Burn Out Syndrome – the Ayurveda perspective

By Dr. Sajan Kumar Somarajan (B. A. M. S)

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People are pushed to work in jobs which do not suit them, overload and overtime, hardly accessible or nearly impossible targets which are to be achieved, high competition and challenges for survival and promotions, growing insecurity of jobs, loss of understanding, compassion and companionship in the working conditions and so on, there are many factors loading stress. The goal of this article is to trace out the Ayurveda understanding of Burn Out Syndrome and explain where and how Ayurveda could help.

Susceptibility in Ayurveda Point of View:

Jonas: Mosby's Dictionary of Complementary and Alternative Medicine defines Burn Out as, „a state that occurs when energy is used up faster than it is restored“. This is an explanation which is very much relevant in considering the Ayurveda perspective on the category of poeple who are susceptible to Burn Out Syndrome. Among the various body constitutions categorized based on the three Doshas, Vatha (Air element dominating), Pitha (Fire element dominating) and Kapha (Earth and Water elements dominating), the constitutions with Pitha, Vatha and combinations of both are the ones very much susceptible to Burn Out Syndrome.

Pitha Constitution:

The dominant fire element which is having divergent structure makes Pitha Constitution individuals possess warm and easily sweating body. This is due to the high peripheral circulation they have. Pitha constitution people have strong appetite and thirst, strong digestive power and high metabolic rate. Mentally they tend to be proud, imotional, dominant, highly competitive and ambitious, perfectionistic and keeping high standards in everything for themselves. They are able to put lots of energy in to what they are engaged in and a group of subordinates also they could energise and lead. They are intelligent and their strong mental fire or intellect makes them able to understand situations and problems faster and make decisions and find solutions for problems easily. They bring forward new vision and ideas and work hard for realizing it. These qualities make them naturally become enterpreneurs, managing directors, managers, Political leaders, revolutionists, artists, sportsmen, rebels, terrorists, etc. They have a kind of 'Warrior attitude'. They like to fight and win. To some extent they hold the psychology of a king getting immediately pleased of praise and getting angry of critisicm, and suspicious and anxious of the opponents whether they make plans to conquer his own country or territory on one side, while on the other side pondering dreams of winning and conquering the neighbour lands as well. Being in between such paradoxes and extremes, always tending to be in the field of conflicts is the natuture of this category. They are like a soldier, born to fight, coming home from the battlefield in the evening complaning of the stress and strain a lot; but in the next morning, cannot stay away from the battlefield.

The highly sensitive and emotional nature makes them react instantaneously to stressful situations. Because of the divergent nature of fire itself this is typical for them and often the reactions become intense and excessive. Like a spark from one side causing an explosion on the other side, for silly reasons even, sometimes they burst out in to emotional flooding causing tremendous loss of energy. And due to the imbalance in constitution making Agni or fire dominate over the converging elements, Water and Earth, Pitha constitution naturally spend excess energy in everything what they do. They have a tendency of overdoing everything attempting high standards and perfection. In reality, the energy we spend in all kinds of works or action what we do, balances to a great extent with the reaction from the other side. The higher the reaction side and the lower the action side, the loss of energy becomes very low or even zero or could gain also. An excited audience applauding and dancing frantic would make a singer on the stage instead of getting tired or exhausted, bring up the performance to such high levels which may surprise even himself or herself. The students showing no interest and looking bored or exhausted will not let a teacher continue long with his lessons. Similarly there is an exchange of psychic energy in all what we do. For people in caring and social professions, this interaction is too much and especially the clients are in need of and demanding psychic energy from them as well. Considering Pitha constitution, they always have their innate tendency to give more than needed and get back less. Keeping the same and working in the caring and social proffessions make them highly vulnerable to Burn out.

Pitha constitution holds a dominant ego making them highly self conscious. They like to be in the prominent and topmost positions, in the limelight, expecting and demanding obeyance, respect, praise and admiration. These kind of reactions make them highly satisfied, while criticism make them shattered, leading to high levels of disappointment and exhaustion. They take too much of responsibility in everything they are involved. Victories make them feel very happy and proud, while failures make them blame too much and torchure themslves. High level of ego make a person believe or feel like he or she is very much responsible for everything, either victory or failure and that make them take too much of responsibility in everything they are involved. In reality, there are many factors affecting the success or failure of all what we do or attempt. Our colleagues, favourable circumstances, the factors of luck and timing, etc also have their roles behind our success or failure. Instead of thinking like 'because of my wisdom, smartness, effort and involvement, everything has become successful', if we take it like, 'I was only a part of the whole factors behind', excessive responsibility which is an unnecessary burdon, could be reduced.

The first day of the practical training for driving test is stressfull indeed, for anybody. Being on the driver seat for the first time in life makes one feel like what all movements the car going to make is his or her responsibility. After few months, he same person is driving, listening to music or speaking to somebody and wondering at what ease the car goes now; just like going by itself! On the first day, driving appeared like a hundred percent action. But later, the reaction part has developed and that made the individual leave stress and find ease; understanding that drivng is not just an action, but reaction too and being more on the reaction side makes driving enjoyable also. Being very much in the reaction side brings down the loss of energy to the minimum and complete reaction makes it zero, like something floating on a river surface. Ego is completely sunken in to unconsciousness when we sleep deep and then we relax and recharge to the maximum. Ego makes one possess own interests, decisions and will; like a fish in the water stream trying to swim in to a direction other than that of the current. If we find a suitable profession which is having a relevance in the contemporary times and in its location and do something meaningfull, helping society or somebody in need or try to provide a good or service for which already a demand is existing, we are more reacting to the necessities. If we attempt to sell something which is outdated, irrelevant or not in demand, will face heavy loss of energy.

Pitha and Pitha-Vatha constitutions tend to be of low stamina. And in case of Pitha constitution, sudden outbursts of energy makes sometimes the energy level completely down. They often get exhausted in the afternoon itself especially when it is hot and need rest and refreshments. A nap is good in this situation to recharge, instead of a cup of coffee or some energy drink to tap the energy from the reserve also. In Ayurveda point of view, nothing; either work or excercise, mental or physical should not be done until getting totally exhausted. A certain amount of energy or strength should be left not used. And it is important for Pitha, Pitha-Vatha and Vatha constitutions to pay more importance to gain and save energy and try to reduce the expenditure. This is simply like what we do with money. Spending should be always less than earning and keeping this difference make the volume of savings grow, which constitute our financial strength.

Burn Out Syndrome patients very often belong to the above said category of constitution and many are aged around fifty; an age, somewhat like the starting of the afternoon part of life. In Ayurveda concept, Kapha dosha dominates in all living beings in the first one third of life and Pitha in the second and Vatha at the end. Because of this support of Kapha, the early one third of life is that of growth and strengtheing. Through this protection from the side of nature, in younger ages people could do many things which affect health negative; even though not getting sick. The more older we become the more nature takes back this protection and care and it becomes our sole responsibility to take care of our health. Pitha and Pitha-Vatha constitution people realise this in big contrast, in the form of a real crisis which demands an entire change of lifestyle even.

Vatha Constitution:

Individuals belonging to Vatha Constitution are characterised by poorly developed physique, restlessness, hyperdynamicity, extrovert nature, often with low blood pressure, cold hands and feet, dry skin etc. Dominance of Air Element gives them lightness and promote all these qualities. They eat small portions and tend to munch a bit of something every now and then, rather having big meals at conventional timings. Insomnia, waking up in between sleep with slight disturbances, difficulty in finding sleep, etc also affect them. Normally they sleep less hours and less deep. Altogether, Vatha constitution spend energy much more than what they gather. This basic nature makes them also a highly susceptible group concerning Burn Out Syndrome and especially when strong Pitha associates in the constitution.

Concept of Ojas:

Ojas is defined as the radiance (Thejas) of the basic materials of the body(Dhathus). There are seven basic materials which constitute the physical body in Ayurveda concept; which are evolving from the essence of food and drinks assimilated, one after the other. Each dhathu is transforming in to the next and this chain of transformation ends up in the formation of Ojas which is somewhat like the ultimate essence of the entire metabolism. Suklam or germplasm is the last dhathu which holds the complete essence of the whole organism. Thejus is the visual aspect of agni (Fire element), the brightness of Fire element. There are the three basic principles behind the formation of consciousness and the whole universe as well; named as Sathwam, Rajas and Thamas. Sathwam orients freedom, knowledge, truth, light and immortality. Thamas represents darkness, ignorance, fear, death, stativity, inertia, etc. Rajas is something in between Sathwam and Thamas, the field of conflicts in between Satham and Thamas, the zone of stress, emotions, greed, envy, aggression, etc. They are functioning in everything existing in various proportions. Can say, relatively a candle is more representing Thamas, flame, Rajas and the light spreading, Sathwam and matter is relatively more Thamas, various forms of energy indicates Rajas and consciousness is Sathwam.

In other words, in heat Rajas is dominating and Sathwam in the light and Thamas in inert material forms. Thamas awakens or activates in to Rajas and then releases Sathwam like a piece of coal turning in to ember and then developing the flame. This is the way of evolution. Involution is assumed to happen in the reverse way; getting degraded in to Rajas and then Thamas , causing the material manifestation of everything. We may consider photosynthesis as an example for involution, for instance. Ayurveda consider the structure of plants as just the reverse of humans, head down and limbs upheld. If we consider the metabolism in plant and animal kingdoms complementing each other as the two halves of a circle, plants are more receiving the cooling downward flow of the cosmic energy (feminine, represented by element Water) which is productive and animals and humans stay on the other side of the circle, either directly or indirectly consuming the products of the plant knigdom, decompose, release and use the stored energy. This is the heating upward flow of the cosmic energy (masculine, represented by element Agni or Fire). Ojas signifies the ultimate result of this complete cycle of transformations; the release of Sathwam back in to its original form. In the modern scientific terms, it is the journey of light starting from photosynthesis downwards and then returning or getting released through digestion and metabolism as Biophotons, through the completion of a whole cycle of transformations. Eventhough energy is utilized in many steps, in Ayurveda perspective, perfect completeion of digestion in its last step releases a form of light as radiance and that establishes a link in between individual life and Cosmic Prana. Altogether the entire flow of energy through metabolism thus forms an extension of the flow of cosmic energy like a loop, starting and ending in it. Keeping the connection with Cosmic Prana enables the individual to access the infinite source of energy. Disconnected completely from this ultimate source of highest form of energy makes one somewhat like a fruit fallen from the tree; depend completely on the limited energy posessed and manage through its exchanges. Yoga, Meditation, Prayers and other spiritual practices are orienting to re-establish this connection for short intervals.

A seed in sleep represents Thamas; physiology and growth of the plant signifies Rajas and the radiant flower opening symbolizes the ultimate development of Sathwam. Successful completion of a life cycle is indicated by flowering and fruiting. The basic character of Thamas is said to be the property of making 'Aavaranam', or covering. If we consider the first leaves opening when the seed sprouts, as the opening up of a layer of covering and all new pairs of leaves opeing as layers of coverings, the flower opening at the end marks the end of Thamas freeing pure Sathwam. The covering character gives Thamas a basic spherical form. Through opening all layers of coverings, what comes out at the end is thus the centre of the sphere. The Hindu concept of Gods and Godesses standing or sitting on lotus flowers should be understood like this. Similarly, successful completion of the entire metabolic cycle is bringing out sathwam in the form of Ojas, like flower being the last product of the plant, since fruit and seed belongs more to the next generation. Seed to flower is the upward growth part and fruits and then seeds are directed downwards. In water cycle (hydrologic cycle), clouds stand in place of flower and rain drops are like the fruits and seeds. The chain of life through re-births is also supposed to end up in the opening of the thousand petalled lotus in the same way. Regarding this journey of consciousness through many lives in search of release, the famous Manthra from Rig Veda goes like;

Asatho maa Sath gamaya

Thamaso maa jyothir gamaya

Mruthyor maa Amrutham gamaya

It means ''Lead me from untruth to truth, from darkness to light and from death to immortality''. Here we see that each line means the same; untruth, darkness and death are the same and truth, light and immortality as well. Al focus the journey from Thamas to Sathwam.

Ojas itself is feeding or brightening or strengthening consciousness. A perfect and uniterrupted meal resulting in complete satisfaction, a sexual union ending in orgasm, growth of a plant ending in flowering and fruiting, etc are all structurally similar to this explanation of formation of Ojas; and of course, the basic model behind this concept is the attainment of the supreme bliss at the moment of the ideal completion of life. In other words, fruitfulness is an essential goal of any project and by attaining success through perfection and completion only we could balance the whole energy spend for that. when we apply the same in jobs, satisfatcion becomes an essential necessity which makes a person balance the energy he or she has used. Acknowledgement, appreciation, etc thus hold an important role in balancing the energy loss. And for satisfaction, the job should be matching for the personality and the individual should be knowing his or her job well and enjoying doing it as well. When the job itself is the biggest passion and focusing on it and working for long in a devoted way, higher levels of ease opens like different quantumn levels and this leads the individual in to the achievement of special skills making him or her highly distinct in the particular professional field. Instead of making exhausted, job itself turns energising in such levels.

Prabha and Chhaaya:

Ayurveda explains that each individual is having Prabha and Chhaaya or radiance and dullness (shady or dim) in the physical body. Prabha is related to properly functioning Agni and Chhaya with Aamam (accumulation of toxins, waste and unnatural products due to improper metabolism caused by weak Agni) and Thamasic mind. It is said that Prabha is visible from far while Chhaaya becomes visible only when observed close. For example, when a group of people are coming across, our attention will be attracted by the most radiant face before all others, just like a flower in the bushes. It is a natural instinct making the bright and moving objects always steal our attention instantly. Dullness or darkness on the face will become visible only when a person is close enough. Giving radiance to skin is said to be a function of Pitha. In adolescent and youth stages of life, Pitha becomes intense and most balanced. This is giving teenagers and youth glowing skin. Chhaaya overshades this Prabha when one is highly exhausted, affected by toxins or Aamam and when highly depressed, perplexed, afraid or when in grief. Sensing Chhaaya, someone familiar is immediately asking you; ''what is wrong with you?!''

Deferentiating Prabha and Ojus:

Eventhough Ojas is explained as the radiance of Dhathus, it is emphasised that mostly it comes from transforming the last Dhathu, Suklam. Thejus or radiance of Ojas is like the purest heatless brightness. Prabha is more like the light from an ember, incandescent in character, while Ojas is more like a luminescence. Prabha comes from physical biochemical processes. Ojas is the cream layer of this and it is more connected to mind and soul. A Sathwic person is said to be naturally immune to diseases and even whenever getting an illness, it is healing faster and easier also. And following righteousness (Dharma) and truth, keeping cleanliness, living simple, etc are said to be promoting the longevity of life. It should be understood that when Thamas in the physical and mental planes are reduced, life becomes somewhat like more and more transparent for the cosmic energy. This is similar to the transformation of carbon from the coal form in to diamond. Thus a part of Ojas is radiance added from outside like the shine of the diamond. Spiritual refinement enrich this part. Radiance visible in old people is relatively from this side, since Pitha and Agni are naturally weak in old age.

Anyway, visually a sharp distinguition in between Prabha and Ojas is impossible. For the same reason, it is said that the colour of ojas is like that of Moonlight; added with tinges of red and yellow. These undertones of red and yellow represent the lower intensities of Agni in the lower level transformations (transformation of lower Dhathus) like a flame showing redish, yellowish and bright whitish and bluish tones in different zones. It should be noted that Prabha and Ojas from the side of metabolism naturally attains high intensity in youth stage and gradually weakens like the ember; while the strength added to Ojas from the side of consciousness could be developed throughout the time. Depending on food, medicines, food supplements, exercise, etc for maintaining and developing Ojas is certainly helpful; but only up to certain limits. This makes achievement of spiritual wealth most important for immunity and a long and healthy life. It is inevitable that ember eventually has to burn out in to ash completely; while diamonds shine forever.

Heart; the centre of Ojas:

In Ayurveda perspective, heart is the centre of life, where physical body and consciousness come in contact with each other. Ojas stands as a linking medium in between them. It is the representative of agni. Like light is needed for vision, Ojas is the medium through which consciousness reach each and every nook and corner of the physical body. Low Ojas makes this linking weak, leaving body and mind less vital. Like many parasitic plants, Lichen, Fungi, Moss, etc find place on old trees, body and mind having weak ojas creates dark crevices where consciousness does not reach, providing home for pathogens and parasites. Heart is the lamp from which the light of Ojas spreads all over the body and the radiance which could be visualised is the outshine of this inner light. Weakening of Ojas is causing the detachment of consciousness from the physical body in its subtle levels. Complete loss of Ojas results in immediate death where the connection of consciousness with the body gets completely lost. In Ayurvedic view, patients critically ill stops responding to medicines when Ojas is completely lost.

Factors which weaken Ojas:

Ojas is said to be cold in property. Too much of heat and physical activities and emotions which are heating up in nature weaken Ojas. Starvation, exhaustion, excessive indulgence in sex, freequent outbursts of anger, continuously being under stress, deep and long lasting worries, etc are mentioned as the causes of loss of Ojas. Starvation and physical and mental exhaustion enhances Agni which burns out all energy resources and then burns down the basic materials of the body and finally Ojas also. Exposure to exessive heat also does the same. On the other hand, eating too much and drinking very cold water, etc also affect Ojas negatively because Agni should be maintained strong enough to support all its branches in various forms in the physical and mental levels working out all transformations. Loss of too much of Sukla dhathu through being too much involving in sex makes Ojas go weak since mainly Ojas is developing through transforming this final Dhathu. Anger, stress and worries burns out Ojas from the psychical and mental levels.

Signs of Weak and Strong Ojas:

Low Ojas makes a person always anxious, worried, afraid and hopeless. Along with loss of strength in the mental level, physically also he or she is getting very weak. In this stage, the individual becomes less active and thoughtfull all the time. Sense organs become weak and intolerant to sensations. Dullness will dominate physically and mentally, leading to pessimistic attitude to everything. Skin, nails and hairs will turn dry. In contrary, when Ojas stays strong, confidence, strong positive energy, will power, growth and strength will be expressed.

From another angle, Weakening of Ojas happens when Kapha gets weak and Vatha goes high. The signs of exorbitant Vatha are presented as loss of weight, loss of radiance (dominance of Chhaya over Prabha), developing a desire for warmth, shivering, flatulence, constipation, etc. Keeping these points which clearly indicate the Ayurveda point of view on Burn Out Syndrome, let us have a comparison of the same with the modern viewpoint.

In general:

Just like when we are hungry we need to eat and when thirsty, need to drink, when exhaused, we need to rest. Intervals of inaction restores the energy spent and makes the body and mind fit for action again. There should be sufficient freetime for everybody to rest, relax, sleep, refresh, repair, recharge and rejuvenate. The more stressfull and hard the job, the more free time and rest is needed.

Contemporary world demands endless energy from each employee and stress has become an inevitable side effect of working. More results, more profits, more efficiency and dynamicity are demanded everywhere all the time. Individuals also search for better income, more savings, more purchases and consumption of all pleasures, etc. The masculine characters are dominant in this culture and that considers the feminine side weak silly and ridiculous. Being slow, patient, calm, finding satisfaction in simplicity and with the minimum of everything, being vegetarian, compassionate, etc are all considered weakness or laziness by the other side. The qualities of masculine side, for example, being highly ambitious, competitive, hard working, etc are considered highly positive. Actually both should balance with each other. Dominance of the masculine side is actually the reason behind the onset and widespread of Burn Out Syndrome.

Management of Burn Out through Ayurveda:

The key point of Ayurveda management of Burn Out Syndrome is pacifying Pitha and Vatha and enhancing Ojas. In Ayurveda perspective, all strengthening and rejuvenating treatments work against Burn Out Syndrome. Along with such a course of treatment, complete rest, councelling, meditation, Yoga, etc are supportive. Burn Out Syndrome is more a psychological problem than physical. In Ayurveda perspective, spiritual and philosophical knowledge is the ultimate medicine for the disorders of mind. So, a comprehensive understanding of Burn Out Syndrome by the patient itself is the foundation of all treatments. Treatments of any kind could be of help and bringing good results only when the patient realizes the reasons and circumstances which has lead to the development of the disorder and come to a firm decision to overcome. This will also help the patient to take precautions and preventive measures. This approach of Ayurveda could lead to the complete and permanent erradication of the disease.

In words of Manusmruthi, one of he oldest scriptures of Hindu Philosophy; „One who ruins Dharma gets destroyed by Dharma and the one who supports Dharma gets protected by it“. Dharma is the social and universal harmony. Anybody working against the social and universal harmony gets ultimately destroyed by Dharma. One who goes in harmony with that and supports it by all what he does physically and mentally, gets supported by Dharma when he is in need. Balance of doshas or the state of health is an extention of Dharma itself within the miniature Universe of body and mind. Understanding that we are a part or cell or organ in the vast field of Dharma and acting accordingly will keep us connected with Dharma and that provides an unending supply of energy. Dominance of the self makes us alienated and detached from Dharma and left alone with limited amount of energy. When managements and workers come in to such a state of unity in the workplace, there comes a harmony and ease which makes work enjoyable. When management and workers see each other as opponents and suspicious of each other, the result is somewhat like the development of allergies and autoimmune diseases, where the essential factors behind balance itself misunderstanding and fighting with each other.

©Dr. Sajan Kumar Somarajan

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