The biology of burnout: Causes and consequences

Summary & key facts

This 2021 review looked at research on the biology of burnout, which it defines as exhaustion from long or excessive workplace stress. The authors found evidence that burnout is linked with ongoing activation of the nervous system, problems in the body’s fast stress response (the sympathetic-adrenal-medullary axis), and changes in cortisol levels. Some studies also report altered immune and other hormone measures, and possible downstream effects such as higher allostatic load, changes in brain structure and function, inflammation, metabolic and heart problems, and earlier death. The review notes many study limits — varied patient groups, low specificity of burnout measures, and mostly cross-

Key facts:

• Burnout is defined in the paper as a state of exhaustion resulting from prolonged and excessive workplace stress.
• The review reports that burnout is associated with sustained activation of the autonomic nervous system and dysfunction of the sympathetic-adrenal-medullary (SAM) axis (the body’s rapid stress-response system).
• Studies summarized in the review found alterations in cortisol levels in people with burnout (cortisol is a major stress hormone).
• Some studies have shown altered immune function and changes in other endocrine (hormone) systems in people with burnout, but these findings are limited and not consistent across studies.
• The review lists possible consequences reported in the literature, including higher allostatic load, structural and functional brain changes, excitotoxicity, systemic inflammation, immunosuppression, metabolic syndrome, cardiovascular disea
• A major limitation is that most studies were cross-sectional (measuring people at one time point), which prevents understanding how biological measures change over the course of burnout.
• The authors recommend future research with more homogeneous clinical samples, use of challenge tests, and prospective (follow-up) studies to help distinguish burnout from depression and to develop specific treatment targets.

Abstract

Further examination of biological mechanisms of burnout would benefit from more homogeneous clinical samples, challenge tests and prospective studies. This would assist in differentiation from conditions such as depression and aid with development of specific treatment targets for burnout.

Topics

Cardiac Health and Mental Health Healthcare professionals’ stress and burnout Musculoskeletal pain and rehabilitation

Categories

General Health Professions Health Professions Health Sciences

Tags

Allostasis Allostatic load Burnout Clinical psychology Depression (economics) Economics Environmental health Immunology Macroeconomics Medicine Physiology Population Psychology