Why modern stress stays trapped
The human stress response was designed for short-term threats. A stressor appears, the body mobilizes, the threat passes, stress hormones clear. The body returns to safety.
Modern stressors don't follow that path. A difficult email triggers the same physiological response as a physical threat — but rumination doesn't clear stress the way physical action does. As Robert Sapolsky explains in Why Zebras Don't Get Ulcers, 3rd ed., humans are unique in their ability to activate a stress response through thought alone — and equally unique in their inability to switch it off. "We are using an acute stress system for chronic problems," Pennacchia explains. The stressor is addressed, but the hormones remain. Over time, that accumulation becomes chronic stress — and combined with emotional suppression, eventually leads to burnout.
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The body needs signals that the threat has passed. Without them, the cycle stays open.
Stephanie Pennacchia, LPC-MHSP, child, adolescent and adult therapist, Nashville Child & Family Wellness Center
Strategies to break the cycle
Pennacchia and Criste organize effective coping across three categories: physiological regulation, cognitive strategies and relational approaches. Drawing from over one category makes them significantly more effective — ideally, all three.
Physiological regulation
Move your body: Physical movement is one of the most direct ways to clear stress hormones like cortisol and adrenaline. Activities that elevate your heart rate help the body process and release what accumulates during stress — and close the stress cycle in a way that thinking through a problem simply can't.
Try progressive muscle relaxation: Stress lives in the body, not just the mind. Progressive muscle relaxation — systematically tensing and releasing each muscle group from feet to face — helps relieve the physical tension that builds during chronic stress. It's particularly effective for sleep issues. Guided versions are widely available online and take less than 15 minutes.
Use your breath: Box breathing — inhale for four seconds, hold for four, exhale for four, hold for four — overrides the fight-or-flight response and activates the parasympathetic nervous system. It's discrete enough to use anywhere, including the middle of a difficult conversation.
Cognitive strategies
Shift your inner dialogue: Recognize and challenge unhelpful thinking patterns. The most common ones: dichotomous (all-or-nothing) thinking, "shoulds" and "musts" that leave no room for being human and selective attention to negatives while discounting positives. These patterns shape how we lead and how we show up for the people around us.
A useful technique is the "leaves on a stream" exercise, rooted in mindfulness. Visualize yourself on a bridge, looking down at a stream as leaves float past. As thoughts, feelings or distractions arise, place each one on a leaf and watch it float away. Three to five minutes is enough. It creates distance from distressing thoughts without requiring you to solve them.
Practice gratitude: The brain works through reinforcement. If perfectionism has trained it to scan for failures and flaws, it will find them. Gratitude practice retrains that focus intentionally — not as a positive-thinking exercise, but as a neurological one. Start externally, with things outside yourself, then move inward. Over time, it shifts what the brain defaults to noticing.
Align with your values: Values are more stable and enduring than goals — they give life meaning and inform the limits we set. Pennacchia offers a useful diagnostic: if one value is operating at a ten and others are running on empty, overall wellbeing suffers regardless of how productive you feel. Identify your top values, then honestly assess how much your daily life reflects them.
Relational strategies
Seek safety cues and connection: Surrounding yourself with people or environments that feel familiar and safe signals the body to relax. Pair this with genuine emotional release — laughing, crying, creative outlets — to counter the suppression that sits at the core of burnout.
Practice self-compassion: Self-compassion inhibits fear and activates courage. It shifts activation in the brain regions that manage difficult emotions, reduces cortisol and increases oxytocin — building physiological resilience over time.
Many high-achieving women show kindness to others but maintain a harsh inner narrative toward themselves. A simple tool to interrupt that pattern is the self-compassion break, developed by Dr. Kristin Neff.4 When a hard moment hits, try: "This is a moment of stress. Stress is a part of life. May I be kind to myself." It sounds simple. That's the point. Like any skill, it becomes more genuine with practice.
Try loving-kindness meditation: Loving-kindness meditation extends that same compassion outward — and in doing so, creates measurable physiological changes. Start by recalling a moment of warmth you've felt toward or from someone you care about. Then direct that feeling toward them by silently repeating: "May this person be at ease. May they be content with their life. May they be joyful. May they feel safe and secure." Repeat three times, then extend the same wishes to someone neutral in your life.
As you move through the practice, you may notice physical shifts — a softening in the jaw, slower breathing and a sense of warmth. These are signals of safety reaching the nervous system. They matter because they're the same signals the body needs to close the stress cycle.
Expert advice
Effective coping and self-care aren't the same thing — and you need both. Self-care is preventative: consistent practices that maintain your baseline. Effective coping is intentional: the strategies you reach when difficult emotions and stressors arrive. Think of it as emotional bubble wrap. During ordinary times, your standard layers are enough. During periods of chronic stress, you need more.
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With burnout, there's already a lot on your plate. Sometimes it's about finding something simple — like saying, 'I know I should go for a walk' and actioning this. If you're open to it, even a small step can make a difference.
Stephanie Pennacchia
The perfectionism factor
Perfectionism is often a strength. Whether it helps or harms depends on its root.
Adaptive perfectionism is rooted in self-compassion. Standards are high but adjusted to the situation. Expectations connect to actual strengths. Delegation is possible.
Maladaptive perfectionism is rooted in fear of failure, fear of mistakes, fear of judgment. It keeps the nervous system in a state of threat. And because the brain's reward system genuinely lights up with productivity and accomplishment, the gravitational pull toward more work is biological, not just habitual. Pennacchia names it plainly: the perfectionist motto is "Relaxation must be earned."
If that lands, keep reading.
It doesn't only show up in big, visible ways. It shows up in two minutes between a meeting and a call — and choosing to answer emails instead of stepping away. It shows up in the show playing in the background while your attention is entirely on your phone. Catching it in small moments is where the shift starts.
Signs you may be in maladaptive perfectionism
- Inflexibly high standards across all areas of life, regardless of context
- Self-worth tied directly to performance outcomes
- Inability to rest until every task is complete
- Excessive checking, reviewing or correcting before submitting work
- Inability to delegate, even when it would serve everyone better
- All-or-nothing thinking: either perfect or a failure, with nothing in between
- Participating in tasks out of obligation rather than engagement
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Perfectionism can be such a strength, but it has to be channeled in helpful ways. Look at the list of maladaptive examples, find a few you recognize — and lean into the adaptive versions in the coming days and weeks.
Caroline Criste, LPC-MHSP, CEDS, Licensed professional counselor, Nashville Child & Family Wellness Center
Boundaries, communication and the invisible load
Gallup data shows that 36% of women in dual-income households carry exclusive or primary responsibility for six or more household duties, compared to just 9% of men.3 That number understates the real weight, because it doesn't capture what happens before any task begins.
"It's the domestic labor itself," Criste explains. "It's knowing when products run out, planning meals around everyone's preferences, scheduling the cleaner if you outsource. The management never stops." That cognitive overhead reduces the time and energy available for recovery — and makes sustainable balance structurally harder to achieve, regardless of how organized or efficient you are.
Clarity about what matters most makes limits easier to establish and easier to defend. A useful starting point: set your limits based on your worst day, not your best. That's the version more likely to hold when it counts.
For communicating those limits, the DEAR MAN framework — developed by Marsha Linehan as part of dialectical behavior therapy (DBT), the DBT Skills Training Manual, 2nd ed., — provides a clear script. It's especially useful when setting a boundary feels uncomfortable or when previous attempts haven't landed the way you intended.
D — Describe: "I've noticed that when I get home from work, there's often still a lot that needs to happen for the evening."
E — Express: "I find myself feeling frustrated and overwhelmed."
A — Ask: "I'd like us to identify a few more things you're willing to take on regularly."
R — Reinforce: "It would give me more capacity when I get home and improve our time together."
M — Mindful: Stay on the core request. If the response is, "What about last week when I did everything?" acknowledge it and return: "I'm not dismissing that. What I'm asking for is consistent support in the future."
A — Appear confident: Don't qualify your ask into nothing. "If you wouldn't mind, it'd be fine, but no big deal" undoes everything before it.
N — Negotiate: Where specifics don't matter, leave room. Where they do, hold firm.
One thing worth naming directly: vulnerability isn't weakness. Research shows that people who communicate authentically — who let others see when they're struggling — are more likable and more likely to receive meaningful support. When what we project externally doesn't match what we're experiencing internally, it increases stress and quietly erodes the connections that protect against burnout in the first place.
Build in accountability
One of the most practical tools Pennacchia uses at Nashville Child and Family Wellness Center is the burnout rating. At the start of every team meeting, each person rates their burnout on a scale of zero to five. A high rating triggers a check-in — an honest conversation about workload, capacity and what support is needed. Colleagues hold each other to limits they've already stated, stepping in when perfectionism starts to override good judgment.
It works because burnout is likely to show up at work either way. The only question is whether it's named and managed — or invisible and compounding.
