Burn Out

Burn-out is in de meeste gevallen het eindstadium van een jarenlange overbelasting op het werk. Vaak gaat het bij burn-out om mensen die jarenlang hun hart en ziel in hun werk hebben gelegd en uiteindelijk tot de conclusie komen dat ze er te weinig voor terug krijgen. Ze hebben het gevoel niet beloond te worden voor al de gedane inspanningen. Door die conclusie en door dat gevoel zakt hun motivatie om nog te werken volledig weg. Men is opgebrand, uitgeblust, uitgeput en leeg. Fysiologisch zijn vooral de bijnieren overbelast.

Many herbal remedies may be appropriate in treating your adrenal-related health problems, including adrenal burnout. Commonly used herbal treatments for this health purpose, states Phyllis A. Balch, a nutrition researcher and author of "Prescription for Nutritional Healing," include several types of ginseng, milk thistle to improve liver, and therefore adrenal, function and herbs that possess calmative action, including valerian and kava kava. Ashwagandha and echinacea may also be helpful in treating this condition. The effectiveness of these herbs in treating adrenal burnout has not been extensively studied using contemporary scientific testing procedures.

A Powerful Herb

Ashwagandha is a powerful herbal remedy that has historically been used to nourish and support the health and function of your adrenal glands. Ashwagandha has long been used by practitioners of Ayurvedic medicine in India. Ashwagandha, notes naturopathic physician Sharol Tilgner, author of "Herbal Medicine From the Heart of the Earth," has hypotensive and adaptogenic action. An adaptogen is a substance that may improve your response to stress, fatigue and anxiety, which are all factors that may contribute to adrenal burnout.

Treating Adrenal Exhaustion

Fortunately, adrenal exhaustion can be fairly easy to treat. It works best to combine lifestyle, diet, and nutritional/herbal support. 

Adaptogenic herbs can also help keep your adrenals healthy by boosting your ability to deal with stress. Instead of over stimulating the adrenals like caffeine does, adaptogens actually support proper function and help them produce cortisol in natural patterns. Try rhodiola, which was found in one clinical trial to reduce fatigue in 56 physicians on night duty. Take a daily dose of 100 mg. of a standardized amount of 3 percent rosavins and 0.8–1 percent salidroside. You can also take a combination of gingko biloba and ginseng. This dynamic duo works together to tackle both short-term stress and chronic, adrenal-depleting stress. I recommend taking 120 to 240 mg. of a standardized ginkgo extract and 200 mg daily of a ginseng extract standardized to contain 4 to 7 percent ginsenosides.

The herbal medicine Rhodiola rosea has been shown to improve performance and mood under stress with a study suggesting it may help relive work related burnout and fatigue as well.A group of men and women aged between 20 and 55 years with high levels of work related burnout took Rhodiola or placebo daily for 28 days.

Compared to placebo Rhodiola improved several measures of mood, mental performance, cognitive function and fatigue. Rhodiola also resulted in a significant reduction in the stress hormone cortisol.

Rhodiola “exerts an anti-fatigue effect that increases mental performance, particularly the ability to concentrate, and decreases cortisol response to awakening stress in burnout patients with fatigue syndrome” concluded the study investigators.

References:

References


Restoring optimal adrenal health

Restoring the adrenal glands is one of the hubs around which we focus to bring you back to optimal health and vitality after too much stress. This is not something that happens quickly, and it is realistic to expect recovery to take from 6 to 9 months.

Liquorice (Glycyrrhiza glabra) has long been used to help with the recovery of adrenal fatigue; in fact, it was the ‘drug’ of choice in former times for the treatment of Addison's disease, which is a disease of complete adrenal failure. This root supports the glands by reducing their need to manufacture cortisol, because it provides a natural constituent called beta-glycyrrhetinic acid, which behaves like cortisol, thus sparing the glands the necessity of producing their own cortisol. And so the adrenal glands can rest and recover.

Liquorice also demonstrates anti-inflammatory and anti-allergic actions,[12] which is very helpful for those with Th2 dominance, and depressed Th1 immune imbalance. Marvellously, liquorice also has anti-viral properties.[13],[14] For these reasons, liquorice is an excellent choice for those who are burnt out with a poor immune response to viruses. Do be aware that large doses of liquorice can increase the blood pressure and reduce potassium levels.

Ashwagandha (Withania somnifera) is particularly useful for people who have been debilitated for long periods of time. The person may feel weak, easily succumbing to shock or fright with further weakness and fragility. Usually, someone in that state has a low libido. Discussing libido may seem as if I am deviating from the point, but a person's libido is a good indication of their vitality. If you are too tired or wired, sex isn't going to happen.

A study in Calcutta measured the effect of Withania on chronically stressed adult male rats. The male rats experienced mild, unpredictable shocks to the feet once a day for 21 days. The effect of this stress brought about significantly raised blood sugar levels and glucose intolerance, increased blood cortisol levels, stomach ulcers, sexual dysfunction, reduced cognition, mental depression and reduced immune resistance – all the symptoms humans display with chronic stress. However when the mice were dosed with Withania, their resistance to stress significantly improved.[15] Distressing as it is to read animal studies, this study does show us in compressed time-line just how damaging stress is to our bodies, and how significantly plant medicine can help us to cope with on-going stressful events, as well as recovering from this life-style. (Profound apologies to all laboratory rats who suffer as a result of the scientific quest for confirmation of herbal knowledge already gained through hundreds of years of safe use)

Hence, this herb restores energy levels in those who are debilitated, and is also used as a sexual and fertility tonic.[16] Withania helps to rebalance the immune system when Th1 is too low.[17]

Look at the name – Withania somnifera; somnifera means – “to promote sleep”. I find this herb marvellously restorative when given at bedtime to people with adrenal fatigue. If given with a little liquorice and passionflower it promotes a wonderfully restful sleep, nourishing the adrenal glands while the person is resting.

Adrenal imbalance can often leave you craving salt. Most of us are aware that salt can increase blood pressure but low blood pressure (hypotension) is a very common sign of adrenal imbalance. Making a cup of liquorice tea with a pinch of sea salt is a great tonic for the adrenal glands.

When under stress, the adrenal glands and the body as a whole require a great deal of B vitamins as well as magnesium (commonly found in oats, cashews, brazils, hazels, walnuts and pecans, organ meats, egg yolks, wholegrain bread, berries, brown rice, and soya beans). The adrenals also require great quantities of vitamin C, and a supplement is crucial, but try to include lots of the following foods which are rich in vitamin C - green leafy vegetables, plus broccoli, tomatoes, most brightly coloured fruits, especially berries and kiwis, sweet red peppers.

Helping the digestive system and blood sugar levels:

One of the most immediate and effective things you can do for your health is to keep your blood sugar levels even. Low blood sugar levels are very stressful for the body, and the adrenal glands have to pump out cortisol to raise blood sugars. By regularly eating small quantities of highly nourishing foods which are rich in healthy fats and protein, such as ½ an avocado, some smoked mackerel, a blob of humus and sliced raw tomato, you will instantly feel more balanced and strong. Eating slowly and enjoying your food will encourage your stomach to secrete digestive enzymes, so that food is broken down and absorbed into the blood stream, delivering the healing nutrients to every cell in your body. Caffeine, sugar and alcohol will give you nothing but a short-term buzz which takes you further over the edge of health collapse.

Sleep deeply and peacefully:

Many people with long-term fatigue are utterly exhausted, yet ironically, they cannot sleep properly. All through the day they feel drained, with no energy, but then, a miracle occurs! The clock strikes 11pm and, PING – they wake up! Suddenly there is the energy they have lacked all day, and so they whizz around getting things done and often don't go to bed until the early hours. If you allow yourself to become a night owl, the pattern becomes very hard to break and this can become quite an isolating way of life.

Others find that they just cannot fall asleep because they are “tired but wired”, or some fall asleep but to wake suddenly in the night. What can you do?

Get to bed early enough:

Do try to be in bed by 10pm with a lovely warm drink, and a gentle book or music to soothe your mind. If you do choose to watch television, steer away from the rampant misery which seems to be so popular and more towards kindly programs. Do not read thrillers because exciting as they are, they are also difficult to put down. Do not surf the net, which is stimulating too. There is evidence that light from the screen interferes with melatonin production in the brain. Instead, read something gentle. Then you will find that your mind slows down and by that watershed hour of 11pm, you have dropped your book and slipped into a restful slumber. In time, this pattern will help to re-set your internal clock.

Please do be aware that if you have struggled to sleep for months or years, when you do finally start to have regular full night's sleep, you will probably wake in the morning feeling even more tired than before. That is quite normal and it will change. The body has had such a long time managing without adequate rest, that now it is finally able to let go. After a few weeks, the tiredness will lift and you will feel wonderful again.

It might be helpful to have a warm bath with a double handful of Epsom salts, which is rich in magnesium and will relax your muscles, and promote a good sleep. A few drops of essential oil makes bath-time a delightful spa-like experience.

Before you take your bath, you might like to have a dose of Passiflora incarnata. This wonderful herb quietens the mind, leaving one feeling deeply peaceful. Or you might prefer to take to bed a cup of warm milk, with a little honey and a lavender flower head floating in the milk – this too will help you to have a restorative night's sleep.

Often people awake during the night because their blood sugar levels have dropped. Keep a snack, like half a cup of sugar-free muesli in almond milk, next to your bed so that you can have a little nibble and drop back to sleep.

Herbs which strengthen the immune system:

St John's Wort is so much more than just a herbal anti-depressant. Medical herbalists think of this plant as a nerve restorative, calming and nourishing a debilitated nervous system. It also has significant anti-viral properties.[18],[19],[20] By helping to restore the exhausted nervous system whilst at the same time reducing the viral load, this herb offers significant help to the over stressed and burnt out individual.

Astragalus membraneus also has significant anti-viral effects as well as acting as an immune and stamina tonic.

According to Dr Holick of the Boston University School of Medicine, low vitamin D levels are also associated with muscle weakness and pain and may be misdiagnosed as fibromyalgia and chronic fatigue syndrome. Vitamin D has significant immune tonifying actions, so if you find yourself vulnerable to recurrent viral infections, and suffer from an unexplained aching body, ask your health care practitioner to check you vitamin D status, and then get your skin into the sun.

Coriolus falls into the category of medical mushrooms, which have been used for centuries by the Chinese to sustain immunity and stamina. Coriolus modulates the immune system by up-regulating Th1, and down-regulating Th2, restoring that crucial Th1/Th2 balance.[25],[26] Furthermore, Coriolus shows impressive anti-viral properties against HIV and herpes viruses, as well demonstrating liver protective properties.

Verdere info


Therapy of the burnout syndrome Published online 2012 Jun 14.

Dieter Korczak,*,1 Monika Wastian,2 and Michael Schneider3

In 14 studies burnout is treated with CBT, stress management training, roots of Rhodiola rosea, physiotherapy, Qigong or music. Self-help groups, interventions at the working place and meditation are further treatment approaches. One study reports the use of a multi-modal psycho-, activity- and relaxation-therapy. Besides that psychotropic drugs are used – primarily antidepressants and anxiolytics.

The evaluation of the efficacy of the therapies is problematic. There is only one study for roots of Rhodiola and one for physiotherapy. The two Qigong studies are published by the same lead author. Even in case that several studies are existent for one therapeutic approach, the specific intervention techniques, the intervention intensity and the intervention duration are different. For the measurement of the therapy outcome the Maslach Burnout Inventory (MBI) is mainly used, but without standardized cut-off-values and without clinical validation. In several studies burnout is reduced without therapy or using standard care. The remarkable occurrence of disturbance variables during the treatment can influence the therapeutic effect as well in positive as in negative ways. Taking into account the different limitations CBT and roots of Rhodiola are the most effective therapies in reducing burnout. The results concerning the other therapies are not consistent.


Burnout: evaluation of the efficacy and tolerability of TARGET 1® for professional fatigue syndrome (burnout). Jacquet A1, Grolleau A2, Jove J3, Lassalle R3, Moore N4. J Int Med Res. 2015 Feb;43(1):54-66. doi: 10.1177/0300060514558324. Epub 2014 Dec 23.

OBJECTIVE:

To study the effect of a dietary supplement (TARGET 1®: a combination of casozepine, taurine, Eleutherococcus senticosus and extramel) on burnout symptomatology.

METHODS:

A 12-week, double-blind, randomized, placebo-controlled trial was conducted in workers engaged in professional contact with patients, students or clients. All were affected by burnout syndrome based on a score of ≥4 on the Burnout Measure Scale (BMS-10). The primary outcome measure was the change in the BMS-10 score; secondary outcome measures included the change in the Maslach's Burnout Inventory scale-Human Service Survey (MBI-HSS) score and the Beck Depression Inventory. Five scores were evaluated.

RESULTS:

Eighty-seven participants were enrolled in the study: 44 received the active formulation (verum group); 43 received placebo. After 12 weeks' supplementation, the placebo group showed significant improvements in scores for BMS-10, MBI-HSS fatigue and the Beck Depression Inventory, but MBI-HSS depersonalization and task management were not improved; the verum group showed significant improvements in all five scores. The verum group consistently showed significantly greater improvements in scores than the placebo group.

CONCLUSIONS:

TARGET 1® significantly improved the symptoms of burnout after 12 weeks' use.


Weerbaar tegen stress & burn-out

Tegenwoordig lijden veel mensen aan negatieve stress. Niet alleen in het zakelijke leven is het druk, steeds vaker is men eveneens privé drukbezet. Voor iedereen die tegen burn-out aanzit: dit overzicht van plantenextracten die u helpen om de gevolgen van stress de baas te blijven.

Avena sativa (haver), gestandaardiseerd op flavonoïden zoals isovitexine

Ontschorste havervrucht wordt gebruikt bij zenuwachtigheid en slapeloosheid. De positieve invloed op de slaap is te danken aan de aanwezigheid van tryptofaan (voorloper van melatonine) en melatonine zelf. Melatonine wordt het slaaphormoon genoemd omdat het enkel 's nachts wordt aangemaakt. In periodes met een heel drukke agenda kan uw slaap-waak ritme van slag raken. Melatonine (en dus Avena sativa) helpt dan het bioritme normaliseren.

De havervariëteit die gebruikt wordt voor de Neuravena®-kwaliteit werd op voorhand gescreend op doeltreffendheid in laboratoriumtesten. Deze haver gaf in de testen een duidelijk remmend effect op MAO-B en PDE4. Dit zijn twee functionele eiwitten die onze mentale gezondheid beïnvloeden.

MAO-B (monoamine oxidase B) versnelt de afbraak van serotonine, noradrenaline en dopamine in ons lichaam. Dit zijn de signaalgevers van het zenuwstelsel die betrokken zijn bij een beter gemoed, welzijn en blijdschap. PDE4 (phosphodiesterase 4) heeft vele functies in het lichaam. Remmers van PDE4 worden momenteel bestudeerd als antidepressiva en als stimuli voor het geheugen. Door MAO-B en PDE4 af te remmen, bezit deze Avena sativa het potentieel om uw emotioneel welzijn en geheugencapaciteit te ondersteunen.

Rhodiola rosea (rhodiola), gestandaardiseerd op rosavine

Recent onderzoek duidt op het belang van rhodiola voor patiënten met een algemene angststoornis of milde tot matig ernstige depressie. Het stresswerend effect was al eerder bestudeerd.

Het stresswerend effect van rhodiola werd bestudeerd bij 56 gezonde mannen en vrouwen (24-35 jaar oud) die tijdens de nacht werkten. Nachtwerk is een niet te onderschatten stressfactor. Gedurende twee weken gebruikten ze dagelijks een rhodiola extract. Tijdens deze periode waren ze minder vermoeid en was hun mentale alertheid duidelijk verbeterd (beter kortetermijngeheugen, beter reactievermogen op geluiden en visuele stimuli, beter concentratievermogen).

Ook de invloed van rhodiola op examenstress werd onderzocht in een gecontroleerde studieopzet. Vijftig studenten namen deel aan het onderzoek. De helft van de studenten kreeg gedurende 20 dagen een rhodiola extract, de andere helft een nepmiddel. Studenten uit de behandelde groep rapporteerden een betere fysieke en mentale fitheid dan de studenten uit de controlegroep (nepmiddel). Ze waren in de wolken over het gunstige effect van rhodiola op hun mentale vermoeidheid. Bovendien sliepen ze beter, hadden ze minder nood aan slaap, was hun algemeen goed gevoel verbeterd en nam de motivatie om te studeren toe.

Eleutherococcus senticosus (Siberische ginseng), gestandaardiseerd op eleutherosiden

De therapeutische indicaties voor Siberische ginseng zijn volgens ESCOP: verminderde mentale en fysieke capaciteit zoals zwakte, uitputting, vermoeidheid, concentratieverlies en herstel na ziekte.

Siberische ginseng staat gekend als de plant die Russische atleten hielp/helpt ondersteunen. De plant is geliefd bij sporters omwille van de prestatieverhogende impact van de bestanddelen (betere aanpassing aan verlaagde zuurstofatmosfeer op grote hoogte, langer uithoudingsvermogen).

Het effect van Siberische ginseng werd t.o.v. een nepmiddel getest bij 76 CVS-patiënten. Na 2 maanden suppletie vertoonde een subpopulatie van de gebruikers (diegenen met milde tot matige vermoeidheid) een statistisch significante verbetering in vitaliteit. Voor de grote groep was de significantie slechts aanwezig op 1 maand suppletie, en verdween ze op 2 maanden suppletie. Siberische ginseng is dikwijls efficiënter bij onderbroken gebruik.

Andere kandidaat plantenextracten

Melissa officinalis (citroenmelisse), gestandaardiseerd op rozemarijnzuur, wordt volgens ESCOP aangeraden bij krampen van het maagdarmstelsel, en door de Duitse Commissie E voor nerveuze slaapproblemen.

Schisandra chinensis (schisandra) induceert bij gezonde personen een beter uithoudingsvermogen, een fijnere motoriek en een hogere mentale capaciteit. Diverse klinische studies tonen het nut van schisandra bij psychiatrische aandoeningen (neurose, depressie, alcoholisme,...), griepepidemieën en uiteenlopende ontstekingsprocessen (aan sinussen, oren, longen, maag,...). Een schisandra extract wordt gestandaardiseerd op schisandrinen.

Referenties


Comment se sortir d'un burn-out ?

C'est en fait le moment où l'organisme craque face à toutes ces agressions. C'est la goutte d'eau "psychique" qui fait déborder le vase de l'épuisement physique. Travail, traumatisme, divorce... ne sont ici que des déclencheurs d'une situation qui empire chaque jour. La grande erreur médicale concernant ce sujet est de rechercher la cause dans les conditions de travail exclusivement, alors qu'elle est ailleurs.

Or, il existe une batterie de moyens naturels qui peuvent vous aider si vous vous sentez concerné, à prévenir et adoucir ce type d'événement désagréable. Voici comment éteindre le feu 

1 - combler les carences nutritionnelles (magnésium, fer, zinc, oméga 3 notamment) 

2 - faire appel aux plantes qui peuvent nous aider à gérer les situations de stress.

Parmi elles, la rhodiola (Rhodiola rosea) qui favorise l'oxygénation du sang augmentation des échanges métaboliques, une amélioration des fonctions organiques et émonctorielles, et donc un mieux-être au plan psychoémotionnel et énergétique. Elle favorise une adaptation générale au stress sans exciter l'organisme.

On peut aussi opter pour le bacopa (Bacopa monnieri): de très anciens écrits ayurvédiques préconisaient cette plante grasse, sous le nom de brahmi, en cas d'anxiété ou de troubles affectant l'intellect (manque de concentration, fatigue mentale, pertes de mémoire...). Elle révèle son efficacité dans des conditions de stress accompagnées de manque de sommeil.

La schizandra (Schizandra sinensis) est aussi un stimulant puissant et à large spectre, soutenant un grand nombre de fonctions métaboliques, dont le foie et plus encore les reins et les surrénales, qui sont généralement «vidés» dans le cadre d'un burn-out.

L'ashwagandha (Withania somnifera). Cette plante tonifie les ressources physiques et mentales et permet l'apaisement global et la reconstitution de réserves. L'ashwaganda influence favorablement l'équilibre émotionnel et calme les troubles du sommeil.

Le millepertuis (Hypericum perforatum) remplacera avantageusement les antidépresseurs chimiques pour les perturbations psychiques modérées, sans aucun effet secondaire.

Le griffonia (Griffonia simplicifolia) aidera donc aussi dans le rétablissement de l'humeur, d'autant qu'elle améliore significativement la qualité du sommeil.