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The people in the know now understand that what we call "burnout" is not a psychological disorder at all, but sub-clinical[1] adrenal fatigue caused by stress,
by ahoyhere 13y ago
The people in the know now understand that what we call "burnout" is not a psychological disorder at all, but sub-clinical[1] adrenal fatigue caused by stress, period. In other countries with superior medical system integration, like Austria/Germany, this is an accepted medical fact.
If you stress out a rat long enough, its adrenal glands will actually bleed. If you stress out a human long enough, you cause first a huge ongoing spike in cortisol etc., and later, a serious drop as the damage is done. This can be measured easily using a 24-hour cortisol saliva or blood test, but it rarely is. (Related hormones: DHEA, thyroid).
Symptoms of burnout are just like the symptoms of CFS/low thyroid because they are part of the HPA (Hypothalamic-Pituitary-Adrenals) Axis. They're tightly coupled.
While short bursts of endorphins will make you feel better, the effect will be temporary. Endorphins will not make your adrenal glands or thyroid work again. Instead, they mask the symptoms… but only for a while. There are only three ways to get better: Dramatically cut stress. Wait. Take medication. Pick 2.
[1] "Sub-clinical" usually means "not measurable," but in the case of "burnout" and adrenal fatigue, it is absolutely measurable. However, I call it sub-clinical because of the way most doctors think of the adrenal glands. Most doctors believe that the adrenal glands are binary: they are either working perfectly, or totally non-functional (Addison's disease). Unless you're on the verge of death from lack of cortisol, they will tell you you're fine.
If you have burnout, get your 24-hour saliva test. Take your morning temperature with an old-fashioned thermometer under your arm for 10 min. Look up the other symptoms of adrenal fatigue and hypothyroid. There's plenty of research published about how burnout is measurable and related to the HPA axis -- you don't have to take my word for it. There are lots of support groups, too, where the sufferers have often presaged the research.
And for god's sake, stop telling yourself it's about failure or investment or whatever and stop stressing yourself out, period, or you can get like I am and it can become permanent.
EDIT: If you google "burnout syndrome" you will read several sources claiming that there is no proof it's a real thing. This is 100% false. They also say it's not accepted by the medical community, but rather a quacky way to sell supplements. It's true that most doctors are unaware of the research, but the ones who do treat it with real medicine (see below).
It's painfully easy to say "There's no proof" but a 5-minute search of Google Scholar shows otherwise:
http://www.psychosomaticmedicine.org/content/61/2/197.short http://www.psychosomaticmedicine.org/content/61/2/197.short (from 1999!)
http://psycnet.apa.org/index.cfm?fa=search.displayRecord&UID=2005-13290-009 http://psycnet.apa.org/index.cfm?fa=search.displayRecord&...
http://www.sciencedirect.com/science/article/pii/S0022399999000070 http://www.sciencedirect.com/science/article/pii/S0022399999...
http://www.psychosomaticmedicine.org/content/62/2/286.short http://www.psychosomaticmedicine.org/content/62/2/286.short
http://gimle.fsm.it/28/1s_psi/05.pdf http://gimle.fsm.it/28/1s_psi/05.pdf
The theories from doctors who've spent their lifetime researching it go as follows: Burnout happens in stages. In the early stages, cortisol etc. are elevated. In the later stages, the "fatigue" sets in, and cortisol is too low. I personally spent 3+ months in low-cortisol hell and it was the most awful time in my life… and there have been some really bad times in my life. .
And there are quite a lot of endocrinologists etc. who will treat low-testing cortisol patients with hydrocortisone, isocort or florinef or other drugs which are not "supplements" by any stretch of the imagination.
IF you are stressing yourself out, and IF you keep going down that road, this is what you have to look forward to:
Being unable to get out of bed. Being unable to make the simplest of decisions without feeling like you're having a panic attack. Being unable to read, because it's too much information at once. Being unable to watch TV shows that have too many "facts" in them. All of the above -- including simple questions of "What do you want for lunch, honey?" -- triggered panic-like attacks in me, who'd never had a panic attack despite years of physical and emotional abuse as a child. It was like being surrounded and squeezed and shouted at by a million people all at once, just to try to listen to my lunch options. That is because cortisol is required to rise to the "stress" of every day living… standing up from sitting is a stress, making decisions, etc., all create tiny spikes of cortisol to help you cope. If your cortisol is too low, you are screwed.
Is there any "victory" worth a life like that? Can you even call that a life?
- nate 13y agoAmy, this is great. Thank you! > cortisol is required to rise to the "stress" of every day living So stress seems impossible to avoid completely right? There's going to be some amount of it. When an email comes in about some snafu in the thing I'm making I can't avoid a spike in cortisol right? What's the smartest approach to managing it? I seem to do typical things like working out, etc. But I also love working. Should I be somehow measuring cortisol and when it gets above X level, I need to take some action to reduce it? This seems like a hard thing to do right, if I'm just going by gut instinct to check where I'm at.
- ahoyhere 13y agoThere's a spring drizzle, and then there's a hurricanes, both of which you can call "rain." One makes flowers come up, the other crushes and rips the flowers out of the ground. So. "Stress" is not a good conversational word for what happens when you go from laying in bed to standing up. But it is the technical term. I loved working, too. I'd work when I was moderately ill. I'd work long hours. I was enjoying it… mostly. That is no protection. If I'd dropped certain responsibilities, rested when I was sick, worked fewer days, and cared less [1], I probably wouldn't have ever gotten this bad. That's about all I got for you. I don't know all that much about that stage of the syndrome because I never had any tests at the time. I would get sick, take some of the time off, then get right back to it. Nobody was forcing me. When not sick, I would need to take several days off in a row to relax and then I'd find myself more creative again. I guess that was a sign. If you can get the test for cheap, why not? But it'll only tell you trends compared to yourself, unless you are either very high or low. There's info on the Stop the Thyroid Madness site about reliable labs. [1] (By "cared less" I don't mean "stopped caring about my work/life" but rather "stopped caring about stupid shit" which, believe it or not, is most of it. But that's not something you can understand until you've experienced it. It's great to know just how little what I do matters. Very freeing and not at all demotivating.)
- outworlder 13y ago> Being unable to get out of bed. Being unable to make the simplest of decisions without feeling like you're having a panic attack. Being unable to read, because it's too much information at once. Being unable to watch TV shows that have too many "facts" in them. All of the above -- including simple questions of "What do you want for lunch, honey?" -- triggered panic-like attacks in me, who'd never had a panic attack despite years of physical and emotional abuse as a child. It was like being surrounded and squeezed and shouted at by a million people all at once, just to try to listen to my lunch options. Holy...! You have described my current condition even better than I could. Interestingly, I just came back from a doctor who, after reviewing my blood tests(standard blood tests), said that there wasn't anything wrong with me and my issues were lack of exercise. Which may be true, but getting out of the bed currently IS an exercise for me. It is getting better though, two months after quitting my job - I can even enjoy Hacker News again. Since you've gone down this path, what would you suggest? I am having a hard time convincing any doctors to do a more complete examination. I was going to focus next on sleep disorders, but now I think it might be worth talking to an endocrinologist...