I’ve always thought it was a little strange whenever a friend or colleague tells me they’ve “hit the wall.” I didn’t think it was that hard to keep an eye on how much you work. If you work too much, just work a little less, right?
But after reading Niklas Nygren’s post, everything fell into place.
“I’m 43 years old, married, and have two children. I’m a specialist in psychiatry and am employed as a senior physician at a outpatient psychiatric clinic. I’m sick because one day, my brain decided that it had had enough. Our efficient cooperation ended on a beautiful May day. ‘End’ might be a bit drastic, but I could no longer do my job. I was sitting in my chair and a fuse blew out in my brain, as one psychologist put it.
Occupational burnout. A lot of research and many good articles are available in this area. But it ultimately all comes down to this: Our brains are designed for short episodes of stress. During these episodes, we can perform a lot quickly. Stress acts as a kind of turbo mode or overheating system for the brain. It’s a good, purposeful system that helps us fuction and react quickly in high-pressure situations. But this system is not modern. It’s older than humans in our present form and similar to systems found in the animal kingdom in general.”
“For our brain and stress system to function optimally over time, there needs to be a balance. After an episode of overheating, the system needs to switch down, cool off, and recover. That sounds reasonable, right? But what happens if it doesn’t? Modern research shows that stress, and more specifically, stress hormones, work corrosively on the brain over time. When nerves constantly bite at the brain, stress hormones makes them shrink. Nerve endings retreat and a gap is created between various nerves.
The signals don’t travel the way they should. It’s a bit like like a cell phone network with poor coverage: conversations drop and the sound quality is poor. This causes concentration and memory function to deteriorate. The constant bathing in stress hormones also leads to, for example, the degradation of sleep. Pretty obvious, right? It might take a long time before it impacts daily life, and by that time, it’s probably gone too far.”
“So there I sat on my chair. My body and brain united and went on strike. It took me 1.5 hours to get up from my chair. Thank goodness, I didn’t have any patients waiting. Despite this, I continued to try to keep working. It didn’t work. Everything that worked before, to pull together and start rolling again simply didn’t work. Sick leave was the only option. The first month, I sat in my armchair. Going to the store 200 meters away to buy a liter of milk was a day-long project.
The brain and its nerves can heal and grow back, but it takes time. A long time. Some functions might not return. Studies show that the reaction to stress is affected for several years to come. What helps are meditation and physical activity in the right dose. Both activities calm the brain and lower stress levels.
To help my rehabilitation, I called a therapist and a doctor. The doctor’s task was mainly to assess me and authorize my sick leave. Medication was irrelevant. Many people in similar situations suffer from mood swings, depression, and anxiety. However, this is a condition that differs in brain chemistry from fatigue. They rarely coexist. Not in my case. The joy of life is there and I haven’t had anxiety.
How could this be? I, of all people, should have my eye on this. My therapist said at one of our first meetings that my brain works in the same way as everyone else’s. ‘No,’ half-jokingly. But in hindsight, it’s not so surprising that my brain eventually went on strike. I was more or less in active stress all my waking hours. Receptions, meetings, courses, administration work, supervising others, travel, commuting, housework, gardening, cooking, washing dishes—activities of all kinds. Like everyone else, my life doesn’t go according to plan. At the least practical moments, disease and death emerge without warning. Time is shrinking, everything comes to an end.”
“Stress hormone levels never get the chance to recover completely. In order to save time, I never gave them a chance to recover. My garden grew weeds. My cooking became basic. My potted plants died out several years ago. Last year before I took sick leave, I couldn’t bear to listen to the radio in the car. My brain clearly signaled that it couldn’t handle any more stimulus.
Back in 2008, a colleague drove me to the emergency room because my heart was racing. There was nothing wrong with my heart. It was stress and lack of recovery. I didn’t get sick, but returned to work the following day. That’s what it’s like to be Superman. I was unaware that my strength was also my Kryptonite. There’s a lot to think and write about concerning the underlying mechanisms of my behavior. Mechanisms that are by no means unique to me. However, I’m leaving that question at this point.
Just over a year has passed and my brain is slowly but surely healing. Right now, I find myself in a kind of in-between. I’m approaching a return to working life. To begin with, in terms of work, I’ll do the training equivalent of 25 percent. No patient work. It’ll probably take a while.”
This post was written by Niklas Nygren and has been translated and published with his consent. His blog can be found here (in Swedish).
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