One of the greatest health challenges in our lives is the phenomenon of burnout. It occurs when there is enough negative stress that persists over time. As many of us know, stress is an integral part of being human. It can be positive (an upcoming wedding or birth of a child) or negative (job loss or physical injury). At its core, stress is any physical, mental, or emotional factor, external or internal, that causes bodily or mental tension. Chronic workplace stress is an epidemic in the United States and the world. According to the American Institute of Stress, 80 percent of American workers say they feel stress on the job, and half say they need help with managing stress.
Burnout, as defined by the World Health Organization, is a syndrome resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:
- feelings of energy depletion or exhaustion
- increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job
- reduced professional efficacy.
This definition refers to job burnout, but the reality is that we can experience burnout in any facet of our lives if there is enough chronic negative stress. It can be personal stress, relational stress, or societal stress. Furthermore, someone who is a caregiver under chronic negative stressful conditions can experience caregiver burnout.
When we think of burnout, we think of the emotional and mental components. However, research has shown there are many physical health issues that increase due to burnout: immune system dysfunction, heart disease, and cancer, for example.
What has only recently been discovered is the connection between burnout and atrial fibrillation (AFib). AFib is the most common heart rhythm disorder worldwide, affecting more than 33 million people across the globe. In the US, AFib is responsible for approximately 130,000 deaths and 750,000 hospitalizations every year. Most importantly, AFib is one of the most common causes of stroke, and in many cases, can be silent yet deadly. People can suffer from chest pain, palpitations, shortness of breath, or dizziness. Not infrequently, the only symptom of AFib may be fatigue, and there are many things in life that can cause that – including burnout. The conventional risk factors for AFib include, but are not limited to, age over 65, diabetes, obesity, sleep apnea, thyroid disease, and alcohol intake.
However, in a recent study published in the European Journal of Preventative Cardiology, Dr. Parveen Garg and colleagues from the University of Southern California-Keck School of Medicine found a striking connection between AFib and burnout. The researchers followed almost 12,000 men and women who did not have a diagnosis of AFib over a 25-year period. Study subjects were evaluated for psychosocial measures of anger, exhaustion, social support, and antidepressant use. Those results were compared to the number of people who developed AFib over the same time period. No association was found between levels of anger, social support, or antidepressant use. However, people who scored highest in vital exhaustion were more likely to develop AFib. Vital exhaustion was a term used by the World Health Organization to describe what is now called burnout.
This study raises significant concern about whether burnout, which is pervasive all over the world, can be a risk factor for developing AFib. In other words, people who may not have any other risk factors for AFib could potentially develop it as a result of experiencing burnout.
What can be done? Setting boundaries and balance with our work and personal lives is a key part of preventing burnout. However, there are many instances where people have limited ability to control those boundaries based on their job requirements. Equally important to setting boundaries is developing greater resilience in the face of chronic stress. Resilience is the ability to quickly recover from or adjust to a stressful event or circumstance. The Mayo Clinic has useful information on burnout and strategies to prevent and manage it.
Aseem Desai is a cardiac electrophysiologist and author of Restart Your Heart.
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