Burnout: The Cortisol Connection
Cortisol is a clock-driven hormone with a daily cycle. Chronic stress disrupts this cycle, and that misalignment may not just reflect burnout; it can actively fuel it.
Burnout is more than a buzzword. It’s a biological signal – your body’s way of saying, “I can’t keep doing this.” While we often think of burnout as purely psychological or professional, growing evidence shows it’s deeply chemical too. At the center of this story is cortisol, a hormone critical for managing stress and energy. In this post, we’ll explore how burnout alters that healthy cortisol rhythm, why a broken cortisol cycle can worsen burnout, and what you can do to restore balance.
What Happens to Cortisol in Burnout?
Burnout often stems from chronic workplace pressures or life challenges that don’t let up, leading to constant activation of the stress response. Over time, this can throw the cortisol rhythm off-kilter. Research has found that people experiencing burnout frequently show altered cortisol patterns. For example, in one study, individuals with clinical burnout had a significantly blunted cortisol awakening response (a weaker-than-normal rise after awakening) compared to healthy controls.¹ In other words, their cortisol failed to peak as it should in the morning. Another study observed a similar effect in exhausted but otherwise healthy workers: a flatter overall cortisol profile through the day, mainly due to lower-than-normal cortisol in the morning.²
Why does this happen? Scientists believe that prolonged stress can dysregulate the hypothalamic–pituitary–adrenal (HPA) axis, the system that governs cortisol release. In the early stages of burnout, your body might pump out excess cortisol for an extended period, your “alarm” is stuck in the ON position. But as stress continues unabated, the HPA axis may start to lose its sensitivity or “wear out.” Think of it like noise in a car alarm: initially loud, but if it blares nonstop, eventually the battery weakens. In advanced burnout, cortisol output can drop below normal at key times of day. You will still produce some cortisol but the fine-tuned 24-hour cycle is disrupted. The normal peak-and-valley pattern turns into a plateau or an erratic line. This is why some burnout sufferers report feeling exhausted every morning, their cortisol is not kicking in with the usual morning boost, and then wired at night, because their cortisol might not be shutting off properly before bed.
The Vicious Cycle
A disrupted cortisol rhythm doesn’t just mirror burnout; it can make it much harder to recover, creating a vicious cycle. Imagine waking up after a poor night’s sleep: if your cortisol is supposed to help you feel alert but it’s in short supply, you’ll drag through the morning. Daytime fatigue, brain fog, and lack of motivation, classic burnout symptoms, can be partly explained by that blunted cortisol rise. On the flip side, if your stress system is so hyper-alert that cortisol stays too high later in the day, you might experience anxiety, irritability, and insomnia, making it difficult to recharge. Over time, chronic high cortisol (especially at night) can wreak havoc on your body.
Notably, some research suggests that the more severe the burnout, the more pronounced the cortisol dysregulation. In severe burnout cases, the body’s stress-hormone system may hit a state of hypocortisolism, an inability to mount a normal cortisol response even when it’s needed.³
How to Restore Your Rhythm
Breaking out of burnout requires not just psychological change but biological recalibration. Recognizing cortisol’s role in burnout gives us new therapeutic strategies. Here are some take-home points, some of which I’m hoping will be familiar from previous posts:
Prioritize Sleep and Consistent Wake Times: Maintaining a regular sleep schedule can help re-anchor its rhythm. Try to go to bed and wake up at the same times each day (even on weekends).
Morning Light, Morning Movement: Natural light is a powerful circadian cue. Getting sunlight in the morning (within the first hour of waking) signals your brain that it’s daytime, which supports that cortisol surge and boosts alertness. Some light exercise early in the day can also gently stimulate cortisol (in a healthy way) and energize you. Conversely, try to minimize stressful activities or heavy workouts late at night, as these can spike cortisol when it should be winding down.
Build in Recovery Rituals: Remember that stress recovery is as important as the stress response. To break the burnout cycle, integrate short recovery periods into your day. This could be mindfulness meditation, a brief walk outside, breathing exercises, or listening to music – anything that helps signal safety to your brain. Such practices activate the “rest and digest” side of your nervous system, which counterbalances cortisol’s effects. Over time, regular recovery moments teach your body that it’s okay to relax, preventing cortisol from staying chronically elevated. Research shows that stress-management interventions (like meditation or therapy) can actually help normalize cortisol levels in healthy adults, which may buffer against burnout.⁴
Seek Support and Professional Help: Severe burnout might require more than lifestyle tweaks. If you’re experiencing persistent exhaustion, mood changes, or other concerning symptoms, consider talking to a healthcare professional. They can assess if there are underlying issues (sometimes chronic burnout can mask conditions like adrenal insufficiency or depression) and suggest personalized interventions.
Burnout is not “all in your head”; it’s very much in your hormones. Cortisol, with its daily peaks and troughs, is meant to keep you energized by day and relaxed by night. When that rhythm collapses under chronic stress, it can create a cascade of fatigue, brain fog, and health issues. The key takeaway is that restoring your normal circadian rhythm is crucial to recovering from burnout.
Dr. Jonathan Moustakis
Co-founder and CTO of Lume Health
References:
Oosterholt BG, Maes JHR, Van der Linden D, Verbraak MJPM, Kompier MAJ. Burnout and cortisol: evidence for a lower cortisol awakening response in both clinical and non-clinical burnout. J Psychosom Res. 2015 May;78(5):445-451. doi: 10.1016/j.jpsychores.2014.11.003. Epub 2014 Nov 8. PMID: 25433974.
Lindeberg SI, Eek F, Lindbladh E, Ostergren PO, Hansen AM, Karlson B. Exhaustion measured by the SF-36 vitality scale is associated with a flattened diurnal cortisol profile. Psychoneuroendocrinology. 2008 May;33(4):471-7. doi: 10.1016/j.psyneuen.2008.01.005. Epub 2008 Mar 4. PMID: 18295411.
Lennartsson AK, Sjörs A, Währborg P, Ljung T, Jonsdottir IH. Burnout and Hypocortisolism - A Matter of Severity? A Study on ACTH and Cortisol Responses to Acute Psychosocial Stress. Front Psychiatry. 2015 Feb 2;6:8. doi: 10.3389/fpsyt.2015.00008. PMID: 25698980; PMCID: PMC4313581.
Dziurkowska E, Wesolowski M. Cortisol as a Biomarker of Mental Disorder Severity. J Clin Med. 2021 Nov 8;10(21):5204. doi: 10.3390/jcm10215204. PMID: 34768724; PMCID: PMC8584322.
