What Happens to Your Body During Burnout?

Burnout is more than feeling tired. When stress continues for a long time without enough opportunity to recover, it can affect sleep, energy, digestion, concentration, mood, and how well we cope with everyday demands.

Our bodies are built to handle stress and then settle again once the pressure passes. When stress doesn’t let up, the systems that manage that response can change, which affects how we adapt and recover (Herman et al., 2016; Chrousos, 2009).

Understanding some of that biology helps explain why persistent fatigue, or feeling “wired but tired”, is often more complicated than needing a few days off.

In short:

• Prolonged stress can alter how the body’s stress-response system regulates itself.
• This may show up as disrupted sleep, fatigue on waking, or difficulty switching off.
• Digestion is closely connected to this, through what researchers call the gut–brain axis.
• Fatigue has many possible causes. Persistent or worsening symptoms need a medical assessment, not a guess.

How is burnout different from ordinary tiredness?

Ordinary tiredness resolves with rest. Burnout is what can develop when the demands placed on someone consistently outweigh their opportunities to recover, over weeks or months rather than days.

The distinction matters because the two respond to different things. A weekend off addresses tiredness. It rarely touches a pattern that has been building for a year.

What happens in the body during prolonged stress?

The stress-response system and cortisol

One of the body’s major stress-response systems involves communication between the brain, the nervous system and the adrenal glands. This is often called the hypothalamic-pituitary-adrenal axis, or HPA axis, and it helps the body respond to physical and psychological demands, partly through hormones such as cortisol (Herman et al., 2016).

Cortisol does a great deal in the body. It plays a role in our daily rhythms and helps us respond to changing demands (Chrousos, 2009).

When stress is prolonged or repeated, the regulation of this system can shift. Researchers have examined altered cortisol patterns and changes in stress-system regulation in people exposed to ongoing stress (Chrousos, 2009; Herman et al., 2016).

For some people this shows up as difficulty settling at night, broken sleep, or waking already exhausted — the familiar experience of being tired but unable to switch off.

Worth remembering: sleep problems and fatigue have many possible causes. They should not automatically be put down to stress or burnout.

Cellular energy

Every cell needs energy. Inside our cells are mitochondria, which play a central role in producing that energy.

Researchers have explored how psychological stress relates to mitochondrial function and oxidative stress. Current work suggests stress can influence these processes, though this remains an evolving area of science (Picard & McEwen, 2018).

Prolonged stress may therefore be one contributor to physical and mental fatigue. It is not the only one. Sleep, nutrition, medications and a range of health conditions all play a part, so persistent tiredness should never simply be attributed to mitochondrial function.

The gut–brain connection

Stress also reaches the digestive system. During demanding periods, some people notice changes in appetite, bowel habits, digestive comfort or food choices.

There is ongoing two-way communication between the gut and the brain — the gut–brain axis — involving the nervous system, the immune system, gut microorganisms and a range of signalling pathways. Research has examined its relationship with stress, mood and cognition (Cryan et al., 2019), as well as connections between stress, the intestinal environment, intestinal permeability and neuroinflammation (Kelly et al., 2015).

The relationship runs both ways. How we feel can influence digestion, and signals from the digestive system can communicate back to the brain.

Why does nutrition matter during prolonged stress?

The body’s stress response uses energy and nutrients. Several vitamins and minerals are involved in energy metabolism and normal nervous system function:

• Magnesium — involved in numerous biochemical reactions and contributes to normal muscle and nervous system function. Researchers have investigated the relationship between magnesium status and stress (Kirkland et al., 2018; Pickering et al., 2020).
• B vitamins — involved in energy metabolism and normal nervous system function.

This does not mean everyone under prolonged stress is deficient in either. Nutritional requirements are individual, and dietary intake, lifestyle, health status and medications are all relevant.

That is why a personalised nutritional assessment is more useful than reaching for a generic “stress supplement”.

What does a naturopathic approach involve?

There is rarely one simple answer when someone is persistently exhausted. A useful approach asks a broader question than “how do I get more energy?”

A naturopathic consultation considers the whole picture rather than one symptom in isolation. Depending on the person, that may include:

• Nutritional intake and dietary patterns
• Sleep and daily routines
• Stress and workload
• Digestive wellbeing
• Movement and physical activity
• Relaxation, rest and recovery time
• Emotional wellbeing
• Relevant health history and medications

Where appropriate, further assessment or pathology testing may be discussed, with referral to a medical practitioner or other suitably qualified professional where indicated.

What about herbs and supplements?

Herbal medicine has a long history of traditional use, and several botanicals have been studied in relation to stress and fatigue. The evidence is worth reading carefully.

Research has investigated Withania somnifera (ashwagandha) in relation to perceived stress and anxiety (Chandrasekhar et al., 2012). Rhodiola rosea has also been reviewed for physical and mental fatigue, and that review found the research contradictory, with methodological flaws limiting any accurate assessment of efficacy (Ishaque et al., 2012).

In other words, some findings are promising and some are inconclusive. Neither establishes that a particular herb treats burnout, and neither says anything about whether a herb is appropriate for a specific person. Herbal and nutritional preparations carry contraindications, precautions and potential interactions with medicines.

Self-prescribing on the basis of an online article — including this one — is not a good idea.

When should you see a doctor?

Persistent or unexplained fatigue should not be assumed to be burnout.

Fatigue has many possible causes. If symptoms are persistent, worsening, unusual or affecting daily life, discuss them with a medical practitioner or another appropriately qualified health professional. Naturopathic care can sit alongside conventional healthcare where appropriate. It does not replace medical assessment or treatment.

A different question to ask

Burnout is not a personal failure. Sustained stress affects how we sleep, think, digest and function day to day.

Understanding the body’s response to it can shift the question from “why can’t I cope?” to something more useful: what might my body and my life actually need right now?

References

• Chandrasekhar, K., et al. (2012). A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults. Indian Journal of Psychological Medicine, 34(3), 255–262.
• Chrousos, G. P. (2009). Stress and disorders of the stress system. Nature Reviews Endocrinology, 5(7), 374–381.
• Cryan, J. F., et al. (2019). The microbiota-gut-brain axis. Physiological Reviews, 99(4), 1877–2013.
• Herman, J. P., et al. (2016). Regulation of the hypothalamic-pituitary-adrenocortical stress response. Panminerva Medica, 58(1), 37–52.
• Ishaque, S., et al. (2012). Rhodiola rosea for physical and mental fatigue: a systematic review. BMC Complementary and Alternative Medicine, 12(1), 70.
• Kelly, J. R., et al. (2015). Breaking down stress: gut microbiota, intestinal permeability and neuroinflammation. Frontiers in Cellular Neuroscience, 9, 392.
• Kirkland, A. E., Sarlo, G. L., & Holton, K. F. (2018). The role of magnesium in neurological disorders and stress. Nutrients, 10(6), 730.
• Picard, M., & McEwen, B. S. (2018). Psychological stress and mitochondria: a conceptual framework. Psychosomatic Medicine, 80(2), 126–140.
• Pickering, G., et al. (2020). Magnesium status and stress: the vicious circle concept revisited. Nutrients, 12(12), 3672.