Stage 1
Overextension
Still functioning at a high level — but running on fumes, caffeine, and adrenaline.
- Sunday-night dread
- Sleep procrastination
- Caffeine-dependent mornings
- Resentment toward small requests
Condition guide
Burnout isn't laziness. It's a nervous system that ran out of runway.
Burnout is a syndrome of chronic exhaustion, cynicism, and reduced effectiveness driven by sustained, unrelieved stress. It's recognized by the WHO as an occupational phenomenon — but in our clinic we see it most when it's layered on top of untreated ADHD, anxiety, or depression. Naming what's actually underneath is the entire point of an evaluation.
Clinical framework
Three patterns of burnout we see
Stage 2
Disengagement
Cynicism and emotional distance from work, relationships, or both. Quality of work starts to slip.
- Going through the motions
- Snapping at colleagues or family
- Loss of meaning in work
- Doom-scrolling instead of resting
Stage 3
Collapse
Full physical and cognitive shutdown. Often misdiagnosed as depression — and often coexisting with it.
- Inability to start simple tasks
- Crying without obvious trigger
- Frequent illness, GI issues, headaches
- Considering quitting everything
What it actually feels like
Common symptoms in adults
Exhaustion
- Tired even after sleep
- No bandwidth for the people you love
- Brain fog and word-finding issues
- Physical heaviness, low stamina
Cynicism & detachment
- Resentment toward work or caregiving
- Going through the motions
- Loss of meaning or purpose
- Withdrawal from team and friends
Reduced effectiveness
- Tasks take twice as long
- More mistakes than usual
- Procrastination and avoidance
- Imposter feelings escalate
Physical signs
- Tension headaches, jaw clenching
- GI changes, appetite shifts
- Insomnia or hypersomnia
- Frequent colds, slow recovery
Your first visit
What a comprehensive burnout evaluation looks like
- 01
Pre-visit intake & screeners
You'll complete the Maslach Burnout Inventory (or Oldenburg Burnout Inventory), PHQ-9, GAD-7, and ASRS so we can untangle burnout from depression, anxiety, and undiagnosed ADHD.
- 02
60-minute clinical interview
A psychiatric provider explores work and caregiving load, sleep, recovery time, history of prior burnout, medical conditions, substances, and your life context — not just symptoms in a vacuum.
- 03
Differential — is it really just burnout?
Burnout, MDD, PDD, and adult ADHD overlap heavily. We separate them because the treatment is different — antidepressants don't fix burnout, and rest doesn't fix untreated ADHD.
- 04
Medical rule-outs
Thyroid disease, anemia, sleep apnea, vitamin D and B12 deficiency, and perimenopause routinely look like burnout. When indicated we recommend targeted labs.
- 05
Shared-decision recovery plan
A written plan that may include short-term medication for sleep, mood, or focus, structured recovery practices, therapy referrals, and a frank conversation about workload and boundaries.
Evidence-based
The diagnostic tools we use
Primary burnout scale
Maslach Burnout Inventory (MBI)
The most-studied burnout measure — exhaustion, cynicism, and reduced personal accomplishment.
Alternative burnout scale
Oldenburg Burnout Inventory (OLBI)
Captures exhaustion and disengagement; well-validated across occupations.
Depression screen
PHQ-9
Critical for separating burnout from a depressive episode (and often both are present).
Anxiety screen
GAD-7
Sustained anxiety is a major driver of burnout and changes the treatment plan.
ADHD screen
ASRS-v1.1
Untreated adult ADHD is a leading hidden cause of repeat burnout cycles.
Functional impact
WHODAS 2.0
Tracks daily functioning so you can see recovery progress objectively.
Differential diagnosis
What we rule out first
Major depressive disorder
Adult ADHD
Generalized anxiety disorder
Hypothyroidism
Anemia / iron deficiency
Sleep apnea / chronic insomnia
Perimenopause / hormonal shifts
Chronic pain / inflammation
Long COVID
Substance use
PTSD / moral injury
Adjustment disorder
After your evaluation
Targeted medication
If an underlying condition is identified (depression, anxiety, ADHD), we treat it. Burnout itself responds to recovery, not a pill.
Recovery architecture
Concrete sleep, movement, and recovery interventions, plus a frank conversation about workload, boundaries, and energy budgeting.
Therapy referrals
We refer to therapists who specialize in burnout, perfectionism, and high-achiever recovery work.
Ready to find out what's actually underneath the burnout?
Start with our 10-minute assessment. You'll get an instant clinical snapshot and the ability to book a comprehensive evaluation with a psychiatric provider.
This page is educational and does not constitute medical advice. If you're in crisis, call or text 988.