# The biology of burnout: Causes and consequences Bayes, A., Tavella, G. and Parker, G. (2021) ‘The biology of burnout: Causes and consequences’, _The World Journal of Biological Psychiatry_, 22(9), pp. 686–698. Available at: [LINK](https://doi.org/10.1080/15622975.2021.1907713) >[!Abstract] > Abstract Objectives Burnout is a state of exhaustion resulting from prolonged and excessive workplace stress. We sought to examine biological underpinnings of burnout, focussing on mechanisms and physical consequences. Methods We searched the literature on burnout and evaluated studies examining biological parameters in patient populations (i.e. ‘clinical’ burnout) as well as in individuals from the general population judged as having some degree of burnout evaluated using a dimensional approach. Results Findings suggest that burnout is associated with sustained activation of the autonomic nervous system and dysfunction of the sympathetic adrenal medullary axis, with alterations in cortisol levels. Limited studies have also shown altered immune function and changes in other endocrine systems. Consequences of burnout include increased allostatic load, structural and functional brain changes, excito-toxicity, systemic inflammation, immunosuppression, metabolic syndrome, cardiovascular disease and premature death. Limitations of studies include variability in study populations, low specificity of burnout measures, and mostly cross-sectional studies precluding examination of changes across the course of burnout. Conclusions Further examination of biological mechanisms of burnout would benefit from more homogeneous clinical samples, challenge tests and prospective studies. This would assist in differentiation from conditions such as depression and aid with development of specific treatment targets for burnout. ## Limitations of study - variability in study populations - low specificity of burnout measures ## Notes - Burnout is associated with changes in the nervous system - Burnout has been shown to alter immune function and changes in other endocrine systems - consequences of burnout - Nothing Left in the Tank %% [Open in Zotero](zotero://select/items/@bayes2021) ### [[burnout is associated with changes in the nervous system]] > Findings suggest that burnout is associated with sustained activation of the autonomic nervous system and dysfunction of the sympathetic adrenal medullary axis, with alterations in cortisol levels. ^9-1l9 ### [[burnout has been shown to alter immune function and changes in other endocrine systems]] > Limited studies have also shown altered immune function and changes in other endocrine systems ^zacp1 ### [[consequences of burnout]] > Consequences of burnout include increased allostatic load, structural and functional brain changes, excito-toxicity, systemic inflammation, immunosuppression, metabolic syndrome, cardiovascular disease and premature death. ^v-8iw