The mention of mindfulness has an instant Marmite effect, with those who swear by it and those who roll their eyes because it doesn’t work for them.

Mindfulness is the practice of anchoring your attention in the here and now by deliberately noticing the present moment in a non-judgmental manner, typically by focusing on the breath or the body. Evidence for its effectiveness is bountiful, with participants being helped with a range of difficulties, from anxiety to chronic pain.

Mindfulness obviously can’t resolve the many reasons for burnout, but it has been a go-to recommendation for self-care for many years. Yet this hasn’t been enough to address the rise of burnout, which now affects one in five people to the point of being signed off sick.

Burnout occurs when there is chronic unmanaged occupational stress. There are three dimensions to this:

1. Physical and emotional exhaustion
2. Detachment from work
3. Reduction in professional efficacy

The impact of these varies in severity. At one end is high-functioning burnout. This is when signs of stress (such as physical tension, difficulty concentrating, insomnia and anxious thoughts) are experienced alongside the three dimensions, but the individual masks their struggles, concealing them from others and possibly also from themselves. In my practice, patients often say they feel like they are ‘running on empty’ or ‘just going through the motions’ and almost permanently anxious, irritable or just numb to it all. Yet they carry on, pushing it down, constantly trying to reach the endpoint of the stressors, which, with ever-increasing stimuli and demands, is rarely reached.

If they carry on without a proper break and the stressors continue they can tip into clinical burnout. This is the dysfunctioning end. The body forces a stop for you. This could look like not being able to get out of bed one morning, temporarily losing the ability to talk, stress-induced non-epileptic seizures or other health issues.

If you’re somewhere between high functioning and dysfunctioning on the burnout continuum, then your nervous system is stuck in survival mode, oscillating between frenzied and restless mode (sympathetic nervous system) and trapped, lethargic and disconnected mode (dorsal nervous system). This is not sustainable. A healthy nervous system should move fluidly between the range of modes but, importantly, return to rest and digest mode to give the body the restoration it needs to recover. 

There is a common misconception that mindfulness is an instant stress reliever; in fact, it is a practice that deepens your awareness of your body and mental states. Here are three key reasons why burnout makes mindfulness tricky for those who are coming to it for the first time during their symptoms.

Only when we are in rest and digest mode do we have full access to the part of the brain responsible for rational thought: the prefrontal cortex. This impacts our ability to make decisions, problem-solve and, importantly for mindfulness, notice thoughts without getting caught up in their content.

Many mindfulness meditations involve stillness. For a nervous system in fight or flight mode this not only feels physically uncomfortable (because the energy from the sympathetic system causes racing thoughts, increased heart rate and tensed muscles), but it also creates a strong urge to do or fix. If people don’t realise this, it sets the mindfulness practice up for failure, so they stop and give up, believing they’re unable to do it properly or that it doesn’t work.

Another aspect of mindfulness is the tuning into the sensations in the body. Again, if you’re not in rest and digest mode this is likely to be intense. For a burnt-out individual who has typically thrown themselves into work, this can be at direct odds with their usual repertoire of coping skills and can exacerbate anxiety in the short term.

All of this is particularly hard for neurodivergent adults or those with histories of trauma (the proportion of UK adults this includes is high). Without understanding your full backstory and psychology, expecting to drop into a mindfulness meditation can be unhelpful. It can also result in symptoms that feel confusing to someone without training. 

No, despite all of this I still believe in the power of mindfulness, but it’s unlikely that downloading a mindfulness app in the throes of burnout is going to cut it.

The ideal is to establish mindfulness as a practice before life goes sideways. Imagine you’ve bought a new tent for an expedition. You wouldn’t put it up for the first time on windy moors in the middle of a storm. You need to see how the poles slot together in a calm back garden first. The skill of mindful awareness will help protect you in a storm. And by this I mean help you respond appropriately to your mental and physical needs. 

If you haven’t got a mindfulness practice in place, what else can you do to treat burnout and manage your mental wellbeing? Here are some recommendations. 

Stress management techniques:

• Techniques to discharge excess energy and adrenaline, such as progressive muscle relaxation, exercise and stretches
• Techniques to signal safety to the nervous system, such as rhythmic breathing or social connection with someone who is calm (a hug or phone call)

Trauma-informed mindfulness:

This is a growing trend. It teaches self-soothing and self-regulation before mindful awareness training. Instead of focusing on internal sensations like the breath, you’re invited to focus on something external like music or the space around you. Instead of dropping into stillness with a sitting meditation, you’re invited to do an activity mindfully, such as walking or making tea.

Self-soothing practices

Tending to physical distress in burnout should involve the way you speak to yourself. Softening your inner tone of voice to mimic how you would speak to someone you care about is a good starting point. A default for many when stressed is to talk to themselves with a hard, accusatory tone. When we switch to this alternative, compassionate tone, while using wording that acknowledges how hard the situation is, we tap into our attachment chemistry, which has a calming effect. If this is hard for you, it’s not a sign that you’ve failed, it’s a sign that this skill wasn’t developed in childhood. A good option to try is compassion-focused therapy.

Learning mindfulness with a teacher

Learning mindfulness with an experienced teacher makes a big difference. They will help you understand that you aren’t failing when your mind wanders and guide you through any tricky experiences to gain maximum understanding of this.

Mindfulness-based stress reduction (MBSR) programmes are the gold standard for this. There should be one local to you or online.

Dr Claire Plumbly is a clinical psychologist and author. Get more details about the strategies listed here and more in her debut book Burnout: How to Manage Your Nervous System Before It Manages You (Yellow Kite, 2024).

Frame Of Mind is Stylist’s home for all things mental health and the mind. From expert advice on the small changes you can make to improve your wellbeing to first-person essays and features on topics ranging from autism to antidepressants, we’ll be exploring mental health in all its forms. You can check out the series home page to get started.

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