The Hidden Truth About Burnout: It's Existential.

It starts in the mind, ends in the body and sucks your soul down with it.

However, understanding the real science behind chronic exhaustion and what actually helps is important- but- not rocket science.

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You feel stressed. You've been told you need to "manage your stress better." It’s causing headaches, weird unexplained and undiagnosable symptoms. You've been told it's all in your head. The problem may not be the stress or the stress biochemistry, maybe its that your body can't produce enough stress hormone anymore. Regardless, burnout is an all encompassing circling the drain kind of event.

When I was 1 year away from graduating Chinese medical school I collapsed. Adrenal exhaustion was the official diagnosis, but very few allopathic doctors knew what to do with this. Chinese medicine doctors called it spleen qi xu, naturopaths threw supplements and vitamin injections at it, the original diagnoser, an osteopath I saw the day after my collapse, was the only one that held my hand and looked me in the eyes. He asked me if I had been sick- yes while traveling exactly a year prior. Had I endured childhood trauma? Yes. Had I endured sexual trauma? Also yes. I was a single mother, in school, owned a home and worked a job. Stressed, exhausted? Yes. He told me to go to bed for 6 months. No.

Allopathy tried to inject me with cortisol. No. Eat more meat, swallow more vitamins, quit school. NO. So I pushed through and collapsed multiple times over until I lost everything anyway. Two other successful entrepreneurial friends- women- hit the same wall at the same time and we all went through a very similar spiral. Now, it is known professionally as burnout.

New research is expanding on everything we thought we knew about burnout. And it explains why stress management techniques, supplements, vacation time- don’t work.

Think of cortisol as your body's natural energy tonic. It's the steroid hormone that gets you out of bed in the morning, helps you focus during challenges, and gives you the energetic ability to handle whatever life throws at you.

In a healthy system, cortisol follows a rhythm.

• Morning: High cortisol gives you energy to start your day

• Afternoon: Moderate levels keep you alert and focused

• Evening: Low levels help you wind down for sleep

It adapts to what you need, when you need it.

For years, the wellness world has told us chronic stress creates too much cortisol, and too much cortisol makes you sick, anxious, and tired. The solution is to reduce stress, lower cortisol, feel better.

This led to the rise of meditation apps promising to lower your cortisol, supplements marketed to reducing stress hormones, adrenal cortex capsules, advice to eliminate stress at all costs and yoga et. al., centered on nervous system regulation.

And while these things can be helpful, they're based on an incomplete understanding of what's actually happening in many burnt-out bodies. Truth is your stress navigation system could be under performing.

If your body, brain and mind have been surviving in hustle mode, hypervigilance or chronic stress for a long period of time, the likely culprit is a deficiency in cortisol. It’s similar to an immune system that cannot mount a proper response to an invader. A fever is a good sign when you are sick- no fever when there should be one is a bad deal. Likewise, the hormones that help you manage stress run low and can go from overdrive to complete overwhelm.

Scientists call this hypocortisolism - fancy Latin for "not enough cortisol." And it explains why you might feel

• Exhausted even after sleeping because you don't have the morning cortisol surge to wake you up.

• Overwhelmed by normal tasks because you lack the hormone that helps you handle challenges.

• Unable to bounce back from stress because your system can't produce the cortisol needed for recovery.

• Like you're running on empty because biochemically, you are.

Your cortisol system is like a car engine backfiring in a parking lot. Awkward. There are phases of tolerance we all possess. Our ability to adapt is tested and the more trauma or adverse experiences we have in life can definitely take a toll. Unfortunately, the more trauma we tolerate, the higher tolerance we have for hard shit. Eventually, even the strongest among us get depleted.

Phase 1 - Normal Operation: Your adrenal glands are the engine that produces cortisol smoothly in response to daily demands. You feel energized, resilient, able to handle life's ups and downs.

Phase 2 - High Demand: Life gets intense. Work stress, family pressures, health challenges. Your engine starts working overtime, producing more cortisol to meet the demands. You might feel "wired and tired" but still functional. We are only able to manage this type of energy for a short time.

Phase 3 - Overdrive: The demands don't let up. Your engine is constantly revving. You're producing cortisol around the clock just to keep up. You feel anxious, have trouble sleeping, maybe gain weight or get sick more often. Your immunity is impacted and because cortisol is working over time your body may begin to fail to fight illness the same way- it can become such a problem your body may no longer mount an immune response to invading pathogens.

Phase 4 - System Breakdown: Your engine has been redlining for too long. The parts start to wear out. Your adrenal glands become exhausted and can't produce adequate cortisol anymore. This is where the real trouble begins.

In Phase 4, you don't need less cortisol - you need your system to be able to produce adequate amounts of it again. Also, I sincerely apologize for the weird engine metaphor. I actually find it creepy and never like to describe health parallel to anything mechanical. Western medicine likes to attribute the body to a machine, the brain to a computer and I feel this is their 1st step in the wrong direction.

If you have hypocortisolism, you might experience feeling less alert, extreme fatigue that rest doesn’t fix, difficulty getting out of bed in the morning, afternoon energy crashes, tired but unable to sleep and brain fog with difficulty concentrating. Physical symptoms (and my personal experience) dizziness, cravings for salt and sugar, low blood pressure, muscle weakness, getting sick frequently (and taking forever to recover) or not getting sick at all, digestive issues, nausea and of course the mental and emotional load.

Overwhelmed by normal responsibilities and an inability to handle even small stressors are a telltale sign of burning out. Depression or feeling emotionally flat, anxiety (which often seems to go hand in hand with depression) or feeling like you are running on fumes and the edge of collapse are also signs to watch for. The apathy, lack of motivation or hope and the striking depth of a loss of self tends to accompany burnout.

Everything feels harder than it should. Tasks that used to be routine now feel overwhelming. Your body feels like it's betraying you, no matter how much you rest or how well you try to take care of yourself. Very few practitioners understand the full spectrum of burnout. The more times you burn out, the more likely you will again and there is such a thing as a point of no return.

Traditional Vacations, Time Off, Stress Management, Nervous System Regulation… Doesn't Work to Heal This.

If your problem is an under-performing cortisol system, then meditation apps, stress reduction techniques and breathwork are like trying to fix a broken engine (again with the motor thing) by driving more slowly. They're not addressing the real fundamental problem.

Relaxation is superficial. Small talk is exhausting. Eating perfectly or detoxing or supplementing with all the things helps, but barely because if you are not digesting, absorbing, pooping or getting the right kinds of supplements and minerals, maybe just throw your money out of the car window while driving down the freeway instead. You could sleep all day and all night and not feel any more rested because sleep isn’t restorative like it used to be. Maybe you think you need to reduce your workload or get a divorce or name some other culprit, but a massive life transition is maybe creating more insanity. Nothing worked. Nothing is working. It's not because you're doing it wrong -it’s because it’s the wrong approach.

If you suspect your cortisol system is under-performing, how do you actually help it recover? All the things mentioned above are useful because any attention toward self-care is a positive move. Here’s a list of the basic initial steps toward bio-balance. The deeper, less discussed options will follow in another post.

1. Support Your Adrenal Glands:

Your adrenal glands are the tiny organs that produce cortisol. They need specific nutrients to function properly. They need key nutrients like:

• Vitamin C: Your adrenals use more vitamin C than any other organ. Load up on citrus, berries, bell peppers, and consider supplementing.

• B Vitamins: Especially B5 (pantothenic acid) and B6. Found in whole grains, meat, eggs, and leafy greens.

• D3: Supports overall adrenal function and influences the hypothalamic-pituitary-adrenal (HPA) axis- crucial for regulating cortisol levels.

• Magnesium: Critical for adrenal function. Try magnesium glycinate before bed.

• Potassium: Acts as a regulator of aldosterone production which impacts the adrenal cortex.

• Salt: If you're craving salt, your body might actually need it. Don't restrict sodium if you have low cortisol (and it balances potassium as well).

2. Eat to Support Steady Energy

Your blood sugar and cortisol are intimately connected. When blood sugar crashes, your adrenals have to work harder:

What to do:

• Eat protein with every meal and snack

• Don't skip meals, especially breakfast- start of the day when cortisol should be highest

• Limit caffeine (it forces your tired adrenals to produce cortisol artificially)

• Avoid sugar rollercoasters that stress your system

• Consider eating a small protein snack before bed if you wake up at 3am

3. Time Your Activities with Your Natural Rhythms

Instead of fighting your low-energy system, work with it:

Morning: Even if you feel tired, try to get some sunlight and gentle movement to support your natural cortisol rhythm. Sitting yoga, a short walk- is enough.

Afternoon: This is often when people with low cortisol feel the worst. Plan lighter activities, avoid important decisions, have a protein snack.

Evening: Support your system's attempt to restore by creating calm, predictable routines. Bed before 10:30 helps keep you from getting your false second wind.

Take as many 10 minute time-outs as needed to lay down, close your eyes, breathe deeply. Get into child’s pose or savasana. If sitting, sit up straight and breathe slow and deep for at minimum 3 minutes. Your exhale should be longer and slower than your inhale.

4. Gentle Movement (Not Intense Exercise)

High-intensity exercise can further stress already exhausted adrenals. Instead try:

• Walking in nature

• Gentle yoga

• Swimming

• Stretching

• Tai chi or qigong

Save intense workouts for when your energy naturally- and actually- returns.

5. Stress Management That Actually Helps

The goal isn't to eliminate all stress (impossible), but to build your capacity to handle it:

Nervous system regulation techniques:

• Deep breathing (especially extending your exhale)

• Cold/warm therapy (brief cold exposure can help support healthy cortisol patterns)

• Vagal tone exercises (humming, gargling, gentle neck stretches)

• Progressive muscle relaxation

6. Sleep for Restoration

Quality sleep is when your adrenals do their repair work:

• Keep a super consistent sleep schedule (even on weekends)- even if you don’t sleep when you think you should. You are retraining your brain and body.

• Make your bedroom cool and dark

• Consider blackout curtains - even small amounts of light can disrupt cortisol recovery

• If you wake up between 1-4am regularly, you might need a bedtime protein snack- but I would also suggest Chinese medicine to help further dive into what might be underlying.

7. Gradual Capacity Building

As your cortisol system starts to recover, you can slowly build back your tolerance for challenge:

• Start with tiny amounts of positive stress when you're feeling good- (like driving to brunch with a friend and finding parking.)

• Gradually increase activity levels as energy returns- like adding an extra 10 minutes to your walk.

• Celebrate small improvements rather than pushing for dramatic changes- it can take 6 months to a year to recover.

• Learn to be still, be quiet, say no- it’s uncomfortable to set boundaries sometimes, but your health depends on it now.

If you recognize yourself in this, consider working with:

Functional medicine doctors who understand adrenal fatigue and can run proper cortisol testing (saliva cortisol throughout the day, not just morning blood tests).

Naturopathic doctors who can recommend specific supplements and dietary/herbal support for adrenal recovery.

Trauma-informed therapists if your burnout stems from chronic stress, PTSD, or developmental trauma.

Your exhaustion isn't a character flaw, its not laziness or failure to be healthy enough. Your body doesn’t need fixing. It needs nurturing. Recovery is possible. Your energy can return. You can feel like yourself again.

But it starts with understanding what's actually happening in your body - and giving your system what it actually needs to heal, rather than what has become a toxic wellness culture- says you should need.

Research shows that nurses with burnout had "decreased basal salivary cortisol levels in the morning" The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders - ScienceDirect - meaning their systems couldn't produce the cortisol surge needed to handle daily stress.

In PTSD specifically, "hypocortisolemia was observed during the night" Modeling Cortisol Dynamics in the Neuro-endocrine Axis Distinguishes Normal, Depression, and Post-traumatic Stress Disorder (PTSD) in Humans | PLOS Computational Biology compared to normal subjects, while depression showed the opposite pattern.