Stress and burnout

Chronic stress: when rest stops working

Stress isn't a problem in itself. It's how the body meets a demand, and when the demand ends the response switches off.

The problem starts when it doesn't. When the recovery phase never fully arrives, and each new demand begins from a level of activation that never went back to zero.

The most reliable signal isn't how tired you are. It's that rest stops paying you back: you sleep and wake up tired, you spend a weekend doing nothing and Monday is identical.

Physical symptoms of stress

Prolonged stress shows up in the body before it shows up in thought, which is why many people arrive after months of medical investigation.

Sleep problems, falling asleep or waking. Tension in the neck, shoulders, jaw. Digestive problems. Recurring headaches. Changes in appetite. More frequent infections. A tiredness that doesn't match what you've actually done.

If tests find nothing, it doesn't mean the symptoms weren't there. It means the body was responding to something that isn't an illness.

Workplace burnout: the three components

Burnout isn't simply tiredness from too much work. It has a recognisable shape, and it develops in three directions at once.

Exhaustion. Energy doesn't rebuild. It isn't the tiredness of a hard day: it's a baseline tiredness that precedes the day.

Detachment. You move away emotionally from what you do. The people you work with become items to process. Cynicism grows, and often surprises the person feeling it arrive.

A sense of ineffectiveness. The impression of no longer making a difference, of not being as good as you were, of never really finishing anything.

Burnout mostly affects people who invested heavily: it rarely reaches anyone who was indifferent to their work from the start.

Why you collapse when you finally stop

Many people don't break down during the difficult period but immediately afterwards. On holiday, on the first free weekend, at the end of a project.

That isn't a coincidence. While the demand is live, the activation sustains it. When the demand drops, the activation drops too, and everything that was postponed arrives at once.

That produces a further difficulty: you start to dread the breaks, because that's where you feel worst.

Stress, anxiety and insomnia

Prolonged stress and anxiety feed each other. Stress lowers the threshold at which the alarm system fires; anxiety prevents the recovery that would reduce the stress.

Sleep is often where it shows first. Not being able to fall asleep because your head won't stop, or waking at four with the thoughts already running, is among the earliest signs and among the last to settle.

Therapy in English for stress and burnout in Milan and Monza

I'm an Italian psychologist and psychotherapist, registered with the Order of Psychologists of Lombardy. I see people in two practices in Milan, in Monza and in Cernusco sul Naviglio, and online, in English and in Italian.

Milan runs on demanding work, and a large part of the people I see in English came here for it. That adds something specific: performing in a second language, being far from the people who'd notice you were struggling, and a visa or a contract that can make stepping back feel impossible.

The first session is about how long it's been going on, what changed, and what's already been tried. It also serves to distinguish: prolonged stress, burnout and depression share symptoms but aren't the same thing, and the work differs depending on which it is.

From there we work on three fronts: reducing baseline activation, rebuilding recovery that actually recovers, and looking at the demands — the external ones and the ones you make of yourself, which are usually the harder to renegotiate.

I don't promise the load will get lighter: often that isn't in the hands of the person in the room. What can be worked on is how that load is carried.

When it makes sense to ask for help

— Does rest still put me right, or not any more?

— Was the tiredness already there when I woke up?

— Have I stopped feeling anything about things that used to matter?

— Has my body been sending signals for months?

If rest has stopped working, waiting for it to start again rarely helps.