Running on Empty: Stress, Burnout and Your Nervous System

Stress is a natural response to pressure or challenge. In short bursts, it helps you get ready and act. But when pressure stays high and there's little chance to recover, stress can affect your sleep, concentration, mood, relationships and physical health.

Burnout is more specific. You might recognise the feeling of still getting through your responsibilities while becoming more and more exhausted, detached and unsure that your effort makes any difference. Burnout is not a personal failing or a sign you aren't resilient enough. It usually reflects a mismatch between ongoing demands and the resources, control and recovery time available.

How is burnout different from stress?

The World Health Organization describes burnout as a work-related problem caused by long-term workplace stress that hasn't been well managed. It has three features:

• Exhaustion: feeling drained of physical and emotional energy.
• Distance or cynicism: feeling detached, negative or cynical about your work.
• Reduced effectiveness: feeling you're no longer achieving or making a difference.

Stress often feels like too much: urgency, rushing and a sense that things will be fine once you catch up. Burnout often feels like not enough: flat emotions, hopelessness and nothing left to give. Burnout is not a medical diagnosis. People also use the word for exhaustion from parenting, caring or other roles. Those experiences deserve support too.

What causes burnout?

Workload matters, but it's rarely the whole story. Research by Christina Maslach and colleagues points to six areas where a poor fit between a person and their work can lead to burnout:

• Workload: too much to do, with too little time or resources.
• Control: little say over how, when or what work is done.
• Reward: effort that isn't recognised.
• Community: poor support, conflict or isolation.
• Fairness: unfair treatment or lack of respect.
• Values: being asked to act against what you believe matters.

Personal factors, such as perfectionism, trouble saying no and a strong sense of responsibility, can make it harder to step back. People in caring roles, healthcare, education, emergency services and small business, as well as carers and parents, are often at higher risk. Because many keep performing well while struggling privately, burnout can go unnoticed until it's advanced.

What happens in your body

The stress response is automatic. When you face a demand, your nervous system and hormones kick in. Adrenaline gets you moving quickly. Cortisol, released through a system called the HPA axis, helps keep you going. Your heart rate, breathing and muscle tension can change before you've even noticed. Other parts of the nervous system help you rest, digest and recover.

This works well when demands come and go. When they keep coming, with worry, poor sleep and little downtime, the strain can build up. You might know the workday is over but still feel braced for the next problem. Scientist Bruce McEwen described how this build-up of "wear and tear" can affect many body systems. However, burnout can't be diagnosed from a single hormone test.

Knowing this can make the experience less confusing. Your reaction is not a personal failure. And it can change, through learning, practice and changes to your circumstances.

Signs worth taking seriously

• Exhaustion that keeps coming back, even after rest or time off.
• Trouble concentrating, remembering, sleeping or making decisions.
• Feeling detached, cynical, irritable or numb.
• Dreading work or other responsibilities.
• Pulling away from people or activities that usually matter to you.
• Frequent headaches, stomach problems, illness or muscle tension.
• Relying more on alcohol, caffeine or other substances to get through.

These signs aren't unique to burnout. Depression, anxiety, sleep disorders and physical health conditions can look similar, and burnout and depression often overlap. Your GP can check ongoing tiredness or new physical symptoms.

What does research say about recovery?

Burnout comes from the interaction between a person and their circumstances. So the best approaches usually address both. A review of burnout programs for doctors found that changes made by organisations, such as to workload, scheduling and teamwork, had bigger benefits than individual strategies alone. Individual support still matters, but it works best alongside changes to the conditions that caused the strain.

For individuals, a review of online CBT programs found they reduced stress compared with control groups. A review of breathing practices found a small-to-moderate reduction in stress, although many studies had limitations. These are useful options to try, not guaranteed fixes.

How psychology can help

A psychologist can help you understand your own stress response: what sets it off, how it shows up in your body, what it means to you and which habits keep it going. Therapy can then work from two directions.

Starting with thoughts and actions ("top-down"): questioning predictions like "if I make a mistake, everything will fall apart", testing rigid rules, problem-solving and setting boundaries.

Starting with the body ("bottom-up"): slow, comfortable breathing and relaxing your muscles can help calm your body. A psychologist can help you notice early signs of stress and practise a response that suits you. Stop any breathing exercise that makes you dizzy or more distressed.

Using both together: after a demanding email, you might first relax your shoulders and let your breathing settle, then question the idea that you must reply straight away.

How different therapies can help

Cognitive Behavioural Therapy (CBT)

CBT can explore rules like "I must always be available" or "rest means I'm lazy", and where they came from. Small experiments, such as agreeing on a realistic time to reply to messages, can test whether every request really needs an instant answer.

Acceptance and Commitment Therapy (ACT)

ACT can help you get clear on what matters when demands pull you in different directions. You can feel guilty about saying no and still choose a boundary that protects your health or family time. Acceptance never means putting up with unsafe work conditions.

Practical steps towards recovery

• Protect recovery time: real breaks, time off and switching off from work messages outside hours.
• Look after the basics: sleep, movement and regular meals are often the first things to slip.
• Reconnect: spend time with supportive people and on activities unrelated to work.
• Talk about workload: where it's safe, discuss demands and support with your manager. Check whether your workplace has an Employee Assistance Program.
• Reconnect with meaning: notice which parts of your role fit your values, and where change is possible.

Getting support at Invision Psychology

Our psychologists offer therapy for stress and burnout at our clinics in Rockhampton (2/72 Bolsover Street) and Yeppoon (3/26 James Street), and by telehealth for people across Central Queensland and beyond.

• You don't need to know which therapy you want. Your first appointment is a chance to talk about what's happening and what you'd like to change.
• Medicare: with a Mental Health Treatment Plan from your GP, you may be able to claim a Medicare rebate for up to 10 sessions each calendar year. See our fees.
• NDIS: we work with self-managed and plan-managed NDIS participants.

Make an enquiry or call 07 5641 4888.

If you need help now

If you or someone else is in immediate danger, call 000. For 24/7 support:

• Lifeline: 13 11 14
• Beyond Blue: 1300 22 4636
• 13YARN (Aboriginal and Torres Strait Islander people): 13 92 76
• Kids Helpline (ages 5–25): 1800 55 1800

An appointment enquiry is not an emergency service.

About the author

Alex Parkes BPsychSci, GradDipPsych, MPsych, MAAPi
Founder and Principal Psychologist, Invision Psychology. Level 1 trained Internal Family Systems practitioner.

Published September 2026 · Last reviewed September 2026 · Next review due September 2027

This article gives general information based on published research. It is not a substitute for personalised advice from a qualified health professional.

References and further reading

• World Health Organization (2019). Burn-out an "occupational phenomenon": International Classification of Diseases.
• Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry.
• McEwen, B. S. (2017). Neurobiological and systemic effects of chronic stress. Chronic Stress.
• Panagioti, M., et al. (2017). Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis. JAMA Internal Medicine.
• Svärdman, Sjöwall & Lindsäter (2022). Internet-delivered cognitive behavioral interventions to reduce elevated stress: a systematic review and meta-analysis. Internet Interventions.
• Fincham, G. W., et al. (2023). Effect of breathwork on stress and mental health: a meta-analysis of randomised-controlled trials. Scientific Reports, 13, 432.
• Healthdirect Australia. Work-related stress.