Ep. 221: Burnout and Brain Health: The Neurobiology of Stress-Related Exhaustion

00:00:00: Welcome to EANcast, your weekly source for education research and updates from the European Academy of Neurology.

00:00:15: Hello

00:00:15: everyone!

00:00:16: And welcome to the EAN podcast Weekly Neurology.

00:00:20: I'm Luka Heimpartowidi will be in Task Force at EAN with Alicia Coroni.

00:00:26: Today we are going talk about burnout and neurobiology behind it.

00:00:32: today We have the owner to have as our speaker, Professor Inbjörg Stottil, Director of the Stress Medicine at University of Gothenburg.

00:00:43: She is internationally recognized as an expert in stress-related exhaustion and it's correlated.

00:00:51: so we are going to go under the first part on this very important topic.

00:01:04: thanks to be here with us today.

00:01:06: Thank you, Luca!

00:01:08: So in these years we are hearing a lot about burnout and all the consequences that are affecting all physicians health workers worldwide.

00:01:19: so it's important to talk about what is burnout?

00:01:23: I will ask Ingbjörg really fastly try to explain mechanisms under it?

00:01:37: Well, the short explanation would be that is a work-related condition.

00:01:42: That's due to long term exposure which has not been dealt with and consequences of this are that you're having symptoms or reactions and sometimes it can turn out clinical condition, clinical symptoms and then we are in Europe say that this clinical burnout.

00:02:03: In Sweden We have another definition called exhausting disorders And it's different for different countries but basically It's about a long lasting exposure That has not been dealt with.

00:02:17: Wow!

00:02:17: It is important especially for at walkers But also any kind of workers who had to to face these conditions.

00:02:25: And what about the effect that burnout and stress, chronic stress condition can affect on condition or general overall brain health?

00:02:38: That is quite an interesting question because it depends.

00:02:43: I mean you could think that exposure is perceived in different manner for people and you have sort of different situations, both biological and cognitive behavioural and cognition.

00:02:57: So so you will experience the situation differently And it can be going on for a long time For some people and shorter times other people.

00:03:10: The biological and cognitive consequences I would say actually depends with burnout.

00:03:19: is that, well it's a problem of all psychiatric diseases.

00:03:24: That we do not have unified biological markers.

00:03:29: We can look at depression and you will see the same effects for different people but we are expecting that to burn out which is quite interesting because sometimes we're demanding something one thing and burn out.

00:03:49: For instance, you would think that cortisol which is the stress hormone... ...that some people say it's not working at all.

00:04:01: so its actually low if your having hypocorticellemia or its very high because of your very stressed Or nothing has changed.

00:04:11: And when looking at literature You see everything!

00:04:15: Some studies show high cortisol, some studies showing low cortisol in burnout people but most studies show no effects.

00:04:26: And this is because we mix the knowledge about acute stress reaction which affects cortisol and chronic stress effect with a totally different thing.

00:04:40: so like we are thinking that cortisol has a chronic effect of something acute catabolic hormone to help us deal with the stress situation.

00:04:52: So you cannot use cortisol as a mark of burnout, for instance but there are things that have happened... But when it comes to cortisol you can't use that.

00:05:02: Very interesting!

00:05:05: For instance I would say also that it's interesting considering in busy years we're stressing about brain health mental health very important topic when you have to talk about preventable manners, what we can do?

00:05:20: To prevent some disorders.

00:05:22: Do think if we are not very effective from the biomarker perspective... ...do you think there's any kind of identifiable risk factors that can make individuals more vulnerable to stress-related disorders?

00:05:39: Well!

00:05:39: We're affected but differently.

00:05:42: That is sort of a tricky part for burnout Like I said, other psychiatric conditions.

00:05:49: So what we see in our research and another reason is that... ...we have an effect of many neurobiological mechanisms.

00:05:57: We see effects on neurotrophic factors Even neurofilament light which isn't a good thing This sort of brain marker for... for that something is wrong with the brain and we see some effects on astrocytes, but not in everyone.

00:06:21: So it's sort of a point where you will see an effect on brain health a clear biological effect, but in others you will not.

00:06:31: But you might see something else that they have increased the blood pressure or effects on the glucose system and approaching diabetes... Or another situation with some other metabolic hormones.

00:06:48: so it's different!

00:06:50: So we are affected But we are differently affected.

00:06:54: So there is no sort of common Marcus, but that people are affected by a lottery.

00:07:00: at some sense That's really the case... ...but not in The same manner.

00:07:08: Yeah Definitely!

00:07:09: This may be the tricky point because We're differently exposed and different individuals.

00:07:14: so it's very difficult for this perspective.

00:07:18: I will say also us as workers, academicians, researchers Our this category of workers keen to work a lot study a lot to have a lot of hours in the hospital stress-related condition everywhere appreciate instead those maybe other more situation.

00:07:37: so And we are also an era over.

00:07:42: A lot of possible device.

00:07:44: Smartwatch any kind of our smartphone is a full information about our body, but do you think that there could be some kind of practical example, how to monitor our stress level and maybe recognize out early warning signs.

00:08:08: I think that we sometimes have to think the burnout is not like... approaching or coming up in an hour, two or in the acute stress situation.

00:08:21: It's a situation that you have been dealing with very problematic situations both at work and also on your private life.

00:08:31: You don't leave the cortisol of the stress system five o'clock in the afternoon when leaving shifts totally different brain or hormone system.

00:08:45: So there is the whole life situation and burnout, this classifies as being something that has been going on for quite a long time And it's I mean we can deal with A lot of things.

00:09:00: We are very robust and we're very adaptable As people...and we cannot confuse everyday live situations With The situation will burn out, which has been going on for a very long time.

00:09:16: And I think that when it comes to the... There are clear situations where you should be worried and this is when You come home from work or you've been trying to rest For like days or weeks or months ...and you're not getting any recovery.

00:09:38: We work we go home we rest and everything will be fine.

00:09:42: But when you're not capable of resting, that the tiredness is not going away for days a week then you should consider this situation.

00:09:54: And also sleep disturbances are very much almost all people with burnout exhaustion or clinical burn out.

00:10:02: they have sleep disturbacies.

00:10:05: You could actually fall asleep easily but you will wake up in the middle of night and not be able to fall asleep again.

00:10:12: It's like concerns, things that are thinking about all the time.

00:10:17: so if this is a situation where we're feeling it can't deal with us then... We might look at situations when there should be some concern.

00:10:27: otherwise I mean..we could cope perfectly.

00:10:31: everyday life situation stress for most people.

00:10:36: it's important not to mix that.

00:10:41: It is definitely very thoughtful, maybe difficult because we are really able to cope but sometimes seems like we're burned out.

00:10:54: talking about burnout cause its something like you continue to say and I don't know not clear interventions of something that we can do in practically our lives, because so we are stressed from any kind of generation.

00:11:09: From the students to their early career workers as well.

00:11:14: a professor... So will live in stress condition and we are able to adapt.

00:11:18: but uh Do you suggest there is something like evidence-based prevention strategies?

00:11:23: Something this practical does again

00:11:29: difficult when it comes to the evidence-based part, because... It's different things that have affected people differently.

00:11:36: And then if you would generalize is like giving this same treatment to cancer patients with different cancers or with different tumors?

00:11:47: Is not going work!

00:11:48: Because they are unique for every person.

00:11:52: The most important thing ...is to deal with a situation that made you stressed as the exposure.

00:12:03: And when it comes to the workplace, we tend to fix the individuals.

00:12:09: You will just have a stress management or exercise training mindfulness yoga and then be better prepared To deal with very high workload.

00:12:26: That is fine when it comes to the individuality.

00:12:30: It's good to exercise, is good to be mindful... ...it's good too have a very good stress strategies but this not gonna fix unclear work situation.. ..is NOT going to fix high workload.

00:12:45: Exercise has no effects of high workload!

00:12:49: Mindfulness does not either.

00:12:51: So we are trying often in intervention to fix the individual, to deal with a situation instead of having an intervention pointed towards what is really the problem.

00:13:06: And it's almost always if this has been seen in literature... ...the organisational level for work environment.

00:13:18: that is best preventive strategy.

00:13:20: It's nothing wrong within individual measures and good being healthy shapes But again, it's not going to fix the real issue.

00:13:32: Definitely!

00:13:32: Maybe from our organization there will be a moment where we receive notification about within that you are under stress.

00:13:41: possibly you need two days off.

00:13:44: maybe this is something easy but I agree with the fact that health system needs to heal itself to be sure that cannot develop too much stress.

00:14:02: But I would love to close this conversation with your positive closing, so about recovery is possible from burnout?

00:14:14: Absolutely!

00:14:15: For the individual, the recovery is most important and on an individual measure exercise The best thing that you can do, along with stress management and so on the individual level.

00:14:33: But again I urge people to discuss their work situation in a workload because they could still do the same amount of work but organize them better.

00:14:45: give the management's tools to be able see employees to detect burnout at good times.

00:14:56: So we can prevent this if you just work on the level that we need to work.

00:15:02: And, you can recover from burnout... ...if you do sort of a combination of both individual group and organizational levels.

00:15:12: So, thanks also for this nice closing.

00:15:15: I would love to just have a summarize from our audience.

00:15:19: so we talked about the work related.

00:15:22: stress disorders that connect maybe different name around different countries is variegated in different group of symptoms.

00:15:34: The neurobiology bit... cannot be defined.

00:15:37: My course itself is very different within each individual, a stress.

00:15:42: it's not just at work or we have to be able to cope with that even in our lives.

00:15:49: so we can introduce this kind of new time about work-life balance and something really important recovery from burnout if possible.

00:15:58: It's important to be sure, manage the stress at work and how you cope with your individual level.

00:16:08: And we are waiting for our new organization from The Health System to avoid stressing out so much about The Health Worker.

00:16:17: So I would say thanks Ingjord for being here with us.

00:16:22: Thanks everyone who wants to listen this podcast Goodbye!

00:16:35: This has been EANcast Weekly Neurology.

00:16:38: Thank you for listening!

00:16:39: Be sure to follow us on Apple Podcasts, Spotify or your preferred podcatcher for weekly updates from the European Academy of Neurology.

00:16:47: You can also listen to this and all our previous episodes in the EAN Campus.

00:16:52: to gain points & become an EAN expert in any of her twenty-nine neurological specialties Simply Become An EAN Individual Member To Gain Access.

00:17:01: For more information visit www.ean.org.

00:17:05: That's E-A-N dot.

00:17:07: O-R-G backslash membership.

00:17:09: Thanks for listening!