In a world where nearly one in four people globally report symptoms of burnout, the impact of this pervasive issue is undeniably profound and understanding and addressing it is crucial.
We sat down recently with alum Brankele Frank (Amsterdam, 2013-16), a neurobiologist, writer and public speaker, and Jacqueline Brassey, co-leader of Healthy Workforces and Director of Research Science at the McKinsey Health Institute. Jacqueline also specializes in resilience, emotional flexibility, self-efficacy, and adaptability. Read their discussion on what burnout is, how it affects the whole body, and what we can do to avoid it.
Brankele Frank: First we need to say that there is currently no international scientific consensus on a definition of ‘burnout.’ In North America, people tend to use it to describe symptoms of being overwhelmed and exhausted, whereas in parts of Europe, it is a medical diagnosis describing a serious condition where the exhaustion has led a person to not be able to function in everyday life anymore. I am coming from the perspective of the European definition.
I see stress on a spectrum. There’s normal, healthy stress that, biologically, is a very necessary mechanism. People are quite resistant – we can handle stress, even chronic stress, for a long period of time. But you do, at some point, need to rest in order to give your body the ability to come back to normal, and your systems to regulate.
If you do not rest, and you continue to have stress, then you get into the sphere of what we call being "overstrung," which is where you start having stress symptoms. You will notice small glitches in your functioning. For example, you become irritable, you leave your keys in the fridge, or you go out grocery shopping, but then you forget what you were going to buy.
In this phase, you can still slow down and be fine within two or three weeks, as long as you get enough rest. If, however, at this stage you continue to work and continue to put yourself through whatever it is that is giving you stress, then you could cross the threshold of a burnout, which is a state of total exhaustion, both on a physical and emotional level, where usually people are unable to fully function for a few months or even years.
Jacqueline Brassey: You have said that you have had two experiences of that kind of serious burnout. What were those experiences like?
Brankele: When I had a burnout the first time, I really couldn't believe what was going on, because I was stripped of so many functionalities that it felt as if my whole identity had vanished.
I couldn't think straight; I couldn't remember things; I couldn't talk without losing my train of thought; I couldn't say the days of the week in the right order; I couldn't do two plus two. So very basic cognitive capabilities had just completely vanished. At the same time, I was extremely tired, suffered from insomnia and headaches and was hypersensitive. It felt like I had pulled an all-nighter and was extremely hungover, but without the partying that usually precedes that, and regardless of how many hours of sleep I got.
Jacqueline: In your research, what have you found to be the most surprising or unexpected effects of burnout on the mind and body?
Brankele: I was amazed by the real physical, morphological changes that you can see in the brain. If you’re under enough chronic stress, you will be flooded with stress hormones that eventually cause changes in how your brain cells grow, function, and work together. In severe burnout, brain volume actually shrinks and there is a decline in neurons in the areas of your brain that are responsible for cognitive abilities like concentration, rational thinking, and memory.
Areas of the brain that process emotion, on the other hand, tend to grow and become more reactive, causing you to become hypersensitive, irritable, edgy, and more emotionally unstable.
People with serious burnout have the same telltale molecules in the brain as people who have had light traumatic brain injuries, such as concussion. So even though there hasn't been a physical accident, your brain has been ‘broken.’
When you’re suffering from chronic stress, the way that you behave is different, and the way you sleep and eat are different, which means that you quickly get into vicious cycles and negative spirals, which then give rise to this annoying phenomenon of stress causing more stress.
Jacqueline: It makes me think of something that [sleep neuroscientist and McKinsey alumna] Els van der Helm said: "If you sleep less, you think you can perform well." It's like drinking too much and thinking you can drive well. But actually, your performance is hindered.
Brankele: Yes. The adrenaline your body makes to keep yourself going tricks you into thinking that everything is fine, because it gives a slightly euphoric feeling. You can get addicted to that feeling, because it's empowering to think that you can juggle everything at the same time. It can make you feel invincible. But what you don't realize is that you can only do all of those things because of the adrenaline, which is detrimental for your health in the long term. In biology we call this state ‘wired but tired’.
Jacqueline: You've written a book on burnout, “Over de Kop,” which has received critical acclaim and is already in its fifth print run [currently available in Dutch]. What do you hope your readers will take away from it?
Brankele: Initially what inspired me was my own frustration with how I was treated when I was sick, because no one could really explain to me what was going on. Being a consultant and a trained scientist, I wanted to understand. I noticed that a lot of other people were also looking for these answers but didn't necessarily have the background or the means to dive into it.
My mission with the book and all the work I do around it is to increase awareness about how stress works – that it's not simply something psychological, but it's a fundamentally biological mechanism, which also has physical consequences. Not everyone will have a serious burnout, but everyone will experience detrimental effects from chronic stress. It’s important we move away from the ‘mind over matter’ adage, as being estranged from our bodies can lead to serious harm.
I try to be a companion to people who have gone through the same process, and offer help. The book is also for employers and society at large.
Jacqueline: The McKinsey Health Institute recently published an article about this, based on research in 30 countries: “Reframing employee health: Moving beyond burnout to holistic health.” We discuss how organizations can help create a workplace that prioritizes all aspects of health: physical, mental, social, and spiritual.
Brankele: Companies need to take care of their people, who are their biggest assets. And society at large is going to face big problems now that an increasing number of people are suffering from stress-related illnesses and are becoming burnt out.
Jacqueline: What are some things you would suggest that people can do for themselves to avoid burnout?
Brankele: We all know the basics: sleep enough, eat healthily, and exercise. Those will all lower your stress hormones and help to keep you happy. Being in nature and cuddling are also great for that same purpose.
There's also something a bit more out of the ordinary that I would really like to emphasize in our education system, as well as the workplace, and that's the importance of emotional intelligence and awareness. A lot of stress comes from us suppressing our emotions and not processing them adequately.
We should be teaching kids what emotions are, how they feel, what we can do with them, and what it means to go through and process them. Because if we don't, we will get a lot of internal stress from not confronting ourselves with our emotions and won’t be able to resolve conflict in a proper way.
I'm not saying everyone should constantly cry in the workplace. But I am saying that I would love for everyone to have a psychologist, or another type of trained professional, who could help them uncover what their own coping mechanisms and underlying beliefs are, and to try to help them dissect the forces behind their behavior. Because that is usually what stops us from listening to our bodily signals and what pushes us to go beyond our limits.
Jacqueline: People can also have a paralyzing crisis of confidence, sometimes driven by lack of emotional flexibility skills, which can eventually lead to burnout as well. I never experienced a burnout myself but I have been through a crisis of confidence, and co-authored a book addressing it, “Authentic Confidence,” and also designed and implemented a training on this at the Firm, still available today. Everyone has insecurities, but you can learn to manage them.
Brankele: Yes, definitely.
Jacqueline: How do you envision burnout being addressed in the next few years? How will the space of burnout awareness and solutions evolve?
Brankele: I do think that there is less of a taboo on talking about mental health than there used to be, so that is definitely going in the right direction, and a lot of employers are taking note of the fact that they should be involved in it. They're obviously not solely responsible for it, but there is a responsibility to help keep their employees healthy.
However, I do fear that it will get a bit worse before it's going to get better. I'm afraid that we will need a few more crises before people will really hit the brakes, as stress-related absenteeism has increased quite significantly in the past few years and I don’t see that changing any time soon.
Also, there are quite a lot of societal problems: insecurity, loneliness, housing and climate crises, financial worries – to name a few – that all cause stress and increase the pressure of daily life. On the other hand, there are quite a lot of movements that are going in the right place and that offer solutions. My hope is that through awareness, open conversations and empathetic and vulnerable leadership, people will start to realise we can’t keep treating ourselves as robots, and things will improve.
I do think it's inspiring for people to at least ask themselves, "What do I want in my life? What do I need? How do I want to participate in society? How do I want to contribute?" The younger generations are much more vocal about their own desires and needs and are less willing to join the rat race.
In the next 10 to 20 years, I’m sure we will be seeing a lot of interesting new research on the interdependencies of our mental health, immune system, nervous system and emotional life. We have only just started uncovering the fascinating ways in which they are all interlinked.
Jacqueline: Thank you for all these insights, Brankele. I hope readers will find and follow you on your social platforms and learn from your continued research.
