In 2019, the World Health Organization (WHO) updated the International Classification of Diseases to expand the definition of burnout as an occupational phenomenon. (16) This phenomenon affects students (4) and professionals in any workplace, including healthcare professionals. (6) Workplace burnout has been estimated to affect nearly half of medical students, residents, and physicians in the U.S. (14)
Understanding burnout and the contributing factors may help to recognize and prevent it. Lifestyle interventions, such as physical activity, dietary supplements, mindfulness programs, cognitive behavioral therapy, and sleep hygiene may be beneficial for individuals experiencing occupational burnout.
What is burnout?
While burnout is not classified as a medical condition or diagnosis, it has been defined as a syndrome that results from unmanaged chronic stress in the workplace. The WHO specifies that this term does not include areas of life outside of one’s occupation. (15) Burnout is characterized by changes in mood and possible physiological changes, such as dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis. (8)
Individuals with burnout experience:
- Exhaustion or energy depletion
- Increased negative feelings, cynicism about one’s job, or mental distance from work
- Reduced efficacy in the workplace (15)
Medical literature has defined three “subtypes” commonly seen in burnout. These subtypes include:
- Classic burnout, where an individual has worked to the point of exhaustion
- Under-challenged, where the individual becomes negatively affected by monotonous work
- Worn-out, where the individual faces too much stress or too little gratification and stops putting in effort or lacks enthusiasm for their work (8)
Signs, symptoms, and complications of burnout
Burnout symptoms may vary in severity depending on the individual, and include:
- Difficulty concentrating
- Gastrointestinal disorders
- Increased pain sensitivity
- Increased susceptibility to infection
- Major depression
- Muscle tension
- Ongoing fatigue
- Sleep disturbances (8)
Burnout may increase the risk of coronary heart disease and myocardial infarction (heart attack). (8) Burnout may also be associated with substance abuse and an increased risk of suicidal thoughts. (4)
Causes and risk factors of burnout
Factors that are associated with employee burnout include a large workload, a high number of working hours per week, physical or verbal abuse in the workplace, a poor occupational culture, and a tendency not to seek help. Individuals working in “helping professions”, such as healthcare workers, may be at an increased risk for developing work burnout. Higher rates of burnout have been noted in several medical specialties, including emergency medicine, family medicine, and internal medicine. (6)
How to avoid burnout at work
Burnout prevention relies on the occupational setting or systems in place, as well as individual efforts. Workplace management should consider implementing mental health interventions, such as mindfulness-based programs, which have been shown to improve employee health and wellness, as well as work performance. (5) A meta-analysis of web-based mental health interventions found that digital programs were as effective as traditional programs at increasing work effectiveness and improving the wellbeing of employees. Digital mental health interventions may also provide the added benefits of increased anonymity and increased convenience or accessibility for employees. (2)
How to recover from burnout
While preventing burnout before it happens may be ideal, it’s not always possible. Take some time to consider whether you experience the above signs of burnout at work. To support your physical and mental wellbeing, consider these strategies for burnout recovery.
Physical activity for burnout
Research suggests that engaging in physical activity may improve psychological wellbeing in a workplace setting. One systematic review identified that yoga, walking, and other forms of exercise improved employee wellbeing when compared with no intervention. (1)
Dietary supplements for burnout
Several dietary supplements may help improve tolerance to stress in the workplace and manage symptoms and signs of burnout. For example, in a preliminary clinical study, an extract of Rhodiola rosea, an adaptogenic herb, was shown to improve several parameters of burnout in as little as one week of treatment. (9) Similarly, licorice (Glycyrrhiza glabra) root extract may help regulate levels of cortisol, commonly referred to as the “stress hormone”, particularly in individuals with low cortisol. (8)
A randomized clinical trial studied the effects of omega-3 fatty acid supplementation compared to a placebo in hospital nurses. The omega-3 intervention was associated with improved Hospital Anxiety and Depression Scale scores, depression severity, insomnia severity, and presenteeism, when an individual’s work quality is affected by a health condition. (13)
B complex vitamins, which contain a combination of the eight water-soluble B vitamins, may benefit individuals experiencing chronic work stress. A three-month, double-blind, randomized controlled trial found that supplementing with a B complex was associated with decreased confusion, personal strain, and low or dejected mood in relation to workplace stress. (12)
Mindfulness programs for burnout
A variety of mindfulness programs have been researched for their potential to reduce workplace stress and improve wellbeing.
One randomized clinical trial examined the effects of a nine-month intervention in which physicians participated in one-hour meetings during their working hours every two weeks. The group meetings involved physician-led discussions around self-reflection, mindfulness, and shared experiences, as well as learning in small groups, which was intended to build a sense of community among individuals. Physicians in the control group were instructed to take the same amount of time away from work and spend it how they felt would be most useful. The study found that physicians in the intervention group demonstrated greater improvements in empowerment, engagement, and meaning than the control group, with benefits lasting a year following the intervention. There were significant decreases in overall burnout, emotional burnout, and rates of depersonalization in the treatment group. (14)
Improvements have also been seen in shorter mindfulness interventions. In a ten-week randomized controlled trial in intern doctors during their emergency room rotation, the mindfulness training involved a combination of mindfulness education and common exercises, such as mindful eating. Participants in the treatment group saw greater improvements in workplace burnout and stress when compared to the control group. (6)
Cognitive behavior therapy for burnout
Cognitive behavior therapy (CBT) is a type of psychotherapy that encourages individuals to explore their thoughts, emotions, and behavior in order to identify and address negative thought patterns. The goal of the therapy is to improve mood and change the individual’s behaviors. (3) A systematic review of work burnout treatment found that, in the majority of studies, CBT improved emotional exhaustion. (10) Improvements in individuals with burnout may result from the subsequent improvements in sleep quality and increased perception of competence following CBT. (11)
Sleep hygiene for burnout
Research suggests that impaired sleep may be involved in burnout-associated fatigue. (8) Some of the above approaches, such as mindfulness programs and CBT, may also improve sleep. (5)(11) Additionally, improving your environment and sleep habits, known as sleep hygiene, may help to promote better sleep. Tips to improve sleep hygiene include:
- Limit caffeine intake (e.g., coffee, caffeinated tea, soda, chocolate) in the evenings, particularly if you are sensitive to caffeine
- Limit nicotine and alcohol intake, which may increase wakefulness throughout the night
- Reduce bedroom noise
- Maintain a regular sleep schedule
- Incorporate regular physical activity, which has been shown to improve sleep in individuals with or without sleep complaints (7)
For more information, read about natural insomnia treatments on the Fullscript blog.
The bottom line
Burnout syndrome results from unmanaged, chronic workplace stress. Burnout recovery or prevention may involve various lifestyle interventions, such as physical activity, dietary supplements, mindfulness, CBT, and sleep hygiene. We encourage you to advocate for yourself at your workplace. If you’re a patient, speak with your integrative healthcare practitioner for additional support or supplement recommendations.
Fullscript simplifies supplement dispensingCreate your dispensary today I'm a patient
- Abdin, S., Welch, R. K., Byron-Daniel, J., & Meyrick, J. (2018). The effectiveness of physical activity interventions in improving well-being across office-based workplace settings: A systematic review. Public Health, 160, 70–76.
- Carolan, S., Harris, P. R., & Cavanagh, K. (2017). Improving employee well-being and effectiveness: Systematic review and meta-analysis of web-based psychological interventions delivered in the workplace. Journal of Medical Internet Research, 19(7), e271.
- Cukor, D., Pencille, M., Rosenthal, D., & Kimmel, P. L. (2017). Psychosocial Issues in Dialysis Patients. In Handbook of Dialysis Therapy. Philadelphia, PA: Elsevier Inc.
- Ezenwaji, I. O., Eseadi, C., Ugwoke, S. C., Vita-Agundu, U. C., Edikpa, E., Okeke, F. C., … Agu, M. A. (2019). A group-focused rational emotive behavior coaching for management of academic burnout among undergraduate students: Implications for school administrators. Medicine, 98(30), e16352.
- Hilton, L. G., Marshall, N. J., Motala, A., Taylor, S. L., Miake-Lye, I. M., Baxi, S., … Hempel, S. (2019). Mindfulness meditation for workplace wellness: An evidence map. Work (Reading, Mass.), 63(2), 205–218.
- Ireland, M. J., Clough, B., Gill, K., Langan, F., Oconnor, A., & Spencer, L. (2017). A randomized controlled trial of mindfulness to reduce stress and burnout among intern medical practitioners. Medical Teacher, 39(4), 409–414.
- Irish, L. A., Kline, C. E., Gunn, H. E., Buysse, D. J., & Hall, M. H. (2015). The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Medicine Reviews, 22, 23–36.
- Kakiashvili, T., Leszek, J., & Rutkowski, K. (2013). The medical perspective on burnout. International Journal of Occupational Medicine and Environmental Health, 26(3).
- Kasper, S., & Dienel, A. (2017). Multicenter, open-label, exploratory clinical trial with Rhodiola rosea extract in patients suffering from burnout symptoms. Neuropsychiatric Disease and Treatment, 13, 889–898.
- Korczak, D., Wastian, M., & Schneider, M. (2012). Therapy of the burnout syndrome. GMS Health Technology Assessment, 8, Doc05.
- Santoft, F., Salomonsson, S., Hesser, H., Lindsäter, E., Ljótsson, B., Lekander, M., … Hedman-Lagerlöf, E. (2019). Mediators of change in cognitive behavior therapy for clinical burnout. Behavior Therapy, 50(3), 475–488.
- Stough, C., Scholey, A., Lloyd, J., Spong, J., Myers, S., & Downey, L. A. (2011). The effect of 90- day administration of a high dose vitamin B-complex on work stress. Human Psychopharmacology: Clinical and Experimental, 26(7), 470–476.
- Watanabe, N., Matsuoka, Y., Kumachi, M., Hamazaki, K., Horikoshi, M., & Furukawa, T. A. (2018). Omega-3 fatty acids for a better mental state in working populations – Happy Nurse Project: A 52-week randomized controlled trial. Journal of Psychiatric Research, 102, 72–80.
- West, C. P., Dyrbye, L. N., Rabatin, J. T., Call, T. G., Davidson, J. H., Multari, A., … Shanafelt, T. D. (2014). Intervention to promote physician well-being, job satisfaction, and professionalism. JAMA Internal Medicine, 174(4), 527.
- World Health Organization. (2019, April). ICD-11 for Mortality and Morbidity Statistics. Retrieved from https://icd.who.int/browse11/
- World Health Organization. (2019, May 28). Burn-out an “occupational phenomenon”: International Classification of Diseases. Retrieved from https://www.who.int/mental_health/evidence/burn-out/en/