Burnout Is Not “Just in Your Head”: Understanding Stress, the HPA Axis, and Recovery

“Burnout” is often dismissed as simply being tired or overwhelmed.

But clinically, burnout represents a very real constellation of symptoms rooted in chronic stress physiology. While the term adrenal fatigue is controversial in conventional medicine, dysfunction of the hypothalamic–pituitary–adrenal (HPA) axis is well documented and increasingly recognized as a driver of persistent fatigue, mood changes, and stress intolerance.

Burnout deserves to be treated like any other health concern — because it is one.

The Physiology of Stress: What’s Actually Happening?

Your adrenal glands are small endocrine glands that sit on top of your kidneys. They produce several key hormones, including:

  • Cortisol (your primary stress hormone)

  • Aldosterone (fluid and blood pressure regulation)

  • DHEA (a precursor to sex hormones)

  • Catecholamines such as adrenaline and noradrenaline (fight-or-flight response)


Their primary role is to help your body respond to stress — whether that stress is physical, emotional, environmental, infectious, metabolic, or inflammatory.

When stress is acute and short-lived, this system works beautifully.

When stress becomes chronic, the system can become dysregulated.

What Chronic Stress Does to the Body

Ongoing stress exposure can:

  1. Deplete essential nutrients required for hormone production and nervous system regulation (e.g., B vitamins, vitamin C, magnesium, zinc).

  2. Disrupt normal cortisol rhythms (either elevated, flattened, or blunted output).

  3. Alter blood sugar regulation.

  4. Increase inflammation.

  5. Reduce resilience to future stressors.


Rather than the adrenals “burning out,” what we often see clinically is a maladaptive stress response — where the body no longer mounts or regulates stress hormones efficiently.

Common Symptoms of Burnout / HPA Axis Dysregulation

Burnout symptoms can look like:

  • Chronic fatigue or difficulty waking

  • Mid-afternoon crashes

  • Dizziness or lightheadedness

  • Brain fog and poor memory

  • Reduced stress tolerance

  • Anxiety or feeling easily overwhelmed

  • Apathy or lack of motivation

  • Digestive disturbances

  • Sex hormone imbalances

  • Blood pressure irregularities


Many people normalize these symptoms — but they are signals.

How We Support Recovery

Recovery is not about “pushing through harder.”

It is about restoring physiological resilience.

1. Nutritional Repletion

Support may include:

  • B-complex vitamins

  • Vitamin C

  • Zinc

  • Magnesium

  • Adaptogenic herbs (individualized)


*These are not individualized suggestions and should not be taken before speaking to a healthcare provider. All supplementation should be personalized to your unique needs.

2. Blood Sugar Stability

Adequate protein intake and balanced meals are foundational for regulating cortisol patterns.

3. Nervous System Regulation

Intentional stress reduction practices are not optional — they are therapeutic.

This may include:

  • Reducing caffeine and alcohol

  • Improving sleep hygiene

  • Structured recovery time

  • Gentle movement vs. high-intensity overtraining


4. Functional Testing

In clinical practice, tools such as:

  • 4-point salivary cortisol testing

  • Hair Tissue Mineral Analysis (HTMA)


can provide insight into how the body is responding to stress and where support is needed.

Burnout Should Not Be Your Baseline

Living in a constant state of exhaustion, overwhelm, or mental fog is not a personality trait.

It is not laziness.

It is not weakness.

It is often a physiological response to prolonged stress.

Your body is adaptive — but it is not infinite.

If any of this resonates, know that recovery is possible. With the right assessment, nutritional support, and lifestyle recalibration, resilience can be rebuilt.

Burnout is not something to push through.

It is something to listen to.



Alexandra is a Certified Holistic Nutritionist specializing in mood, stress, cognitive health, and gut heath.

Let’s work together.

You can explore my 1:1 coaching services HERE, designed to support stress recovery, nervous system balance, digestion, and long-term wellbeing.

And if you’re craving deeper answers, I also offer specialized testing — including GI mapping, cortisol testing, DUTCH hormone, and mineral analysis — so we can create a plan that’s tailored to your unique physiology.

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The Biology of Not Giving Up