 Lots of people say they felt burnt out at work or they feel burnout in general in their life. But in my experience in my private clinical practice, there are nine common signs of burnout that is really medical burnout, meaning there is something physiological going on. So in this video, I thought I would share a bit about the history of this as well as what those signs and symptoms actually are. Hey guys, I'm Dr. Alex Hein, author of the health book, Master of the Day and Doctor of Acupuncture and Traditional Chinese Medicine. So before we jump into this video, there are two very important links right below the video. The first is for a free guide, which is four daily rituals that can potentially help you add years to your life with traditional Chinese medicine. And the second is if you'd like to become a patient of mine locally in Los Angeles or virtually via telemedicine, you can reach out to my private practice by clicking the link right below. Now the history of what is called nervous exhaustion is very, very interesting. Certainly in the West, there's a long history of what used to be called neurasthenia. So especially there are lots of writings and lots of medical works beginning around the late 1800s, going into the early 1900s in North America. And one of the reasons for that is that this is really the beginning of this industrial age. This is the beginning of people moving from working on farms and ranches to becoming intellectual skilled workers, right? Where people were going to their desks and literally working at a desk all day. One of the first times in history where that became the norm as opposed to the exception to the rule. So you have all these workers going to do intellectual labor, meaning the body is not physically moving for basically the first time in history. And people are now crunching numbers, doing long hours of studying and then continuing to just do that. And this is becoming a societal trend overall. And there's a rise in a certain kind of condition that became called neurasthenia or Americanitis. Now neurasthenia was in the West at this moment in history. Of course these symptoms have always existed, right? They just reached this crisis point in our culture. Now these symptoms were often characterized by an elevated heart rate, palpitations, indigestion, headaches, elevated blood pressure, that sort of thing, fatigue, anxiety, depression. Now that cluster of symptoms used to be called neurasthenia. Now even though this is considered nervous exhaustion in particular, it's considered an archaic term meaning it is no longer used in medicine. It is still real in the way that it can occur in people. So I find that for many people that are excessively working, particularly skilled labor where they are not physically moving much, people are a lot more prone to this condition as a result of stress. Now within traditional Chinese medicine, there's a very similar term that has gone back thousands of years called shu lao. Now shu lao is basically called sometimes translated as deficiency taxation. So lao is like the same character as basically to work or to labor, right? Like someone physically working, excessively working. And shu is the character basically for deficiency. So you've basically worked yourself into an exhausted sort of debility, right? An exhausted sort of state. So let's talk about those signs and symptoms now. Now the first sign is having an elevated heart rate. One of the most common signs and symptoms that we see in my profession is that people who are exposed to chronic levels of stress and stress hormones begin to develop an elevated heart rate. Now at first it may just happen every once in a while. You get home from a long day of work and you're noticing, wow, it takes me a long time to calm down. But eventually what happens is it becomes prolonged and your heart rate may be elevated for hours after working. Now within traditional Chinese medicine, the elevated heart rate is what we call heart yang deficiency, meaning your heart has to pump harder, faster, more beats to get the same effect. So what is paradoxical, right? A state of deficiency where the body is decompensating then produces basically an increase in blood pressure that the body wants to generate to compensate. So what we tend to see is that heart yang deficiency, as we call it, is basically nervous system overwhelm. If I could make a one-to-one correlation, which is not easy to do, I would say it's excess nervous system activity, right? You're working all day, you're studying all day, you're stressed, and you begin to notice your heart and your chest. You begin to notice your pulse rate is in the 70s, 80s, 90s, hundreds even. Now for a lot of people, if that goes on long enough, they will start to have an arrhythmia called a palpitation. So that brings us to sign number two, which is arrhythmias, right? Heart palpitations are one of the common signs that I see of burnout. So again, this is physiological. This is where you've been either pushing yourself for so long or exposed to chronic stress for so long that now those elevated stress hormones are basically causing an arrhythmia. Now the first two, in my experience, are very easy to treat clinically with Chinese formulas. The formulas from TCM, first class, best in class to treat these symptoms, I treat them every day in my private practice. But we say that as the heart yang gets weaker and weaker and weaker, it will begin to compensate by trying to speed up, speed up, speed up. And actually, once it speeds up, one of the next steps is that it can develop these arrhythmias like a palpitation. The third sign is light or fragmented sleep or insomnia. What inevitably happens to people when they are exposed to stress for a long enough period of time is that three key signs and symptoms of what we call heart yang efficiency, which is basically sympathetic dominance, excessive stress hormones, show up. Changes in the heart rate or heart rhythm, insomnia, and typically anxiety or depression, those three, that trifecta, the dream team of the horsemen of the health apocalypse, very commonly occur together. So inevitably what happens is, first of all, people notice every now and then I don't sleep well, right? Generally I'm a good sleeper, but yeah, I've been getting insomnia for the first time. Not sure why, but it's no big deal. And then they consistently get that. And then they get those nights where they can't fall asleep. And then they get those nights where they maybe fall asleep, can't fall asleep, then they wake up in the middle of the night. And then at its most severe degree, people can't fall asleep all night. So it ranges from random insomnia, consistent insomnia, and then up all night, very, very serious, nervous exhaustion, as it's called. The fourth sign is constant fatigue. So fatigue is a common experience in daily life for many of us. But for a healthy person, if you rest, fatigue goes away. And if you're consistently exhausted, if you consistently rest, the fatigue will go away. But in people who are constantly in a state of tension because of the excessive stress hormones, what inevitably happens is that because the body is always in fight or flight, it's always on high alert, it is constantly buzzing with a kind of tension of the nervous system activity from the stress hormones. So not only is there physical tension, but there's an actual constant feeling of, you know, we use that term deficiency taxation in Chinese medicine, right? A term almost 2,000 years old from one specific medical text. But it's this constant taxing of yourself that anyone can tolerate for a while, right? Anyone can go on a few hours of sleep, maybe for a few months. But it's people who have prolonged insomnia that then begin to decovencate and begin experiencing symptoms of chronic fatigue or depression or things like that, where one night of bad sleep will put them in a very, very dangerous state as opposed to someone who's always sleeping well, who has one night of mis-sleep, they're fine. They almost can feel nothing. So what inevitably happens is what is fatigue once in a while is a steady constant malaise, like a low-grade feeling of depression that is always there. Again, you may still be functional. You may still be existing in your day-to-day life. But if you're being real with yourself and you're relaxing for a minute, you know you don't feel well consistently. The fifth sign of nervous exhaustion is indigestion. Now it's interesting that way back when, even when this Wikipedia entry was written about the history of neurostenia in the West, dyspepsia, right, so indigestion, was noted as one of the key signs and symptoms. Now indigestion probably is the single most common symptom GERD, acid reflux, that I see in my private clinical practice. And there are many reasons for that. But stress is just one of them, right? Obviously, poor dietary choices, eating a lot of food, a standard American diet, underlying predisposition, those all can be factors. But the one that I see is this indigestion that happens from people who are constantly under stress or not taking the time for proper meals or eating while working on the computer still. I remember reading a very interesting paper some years ago that showed that if people are even listening to a radio while they're eating, they actually produce less pancreatic enzymes, less digestive enzymes than someone who's, let's say, just looking out the window and relaxing. So you can imagine the context of our modern culture where every single person is flipping through Instagram reels while they're eating a meal or they're working while eating a meal or they're just not even eating meals altogether. You can imagine that nervous system burden and how it affects ourselves internally, even if you're making good dietary choices. Sign number six is anxiety or feeling on edge or depression. So inevitably, when your nervous system is being pushed to the point where it's buzzing like this with tension all day, you're not going to feel grounded. You're not going to feel calm. You're going to feel on edge. The way I describe this to my patients, it's almost like your nervous system has too many guards in the watch tower, and instead of there being five guards looking for the Trojans coming, there are 1,000. And so what happens when you have too many guards in the watch tower? Every little rabbit in the bush at night, they think is the Trojans coming. So your body should ordinarily respond to a severe threat with a severe change in physiology to prepare you to deal with it. But when the nervous system is on high alert, it's hypervigilant, what inevitably happens is that those little rabbits in the bushes at night are provoking 1,000 archers attacking this imaginary foe. So the body on high alert like that inevitably is not going to make you feel very well, because that is something that evolutionarily we've been designed to just utilize when we have to. But when that becomes all the time, there's anxiety is typically the first response. So an elevated nervous system response. Sign number seven is difficulty breathing or stuffiness in the chest and ribs. Now what's very interesting, one of the historical anecdotes as to why the term hypochondria exists is fascinating. This area below the ribs is called the hypochondral right below the rib side area. And within traditional Chinese medicine, this zone is basically governed by the liver, the gallbladder, and the triple warmer. Now stuffiness or distension in the ribs is often put into this catch all phrase called liver cheese stagnation. Now liver cheese stagnation is a real thing, right? Will some device or some tool or some kind of imaging or labs ever be able to measure liver cheese stagnation? No, it's a cluster of signs and symptoms that are one part objective, one part subjective. But patients inevitably feel this kind of stuffiness or fullness in the chest like there's a belt over their chest or there's just sensation in the ribs. Now this is a real symptom, but it is subjective. Now in the West, this was typically applied to women who are called later hypochondriacs because they were believed to be making these symptoms up. And so the sensation around the ribs, hypochondral right below the rib side was often called these people that came in were then called hypochondriacs because it was a such a common symptom and pattern and I'm sure many physicians thought it was just people being dramatic. Now it's real within traditional Chinese medicine. This subjective symptom is one of the key diagnostic signs of this kind of stress response. So this stuffiness in the chest can be related to that specific sign and symptom along with anxiety. Now the final sign of this nervous exhaustion or burnout is areas of physical tension in three specific areas. So the first area that I tend to see is the suboccipital area, the back of the neck. The second, the sternocleidomastoid muscles. And the third, the jaw. So these areas of the body are basically referral zones for the stress response. So people who have chronically elevated stress hormones or like I mentioned in points one and two, what we call heart young deficiency, which is basically this elevated heart rate, palpitations, anxiety, very commonly present with this exact same pattern, a pattern of quote adrenal stress. So we utilize very often, you can use acupuncture, you can use obviously lifestyle, but internal medicine formulas from traditional Chinese medicine are very effective to treat this. Because again, we are treating the physiology, we're treating the stress response. And these zones are just some of the basically, I hate to say referral zones or reflex zones for this systemic response in the body. So physical tension can occur anywhere of course, right? Some people stress they feel in their gut, some people manifest in their menstrual cycle, some people in headaches or migraines, but these zones are some of the most common that I see. So these are eight or nine of the most common signs and symptoms I see of nervous exhaustion or burnout. And they're somatic, so they're useful to know because they're something that you can readily identify as even if I may not feel stressed, my body is showing all the signs of stress and that is what will make me sick. So I can back off. All right guys, so that's what I have for you here today. Don't forget to check out the links right below this video and I'll see you soon.