Feeling exhausted, irritable, and dejected all the time — aka burnout — is not good for your mental well-being. And when it occurs at work, it’s not good for your career either.
A new study suggests that burnout may also cause damage to the heart that can lead to a potentially deadly irregular heart rhythm.
In addition to an irregular heartbeat, AFib can cause symptoms such as chest pain, heart palpitations, dizziness, shortness of breath, and fatigue. AFib can also increase your risk of stroke, even when symptoms aren’t present.
This study suggests that “exhaustion and poor coping abilities, along with depression symptoms, can contribute to atrial fibrillation,” said Dr. David Friedman, director of Heart Failure Services at Northwell Health’s Long Island Jewish Valley Stream, in Long Island, New York, who wasn’t involved in the study.
Stress, burnout, and heart health
Vital exhaustion is more than just depression.
The World Health Organization ties burnout to “chronic workplace stress that has not been successfully managed.” It may show up as exhaustion, being cynical about work, or feeling less effective at your job.
A recent Gallup poll found that about two-thirds of full-time workers experienced burnout on the job, with almost one-quarter feeling burned out “very often or always.”
Among physicians, burnout is just as high — around 67 percent.
“But the impact on AF has not been established,” said Shah, who wasn’t involved in the study.
Previous research on the link between AFib and mental health has been mixed.
In one study, young and middle-age veterans with post-traumatic stress disorder (PTSD) had a higher risk of developing AFib.
Another study suggests it may be a two-way street: AFib can cause depression and anxiety, but depression and anxiety may also create an environment in the heart that allows AFib to start or worsen.
Dr. Matthew Budoff, a cardiologist at the UCLA David Geffen School of Medicine in Torrance, California, who wasn’t involved in the study, said it’s not surprising that burnout might increase someone’s risk of AFib.
“When patients are stressed out, their adrenalin levels go up and that can drive one into atrial fibrillation,” he said. However, he pointed out that the effect of burnout on AFib in the new study was “modest.”
Small effect of burnout on AFib
In the new study, Garg and his colleagues followed more than 11,000 people for almost 25 years, looking for signs of vital exhaustion, anger, antidepressant use, and poor social support.
The researchers found that people with the highest levels of vital exhaustion had a higher risk of developing AFib during follow-up compared to those with no or a low level of vital exhaustion.
People who reported using antidepressants also had a higher risk of developing AFib, although this effect went away when the researchers took into account other factors that can contribute to AFib.
No connection was seen between anger or poor social support and AFib.
Researchers found that 20.7 percent of the most exhausted people developed AFib, while only 18.2 percent of the least exhausted did.
Dr. Nicholas Skipitaris, director of cardiac electrophysiology at Lenox Hill Hospital in New York City, said the small difference between these two groups is not very “clinically meaningful.”
Especially since the most exhausted group was dealing with extreme burnout for a number of years.
“For people with an average amount of stress — if they don’t otherwise have some predisposition for atrial fibrillation — I don’t think that the stress alone is going to cause them to have atrial fibrillation,” said Skipitaris.
There are several other well-established risk factors for AFib that you can modify, such as high blood pressure, heart disease, and binge drinking.
More research is needed to understand the relationship between burnout and AFib.
But Friedman said stress can activate the body’s physiologic stress response and cause the release of pro-inflammatory molecules. They may damage the heart tissue, which could then lead to the development of AFib.
Skipitaris said additional studies could look at whether “increased levels of inflammatory markers and increased stress somehow changes the electrical system of the heart to cause you to have AFib.”
Learning to manage stress
Although the new study found a small effect of burnout on the risk of developing AFib, chronic stress can affect the body in other ways.
“People who are at risk of feeling chronically demoralized, dejected, and with little ability to affect positive changes may find themselves at higher overall cardiovascular disease risk,” said Friedman.
So even if your risk of AFib is low, learning to eliminate or manage stress is still a good thing.
“People need to find ways of alleviating stress when they feel burnout,” said Budoff, “be it by exercise, other interests or, of course, by changing their environment.”
Shah also pointed out that while mental health can have a negative effect on your physical health, the flip side is also true.
“Positive psychology interventions, such as increasing gratitude and forgiveness, lead to improvement in inflammatory markers and overall cardiovascular health,” he said.
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