Why do we get Burnout?

It’s not rare to see the question “Why do we get Burnout?” in one way or another.

I’d say it’s because of the overconsumption of our double-edged sword, STRESS. Stress is a response to something. It’s either an inner or outer stimuli, a thought or an emotion that increases physiological activity in the individual – a reaction to a threatening or challenging situation. The stress response from the sympathetic nervous system is a lovely thing that has increased our ability to survive throughout the ages. Again – it’s there to increase your chance of survival. A companion and a sweetheart of a function for millions of years. Essential and primal. It makes you wind up and mobilize energy, which is really useful.  It used to help us be more alert and on our toes when necessary, or even start out that way before the event. You either fight, or you run for your life. To play dead is another option that is less commonly referred to; practically the opposite of the first two. The alternative is to faint or become apathetic. “Freeze” is another word for it; fight – flight – or FREEZE. This one occurs when the stress is all too much and overwhelms us.

Today stress is rarely life-threatening for most of us – but long term instead. Using the turbo that, over time, works as a double-edged sword is where it went wrong.

Today we “don’t have time,” and we’ve got anxiety because we’re producing and doing too little. You wake up at night and think about your projects. Rush from one place to another from nine to five. Kids at home and stuff to do until bedtime. Projects in your spare time and tasks in your workspace. Tough conversations and economy. You are keeping up with the Joneses and tending to the mortgage. People might think things, and there are infinite stimuli to check, keep track of, remember, analyze and judge. There’s food to think about, kids to drive, someone to please, and a home to keep tidy. Every little thing times a million turns into an inhuman load of tasks. And oops! The stress response was ever-present. There was no immediate threat, but that didn’t matter. You felt it, acted on it, and made it so. Demands from yourself and/or those around you, regardless of actual threats, are stressful and a massive issue over time.

It seems as if everything gets threatening if the brain gets a chance to see it that way. Hurrying to get things done “or else” leads to stress which leads to a feeling that it’s practically dangerous.

As well as the fact that people will always find problems. You’ll just have to find what problems you’d like. A prince with no problems will find the smallest flaws and make them huge. Those who starve won’t notice what you might be bothered by; a hole in the sleeve, a blister between toes, or neighbors doing this or that. If you don’t have any problems, the smaller ones will feel big. If you don’t have any food – that’s likely your problem.

So, what truly haunts, hunts, and stresses you out? Is it necessary and there for a good reason? Why does it stress you out, and what can be done?

An ever-present stress response, rather than just for a while when necessary… Could a parallel to horses and other animals running until they drop dead at its place here? The inventor of the marathon who ran to get the message through – who then supposedly dropped dead once it was delivered?

Generally, we get more threatened and stressed when we lack control. More pressure, higher speed, and uncertainty without enough chance and resources to influence, affect and change the situation will be more stressful. Having a big responsibility and a large workload will do its part, but the sheer volume of things to do might not be a problem of equal magnitude if you can control it. High demand and little control increase the risk of ill health. It’s even been shown that little control is stressful when it’s not really “necessary”. If it’s not very important – and you’re without control – it could still be stressful.

However, as fond as I am of Stoicism, I have to add something to this. This control aspect does NOT apply to those who tend to focus on what they TRULY CAN control. Focusing on what you can control, which is covered in a snippet in the book, is one of the biggest tricks in Stoicism.

Low demands and low control make the situation passive. It might be a decent position to get depressed or a burnout from practically becoming bored out.

This could be a problem when you really need to get paid, but you’re out of options, so you do something below your level. You’re not getting stimulated enough to get challenged by the demands – though you didn’t get in a position where you’re in control to change it either. Neither hard nor interesting – and you’re here day in and day out… What can you do about it?

High demands and low control make the situation tense and likely bothersome. This is a situation where you’d become exhausted from long-term stress. You’re under pressure, and the load is on you without any chance of getting away (or so it seems).

This is the category to be in to get ruined by stress. Perhaps you’re employed, and the boss demands too much of you, and the to-do list just keeps growing? This could, of course, be a problem from home or from within as well. A spouse and the social situation could demand more than you can endure, or YOU could put yourself in a mess that drains you of more than you can spare.

Low demands and high control make the situation relaxed. No problem here. You’ll likely be quite fine… or at least avoid getting stressed.

This could look comfortable and pleasant, but you could choose to aim higher if this is the case. You don’t want to get more problems than you “need” – but perhaps you should do something to get stimulated. Having nothing to worry about or tend to could sound ideal, but this is also the perfect space to bloom in. What do you want to do? What do you want to achieve? Who do you want to be? If you’re here, this could be your chance to pick where to go to do whatever you want.

High demands and high control makes the situation active. Demanding and stressful – but it feels positive. It’s a challenge rather than a threat. You’ve got power, resources, and influence. It’s a kick to get to work. It doesn’t necessarily have to matter if you’re amused and energetic. Something lovely can get too much, regardless. Eating cake is lovely and makes everyone happy… But it can still become too much, and enough is enough. Doing awesome stuff and being amused is great – having too much of something very stimulating that gives quite a stress response for too long is not. So if this is the case – be careful. Stress might be bothersome over time, even though it feels positive and challenging rather than bothersome.

You’re still just one person.

This could be the situation of a boss, leader, or entrepreneur. Use the privilege of control to your advantage and actually do delegate, automate, say no and use all of those clever ways to influence your situation to make you into more than one person. You might get enough off your plate to keep going with whatever you’re doing for a lifetime. Use that privilege.

What is stress?

It’s a quite complex physiological reaction to mobilize the body and brain to focus on the danger and have enough energy to do what’s necessary and improve memorization to make sure it’s remembered until next time.

“There’s obviously something important going on; better act well – and then remember it!”

“Where was that lion?” or “I almost died! Better remember HOW!”

The part about memorization is quite new, but Posttraumatic stress disorder, PTSD, and panic attacks underline this fact really well.

The lower degrees of stress start by activating attention, energy, and memory. Stressing further goes beyond that. The body becomes more activated in more ways. Pragmatic parts of it when fighting would be to redirect blood to muscles to be ready to act, increase heart rate, increase muscle tone, and widen pupils to take in more light to see better. Less useful things here would be a dry mouth and soaked clothes from sweat when talking in front of people. These functions of the increased physiological activation are on a scale from “slightly increased attention” to “panic attack”. The parasympathetic is the opposite of the sympathetic nervous system, where the sympathetic is the one that is activated when you get stressed. They’re always in a sort of tug-o-war and make functions go opposite ways. Where one of them dilates, the other one contracts. If one increases muscle tone, the other will decrease it. Redirect blood from something – or to the same thing.

The stress response

How it works is more or less explained by explaining the Hypothalamic–Pituitary–Adrenal axis or “HPA-axis” and its parts, including the amygdala that interprets the threats.

The amygdala

It is shown to have a role in processing memory, decision-making, and emotion, primarily the negative ones, including fear, anxiety, and aggression, making it into something of a “panic button” or “area of interpreting threats”. Hunting, being hunted, winning something grand, or losing everything. Survive or prosper. If it’s big, new, and something to react to – it’s likely stressful, and off we go, thinks the amygdala. Some of what it responds to is rational, and some things are less so since it’s connected to the brain’s rational and irrational parts. Connect to everything – to react as quickly as possible. Missing something might be fatal.

This isn’t the cool, brave, and predator-like part of your brain. It’s rather like the prey – like a horse or rabbit hearing something rattle in the woods. First, there’s fear, the stress response, and the acting. THEN, you’re free to reason logically.

The amygdala initiates the stress if something is threatening – partially depending on what you’ve been practicing. Worth noting already is that this is something you can practice. If you’re generally calm, pragmatic, and rational – it’s less likely to blow the horn for a full-scale panic response. Those could undoubtedly be affected by such easy means as mindfulness practice and cardio. You’re far more likely to get a potent response if you’re neurotic, anxious, and generally stressed, have been so for a long time, and try your best to avoid changing that. Once the amygdala goes for it, a distress signal is sent to the hypothalamus.

Hypothalamus, “below thalamus”.

The hypothalamus is a bit like a command center. It regulates metabolic processes and the autonomic nervous system. It also produces and secretes certain neurohormones to tell the pituitary gland to do the same. It controls body temperature, hunger, thirst, fatigue, sleep, and circadian rhythms. Plenty go through here, but the relevant parts are: It excretes Corticotropin-Releasing Hormone (CRH) to the pituitary gland, meaning that it activates the autonomic nervous system.

Pituitary gland

The pea-shaped tiny structure at the bottom of the hypothalamus reacts to the CRH from the hypothalamus and then produces AdrenoCorticoTropic Hormone (ACTH) to stimulate the production and release of cortisol from the adrenal gland.

Adrenal glands

The small glands on top of the kidneys get the ACTH which is the message to produce and excrete cortisol, epinephrine/adrenaline, and norepinephrine/noradrenaline into the bloodstream.

Adrenaline/epinephrine increases blood flow to muscles, and the heart’s output by increasing the heart rate [it acts on the SA Node(sinoatrial/sinus node), a cell group in the heart with the ability to produce an electrical impulse spontaneously]. This is done by binding to specific receptors, which, in turn, will stimulate the sympathetic nervous system. The adrenaline will increase breathing frequency and dilate small airways in the lungs. Sight, hearing, and other senses become sharper. The amount of available energy increases, both in the shape of blood sugar and fats, as it’s released from their storage sites to supply energy to necessary parts.

Norepinephrine excreted into the blood affects the sympathetic nervous system, where it’s the most important substance for signaling. It’ll increase the heart’s performance by increasing the force generated, heart rate, and blood volume pumped with each contraction. It contracts blood vessels which increases blood pressure and aids in keeping awake, alert, and attentive.

Cortisol increases blood sugar [gluconeogenesis], suppresses the immune system, and aids the metabolism of fat, protein, and carbohydrates.

This happens quickly.
The amygdala and the hypothalamus start the cascade before you’ve decently processed what’s going on.

In short – you get going! Energized and on your feet! Less blood to irrelevant things like the logical and reasoning prefrontal cortex, or whatever tends to digestion. Smaller things like hands don’t need blood – more of that blood to large arm- and leg muscles to make things happen! Blood coagulates better – if you’re going to war, let’s make sure you’re not the one who bleeds out first!

However, if the stress becomes overwhelming, you won’t be of much use. If it’s far too much or if you’re somewhat prone to “freezing” rather than fight or flight, you’ll get a response in the parasympathetic nervous system where it’ll try to make you play dead. You’ll get powerless and perhaps even faint.

The HPA axis relies on these hormonal signals to keep this “gas pedal” going. As long as you continue to find dangerous things, you’ll get some CRH [corticotropin-releasing hormone] from the hypothalamus and then ACTH [adrenocorticotropic hormone] from the pituitary gland, which then will get the adrenal glands to do their thing and release stuff like cortisol. You’ll be up and alert until you’re done. When the threat passes, your cortisol levels can return to normal, and at last, the parasympathetic nervous system gets to do its thing. Relax, digest some food, recover and heal.


How and why do we get sick? We’re made for stress. If the system were nothing but toxic, we wouldn’t have the function. But it’s functional and even GREAT TO HAVE for minutes and hours. Not months or years. We’re made for most things in moderation, and too much comes with consequences. That goes for everything from water and food to pharmaceuticals and physical activity.

Muscles increase their tone, which is great until it gives you pain and troubles in the purely physical parts – tension headaches which might turn into migraines. Back pain or more widely spread in the body and sometimes harder to pinpoint.

Keeping alert is great until you’ve got sleep disorders. You can’t hurry the concept of sleep. Your physiology knows that, regardless of if you do. It’s not uncommon to crash entirely after a short of insomnia. Once you can’t sleep, you’re going down quickly. Sleep was the last part of keeping things together. That’s when you got to recover. Once that’s gone, the slippery slope gets too slippery.

Persistent surges of the hormones that increase heart function can contribute to cardiovascular disease by damaging blood vessels through increased blood pressure. Constricting the vessels, making blood coagulate easier and go faster, puts an unnecessary load on the system, resulting in dire consequences such as heart attack or stroke.

High levels of cortisol will, over time, lead to a variety of consequences. A newer finding is that it erodes the connections between nerve cells in the brain. This could be THE, or part of the, reason why so many get so many cognitive symptoms from long-term stress.

Cortisol will try to keep elevating the blood glucose levels for as long as it’s present. That might definitely increase the likelihood of getting diabetes type 2, just as if you kept eating at all times. Is it the cortisol itself or something that correlates with the cortisol that makes people actually eat more or even use comfort food? Regardless, more stress makes people more prone to eat whatever is worse for the modern man. We get more prone to eating fattier and sweeter food the more stressed we are unless you belong to the part of the population that does the opposite – forgetting to eat altogether, which isn’t a healthy option either.

Cortisol will break down bone, just as if you kept eating cortisone, which might lead to osteoporosis, and it will break down muscle, making the body composition worse as you’ll get more fat and less muscle. That might contribute to more pain and worse health.

It seems to have a negative effect on the immune system. In the short term, that could be useful as it prevents the production of inflammatory mediators and decreases inflammation, just as exogenous cortisone does. Over time, the function will make immune cells produce fewer receptors and become more immune to the substance, leading to an increased inflammatory response or “chronic inflammation”. This is likely why autoimmune problems seem to blossom when the individual gets too stressed for too long.

The effects on digestion seem to be able to cause long-term troubles. This is fuzzier, but it’s not uncommon for people to get IBS symptoms that last even after managing their long-term stress. Perhaps the autoimmune response earlier might be a part of the reason?

Emotional issues are another widespread one. It’s been shown that long-term stress might affect areas of the brain that tend to regulate emotions, memory, and focus, resulting in more emotions. That’s rarely primarily the good ones.

Depression could come from long-term stress, which shrinks certain brain areas and further diminishes connections between neurons, just as the cortisol did. One thing leads to another, which gives you what you don’t want.

When we know all of this, it’s terrific to get a few heads up once we get too stressed. Perhaps some tension headache, an upset stomach, stiffness in your shoulders, or something similar.

Those are pretty forgiving.
Those are not the big problems.
You’ll survive.
Listen when it’s on that level.
If you don’t, the signs will increase.

Check in on the body often enough to know what’s going on, and you’ll be fine. The big consequences won’t jump you in the middle of the night without any warning. You’ll get your notifications. Probably not even just once or twice. Listen to them and change things up once you’re warned – that way, you won’t have to suffer from the serious long-term consequences.

If you’re interested in doing something about it, I help people with just that. Go to www.mbdolor.com/contact if you’re interested in getting help or www.mbdolor.com/book if you prefer to do it yourself.

Full series:
The Big Three: What Is Burnout?
Why Do We Get Burnout?
Treating Burnout

If you’re curious about how to treat yourself, here’s another post on the subject:

Why do we get burnout?

I’d say it’s because of the overconsumption of our double-edged sword, STRESS. Stress is a response to something. It’s either an inner or outer stimuli, a thought or an emotion that increases physiological activity in the individual – a reaction to a threatening or challenging situation. The stress response from the sympathetic nervous system is a lovely thing that has increased our ability to survive throughout the ages. But it burns the candle at both ends… And then some. Use stress with caution.

What is stress?

It’s a quite complex physiological reaction to mobilize the body and brain to focus on the danger and have enough energy to do what’s necessary and improve memorization to make sure it’s remembered until next time. How it works is more or less explained by explaining the Hypothalamic–Pituitary–Adrenal axis or “HPA-axis” and its parts, including the amygdala that interprets the threats.

What are the consequences of stress over time?

Burnout, in short. But that can of course be explained further. Pain, sleep disorders, CVD, nerve damage in the CNS and cognitive problems, more negative emotions and depression, diabetes, osteoporosis, immune deficiencies, and autoimmune disorders are some of the consequences.

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