how to identify stress and burnout

Burnout Detected In Sweat

What if that pesky bodily response could revolutionize healthcare?
how to treat anxiety

Identifying Warning Signs

If you listen to your body when it whispers, you won’t have to hear it scream

—Cherokee Proverb

How Do We Know How You Really Feel?

People are notoriously bad reporters of their own experiences. In fact, these cognitive errors in perception underlie many of our modern mental health diagnoses ranging from generalized anxiety to major depressive disorder. These cognitive errors can also lead to confusion about how practitioners interpret a patient’s condition. 

In fact, even doctors who have been to medical school and should know better, can regularly discount a patient’s stress experiences. Many doctors falsely believe that stress or burnout is not a real physical condition. Not exactly the thing you want to hear in the throes of anxiety or, worse, a panic attack, right?  

It’s Not All In Your Head

Now science is close to actually quantifying burnout in an objective way. Wild! A team in Switzerland’s Lake Geneva area, which is already known as Health Valley, have been working hard to use nanotech to measure stress (hopefully they don’t burn out). The Swiss engineers at Nanolab have partnered with the skin-sensing device startup Xsensio to create a small wearable sensor. This device has the capability to be placed right on a patient’s skin in the form of a discreet and wearable patch. These researchers hope that they will soon be able to continually measure a person’s concentration of cortisol in practically realtime. This is crucial for quantifying burnout since cortisol is the body’s primary stress biomarker  

Cortisol: A Double Edged Sword

Cortisol is a steroid hormone produced by our adrenal glands from cholesterol. Cholesterol is actually a precursor  for the synthesis of many biological components in our body like steroid hormones, bile acid, and even vitamin D. When chemically isolated, cholesterol is a yellowish crystalline solid with a bad rap for clogging and hardening arteries. But don’t have a heart attack yet! Like many of us – cholesterol not only has a bad side, but a good side too. In fact, we actually need cholesterol and its many byproducts like cortisol. Cortisol has a good side too (the one it shares on Instagram). But seriously, cortisol is responsible for many essential functions in our bodies. Cortisol helps regulate blood pressure as well as metabolism. It also plays a big role in our cardiovascular and immune systems.

When we find ourselves in a stressful situation, either perilous or mundane, cortisol is the chemical that takes charge. “Cortisol can be secreted on impulse – you feel fine and suddenly something happens that puts you under stress, and your body starts producing more of the hormone,” reports Adrian Lonescu, leader of Nanolab.

While cortisol is a literal lifesaver when we need to respond to stressful situations, it’s really a double-edged sword. It’s typically secreted throughout the day and follows our circadian rhythm, increasing as we rise and then gradually decreasing as we get closer to bedtime. “But in people who suffer from stress-related diseases, this circadian rhythm is completely thrown off,” states Lonescu.

How It Works

Standard cortisol assessments such as blood draws are really just  snapshots of a single point in time. Yet, due to the natural variability in cortisol levels throughout the days, these glimpses can be woefully inadequate for understanding our actual stress levels. A desire for increased accuracy and understanding of our body’s cortisol response was a key motivator for Lonescu because, “if the body makes too much or not enough cortisol, that can seriously damage an individual’s health, potentially leading to obesity, cardiovascular disease, depression or burnout.”

Nanolab’s patch consists of a transistor and an electrode constructed from graphene, chosen due to its unique proprieties like high sensitivity and the ability to detect chemicals at even low levels. Graphene is trending in Nanotech because of its high thermal and electrically conductive properties. It conducts electricity better than any known chemical (that’s hot!). It’s also very lightweight, being only one atom thick (someone’s been working out!).

The graphene in the patch functions through the addition of aptamers, which are specific fragments of single-stranded DNA or RNA chosen because of their ability to bind to specific compounds. The aptamer in Nanolab’s patch carries a negative charge. This way, when it detects cortisol, it instantly captures the hormone, causing aptamer’s strands to quickly fold up and carry the charge to the electrode surface. The device picks up on this charge and uses it to consistently track the cortisol concentration in the wearer’s sweat.

Engineering Better Healthcare

To date, no other system can monitor cortisol concentrations throughout the continuum of the entire circadian cycle. “That’s the key advantage and innovative feature of our device. Because it can be worn, scientists can collect quantitative, objective data on certain stress-related diseases. And they can do so in a non-invasive, precise and instantaneous manner over the full range of cortisol concentrations in human sweat,” points out Lonescu. 

Think about what this could do for psychological syndromes like burnout, which are caused by prolonged stress? “For now, they are assessed based only on patients’ perceptions and states of mind, which are often subjective,” indicates Lonescu. “So having a reliable, wearable sensor can help doctors objectively quantify whether a patient is suffering from depression or burnout, for example, and whether their treatment is effective. What’s more, doctors would have that information in real time. That would mark a major step forward in the understanding of these diseases.” And who knows what’s next, it’s possible this technology will be integrated into smart bracelets. “The next phase will focus on product development to turn this exciting invention into a key part of our Lab-on-SkinTM sensing platform, and bring stress monitoring to next-generation wearables,” states a lab representative. 

As psychologists, we are eager to see how these innovations could help our patients. By understanding not only what exact situations exacerbate burnout, but also what coping strategies mitigate it, patients can feel empowered to know what to avoid and most importantly, what helps. Psychologists can also review long-term stats and trends with their patients. Looking at both the micro and macro level can help even the most frazzled patient see, with objective data to boot, that even they have had some chill times and maybe even some good weeks!  

Until this patch reaches the mainstream, there are many ways to understand burnout and how it affects you.  

licensed clinical psychologist for anxiety and trauma in Arlington, VA

about the author

Dr. Britt Lindon

Founder & President

I understand ambitious but thoughtful & creative, purpose-driven people because I am one. Sooner or later, if you are these things, you find yourself confronting an existential conundrum: how to win the game when…