'Vital' Exhaustion Isn't Just Bad For Your Brain, But Your Body Too

You've probably never heard of it – but you might have experienced it.
Vital exhaustion has been linked to an increased risk of heart attack in men.
Vital exhaustion has been linked to an increased risk of heart attack in men.

‘Vital exhaustion’ – which many refer to as burnout syndrome – isn’t something you want to leave unchecked.

A study has found men experiencing vital exhaustion – described by the authors as “excessive fatigue, feelings of demoralisation and increased irritability” – are more likely to have a heart attack.

The research, presented at an online scientific congress of the European Society of Cardiology (ESC), also found the issue was particularly pronounced in men who had never married, as well as those who were divorced and widowed.

Dr Dmitriy Panov, of the Institute of Cytology and Genetics in Russia which led the study on vital exhaustion in men, says the issue is a response to problems in people’s lives, “particularly when they are unable to adapt to prolonged exposure to psychological stressors”.

‘Vital exhaustion’ is defined as “a state characterised by excessive fatigue, lack of energy, sleep disturbances, and feelings of demoralisation”, according to the American Psychological Association.

The phrase is often used interchangeably with ‘burnout’, which the World Health Organisation (WHO) defines as being characterised by feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and reduced professional efficacy.

For the study, researchers used data from the WHO’s Monica Project – 657 men aged 25 to 64 years old in Novosibirsk, enrolled in 1994. Symptoms of vital exhaustion were assessed and participants were classified according to their level: either none, moderate or high. They were then followed-up for 14 years.

Overall, two-thirds (67%) of the men had vital exhaustion – 15% had high level exhaustion and 52% had a moderate level – while 33% were unaffected. Nearly three-quarters (74%) of men with high blood pressure had vital exhaustion.

The researchers analysed the association between vital exhaustion and the risk of having a heart attack and found that compared to those without vital exhaustion, men with moderate or high levels had a 2.7-fold greater risk of a heart attack within five years and a 2.25 higher risk within 10 years.

The issue was pronounced in never-married, divorced and widowed men – Dr Panov said living alone indicates less social support, “which we know from our prior studies is an independent risk factor for myocardial infarction and stroke”.

Other studies have linked exhaustion to heart problems in both sexes. One linked burnout to atrial fibrillation (AF) – an irregular heartbeat – which is a major cause of stroke. It found participants with the highest levels of vital exhaustion, or burnout, had a 20% higher risk of developing AF, compared to those with little to no evidence of burnout.

An analysis of studies on burnout found the issue is also a significant predictor of other physical issues like: high cholesterol, type 2 diabetes, heart disease, musculoskeletal pain, prolonged fatigue, headaches, gastrointestinal issues, respiratory problems, severe injuries and dying before the age of 45.

Insomnia, depressive symptoms, and other psychological ill-health symptoms are some of the mental implications of burnout, the same analysis found.

Dr Panov said it’s clear efforts to improve wellbeing and reduce stress at home and at work can help reduce vital exhaustion.

If you feel burnt out or exhausted, the NHS advises against turning to unhealthy coping mechanisms like smoking or drinking alcohol – and instead doing exercise, taking control of the situation causing you stress, practising self-care and helping others. It might also help to prioritise sleep and spend time outside.

Neil Shah, chief de-stressing officer for The Stress Management Society, likened a burnt out person to a bridge under strain. “Imagine a bridge that has too much weight on it... it doesn’t matter how well constructed the bridge is, any bridge with too much weight on it is going to collapse,” she said. “And that collapse is going to be severe; the whole bridge is going to come crashing down.”

Mindfulness could be beneficial to those who are stressed, to help them live more in the moment, said Shah. And breathing exercises may help – take five minutes out of your day, sit comfortably, and focus on your breath. There are a number of apps you can download on your phone to help guide you.

For those living alone, who could be more at risk of heart issues related to burnout, Dr Panov suggested involvement in community groups as one way to increase social support and become less vulnerable to stress.

“Together with a healthy lifestyle, these measures should be beneficial for heart health,” he said.

Useful websites and helplines

Mind, open Monday to Friday, 9am-6pm on 0300 123 3393.

Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill).

CALM (the Campaign Against Living Miserably) offer a helpline open 5pm-midnight, 365 days a year, on 0800 58 58 58, and a webchat service.

The Mix is a free support service for people under 25. Call 0808 808 4994 or email help@themix.org.uk

Rethink Mental Illness offers practical help through its advice line which can be reached on 0808 801 0525 (Monday to Friday 10am-4pm). More info can be found on rethink.org.