Is your job killing you?

Workplace burnout can lead to numerous serious health issues — and even premature death.

Burnout doesn’t only make work feel demoralisingly futile; studies show it may precipitate a fatal heart attack or stroke, or prompt chronic illnesses such as type 2 diabetes or dementia.

Is your career killing you by stealth? If you feel excessively tired, devoid of energy, demoralised and irritable, you have the classic symptoms of a condition with disastrous potential: occupational burnout.

Burnout doesn’t only make work feel demoralisingly futile; studies show it may precipitate a fatal heart attack or stroke, or prompt chronic illnesses such as type 2 diabetes or dementia.

A 25-year survey of 11,000 people published this month in the European Journal of Preventive Cardiology warns those with the most symptoms of burnout have a 20 per cent higher than normal risk of atrial fibrillation, the most common form of heart-rhythm disturbance (arrhythmia). It also significantly increases the risk of heart attack, stroke and death.

It is not the first time burnout has been linked with cardiovascular disease. In 2017 a six-year survey of more than 100,000 people by New York researchers in The American Journal of Cardiology concluded burnout is significantly associated with a higher risk of stroke, heart attacks and fatal haemorrhages — or death from any cause.

What’s more, if sufferers survive those strokes or coronaries burnout makes them much likelier to suffer another one, Hungarian psychiatrists warned last year in the International Journal of Clinical Health Psychology.

The author of the most recent study, Parveen Garg, an assistant professor of clinical medicine at the University of Southern California in Los Angeles, says burnout may harm our hearts by chronically overstimulating them.

“When we are persistently stressed or exhausted by work, it can cause chronic stimulation of the fight-or-flight response,” Garg says. “This involves constantly raised levels of stress hormones such as adrenalin and norepinephrine. These can damage the tissue of your heart.”

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The risk is increased by the fact occupational burnout is associated with tissue-damaging inflammation.

“When these two things are chronically triggered they can have serious effects,” Garg says.

Occupational burnout, which was first recognised in the mid-1970s, and is diagnosed as a combination of excessive fatigue, increased irritability and feelings of demoralisation, endangers not only our cardiovascular systems. In 2017 a 13-year study of more than 9000 Danes found those suffering strong symptoms at the start were 30 per cent more likely to develop type 2 diabetes.

A study in September last year by occupational health doctors at the University of Navarra in Spain warns in the Journal of Occupational and Environmental Medicine that burnout may drive type 2 diabetes so strongly that attempts to treat it through diet and weight loss may fail.

This may be explained by the inflammation mentioned by Garg — such inflammation is believed to increase the risk of type 2 diabetes.

Burnout also appears to increase people’s risk of dementia, another disease that is believed to be triggered by chronic inflammation.

Public-health experts at the University of Copenhagen in Denmark followed nearly 7000 people for 15 years and found the more symptoms of burnout a person reported, the greater their risk of dementia.

Their report, published in the Journal of Alzheimer’s Disease, indicated those with five to nine symptoms had a 25 per cent higher risk of dementia than those with none, while those with 10 to 17 symptoms had a 40 per cent higher risk.

It is tempting to assume that occupational burnout is the preserve of older workers counting the days to retirement. However, a Gallup study of 7500 employees warns younger generations suffer most: 28 per cent of millennial employees (aged 23 to 38) complained of feeling frequent or constant burnout at work, compared with 21 per cent of older staff.

If the prospect of a new “generation burnout” were not sufficiently worrying, the rate of recovery can be low and slow.

A 2016 report in the journal Biological Psychology, for example, says that 18 months after being diagnosed with clinical burnout, patients typically “had got better, but were not ‘well’”. Almuth McDowall, a professor of organisational psychology at Birkbeck University of London, believes many sufferers are diagnosed too late.

“Chronically high levels of the stress hormone cortisol change the brain’s biochemistry. This makes people see the world negatively. The more they think negatively, the more it strengthens brain pathways that make it react in that way,” she explains.

The condition is insidious, she says: “It creeps up on you slowly but surely. It affects your relationships. You get more cynical, less sociable. You withdraw from those who might help, rather than seeking them.

“The organisational context is that we work in an era of sky-high expectations. Over the past 10 years the demands and complexity of people’s jobs have risen exponentially.”

Last year the World Health Organisation included burnout in its international classification of diseases as “a syndrome resulting from chronic workplace stress that has not been successfully managed”.

International surveys report that the worst affected jobs are in healthcare, social work, policing, teaching and customer services, and executive posts in law and management. Several studies have found that about a third of staff at Britain’s National Health Service suffer. The most recent was published in the Journal of the Intensive Care Society in November by Laura Vincent, a medical consultant at the John Radcliffe Hospital in Oxford.

Her survey of nearly 1000 intensive care staff shows one in three scores highly on at least one of these symptoms: feeling disengaged and aggressive; inadequate and ineffective; and being emotionally exhausted.

Vincent hopes to engage an occupational psychologist to help change the culture in NHS intensive care.

“Staff engagement is crucial for patient safety, as well as for patient care and staff retention.” she warns. NHS burnout creates a vicious cycle, she adds: “If you have a high rate, you have more unworked shifts, more vacancies and a higher burden on staff, which causes more burnout.”

Those at most risk can help to protect their hearts, bodies and brains by maintaining their general health, says Mika Kivimaki, a professor of social epidemiology at University College London and the director of the Whitehall II study, which has followed the mental and physical health of more than 10,000 British civil servants since 1985.

“I think stress and emotions are harmful in terms of triggering heart troubles in people who already have cardiovascular problems. Job burnout can be one of the triggers. But it is important to remember lifestyle factors, such as smoking, high blood pressure and high cholesterol, will play a bigger role in causing heart disease than will adult stress,” she says.

If you want to protect your heart from chronic stress, the standard strategies of keeping slim, exercising and not smoking all help best.

But if you want to protect yourself from burnout, a whole new raft of strategies may be needed.

WHAT TO DO

FIND A FRIEND
We need “momentary work happiness” to keep us going, according to a Dutch study in The Journal of Psychology in 2016. Failing to find any fun during the day puts us at the highest risk of burnout, the report warns.

CHANGE JOB
If your work is a strain, you must make things easier rather than trying to be a hero, Almuth McDowall, a professor of organisational psychology at Birkbeck University of London suggests. “Think about the aspects of your role with which you are struggling,” she says. “Is it realistic for you to deliver all of your workload or should you be delegating? If you can’t change the role, consider leaving.”

PRACTISE GRATITUDE
Psychologists at Duke University in North Carolina studied nurses and doctors who were asked to record three incidents that had made them feel grateful each day. They reported in the BMJ Open last year that the volunteers suffered less burnout and a better sense of work-life balance, not least because they focused on their job’s most positive aspects.

REBALANCE WORK-LIFE
Siobhan Murray, a psychologist and psychotherapist and the author of The Burnout Solution, says work stresses can be kept in check (and in perspective) by nourishing our personal lives. It’s healthy to be selfish by freeing up time to spend on hobbies, sport and anything else that makes us feel fulfilled, she says.

SPOT THE SIGNS
Occupational psychologists at the Mayo Clinic in Minnesota have compiled this checklist. They warn that saying yes to any of these six questions means you may be at risk of job burnout:

● Have you become cynical or critical at work?
● Have you become irritable or impatient with co-workers or clients?
● Do you lack satisfaction from your achievements?
● Do you feel disillusioned about your job?
● Are you using food, drugs or alcohol to feel better or to simply not feel?
● Are you troubled by unexplained headaches, digestive problems or other physical complaints?

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