Burnout when everyone relies on you: looking like you're coping when you're not

Shena Lee-Anthony told her boys to go upstairs and promised she'd come up to kiss them goodnight in a little while. Hours passed. She couldn't move. Night turned to day, and when she desperately needed the toilet, she rolled off the sofa onto the floor and tried to crawl there. She didn't make it.

My body just completely shut down.

At the time, Shena was navigating a divorce, holding down a senior role and caring for a seriously unwell child. All the way through, she kept telling herself she could manage. Her medical tests came back fine. One doctor diagnosed chronic fatigue syndrome, but the picture never quite fit. It was only years later, after studying burnout, that she understood what had happened to her: a severe case of burnout that needn't have happened, her words, if she had been honest.

Shena is a rehabilitation physiotherapist and health and wellbeing coach who now works with high-functioning women, many of them founders and senior leaders, who arrive saying something isn't right. This is what she wants you to know.

Looking like you're coping when you're not

Burnout has become a buzzword, Shena says, and that makes it harder to spot the real thing. Feeling stressed or tired is different: you can come away from the situation, rest, reset and go again. Burnout is what happens when stress becomes chronic, when you're in a heightened stress state for so long that there is never any reset.

By then it's physiological. The body's stress communication system, the HPA axis, becomes dysregulated. Cortisol, which should be high in the morning to wake you and low at night so you can sleep, ends up all over the place. High cortisol suppresses melatonin, your sleep hormone, so you go to bed exhausted and lie there wired. Your circadian rhythm, energy systems, digestion and hormones all follow. You don't sleep well, you have no energy, you don't eat well, and the loop feeds itself.

Exhausted but unable to switch off: the signs she explained away

Looking back, Shena can list what her body was telling her. Feeling tired but wired, going to bed and still not being able to settle. Waking up without ever feeling rested. Irritability. One afternoon she caught herself thinking, about her own boys playing, why are they laughing? I don't want them to laugh. That was not who she was.

There was, as she puts it, no living in the gold. But there was always another reason. She felt overwhelmed because of the divorce, because the doctors didn't know what was wrong with her son, because of working full time while someone else cared for him. Every sign had an explanation that wasn't I'm not coping. If you're reading this with a reason of your own ready, that's worth noticing.

Feeling ashamed of not coping

So why didn't she ask for help? One word: conditioning. Many high-functioning women were labelled capable and resilient early, sometimes in childhood, and over time that label becomes an identity. Some came through adverse situations and decided they would never quit and never go back. Either way, you grow into the woman who has it all together.

There is so much shame attached to not being able to cope when you've already accepted that label of being so resilient. How can I let that image slip? Because if I do, who am I?

Underneath the shame, Shena describes a kind of grief: realising she was not the superwoman she had convinced herself she was. I am human, she says, and my body breaks. And she is honest that she is partly responsible, because she wasn't honest, and because she didn't listen to her body telling her something was wrong.

There is also the reality that some people can't simply slow down. If children depend on you, you keep pushing through because they are the priority. Shena did exactly that, until she reached the point where she could no longer look after her boys well because she had become so unwell herself. Burnout when everyone relies on you doesn't announce itself. It just keeps asking for one more day of coping.

Finding it hard to ask for help

I needed to be honest about not coping. I needed to be honest about the amount of stress that I knew that I was carrying was too much for me. I needed to be honest to say, I need some help.

I recognised so much of myself in this part of our conversation. I've got this. I don't need anything from anyone. I'm capable and competent and I can do it. Asking for help is a really, really hard thing for me to do, and I suspect I'm not alone in that. The honesty Shena describes sounds simple. For the woman who never drops anything, it is the hardest first step there is.

People pleasing, perfectionism and burnout

Once someone comes to her, Shena starts with an honest conversation: not the image you've worn, but how you really feel about what's going on in your life. Then she looks at the whole picture, because burnout is rarely just about work. And she looks at what drives us to operate the way we do.

Are you a people pleaser, doing things to make someone else happy at your own expense? Does everything have to be perfect, or would 80 per cent do for most of it? Are you hyper-functioning, managing everything, taking on responsibility for everybody else? Often, she says, it's the way we ourselves operate that puts us on the path to burnout. I smiled at this part, because I'm a hyper-perfectionist with strong people-pleasing tendencies, and both times I've burnt out, that's exactly how it happened.

What does rest actually look like?

Recovery takes time. It is never a quick fix, and telling someone to get nine hours of sleep doesn't work when their system is too dysregulated to sleep. The first job is calming the nervous system and helping that person feel safe in their own body again: breathing exercises, sensory grounding, anything that brings them out of the always-on work-driven state.

Then comes rest, and this is the part I loved. Rest is not one thing. For some people, staying still is uncomfortable, so stillness won't work. For one person rest is sitting quietly with a warm cup of tea. For another it's dancing, moving, releasing tension. Active rest and still rest both count. My own rest is active: sitting in front of the television makes me an anxious mess, but pottering or wandering around a market is my meditative state. It took me a long time to learn that rest isn't lazy or a cop out. It's the secret weapon that lets me be the best I can be.

If you don't rest, whatever way you decide that suits you to rest, there's no reset in the body. And you just keep going and pushing through until you crash.

Around rest sit the other foundations: nutrition, because you cannot recover from burnout while eating on the go, and pacing. Shena's rule is one I keep repeating to myself: most things in our lives are not an emergency. Unless it's life and death, you don't have to do everything right now, at full intensity, perfectly.

If any of this feels uncomfortably familiar, the honest conversation Shena starts with is one you can have with yourself today: how do I really feel? Not the image. The real answer.

This article shares personal experience and general information. If exhaustion is persistent, unexplained or affecting your daily life, speak to your GP rather than assuming it is burnout.