The five stages of burnout: Recognize & reverse the stress-burnout cycle

The five stages of burnout: Recognize & reverse the stress-burnout cycle

Burnout is a state of mental and physical exhaustion. You might question the direction of your life or sense that you're spinning your wheels, constantly working but not accomplishing anything. With burnout comes a loss of motivation and the desire to check out.

Like stress or trauma, burnout isn't something you can think your way out of; instead, you have to unravel it at a physiological level. You can do this by identifying and reversing the distinct stages of burnout at their source. 

The physiology of burnout

People become burnt out when their stress outpaces their ability to recover. When stress becomes chronic, stress hormones wreak havoc on the body, disrupting the delicate balance of the autonomic nervous system

When the nervous system tips out of balance, the parasympathetic (rest-and-digest) nervous system can't do its essential work of repairing the body from stress. 

Stress transforms into burnout if you rely on coping strategies that amplify your tension, like drinking excess caffeine or being sleep deprived. These habits effectively train the body to be tuned to a heightened state of stress, leading to burnout. 

The five stages of burnout: Reversing the tides of exhaustion 

Psychologists recognize burnout as a succession of stages. If you can notice each stage as it emerges, it can be a reminder to initiate stress-relief practices before the stress intensifies.

  • A honeymoon phase: In the excitement of a new role, you might focus on your work at the expense of your own priorities. When you override your inner compass or bodily signals for the sake of your performance, you can initiate a path to burnout. 
  • The onset of stress: This phase begins when stress becomes intermittent. The unpredictability can cause anxiety, avoidance of work-related decisions, and trouble focusing.
  • Chronic stress: At this phase, tension and pressure become intense, overt, and constant, leading to procrastination and apathy.
  • Burnout: This is the turning point where burnout sets in completely: Exhaustion, cynicism about the value of your work, and ineffectiveness reach a fever pitch.
  • Habitual burnout: If you don't mitigate the causes of your burnout, anxiety, and stress can become chronic, embedded aspects of your life. 

Why HRV training is the antidote to burnout

To prevent or reverse burnout, it’s critical to create a platform of physiological safety. While mental coping strategies can be useful, exercises that induce safety at a nervous system level serve as root-cause level approaches. 

Heart rate variability (HRV) training is the best way to do this. HRV refers to the variations between heartbeats. It's a metric of nervous system balance: it indicates how resiliently your nervous system responds to changing demands of the environment.  

You might be up against some significant setbacks, but training your HRV will give you greater clarity and resolve to face them. And if you're already feeling burnt out, HRV training can work to unravel the problem at its source. 

HRV training tool #1: Intermittent fasting

Fasting is a form of healthy stress (eustress) that triggers a healthy improvement in your ability to adapt to challenges. Fasting gives the body a break from digestion, allowing it to turn on cellular maintenance programs. One critical program is autophagy (or "self-eating"), a way of clearing damaged tissues and defending against the corrosive effects of stress [1].

The most accessible way to practice intermittent fasting is the 16/8 method. This approach restricts your eating window to eight hours while fasting for sixteen. A doable eating window might be between 1 and 9 pm. The beauty of this approach is that you'd be asleep for a large part of your fasting period, making it a relatively low-effort way to improve your resilience.

HRV training tool #2: The Apollo wearable

The Apollo wearable is the most undemanding way to catalyze a state change. The device delivers silent, soothing vibrations clinically proven to engage the parasympathetic nervous system, improving HRV, sleep quality, focus, and more. Just like breath work, meditation, or a hug, the Apollo signals safety to the nervous system, but it doesn't require you to do anything.

In an open-label evaluation of the Apollo wearable for nursing staff facing stress and burnout, the participants' stress scores went down by an average of 40% over two weeks [2]. Using the Apollo, the nursing staff reported significantly better sleep, energy, mood, and focus levels.

HRV training tool #3: Exercise

Exercise can be a powerful way to rewire thoughts and behavior patterns that might be contributing to your stress. It's known to improve neuroplasticity, the ability of the brain to create new neurons and networks [3]. Daily exercise can help you release dysfunctional habits and replace them with new skills, perspectives, and ways of being in the world.

If you haven't been exercising, start small. Even five minutes of moderate to high-intensity exercise can raise your mood and energy levels. If you focus on small yet consistent movement, you'll build momentum, and you won't take much willpower to continue. 

Once you've committed to daily exercise, you can move beyond your initial commitment. But when the habit is new, overworking yourself can be counterproductive. When you do less than what's possible, you break through resistance without overextending yourself. 

About Dr. Joseph Maroon

Dr. Maroon is clinical professor of neurological surgery and the Heindl Scholar in Neuroscience at the University of Pittsburgh School of Medicine. He received his medical and neurosurgical training at Indiana University, Georgetown University, Oxford University in England, and the University of Vermont. He is board-certified in neurological surgery.

Dr. Maroon’s clinical and research interests are in the development of minimally invasive surgical procedures for the brain and spine; the prevention and treatment of traumatic injuries to the central nervous system; innovative approaches to pituitary and brain tumors; and complementary approaches to inflammatory diseases of aging.


  1. Glick, D, Barth, S, Macleod, KF. Autophagy: Cellular and molecular mechanisms. Journal of Pathology. 2010. 221(1): 3-12. doi: 10.1002/path.2697
  2. (2021, March 21). Apollo reduces stress in nursing staff by 40% in two weeks. Apollo Neuro.
  3. Hotting, K and Roder, B. Beneficial effects of physical exercise on neuroplasticity and cognition. Neuroscience Biobehavioral Review. 2013. 37(9 Pt B): 2243-57. doi: 10.1016/j.neubiorev.2013.04.005.