivation to change your life. The reward center in the brain is hardly ever activated anymore. You want to do something about it, but you can't get it done. Then your world collapses and the only thing you want is to have a long sleep.
Burnout
In case of burnout, work has been nourishing. You bare responsibility and don't want to disappoint anyone. It's all just too much and there seems to be no end to it. You work longer and wake up earlier. Once awake, you get up because you might just as well finish that report. One day you meet the man with the hammer. You can't find the keys of your car and you even don't know what day it is. You feel totally shattered and you do not understand what's going on.
Cortisol
The previous blog was about varying the state of readiness in response to the challenges from the environment. In the period prior to a burnout you experience a permanent high state of readiness. The stress system is running at full speed. Adrenaline is high and extra cortisol is added during peaks. Under normal circumstances cortisol breaks down within a few hours, but in that period, cortisol keeps on being produced.
Hippocampus
Within the brain the hippocampus in particular is sensitive to cortisol. This area monitors all the risk signals and plays the role of gatekeeper in increasing states of readiness. In addition, the hippocampus also sends information back to the system that produces cortisol. It is part of the feedback mechanism.
Vicious circle
Unfortunately, the hippocampus cannot tolerate high levels of cortisol. The receptors become over-stimulated and infected. This leads to an inflammatory response, leading to the death of local brain cells. The hippocampus starts to malfunction and too many stress inducing signals slip through beyond the control of the hippocampus, leading to a further increase in the state of readiness. Besides that less and less inhibitory information is sent to the cortisol producer. This creates a vicious circle in which more and more cortisol is released. Ultimately this leads to so much cell death that holes appear in our brain. These are visible on a MRI scan.
Brain damage
A burnout is thus the result of brain damage. This explains why a few weeks of rest have no improving effect. Although the cortisol level reduces due to the complete absence of pressure, the hippocampus does not recover solely from resting. Fortunately, in this area of the brain there are stem cells that can foster the growth of new brain cells. The hippocampus can therefore be rehabilitated, but only at a slow pace. This recovery process can take years and there is no guarantee that it ever completely succeeds. A burnout can lead to lifelong health problems.
Recovery
A slow recovery is one of the major differences between burnout and breakdown due to depression. In the latter case it is good to take a break, but within a few weeks you need to start working again. Learning to discover what suits you best is like finding the pot of gold. You have to dig; otherwise you will never find anything. In case of burnout, in the first few months you cannot even think about work. Recovery begins with a period of relaxation and then you must re-learn how to recognize and handle stress signals. Once you can master them, the sacred fire is allowed to reignite, but only in moderation.
Juni Daalmans July 2013 Brain Based Safety
More information on brain based safety can be found on www.brainbasedsafety.com and in the book "Human Behavior in Hazardous Situations. Best Practice Safety Management in the Chemical and Process Industries." 2012 Elsevier
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