Burnout doesn’t always look like exhaustion. An experienced physician reveals the subtle warning signs that stress, poor recovery and years of self-neglect may be catching up with you
Burnout can be extremely serious – and yet we treat it as another modern buzzword. The reality is that it’s actually a very dangerous consequence of what can be years of self neglect.
“Many people assume burnout means exhaustion, but in my experience exhaustion is often the symptom rather than the root cause.”
That’s what Dr. Kenneth Ro, MD, an internal medicine and emergency physician with more than 35 years experience says. He used to focus on diagnoses and treatment, but his experiences have encouraged him to learn more about what brings patients to the emergency department in the first place.
“I became fascinated by the accumulated effects of stress, poor recovery, neglected health, strained relationships, loss of purpose, and the gradual disconnect that can occur when people spend years focused on taking care of everyone except themselves,” says Ro.
“The heart attack, stroke, or cancer diagnosis was often the final chapter of a much longer process that had been unfolding for years.”
Now, he focuses on helping men recognise the patterns that lead to fatigue, declining performance, burnout, and chronic disease before those patterns become crises.
We asked him why it’s so important to pay attention to burnout and what you should look out for in yourself and others.
Why do we get burnout?
“Ironically, the people who are most vulnerable to burnout are often the people who are best at pushing through discomfort,” says Dr Ro.
“What I see most often are successful people who continue functioning at a high level while gradually becoming disconnected from their health, their relationships, their sense of purpose, and ultimately themselves. They are still productive. They are still showing up for work. They are still taking care of responsibilities. From the outside, everything appears fine.”
But often the appearance of everything being ‘fine’ can be what is so risky – as it enables people suffering to carry on, and those around them to often not notice what’s going on inside.
“The problem is that they no longer feel like themselves,” says Ro. “Their energy is lower, their enthusiasm is lower, and life begins to feel more like something they are managing than something they are fully experiencing.”
“By the time most people recognise burnout, the process has usually been developing for quite some time.”
What’s the problem with keeping on, keeping on?
Dr Ro says that one of the biggest dangers with people who perform so well is that it can mask dysfunction for a long time. “Many high-performing people continue producing results even while their physical and emotional health are deteriorating underneath the surface.”
“The same qualities that help people succeed—discipline, resilience, responsibility, and persistence—can also allow them to ignore warning signs longer than they should,” says Ro, who says he’s seen people normalise symptoms like bad sleep, weight gain, no libido, low energy levels, chronic stress and emotional disconnection because they can still get what they need to get done.
“The body, however, keeps score. Eventually those issues often show up as more significant problems affecting physical health, relationships, mental well-being, and overall quality of life,” says Ro.
7 signs your burning out – or already have
Here’s Dr. Ro’s seven warning signs that you might be suffering with burnout.
- The first sign is persistent fatigue that doesn’t improve with rest. People often describe feeling tired all the time, even after a full night’s sleep or a weekend off.
- The second is a noticeable loss of enthusiasm. Activities that once felt meaningful or exciting begin to feel like obligations.
- The third is increased irritability. Many people expect burnout to look like sadness, but it often appears as frustration, impatience, cynicism, or a shorter temper.
- The fourth is difficulty concentrating. People notice more brain fog, decreased focus, forgetfulness, and a sense that their mental sharpness isn’t what it used to be.
- The fifth is declining physical performance. Workouts feel harder, recovery takes longer, and motivation to exercise begins to decrease.
- The sixth is reduced libido, which is often one of the earliest signs that stress and recovery have fallen out of balance.
- The seventh, and perhaps most concerning, is emotional disconnection. People describe feeling less present with their spouse, children, friends, and even themselves. They continue moving through life, but often feel as though they are doing so on autopilot.
What should we do if we can relate to this?
If you’re reading the above symptoms and nodding your head, then it might be time to think about making a change. But how? It can be hard to know where to start with improving your own wellbeing. So, what does the doctor advise?
“The first step is to stop normalising [these symptoms],” says Ro. “Feeling exhausted, disconnected, and depleted should not automatically be accepted as an unavoidable consequence of getting older.”
“The next step is to take an honest look at recovery,” he suggests. “Most people focus exclusively on stress, but recovery is often the missing piece. Sleep, exercise, time outdoors, meaningful relationships, nutrition, and periods of genuine downtime all matter.”
The doctor suggests starting small. “One of my favorite recommendations is five minutes in the morning without your phone. Step outside, get some sunlight, and decide how you want to show up that day. At night, spend another five minutes slowing down before bed rather than ending the day with more stimulation and distraction,” he says. That certainly sounds achievable for the average person.
“Small habits may not seem significant in the moment, but both recovery and neglect compound over time.”
If you or someone you know is struggling, there is help available.
For UK and Republic of Ireland, please find the following helplines:
- Samaritans: Call 116 123 (free from any phone, does not appear on phone bills) or email [email protected].
- Shout Crisis Text Line: Text SHOUT to 85258 for free, confidential, 24/7 text support.
- CALM (Campaign Against Living Miserably): Call 0800 58 58 58 (open daily from 5 pm to midnight)
For US call 988 for a support helpline:
- At the 988 Suicide & Crisis Lifeline: Call or text a suicide and crisis hotline for free, 24/7 support.
- Crisis Text Line: Text HOME to 741741 to connect with a crisis counsellor
