The anatomy of burnout — Sanne Andersen

What Is Burnout?

Burnout is not a single illness, but a stress-related syndrome. It overlaps with conditions such as chronic stress and can resemble depression and anxiety, but it is typically rooted in prolonged strain without sufficient recovery.

When the body is exposed to long-term stress, a range of interconnected changes occur in the brain, nervous system, and overall physiology. If the condition is not addressed, this can result in burnout.

Several key areas of the brain play an important role in this process. The amygdala, which functions as a kind of alarm center, often becomes overactive during stress. This means a person becomes more vigilant and sensitive to potential threats, which may show up as restlessness, irritability, and difficulty sleeping.

At the same time, the prefrontal cortex — which normally helps with overview, planning, and decision-making — becomes less effective. This can make it harder to prioritize and think clearly, and many people experience a kind of mental “fog.” The hippocampus, which is important for memory and stress regulation, can also be negatively affected by prolonged stress. This may result in poorer memory, reduced ability to learn, and a weakened ability to regulate the body’s stress response.

These changes are closely connected to the nervous system. The sympathetic nervous system, which activates the body’s “fight-or-flight” response, often becomes overactive and can feel as though it is constantly switched on. This can lead to symptoms such as increased heart rate, muscle tension, and inner restlessness. At the same time, the parasympathetic nervous system — which normally helps the body relax and recover — becomes underactive. This makes it harder to feel calm and recover from stress.

Stress also affects the hormonal system, especially the so-called HPA axis (hypothalamus, pituitary gland, and adrenal glands), which regulates the production of the stress hormone cortisol. At the beginning of a stress response, cortisol levels are often elevated, but with prolonged stress they may become irregular or even lower than normal. This imbalance can lead to sleep disturbances, fatigue, and a weakened immune system.

In the body, stress appears as a general imbalance. The autonomic nervous system can become stuck in a constant state of alertness, meaning that heart rate, blood pressure, and muscle tension remain elevated. In addition, prolonged stress can increase low-grade inflammation, which may affect energy levels, mood, and the experience of pain. Many people also experience problems with energy and metabolism, such as unstable blood sugar, persistent fatigue despite rest, and reduced physical resilience.

Finally, stress has a clear impact on sleep and circadian rhythm. It may become difficult to fall asleep, people may wake more often during the night, and sleep rarely feels truly restorative. The hormone melatonin, which normally helps regulate sleep, often functions less effectively during stress, further reinforcing sleep problems.

Overall, stress is therefore not only a mental state, but a whole-body reaction in which several systems influence one another and can create a self-reinforcing imbalance if the strain continues for too long.

In short, burnout is a condition where:

the brain remains in a state of alarm
the nervous system is out of balance
stress hormones are disrupted
the body is not allowed to recover properly

Perspective

The important thing to remember is that the condition is reversible, but it requires:

reduced strain
more recovery
regulation of the nervous system (for example through calm breathing or body-based practices such as reflexology)

Below is a suggestion for a calm evening routine that combines reflexology, breathing, and body awareness in relation to burnout — specifically aimed at improving sleep. You can also simply pick the parts that feel most useful to you.

30–40 Minute Evening Routine

1. Wind Down (10 min)

Purpose: calm the sympathetic nervous system

Turn off screens or use dim lighting
Avoid new information or work
Sit quietly and take 5–10 slow breaths

This sends a signal to the brain (especially the amygdala):
“The danger has passed.”

2. Breathing Practice (5–8 min)

Purpose: activate the parasympathetic nervous system through the vagus nerve

4–6 breathing:

Inhale through the nose for 4 seconds
Exhale through the mouth for 6 seconds
Pause for 1–2 seconds
Repeat for 5–8 minutes

The longer exhalation lowers the heart rate and helps calm the body.

3. Reflexology (10–15 min)

Perform slowly and calmly, preferably with a little oil if desired.

Solar Plexus Point (stress relief)

Find the point in a vertical line below the third toe, just beneath the ball of the foot (slightly above the middle of the foot).

Press gently with your thumb for 5–10 seconds
Release slowly
Repeat 5–10 times on each foot

May help reduce the stress response (linked to the HPA axis).

Head/Brain Zones (the toes)

Massage all the toes, especially the tips/pads and the underside.

Use small circular movements and light pressure
Continue for 2–3 minutes on each foot

May help the prefrontal cortex “let go,” quiet racing thoughts, and make it easier to fall asleep.

Spine Zone (inner edge/arch of the foot)

Move your thumb along the inside edge of the foot from the big toe down to the heel.

Use firm but comfortable pressure in a slow movement
Repeat 5–10 times on each foot

Helps relax the entire nervous system.

4. Lie Down and Do a “Body Scan”

Purpose: release physical tension

Mentally move your attention from the head → down to the feet
Relax tension area by area

This can help reduce activity in the amygdala and guide the body into a state of rest.

5. Sleep Setup (2 min)

Support melatonin production:

Keep the room dark and cool
Go to bed at the same time every day
Avoid using your phone in bed

What You May Begin to Notice (after days or weeks)

Of course, this depends on your starting point, but many people experience:

falling asleep more easily
fewer awakenings during the night
less inner restlessness
better energy levels during the day

This does not always work from day one — but repetition helps and teach the body a sense of safety again.