Breaking Free from Burnout: From Surviving to Thriving
How to Slow Down, Heal Burnout, and Start Creating Purpose
By Katie Simons, PharmD BCPS
There’s a particular kind of ache that creeps in when we’re running on empty, and it's not always super obvious. It doesn’t necessarily look like panic or collapse. Sometimes, it feels like going through the motions in a life that used to matter to you. You know this was your dream job, dream relationship, dream life at one point, but what happened? You show up, do the things, check the boxes—but somewhere along the line, you stopped feeling like yourself. What does it even feel like to feel like myself anymore?
You might call it feeling stuck. Or lost. Or unmotivated. Or in a funk. But none of these descriptions quite capture the extent of the internal experience of dullness. And you start to wonder "What's wrong with me?" "Why can't I figure out what I'm supposed to be doing?" "Why do I feel so disconnected from the things I used to care about?"
This is what it feels like to be in survival mode.
In the modern medical world, we call survival mode by different names. Depression. Anhedonia. Burnout. Generalized anxiety. But when we take a step back to look at the root of what's happening, these are all descriptions of nervous system overload. When the nervous system is chronically overloaded, it prioritizes protection above everything else, and we begin to functionally dissociate and lose access to sensations of fulfillment, creativity, and purpose. The body's focus is on just getting through the day. Survival mode is what happens when we’ve asked ourselves to keep going too fast for too long without real rest—when the demands of life override the capacity of our bodies to regulate, digest, feel, and connect.
And when you're in it, life becomes a tunnel. Everything either feels like an emergency or like it doesn't matter at all. You lose the ability to discern what actually matters, because your system is too overloaded to feel deeply or think clearly. You stop dreaming because dreaming requires hope. You stop caring because caring requires capacity. You stop listening because listening requires stillness, and stillness can feel terrifying when your nervous system is screaming "go." It's not that you don’t want to live with purpose—it’s that you’ve lost access to the part of yourself where purpose arises. Purpose doesn’t come from pressure or productivity; it comes from presence. And presence can only return when the body feels safe enough to stop bracing for impact.
The good news? Survival mode isn’t a life sentence. It’s a signal—a call to slow down, come back to the body, and start tending to what got overlooked in the race to hold it all together while getting to some arbitrary outcome. And from that place, meaning can begin to return. Not because you found it out there somewhere, but because you created it from a place of safety, clarity, and connection within.
When Your Body Waves the White Flag
There was a moment, a few years back, when I came face-to-face with the experience of burnout. I was sitting at the Salt Lake City VA hospital, staring blankly at my computer screen. My to-do list and calendar glared back at me like a drill sergeant—emails, meetings, projects, documentation, committees, patient reviews. Everything blurred together while I just sat there. Numb. I wasn’t stressed. I wasn’t overwhelmed. I was beyond all of that. What I felt was total and complete apathy, like my system had short-circuited. I had no motivation, no energy, and no connection to why I was doing any of it. I was exhausted to the core, and the truth was—I didn’t care anymore. It hit me in that moment: I was done. I had no more to give.
Burnout is often talked about as an emotional or psychological state, but at its root, it's a physiological one. It’s what happens when the body’s internal stress response systems—designed for acute danger—are left activated chronically. When the system doesn’t get the signal that the danger has passed, it can’t return to baseline. Over time, this wears down the body, mind, and spirit.
Your nervous system has two primary modes: the sympathetic branch, which prepares you to fight, flee, or freeze; and the parasympathetic branch, which supports rest, digestion, connection, and healing. Ideally, the body moves fluidly between the two. But burnout occurs when the sympathetic system is stuck in the “on” position for too long. Cortisol and adrenaline surge day after day, pushing you into hypervigilance even when the "threat" is just your inbox or a traffic jam. Eventually, this chronic activation begins to dysregulate the entire system. Inflammation increases, hormones destabilize, and the systems responsible for energy, motivation, and resilience become depleted.
One of the key players here is the hypothalamic-pituitary-adrenal (HPA) axis, which regulates your body’s response to stress. In the early stages of burnout, this axis may become overactive, pumping out stress hormones like cortisol and adrenaline to keep you going. You might feel wired but exhausted, anxious yet numb. As burnout progresses, the HPA axis can become sluggish or dysfunctional, leaving you feeling foggy, flat, inattentive, and deeply fatigued. Neurotransmitter levels like dopamine, serotonin, and GABA begin to drop, which is why burnout often mimics depression. You lose motivation, joy, and the ability to feel present, focused, and engaged.
As the yo-yoing impact of chronic cortisol overproduction and adrenal fatigue continues, symptoms progress to include potential systemic inflammation, increased pain sensitivity, persistent fatigue, immune system suppression, and even autoimmune dysregulation. One of the most overlooked effects is the disruption of the gut-immune axis. Cortisol affects the integrity of the gut lining, making it more permeable—a condition often called 'leaky gut.' This allows food particles and toxins to enter the bloodstream, triggering immune reactions and low-grade chronic inflammation throughout the body. Chronic stress also reduces the production of digestive enzymes and slows gut motility, leading to bloating, constipation, or IBS-like symptoms. Over time, the balance of gut microbiota shifts, reducing resilience and impacting everything from mood to immunity to weight regulation. Because the gut and brain are deeply connected through the vagus nerve, these disruptions feed back into emotional regulation, creating a vicious cycle that keeps you locked in survival mode.
And it doesn’t stop at hormones. Chronic stress begins to impact brain structure as well. The prefrontal cortex—the part of your brain responsible for planning, decision-making, and regulation—starts to go offline. Meanwhile, the amygdala, your brain’s fear center, becomes overactive. The hippocampus, which helps process memory and regulate emotion, can even begin to shrink. These changes don’t just affect how you feel in the moment—they shape your sense of self and possibility.
Despite the message of guilt that often accompanies burnout, it isn’t a failure of willpower. It’s a survival adaptation. The body prioritizes protection over passion. In survival mode, energy gets rerouted away from long-term growth and toward short-term safety. Physiologic functions as well as psychological ones such as creativity, empathy, and future planning all take a backseat. You stop caring about purpose not because it doesn’t matter, but because your system doesn’t have the bandwidth to contemplate anything beyond the next task.
And here’s where it gets tricky: slowing down, which is exactly what you need to heal, can actually feel unsafe. Rest activates the parasympathetic system—but if your body hasn’t felt safety in a long time, rest and quiet can trigger anxiety. When the body is stuck in survival mode, stillness feels like vulnerability. If you've been running from a tiger for years, standing still can feel dangerous. Doing nothing can feel like giving up and failure. The very thing your system needs most becomes the thing it resists.
The more you override your body’s signals, the more disconnected you become. And in our society, that disconnection is often encouraged. We’re taught to power through, to earn rest, to prove our worth by pushing beyond our limits, and the world is full of quick fix solutions to distract us just long enough to keep us in the loops—think doom scrolling, alcohol, weed, sugar/food, TV, online shopping, porn, etc. But eventually, something gives. The body whispers. Then it speaks. Then it screams.
Burnout is that scream. It’s the body’s way of saying: I can’t live like this anymore. And it’s not a breakdown—it’s an invitation to come home to yourself.
The Paradox of Healing
Much to my chagrin, realizing I had hit the wall of burnout did not actually solve the problem. Taking the steps to allow time and space to slow down was the next necessary step, and logistically that was a nightmare. The world is always going at the pace of a speeding train, and I had to get off the train. So I jumped. For me, this looked like quitting my job. This was no small thing. My job had been my dream job, and I had taken my career path further than I had ever envisioned. I had put my soul into the healthcare system for over a decade, and I had made a positive impact along the way. But just as much as I had poured my soul into my career, the job, along with life events, was currently sucking the soul out of me. It felt like I had little choice but to make a drastic change.
I landed in a very low-key job at a cannabis pharmacy. At first, moving to a part-time, low-demand job was sweet relief, especially being freshly divorced. It was a much needed change of pace. I could sleep in pretty much every day, and on the days I did work, I pretty much did…well, very little. I traveled during that time. I didn't know what was next, but life had slowed down enough to breathe, and I was enjoying breathing.
What I did not anticipate was what came next. It only took a couple months before I started to get restless. I had so much time on my plate, and I wasn't sure how to fill all of it. And of course I had to fill all of it! The moments of stillness, quiet, and solitude were truly excruciating—I had no idea how to be with myself. The narrative from my oh-so-present inner critic began to flare up: “You’re falling behind. You’re not doing enough. You should be more productive. You should be better by now. You're a failure—Quitter! You'll never amount to anything in life.” Wow, did my ego not like this new pace! Slowing down wasn't just slowing down; it was making space to feel what I'd been running from internally for my entire life. Unworthiness. And for that kind of slowing down, I was completely unprepared.
My experience is what often happens when we first step off the train and out of survival mode, whether quitting a job, pairing back time commitments, leaving a toxic relationship, or simply creating more defined work/life balance. As mentioned above, stillness can trigger unease. Spaciousness can feel disorienting. This is because your nervous system has become accustomed to a certain level of stress activation—it’s become the norm and our bodies believe it's necessary for survival. When we stop, the narrative of our psyche's survival mechanism, the ego, jumps right in to try to bully us back into survival mode. It pulls up all the narratives we were conditioned to believe as children. You have to work hard to get anywhere. You're only worth what you can produce. You're not lovable if you're not successful. You will be shunned if you do not put on a good face and live up to everyone’s expectations of you. None of these are truths—in fact, they are all straight bullshit—but they are deeply embedded within our capitalistic, patriarchal society.
So if step one is slowing down, step two, inevitably, is facing our inner demons. If we don't, we end up believing the inner critic narrative and go right back to the grind. Facing our demons means using our newfound free time to go deep inside ourselves—some would even say, to visit the Underworld. This all sounds quite dark and ominous. In reality, it's only scary from the outside. Once inside, it's truly just shining the light on one simple question—what has really been driving me all this time? What do I believe to be true about myself and the way the world works that has motivated me to drive myself to the point of illness? If we are capable of being really honest with ourselves, we will find that the answer to this question illuminates all our deepest, darkest fears. Fear of abandonment. Fear of rejection. Fear of shame. Fear of unworthiness.
And wow, can these fears feel SO REAL. The emotional signatures tied to these fears run deep, generations deep, and they are excruciatingly painful...when we believe them. Here’s the thing about fear: most of the deepest fears we run from are connected to false narratives—they are lies. And as we do the work to bring these fears into our conscious awareness, into the light of day, the big boogie monsters start to turn into bunnies and hop away. Abracadabra! It's in the quiet that we gain access to awareness of the conditioned patterns and fear-based narratives that have been driving us for our whole lives. We begin to see where we internalized beliefs that our worth is measured by our output, that rest is weakness, that success means self-abandonment. We begin to feel what those stories have cost us. And we start to realize that healing is not about becoming someone new, but about remembering who we are without fear running the show.
In this remembrance, we find access to step three—rediscovering our natural rhythms. All of nature runs in cycles and rhythms: daily, monthly, seasonal, and even existential. We are just part of nature. When we listen to our own rhythms, we begin to feel when we’re meant to act and when we’re meant to pause. We start noticing cycles within and around us—moments of expansion and contraction, energy and rest, clarity and cocooning. These cycles are intrinsic to nature and to being human, and yet we’ve been conditioned to override them in service to the illusions of linear growth, productivity, and constant forward motion. But nature doesn’t operate that way. The moon waxes and wanes. The seasons shift. Even our heartbeats are a dance between contraction and release. When we slow down enough to attune to these rhythms, we realize how much we’ve been pushing against life’s natural pace. And in that space—of alignment rather than resistance—meaning doesn’t need to be forced or figured out. It starts to emerge. Slowly. Organically. From within.
Purpose Isn’t Found - It’s Forged
I'll tell you a secret—I don't work 40 hour weeks anymore. No one makes my schedule, and I often go to yoga or for a walk in the middle of the day. My office is a sweet room in my home, and I get to my desk around 10am after my morning routine of reading, moving, and meditation. I love, love, love seeing my clients and holding space for them to heal and grow. I continue to be humbled by how my financial needs continue to be met in abundance. I feel more fulfilled now than I ever have before, and I know there is more to create.
In doing the work outlined above, one fundamental truth became clear to me: purpose and meaning are not something you find out in the world—they're something you create from within. They don’t exist like buried treasure waiting to be uncovered. They’re not buried in a job title or waiting at the end of some long external search. They emerge from the way you choose to meet yourself and your life, over and over again. No one else can define what matters to you. No one else can give you your purpose. It has to be self-authored. And that authorship begins when you direct your energy toward what feels meaningful to you—when your actions, however big or small, align with what lights you up inside.
This doesn’t require grand gestures. Meaning can be made in small, sacred decisions: making a meal with care, saying no when your body whispers no, letting yourself rest without guilt, reaching out instead of retreating, being honest instead of performing, writing with intention, and playing and dancing because it's joyful. These are not just habits—they are declarations of who you are. With each act and decision, there's an alignment towards authenticity, and a self-discovery of the capacity for passion.
Passion is a fascinating thing. When you're in survival mode, passion just adds to the overwhelm. There's no space for it. But once the nervous system is regulated, your mind begins to clear, and suddenly there’s space. Space to feel what matters. Space to notice what brings life. Space to say "YES" to the things that resonate, and "no" to the ones that don’t. And in that space, meaning becomes less of a mystery and more of a practice. A way of being.
With each act of alignment, trust begins to build—trust in yourself, and in life. You begin to understand, not just mentally but somatically, that you don’t have to hustle to earn your worth. You start to feel, deep in your body, that it’s safe to move at the pace of presence. You see how life opens when you stop pushing and start listening. You begin to trust that your path doesn’t need to be perfectly mapped out from the start. It will unfold one step at a time, if you’re willing to take the next step that feels most alive. And that trust builds momentum—not the frantic kind fueled by fear, but the grounded kind fueled by inner clarity. Over time, your decisions become less about proving something and more about honoring what you know to be true inside yourself. That’s when life begins to feel like it’s truly yours.
The question is no longer: What is my purpose? The real question becomes: How do I want to live? Not someday, not after everything falls into place—but right now, in this moment. This question invites us into radical presence, and that’s not always easy. Our minds are addicted to the future, to contingency plans, to the illusion of safety that comes with mapping it all out. But presence—the kind that lives in your breath, your body, your choice to soften instead of brace—that’s where life is happening. That’s where our real power lives.
To live from presence is to root into reality as it is, not as we wish it would be. It’s to feel the ground beneath your feet and choose what’s true, right now, from that place. And when we begin living from presence, purpose starts to show up—not as a rigid task or assignment, but as a frequency we carry. It’s not something we chase down, but something we emit. It infuses the way we speak, the way we move, the way we love, the way we offer ourselves to the world. It’s not what we do—it’s how we do it. That’s the real pulse of purpose. That’s where meaning becomes magnetic. And just like a magnet, it doesn’t need to reach or grasp—it draws in what resonates naturally. The more you live in alignment with presence, the more life begins to organize itself around that frequency. Synchronicities show up. Opportunities feel less forced. Connections feel more true. Decisions become simpler because you’re no longer filtering them through who you think you’re supposed to be. You’re responding from who you actually are. In this way, purpose stops being a goal and starts becoming a gravitational field—one that’s fueled by the authenticity of your lived expression, moment by moment.
Authenticity - Your Permission Slip
Research in neuroscience shows that authenticity creates coherence between your heart, mind, and nervous system. This coherence generates what scientists call "high-frequency electromagnetic fields"—essentially, you become a tuning fork for what you want to create. This isn't woo-woo. It's measurable. When you're aligned with your authentic self, you literally emit different energy that affects everything around you.
So if you're reading this from a place of burnout; a place where you're feeling lost, disconnected, or unsure of what comes next—this is your permission slip: Permission to stop. Permission to rest. Permission to disappoint people. Permission to start over. Permission to be human. You don't have to earn your worth. You don't have to prove your value. You don't have to optimize your way to happiness. You just have to come home to yourself.
Recovery from burnout isn't a sprint, it’s a long game—it’s a complete restructuring of how you relate to yourself and the world. It's not about getting back to who you were before. It's about becoming who you were meant to be all along. The person you're becoming doesn't need to hustle for worthiness. Doesn't need to prove anything. Doesn't need to earn the right to exist. That person already knows their value. Already trusts their path. Already lives from a place of deep, unshakeable knowing and connection. That person is you.
Start with your body. Start with rest. Start with honesty. Let yourself slow down, not just in pace but in presence. Make space to feel what’s true. Make space to feel what hurts. And make space to listen for what is quietly, patiently waiting underneath the noise. Hear the invitation to live differently, to value yourself differently, to show up in the world as who you actually are instead of who you think you should be.
Your authentic self is not a luxury you can't afford. It's the foundation everything else is built on. The world doesn't need another person running on empty. It needs you—rested, authentic, present, and fully alive.
This is your life. Not a dress rehearsal. Not a practice round. This is it. This invitation is simple: stop performing your life and start living it.
