Burnout - Mental or Physical?
The first thing to understand about burnout is that it is not caused by a single event, but rather a prolonged period of unmanaged stress that has not been managed correctly or not at all. Yet the question still stands, is it mental or physical?
The WHO defines burnout as a 'syndrome resulting from chronic workplace stress' that has not been managed correctly. It is not classified as a disease, but as an occupational phenomenon characterised by three key features: persistent exhaustion, growing cynicism towards work, and most noticeably reduced professional effectiveness. Furthermore, this concept also applies to sport where athletes experience comparable symptoms after prolonged physical and psychological stress.
The important thing to recognize is that it stems from mental stress and that is where burnout begins. In fact, in a paper titled "Mental and physical health outcomes of burnout in athletes: a systematic review and meta-analysis" they stated that burnout may also simultaneously increase the risk for other health consequences. They also later stated one of the most important underlying symptoms of burnout that is often misunderstood when an individual thinks they may have burnout, that is:
Individuals with mental illness who successfully managed their condition were now viewed as healthy. Meanwhile, individuals without mental illness could be viewed as poorly if they were unhappy.
But what does this really mean? It means burnout is not always easy to recognise. When someone is experiencing burnout they will constantly appear unhappy or emotionally distressed, but this is not always the case. An individual may continue to perform well, socialize, and appear positive on the outside while internally experiencing persistent exhaustion, chronic stress, and a declining ability to cope. As a result, burnout can often go unnoticed until its effects begin to impact both mental and physical health.
Physical health is defined as the overall condition of the body. This can be measured by biomarkers (which is the most accurate), however self-reports through standardized questionnaires are also used to measure physical health. The self-reporting side of physical health may seem unnecessary as bio-markers are more consistent, but it's done to see how individuals subjectively feel with respect to their physical condition. When these two measurements provide an inconsistent story about the athlete (when compared to the biomarkers), it often reflects what the athlete is feeling rather than what the athlete is performing.
In 1993, Bruce McEwen and Eliot Stellar proposed the theory of allostatic load, which explains what happens when the body is exposed to stress for long periods. But when the demands placed on athletes consistently outweigh our ability to recover, the body never fully returns to its 'normal state'. Instead, stress begins to accumulate, creating what the researchers called allostatic overload, meaning a state of prolonged strain that can impair recovery, reduce performance, and increase the risk of both physical and mental health problems, including burnout.
Some of the negative mental side effects of burnout include:
Depression - Burnout is strongly associated with increased depressive symptoms in athletes, with research showing that athletes experiencing greater levels of burnout are more likely to report feelings of low mood, emotional exhaustion, and reduced motivation.
Anxiety - Athletes experiencing burnout often show higher levels of anxiety, including stress, and feelings of being overwhelmed, as a result of ongoing physical demands exceed their ability to recover can contribute to psychological strain.
Mood swings - Burnout is linked with greater negative emotions, including frustration, irritability, and emotional exhaustion, while also being associated with lower wellbeing and reduced satisfaction with life and sport.
Sleep/ fatigue - Burnout is associated with poorer sleep quality, increased fatigue, and more physical symptoms, suggesting that prolonged psychological stress can impair recovery, immune function, and therefore overall physical health.
Overall impact - A systematic review and meta-analysis of 54 studies involving nearly 14,000 athletes found that burnout is most consistently linked with negative mental health outcomes, particularly depression, anxiety, psychological distress, and reduced wellbeing, while evidence for physical health effects is growing.
Burnout has been associated with a marginal increase in injuries and training days lost to injury, although current evidence is limited and more research is needed to determine whether burnout directly increases injury risk. One study by Grylls and Spittle in 2008, also found that injured athletes reported higher levels of burnout than uninjured athletes. However, because so few studies have examined this relationship, the evidence is still limited and more research is needed to determine whether burnout directly increases injury risk. The simple reason for this is that more research has been geared towards the psychological effects, rather than the physical side-effects.
Conclusion
Research has repeatedly displayed that burnout, as well as its own symptoms, has a strong correlation to negative health outcomes. Yet, if we were to ask if burnout is physical or mental, the correct answer would be mental which can potentially lead to physical. It begins with a chronic psychological stress that exceeds an individual's ability to not only cope but recover, which in turn can lead to disrupted sleep, impaired recovery, increase and prolonged fatigue, and weaken immune function, which can contribute to a variety of physical health issues.
The button titled 'Research paper' is a direct link to a research paper titled 'Mental and physical health outcomes of burnout in athletes: a systematic review and meta-analysis' which is authored by Hanna L. Glandorf, Daniel J. Madigan, Owen Kavanagh & Sarah H. Mallinson-Howard.
