Sep. 5. 2018
Written By:
McKel (Hill) Kooienga
McKel Hill Kooienga, MS, RDN, LDN

McKel Hill Kooienga, MS, RDN, LDN

Founder of Nutrition Stripped and the Mindful Nutrition Method™

What is burnout? Most of us will experience some level of burnout in our lifetime, and nourishing yourself mentally, emotionally, and physically is key to preventing it.

Did you know that 50% of medical students, physicians in training, and practicing physicians are at significant risk of burnout? (1) It amazes me, yet I understand, the people who are giving all their energy to taking care of others, put their own wellbeing and health lower on the priority list. We’re peeling back some layers to help answer the question of what is burnout and how to tell if you have burnout.

But guess what, burnout doesn’t just affect physicians and people in the medical professional industry, it impacts all of us from entrepreneurs and business owners, to mothers, to students — burnout doesn’t discriminate.

This is why one of my favorite mantras rings so true to my lifestyle, but also I hope for all my fellow health professionals out there — you have to show up fully for yourself in order to show up for others.

You have to show up fully for yourself in order to show up fully for others.

What Is Burnout?

Burnout is defined by the World Psychiatry as “… a psychological syndrome emerging as a prolonged response to chronic interpersonal stressors on the job. The three key dimensions of this response are an overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and lack of accomplishment. The significance of this three‐dimensional model is that it clearly places the individual stress experience within a social context and involves the person’s conception of both self and others.” (3)

Burnout Is Bad For Our Health

Stress isn’t always a bad thing, we actually need stress for certain situations. We know too much stress in our lives is bad for our health, and if burnout is the result of chronic stress, then you guessed correctly that burnout is bad for our health too. Stress can be either a triggering or aggravating factor for many diseases and health conditions (4).

Chronic stress and our brain health

Stress doesn’t just make us feel like we have a serious case of brain fog, but it’s this “fog” of stress that decreases overall cognitive performance from decision-making, paying attention, judgment, and learning (4).

Not to mention, some studies show the literal structure of our brain changes with chronic stress — including the gray matter which is responsible for higher brain functioning like decision making, thinking, and is packed with nerve cells, the other half of our brain volume is called white matter. White matter is a network of fibers that allows the brain to communicate between regions, it gets the name white matter because there’s a white myelin sheath surrounding it which is responsible for the electrical flow of signals between neurons (7).

Of course, our brain health is directly related to the health of our immune system. Our body produces cytokines in the brain during a time of psychological stress, which induces an acute phase response in our body which happens naturally when we get an infection or a wound/cut/tissue damage — but in chronic stress, we have increased levels of circulating cytokines (one of several inflammatory biomarkers).

Our mind and body are a machine, when we’re in a situation of stress (i.e. the brain thinks we’re in danger), the neuroimmune communication is set in motion as the inflammatory markers increase (i.e. the cytokines produced by stress-stimulated immune cells) tell the body we’re in stress which further makes this situation a repeating cycle. The damage comes when this cycle becomes persistent, the abnormal levels of cytokines can damage the parenchyma (i.e. the functional bulk of an organ or tissue) which can physically change the structure of our brain (8).

Chronic stress and our immune system

Stress becomes bad for our health when it’s chronic — our body has a negative feedback mechanism that controls the stress response and when you’re in chronic stress, this response doesn’t work. A resistance develops and the levels of molecular mediators of stress remain very high which then compromises our immune system and in the long term can damage organs and tissues (5).

Inflammation, which in most cases is a prelude to disease, also occurs in people who have chronic stress. The neuroimmune axis (in a nutshell, how our immune system communicates with the nervous system), gets overstimulated and breaks down which can cause immune imbalances, low-grade inflammation, hormonal imbalances, and may lead to disease such as atherosclerosis (5).

There are many known health conditions that are a result of stress and chronic stress including inflammation, cardiovascular conditions, diabetes, cancer, autoimmune issues, depression, and anxiety (8). Eating a diet rich in foods that reduce inflammation is key, but also managing stress is pivotal!

14 Potential Signs Of Burnout

Because burnout is difficult to diagnose and there are no textbook criteria for the diagnosis, some studies suggest that there they may be a biomarker used in diagnosis, DNA methylation markers might be able to show how individuals respond uniquely to stress and the psychopathology differences of burnout and other mental disorders (3).

Again, these signs and symptoms of burnout will look different for everyone but be aware and on the lookout if you or someone you love is experiencing any of the following:

  1. Spending more time alone than your normal — avoiding activities you normally would enjoy engaging in
  2. Experiencing emotional highs and lows, emotional instability
  3. Feeling overwhelmed, fear, anxiety, self-doubt that’s hard to shake
  4. Feeling “alone” and like you’re “doing it all”
  5. Working longer hours than normal while being preoccupied with work while not at work
  6. Not spending the time to yourself in self-reflection or activities that make you feel good and connected with yourself
  7. Feeling very tired despite sleeping your normal hours — hard to wake up in the mornings
  8. Feeling like you’re on a plateau with work/personal/life
  9. Feeling detached from your beliefs, core values, and goals
  10. Having a shorter temper than your normal
  11. Psychosomatic feelings of health issues: hormonal imbalances, digestive issues, colds, that are difficult to identify or diagnose
  12. Having a general feeling of “lack” — like you’re not doing enough or are enough
  13. Experiencing panic attacks, dizziness, or increased heart rate
  14. Feeling like you can’t think straight or have brain fog

How Do You Know If You Have Burnout?

The tricky thing about burnout is its kind of like a slow leak, it’s not as though you wake up one morning feeling burnout, it’s more of a gradual rise of these symptoms and signs which makes it more difficult for some people to realize that something is wrong in the first place. The first and most important step before you dive into self-reflection or trying to diagnose yourself is to go talk to someone — anyone from a friend to a therapist.

Burnout looks different for everyone depending on your lifestyle and causes of burnout, but take a look at some of these questions to ask yourself and gauge where you might be in the spectrum of burnout. Some of these questions were taken directly from a study from the College of Family Physicians of Canada in 2008 and the other questions with burnout (2).

  • Do you schedule and spend time with yourself?
  • Do you schedule and spend time with your family?
  • Do you eat healthy meals to nourish your body?
  • Do you make sleep a priority?
  • Do you feel excited and joyful about work and life?
  • Do you tend to identify or recognize yourself as a “workaholic”?
  • Do you make the time to engage in hobbies and activities outside of work?
  • Do you routinely talk about your challenges, hardships, and feelings with a friend/family member or professional?
  • Do you make time for exercise and movement weekly?
  • Do you spend time in self-reflection?
  • Do you place high expectations on yourself or others?
  • Do you emotionally react to others in highs and lows — i.e. happy to sad quickly?
  • Do you have a history of depression, anxiety, or overwhelm?
  • Do you have a history or currently have hormonal imbalances?
  • Do you obsessively think about work/health/one topic?

Again, this article isn’t a diagnostic tool for burnout, that’s where licensed psychologists come into play. This can start to awaken some journal prompts for you to explore your situation and reflect.

The ~ Feel Better From Burnout ~ Checklist

First, take a deep breath and know that it’s okay, you’re not alone, and there are so many lifestyle things you can do to feel better. Here are a list of items, books, resources, and foods that may also help you if/when you experience burnout.

Right now, let this be a time that you put yourself first and concentrate on making healthy choices for yourself, and getting into the routine of practicing your unique definition of self-care. This can be as simple as going to bed and waking up at consistent times to train yourself and your body on regular sleep patterns, making a couple healthy recipes you want to try or if you need help with that just as a friend or loved one to cook with you!

Books to read:

  • Power of Now — a personal favorite and for me, a life-changing book
  • Judgment Detox
  • The Alchemist
  • Heart Talk
  • Essentialism
  • Option B
  • The 7 Habits Of Highly Effective People
  • The Four Agreements
  • Daring Greatly

Feel good recipes:

How to chill out:

  • Find something you love to do that’s creatively stimulating — art, dance class, poetry seminar, etc.
  • Go outside. Breathe in the fresh air and take a hike in the woods
  • Get as ~ woo ~ as you want by lighting some sage, palo santo, candles, or essential oils to get some aromatherapy going
  • Take a bath with good smelling essential oils that make you feel good
  • Read some inspirational books mentioned above
  • Journal. Make the time to write everything that’s going on in your head, out on paper to clear your mind
  • Sleep at least 8 hours a night — check here for more tips on how to sleep well 
  • Find joy in activities you like again by not placing an outcome or a measurement of achievement, just do it because you like it!

How To Feel Better After Burnout

After you feel you’ve gotten over the hump of burnout, this is one of the most beautiful times, not because you feel like a unicorn skipping on sunshine, but because you now have the self-awareness to pinpoint your mental, emotional, physical health status to then prevent future burnout.

You can now reflect and learn your unique signs of burnout and how your body is communicating with you about signs of burnout before you experience it the next time. A couple of ways to be more proactive this time around is to set clear concise boundaries with work/whatever was a trigger for causing your burnout, learning the power of saying no, reclaiming your personal alone time on the weekends or during the week, cutting down on the amount of work if possible, engaging in weekly creative activities that make you feel good, and doing things for the sake of joy without attaching an outcome for achievement with them.

If You Need Help, Talk About It.

Always remember, that you’re not alone even if it feels like you are and that nothing ever stays constant — we’re always evolving and changing, that’s true for the hard times too.

  1. Physician Burnout and Well-Being: A Systematic Review and Framework for Action. David A. Rothenberger Dis Colon Rectum. 2017 Jun; 60(6): 567–576.
  2. Stress, burnout, and strategies for reducing them: What’s the situation among Canadian family physicians? F. Joseph Lee, Moira Stewart, Judith Belle Brown. Can Fam Physician. 2008 Feb; 54(2): 234–235.
  3. Understanding the burnout experience: recent research and its implications for psychiatry Christina Maslach, Michael P. Leiter. World Psychiatry. 2016 Jun; 15(2): 103–111. Published online 2016 Jun 5. 
  4. Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI Journal. 2017;16:1057-1072. doi:10.17179/excli2017-480.
  5. Mariotti A. The effects of chronic stress on health: new insights into the molecular mechanisms of brain–body communication. Future Science OA. 2015;1(3):FSO23. doi:10.4155/fso.15.21.
  6. Bakusic, J., Schaufeli, W., Claes, S., & Godderis, L. (2017, January). Stress, burnout, and depression: A systematic review of DNA methylation mechanisms. Retrieved from
  7. Chronic Stress Can Damage Brain Structure and Connectivity. Psychology Today.
  8. Mariotti A. Advances in pediatrics. The effects of chronic stress on health: new insights into the molecular mechanisms of brain–body communication. Published November 2015.