Inside Burn(out) – How burnout affects the stomach and intestines

“Stress hits the stomach!”, “I have to digest this thing first!”, “This spoils my appetite!”. We all know stressful situations in everyday life that have created these very phrases. They tell of how our body reacts to an emotional imbalance and forces us to take our foot off the gas for a moment.

But what if these stresses are no exception, and thus the gastrointestinal problems from a certain point on become rampant and visit us more and more regularly, even making everyday life unmanageable? From this point on, it could be that our body wants to alert us to a burnout disease. Perhaps you sometimes ask yourself: What is going on with me? Is this already burnout or am I just a bit overworked?

Importantly, one in four Germans say they are frequently under stress, half of them even believe they are at risk of burnout, and 6 in 10 respondents complain of typical burnout symptoms such as persistent exhaustion, inner tension, and back pain. (Pronova BKK, 2018)

What distinguishes a burnout syndrome from “normal” stress

Burnout can be defined as an interaction of physical and emotional states of exhaustion, which result from a continuous professional and/or private stressful situation. But be careful, burnout does not equal stress! Only a prolonged episode of stress – chronic stress – can lead to a permanent imbalance between tension and recovery. The result of this disturbed balance is then usually an enormously weakened performance. The following stressors, for example, can be responsible for chronic stress:

Physical stressors: illness, stimulus overload, climatic conditions, hunger
Psychological stressors: over- or under-demand, fear of failure, time pressure
Social stressors: Negative working climate, lack of recognition, conflicts

Now, whether chronic stress actually arises from the above stressors depends on our individual assessment of the situation, the resources available to cope, and the intensity and duration of the stressors.

The main symptoms of burnout

Burnout syndrome is characterized by a state of exhaustion, alienation and reduced performance. Statements such as, “I can’t take it anymore!” or “Stress at work, and at home is getting on top of me.”, are typical warning signs of an onset of suffering.

Exhaustion: The affected person has the feeling of being emotionally and physically burned out. Emotionally, this manifests itself in dejection, feelings of anxiety and inner emptiness. Symptoms that are also associated with depression. On the physical level, for example, there is chronic fatigue, gastrointestinal problems and tension.

Depersonalization: Characterized by a distant, indifferent attitude towards work and other people, a successive reduction of sympathy, purposefulness and social relationships develops here. Not infrequently, all this is replaced by cynicism – friends are experienced as a burden, superiors as a threat and colleagues as a nuisance.

Decreased performance: The affected person experiences a loss of confidence in his own abilities and perceives himself as a failure. For any tasks, more effort and time are now needed. Likewise, the regeneration time is also getting longer. A long weekend or a vacation is suddenly no longer enough to gather new energy.

When stomach and intestines suffer from “burnout” – A case study

Mr. S. has three children, a house with a garden and works as a department manager. One would describe his life as “fulfilled.” On the job, he is considered a workhorse. No task is too hard for him. His resilience seems endless. He often takes evening shifts, shifts on weekends and at the same time tries to spend as much time as possible with his family. Last year, his mother was diagnosed with dementia and he now tries to attend as many medical appointments with her as possible. The first signs of failure are becoming noticeable.

Again and again he wakes up at night with heartburn and feels less appetite than before. The poor sleep shows its consequences in minor mistakes at work or forgetting appointments. By taking a lot of caffeine and medication, he tries to pull himself together. He needs more time and energy for tasks that he used to do with his left hand. At first, Mr. S blames all of this on his age and makes casual remarks about it. Eventually, however, persistent bubonic pains and diarrhea come along and his family doctor has to write him off sick for the first time. Mr. S. is deeply insecure and self-doubt begins to gnaw at him.

The abdominal brain as an important part of the nervous system

The stomach and intestines are among the most commonly affected organs that go haywire when we are out of balance. But, how does our gut know, for example, that we are worried about our sick mother or that the workload is just overwhelming us beyond measure? The gastrointestinal tract actually has its own nervous system – also called the belly brain – which is in close communication with our brain. Accordingly, it is not surprising that in the case of permanent tension, restlessness or anxiety, some people react with diarrhea or stomach pain.

It is also known that stress hormones cause the release of various digestive enzymes, which in turn cause reduced blood flow and movement of the gastrointestinal tract. The production of protective mucous substances is shut down, our mucous membranes can be attacked unhindered by stomach acid, and inflammatory processes are set in motion. The main symptoms include:

  • Heartburn
  • Constipation
  • Stomach pain
  • Flatulence
  • Nausea
  • Diarrhea
  • Lack of appetite
  • Abdominal pain
  • Feeling of fullness

Even if organically everything is in order, it can come to the above complaints and symptoms. Doctors speak here of a so-called irritable stomach or irritable bowel, for the development of which chronic stress is the most decisive factor.

Treatment approaches

The treatment of burnout – including the resulting physical symptoms – consists of various components and is individually tailored to the needs of the affected person. The earlier the intervention, the better the healing process. Treatment often begins with strengthening personal resources and relaxation, as well as alleviating physical symptoms.

There are patients who report an unimaginable dimension of stressors: An 80-hour work week, meals on the road, lots of coffee, little sleep or caring for terminally ill relatives. And despite all this, they can’t imagine why their gastrointestinal system is making complaints.

At this point, the first thing to do is learn to appreciate the stressors. Only then can the confrontation with the causes of burnout take place in order to change behaviors and circumstances in the long term. In this context, relaxation techniques, behavioral therapy, body therapy, group therapy and depth psychological methods are helpful.

Objectives of burnout therapy at a glance

  • Recognizing and adhering to limits in a timely manner
  • Leading a healthy lifestyle (e.g., balanced diet, regular exercise)
  • Learning coping techniques for stressful situations (e.g., meditation)
  • Create conducive working conditions and change the work situation if necessary
  • Accepting help and handing over tasks
  • Maintain social networks and hobbies

Burnout therapy thus pursues the goal of a balance of tension and relaxation (work-life balance) to restore. This goes in many cases, however, not overnight. If the symptoms of burnout syndrome are very pronounced, it may make sense to carry out psychotherapeutic treatment as an inpatient in a clinic.


Deutsches Ärzteblatt:, accessed Jan. 11, 2022

Konig, Roland: Schnelle Hilfe Bei Burnout: Leicht Anwendbare Methoden Für Psychotherapeuten, Coaches und Betroffene. Wiesbaden, 2020

Matura, Silke ; Oertel, Viola: Bewegung und Sport gegen Burnout, Depressionen und Ängste. Berlin, Heidelberg, 2017

Stock, Christian: Burnout: Recognize and prevent. Freiburg, 2015.

Categories: Burnout

Verena Klein
Autor Verena Klein
"Die LIMES Schlosskliniken haben sich auf die Behandlung von psychischen und psychosomatischen Erkrankungen spezialisiert. Mit Hilfe des Blogs möchten wir als Klinikgruppe die verschiedenen psychischen Erkrankungen näher beleuchten und verschiedene Therapien sowie aktuelle Themen vorstellen."

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