Stress management for for burnout prevention

The autonomic nervous system

Have you ever consciously thought about how your heart beats, how you digest that burger from last night? Or how to keep your blood sugar and body temperature stable? Of course not! This is what your autonomic nervous system(ANS) is doing for you, all day everyday. Your ANS like the word says it regulates everything that is going on in your body on a non-conscious basis. 

Rest & Digest vs Fight or Flight 

The ANS is divided into two branches 1. Parasympathetic Nervous system(PNS) commonly referred to as your rest and digest and 2. The sympathetic nervous system(SNS) or Fight or flight response. As you can see in the chart above, these systems have many implications on the body and are complete opposites of each other. The PNS / SNS Continuum It’s not that you are either in a fight or flight state, or a rest and digest state, but rather somewhere on a continuum between the two. Where that depends on under how much stress your body currently is and how well you are able to recover from this stress. We can objectively measure where you are on the continuum using HRV.

Heart Rate Variability

HRV emerges from the interplay between these two competing branches. Essentially, in a balanced nervous system, our hearts are constantly getting “mixed messages” — commands to increase heart rate from the sympathetic nervous system and commands to decrease heart rate from the parasympathetic nervous system — these mixed messages cause the resulting heart rate to be in a constant state of fluctuation. HRV measures irregularity in the heart rate. Consider a heart rate of 60 beats per minute; one might take this to imply that the heart is beating consistently once per second, while in actuality, beat-to-beat times could range from 1⁄2 a second to 2 seconds. 

Accumulation of stressors

 When we think about stress we often think about work or exams etc. Less obvious stressors are, poor nutrition, poor sleep, inflammation, training, but also arguments with your spouse, family tragedies, basically just life in general. The accumulation of these stressors we call the allostatic load. 

Allostatic load

  • Poor nutrition
  • Poor sleep
  • Nutrient deficiencies
  • Inflammation
  • Intestinal permeability(leaky gut)
  • Work stress
  • Social stress
  • Life

When it gets nasty

 All this being said, stress doesn’t have to be a bad thing perse. During training for example we put a certain amount of stress on the body in order to make it adapt e.g. grow muscle, get stronger, run longer, faster etc.  When it gets nasty is when the accumulation of stressors becomes greater than the body’s ability to recover from this stress. In other words the allostatic load becomes bigger than the recoverability.

 

When it gets really nasty

 You probably don’t need to worry too much when this happens every so often. When it really gets problematic is when you’re under these stressors for a prolonged period of time. What happens then is best explained through Dr. Han Seyl’s General Adaptation Syndrome(GAS) model.

  1. Alarm phase: The body releases stress hormones / mobilizes energy in response to the stressor
  2. Resistance phase: Prolonged stress leads to stress hormones accumulating to sustain arousal
  3. Exhaustion phase: Bodies resources are depleted

The crucial phase

 It can take months or even years for the exhaustion phase to kick in. But when it does kick in, it can get pretty nasty, burnouts, depression and inability to perceive pleasure to name a few. It is therefore crucial to detect the resistance phase early on and handle appropriately. The problem is that the body will often downregulate your perception of stress until it’s too late. So how can we then detect if we are moving towards the exhaustion phase? 

Signs & Symptoms

  • Feeling tired / sluggishness
  • Decreased performance
  • Energy levels are down
  • Being sick more frequently then normal
  • Can’t get enough sleep
  • Disrupted sleep / waking up early
  • Difficulty concentrating / impaired cognition
  • Low libido and sexual drive

 

Objective measurements

  • Low HRV
  • High blood pressure
  • High resting heart rate
  • High morning blood glucose

 

Tipping the scale

 In order to restore balance we can do two things:

  1. Increase recovery
  2. Decrease stress

Increase recovery

 Although there are probably tons of things the average person could do to improve their recovery, I will focus on the things that have shown to have the biggest impact on the ANS and HRV. 

  1. Improve aerobic fitness: action number one is to improve the body’s ability to recover. How does this work? The aerobic system is the primary system aiding recovery at rest. By improving the aerobic systems ability to produce energy the body is able to recover faster, this also makes the body more resilient to stress. Furthermore aerobic training causes vasodilation(widening) of blood vessels which decreases heart rate and it has also shown to have a positive effect on HRV.
  2. Sleep: One night of poor sleep will probably not affect your HRV that much, it’s when sleep debt accumulates over a period of time problems arise. We want to focus on sleep quantity but also sleep quality. Waking up at night and waking up early have been shown to be early signs of depression and burnout. More on this here: Robert Sapolsky – Biology of depression
  3. Breathing: The way we breathe is highly correlated with the state of our ANS. High (chest) breathing indicates a fight or flight state, low (belly) breathing a more relaxed state. When we know this we can pay attention to when our body is shifting towards a more stressed state and we can implement some breathing techniques to bring it back down. So the next time you feel tightness in your traps, neck etc. try some of the following

High / low breathPRI 90 / 90 breathingDiaphragmatic breathing

Decrease stress

 As with increased recovery there are probably a 100 things you could do to decrease stress. Only the time it would take would do all of these things would probably outweigh the possible benefits, therefore I’ve again chosen to give you the most “bang for your buck” solutions which you can implement with the least amount of effort.  

  1. Meditation: Only 10 minutes of mindfulness meditation has shown to decrease cortisol levels by over 20% in subjects. Meditation could possibly also aid in improving your perception of stress.
  2. Training: Training however useful can be an additional stressor on the body. Low rep heavy squatting or deadlifting take huge amounts of effort from the nervous system. It could therefore be a good idea to step away from these exercises for a period of time and focus on more structural / higher rep work.
  3. Stop eating crap: Junk and other highly processed foods contain tons of “bad” nutrients which might possibly cause inflammation and intestinal permeability. Intestinal permeability is caused when things cross the intestinal lining which shouldn’t be there, the body’s immune system will attack those invaders which again will cause inflammation to go up.
  4. Get a hobby: doing something you like, with people you like and preferably without boozing has shown to drastically improve stress levels and your overall ability to handle stress.
  5. Lose fat: Your fat cells actually act as an organ itself in the body, which means they send out hormones like leptin, but also pro-inflammatory chemicals which cause systemic inflammation. Inflamed fat cells feel rock hard and can also hurt when you grab them. Yes I’m talking about your love handles..!
  6. Ashwagandha: A Chinese herb that acts as an adaptogen, meaning it will adapt to your current cortisol output and try to bring it back to baseline. This is probably my favorite go to supplement when I’m going to a stressful period, this is however not a permanent solution!

 * I’m mainly focussing on managing physiological stress, for optimal results these should go alongside psychological help.

 

Conclusion

 Stress is an accumulation of psychological and physiological stressors. We can measure the current state of the body using subjective and objective markers as HRV, HR, BP and blood glucose. By looking at trends of these measurements we can actively start implementing protocols to improve recovery and decrease stress levels