The Biology of Burnout (Part 2): What Understanding Can't Do

Why do so many people with depression struggle to stop their antidepressants? What if the answer isn't about willpower — but about missing nutrients your brain needs to function?  Dr. James Greenblatt has spent 30 years in inpatient psychiatry. He watched patients go from one medication to two, then three, then five. Suicide rates kept climbing. And he started asking: What if the brain is simply missing what it needs? His new book Finally Hopeful explores the biological causes of depression most doctors never test for. → Get the full episode breakdown at Biology of Trauma® Podcast - Episode 156: Can't Get Off Antidepressants? Ask for These Lab Tests In This Episode You'll Learn: [04:09] Why Dr. Greenblatt wrote Finally Hopeful after 30 years in psychiatry [12:50] Vitamin D as the foundation: Why nothing else works without it — not meds, not therapy [14:35] How vitamin D deficiency affects serotonin production in the brain [12:50] Dr. Aimie's personal story: vitamin D levels of 12, then only 20 with supplementation [17:06] Why vitamin D deficiency is one of the most common factors in people who can't stop antidepressants [18:48] The gut-serotonin connection: 90-95% of serotonin is made in the gut [21:00] The building blocks your brain needs: iron, B12, folate, zinc, magnesium [24:57] Brain inflammation and its connection to suicide risk [26:14] Why sleep deprivation creates inflammatory markers within hours [32:07] The simple labs to ask your doctor about — and why testing is the only path forward Resources/Guides: Free Guide: Top 3 Biochemical Imbalances That Affect Mood - a starting point for understanding the most common nutrient imbalances connected to depression The Biology of Trauma book - Available now everywhere books are sold. Get your copy Foundational Journey - The 6-week program to create inner safety and shift your nervous system. Build the foundation that allows your body to actually use the nutrients and support you give it. Dr. James Greenblatt - Get a copy of the Finally Hopeful book and find more resources at https://www.jamesgreenblattmd.com/ Related Podcast Episodes: Episode 41: Solutions for Low Serotonin and GABA in Trauma with Trudy Scott Episode 101: Brain Inflammation: Addressing The Overlooked Gatekeeper To Trauma Release with Dr. Austin Perlmutter

What if the slogans we've trusted about healing are actually in conflict? "The body keeps the score." "Time heals all wounds." We've heard both. They can't both be true. Here's the tension. If time heals all wounds, staying busy should eventually work. Decades of pushing through should land us somewhere good. But that's not what happens. The body keeps the score whether we acknowledge it or not. I go deeper into the research from my conversation with Dr. Karestan Koenen in Episode 155. She followed 100,000 women over twenty years. What she found confirms what I see clinically. Unresolved experiences don't fade with time. They become biology. That background sense of danger we can't quite name? That's our nervous system still on guard. This was never about time. It's about what happens when we ask the nervous system to stay alert indefinitely. In this episode you'll hear more about: Why staying busy creates allostatic load: When we push through without processing, we ask the nervous system to sprint forever. Dr. Hans Selye mapped what happens next. The body reaches a point where it cannot maintain that response. Then things fall apart. The difference between stress and trauma: Stress is a sprint. Trauma is what happens when we've sprinted as far as we can but the danger is still there. The terminology matters. Calling it all "chronic stress" doesn't capture the truth of breakdown. The body trauma loop: The cycle between activation and shutdown sits at the core of every chronic health condition. Stressed out, then breakdown. Activated, then burnout. This loop can never contribute to health. Where the body actually holds trauma: People ask if it's in their liver or pinky toe. The answer surprises them. The body holds trauma in patterns. The glass of wine. The procrastination. The exhaustion that won't lift. What I'm actually assessing: I don't ask for a checklist of how bad your childhood was. I ask what's going on now. How reactive are you? How adaptable? How long before you hit shutdown? Those patterns tell me what your body is still holding. Why there's hope in this science: When we recognize the body trauma loop, we know what to do. We untangle piece by piece. Step by step. We create a biology of healing. The body holds trauma through its patterns of surviving. When we understand this, we work with our biology. Not against it. Resources/Guides: Biology of Trauma book — Available now everywhere books are sold. Get your copy Free Guide: How Trauma Shows Up in the Body — A comprehensive starter guide to understanding the physical manifestations of trauma 🎙️ Check out the main episode this follows: Episode 155: Time Doesn't Heal—It Becomes Biology with Dr. Karestan Koenen 💭 Try this practice this week: Notice when you reach for your go-to survival strategy. Wine, scrolling, ice cream, overworking. Before you do, pause. Ask: "What am I feeling in my body right now? What am I trying to soothe?" That awareness is the first step. Leave a review on Apple Podcasts, Spotify, or YouTube. It helps others find trauma-informed care.

We've been told time heals all wounds. Go back to work. Stay busy. But what if decades of stress are still rewriting the body right now? Dr. Karestan Koenen, a Harvard researcher who has followed 100,000 women over twenty years, shares what she's discovered about how unaddressed trauma doesn't fade—it becomes biology. In this conversation, we explore why major disease studies have ignored trauma, how stalking affects women's heart health, and what epigenetics reveals about catching these changes early. → Get the full episode breakdown at Biology of Trauma® Podcast - Episode 155: Time Doesn't Heal: What 20 Years of Research Actually Shows In this episode you'll learn: [01:54] The Pattern No One Was Tracking: How clinical observation at the VA revealed PTSD and diabetes worsening together—before research proved it [04:04] Stalking and Heart Disease: Why women on the editorial board said "of course this is true" while men said "there's no way" [05:35] The Gap in Major Disease Studies: Why the cohorts that shaped our understanding of diet, exercise, and disease never measured trauma [11:27] How to Define Trauma: Uncontrollable, unpredictable, and overwhelming—and why the pandemic qualified [14:41] When Coping Mechanisms Take a Toll: How the adaptations that helped us survive can interfere with where we want to go [17:14] Resilience Redefined: Why you can have symptoms and still be making meaning—and why the person in front of you is always a survivor [23:58] Loss of Life Purpose: How retirement, death of a spouse, or role changes directly impact physical health and longevity [28:47] Time Doesn't Heal—It Becomes Biology: Why going back to work and staying busy doesn't make trauma fade [32:33] The Biology of Adversity Project: How epigenetics research may catch changes before chronic conditions develop [34:17] Somatic Practices Without the Story: The future of yoga, breathwork, and body-based approaches for resetting the nervous system Resources/Guides: Biology of Trauma book - Available now everywhere books are sold. Get your copy Free Guide: How Trauma Shows Up in the Body & What To Do About It - Understand why your body responds this way. Learn what helps. Related Podcast Episodes: Episode 86: Is Trauma Genetic or Epigenetic? Insights with Dr. Bruce Lipton Episode 116: The Body Keeps Score: How Trauma Rewires Your Nervous System with Dr. Bessel van der Kolk

What if the habit you've been trying to break is actually how you learned to survive? It's January. You've made the resolution. This year will be different. You start strong. First week goes well. By February, you're back where you started. Maybe feeling worse because now you've added shame to the pile. I share about Rachel, a 42-year-old marketing director. She tried everything to stop late-night eating. Willpower. Mantras. Accountability apps. Nothing worked for more than a few weeks. When I asked what she felt right before reaching for food, she'd never thought about it. That knot in her stomach? It went away when she ate. Her nervous system had found a way to keep emotions manageable. This wasn't about the food. It was about how she was getting through life. In this episode you'll hear more about: Why willpower isn't the problem: When we try to remove a survival strategy through willpower alone, our nervous system panics. We just took away one of its tools without offering anything in its place. The difference between a habit and a survival strategy: A habit is brushing our teeth or taking the same route to work. A survival strategy helps us cope when capacity has been overwhelmed. Late-night eating, scrolling, overworking—these are never just habits. Why our body fights back: Our nervous system won't give up a survival strategy easily. Its job is to help us survive. Of course we're back at the refrigerator by end of January. What one of my course members realized: "My protectors are able to relax when I create safety and support in my nervous system." That's the step most people miss. Why capacity matters for resolutions: Capacity is how much stress we can hold before we get overwhelmed. When we remove a survival strategy without building capacity, we overflow right back into overwhelm. Two ways to create space: We can create safety inside our current container. This removes the need for numbing and distraction. Or we can build a larger container that holds more. It is never about the behavior. The behavior is the downstream effect. When we understand this, we can work with our biology instead of against it. Resources/Guides: Biology of Trauma book — Available now everywhere books are sold. Get your copy 🎙️ Check out this week's main episode, Episode 154: The Biology of Burnout (Part 2): What Understanding Can't Do 💭 Try this practice this week: Before you reach for that habit you're trying to break, pause. Ask yourself: "What am I feeling in my body right now? What is this survival strategy helping me avoid?" Leave a review on Apple Podcasts, Spotify, or YouTube. It helps others find trauma-informed care.

In part one, we learned why so many of us stay stuck despite trying everything. This episode reveals what actually worked for the dogs in that study. Spoiler: it wasn't understanding. It was movement. I share Claire's breakthrough moment standing at her kitchen sink. What she felt in those 90 seconds changed everything. →  Get the full episode breakdown at Biology of Trauma® Podcast - Episode 154: The Biology of Burnout (Part 2): What Understanding Can't Do In this episode you'll learn: [01:08] How the Dogs Learned to Jump Again: Researchers had to physically move their legs—explaining jumping didn't work [03:30] Why Understanding Isn't Enough: The gap between knowing what to do and being able to do it [05:09] Claire's Aha Moment: Why all her knowledge hadn't created lasting change [08:30] What Happens When We Don't Complete Stress: Two options—complete it or head into burnout [10:04] The Startle Response: How to stop activation before it becomes a full stress response [12:09] The Cost of Not Looking: Avoiding problems drains the energy we need for real demands [15:19] Trying Better, Not Harder: Starting small creates new experiences instead of depletion [18:18] Claire's Kitchen Sink Moment: What completing a stress response actually feels like [20:02] Stress as a Sprint: Why we need the exhale, not just the push [23:35] The Body Already Knows: Our nervous system knows how to complete—we just block it Resources/Guides: Biology of Trauma book - Available now everywhere books are sold. Get your copy Becoming More Calm Alive - A song about the exhale. Learning to let our body complete what it's been holding. Related Podcast Episodes: Episode 153 (Part 1): The Biology of Burnout: Why Pushing Through Stops Working Episode 121: Finding Your Why: How to Break Free from Burnout and Build Meaningful Work  

What if the hustle that's wearing you out is actually how you learned to matter? In this final part of my three-part conversation with my friend Jalon, we get honest about why slowing down can feel so threatening. For those of us who weren't seen for who we were, doing became the way we proved we deserved to exist. I share about the moment I stopped blaming my body for breaking down and started thanking it. My body didn't betray me. It was the only thing that could get my attention. I was the kind of person who needed those health issues because otherwise I would never have listened. Jalon and I use the car running out of gas analogy to talk about what it looks like to actually listen before you're stranded on the side of the road. Spoiler: it's not about listening perfectly. It's about catching the warning light a little sooner next time. In this episode you'll hear more about: Why hustle feels like safety: For those of us who weren't seen authentically, we created ways to matter through doing. The more you carry, the less you sleep, the more you prove you're worth keeping around. When your body quits before you do: Thousands of patients I've worked with have bodies that got sick as the only way to make them slow down. And they still don't see it. They just hate their bodies more. Taking full responsibility changed everything: I stopped feeling betrayed by my body and realized I was exactly the kind of person who needed those health issues. Otherwise I would've just found more caffeine, more exercise, more emotional eating. The gas tank analogy for listening to your body: Why do we see the fuel light and try to gauge how much further we can push? What if we just stopped at the next exit instead of ending up stranded? Balance was all I wanted: I didn't want the go-stop pattern anymore. I just wanted to know I'd get to my destination without wondering if I'd make it. Hustle isn't a discipline problem. It's often how we learned to matter. And now we get to reprogram that. 🎙️ Check out this week's main episode, Episode 153: The Biology of Burnout: Why Pushing Through Stops Working 💭 Try this practice this week: Notice when you're pushing past a warning sign. Ask yourself: "Am I hustling right now because this matters, or because I'm trying to prove that I matter?" Catch Part 1 and Part 2 of this conversation here. Leave a review on Apple Podcasts, Spotify, or YouTube. It helps others find trauma-informed care.

If more self-care worked, it would've worked by now. In this episode, I share my own burnout story and introduce Claire—a patient whose chronic fatigue reveals a missing piece in how we understand stress. Through the research on learned helplessness and the metaphor of the elephant tied to a stick, this episode uncovers why so many of us feel stuck despite trying everything. → Get the full episode breakdown at Biology of Trauma® Podcast - Episode 153: The Biology of Burnout: Why Pushing Through Stops Working In this episode you'll learn: [00:50] The Energizer Bunny Who Couldn't Push Anymore: Claire's story of chronic fatigue and missing her daughter's track meets [03:39] Why Self-Care Fails: The backwards truth about stress that keeps us stuck on the hamster wheel [05:13] Skill #1 — Generate a Good Stress Response: Why wimpy stress responses lead to burnout and trauma biology [06:36] Skill #2 — Complete and Reset: The exhale our bodies never learned to do [07:35] The Critical Line of Overwhelm: What happens when stress builds without reset [13:46] Learned Helplessness Research: The study on dogs that changed everything about understanding why we stay stuck [19:51] The Elephant Tied to a Stick: How early experiences program us to believe we cannot escape [11:19] The Voice Underneath: Recognizing the quiet belief that "other people can have good lives, but not me" [25:31] What Comes Next: Preview of how the researchers helped the dogs get unstuck Resources/Guides: Biology of Trauma book - Available now everywhere books are sold. Get your copy Related Podcast Episodes: Episode 31: Am I Tired, Or Is This Trauma? The Roots Of Fatigue with Dr. Evan Hirsch Episode 122: Shutdown Before Stress: The Misstep in Trauma Healing That Often Gets Missed  

What if the grief you've been pushing away is trying to tell you something? In this mini episode, I open the vault on my live Q&A with Biology of Freeze students. These are the real questions people ask when they're in the deep work. The answers might surprise you. A caregiver asked how to show up for her family while grief keeps pulling her under. A practitioner wondered why her autoimmune clients can't take action. I share the exact practice I use when grief hits like a wave. Spoiler: it's not positive thinking. It's not pushing through. It's pausing long enough to let that part of you feel heard. In this episode you'll hear more about: The grief practice no one taught us: Why ignoring emotions or "staying positive" abandons the hurting part. I share the phrase I say out loud when grief shows up. It starts with: "I'm having a feeling right now." How to stay present to pain without drowning: The physical gesture I use to stay connected instead of numbing. It's not about making it go away. It's about not leaving that part alone. What grief is really pointing to: Behind every wave is something you deeply value. Give it space. You'll get clarity on how you want to live. Generational trauma lives in the body: I break down how ancestral patterns show up in beliefs, sensations, and even DNA. The good news? All of it can be rewired. Why autoimmune clients can't take action: This isn't motivation. It's learned helplessness from early overwhelm. The roots often start before you could talk. Body work sending you into shutdown? If dental work or sauna leave you crashed for weeks, it might not be emotional. Your detox pathways might not keep up. Music as nervous system medicine: Not all calming music actually calms you. I explain what tempo range shifts your heart rate. Our grief isn't a problem to solve. It's a messenger pointing us toward what matters most. 🎙️ Check out this week's main episode, Episode 152: Am I Too Old or Stressed To Get Pregnant? The Real Reason with Dr. Ann Shippy 💭 Try this practice this week: When a feeling shows up, pause. Say out loud: "I'm having a feeling right now." Put your hand where you feel it. Ask that part: "What do you want me to know?" Leave a review on Apple Podcasts, Spotify, or YouTube. It helps others find trauma-informed care.

The same nervous system patterns that keep us stuck in survival mode may also be telling our body it's not safe to create new life. In this episode, I'm joined by Dr. Ann Shippy, a leading functional medicine physician and former chemical engineer who reveals the hidden biological barriers to conception.  Get the full episode breakdown at Biology of Trauma® Podcast - Episode 152: Am I Too Old or Stressed To Get Pregnant? The Real Reason In this episode you'll learn: [00:01:20] Why the fertility narrative around age may be missing the bigger picture—and what's actually driving infertility rates [00:02:28] How one patient at 41 conceived easily after addressing heavy metals, microbiome imbalances, and hormonal dysfunction [00:04:16] The identity wound that infertility triggers—and why "am I enough?" surfaces when conception feels impossible [00:09:37] Why hope itself shifts biology and creates an environment welcoming to new life [00:10:45] How environmental toxins—even from healthy activities like golf—create hidden fertility barriers [00:11:48] The "time capsule" concept: How eggs and sperm collect information about stress, trauma, toxins, and nutrient status [00:13:55] The parallel between neuroception and fertility—both systems asking the same question about safety and capacity [00:16:41] Why infertility is fundamentally an energy problem—and how mitochondrial function determines whether the body says yes to new life [00:18:12] How pregnancy can deplete an already exhausted body and create chronic patterns of depletion [00:20:06] The first step Dr. Ann recommends for anyone wanting to conceive—even in their mid-forties  

What if the reason we can't say no isn't a willpower problem—but a nervous system problem? In Part 2 of this raw, unscripted conversation, Dr. Aimie Apigian and her friend Jalon Johnson go deeper into what actually happens inside our body when we try to set a boundary. This isn't theory—it's two people sharing what it felt like to rehearse conversations for days, to brace for rejection, and to genuinely believe the world might end if they said no to family. From the realization that we've been having hour-long arguments with people entirely in our heads, to the moment the sun still came up after saying "I'm not coming," this episode gets honest about why boundaries feel like pulling the pin on a grenade—and what changes when we finally let it go. In this episode you'll hear more about: The conversations we have that never actually happen: Dr. Aimie's revelation that she would spend hours—sometimes days—rehearsing both sides of a conversation with someone, anticipating their response, forming rebuttals, all before saying a single word out loud. The exhausting mental gymnastics of trying to manage someone else's reaction before it even exists. Why "no" feels like a threat to survival: Jalon's insight that if you've never been comfortable saying no, your nervous system treats it like danger. The activation, the bracing, the preparing for impact—it's not dramatic, it's protective. And it makes sense when we understand what we learned in childhood. "No with a period is a complete sentence": The reframe Jalon's first therapist gave him that he's carried ever since—and why most of us still struggle to say no without attaching explanations, justifications, and apologies to soften the blow we're sure is coming. The world didn't end—and that changed everything: Dr. Aimie's experience of finally setting the boundary, bracing for disaster, and then... nothing. The sun came up. The family moved on. And she was able to show up as the person she actually wanted to be instead of the drained, resentful version running on empty. Self-care feels frightening when you've never done it: Why taking care of ourselves can feel more threatening than burning out, and how building tolerance to rest—just like building tolerance to anything new—takes practice, not perfection. Asking "why" until you get the real answer: The technique both Dr. Aimie and Jalon use to get beneath the surface reason—asking why five, six, seven times until the truth finally shows up. Dr. Aimie's application of this to her emotional eating patterns and what she discovered underneath the hunger. Setting a boundary isn't about having the perfect words or the right explanation. It's about recognizing that the discomfort we feel isn't proof we're doing something wrong—it's proof we're doing something new. Our nervous system learned that saying no was dangerous. It will take time to teach it otherwise. And in the meantime, we can hold both: the part that's terrified and the part that knows we need this. 🎧 This is Part 2 of Dr. Aimie's conversation with Jalon Johnson. If you missed Part 1, it's linked below—we talked about the exhausting reality of showing up to family gatherings after we've changed and they haven't. Part 3 goes deeper into the hustle: why we push ourselves to prove our worth and what happens when our body finally says "enough." 🎙️ Check out this week's main episode, Why Trauma Returns in Midlife: A Chinese Medicine Lens with Dr. Lorne Brown 💭 Where in our life are we still rehearsing conversations that haven't happened yet? What would it feel like to just say no—and let them have their reaction? Leave a review on Apple Podcasts, Spotify, or YouTube—it takes two minutes and means more than you know. Thank you for being here.