The Surprising Truth About Burnout, Stress, Inflammation & Your Immune System
Updated: Jan 7
We now know a lot about who is at risk of Covid-19 and how stress resulting in burnout can make your immune system more vulnerable. This is thought to be one reason why so many health professionals have been adversely affected by Covid-19 and why if you are a professional under a lot of stress you might want to consider how best you can support your health with a new outlook in 2021.
In the current lockdown many of us are juggling a professional career whilst working from home in less than ideal situations, adding additional stress on top of an already difficult work environment. Think laptop on the kitchen table or desk in the lounge with kids running round and a zoom meeting. Think getting out of bed, checking emails in bed with your phone and turning on your computer before breakfast. Whatever your circumstances recent surveys suggest most of us are finding lockdown a stressful situation. You may have lost a loved one to the virus or suffered the adverse effects yourself. Added to this is the pervasive fear in society, played out every day in the media and felt by us when we venture into the shops or stepping off the path when we pass someone in the street. We no longer have a standard structure to our day, many of us are not going outside as much with no commute necessary, we no longer get to sit next with real colleagues and have a good chat or laugh, all things that as human beings we tend to thrive on.
Few people realise that mental or emotional stress can push our bodies into a state of physical stress and this is the mechanism that makes your immune system vulnerable to viral illness. Being in a state of constant or chronic stress results in imbalances in our body systems and our health. Added to this are physical and environmental stressors, such as too little exercise or too much alcohol, which put further stress on the body contributing to the potential for health problems. I want to explore this to help you understand and manage some of the potential stressors that you might be experiencing to help you avoid burnout and stay in good health.
Stress & Fear
Most people understand our response to fear as our bodies response to threats or danger which is organised by the Sympathetic Nervous System. This is known as the fight or flight response and makes physiological changes in our bodies when we sense fear or danger. These changes include the release of cortisol and adrenalin which increases our heart and breathing rates, it sends more blood supplies to our muscles and away from our digestive system and enhances our vision. All this is designed to help us fight off a predator or run away from a lion. A little bit of stress can be a good thing, it can help us when we are competing in sport, getting married or having a baby, it make us feel excited and improves our performance. But when stress becomes too much it has a negative effect and becomes distress. It can build up when we are dealing with difficult situations or feel overwhelmed and can leave you feeling distracted, anxious and unable to cope.
Normally within a couple of minutes after experiencing an acute stress we should bounce back into a normal state or relaxation courtesy of the other branch of our autonomic nervous system, our Parasympathetic Nervous System (PNS) and specifically the ventral component of it. In this state our heart rate, blood pressure, breathing, muscle tension, digestion, metabolism and immune system all return to normal. However, if the stress continues after the initial shock then the activity of the sympathetic nervous system declines and adrenaline secretion is lessened, but some activity remains at above normal levels. If the stress continues and the body is unable to cope, there is likely to be breakdown and we are likely to burnout.
Burnout is the body’s way of protecting us by sending us into survival mode. An example from nature would be when a baby antelope plays dead and the predator senses it and lets it go being fooled into thinking it is carrion. If you have ever experienced a profound shock such as an unexpected death in the family, or maybe been in a car accident, you may have felt the effects of this mode which can include collapsing, fainting or feeling completely numb. Sometimes under extreme chronic stress our bodies get shocked into this survival mode and get stuck there. This can result in extreme fatigue, a feeling of being dissociated or detached or depressed and is the response of the dorsal (primitive) part of the PNS.
Mental & Emotional Stress
In 2020 and moving into 2021 we have had to deal with more stress than ever. Covid-19 has created a huge fear in society, not only of the virus itself, but of human interactions in our day to day lives. However, even before Covid-19 hit many of us were at risk of suffering stress and burnout. You might have already had to cope with a range of stressors including mental and emotional ones, such as relationship difficulties or grief, financial difficulties or work-related pressures and cognitive stressors such as feeling isolated, having too much information to process and uncertainty, all of which add to the mental load you carry around.
Physical & Environmental Stress
While you might associate psychological stress with risk of burnout you might not realise that non-mental stressors can also contribute to burnout. Examples of physical and environmental stressors on the body include: the extremes of exercise, both lack of it and extreme exercise; poorly regulated blood sugar levels; excess body fat; injuries from accidents; surgical interventions; extreme cold or heat exposure; dehydration; nutritional deficiencies; lack of sleep; infections; pollution and toxins from chemicals or alcohol/drugs.
Stress, Inflammation & Immunity
Some of the stressors above can be both a result of stress and continue to contribute to stress in a vicious circle. An example of this is high blood sugar which can rise under stress but also places a stress on the body which will constantly try to rebalance it. Another example would be body fat which can increase long term with high cortisol secretion under continued stress but body fat itself results in inflammation which is a physical stressor for the body to cope with.
Whether it is mental, emotional, environmental or physical stress our body has to cope with it by trying to rebalance our biochemical functions and bring them back into balance. If stress continues as a chronic situation it can result in inflammation and have a significant effect on the immune system that ultimately manifests in illness. This in turn can raise the risk of immune system dysfunction.
One of the difficulties of our modern lifestyle is that we often accumulate stressors without realising it until we stop to consider our lifestyle. To give you an example, you might be a doctor, lawyer or accountant with a significant amount of work-related stress, perhaps combined with some minor family relationship stresses but this year you have had to work in unusual circumstances and feel more isolated or have more distractions to cope with at home and feel more anxious. In addition perhaps you have drunk more alcohol and stopped exercising as much due to your emotions during lockdown. It might also be difficult to stop work when there is no natural end to the work day and colleagues are still online. Dark nights and lock down mean you are not able to meet friends to have a laugh and relax together. Each and everyone of these stressors contributes to how healthy you are and how well your immune system is functioning.
Fatigue & Inflammation
Fatigue is one of the symptoms of burnout but interestingly also one of the main symptoms of chronic fatigue and post-viral conditions such as Long-Covid. Collectively each of these conditions is associated with sleep disruption, depressive or anxiety symptoms and brain fog as well as fatigue. They are also all linked to chronic low levels of inflammation, a reduced immune response and raised blood glucose levels.
Inflammation is the common mechanism behind all three of these conditions and is also the common underlying factor with many chronic diseases. Inflammation is the body’s natural response to injury or infection and involves activation of both immune and non-immune cells to protect us from bacterial, viral and toxic dangers by eliminating them and promoting repair and recovery. Inflammatory responses induce energy saving behaviours known as ‘sickness behaviours’ such as fatigue, altered sleep patterns and social withdrawal as well as increased blood pressure and blood sugar levels. These behaviours help the body to survive during physical injury or infectious threats which is a good thing as long as it is a temporary situation.
This normal inflammatory response is usually an acute phase with temporary increases in inflammation and immune activity that that resolves once the threat has passed. However, we now know that certain social, psychological, environmental and biological factors (the stressors we talked about above) can prevent the resolution of this acute phase and result in persistent low level chronic inflammation and can continue to activate your immune system. This shift in inflammation from acute short lived to on-going and long-lived can cause a breakdown of the normal balance of the immune system, known as immune tolerance. Immune tolerance is how your body responds to different molecules and particles deciding which are foreign and should be attacked and which are self and should be tolerated. A lack of proper tolerance can result in the immune system attacking our own body tissues resulting in autoimmune disease. Examples of autoimmune disease include Rheumatoid Arthritis (joint tissue is attacked), Coeliac Disease and Inflammatory Bowel Disease (the gut lining is attacked) and Type1 Diabetes (the pancreas is attacked). It can also reduce the effectiveness of our normal immune, leading to increased susceptibility to infections and other diseases and potentially a poor response to vaccines.
How To Beat Burnout and Avoid Inflammation
The good news is that there are things you can do to help prevent or cope with burnout that will improve your health overall.
Here are my 5 Strategies to help you beat burnout and keep you as healthy as possible in the current pandemic situation. I am keeping this as simple as possible for you so here are five things you can do every day from the start 2021 to make your health a priority. Done together these five strategies have a synergistic effect, meaning that the total effect is greater than the effect you get from doing them individually. Start right now and make this your New Year’s Resolution for 2021.
1. Prioritise Sleep
Aim for at least 8 hours of sleep every night. Workout what time you need to go to bed to ensure you can have 8 hours of sleep every night. Then set an alarm on your phone to go off one hour prior to this and start to wind down and relax prior to getting into bed. Read a book, have a bath, listen to relaxing music, gentle stretching or meditation. For more ideas on a night-time routine check out my sleep blog. Sleep is key for good health and is known to help control our metabolism, regulate our weight, help store our memories and promote a positive mood and good mental health as well as helping our body repair damage and balance our immune system.
Get up and move every 30 minutes. Set another alarm on your phone for the time you begin work and when you finish and give yourself a reminder to move. I do not necessarily mean exercise but I do mean move. Walk round the house or garden or up the stairs, do a couple of squats, learn a couple of yoga moves like cat/cow and forward fall. Literally take between 2 and 5 minutes to do this and then head back to work. Moving regularly avoids being sedentary and helps us produce energy efficiently which ultimately makes us feel less tired.
Take 3 Deep Breaths. Every time you notice you are feeling stressed I want you to stop and take 3 deep breaths. This helps move your nervous system back into its optimal mode. To do this properly you need to activate your diaphragm. The best way to do this is to practice the feeling by lying on your back with your hand on your stomach. When you breathe in your hand and stomach should move towards the ceiling rather than your chest. Once you have mastered this you can easily do it at your desk or in a queue at the supermarket or when out and about.
4. Eat Well
Eat lots of colourful plant foods. Colourful plant foods are packed full of anti-inflammatory compounds which are good for you and help to dampen down an overactive immune system. Try to make sure you get some at every meal including breakfast. Plan and buy them with your weekly shop. Suggestions include raspberries, blueberries, broccoli, spinach, peppers, apples, rocket, butternut squash, oranges, tomatoes, beetroot, sweet potatoes, celery, carrots. Grate them into salads or coleslaw, add them to soups or serve up as a side dish.
5. Spend Time in Nature
Take yourself outside every single day at a time when it is light. Maybe when you drop your kids off at school or pick them up? Or wrap up warm and take your coffee break outside? Have a short walk at lunchtime? Visit a park or forest at the weekend? Or simply stop work and look out of your window if none of these are possible. You ideally want to see the green (plants) or blue (water) hues of colour of nature. Pause and feel the wind on your face, the sun on your skin, notice if birds are singing and take in the patterns of the trees and plants around you. Being in nature has a profound effect on our nervous system, calming it and restoring it to balance.
If you want to know more about how to re-energise yourself or beat burnout and fatigue head over to my website and register for my newsletter.
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