On the Road to Burnout: The Effects of Chronic Stress

We’ve all experienced the feeling when the week has already been grueling and it’s only Monday. By the time it’s Thursday or Friday, the only motivation we have left is that the weekend will soon arrive and bring a much-needed break from work and time to connect with friends and family. If that weekend break from the emotional and physical challenges presented by school or professional work is disrupted, whether it be by schoolwork that creeps into Saturday or nagging requests from your boss on Sunday, we are putting ourselves at risk of living in a constant state of stress. Living with this ongoing burden of stress — often called chronic stress — can take a severe toll on our mental and physical well-being.

Your Body on Chronic Stress

Chronic stress, or stress that persists for long periods of time, locks the body in a state of excitation and heightened awareness. The level of cortisol — one of the body’s primary stress hormones — in the blood remains high, immune suppression persists for long periods of time, and hippocampal volume in the brain decreases. Among other effects, cortisol also increases your heart rate and blood pressure, and interferes with proper digestion. Living in this state of constant stress, where the body remains vigilant and wary of threats, puts individuals at greater risk for developing a variety of mental and physical illnesses.

From a psychological standpoint, people living with chronic stress show increased risk-taking and decreased executive functioning. Similarly, chronic stress has been shown to affect cognitive functioning, with numerous research studies suggesting that chronic, early-life stress increases your risk of developing certain forms of mental illness, like depression and other mood or anxiety disorders. There is also evidence that chronic stress can rewire certain areas of the brain, changing the way neurons express genes and how neurons communicate with each other.

The most scary aspect of chronic stress, however, is its potential to have lasting effects on your body and your long-term health. It can increase your susceptibility to diabetes, ulcers, infections, and other physical illnesses. In periods of chronic stress, your metabolism changes and can severely impact how your body produces and consumes energy. These problems, sometimes minor on their own, can often compound and lead to complex interactions of multiple issues, all stemming from increased cortisol and living in this constant state of stress.

So what does this all mean?

Frankly, it’s inevitable that we will all encounter periods where everything just feels like it’s too much to handle. Moments will come when the demands of our personal, professional, or social lives are just too great to deal with at the same time and we can’t find even a single moment to step back and relax. For some, that may be a tough semester in school; for others, that could be a period of adjustment to a new job that is unexpectedly demanding. For many healthcare professionals, caring for patients infected with COVID-19 and dealing with the emotional effects of the current pandemic may be a period where constant stress is simply inevitable.

Whenever these moments come, now or in the future, it is important to take a step back, put things in a new perspective, and find ways to break what can be a devastating cycle of chronic stress. Mindfulness techniques, exercise, and spending time with loved ones have all proven to be effective ways to help disrupt these periods of constant stress and promote well-being. In order to avoid burnout, as a physician, student, or friend, we have to take care of ourselves and identify when we’ve reached this moment of prolonged stress. This will allow us to stop, recenter, and refocus our energies on our physical and mental well-being.

Everyone approaches their mental health differently and that’s perfectly okay — the important part is that we all take the time to prioritize our own mental well-being when it is in jeopardy. Whether that means picking up a new book, talking through feelings with a friend, or reaching out for professional support, each of us needs to keep our own well-being in perspective. No matter the obstacle or challenge, we must each find ways to keep our heads clear and bodies sound as we find ways to stay healthy.