How To Avoid Burnout If You Have High-Functioning Anxiety And Depression

Five vertical matches, each of which represents varying levels of burnout

How To Avoid Burnout If You Have High-Functioning Anxiety And Depression

By Dr. Elayne Daniels | May 31, 2021 |

Anxiety, depression, and burnout zap the joy out of life. Sometimes they co-occur and can be difficult to distinguish from each other. Avoiding burnout if you have high-functioning (or not-so-high-functioning) anxiety or depression can be extra tricky, especially with overlapping signs and symptoms. 

Because anxiety and depression lower your resistance to stress, your threshold for staying engaged in life is also diminished. This becomes the perfect storm for burnout.

What is burnout? How do you know if you are burned out?

This is a good question. You need to know what you’re looking for in order to identify it and do something about it.

Burnout can happen to anyone and goes deeper than merely feeling tired and stressed. When burned out, people feel mentally, physically, and emotionally exhausted. Drained. They tend to be pessimistic and feel like they have nothing left to give. Dealing with everyday responsibilities becomes too much. Even getting out of bed is daunting.

The backside of a woman sitting on the edge of a bed looking out the window while in her bathrobe.

Burnout happens as a result of chronic stress.

A common example is caretaking while juggling other home and work demands. Exposure to negative health or political news day after day can also take a cumulative toll.

The recent political climate surrounding the 2020 election led to burnout for many, as has living through the coronavirus pandemic.

Along with an increase in burnout rates, anxiety and depression rates have also increased during this time.

Burnout tends not to go away on its own.

Signs of burnout include exhaustion, isolation, anxiety, depression, and feeling numb. The emotional, physical, and mental exhaustion of burnout worsens the symptoms of depression and anxiety.

When a battery loses its charge, it must be recharged in order to function. Burnout creates the same scenario for us humans.

What is high-functioning anxiety?

The term “high-functioning” anxiety is not a real thing in the world of official diagnoses. There are no objective criteria. But we all kind of know what the phrase is referring to.

For some people, high-functioning anxiety may refer to a person who worries, stresses out, and has episodes of physical signs of anxiety. Physical indications include symptoms like increased heart rate, headaches, and racing thoughts — all effects that are undetected by the outside world. 

For others it may mean periodic anxiety symptoms that do not last long enough or become intense enough to interfere with their day-to-day lives.

Let’s say a person with high-functioning anxiety does not appear anxious on the outside. In fact, she appears to have her act together. She is kind, friendly, productive, and organized. This hypothetical high-functioning person with anxiety does not appear anxious. However, on the inside she overthinks everything and often believes she can’t measure up. She’s filled with self-doubt and has difficulty saying ‘no’ to requests.

What is high-functioning depression?

The term “high-functioning” depression, just like “high-functioning” anxiety, is neither clinically valid nor diagnostically existent. In other words, it has no standard definition. Different people may mean different things by the phrase “high-functioning”. 

For some, it may suggest having symptoms of depression, such as sadness, low energy, appetite changes, and insomnia. However, that person purposely doesn’t display any outward signs of depression. Instead, on the outside, the person appears to be functioning well in life – at work, home, and with friends and family. 

High-functioning depression could also refer to people who have bouts of depression that are short-lived, relatively mild, and not conducive to much derailment in their lives.

While anxiety and depression are considered psychiatric conditions, burnout is a reaction to stress.

There are treatments for anxiety and depression. The usual ‘treatment’ for burnout is to take time off or ‘recharge your battery’ in some other restful, restorative way. Unfortunately, that’s not always possible. The majority of people don’t have the kind of finances, job security, or back-up contingencies to enable that kind of elective time off.

The emotional, physical, and mental exhaustion of burnout worsens the symptoms of depression and anxiety.

The ways to avoid burnout are similar, whether you have high-functioning anxiety and depression or not.

How can you avoid burnout if you have high-functioning anxiety and depression?

If you’re already anxious and depressed, you’re more prone to burnout. Recognizing and addressing anxiety and depression before they are worsened by burnout is difficult but certainly ideal. If your stress tolerance is low due to anxiety and depression, going below that bar into the burnout zone doesn’t take much.

Self-awareness is key to avoiding burnout. So is self-care.

You decrease the likelihood of burnout by prioritizing self-care. Maybe that means going for more walks, talking more often with friends, or saying ‘no’ more consistently to requests at work. Maybe it’s even that Netflix series you watch while your puppy is snuggled up next to you. Whatever it is that helps you to replenish. 

My favorite form of restoration? Getting out into nature. 

Go outside and get a few breaths of fresh air. Look around at the trees, smell the flowers, feel the breeze on your cheeks.

Self-care is often more of a mindset than a prescription for pedicures and bubble baths. (But those are ok, too!)

Self-care is about being on your own side and treating yourself as you would a loved one.

The likelihood of burnout decreases when self-care is part of your daily routine — even if you’re working long hours or taking care of elderly parents. Your obligation is to add moments of joy and/or peace into each day. 

Small self-care gestures can stop stress from taking over and causing burnout. And those same gestures – talking with loved ones for support, being playful, finding things to laugh about, being outside in nature – are also helpful for your general well-being.

When approached with moment-by-moment loving choices, self-care becomes a mindset, not a destination. And burnout falls by the wayside.


I am a Massachusetts-licensed psychologist in private practice. If you’re struggling with anxiety and depression and would like to learn more about working with me, please contact me here.

How Do I Know If I Have An Eating Disorder?

A photo of a woman folding clothes, with only her arms visible.

There are lots of signs of an eating disorder, yet how to know if you have one can be tricky. One of the main reasons you may not know if you have an eating disorder is due to Diet Culture. More about that in a moment.

How to know for sure if you have an eating disorder? Ideally, an informed physician or psychologist would conduct an evaluation of your symptoms. Unfortunately, education and training for eating disorder treatment is woefully inadequate, especially among medical doctors.

Even worse is that a lot of medical professionals don’t actually know how to correctly diagnose an eating disorder. Instead they resort to stereotypes and myths, such as using weight as a main indicator. Or believing that only white teenage girls develop eating disorders.

By the way, in the United States, an estimated 30 million people of all ages and genders have an eating disorder.

So, how do you know if you have an eating disorder?

Knowing if you have one is complicated. Being diagnosed with one can be even more complicated. Again, eating disorders are easily misdiagnosed. And often overlooked by professionals. Many in the medical and psychiatric field do not have training in eating disorders. Or in nutrition. (Can you tell it’s a pet peeve of mine?)

Consider too that an eating disorder is often downplayed by the person suffering from one. S/he may not want it to be identified. Or not recognize that her thoughts and behaviors are part of a bona fid eating disorder.

By the way, you can’t tell by looking at a person if she has an eating disorder. Body size is not an indicator, nor is any specific sign a slam dunk indicator. Girls and boys, nonbinary people, women and men suffer from eating disorders.

You definitely can’t tell by looking at yourself in the mirror if you have an eating disorder. Often your own perception of your body size and shape is distorted.

What is the main challenge of knowing if you have an eating disorder?

A huge challenge for how you know if you have an eating disorder is Diet Culture.

In reality, Diet Culture makes it nearly impossible to distinguish between “normal” and “abnormal” eating and body image. What is considered ‘healthy’ in Diet Culture is often anything but.

Haven’t heard of Diet Culture before? It’s a system of beliefs that equates thinness with worth as a human being. Through the lens of Diet Culture, you’re taught to feel bad about your body. And to judge other people’s worth by their body too. Diet Culture is often disguised as “healthy lifestyle”, “eating clean”, or “Intermittent Fasting”.

No wonder eating disorders are so rampant. Or that what is and isn’t an eating disorder can be tricky to determine.

Diet culture’s solution to any problem is: “Lose weight and you’ll look better, feel better, and be better.”

Taking this insidious message to heart puts you on a fast(er) track to an eating disorder.

Of course more factors than Diet Culture are at play. Regardless, Diet Culture’s messages are pervasive and detrimental. To the point where you may be unaware you’ve internalized them and are being controlled.

A picture of a white plate and a fork and knife on it. There is a frown face  drawn on the plate.

Social media has fueled Diet Culture’s impact. (Instagram is considered the most influential. although I suspect TikTok is a contender for first spot.)

What follows is a list of potential indicators of an eating disorder. This is not a complete list! (Resources are also available online to help you determine if you have an eating disorder.)

Possible indicators that you may have an eating disorder include:

1. Preoccupation with food, weight and/or the shape of your body.

  • Thinking about food all day – what you ate, wish you could eat, wish you did not eat, and how to compensate for what you ate.
  • You’re constantly thinking about your body and comparing yourself to others, especially to people on social media.
  • You weigh yourself often, and the number on the scale determines your mood and how the day goes.

2. Not eating certain foods for fear that something bad will happen to you.

  • A common example is cutting out particular food groups out of fear that they will cause you to ‘get fat’.
  • Another example is believing myths, such as sugar is toxic or addictive.

3. Feeling out of control over the amount of food you’ve eaten, at least once a week.

  • You might have binges. If you feel a loss of control when eating, you’re bingeing.
  • Bingeing is usually secretive. And is inevitable after a period of restriction.
  • Sometimes you may think you’ve binged because you’ve eaten more than you planned.

4. Worrying about the nutrition and calorie content of foods.

  • People with an eating disorder tend to get stressed about eating out. They may look at menus online in advance of going to a restaurant.
  • More than others, people with an eating disorder are influenced by calorie information on menus.
  • Someone with an eating disorder is likely to avoid going to restaurants, or to compensate before and/or after they eat.
  • Avoiding social occasions if food is involved is common.

5. Feeling disgusted or anxious when looking at your body or seeing it in a mirror.

  • A person with an eating disorder is likely preoccupied with looking at herself in the mirror. Or may go out of her way to avoid seeing her reflection.
  • People with certain forms of an eating disorder may wear oversized clothing as a way to hide their size or shape.

6. Constantly comparing your body to friends’, social media influencers, and people you see at the gym.

  • And feeling worse about yourself, regardless of the comparison.
  • You long for your body to look more like so-and-so’s body. You may even think that if you could look like so-and-so, everything would be perfect! You’d be happy, then. (But not really.)

7. Feeling guilty after eating.

  • Food is often categorized as good or bad. In reality, all food is just food. It doesn’t have moral quality.
  • Having an eating disorder often means rigid rules.
  • Violating any rules leads to guilt. Especially when the rules involve food.
  • All-or-nothing thinking is common.

8. Intentionally making yourself vomit or exercise excessively so you don’t gain weight.

  • These are called compensatory methods. They’re habit forming. And dangerous.
  • The purging methods are secretive.

9. Being very aware of calories.

  • You’re vigilant about the calorie or macro content of food, and/or the amount of calories you burn.
  • You have rules about how many calories you’re allowed, and you may track the information in your head, on an app, or with pen and paper.
  • The less you’ve eaten, the better the day. And the more successful you feel.

10. Needing to check your body’s appearance throughout the day.

  • You may frequently mirror check, weigh yourself often, or pinch areas of your body to assess the amount of tissue.
  • These are called checking behaviors and can become automatic.
  • You engage in these behaviors for reassurance that body parts have not gotten larger.

11. Having other symptoms as a result of your behaviors.

  • There are a myriad of medical symptoms and risks involved.
  • “Everyday” physical consequences include headaches, fatigue, dizziness, light headedness, irregular heartrate, gi distress, and constipation.
  • Depression, anxiety, and other mental health problems are common. Or become worse.

12. Treating your body as if it is an object, rather than as a beautiful expression of your life.

  • When you focus on your weight, you are objectifying your body, as if it is a mold of clay to size and shape.
  • Withholding food from yourself is punitive.
  • What about practicing embodiment? BEING in your body as if your body were the instrument through which you live your glorious life?

Ok. So now what?

Early evaluation and diagnosis, as well as effective treatment, stack the deck favorably for recovery.

And, full, complete recovery is possible!

What if you’re still not sure if you have an eating disorder? Consider talking with a specialist on a hotline through one of the national organizations such as the National Eating Disorder Association.

Whether or not you have an eating disorder, educate yourself on topics such as fat stigma, privilege and other social injustices that make up Diet Culture.

For a new perspective, read about Intuitive Eating and body neutrality Both offer a refreshing alternative to Diet Culture.

Let’s ditch Diet Culture together. And delight in size and shape diversity.

Imagine actually enjoying food? Welcoming other pleasures? And feeling comfortable in your body?

This IS possible. As you learn to love yourself more, you’ll break free from the constraints of Diet Culture.

As you become more accepting of yourself, you teach others to be more accepting of you too. And of themselves. Before you know it, you’ll be teaching others to break free from Diet Culture too.

Greater inclusivity will reduce the rate and impact of eating disorders. And lead to unprecedented freedom FOR YOU to let your body be.

I’m reminded of Margaret Sanger’s words: “No one can consider [themselves] free who doesn’t own…. [their] own body.”

The first step toward freedom in your body is to admit having an eating disorder.

By letting go of the shackles of Diet Culture, you’ll be able to experience your life – “happiily full” and with abundance. .


Hi! I am Dr Elayne Daniels, a MA licensed psychologist with a passion to help people of all sizes and shapes improve their relationship with food and their body. If you’re struggling with an eating disorder, live in MA, and want help, please contact me here.

9 Steps For Overcoming Body Image Issues

The back of a woman, who is sitting on a grassy hill overlooking a body of water

How often do you control, starve, punish, speak harshly to your body? Or about your body? Overcoming body image issues is challenging for most women, and, most women have them. It just seems to go along with being a woman. (And, increasingly, a man.)

The mean things you may do and say about your body happen automatically, without you even realizing it. And the self-bullying only worsens body image. Your body hears everything you say or think about it.

The good news is that overcoming body image issues is possible.

Although no one article, tool, wisdom, fad, or behavior that will flip a switch. But, when you use a combination of these 9 steps, you’ll know how you can successfully fall back in love with your body.

Infant girl joyfully looking at her own reflection & playing pattycake.

Toddlers rejoice about the size of their thighs and round bellies!

The 9 Steps:

1. Be aware.

Thoughts turn into actions and actions turns into character. The mind is the powerful aspect of the human body.

Buddha

  • Awareness of how you speak to yourself means you recognize and can therefore change your self-talk to make it more accurate and neutral. By self-talk, I am referring to thoughts.
  • Instead of thinking “my stomach is disgusting and looks like I am carrying twins”, you could simply say “right now I am feeling dissatisfied with how my stomach looks and feels.” The first thought is mean, untrue, and self deprecating. The latter is true and in the moment. Awareness of thoughts means you can gently question their validity and reframe them.
  • Every time you think a particular thought, that thought is strengthened. We are always practicing something. When we think a thought, we are practicing thinking that thought. Be aware of what you’re thinking/practicing and therefore what you’re strengthening. (The fancy term for this is neuroplasticity.)
  • Neuroplasticity means we can actually change thought patterns and behaviors. We can develop a new mindset, new skills, and new abilities.
  • Your body hears, internalizes, and feels everything you say about it. Be aware. Be deliberate.

2. Be here, now.

“The secret of health for both mind and body is not to mourn for the past, nor to worry about the future, but to live the present moment wisely and earnestly.”

Buddha

  • Your body carries history and brings you into the future, yet the here and now, in time and space, IS your body.
  • In any given moment, your relationship with your body is a blend of the past and present; biology, culture, and the environment; emotions, perception, and behaviors.
  • The more immersed in the past or the future your body image is, the less present you are in the here and now. And, the here and now is all any of us has.
  • If you are not in the here and now, you are missing out on presence in your own life. Instead, you’re immersed in judgey, self-critical chatter about the past and future.
  • When in the here and now, you are more likely to notice the deep burgundy color of leaves, melody of robins chirping, and the overall beauty surrounding you.

3. Be-yond objectification.

This image has an empty alt attribute; its file name is 173342686_4296453640401174_4413721931241588586_n-1.jpg
  • Body image is a relationship. It is the relationship you have with your body. Like all relationships, the depth of the relationship is something over which you have some agency.
  • When we objectify our body, we relate to it as if it is a thing. An object to manipulate. Something to focus on, i.e. size and shape. Unidimensional. Like a shoe, pillow, or toaster.
  • Consider if an objectified relationship is the kind you want with your body.
  • Cultural messages are designed for you to believe your body is not good enough, that your relationship must be conflictual.
  • Advertisers and social media are brilliant at promoting body as enemy. Relationships with enemies are rarely neutral or happy.
  • What if you embraced with delight, or at least accepted with neutrality, the whole of you?


4. Be on your own side.

  • Your body is with you for life. It will carry you through life’s ups and downs.
  • Your body will age, experience illness and injury, and change. Everything does.
  • Your body provides you with feedback about emotions, health, the environment and so much more.
  • The more friendly you are in the relationship with your own body, the more you will be able to access its wealth of knowledge.



5. Be joyous.

A joyous woman in a pool, seated in an inflatable and smiling
  • Your body is your own personal pleasure source. Sensory capacities are your gateway into joy.
  • Stop for a moment. Look, listen, feel, taste, smell.
  • BREATHE. That breath of air? That is life.

6. Be active.

a paddle for a kayak
A woman's feet in purple sneakers on a skateboard.
  • Your body is a type of instrument, and not just an ornament.
  • Your body, in water or on the ground, is meant for you to enjoy; it is not just something to decorate.
  • Regardless of age, health, or size, your body has the capacity to move.
  • Maybe the movement is dipping your toe into an ocean’s wave, as it comes to shore. Or stretching your fingers. How about expanding your lungs with a deep breath in, and contracting them with your exhale. Or skateboarding in purple sparkle sneakers.

7. Be courageous.

  • How about tapping into your well of courage and experimenting with these body image recommendations?
  • Be a rebel and be the change you wish for the world.
  • Choose one of these 9 ideas and notice how you feel in and about your body.
  • You DO have agency with your body….especially when you are on your own side.
Well-Behaved Women Round Magnet

8. Be respectful.

  • Your body does hear everything you think.
  • Be kind to yourself. Be kind to your body. Or at least not cruel.
  • Speak to yourself as you would a friend.
  • Consider all your body has carried you through.
  • Have thanks. Give yourself grace.

9. Be you

  • “You” are made up of all the amazing people who came before you. You may have your mom’s hips. Or your grandmother’s ears. Or your dad’s eyes.
  • Your body contains the genetics of your ancestors. You are a walking family tree.

Body image issues are complex. Overcoming them takes time, awareness, and trust.

Start with one of the ideas. Add another as you are ready. You don’t need to do all at once. One step at a time.

Remember to love yourself. Once you do, everything will fall into place.

I am a non-diet, Certified Intuitive Eating specialist and clinical psychologist in MA. If you’re struggling with your body image and/or an eating disorder, and want to chat with me, please contact me here.