There are some days at work where it feels like your to-do list is endless, and there’s no way you’ll make it through. But if those days turn to weeks, and weeks to months, you may be suffering from long-term cognitive fatigue, better known as burnout.
‘Burnout’ was introduced as a medical term in the 1970s, and has been considered a disorder since the end of the 20th century.
How Do You Identify Burnout?
As mentioned above, burnout isn’t just an emotional response to a challenging job. Although there is no one definition, it is characterized by the following symptoms:
Lack of motivation
Abnormal appetite: stress eating or little to no hunger
Fatigue that isn’t relieved by sleep or is disproportionate to previous activity
Loss of passion
Intensifying cynicism or negativity
Decreased cognitive ability (attention span, memory)
Burnout also has impacts far beyond the workplace. Intense cases of burnout alter your personal and social functioning, impact your cognitive abilities, and create physiological brain changes.
Neuroscientists exploring cognitive fatigue have created the Maslach Burnout Inventory, which serves as a framework to quantify and assess burnout in individuals. They identified six key factors of the workplace environment that contribute to burnout:
Burnout then occurs when an individual’s relationship with their workplace in one or more of those areas becomes imbalanced. Although individuals who work in professional caregiving experience the highest rates of burnout, it is certainly not limited to any one industry. Professional athletes, CEOs, postal workers and restaurant servers alike all report cognitive fatigue.
As doctor and professor Richard Gunderman puts it:
“[Burnout] is the accumulation of hundreds or thousands of tiny disappointments, each one hardly noticeable on its own”
Neural Networks Implicated in Burnout
What actually happens to your brain when you experience high levels of cognitive fatigue? There are several brain regions and networks implicated in leading theories.
First, let’s break down the key players. Frontal basal ganglia circuits are networks of neurons connecting regions of the frontal lobe to the basal ganglia, which mediates motor and cognitive functions within the brain.
These circuits play an important role in executive functions, like decision making, memory, attentional control, and planning/organizing.
Studies have found that a lower neuronal density in these circuits is associated with a dysfunctional basal ganglia. These circuits are also heavily associated with motivation and reward programming in the brain, so a physical disruption is likely to lower an individual’s motivation, a symptom of fatigue.
Another important circuit is the connection between the amygdala and the anterior cingulate cortex (ACC). The ACC is associated with processing emotional distress, while the amygdala is responsible for generating strong negative emotion, like fear and anger.
Participants in a functional MRI study with self-reported burnout had a weaker connection between these two regions, suggesting that they have more difficulty controlling their negative emotions.
In severe cases of burnout, when this emotional regulation pathway is broken, people can feel more angry and more frustrated as time goes on. This positive feedback loop accumulates more and more negative emotion in someone’s head.
More Physical Changes in the Brain
My previous post on the neuroscience of meditation discusses changes in grey matter and cortical volume -- in other words, how big parts of your brain are -- as a result of mindfulness. Similarly, researchers have found that burnout impacts the cortical volume of several key areas.
The ACC, medial prefrontal cortex (mPFC) and amygdala are all areas that modulate the brain’s stress response. In participants with self-reported burnout, researchers found thinning in the ACC and mPFC, and a swelling of the amygdala.
The theory behind this volume change is that overactivation of the amygdala, which occurs during extended periods of stress and anxiety, leads to a block in the mPFC activation.
Since the mPFC and ACC cannot regulate and decrease that stress, the amygdala is again activated. This cycle continues and spirals out of control, which leads to intense ‘wear and tear’ on these neural structures. Over time, this creates memory, attentional, and emotional problems.
Beyond the Brain: What Else Does Burnout Impact?
One key study has found that cognitive fatigue wreaks havoc on the neuroendocrine system. The hypothalamus, a brain region, directly impacts the pituitary and adrenal glands and controls the release of cortisol, known as the ‘stress hormone.’
Cortisol is normally produced in a fight-or-flight response, but when stress becomes chronic, cortisol levels remain too high for too long. The hypothalamus responds by downshifting cortisol to abnormally low levels: this is the literal ‘burnout’ of your body’s stress response system.
This condition is known as hypocortisolism, and causes a plethora of negative effects. Your body begins to generate low-grade inflammation all over, which leads to plaque buildup in your arteries, as well as a decreased immune response.
Burnout is also associated with the immune system. Cognitive fatigue arises when microglia are activated. These cells mediate an immune response in the central nervous system, and release cytokines.
Cytokines are signaling molecules that create an inflammatory response. In this case, brain areas associated with reward and sleep control are damaged by this cytokine signaling.
The suprachiasmatic nucleus, which regulates your sleep and circadian rhythm, is particularly impacted. Researchers found that burnt-out patients had an underactive suprachiasmatic nucleus, and reported having trouble falling and staying asleep.
So Now What?: How to Combat Burnout’s Effects
After reading a comprehensive list of all the ways burnout can mess with your cognitive and physical well-being, you’re probably wondering if there’s any way to address its effects. While researchers continue to search for treatments, there are certain steps you can take right now to ‘relight your flame’ and recover from fatigue.
Organizing Your Space Cleaning up your work and home can have a huge impact on your mood and wellbeing. Rather than letting mess accumulate and purging it every week, work on assigning proper places to everything and holding yourself accountable to cleaning up things as you go. For example, try to sort your documents into folders as you work, rather than trying to clean up a whole cluttered desktop. At home, commit to doing the dishes the night before, so you wake up to a clean sink.
Batch Tasks Grouping repetitive tasks and doing them in bulk can clear your cognitive daily to-do list and make the mundane bearable. If you can afford to, buying household essentials like detergent and paper towels in bulk can minimize the amount of time you spend in the store on a day-to-day basis. Similarly, use Apple shortcuts or Excel formulas to streamline your work experience.
Take Breaks OFTEN! Getting up out of your chair at least every hour can do a lot to recenter your attention. Exercise, even if it’s as little as taking a lap or two around the office has been proven to reverse the negative effects of cytokine inflammation on the suprachiasmatic nucleus (as aforementioned)
Engage in Bottom-Up Attention Rest your mind by engaging in bottom-up attention. Most of the time, you are directing your own attention towards specific tasks or goals. This kind of processing is called top-down attention, and can be incredibly taxing for long periods of time. Bottom-up attention happens when external factors stimulate your attention unwillingly, like when you hear a siren and look up to see what it is. It is important to trigger this bottom-up attention ‘modestly’, as one research group put it. Choose an activity that puts little demand on your attention, like walking through the park or watching the sunset. Although watching TV or scrolling through your phone engages bottom-up attention, researchers have found that engaging with screens drains your energy, and does more harm than good in this respect.
Rethink Your Habits Whether it’s falling into toxic patterns of self-sabotaging thought, or constantly being in damage-control mode, there are a lot of different ways our habits burden us with stress. If you constantly take on more work than you can handle, practice being realistic with your task management and saying no. If you constantly forget important things at home, try investing in backups for your phone charger, keys, etc for an emergency.
Most importantly, remember to be kind to yourself. When burnout hits, it hits hard. Don’t blame yourself for feeling fatigued and take the time to rest and recuperate. When you’re ready, you’ll hit the ground running again.
Holtzer, Roee, Melissa Shuman, Jeannette R. Mahoney, Richard Lipton, and Joe Verghese. “Cognitive Fatigue Defined in the Context of Attention Networks.” Neuropsychology, Development, and Cognition. Section B, Aging, Neuropsychology and Cognition 18, no. 1 (January 2011): 108–28. https://doi.org/10.1080/13825585.2010.517826.
Nakagawa, Seishu, Hikaru Takeuchi, Yasuyuki Taki, Rui Nouchi, Yuka Kotozaki, Takamitsu Shinada, Tsukasa Maruyama, et al. “Basal Ganglia Correlates of Fatigue in Young Adults.” Scientific Reports 6, no. 1 (February 19, 2016): 21386. https://doi.org/10.1038/srep21386.
Nazish, Noma. “How To Overcome Mental Fatigue, According To An Expert.” Forbes, September 25, 2018. https://www.forbes.com/sites/nomanazish/2018/09/25/how-to-overcome-mental-fatigue-according-to-an-expert/.