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getting back from burnout

Burnout is a telltale malady of our times.

It’s a state of physical, emotional, and spiritual depletion. It manifests in depression-like symptoms such as lost motivation, decreased productivity, and feelings of cynicism and hopelessness. It shows up in physical symptoms of extreme stress, including digestive shut-down, inflammation, adrenal fatigue, and a compromised immune system.

And rekindling your inner fire is not as easy as rubbing two sticks together.

Melody Miller lived the nightmare of burnout. When her sister, Deena, died unexpectedly of an aneurysm, Miller’s shock and grief were compounded as she was called upon to provide emotional support to her extended family.

“My niece had a birthday a week later. She was 25 when her mom died,” Miller explains. “I felt a responsibility as her mom’s only sister to be big for her. Like I couldn’t be the grieving aunt. I had to figure out a way to lift her up.”

A year later, Miller’s own mother was diagnosed with esophageal and lung cancers. Her father had passed away years before, leaving Miller to stay by her mother’s side.

She shifted into an even higher gear and assumed the role of caregiver, making the three-hour drive to her mother’s home twice monthly to buy groceries, pay bills, and run errands. Soon, she was commuting weekly, keeping herself awake on the long drive by munching on cookies.

A yoga teacher by profession, Miller gave up her classes, which had been a source of healing in that year after her sister’s death. “In the height of the crisis with my mom, I was not able to practice yoga, not able to meditate,” she reflects. “It was too chaotic. I was numbing out. The TV was on constantly.”

During this period, Miller gained 30 pounds and sometimes went a week without a bowel movement. She felt ungrounded, flighty, tearful. Her knees, toes, belly, and back ached. The morning after her mother died, Miller passed out twice in the bathroom.

Once a vibrant, spiritual person, Miller was burned out, body and soul.

Burnout is a common concern, says Frank Lipman, MD, a New York–based integrative physician at Eleven Eleven Wellness Center. He adds that “often it’s the pace of our lives that creates this problem,” and points a finger at cultural and environmental stressors that compound what he calls the “total load” of what a person can handle without blowing a circuit.

“We never turn off — we’re on our phones and computers and televisions all the time,” he says. “Apart from the food we eat, which is not helping, apart from the normal stresses we may have been under for years — a bad boss, a bad relationship — we have this added layer of technology that is making everything worse.”

Contemporary lifestyles do contribute to a “perfect storm” for chronic stress, agrees Roberta Lee, MD, vice chair of integrative medicine at the Center for Health and Healing in New York City. Burnout represents the most depleted end of the stress continuum.

“You’re a vacuous presence,” she says of burnout sufferers. “It’s not that you don’t want to be present; you do. It’s kind of like the ICU [intensive care unit] version of stress.”

For someone in this extreme state, the very thought of embarking upon a proactive path to recovery may seem overwhelming. It often feels easier just to limp through each day, one double espresso at a time. While caffeine, sugar, and alcohol can temporarily distract from a depleted condition, says Lee, “unfortunately, they’re not deep resistance builders.” Recovery from burnout must instead address head-on the factors that erode resilience.

“You can’t just tell someone to fix their marriage or get a job they’re passionate about,” says Lipman. He and Lee direct burned-out patients to begin by taking control of what they can control. Initially, that might just mean taking a day, week, or more off from work; canceling all social engagements; turning off the phone; and spending some time taking care — and taking stock.

Lipman also recommends moving gradually toward eliminating toxins before addressing the emotional side of burnout. Even mustering enough will to ditch a daily doughnut fix can interrupt an inflammatory pattern and shift the body and mind in a better direction. Just a small reduction of stress on the organs can provide energy for change.

“The easiest thing you can do is change your diet, clean up your gut, and optimize the functioning of your organs,” he says. “These things are tangible. People feel so much better when they do it. You start at that level because the other issues are much harder to deal with.”

Lipman’s book Revive: Stop Feeling Spent and Start Living Again (Touchstone, 2009) outlines a six-week dietary- and lifestyle-based approach to healing from burnout. Lee’s book, The SuperStress Solution (Random House, 2010), details a four-week holistic path to recovery. Both recommend restoring resilience through diet, movement, rest, and relaxation.

Remove

Many people consider gas, cramping, constipation, or diarrhea normal. Intestinal woes are often a gut-level byproduct of stress and exhaustion, however, and that bottle of antacids in the desk drawer only masks underlying problems.

The lining of the digestive tract is thin and vulnerable to damage by poorly processed food particles, which bypass normal digestion when the body is on chronic high alert. Over time, the damage may result in food particles leaking through intestinal walls and into the blood supply, a disorder sometimes called “leaky gut syndrome.” This compromises immunity and causes inflammation, Lee says, which can show up as food sensitivities, rashes, and an overall wearing down of physical resilience.

This short-circuiting of the digestive process also causes nutritional depletion, so no matter how well you eat, your body will not be nourished. For this reason, Lipman recommends an elimination diet as a primary step in recovering from the physical effects of burnout.

“The first thing is to clean out the gut,” he says. “When imbalance in the gut is a problem, adding a healthy diet alone won’t be as helpful.”

Lipman recommends eliminating sugar, which stresses the adrenal system. He also suggests cutting gluten, which triggers inflammation in many people, as well as soy, which has been linked to thyroid dysfunction — a common condition in people suffering from burnout. He also advises eliminating caffeine, alcohol, dairy, anything containing hydrogenated fats, and virtually all processed foods.

“Chemically processed foods and foods that include preservatives and flavor enhancers make our cells work very hard and weaken the body,” writes Lipman in Revive. When you’re burned out, you don’t have that energy to spare.

Nourish

After eliminating possible agents of inflammation and dysfunction, adding foods that build strength will further ease the body’s “total load.”

To that end, Lipman advocates a recovery diet high in colorful fruits and vegetables, which are loaded with anti-inflammatory phytonutrients. He recommends healthy fat sources such as olive oil, nuts, and avocados, which contain essential fatty acids that boost immunity and support the brain, and quality proteins such as grass-fed beef, wild salmon, and free-range poultry.

Lee concurs, adding that “cultured foods like yogurt and foods with natural fiber help build the gut.” And she suggests small amounts of dark chocolate as a pleasing way to add antioxidants, lower blood pressure, and promote alertness.

Lipman recommends taking a multivitamin and a probiotic supplement, and adding a supergreens powder to smoothies. In addition, he prescribes adaptogenic herbs — including ginseng, ashwagandha, rhodiola, and eleuthero — to help the body adapt to stress and resist fatigue. (For more on adaptogenic herbs, see “Ancient Healers”.)

A diet with all these elements will speed recovery. If a total dietary overhaul seems overwhelming, try adding two or three of the recommended foods and supplements on a weekly basis, rather than all at once.

Move

Exercise has a well-established antistress effect — and it’s not just about the endorphins. Moderate exercise produces other mood-elevating neurotransmitters, including dopamine, norepinephrine, and serotonin. Lee notes that movement also breaks down stress hormones so they pass out of the body more easily.

Still, for those who are truly depleted, both Lipman and Lee emphasize moderation — and the importance of rest. Exercising too vigorously can be just as damaging as being too sedentary, triggering the sympathetic nervous system’s fight-or-flight response with attendant surges of cortisol.

“When you push, push, push and don’t let the body recover, it is just another stress on your system, adding to total load,” Lipman explains.

Instead, he recommends restorative exercise, noting that most Eastern movement traditions, like yoga and martial arts, incorporate recovery into the regimen. His approach is a less-intense variation of standard interval training, in which short bursts of energy are followed by recovery. Alternating exertion with rest triggers the parasympathetic nervous system to activate the relaxation response, essentially training the body, through movement, to relax.

Lipman and Lee prescribe simple walking as an ideal exercise for burnout recovery. Walking increases circulation, boosts metabolic activity, improves breathing, and clears the head — all without taxing an overexerted system.

Relax

Learning to bring the body and mind to a state of relaxation is critical to building resilience. Yet relaxing on cue is virtually impossible when you’re both tired and wired.

“When you’re in a bad emotional space, you can hardly sit in meditation,” says Joan Borysenko, PhD, author of Fried: Why You Burn Out and How to Revive (Hay House, 2012). She recommends starting with a simple two-minute breathing exercise to calm and regulate the nervous system.

Breathe in mindfully through your nose and breathe out slowly through pursed lips as if you were breathing out through a straw,” she says. “This slows down your breathing rate to four to six times per minute.” It also helps prepare for longer meditation practice. (See “The Spiritual Side of Burnout” below.)

Lipman proposes restorative yoga to help burned-out people recover energy. In restorative practice, props such as bolsters, blankets, and firm blocks support the body in poses designed to release tension and elicit deep relaxation.

“High-spun people don’t know how to slow down,” explains Lipman. “Restorative yoga is a way of getting people to chill out fast.”

“The burned-out person needs some passive intervention,” notes Lee, who also recommends acupuncture and massage as modalities to soothe the senses. These bring about a state of “conscious rest,” she says, which, unlike sleep, teaches the body how to be calmer while awake.

Sustain

As the body reclaims health, making choices that support an ongoing sense of well-being often becomes easier. “People don’t want to feel [burned out] like that again,” observes Lipman. Once people recover, it becomes easier to stay healthy.

Maintaining a reasonable pace of life after burnout is largely a function of connecting mind and body. One of the reasons Lee advocates sensory practices like receiving massage, eating dark chocolate, and taking walks is to help the burned-out person recover an awareness of the connection between physical and mental experiences. This integration shifts the body into parasympathetic mode — a calm counterpoint to the fight-or-flight reaction.

And once you’ve recovered some strength, you’re in a position to make big life changes as needed — finding more-fulfilling work, repairing damaged relationships, or moving beyond the grief of loss.

Melody Miller will attest to this. After her mother died and her caregiving obligations ended, she began to repair her health gradually. She adopted a diet of pasture-raised meats, fresh produce, and fermented foods to aid digestion. She returned to her yoga teaching and personal practice. It took some effort to gain momentum, but once the feelings of vitality began to reemerge, she knew she would recover.

Today, she has rebuilt her foundation and renewed her strength. “Feeling good again,” Miller says, “is a wonderful thing.”

Illustrations by Dave Cutler

The Spiritual Side of Burnout Q & A With Joan Borysenko

Burnout goes beyond physical and emotional exhaustion. Joan Borysenko, PhD, a lecturer on integrative medicine and the mind-body connection, and a licensed clinical psychologist, addresses the spiritual side of burnout in Fried: Why You Burn Out and How to Revive (Hay House, 2012).

Experience Life | In your book you refer to burnout as “a preventable and treatable disorder of the soul.” Is burnout a spiritual crisis?

Joan Borysenko | It is a spiritual crisis. The way I see it, when we’re burned out, we’ve lost our way. Our sense of meaning and purpose has disappeared from view and we don’t know which way to turn. One definition of the soul is “a quintessential human organ whose purpose is to create meaning.” In burnout, our meaning-making apparatus goes awry.

EL | Do people burn out faster if they’re working at odds with
their values?

JB | No question. When you’re working at cross-purposes with yourself, when you’d rather be doing another kind of work, you feel dead-ended and less able to bring meaning to your actions.

EL | You reference tendencies that predispose people to burning out — such as rigid idealism and attachment to specific outcomes, or a relentless drive to prove one’s self. What is the role of self-awareness in overcoming this kind of burnout-prone thinking?

JB | Burnout is absolutely an opportunity to become more self-aware. Oftentimes it’s a crisis that gets us into a place where we’re willing to do some self-reflection — to go inward and make the connection between what we’re thinking and what we’re feeling. For example, I notice I’m having a string of thoughts that are making me feel anxious and depressed. As soon as I am able to notice that, I can see how I’m creating what I feel through how I’m thinking. This gives me a little bit of freedom.

EL | How can we calm ourselves in times of acute stress and reactivity, when we feel like our lives are out of control?

JB | A lot of new neuroscience is looking at ways to change pathways in the brain, to deal with the fear and survival circuits in the limbic system and get them under the control of the more rational prefrontal cortex, where we can reflect and make reasonable choices. This is what we need to do to get out of the path of burnout. Practices like mindfulness meditation — in which we learn to observe our physical and emotional experiences with acceptance, patience, and compassion — have been demonstrated to change activity in the prefrontal cortex in a way that brings back the ability to plan, set goals, and calm down negative emotions.

EL | What about qualities that make people more resilient, like enthusiasm, optimism, and adaptability? How can we cultivate these positive traits?

JB | Surround yourself with joy. I was recently with a group that had an audience with the Dalai Lama. What impresses me about him is his joyfulness. It’s contagious. If you’re around somebody who’s actually exuding joy — a sense of amazement, curiosity — it makes you feel joyful. I’ve always considered joy the natural state of the human soul.

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