
What Your Brain Has to Say About Burnout
The Phenomenon of Burnout
People found it hard to believe when Jürgen Klopp, a highly accomplished football coach, publicly quit his job at Liverpool FC in early 2024. His explanation: 'I am running out of energy'.
Despite many success stories he had accomplished for the club, he felt so worn out that he believed he could no longer perform as well as his fans expected.
His reasoning was simple. Just like a car that eventually runs out of fuel, it was the right moment for him to take a break before his own tank ran empty. So, he pulled the plug.
This was unexpected for many, but it was also seen as admirable for openly sharing his state of mind with the public.
He is not the only one
Many public figures, including athletes — Olympic champion Simone Biles, tennis star Naomi Osaka, and former cyclist Jan Ullrich — actors — Sandra Bullock and Emma Watson — celebrated musicians — Rihanna, Lady Gaga, Beyoncé, and Kanye West — and politicians — such as New Zealand’s former Prime Minister Jacinda Ardern, have also resigned or taken a break for the very same reasons.
They were open about their struggles with exhaustion and a lack of energy, which made it challenging to meet both their own expectations and those of the public.
It can get worse
While Klopp stepped away in time, others ignored their growing exhaustion or could not bring themselves to quit. They pushed on until they completely ran out of energy, and their body eventually forced them to stop.
In this state of complete resignation, individuals have no energy or motivation left to change their situation.
This recently happened to former German Chancellor Schröder, who had to be hospitalized due to severe exhaustion. He also experienced other symptoms that often occur, such as memory and concentration problems, as well as sleep disturbances.
What is burnout?
Doctors refer to his situation as ‘burnout’, a condition the World Health Organization defines as a state of energy depletion or exhaustion [1]. In Sweden, doctors use their own term, aptly named 'exhaustion syndrome’ [2].
This lack of energy can happen to anyone, making it much harder to function at work or at home, which can be upsetting for both employers and family alike.
It can also lead to a cynical attitude toward work and other people, making the person suffering from burnout seem unhappy and pessimistic.
Thousands of years of history
The word "burnout" has been used since the 1970s when psychologist Herbert Freudenberger noticed that volunteers caring for people with drug addictions in New York were emotionally exhausted, unmotivated, and distant from their patients. They became more detached and cynical [3].
Freudenberger’s definition of burnout reflected the situation at the time. Doctors, nurses, and other healthcare workers were increasingly frustrated because they wanted to help people, but healthcare was being run more like a business. They were pressured to spend less time with each patient and to see as many patients as possible. Patients also became more demanding, and respect and gratitude declined.
Although burnout was first described in healthcare workers, it was soon recognized in many other professions.
Yet, even 100 years before Freudenberger, life circumstances at that time led to symptoms similar to what we now call burnout. During the Industrial Revolution, life changed quickly, and people felt great pressure to adapt.
The American doctor, George Miller Beard, noticed that more and more people were mentally and physically exhausted. He thought their brains were struggling with the accelerating pace of life, especially in jobs that required a lot of thinking. He called this condition "neurasthenia," meaning weakness of the nerves [3]. Symptoms included low energy, tiredness, sleep problems, anxiety, and physical complaints like stomach pain and heart palpitations.
Already over 1,000 years before Beard, Christian monks living in isolation and following monotonous routines experienced a state similar to burnout. Life in monasteries led them to a point where they could no longer fulfill their work duties or pray. The term used during the Middle Ages for this condition was acedia, which means a lack of care and motivation, essentially an inability to make any effort.
Concerned about the monks' productivity in work and prayer, theologians classified this state as one of the seven deadly sins, hoping that this would encourage moral change and alleviate the symptoms [4].
Nearly 1500 years before acedia was described, the biblical prophet Elijah went through something like burnout. After winning many victories for his God, he felt mentally and emotionally drained. When his enemies threatened revenge, he became overwhelmed with fear and despair. He withdrew from the world and his friends, isolating himself in the wilderness.
His story shows two key signs of burnout: losing control over emotions and wanting to stay away from others.
The "Great Exhaustion"
Fast forward to today, burnout is on the rise again due to ever-changing circumstances. More than ever, people feel the need to succeed, achieve, and find meaning, especially through their work.
Yet these days, working hard no longer guarantees financial security, adding to constant money worries, which further increases pressure.
The pressure does not end at work. Burnout is also fueled by challenges at home, where the expectation to be the perfect partner and parent is driven by high standards set by both the individual and society at large.
This ideal begins to fall apart when divorce happens or when a child gets seriously sick, forcing parents to rethink their lives. Some parents can relate to "parental burnout," where taking care of children every day leads to a state of constant exhaustion [5].
Life feels like a never-ending race in our 'don't have enough time' culture. Schedules are packed, and everything must be planned to get as much done as possible. There is little time to rest and relax.
On top of this relentless pressure, rapid technological progress, the internet, and social media have created even more demands, raising expectations of a permanent online presence.
Just like during the Industrial Revolution, people are under immense pressure to adapt to the fast pace of change.
Now, AI is advancing rapidly and may change lives drastically. The urge to keep up is growing. Either you learn to use AI to stay employed or risk being replaced by someone who does. There is growing fear that if you cannot keep up, you may be left behind in the AI revolution.
Not surprisingly, the number of people reporting burnout symptoms is rising worldwide. Studies report that often more than 50% of employees are at risk of burnout. Some even call our time the "Great Exhaustion”.
When you lose control
More and more people today, just like in the past, are experiencing burnout due to constant and overwhelming pressure, whether at work or at home.
Since the mid-20th century, thanks to Hans Selye's research, scientists have called this pressure to adapt "stress”, a word that is now commonly used by everyone [6].
However, stress alone does not fully explain burnout. It is only part of the explanation. First, stress can be useful because it prepares your body and mind to handle challenges. It gives you energy, motivates you, and helps you stay focused on reaching your goals.
What is it about stress then that pushes us toward burnout?
What matters most is whether you feel in control of a stressful situation. This sense of feeling in control determines whether stress will boost you or, if you feel out of control, wear you out.
Ask yourself these questions when faced with a difficult situation or problem:
- Do you feel in charge of the situation, and can you guess what will happen next?
- Are you able to come up with a plan or think of ways to solve the problem?
- Do you know someone you trust who understands and can help you plan?
- Are you able to decide when to take a break and rest, if you feel that it is needed?
If you answer "yes" to these questions, you will likely stay in control of the situation, and stress will work in your favor.
On the other hand, if your answer is no, you may feel overwhelmed by your responsibilities and powerless to address them, at the mercy of your surroundings, unsure of what will happen next, unable to come up with a plan, and lacking someone trustworthy to help. In this situation, stress can get out of control and quickly reach unhealthy levels.
Stress, stress, stress
This can easily happen in the workplace [7]. You might be given a task you are not trained for, so you have a hard time coming up with a plan to complete it.
Or you could get overloaded with too many tasks, and you cannot keep track of how to finish them on time and with the required quality. This may also lead you to work extra hours with less time to rest.
Sometimes, the task itself is unclear because your boss is confused or does not communicate well, which makes it hard to figure out how to approach the task.
When a task requires a team effort, not feeling part of the team, poor communication between team members, and inability to trust or rely on your colleagues can cause stress.
If the task and its goal are not personally meaningful to you (you are only doing it for your boss or employer), you may depend on positive feedback, appreciation, and gratitude from those for whom you complete the task to feel rewarded and valued. If management fails to show enough appreciation or recognize the value of your work, it can lead to stress and drain your energy and motivation.
If your boss is unfriendly, unfair, or outright disrespectful, and you feel there is nothing you can do about it, stress increases.
Sometimes, there can be a large gap between what employers value at work and your personal values. For example, a doctor who wants to help patients but is limited to only 5-10 minutes per patient because the management focuses on seeing as many patients as possible can lead to stress.
Apart from external origins of stress from bosses or colleagues, your own internal ambition and dedication can get out of control.
A strong work ethic and high ideals, especially among healthcare professionals, can lead to a deep emotional investment in your work, clients, or patients.
This can cause you to put yourself under constant stress, work long hours, and even take work home, leading to blurred boundaries between work and personal life, especially when you are the manager or boss.
Surprisingly, the other extreme can also cause high stress. This happens when the job is not interesting enough, the tasks are too easy for your training, the work is boring without enough responsibility, you do not learn anything new, and you do not see personal growth in the future. This version of burnout is called 'boreout' [8].
What never-ending stress feels like
When these work stresses continue without being managed, and life at home does not provide much relief, even the most resilient and stress-resistant people start to feel exhausted and head down a dead-end road. This road is usually long and ultimately stops at burnout [9].
It starts with concentration and memory problems (forgetting what you wanted to do just moments ago), making it harder to be as productive as before.
You begin to slow down, and planning your work for the day becomes more difficult.
Once simple problems become harder to solve and creativity fades.
Constant fatigue sets in, and your mind feels clouded. You may struggle to make decisions, you might start asking others to make decisions for you, and you begin to feel ineffective at work.
When this happens, instead of identifying the root cause of the stress, you may blame yourself. You feel you have not worked hard enough and believe you need to increase your workload to make up for the nagging feeling of reduced productivity, which only makes things worse.
The first warning sign that something might be wrong is when you go on vacation or try to relax, but you just are not able to calm down and rest. You continue to feel agitated, tense, and stressed, even during your time off [9].
On the emotional rollercoaster
Then, loved ones and friends start to notice.
Even the calmest people suddenly become more emotional and react more strongly than usual or overreact [9]. The inner tension caused by prolonged stress shows itself as irritability towards others. Conflicts with loved ones and coworkers are inevitable, which only increases stress further.
These conflicts are worsened by another problem that starts to emerge: a loss of empathy. You can no longer put yourself in others' shoes. The interaction with others becomes more rigid and less flexible.
As you continue being stressed, irritability and difficulty controlling emotions start affecting your workplace performance.
You start to feel anxious and fear the future. This anxiety further undermines your ability to work effectively and can also extend to interactions with others. You may begin to avoid people and feel the urge to withdraw with dreams of escaping to a remote, isolated place. However, isolating yourself only worsens your stress, as it cuts you off from the support of others.
The emotional distance comes with further costs for professional performance. Clients and patients may sense your lack of enthusiasm, empathy, and emotional disconnection from yourself and others around you. This may come across as being nonprofessional with potential consequences for you and the employer.
There can be even more drastic emotional changes [9]. You may start feeling paranoid or overly suspicious. You lose your sense of self, feel disconnected and alienated from yourself, and may even feel like you're observing yourself from the outside. This is called depersonalization. Derealization may also occur, making the world around you feel strange or unreal.
Your body and sleep revolt
Amid this emotional turmoil, with declining thinking and concentration, the effects of stress on your body build up.
You may experience heart palpitations, tense muscles, digestive problems, headaches, and frequent illnesses like viral infections due to a weakened immune system. Your energy levels drop, and your libido decreases [9].
These are all warning signs, but you may have a habit of not listening to yourself or your body. As a result, you fail to recognize the signs correctly, do not complain, and do not reach out for support.
Another core problem that regularly develops with constant stress is sleep difficulties. The quality of sleep decreases, you get less sleep and wake up frequently during the night. You feel sleepy during the day, and the lack of restful sleep makes it harder to recover from the impact of stress on your emotions, memory, and thinking ability.
The situation becomes critical
At this stage, you may feel so drained that even putting in a small amount of effort to start a new task makes you feel exhausted quickly.
You begin to avoid activities that require effort and go on autopilot, doing things that can be done automatically without much thought.
You feel physically tired and avoid sports or leisure activities that take up too much energy [9].
If it gets worse, alcohol or even drugs may be your choice to cope [10]. Another common way you may try to relax is by overeating, often choosing unhealthy and fatty foods that quickly create a temporary feeling of well-being.
When the fire's out!
Chronic stress can feel like a never-ending cycle. It affects your emotions, thoughts, and behavior, which in turn creates even more stress and problems. So, it is not surprising that at some point, everything falls apart and you completely collapse.
Sometimes, even a small stressful event like getting sick can push you over the edge and lead to a state of utter exhaustion.
You feel completely defeated and surrender with a deep sense of resignation. Even the smallest effort feels overwhelming, and you lose all motivation to do anything [9].
Nothing seems to matter anymore, and you find yourself thinking, "I just don’t care anymore". Since you have no mental energy left to do anything meaningful, you feel helpless, as if you have completely lost control of your life. You might even start to wonder if life has any meaning at all.
This is the stage where you might end up in the hospital, and doctors diagnose you with burnout.
Isn't it just depression?
If this final stage, the actual burnout, looks like depression to you, you are not wrong. Freudenberger himself noted the similarities between depression and his newly defined concept of burnout.
Some have even assumed that burnout is simply an occupational form of depression caused by long-term struggles at work.
Researchers are still trying to understand how burnout is connected to the various forms of major depression [11].
How would you even know?
To diagnose burnout, professionals use a short test with several questions developed by California researcher Maslach in the 1980s, known as the Maslach Burnout Inventory [12].
The test includes 22 questions that assess emotional exhaustion, depersonalization, and professional accomplishment (how successful and competent you feel).
While taking it as a self-test is popular, high scores do not always mean you have burnout. It is important to be cautious, as a current stressful period at work can also lead to high scores.
Burnout, however, takes much longer to develop with a long history of chronic stress. In a short-term stress episode, you can usually pinpoint the cause. With chronic stress, however, it is much harder to identify a specific origin [9].
Burnout and the Brain
Beyond time: the stressed-out brain
Times change, and so do the conditions that lead to extreme exhaustion. The names for this state have changed over time, from acedia to neurasthenia and now burnout.
But one thing has stayed the same: the way our brain reacts to constant pressure and long-term stress.
Burnout might feel like a candle inside you slowly burns down until all the wax is gone and the flame goes out.
However, in the brain, burnout resembles an overcharged electrical circuit that overheats, causing the wires to melt, leading to damage and gradual malfunction.
When your brain is under intense stress, it reacts like a circuit breaker in a house [13]. If there is a problem with your electrical devices, the breaker flips off, cutting power and turning off all the lights. In the same way, when stress becomes too much, the brain temporarily shuts down certain circuits to protect itself.
If the stress is short-term and managed well, the circuit breaker flips back on, and everything returns to normal.
But with long-term stress, this circuit breaker cannot be flipped back anymore. Instead, brain connections start to break down, similar to wires melting in an overheated electric circuit [14].
These brain circuits stop working properly, causing long-lasting problems with thinking, memory, motivation, pleasure, and emotions. Even when the stress is gone, repairing the broken brain circuits takes time and does not happen overnight.
The part of the brain most affected by stress is the forebrain, located just behind your forehead. It is home to many abilities that make us uniquely human [15].
Your brain likes relaxation
When you are relaxed, your forebrain helps you think through problems, focus without getting distracted, remember things for a short time, be creative, plan for the future, and make decisions.
It also allows you to stay motivated to reach your goals and controls emotions like anger and fear.
It enables you to be careful with what you say and do, avoid bad behavior at work or home, and be social and empathetic.
Healthy stimulation or mild stress can improve these abilities even more.
Your forebrain's biggest enemy
What happens when a situation gets more serious or a task turns out to be harder than expected, and stress becomes stronger?
The brain shifts gears and sees the situation as a possible threat that needs quick action to avoid potential danger. Its first response may seem surprising: it turns off our shiny forebrain, along with all its impressive functions [16].
How would this protect us from danger?
Despite its great abilities, the forebrain works slowly and can make mistakes. Your brain evolved in a time when dangerous animals could be hiding behind every bush, ready to attack. In that moment, there would just not be enough time to be creative, plan, or think things through. If you relied on the abilities of your slow forebrain, you might not have survived, the animal would have been faster.
Instead, your brain switches to a faster way of reacting and dealing with the threat.
Deep inside your brain, there are fallback circuits that make you act quickly without thinking in case of imminent danger. One of these circuits is the striatum. It helps you switch from thinking and planning to using actions you have practiced many times and can do automatically [17].
Another circuit deep in the brain, the amygdala, manages your emotions and helps you react fast. Anger prepares you to fight, fear tells you to run away, and sometimes you freeze and do nothing, hoping the animal does not see you and the danger will pass.
The amygdala also activates the brain's alarm system, making you feel highly alert during stress.
It helps you recall past stressful experiences and how you dealt with them, which supports the striatum in selecting the most appropriate automatic response [18].
At the same time, your body prepares for action. Your heart rate increases, digestion slows down to save energy, and your muscles tighten. This is why you feel tense in stressful situations.
In contrast to the fight and flight reaction, when you freeze, your heart rate slows down, and you might start breathing more slowly as well [19].
Who is running the show?
At this point, the forebrain has handed over control to its deeper brain regions and is relying on well-learned strategies or emotions.
However, the handover is not complete. The forebrain keeps a backdoor open and continues working on a solution.
When a solution is found, and the forebrain determines it can handle the threat on its own, or with some help from others, or even better, reassesses the situation (realizing the "threat" was just a little mouse and not dangerous), it deactivates the survival mode and takes back control again.
This is also the moment when you start to feel in control of the situation, knowing you can manage it. Stress levels begin to drop and eventually return to a level where the forebrain functions at its best.
You can focus again on other tasks where you are given enough time to benefit from the slower skills of the forebrain, without needing to act quickly or under pressure.
Circuit breakers of the brain
When your brain switches from a relaxed, forebrain-dominated state with deliberate thinking to a more reactive state where the deeper brain takes over, it relies on chemicals produced both inside and outside the brain [13].
Dopamine and noradrenaline are two stress-related chemicals produced in small areas at the bottom of the brain. In low doses, they stimulate the forebrain and help with focus and thinking.
But as stress increases, more of these chemicals are released. If stress becomes intense and the level of these chemicals becomes too high, the brain quickly switches off the forebrain and activates deeper brain structures instead.
The stressed brain also triggers the release of stress hormones, like cortisol, which are not produced in your brain directly but on top of your kidneys. These hormones enhance the effects of dopamine and noradrenaline, assisting in either stimulating or shutting off the forebrain, depending on their concentration.
Cortisol also helps form a memory of the stressful event in a part of the brain called the hippocampus, which is located in the middle of the brain and is responsible for creating long-term memories [20].
Additionally, women experience a unique effect. The female hormone estrogen boosts the effects of dopamine and noradrenaline. This may make women feel the impact of stress more quickly than men [21].
Your forebrain melts down
If no solution is found for pressing problems, and more issues arise that the brain cannot control, the stage is set for burnout.
Normally, the rising cortisol levels during stress signal the brain to turn off the stress response, bring cortisol back to normal, and activate the forebrain to take control and solve the problem by thinking [22].
However, if the threat never goes away, this natural reduction in stress hormones does not happen [23]. As a result, the body and brain stay under constant stress, making it difficult to relax even when trying to.
Glutamate, another chemical that is essential for nerve cells to communicate with each other, also increases. Too much of it is toxic and can harm the brain [18].
In addition, stress activates the brain's immune system to prepare for a possible injury [18], which causes inflammation and further reduces forebrain function [23].
All these chemical changes from chronic stress have wide-ranging effects.
In the hippocampus, it stops new brain cells from growing and makes it harder for brain connections to change, which causes problems with learning and remembering something new [20].
In the forebrain, the small connections between nerve cells, which are essential for the powerful abilities of the forebrain, begin to 'melt' and gradually disappear [14].
In the survival system deep in the brain, the opposite occurs [15]. The connections between nerve cells in the amygdala become stronger, especially in women [24], which might help explain why women are more likely to develop burnout [25].
The high amygdala activation makes you feel anxious and brings back stressful, negative memories. You start to focus only on the negative aspects about yourself and your relationships with others [18].
The brain starts to see danger even when there is none. It prefers to be overly cautious and spot a threat that does not exist rather than miss one that could be dangerous.
Moreover, high cortisol affects your sleep. It makes deep, restful sleep shorter and increases lighter sleep with more dreaming. You do not have time to sleep when you are facing a threat. This can cause you to wake up early and have trouble falling back asleep [18]. That is because when you are in danger, your brain tries to stay awake as long as possible.
While the circuit breaker initially shuts down the forebrain temporarily during acute stress, with the option to turn it back on quickly, prolonged exposure to stress causes actual brain connections to change. This sets the brain more permanently in survival mode.
As the forebrain loses its function during both acute and chronic stress, you start to experience the typical symptoms of burnout.
You may have trouble thinking clearly, have difficulties with planning, get easily distracted, struggle with concentration, forget things, and become less creative. You also lose control over your emotions, becoming more emotionally reactive, fearful, or prone to angry reactions.
Bye-bye effort
Chronic stress and reduced forebrain function also affect your motivation and ability to make an effort.
The forebrain helps create the drive to get things done, stress can weaken that drive and make it harder to stay motivated. The more tired you are, the less energy and motivation you naturally have to exert yourself [26].
However, in the beginning, you can still manage to push through the tiredness by staying motivated. You continue putting in effort if you are focused on a reward, like impressing your boss or getting a financial bonus. You keep going, even when you start to make mistakes.
The problem with this approach is that chronic stress damages parts of the forebrain that are important for motivation, together with a deep brain structure called the nucleus accumbens [27]. This part of the brain is essential for creating the drive to take action and for feeling pleasure when you get the reward you were aiming for.
The longer the stress continues, the less joy and satisfaction you feel, even from activities you used to enjoy.
When you are burned out, you cannot use motivation to keep up your performance anymore because you are too exhausted, and your weakened brain cannot produce enough drive to compensate for the tiredness.
The mystery of fatigue
What researchers are still struggling to understand is where mental fatigue originates in the brain. What exactly in the brain tells you how much mental energy you have left?
One simple idea that has been considered is that the brain might lack essential ingredients needed to function properly.
One potential candidate for this 'fuel' is glucose, a type of sugar that the brain uses as an energy source for its nerve cells. According to this theory, low glucose levels would lead to feelings of fatigue and a lack of energy. However, there is limited scientific evidence to support this idea [28].
Another new idea comes from studies showing that doing hard mental tasks for a few hours increases glutamate, a chemical that nerve cells in the brain need to communicate with each other [29]. This chemical is also released more when you are stressed [30].
The proposal is that when there is too much glutamate in the brain, it signals tiredness, telling you to rest so the brain can clear the extra glutamate and can make you feel fresher again [28].
Chronic stress leads to increased glutamate levels in the forebrain [18]. That is because when you work on a task, your stress system is more strongly activated than usual, leading to increased glutamate release and greater activation of brain areas [31]. This may explain why people with burnout get tired much faster when doing tasks.
A third theory is that when you are tired, you simply do not have enough brain chemicals left to produce a proper stress response and activate your forebrain enough to perform a task. When you are under constant stress, dopamine levels start to drop and remain low all the time [32]. This reduces forebrain activity needed for good performance and may explain the enduring feeling of tiredness during burnout [26].
Dopamine is also important for the nucleus accumbens to work properly, which helps you stay motivated and feel pleasure. When dopamine is low during chronic stress, motivation and enjoyment drop too [27].
Stress can also get tired
While burnout can appear as a nonstop stress response with high levels of cortisol, it can also lead to low cortisol levels [33].
In this case, the stress system becomes weaker and does not react as strongly as it usually does. This may happen because the stress system becomes exhausted. When stress lasts too long and is too intense, the body may lower its cortisol levels below normal [34].
Low cortisol can cause severe tiredness, as seen in Addison's disease, where the glands on top of the kidneys stop making enough cortisol [35], or in chronic fatigue syndrome [36]. Low cortisol levels have also been linked to long COVID [37].
Since cortisol helps dopamine activate the forebrain, not having enough of it can lead to poor brain activation below the optimal level and deep fatigue.
Avoiding stress at all costs
Some people become so overwhelmed by intense stress that they shut down their stress response to stay calm [38]. Their forebrain becomes highly active and strongly suppresses the amygdala. At the same time, activity in the insula — a brain area that helps you feel your body and emotions — decreases [39].
While this might feel helpful in the short term, it comes at a cost, especially if you keep avoiding stress completely.
Suppressing all stress makes it harder to create the energy and focus needed to solve problems and get things done.
It also cuts you off from your emotions, making it harder to feel like yourself. You feel numb and disconnected from yourself and others, which can make you detach from loved ones, clients, coworkers, or work in general.
This emotional detachment, or depersonalization, is a core symptom of burnout [7]. Your surroundings might even feel strange or unreal, an experience called derealization.
In addition, not being aware of your feelings can make you miss important signals from your body, for example, when you are too tired or need to eat.
Your body pays the price
While your forebrain takes a severe hit from constant stress, your whole body also gets strained by the high cortisol levels, leading to potentially serious consequences.
You may feel muscle pain, headaches, and chronic constipation, which seem like milder issues.
However, high blood pressure, heart attacks, strokes, osteoporosis, and diabetes can become more serious health concerns [18].
What Can You Do About Burnout?
Turning around
Can the brain changes be undone?
Researchers say yes, connections can regrow if chronic stress is properly managed [15].
But it takes time. A good night’s sleep or a vacation will not be enough. It took a while for the brain's structure to change, and it unfortunately also takes time to undo those changes.
The more severe the changes, the longer it takes to recover. While motivation and energy can return relatively quickly, within weeks or months, issues with thinking, memory, and concentration can take much longer to recover from, sometimes even years [9].
So, what can you do?
To handle the chronic stress reaction in your brain, it is important to break the vicious cycle of stress and coping.
In general, the more stress you experience, the harder it becomes to cope (being in survival mode only helps you with problems you already know how to solve), and the less you manage, the more stress you build up.
You can break the burnout cycle in two ways: by reducing stress and by improving your coping strategies to stay in control when stress comes up.
When you are in burnout, the first thing to do, if possible, is to drastically cut down on stress at home and work. You might take sick leave or ask for help with household responsibilities. It is time to rest.
In cases of severe burnout, it is not recommended to make major life changes like switching jobs or moving homes. These changes can add extra stress and get in the way of your recovery [9].
Self-care
Aside from stepping away from stressful tasks and activities at first, the next important step is self-care.
This starts with making lifestyle changes that are generally known to reduce stress.
Your self-care journey might start with trying to eat healthier.
When you are stressed, it is natural to crave sugary and fatty foods. However, these foods, which are a big part of the typical Western diet, can raise your stress levels and reduce your forebrain and hippocampus functioning [40, 41], even if you are not dealing with any stressful tasks at the moment. Eating less fat and sugar can help you recover from burnout.
Another effective way to help a stressed brain is exercise.
Regular exercise releases chemicals in the brain that help rebuild connections in your forebrain and stimulate the growth of new nerve cells in the hippocampus [42]. This can help undo the brain changes caused by stress and also act as a preventive measure.
Exercising outdoors can be even more beneficial, as being around nature, especially green spaces, reduces stress and improves the functioning of your forebrain [43].
In burnout, you may feel like isolating yourself and avoiding others. However, talking to someone about what you are going through can be very helpful for your brain.
Positive conversations with a trusted partner, friend, colleague, or manager can release a hormone in your brain called oxytocin. Oxytocin directly impacts the function of your forebrain and helps reduce the stress response [44]. It also makes it easier for you to connect with others and find support.
Burnout often causes sleep disturbances, so it is important to focus on improving sleep hygiene. This includes avoiding screens before bed, keeping a consistent sleep schedule, and aiming for 6-8 hours of sleep each night. These simple changes can help you get better rest and support your recovery from burnout.
Another way to reduce the stress response and cortisol levels is through meditation and mindfulness training. These practices can help lower cortisol [45]. They also make you more aware of your body, allowing you to recognize signs of stress, like feeling tense, tired, or hungry, and take action instead of ignoring them.
When you are in full burnout, you might not have the energy or resources to make these changes on your own.
For example, finding the energy to start exercising can be hard, since mental fatigue influences your physical performance [46]. You may have gotten into a habit of eating unhealthy food, which can be very addictive [47].
Thus, it can be helpful to have a coach or therapist to guide you through the initial stages of recovery. They can provide support, help you plan, and assist in implementing small changes, making the process less overwhelming.
Workplace-interventions
The problem with a self-care-only approach is that it can only help so much if the root cause of overwhelming stress at work is not addressed.
Self-care alone might be effective for someone who is an ambitious overachiever and has neglected their well-being for a long time.
However, in many cases, a problematic work environment is the cause of burnout. If employees feel that it is solely their responsibility to recover from burnout by taking better care of themselves, they may feel blamed and resentful.
Research shows that changes in the workplace have a much stronger and longer-lasting effect on preventing burnout or its relapse than self-care measures alone [48]. The best approach is to address both.
Research suggests some recommendations for companies and managers on how to run a workplace that boosts productivity, supports employee well-being, and reduces the risk of burnout [48].
One important factor is enhancing employees' sense of control over their own work. This reduces the feeling of losing control, which is at the core of overwhelming stress that can eventually lead to burnout.
When employees have a say in the tasks they do and how many they take on, and when tasks match their skill level — challenging but not too difficult or too easy — they feel better.
Task variety helps maintain motivation and avoids the stress of monotony.
Offering opportunities for personal growth and learning new skills also supports overall well-being.
Another protective factor is having managers who maintain good relationships with employees, being empathetic and understanding. Most importantly, managers should make employees feel that their work is valued and appreciated.
Giving employees the chance to talk about their situation with managers and colleagues (since others in the company might also be experiencing burnout due to similar work issues) releases oxytocin in the brain, which builds trust, encourages collaboration, and helps reduce stress.
It is also helpful to accommodate employees’ needs to reduce stress, such as offering more time off when needed, providing flexible work hours to balance work with family, and allowing more opportunities for working from home.
Another way to promote employee well-being is to involve them in decision-making and gather feedback. Allowing employees to share their ideas and opinions about the company's direction and strategy, and adjusting the strategy based on their needs and work experience, can make them feel more valued and engaged.
All these workplace strategies help employees feel in control, build trust, and reduce stress. This helps the brain work at its best, which in turn increases productivity for the company.
If these factors are missing at work, it may be helpful to talk to your manager, possibly together with your colleagues, to find ways to improve the situation.
If talking to your manager does not lead to any changes, you might want to think about changing jobs after you have recovered from burnout.
However, making such decisions can be tough, especially if it involves moving to a new location or taking a lower salary and social status, as these changes can bring stress again.
Change your thoughts
When stress comes from your own high expectations, ambitions, and attitude towards work, it is important, in addition to self-care, to reflect on how your thinking might be adding to your stress.
Try to set more realistic goals, reduce perfectionism, and change a habit of avoiding conflict. Also, take time to reflect on what matters in life and shift your values — work is not everything.
A therapist can help you with this personal growth, and cognitive behavioural therapy (CBT) can be effective in boosting your well-being at work and in general [49].
No end in sight
In severe cases, you may feel like life has lost all meaning, everything is pointless, and you see no way out. You may even start to have suicidal thoughts.
In this case, it is essential to seek professional help as soon as possible. Consulting a family doctor, psychologist, or psychiatrist is crucial, as they can offer the support needed.
In this situation, medication, such as antidepressants, is also available to help you and your brain recover more quickly and get you back on your feet [50].
Beware of relapse
It is very important to put these measures in place to reduce stress and ensure they are sustainable.
If these measures are not taken consistently, a relapse into burnout is highly likely.
Alarmingly, a staggering 50% of individuals or more experience burnout again within a few years after the first episode [9].
Your brain will thank you
Burnout is a serious condition.
For some, it may seem like a badge of honor. They have worked so much that they have pushed themselves to complete exhaustion.
Others live and work in an environment where it feels like there is no escape from constant pressure.
Ultimately, the reality is that chronic stress leads to brain damage with a decline in mental, emotional, and social skills, which harms you, your family, and your employer. You can no longer fulfill your personal and professional roles as you would wish.
That is why it is important for everyone, whether you are an employee or a boss, to be aware of how constant stress at work affects you and your brain, and to take action to improve the situation.
Your brain will thank you for it.
References
1. International Classification of Diseases, Eleventh Revision (ICD-11), World Health Organization (WHO). Published online 2019.
2. Lindsäter E, Svärdman F, Wallert J, et al. Exhaustion disorder: scoping review of research on a recently introduced stress-related diagnosis. BJPsych Open. 2022;8(5):e159.
3. Schaufeli WB. Burnout: A Short Socio-Cultural History. Burnout, Fatigue, Exhaustion: An Interdisciplinary Perspective on a Modern Affliction. Published online July 1, 2017:105-127.
4. Bartlett SJ. Acedia: The etiology of work-engendered depression. New Ideas Psychol. 1990;8(3):389-396.
5. Mikolajczak M, Gross JJ, Roskam I. Beyond Job Burnout: Parental Burnout! Trends Cogn Sci. 2021;25(5):333-336.
6. Viner R. Putting Stress in Life: Hans Selye and the Making of Stress Theory. Soc Stud Sci. 1999;29(3):391-410.
7. Edú‐valsania S, Laguía A, Moriano JA. Burnout: A Review of Theory and Measurement. Int J Environ Res Public Health. 2022;19(3).
8. Rothlin Philippe, Werder PR. Boreout! : Overcoming Workplace Demotivation. Kogan Page; 2008.
9. van Dam A. A clinical perspective on burnout: diagnosis, classification, and treatment of clinical burnout. European Journal of Work and Organizational Psychology. 2021;30(5):732-741.
10. Jackson ER, Shanafelt TD, Hasan O, Satele D V., Dyrbye LN. Burnout and alcohol abuse/dependence among U.S. Medical Students. Academic Medicine. 2016;91(9):1251-1256.
11. Bianchi R, Schonfeld IS, Laurent E. Burnout-depression overlap: A review. Clin Psychol Rev. 2015;36:28-41.
12. Maslach C, Jackson SE. The measurement of experienced burnout. J Organ Behav. 1981;2(2):99-113.
13. Arnsten AFT. Stress signalling pathways that impair prefrontal cortex structure and function. Nature Reviews Neuroscience 2009 10:6. 2009;10(6):410-422.
14. Woo E, Sansing LH, Arnsten AFT, Datta D. Chronic Stress Weakens Connectivity in the Prefrontal Cortex: Architectural and Molecular Changes. Chronic Stress. 2021;5.
15. Arnsten AFT, Shanafelt T. Physician Distress and Burnout: The Neurobiological Perspective. Mayo Clin Proc. 2021;96(3):763-769.
16. Joyce MKP, Uchendu S, Arnsten AFT. Stress and Inflammation Target Dorsolateral Prefrontal Cortex Function: Neural Mechanisms Underlying Weakened Cognitive Control. Biol Psychiatry. 2024;97(4):359-371.
17. Vogel S, Klumpers F, Schröder TN, et al. Stress Induces a Shift Towards Striatum-Dependent Stimulus-Response Learning via the Mineralocorticoid Receptor. Neuropsychopharmacology. 2016;42(6):1262.
18. Gold PW. The organization of the stress system and its dysregulation in depressive illness. Mol Psychiatry. 2015;20(1):32-47.
19. Roelofs K, Dayan P. Freezing revisited: coordinated autonomic and central optimization of threat coping. Nature Reviews Neuroscience 2022 23:9. 2022;23(9):568-580.
20. de Kloet ER, Joëls M. The cortisol switch between vulnerability and resilience. Molecular Psychiatry 2023 29:1. 2023;29(1):20-34.
21. Shansky RM, Glavis-Bloom C, Lerman D, et al. Estrogen mediates sex differences in stress-induced prefrontal cortex dysfunction. Molecular Psychiatry 2004 9:5. 2003;9(5):531-538.
22. Hermans EJ, Henckens MJAG, Joëls M, Fernández G. Dynamic adaptation of large-scale brain networks in response to acute stressors. Trends Neurosci. 2014;37(6):304-314.
23. Girotti M, Bulin SE, Carreno FR. Effects of chronic stress on cognitive function – From neurobiology to intervention. Neurobiol Stress. 2024;33:100670.
24. Savic I, Perski A, Osika W. MRI Shows that Exhaustion Syndrome Due to Chronic Occupational Stress is Associated with Partially Reversible Cerebral Changes. Cerebral Cortex. 2018;28(3):894-906.
25. Artz B, Kaya I, Kaya O. Gender role perspectives and job burnout. Rev Econ Househ. 2022;20(2):447-470.
26. Kok A. Cognitive control, motivation and fatigue: A cognitive neuroscience perspective. Brain Cogn. 2022;160.
27. Baik JH. Stress and the dopaminergic reward system. Experimental & Molecular Medicine 2020 52:12. 2020;52(12):1879-1890.
28. Pessiglione M, Blain B, Wiehler A, Naik S. Origins and consequences of cognitive fatigue. Trends Cogn Sci. Published online March 31, 2025.
29. Wiehler A, Branzoli F, Adanyeguh I, Mochel F, Pessiglione M. A neuro-metabolic account of why daylong cognitive work alters the control of economic decisions. Current Biology. 2022;32(16):3564-3575.e5.
30. Sanacora G, Yan Z, Popoli M. The stressed synapse 2.0: pathophysiological mechanisms in stress-related neuropsychiatric disorders. Nat Rev Neurosci. 2022;23(2):86-103.
31. Gavelin HM, Neely AS, Andersson M, Eskilsson T, Järvholm LS, Boraxbekk CJ. Neural activation in stress-related exhaustion: Cross-sectional observations and interventional effects. Psychiatry Res Neuroimaging. 2017;269:17-25.
32. Bloomfield MA, McCutcheon RA, Kempton M, Freeman TP, Howes O. The effects of psychosocial stress on dopaminergic function and the acute stress response. Elife. 2019;8.
33. Bayes A, Tavella G, Parker G. The biology of burnout: Causes and consequences. World Journal of Biological Psychiatry. 2021;22(9):686-698.
34. Fries E, Hesse J, Hellhammer J, Hellhammer DH. A new view on hypocortisolism. Psychoneuroendocrinology. 2005;30(10):1010-1016.
35. Munir S, Rodriguez BSQ, Waseem M. Addison Disease. StatPearls. Published online January 30, 2024.
36. Sapra A, Bhandari P. Chronic Fatigue Syndrome. StatPearls. Published online June 21, 2023.
37. Klein J, Wood J, Jaycox J, et al. Distinguishing features of long COVID identified through immune profiling. Nature. 2023;623(7985):139-148
38. Lee HS, Min D, Baik SY, Kwon A, Jin MJ, Lee SH. Association between Dissociative Symptoms and Morning Cortisol Levels in Patients with Post-traumatic Stress Disorder. Clinical Psychopharmacology and Neuroscience. 2022;20(2):292-299.
39. Krause-Utz A, Frost R, Winter D, Elzinga BM. Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder. Curr Psychiatry Rep. 2017;19(1):6.
40. Sal-Sarria S, López-Taboada I, González-Pardo H, Conejo NM. A shift to a standard diet after exposure to a high-fat, high-sucrose diet from gestation to weaning restores brain metabolism and behavioral flexibility in adult rats. Behavioural Brain Research. 2024;467:115020.
41. Gómez-Pinilla F. Brain foods: the effects of nutrients on brain function. Nat Rev Neurosci. 2008;9(7):568.
42. Ferrer-Uris B, Ramos MA, Busquets A, Angulo-Barroso R. Can exercise shape your brain? A review of aerobic exercise effects on cognitive function and neuro-physiological underpinning mechanisms. AIMS Neurosci. 2022;9(2):150.
43. Boere K, Lloyd K, Binsted G, Krigolson OE. Exercising is good for the brain but exercising outside is potentially better. Scientific Reports 2023 13:1. 2023;13(1):1-8.
44. Takayanagi Y, Onaka T. Roles of Oxytocin in Stress Responses, Allostasis and Resilience. Int J Mol Sci. 2021;23(1):150.
45. Hoge EA, Bui E, Palitz SA, et al. The Effect of Mindfulness Meditation Training on Biological Acute Stress Responses in Generalized Anxiety Disorder. Psychiatry Res. 2017;262:328.
46. Van Cutsem J, Marcora S, De Pauw K, Bailey S, Meeusen R, Roelands B. The Effects of Mental Fatigue on Physical Performance: A Systematic Review. Sports Medicine. 2017;47(8):1569-1588.
47. López-Taboada I, González-Pardo H, Conejo NM. Western Diet: Implications for Brain Function and Behavior. Front Psychol. 2020;11:564413.
48. Gabriel KP, Aguinis H. How to prevent and combat employee burnout and create healthier workplaces during crises and beyond. Bus Horiz. 2022;65(2):183-192.
49. Young P, Elgee A, Chow V, Haslam CO, Barker JB. A systematic review of cognitive behavioral and mindfulness-based interventions for white-collar worker mental well-being in business environments. Mental Health Science. 2024;2(4):e84.
50. Gold PW. Breaking through Depression : New Treatments and Discoveries for Healing. Allen Lane; 2023.
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