The Problem With the Current Narrative

“Burnout” has become a cultural catchphrase. It’s used to describe exhaustion, low motivation, and emotional depletion. But in biological terms, burnout implies a dead battery - something that no longer functions. Humans, however, are not batteries. We are self-regulating, adaptive systems designed to recover when given the right conditions.

Similarly, the rise in depression diagnoses - and corresponding medication use - often reflects our growing misunderstanding of how mind and body interact. While antidepressants are invaluable for major depressive disorder, many individuals diagnosed with “depression” actually experience cognitive overload, non-restorative sleep, nutritional imbalance, or chronic pain-induced fatigue, rather than a primary mood disorder.

Cognitive Overload: The New Epidemic

Modern life floods the brain with continuous stimuli - emails, news alerts, social media, and multitasking. When the brain receives more input than it can integrate, attention fragments, and focus deteriorates. Over time, this “cognitive overload” mimics the symptoms of depression: poor concentration, irritability, low motivation, and mental fatigue.

Research on flow state by psychologist Mihaly Csikszentmihalyi shows that the brain thrives when challenges match skills, producing deep engagement and satisfaction. Yet constant overstimulation disrupts flow, leaving the nervous system dysregulated.

The Missing Link: Whole-Person Care

Current healthcare models are overly reductionist. A patient presents with low energy and poor mood; the solution offered is often a pill. But true recovery requires a whole-person care framework - addressing sleep, stress, relationships, movement, learning, and diet before medication.

This is summarized in the SHIELD model:

• S – Sleep: Restorative, consistent circadian rhythm

• H – Handling stress: Techniques for parasympathetic activation

• I – Interaction: Supportive social connection

• E – Exercise: Regular movement to regulate neurochemistry

• L – Learning: Mental stimulation to strengthen neural circuits

• D – Diet: Nutrient-dense, anti-inflammatory nutrition

These pillars reestablish physiological stability, often reducing mood symptoms without pharmacological intervention.

The Overlooked Role of Pain

Persistent pain is a leading yet underrecognized cause of depressive symptoms. Chronic pain alters neurotransmission, reduces reward sensitivity, and activates shared neural circuits involved in mood regulation. When pain is untreated or undertreated, mental health declines.

Accessible, layered pain care - combining physical rehabilitation, psychological therapies, interventional approaches, and education - must be integrated into mental health treatment. Without this, patients remain trapped in a feedback loop of pain and despair.

Words as Medicine

The language clinicians use profoundly shapes outcomes. Research on placebo and nocebo effects demonstrates that words can alter neurochemical activity (Benedetti, 2014). When a provider tells a patient, “You have depression,” it may unconsciously fix the identity of the illness. Alternatively, saying, “Your brain is overloaded and needs recalibration” preserves agency and hope.

Teaching patients mental mastery tools - such as the Interruption Command (“I choose to breathe slowly now”) - empowers them to break rumination cycles. This simple act shifts neuroactivity from the limbic system’s reactive state to the prefrontal cortex’s executive control, fostering emotional regulation.

Lead With Neuroscience, Not Medication

Medications can buy time for recovery - but they cannot rewire the brain alone. Neuroplastic change requires active participation. Practices combining breath, posture, and cognitive redirection are grounded in neuroscience: intentional breathing modulates the vagus nerve, increases heart-rate variability, and reduces inflammatory markers.

By leading with neuroscience - explaining how actions change the brain - we give patients the tools to become partners, not passive recipients, in their healing.

Brenda’s Path Forward Reflections:

To move beyond the myths of burnout and overdiagnosed depression, medicine must:

1. Adopt whole-person care frameworks before prescribing.

2. Address unrelenting pain as a central driver of mood dysregulation.

3. Train providers in linguistic precision and psychological safety.

4. Empower patients to practice cognitive interruption and recovery skills daily.

“Mental overload is not a disease—it’s a signal. The solution lies not in numbing the mind, but in mastering it.” Dr. Brenda Lau