What if it’s not JUST burnout?
Quit the job, moved to the mountains, spending more time with your kids, and still feeling fried?
Sounds like you did everything “right.” Right?
You quit the soul-sucking job.
You started saying no.
You found things that light you up again.
You learned how to regulate your emotions and create calm.
But why hasn’t your energy returned?!?
Maybe your body still feels like it’s running on a flickering battery.
Maybe you wake up exhausted or crash mid-day (or both.)
You can’t concentrate, and no amount of meditation or magnesium seems to touch it.
Well friends, I hate to say it, but:
burnout isn’t the whole story
Most people use “burnout” as a catch-all for exhaustion. But I think now's the time to make sure y'all are clear that burnout and adrenal fatigue (what functional medicine calls HPA-axis dysregulation) two related, but separate issues.
Burnout lives in your mindset and circumstances.
Adrenal fatigue lives in your biology.
Burnout (the psychosocial side)
Defined by the World Health Organization as a syndrome caused by chronic workplace stress not successfully managed (World Health Organization, ICD-11, 2019).
(The WHO classifies burnout as an “occupational phenomenon” rather than a disease, but for high-achieving women, “work” includes caregiving and emotional labor, too.)
It’s the exhaustion, cynicism, and sense of ineffectiveness that come from misaligned work, impossible expectations, and lack of recovery.
You fix burnout by changing what’s burning you: 1) circumstances — your job, your relationships with work, and 2) your thoughts/beliefs about worth and productivity.
Adrenal fatigue / HPA-axis dysregulation (the physiological side)
This one shows up after the fire.
It’s what happens when your stress system (the hypothalamic-pituitary-adrenal axis) has been running hot for too long … and now IT’s burned out.
When you live in fight-or-flight long enough, your body swaps real energy for adrenaline.
It’s rocket fuel. Powerful, fast, and completely unsustainable.
Think of it like running on espresso shots instead of steady nourishment: you get the quick hit, but the crash always comes.
Stay on it too long and (just like caffeine) your system stops listening to it.
The receptors dull, your baseline stress rises, and it takes more and more to feel “normal.”
You can’t rest because your body doesn’t trust you’re safe.
Meanwhile, cortisol, the hormone meant to keep your energy steady through the day, starts misfiring — spiking when it shouldn’t and flatlining when you actually need it.
Research on burnout and chronic stress shows this exact pattern: flattened or erratic cortisol rhythms after long-term over-activation (Cortisol rhythm meta-analyses, 2015–2024).
That’s why you can change your life on paper and in your mindset, and still feel like you’re crawling through mud.
When Burnout Hands the Baton to Your Body
Here’s what often happens:
You spend years in hustle mode. Your body floods with stress hormones day after day.
Then one day you finally stop.
But your biology doesn’t.
The hypothalamus, pituitary, and adrenal glands are like the gas pedal and brake system in your car.
During burnout, you’ve been flooring the gas nonstop. When you finally let off, the engine floods.
This is HPA-axis dysregulation (A new model for the HPA axis explains dysregulation of stress hormones, 2020).
You’re not in immediate danger anymore, but your body doesn’t trust that yet.
You can’t think your way out of this.
You have to teach your body that the danger is over.
How to Know If You’re There
You wake up exhausted even after eight hours of sleep
You get a second wind late at night
You crave sugar, salt, or caffeine constantly
Small stressors feel like big ones
You’ve become sensitive to noise, light, or chaos
Your mood, cycle, or focus feel unpredictable
You get sick easily, or your body just won’t bounce back.
If any of that sounds familiar, your issue might not be “burnout” anymore. Instead, it's the physiological aftermath.
Step One: Get Data, Not Drama
You can’t fix what you don’t understand.
Start with a few tests to map what’s actually happening inside you:
4-point cortisol test (saliva or dried urine) → shows your energy/stress rhythm across the day (Institute for Functional Medicine, 2022).
Thyroid panel (TSH, Free T3, Free T4, Reverse T3) → burnout often drags thyroid down with it (Romm, 2020).
Ferritin, B12, Vitamin D → nutrient stores that drive energy (Gottfried, 2021).
Glucose/HbA1c → how steady your blood sugar is
Sleep & HRV data (Oura, Whoop, etc.) → your recovery capacity in real time
Look for patterns, not single numbers. You’re mapping a rhythm, not a test score.
Functional medicine practitioners — from the Institute for Functional Medicine to Dr. Aviva Romm and Dr. Sara Gottfried — call this pattern HPA-axis dysregulation, and they use a mix of testing and lifestyle strategies to help the body relearn balance.
Step Two: Re-teach Your Body Safety
As Emily and Amelia Nagoski explain in Burnout: The Secret to Unlocking the Stress Cycle (2019), it’s not enough to remove the stressor — you have to complete the stress cycle your body started. That’s what all of the following steps are about.
Rebuild the rhythm
Get bright natural light within 30 minutes of waking (no sunglasses!). (Sleep and circadian light studies, 2023).
Keep a consistent sleep/wake time, even on weekends.
No caffeine after noon.
Add darkness and quiet before bed (red lights around the house and for reading – NO blue screens!).
Finish the stress cycle
(I did a whole blog on this recently here [link])
Move your body: walk, dance, shake it out.
Laugh until you cry (literally).
Hug someone for 20 seconds or longer.
Create. Sing. Breathe.
Feed the system
Eat protein at breakfast.
Add mineral-rich salt, magnesium, and potassium foods.
Don’t skip meals. Stabilize blood sugar to calm cortisol. (Later, you can add in intermittent fasting as a way to regulate blood sugar, but I wouldn’t recommend it while you’re in the early stages of recovery. It can make things worse, esp. for women.)
Downshift the input
Replace scrolling with silence.
Schedule boredom. Your nervous system needs blank space to recover.
Train your recovery muscle
Gentle resistance or aerobic training supports healthy cortisol rhythms, but keep it restorative, not heroic (Exercise and HPA resilience studies, 2022).
Use slow breathing or HRV-biofeedback to signal safety from the inside out (HRV and breathwork studies, 2021–2023).
Step Three: Track Progress Differently
Old you measured success in productivity.
Recovering you measures it in regulation.
Ask weekly:
Is my sleep deeper?
Am I calmer under pressure?
Do I wake up with a spark instead of dread?
Can I rest without guilt?
Those are your new KPIs.
The Bottom Line
You did the hard part. You walked away from what was burning you out.
Now it’s time to teach your body how to stop burning itself out.
This is about re-training your biology to believe you’re finally safe.
When you do that (when your nervous system, hormones, and energy start syncing again) your vitality doesn’t just come back.
It expands.
P.S. I've spent MANY years working through my recovery from both burnout and HPA-axis dysregulation. It takes grit and determination, and a whole lotta self-compassion. If you're struggling with any of this and you just wanna talk about it, reach out. I'm here for you!