Do you often find yourself avoiding social gatherings because you are too tired? Or spending the weekend in bed? Or maybe you are wondering why the coffee isn’t working anymore? These are classic signs of burn out that we see all the time in clinic. Let’s get into the nitty gritty.

Persistent stress over time leads to burn out, which can manifest as a combination of emotional and physical disturbances. Naturopaths use natural medicine with holistic diet, and lifestyle approaches when treating burn out.

So, what is burn out?

Burn out is a syndrome or collection of symptoms that present because of prolonged stress. It’s more than just feeling a bit tired. The syndrome describes a state of depletion both mentally and physically, as the body adapts to ongoing stressors. Symptoms may include fatigue, anxiety, depression, poor sleep, poor immunity, musculoskeletal pain, and general feelings of inadequacy (to name a few).

Often the source of stress is the workplace and much of the research around burn out looks at stressful occupations in the health sector such as nursing, or doctors in emergency care or on night shifts, although stress can come from any aspect life. It might be that you don’t have enough time for self-care, or that you have kids, work, study, and or caring for an elderly parent. Stress can come in many forms, that we don’t always recognise as stress. Prolonged sitting at the computer is a stress on the body. Even the word stress can make us feel stressed! It’s how we adapt to it that is important.

The Stress Highway

The hypothalamic–pituitary–adrenal (HPA) axis is the highway between the brain and the adrenal glands that regulate the stress response. The main hormone that results from this pathway, is cortisol. Initially, during the first stages of burn out, there is an increase in the stress hormone, cortisol. Overtime, this response can become impaired and result in low cortisol which in turns presents as severe fatigue or burn out. Essentially, burn out is the long-term consequence of ongoing unmanaged stress. Now let’s look at how you can add some traffic lights on the stress highway and give out some metaphoric speeding fines.

Natural medicines and burn out.

Western herbal medicines have a long history of traditional use, and a large body of emerging animal and human literature for various ailments. Herbal adaptogens specifically work to help the body and mind adapt to stress, whether it be emotional, environmental, workplace or otherwise.

Adaptogens such as Rhodiola rosea (Rhodiola), Schisandra chinensis (schisandra) and Eleutherococcus senticosus (Siberian ginseng), work to regulate the HPA axis and improve the body’s resilience and adaptive response to stress. Other adaptogens include Withania Somnifera (winter cherry), Asiatica centella (gotu kola), Panax ginseng (Korean ginseng) and others. Basically, they help us to adapt and perform. There are several herbs that are considered adaptogenic in the Naturopath’s dispensary, and there is science-based evidence to support their use. Importantly, plant medicines work in synergy with each other, which enhances the therapeutic effectiveness.

Adrenal tonics (tone the adrenal glands), nervous system tonics (tone the nervous system), sedatives (calm the nervous system), hypnotics (aid sleep), anxiolytics (reduce anxiety), and antidepressant herbal medicines are also prominent therapeutic actions that are used to target burn out. Natural medicines can not only address the causative physiological disturbance in the stress highway that leads to burn out, but also effectively treat the symptoms. Glycyrrhiza glabra (licorice), Avena sativa (oats), Matricaria recutita (chamomile), Piper methysticum (kava) and Hypericum perforatum (St John’s Wort) are a few examples of plants with these therapeutic activities.

Holistic management including diet, lifestyle and a whole mind/body approach is key to addressing the cause of burn out. This individualised approach will be different for each person, depending on their triggers, contributing, and potentiating factors. Mindfulness, yoga, meditation, healthy diet, and exercise are other examples that may feature as part of the holistic approach to burn out. Particular attention is given to avoidance of stimulants such as caffeine and dietary sugar.

Preventing and treating burn out is critical to prevent long term effects on mental health. Burn out can paradoxically cause anxiety, depression, and metabolic illnesses. Given the prevalence of metabolic and mental illness in Australia, addressing burn out is of paramount concern in the public health sphere. Natural medicines have a long history of use in the treatment of stress and related nervous system ailments, and the modern scientific literature is quickly catching up, to understand how complex plant medicines work for a range of neurological disturbances. Being aware that burn out is a thing, and learning what you need to do to manage it, is the first step to overcoming burn out.

*This article is for general information purposes only and is not a substitute for personalised health advice. Natural medicines may interact with medications and should only be prescribed by a qualified Naturopath in consideration of your individual health case.

References:

Deneva T, Ianakiev Y, Keskinova D. Burnout Syndrome in Physicians-Psychological Assessment and Biomarker Research. Medicina (Kaunas). 2019 May 24;55(5):209. doi: 10.3390/medicina55050209. PMID: 31137738; PMCID: PMC6571619.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571619/

Panossian A, Wikman G. Evidence-based efficacy of adaptogens in fatigue, and molecular mechanisms related to their stress-protective activity. Curr Clin Pharmacol. 2009 Sep;4(3):198-219. doi: 10.2174/157488409789375311. Epub 2009 Sep 1. PMID: 19500070.

https://pubmed.ncbi.nlm.nih.gov/19500070/

Panossian A, Wikman G. Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress-Protective Activity. Pharmaceuticals (Basel). 2010 Jan 19;3(1):188-224. doi: 10.3390/ph3010188. PMID: 27713248; PMCID: PMC3991026.

https://pubmed.ncbi.nlm.nih.gov/27713248/