How is burnout different to being tired? What are the signs that your tiredness could be a sign of burnout?

Let’s face it, everything is more difficult when we’re tired. But tiredness is usually something that is transient – it can be resolved with quality sleep or by embracing other restorative practices, by repletion of iron levels if that’s what is at the heart of the fatigue, or by providing the body with the nourishment that it needs. Burnout, on the other hand, is a deep and unrelenting fatigue – it’s beyond tired. It is often related to various endocrine system glands not being able to produce the hormones we need to have energy; the adrenals, for example. Over my almost two decades in clinical practice, I’ve observed that many people who are experiencing burnout are often wired too. Tired yet wired. They desire deeply restorative sleep more than ever, but unfortunately they rarely experience it.

How long can it take someone to go from healthy to burnout?

There’s no set timeframe, but it doesn’t happen overnight – it takes years of living consistently in what I call the ‘red zone’, which is essentially sympathetic nervous system (SNS; the ‘fight or flight’ response) dominance. When we live from this place, the body is constantly churning out adrenalin and cortisol, the stress hormones that drive this response. The problem is, being “busy” and “stressed” has become the norm for so many people these days, so they may no longer even realise that their body is in a constant state of stress. After years of relentless stress hormone production, the adrenal glands can longer sustain the high output of cortisol (our long-term stress hormone), so they crash, and cortisol output can become low. This has become known as adrenal fatigue, or burnout. 

Why are high achievers vulnerable to burnout and why can it make workaholism worse?

It often stems from wanting to please others – trying to be the best parent, partner, colleague, daughter, sister and friend. On one level this way of living comes from such a beautiful place. It comes because we have beautiful hearts, but even deeper than that it comes because we made up a story a really long time ago that we aren’t enough the way we are; that we aren’t good enough, tall enough, slim enough, pretty enough, brainy enough, on time enough, that we’re just not enough the way that we are, so we spend our lives trying to please everyone in our realm, putting their needs ahead of our own. We rush around and do all we can to make sure that others love and appreciate us so that we never, ever have to feel rejected, ostracised, unlovable, criticised, yelled at, and like we’ve let others down.

There’s immense beauty in being an incredible support system to a lot of people, but there’s a reason why airplanes say ‘put your own oxygen mask on first.’ You literally can’t do all of those things if you’re not okay. And when you’re someone that has been raised to be a good girl, or a people pleaser, it’s important to start to see the benefit for the other person in your saying no.

Why can maintaining a healthy lifestyle and fitness schedule contribute to burnout? 

It’s not a healthy or fit lifestyle that necessarily contributes to burnout, it’s our perception of what this looks like. Many people perceive that to be fit and healthy, they have to thrash their body and exercise with extreme intensity, and that’s just not the case. High-intensity exercise is sympathetic in nature, so it can seem like more stress to an already over-stressed human body. If someone is churning out stress hormones all day, what they really need is calming, restorative movement or a breath-focused practice to take them out of the ‘red zone’ and allow them to activate the calm arm of their nervous system. Worrying about our food choices and how much exercise we do (or don’t do!) only adds to our stress load, and can therefore take away from our health.

I'm interested in how burnout impacts women's hormones - what are the key ways? And tell-tale signs?

In the body, nothing stands alone. Adrenalin communicates to every cell in the body that your life is in danger and cortisol communicates that there is no food left in the world, as this is what stress has historically meant for us. Today, long-term stress tends to be about finances, relationships, the health of a loved one, and our own health or weight, and it is often a perception of pressure and urgency that is driving our stress hormone production. But the body doesn’t know this - our biochemistry hasn’t adapted to modern times to be able to distinguish between the stress hormones made in response to genuine danger and those you make due worrying about your relationships.

Progesterone (one of our sex hormones) is linked to fertility, so when the body is getting the message that your life is under threat or that there’s a shortage of food, the last thing it wants is for a woman to conceive, so it shuts down adrenal progesterone production thinking it is doing you a big favour. Aside from its role in fertility, progesterone is a powerful antianxiety agent, an antidepressant and a diuretic, so when progesterone is low, women may have a tendency to an anxious or depressed mood, and they can retain excess fluid. In other words, they are very likely to experience PMT symptoms. With deep and unrelenting fatigue, people will often crave unresourceful foods – usually sugary foods and caffeine – in a desperate search for energy, and this can also contribute to sex hormone imbalances, challenging PMT and a debilitating menopause.

What are the biochemical reasons for why burnout can lead to memory loss / scattiness? 

An altered cortisol pattern in people with adrenal fatigue tends to prevent restorative sleep, which is essential for our memory. There are different phases of sleep that are required for memory consolidation in the brain, and so when our sleep is disrupted or we simply can’t get enough quality sleep, our memory can be affected.

A feeling of being unproductive and like one is not achieving can be linked to burnout - why does this happen? Is that because you're pushing too hard to be effective?

When we’re constantly in a rush, we often don’t allow ourselves time to pause and reflect on what we’re doing and how we’re doing it, and so we may not be working as efficiently as we could be. We understand that our computer or smart phone slows down and burns more battery, the more programs we have open and they more things you are asking it to do. Twenty-three open tabs of web pages, spreadsheets, documents and presentations, the photo editing, movie playing, music, software updates… our mind can feel very much the same. The more things we have open and unresolved, the bigger the drain on our mind power and energy, from all of these open loops. How many times across a day, a week, a month, a year, decades even, do tasks or situations open up, yet they are never resolved, finalised, or closed? How many emails do you read that you don’t immediately reply to, and they hang in your mind and add to your task load of what’s not yet done? It’s as if you walk around each day with so many tabs open – like websites sitting open on your computer screen – that you never feel like you’ve got it all handled. You never feel like you can rest. You can just imagine what that does to your energy!

Why does burnout lead to insomnia/ uninterrupted sleep? 

When you are in an SNS-dominant state, your body tends to churn out stress hormones and if one of those stress hormones is screaming to every cell of your body that your life is in danger, which is what adrenalin does, your body will never let you sleep deeply because it wants you to survive the imminent attack it perceives.

Cortisol, our long-term stress hormone, also plays a big role in our sleep-wake cycle. A healthy cortisol pattern involves a dip in the evening to allow us to fall asleep, and an elevation early in the morning to prepare us to wake up. For an adrenally fatigued person, cortisol is nice and low in the evenings, but if you don’t get to bed before 10pm, you will typically get a second wind, and it will be much harder to fall asleep if you’re still up at midnight, partly due to the body’s natural next adrenalin surge that tends to happen between 10:30pm and 11:30pm. Their morning cortisol levels also tend to be low, making it very difficult to get out of bed.  

What should readers do if they recognise any of these signs in themselves? Does each symptom need to be tackled individually? 

Bring a sense of awareness into your life. Think about why you do what you do, and what lead you there. Awareness, rather than self-judgment is the first step. Stress reduction is absolutely essential, and nothing activates the ‘calm’ arm of our nervous system better than diaphragmatic breathing. It can literally change your life – and I don’t say that lightly. Any breath-focused practice, such as yoga, meditation, Stillness Through Movement, tai chi or qigong is fantastic.

It’s also essential that the body gets the nourishment it needs through a nutrient-dense real food way of eating. Nutritional and herbal supplementation can also be very beneficial, however this must be under the guidance of an experienced health professional.

Discover how to beat burnout and overcome overwhelm in Rushing Woman's Syndrome by Dr. Libby Weaver, which is out now and published by Hay House UK.