Breaking the Burnout Cycle with Dr. Neha Sangwan MD

Mindy Pelz
On this episode of the Resetter podcast, we're gonna talk about a hot topic that is affecting many of us, and it's burnout. So I have brought you a burnout expert, and this is quite a conversation. So, her name is Doctor Neha Songwan. She is a MD and also a CEO and founder of her company is called Intuitive Intelligence. And she has a really profound way of looking at burnout.

And so, as many of you have heard me say, I'm pretty sure I hit burnout this at least in the last year, launching fast like a girl into the world. And so I've been really trying to quantify burnout. How do you measure it? How do we know what it is? How do we know when we hit it?

And so I've had several discussions with people, but no one has really given the depth and context to this condition that is affecting so many of us as Neha. And so I bring you a really thoughtful discussion on burnout. She has gone through her own burnout experience, which she shares in the beginning of this conversation, and she talks about how burnout, this is the part I really love, isn't as easy as just sitting your butt down and resting. That there are many pieces of burnout and understanding which part of you is burnout. Is it physical?

Is it emotional? Is it social? Is it spiritual? She walks us through the different pieces of burnout. So this is one of those discussions that I'm going to really encourage you to listen all the way through, because the end is actually some of the best.

She really sums it all up. When I asked her and we got talking about what her definition of health is. Definition of health was profound. I've never heard anybody say it quite like how she did, so I want you to hear that. But she also talks about, at the end, her own way, that she has now prevented burnout after spending many years in a burnout state.

So I offer this discussion to you with so much love. I know so many of you are feeling mentally, physically exhausted and you're not quite sure where to turn or how to explain it to your loved ones or how to even understand it for yourself. And I really hope from the bottom of my heart that this discussion gives you a whole new set of tools, a whole new language to be able to talk to the people in your life with. And most importantly, put you on an incredible journey of healing and repairing this beautiful body that you get to live in so that you don't live in a burnout state. So here you go.

Enjoy one of the best discussions I personally have ever had with burnout. You are in for one heck of a treat. So sit back and enjoy this conversation. Hugs to you all. Welcome to the Resetter podcast.

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Let me start off by just welcoming you, Neha, to my amazing group of listeners and to my podcast. I'm so excited to have this conversation with you. So thank you for being here. Thank you. Because I know how sacred community is.

That's super. Well said, because anytime I start with a new guest, there's a moment where I'm really thinking about the listeners and what is it that they need to hear. And it's interesting because with a podcast, it's almost like you're having a continual conversation with the same group of people. And with burnout, this is one that I haven't had this conversation in many years. And as a 54 year old postmenopausal woman who has been on a book, putting books out like you multiple, you know, year after year after year, burnout has definitely come to the forefront of my mind and how do we identify it and how do we, what, where do we know that it's time to put a stop to all the yeses and how do we navigate this moment?

So I'm here, you know, wanting to pull information out of you from my followers, but it's also a personal, these will be personal questions as well, because I would. I would pretty much say I've probably hit burnout. I think. I think I've hit it and I keep dragging myself through it. Yeah, well, when you're saying I think I might have, and you're even saying the word like you're so high functioning and go getting and doing all this stuff that I always say if someone even starts thinking about it, like they're well, well in it, you know, because.

Oh, good. That's what it means. Yeah. Like someone like you saying that after you, you know, you have so much initiative and so much momentum and you're trying to put out podcasts and do all these things, like, by the time that you're noticing that, yeah, it means it's real for you. That's so interesting, because about two months ago, I sat in my therapist's office and I said, I think I've hit burnout.

How would I know? You talked about how you work with these high performing CEO's. And I think one of the things that happens with high performing people is that we've learned to just push through. Like, it's just, it's just, you know, you just learn a job needs to be done. You're going to do it.

If your brain is yelling at you, you learn to tell it to shut up and you keep going. So what I'd love to do to start this discussion is really, like, what is burnout? Like, can we make it a tangible thing? Like, and what is going on in my brain, my body? Like, tell me what it is so I can have maybe a little more respect for that moment?

Neha Sangwan
Yeah. Well, I think it is such an amorphous, overwhelming experience, and most people don't know what it is. They just have a vague sense of feeling heavy or tired or exhausted, and the weekend or a week off not being enough. So let's start with the research. When I burned out in 2004 as a hot, busy hospitalist physician, I was 34 years old.

So you and I are about the same age, going through a lot of the same things. When I burned out as a doctor, I didn't even know what it was, because the people who came to me, I would call it stress leave. And when the employee assistance program. So if someone's struggling in a company or whatever, and then they go to the EAP, EAp sends them to me. I had two things I could do for people that I thought were stressed out.

I could write them. If I thought it was, you know, a real thing, I would write them a prescription for time off that would be paid by their employer. The second thing I could do was give them some cocktail of medications, depending on the context of what they were telling me. Do they need antidepressant, anti anxiety, sleep medication? There's, like, some cocktail of medications I can give them to help them with their symptoms.

That's really effective, because they're a bullet train almost going. Going into a brick wall. So my job is to, like, stop that from happening or if it's already happened, slow their world down and help them through the crisis. So when I burned out, it was literally that for me. And I remember talking to a colleague and thinking I had just sidelined him, because basically what happened is I walked in, I was, you know, doing things in the hospital, but I was so busy.

And I said to a nurse, hey, Nina, would you please give 40 mil equivalents of iv potassium to the gentleman in 636, which in itself requires a lot of cognition, right? Yes. She said, yeah. Interesting. Hey, doctor Sanguan, are you okay?

And I said, yeah, why? And that was my first indication I might not be. And I said, yeah, why? And she said, that's the fourth time in under five minutes that you've asked me that same question, and I've answered you every time. I had no recollection that that was going on, so I was literally already hitting that wall.

And what I'm really grateful for is that she had the confidence to question me because, for sure, I could have prescribed the wrong medication. She could have talked about me to someone else, but she had the wherewithal to say, are you okay? And so one thing I want you to know about burnout is sometimes other people in your life recognize it for you before you do, and you want to be grateful for them. You don't want to be defensive. And you mentioned at the beginning, this high performing piece, the way I say it, is the way we became high performing, taking care of the house, you know, perhaps working, doing all these things that we do, is because we've learned to push through our body rather than partner with it.

Mindy Pelz
Yes. And we do this in many. So. Well said. We do it in so many ways.

Neha Sangwan
Like, I'll tell you mine, when I was a busy doctor in the hospital, crazy. Two ice cold 16 ounce Mountain dews plus a king size Snickers bar, and you could get me through a 36 hours shift without sleep. So each of us has the strategies, the coping mechanisms, the ways that we figure out when our body is giving us important signals, how to override that, to get over the deadline, to get over the next meeting, the next day, the next week. And so while they. That serves us.

So in the end, it ends up not serving us, but for a period. Of time, for sure. Okay, so what is burnout? Let's talk about back. I burned out in 2004.

In 2003, it was not even acknowledged as a, you know, medical like syndrome. It was like, you know, I think maybe there's this extensive tiredness and fatigue and things. Like, it was nothing. It wasn't until 2019 that the World Health Organization said, okay, we think it's prolonged, unmanaged stress at work. At work.

Like, my whole thing is, like, it doesn't matter whether it's at work or at home. There could be a special needs child at home. There could be a troubled relationship at home. There could be your sister who's struggling. And, of course, it could be unmanaged stress at work.

But this is what I want to say. I think the who is going to come around the World Health Organization. Oh, oh, oh, I'm so happy you have belief in that. That's amazing. Well, I don't know when, but I think someday it won't just be labeled at work.

So wherever you have stress that is causing this is how I say it. But wherever you are from, burned out to fully charged can be measured by whether you have a net gain or a net drain of energy on a physical, mental, emotional, social, and spiritual level. Okay, so each of us comes here as uniquely as our fingerprint. In the end, it's the same exhaustion, but there's been an ongoing drain of energy for a long time. So the definition of burnout is a triad.

The first part is, yes, physical, mental, emotional exhaustion. Second is after that's been going on for a while, your physiology, Mother nature, is like made too beautiful of a machine. It adjusts. Oh, yeah. Thank you.

I know, right? Strongly agree. I strongly agree. And we don't give it, Mother Nature enough credit for what this amazing body we get to live, live in. So.

Yeah, absolutely, go ahead. This adjustment that goes on inside us, whether it's our blood pressure, heart rate moving, all of this, we can recover sometimes with sleep, et cetera. Then we start doing these things that are like, hey, can you make my coffee this morning? Can you make it a double? I'm having a rough week.

And we start to adjust on the outside as well. So we've been exhausted for a while. And then the second piece of the triad comes in, which is a combination of two things, really. An undercurrent of cynicism where your mind joins in the fatigue and says something like, no matter how hard I work or I try, I don't know that it's really going to make a difference. And so now all of a sudden, your thinking becomes the undertow to this exhaustion and challenge physically, mentally.

And now you, you start doing things like, even if you're lonely or isolated or working at home or whatever it is, you start pulling away from anything social or interacting because you just don't have the energy, even though you need it. You want the community. You have this thing called depersonalization where you start pulling away and you start referring, like I did that day, the guy in 636. I didn't say Mister Jones, I didn't say miss, you know, whatever. I'm starting to depersonalize, okay?

So we have the exhaustion, we have the cynicism slash depersonalization that starts going on. And then the third part of the triad is ineffectiveness. And I gave you a really good example of that when I hit that wall of saying the same thing five times in a row and not registering the answer. Yeah. So I think that's, that is beautiful.

Mindy Pelz
And thank you for the spectrum, because, you know, I resonate actually with everything you said. The place, the last place that I find my brain getting hooked on is the ineffectiveness. Because, you know, I think, again, we, I'm speaking not only for myself, but for many of the women that listen to this podcast is. It's hard to see ineffectiveness. Like, it would take somebody else, maybe from the outside in, like that nurse did for you.

Like, how do you know if you're being ineffective? And when you're in a situation where you have to perform at work, you need to perform in your family. Like, you know, you just have to keep on going whether you're effective or not. So what is our measurement of ineffectiveness? Well, let's take them through the phases now.

Neha Sangwan
So, you know the triad of burnout. Okay, let's start. Burnout goes across phases. So this is not the same exhaustion. The third part of these phases is exhaustion.

That's not the same as the physical, mental, emotional exhaustion I spoke to you about. But hold on here. So we'll start. Phase one is the alarm phase. The alarm phase is kind of like the moment you've jumped on a treadmill that's going a little too fast.

And it's that experience. It's like your heart skips, someone cuts you off in traffic. It's like that experience. You're leveling up and you're kind of a little bit irritable. You might feel a little overwhelmed, like, oh, this is too much.

The way you might feel this in your body is heart racing, stomach turning, intestinal issues, like gut issues, diarrhea, constipation, something just doesn't feel right. So in that space, first of all, you always go and get that checked out because it might be something physical. But if you get a clean bill of health from your doctor, oh, nothing's wrong with you, then you might want to think about, oh, wow, maybe the stress has kind of overwhelmed my system, and this is like me trying to adjust to that treadmill going too fast. Now, when you start using all those coping mechanisms we talked about, and you stay, stay on that treadmill going at that speed, and it becomes your new normal. That's what happens when you start to have kids and you start to.

Right, you're starting to move down this path where now you're taking on more and more and more. You're using all these coping mechanisms, and pretty soon you are turning up that dial, even 1.1, like it's starting to go even faster and you hit this place. That's called chronic adaptation. Were you using everything you can to barely hang on? You don't have reserve.

So in the first part, you might notice you missed an appointment and maybe you had to pay for even. It could be something as simple as a mani penny. And that's not like you. It's not like you to miss that, all right? I gotta pay the money to have because I missed it.

I didn't cancel. But you're like, wow, that wasn't like me. Or you're so you missed deadlines, you missed appointments, you forget things. You. And this is not menopausal forgetting things, okay?

This is like irritability and, you know, snapping at your loved ones. Now, the interesting thing about burnout is it does have a lot of overlap to menopause in the sense of the symptoms. I was just thinking the same thing. I was like, wait a second. Where do, where does the lack of hormones come in here?

Mindy Pelz
Which we should discuss in a hot moment. But, yeah, keep going. So it's all connected. But anyway, so now you realize that maybe you're going in later, you're ending later in your workday. So just things start shifting.

Neha Sangwan
Then you've been there for a while now you're in chronic adaptation. So now you want to think about things like, you're procrastinating, you're perhaps even calling in sick. Perhaps after a weekend or a week's vacation, you're still not rested, so now you're just not recovering like you used to recover. Right? A lot of people say, oh, yeah, I'll sleep.

I'll work all week, and I'll catch up on my sleep on the weekend. Like, that doesn't, that doesn't actually work. Biologically. It's a good idea, but it doesn't actually work. So the idea there is things have been going on for a long time, and now you're like, do do do do do do.

You're starting to deplete now. The way you know you're in chronic adaptation is because you're requiring more of your coping mechanisms to get the same effect. So maybe you used to say, yeah, I need a glass of wine after work to take the edge off. And now suddenly it's during the pandemic, and you're like, honey, can you hand me the bottle? Right.

Like all of a sudden it's two glasses or it's one cup of coffee, and now you're up to two or three. So people don't actually notice that they're moving across alarm phase chronic adaptation, because they just think they're using the same thing a little bit more. Just more of it. Yeah. Interesting.

Mindy Pelz
Okay, so what happens after that? Yeah, one more thing. Because you're barely hanging on by a thread in this chronic adaptation. One more thing happens, and you go sliding down the slippery slope of burnout to ineffectiveness. And that's the exhaustion phase.

Neha Sangwan
Now, that's different than mental emotional exhaustion. Right. But it's like the exhaustion phase, which is, like, it can sometimes coincide with depression. Not always. It doesn't have to.

It's literally, you know, like, chronic migraines, pain. Like, you literally are not functioning. And you need. I mean, that's when you're in crisis and you need, like, real medical help. But here's what I want people to know.

If you know the triad of burnout, mental emotional exhaustion, cynicism, ineffectiveness, if you know these and you know the phases of alarm phase, chronic adaptation, and exhaustion, I'm pretty sure you're gonna pick this up sooner. You're gonna. Yeah, for sure. Because you. Yeah.

Mindy Pelz
Cause you're giving language to feelings that we dismiss, so. And that's what I hope the whole world has. And this is the deal, too. Yeah. If it's not you, when you're listening, we need you to be the nurse for other people.

Neha Sangwan
That that nurse was for me. If you know this, you are going to be able to see those you love and lead. You're going to be able to say, hey, are you okay? Yes. Yeah.

Mindy Pelz
So what's interesting about this, and I want to, of course, where my brain goes next is, like, okay, like, again, I resonate with everything you just said. I've been in every single one of those positions. And so I'm curious, what do you do about it? Like, if you can catch yourself. So we'll talk about that in a moment, but let's touch on this.

On what you said about all the research I've done on hormones and looking at hormones and what's happening to us through this perimenopausal years, is that I call it a neurochemical armor. As our hormones start to come down, estrogen and progesterone and testosterone also stimulated different neurotransmitters, different types of neurotransmitters like serotonin and dopamine and gabA. So there's, like, this neurochemical armor coming down. You're in your mid forties. Maybe your kids are now teenagers, or you're launching them into the world.

Maybe work is getting really intense, or you're going back into the workplace. And so there almost is that explanation you just made of these three phases. Where my brain goes is, it's much easier to hit those three phases when you don't have as much estradiol, when you're lacking progesterone, when you don't have as much dopamine, serotonin, acetylcholine, glutamate, oxytocin, Gaba. I mean, all these neurochemicals are up for grabs as you go through this. So you're gonna hit burnout much quicker.

Would you agree? Yeah. You're gonna have so much less reserve. You know how I was saying at the beginning, like, where you are from burned out to fully charged is whether you have a net gain or a net drain of energy on a physical, mental, emotional, social, and spiritual level? Well, one of the levels is under physical is stress and hormones.

Neha Sangwan
And so that's the physical part of it. Now, I want you to imagine the mental part of you is going to start saying, I thought I knew my body. Oh, my God. I didn't sleep well last night. Oh, my God.

I'm getting. My midsection is getting fat on it now. Like, what is going on here? So now the thoughts start draining emotionally. You're gonna feel moody.

You're gonna feel all these things because your hormones are all changing. You might even not have a sex drive anymore. So socially, it might shift your relationships and how you're connecting intimately and otherwise. And then on a spiritual level, it's such. It's almost like when we were teenagers and our body was changing and we didn't have control of it, and our hormones are changing, and our world is changing.

And, you know, it's like this whole experience, that kind of menopause, for me, has gone across all levels. And so when you say it. When you say, is it easier to burn out? I have to say yes. I think that it depends on how much reserve you have.

Now, let's say some of our coping mechanisms were eating sugar. If sugar is your thing, that has been shown to, you know, intensify these symptoms. And so we are now having to not only experience all these changes in our body and our moods and our. All of this, we sometimes have to give up the coping mechanisms we've been using to manage the stress in our lives. Yeah.

Mindy Pelz
And, you know, you also have the other. The other side of this, where your adrenals are supposed to actually come over and start making some sex hormones. But if you're, like, in full cortisol production, the adrenals are like, hey, no, I'm over here making cortisol. So it's. You know, what I think is, I'm hoping people are grabbing from this.

Part of the conversation is that burnout is real for the perimenopause and menopausal woman and I think this is why a conversation like this is so ridiculously important for that age. Because I feel like if you go into your perimenopausal years, knowing this could be, that burnout is going to be a much easier state that your body and your brain is going to go into. At least if you have some awareness, you might be able to catch it before it totally takes you down. At least that's the way my brain thinks. So would you, what are your thoughts on that?

Neha Sangwan
No, I think that was well said. I think that's really well said. And I think each person.

The trick here is that there's the stress that's going on for all the things we think we should do, need to do, have taken on. What happens is now our physicality in totality is at play with. Perhaps we're people who don't have strong enough boundaries. We think we need to take care of the kids, and we need to take care of our partner, and we need to take care of the house, and we better be an amazing career woman, and who knows what we've taken on. But now, because this layer comes on, it's actually a wake up call to ask us if the way we've been doing things is actually working.

And now it's time. Now it's time to take care of us. And our body is saying, you gotta prioritize me. I've been carrying you around for a really long time, and please, please, please come back to me. And it stops us in our tracks.

Mindy Pelz
Yeah, thank you for saying that. Because earlier this week, I brought Doctor Lisa Moscone on and, you know, the female brain researcher, and she just put out a book called the menopause Brain. And I asked her, tell me what's going on to the brain during perimenopause and menopause? And she brought something to my attention that I had never heard, and it's called the grandmother effect. Have you heard of the grandmother effect?

Neha Sangwan
I haven't. Tell me. So it's where the brain starts to prune. What? In the perimenopause years, the brain gets rid of the neurons that are no longer necessary, and it starts to rebuild parts of the brain that actually moves it into this highly productive state six years into our postmenopausal years.

Mindy Pelz
And they call it the grandmother effect because it used to be when we were back in the hunter gatherer age, that it was the grandmother that would bring food back to the community and would take care of the kids while the mother was tending to the baby. She just birthed. And, you know, not to be sexist, but the men were out hunting, so the grandmother kept the peace and kept structure to the community while they were looking for food. So there became this reorganization of our brains to step into this incredible leadership role. And the reason that I bring that up is that I think what's happening is that I love this idea of this neuronal pruning where the brain is actually kind of changing the neurons that it doesn't need anymore and bringing new neurons online that in that state, we also may be more susceptible to burnout because there's a massive brain change that's going on.

But if we could take work like yours and hers, and we can bring them together and say, okay, perimenopausal women. So this brain change is going on. There's a really positive place you're going to land maybe a decade from now. But I want. We've given language to the vulnerability of your brain as it goes through this change.

Now you just gave us language to identify it. So now what do we do about that? Because I don't think it's acceptable to have suffer for ten years through that process. Yeah, I think it's, you know what it is? I think the biggest thing it does is women.

Neha Sangwan
Women really do start to reevaluate. They start to reflect, they start to reevaluate. It gives them, if they haven't been someone who's been sharing vulnerably with others, they take it to the next level of doing that. Or maybe they did share vulnerably, but they haven't done that. And so now they begin to talk about things on another level.

And I think it's so beautiful because now, I mean, I've been going through it for a while, and I have been fortunate to have a partner who is empathic about it and, you know, how can I support you? Do you want me to rub your back? Do you want me to stay away from you? Like, just tell me how I can help you. It's amazing.

I gotta say, that's amazing, because most of my life I actually haven't had that. But I think it's been really. So I think finding somebody who you can talk to as well and really share this, even in addition to your doctor, of course, your doctor. But there's something every day about this that had me feeling quite vulnerable through it until I could figure it out. Because these aren't quick fixes, you know, it takes time to normalized hormones.

It takes time to get off sugar and have the effect have you feeling less intense hot flashes and what's happened happening. So it's almost like we're moving into from the quick fix to the rhythms of nature, and you know how each one of us. Yeah. How each one of us surrenders to that happening, I think, is. Is an artist.

Mindy Pelz
So beautiful. So let's dive into a solution here and to give some people some hope. You've said this a couple of times now, and I really think this is interesting, because I can't tell you how many times I've sat and looked at my schedule, and I finally learned that just because my schedule is incredibly full doesn't mean that's going to be an exhausting week. And what I've decided is there's certain activities I do that fuel me, and there's certain activities I do that deplete me. And you said something like the brain.

Oh, what did you say? See, now my menopausal brain's kicking in. But you said there's an expense, and then there's, like, a net expense and. A net gain or a net gain or grain. There we go.

Neha Sangwan
So let's do this, because not everybody's in menopause, so I want to kind of broaden it. Right? Yes. So, great. This is kind of me going through it myself and getting that time off and those medications.

But here's the problem. When I was on stress leave, I was off for almost three months. And in that time, nobody really. It's like three months later, I was sent into the ring for round two with no idea of what got me there or how to do it differently. And so powered by me is my answer to that gap.

And so going through it myself and knowing I needed to figure it out, me helping tens of thousands of patients and colleagues do this, this is what I came up with. When you think on a physical level, I think of the very first and most important thing someone should be thinking of is, do I know how to decipher the unique language of my own body, meaning my own physiology? So when my throat constricts and my stomach turns, do I know what that means? Or do I just assume it's a nuisance that I need to power through so I can get things done? Do I listen to when my heart races or my stomach turns or I'm sweating, or do I just try to move right through it?

So each of us has a unique language, physical signals that our physiology is giving us all the time, even right now, as you're listening to this, feel your bottom, sitting on that chair, feel your feet on the floor and just notice, are the muscles of your body, when you take a deep breath, you know, do, are they open, relaxed, and light, or are they constricted, tight, and heavy? Is there some, is your right hip trying to get your attention? Is your knee or quad annoying you? Did you work out? And do you feel sore?

I don't know what it is for people. It's unique for everyone, but your body's talking. The question is, are you listening? Right. So physically, I break it into stress and hormones.

Okay. Under the physical. Yeah. Food. Food is fuel.

Are you fueling yourself with processed foods out of boxes and, you know, fast food and whatever? Are you someone who thinks thoughtfully about how you nourish yourself and through the day, how that happens? Do you plan it, or is it kind of like a surprise after effect at 02:00 in the afternoon, and you're like, oh, that's why my stomach is, like, eating itself, because I never ate. So it's like, on a scale of one to ten, ask yourself, how satisfied are you with your nourishment and your food? Then go to movement.

And do you have ways to joyfully move your body, joyfully move in your body multiple times a week and sleep? So for sleep, it's like, ask yourself things. Like, so people are supposed to get seven to 9 hours of quality sleep a night. We're supposed to really be able to cycle through 90 minutes cycles at least four times. A lot of times.

Now, what do we do? We have farmed it out. We have rings, and we look at our readiness score to see if we're rested. Like, we don't even check ourselves. It's so true.

Mindy Pelz
It's so true. We're, like, outsourcing whether we're rested. So do you wake up in the morning and do you feel rested? I am so excited to announce something really cool that we are launching from my social media, my podcast from my doctor Mindy universe, and it is the give like a girl project. I have come to understand that what I am seeing so many of you get from learning how to fast like a girl is there's this feeling of empowerment that you are grabbing onto, and then I project that out into the world.

And I think there are so many women that are feeling disempowered right now. There are so many places where we have lost our way, and there's so many nonprofits out there that are supporting these women in a variety of ways. So you're going to see in the coming months I will be profiling some of these incredible nonprofits that are raising up women that really need some extra support. And what I'm going to ask is that if you're moved by any of the nonprofits that I bring you, if it touches your heart, I'm going to ask that you donate to these nonprofits so that together, we can use our power as women to raise the women that are in so much in need right now and are feeling so disempowered. It's called give like a girl.

We're launching it here, so give like a girl is all about raising up women together. We are more powerful together. And I'm so excited to announce this project to you. Can I ask you a question on the physical? Because one of the things that came up in therapy when I was talking about burnout with my therapist, is she her.

One of her questions to me was, do you feel? Tell me what you feel in your body. And I said, I feel completely disconnected from my body. I feel like my head and my body are just two different things. Is that so?

When you took us through that exercise, is it important to also point out that some of the people listening may just be like, I don't even know, like, check in with my body? There's just no body awareness. Is that also a physical symptom of burnout? I want to say congratulations to anyone listening that says, yeah, that's me. Because, congratulations.

Neha Sangwan
You're a master of the external world. You have successfully cut off your connection to your physiology in order to perform in the world. So whenever that happens, what I do is I tell people to kind of take an airpod case, take a smooth stone, take something that fits. Fits nicely in the palm of your hand and in your next meeting. Okay.

When something emotional comes up, when something surprises you, you can do it at the dinner table. You're in a conversation. Ask yourself, hmm, what do I feel inside my body? And if you're like, nothing, I want you to say, I can feel this in my hand. So take something from that outside world that you're a master of and hold it and bring it in, because pretty soon you're going to be like, oh, wow, my jaw.

Oh, my God, my jaw is tight. Oh, my right shoulder blade, kind of. Oh, it feels tight in my chest. But what sometimes we have to do when we're masters of the external world is this is what we got accolades for performing externally. That's how we got belonging.

That's how the world thought we were successful. So, yes, no doubt that we have done this in a very. Been cultured to do this. Perform for our parents, perform for our family, get an a, make money, you know, get promoted. Right.

This is what we get all the likes on social media for. Yeah. So the answer is yes, many, many people are there. And if you're missing, if you're missing all the early signals, then I shouldn't have been so surprised when I was powering through everything with Mountain Dew and telling other people to eat a low fat diet, that I was the one who nearly hit a brick wall. Wow.

Right? So, absolutely. The other thing I would do is I would write down any physical symptoms you have, perhaps reflux, perhaps back pain, perhaps, you know, whatever it is, write those down as well. Now, what I do at the end, so we're going to give you, we're going to give you a burnout, your own burnout assessment opportunity where you're going to get an interactive way to do this yourself and in 1520 minutes, figure out where you are. From burned out to fully charged.

Amazing. In the physical section, when I get down there, I say, now this, look at the answers that you just wrote down for the physical section. And then I want you to check in with your body. And does it feel, as you're focusing on these things, does it feel heavy? Tighten and, you know, constrict it, or does it feel light and open?

Because if you're like this. Yeah, I eat fine. Yeah, yeah. I don't need to sleep that much. I'll catch up later.

Yeah, yeah. I'm really satisfied with all these things. But your body feels heavy when your mind and your body are not in sync. Net drain.

So these two have to. It's not just you answering the questions, that's why I put a six little mini video series with it. So I walk you through each one and tell you, now pay attention to your body. Okay, so physical. That's physical.

And once, if you give yourself a score less than ten out of ten, right, one. One to ten, I ask you, just tell me what would make it a ten? That you would be satisfied. So I want you to know, I'm not telling you you need to eat four cups of leafy green vegetables. I'm asking you whether you're satisfied.

How satisfied are you? Because that will also tell you when you're less satisfied with something, that's a great place to start. Right? Because that's something that's really upsetting. So now.

Mindy Pelz
Yeah. Okay, now let's move to mental. Mental is your thoughts and how you form them. You know, let's say I said to you, let's. Oh, my God.

Neha Sangwan
There's an opportunity to go bungee jumping. What's your first thought that you'd have? I'm scared of heights. So I would say, hell, no, have fun.

Mindy Pelz
I would not. Yeah, yeah. You wouldn't be into that. But then imagine our other friend who was here would be like, I can't wait to feel like I'm flying. Okay.

Neha Sangwan
And another person might say, those things aren't. I'm not sure if those things are safe. Have they been safety tested? Okay, so same situation, same data. One of us might purple, personalize it to myself, oh, my God, I'm gonna die.

I literally am gonna die. Another person might. Yeah, that's what you think. Oh, you know, yeah. So we might project it on to other people.

Oh, that's only for people who are really athletic. Or we might say, you know, I don't know what the safety testing is on that. And go bigger than me or you. If when things happen, people typically pick a way of responding. They don't.

They didn't pick it, but there's patterns. Like, when I was young, I was raised by my grandparents for the first couple years of my life. When I moved back in with my family at two years old, I thought I had done something wrong to be sent away from my grandparents. And so I was really devastated. And from then on, I decided if anything went wrong, it was probably my fault.

So that's personalization. So you can see now in the world how I can take on much more than my own responsibility. That's personalization. And so, in this experience, that would be a net drain of energy, because normally, each experience in life has some combination of it being about me, something about you, and something about things bigger than us. Each conflict, each interaction, all of that.

All right? Comparing and judging other people, comparing yourself to others, and judging different ways that you think about work and how it should be. When someone disagrees with you, do you let it expand your perspective, and do you get curious, or do you dig your heels in and double down on being right? All these are examples in the mental section of the questions I'll ask you. And then notice at the end whether you feel like your body is, you know, open, relaxed, etcetera, or it feels heavy, tight, constricted net gain, net drain, and mental energy.

So now let's do emotional. Emotional is really easy. Emotional is like, how good are you at handling tears, anger, anxiety, grief, trauma, loss, apologizing, forgiving other people and yourself? And play and joy. How so?

The reason I said it's easy is the topic is not easy, but the question is easy. If I want to know where you're having, whether you're having net gain or net drain of energy on an emotional level, I'm going to ask you this. Tell me in which areas of your life you are avoiding a challenge or a difficult conversation. Yep. Yeah.

Is it at home, at work, socially, you know, financially? Entrepreneur? I don't know where it is, but if you can tell me where that's happening, all of a sudden your body's gonna do this thing and then tell me where you're getting, you know, a rise in energy and play and humor and all of that. Right away you're gonna know, okay, for social energy, this one's an easy question, too. It's basically write down the five people or groups of people that you spend the most time with online or in person.

And then as you bring those people to mind and write them all down, focus in on the first one is your. Now you got to tune into your body. When you're with these people, do you feel on that energy gain or drain via your constriction, tightness, heaviness, or open, relaxed, energized? Right. And you do that for each of the people.

Then you look at all five and then you say, okay, overall, how am I feeling? Right. How am I, how am I experiencing this? And then the last one is spiritual. And basically in social, it's about like, you really want to pay attention to being able to give and receive feedback.

You want to be able to know whether you're talking when you don't, when things upset you, do you talk about people or do you talk to them? Do you know how to lean into healthy conflict? You know how to draw, set expectations, make clear agreements, draw healthy boundaries. So it's like a, all your social interactions. If you're somebody who avoids conflict and says yes, when you really mean no, and you don't know how to draw boundaries, you're going to be doing a dance and taking on too much.

Right? And then when we move to spiritual, spiritual energy is so fundamental. People are like, I can't believe you put spiritual energy in a business book or a book on, you know, burnout for working at home. And I said, well, spiritual energy is the most important one. And what I mean by that is it's about knowing what you value.

It's about when you know what you value and what's most important to you, what matters to you. But let's say your top five values. So mine are love, integrity, service, play, and beauty. If I know that those are what matter to me, it helps me. I become much more effective in making quick, quick decisions that align now, short term and long term.

I can move forward and pivot in a pandemic, in a crisis, because I know what matters most. Right. So there's. There's lots of benefits.

It's your value system. It's your value. It's like, yeah. Having an ethos really matters. Yeah.

What's your spiritual gps, right? Oh, yeah. How do you make decisions, especially in a world moving faster and faster? Like, if we don't have all the data and we gotta make a decision, how are you gonna make it? You better be connected to your own body.

You better see how you feel, how risk averse are. That's another piece of spiritual self trust. So one of the questions I ask here is, tell me where you'll take risks and tell me where you avoid risks. So for a long time in my life, I would take risks, mentally, emotionally, socially, spiritually, financially, and entrepreneurially. Not so much physically, like bungee jumping and all that, and not so much romantically, because my heart had been crushed.

And so if you see where people take risks and where they don't, you know, where they trust themselves and where they don't. So what do you do with all. I mean, like, again, I'm going to say, I hear all of those questioning, and my brain is like, okay. Like, I resonated with a lot of things that you said in there, but then the burned out brain says, okay, well, that's. Yeah, like, there's a lot of places there to work on.

Mindy Pelz
How the heck am I gonna put all of those back together? Is it more of just a moment of, like. So you're talking about, like, a quiz that you're. We'll leave a link to that will give you, what, like a rating of your burnout? Is that kind of the way we're looking at that?

Neha Sangwan
Yeah. Yeah. You're gonna be able. At the end of each section, you gotta tap into your own body, and you're gonna. You're gonna be able to see whether you're having a net gain or a net drain.

And so now you know exactly where to focus. Now you know where to focus. Ah, okay. Okay. Got it.

This is so enormous, how the world gets burnout. It's so enormous. And so to personalize it to you, you need to know. I got it. Love that.

Mindy Pelz
Okay. Mine is here. I need to first physical and spiritual and emotional are the ones that are drains. Looks like I was really heavy when we started talking about emotional. Let me go there.

Got it. So you will know where you need to go once you do the assessment, and then the book will give you tools and each section to focus there. Okay, so this is brilliant, because what I'm thinking is. And I just went through this experience myself, where the first 90 days of this year, I was like, I just became really good at saying no. I just said no to everything so that I could try to figure out what I needed to do to be able to get my feet back on the ground.

And then I went on a vacation with a friend, and I call it the sensory deprivation vacation, where we just sat in an Airbnb with a beautiful pool, and we read books and watched shows, and it was, like, the most mellow time. And when I came back, everybody, all my staff and my family, they're like, okay, are you good now? You're good. Like, you took a week off. You're good.

And it was like I was good for a hot moment until I call it the patriarchal pace started back up again. And it made me realize, the reason I share this with you is it made me realize in that moment that recovering from burnout isn't just sitting your ass down like, there's a much more sophisticated path, which you just gave us. It's understanding where you are the most off course. Did I interpret that right? Yeah.

Neha Sangwan
Step one is sitting your butt down. Yeah. Step one is you probably got here because you have something that you're passionate about that you really want to change, and you've been putting your energy and effort into making that happen. And at some point, you start to spin and you start losing energy. And so the first thing is, burnout is a wake up call.

It's a wake up call that a breach has happened. Most often, it begins on a spiritual level, where you're saying yes to things that don't really matter, or you're doing it because you're out of obligation rather than inspiration, and you start draining energy. Or you're like, me? I was like, I will single handedly change healthcare. Right?

Like, not gonna happen, Nahan. Like, nice try. And so it starts with a really noble, I want to do everything for everybody. Right. And in the end, it ends up with you thinking you are super.

A superpower, and somehow the biological laws of the universe don't apply to you. Right, right. And so in that space, you do need to be stopped. And so sitting down is good. But a massage chair on Friday, a sitting down and vegging, you know, in front of the tv for series or in front of your laptop for series, that's not gonna help it in the end.

It's going to slow things down. So perhaps you can start to reflect and get perspective. But I think the big gap is, what do I do with this mess and where do I focus next? And what are the concrete tools that are going to help me heal and go back in the world and do it differently? Right.

Mindy Pelz
So once you, with this test, you now know which piece you need to work on. And I. And I would assume that you have lists of, like, if it's physical, if it's spiritual, if it's social, in the book, you probably have lists of. Here are all the things you can do. One of my questions, as I'm listening to you talk, and I just want to make sure we give.

We help women understand this piece of it. Which is, how do you explain it to those around you? Because I have found that when I've hit these moments where I'm just like, I can't keep going at this pace, I can't quite put words to explain it to my husband or to explain it to my team or to my publisher, it's like, I don't know how to tell you that the brain is no longer as sharp and effective as it used to be. And I don't know what I need to do to get myself back online. So how do we express it to our loved ones and the people we have to perform for?

Neha Sangwan
So we're going to go back to what I said to you in the beginning. It's called the body map, okay? Where we tuned in to ourselves. So if I said to you, hey, Mindy, my throat's been constricted and my heart's been racing and my stomach's been turning. I said yes to getting this done in two months.

And I didn't sleep last night or all weekend. I haven't been able to sleep or focus.

What I think is going on is that I have said yes when I really meant no. And while I don't want to disappoint you, what I have to pay attention to is that my body is actually saying, this isn't going to work. Now, the good news about knowing and deciphering the physical language of your own body, the unique language of your own body, is that what is someone going to say, no, your heart isn't racing? No, your stomach isn't turning? Well said.

It's data. But nobody shares or knows what to do with this in order to explain it. Like, and I'll tell you why. I think from when we were really young, we think about somebody is playing like a child is playing with bubbles or with their brother or whatever, and suddenly you say, okay, honey, it's time to go to school. And they're like, I have a tummy ache.

I can't go to school. And you say, no, no, no, I just saw you playing with your brother. You guys go to school even young. We as adults don't understand that. Actually, what we should be thinking about is, does this child feel lonely on the bus?

Are they getting bullied? Do they have to sit alone at the cafeteria? Because as soon as you said it was time to go to school, their body started talking. And we teach them, no, you were just fine. You go to school.

We teach them at a young age to override those signals. So true. So I don't want anyone to feel like, oh, how did I get here? We live in a society that's moving in a digital, and AI age is moving faster and faster by the minute. Yeah.

And us trying to keep up with this extra, we've literally co created an external world that exceeds the capacity of our own biology. Ooh, that was, that was so well said. Oh, bingo. I call it the patriarchal pace that is just like that production pace. And that you actually bring up a question I was going to ask you is when I hear the definition of burnout, when I hear about all the different pieces of it, I'm like, what human isn't burnt out at this moment?

Mindy Pelz
And what is our way out of it? If the digital world has now exceeded our human physiology? Like, what is our way out?

Neha Sangwan
Well, I mean, I think we have to expand our capacity. So the way that you expand your capacity is, like I said, this game change for me was being able to pick up signals early in my body. If I'm not catching this until really late in the game, I feel helpless at it because it's happening to me. Yes. And when I get the agency to know that throat constriction and stomach turning means I'm not speaking my truth.

Oh, I'm holding back. All of a sudden, in a meeting, I can say, you know what? I said I'd have that by Friday. Monday is going to be a lot better. And the help that I would need is support from the marketing team or, you know, if I'm talking about at home, a cleaning lady, and voila.

I don't know what it is. But in those moments, it's time for us to uplevel our ability to function in this world. And that requires inner work. That requires us knowing ourselves. Picking up signals earlier.

The people, I think, who are going to succeed in this next leg of our life and the race that is now on digitally are the ones who can pick up signals early, are taking data from inside them and using their own intuition, their body's physiology, getting extra information so they can make more decisions with less information at a quicker pace. Amazing. So, yeah, and it's. Yeah, I love what you're saying, and we're not as.

Mindy Pelz
Yeah, and so, you know, what I heard in that is boundaries. You have to learn to set some boundaries, and you have to learn how to express what you need. And I think those are two things. And I don't mean this in a sexist way, any shape or form, but I do believe, as women, we have a real hard time with that. And I can tell you it's a big part of what I'm learning in my own life now is to pull, put down the people pleasing, ask myself what is right for me, and then put the boundary up and then express what I need.

And I think that's another way of looking at it. The way you just said it is that it's never been more important to have a boundary.

For those of you who are listening, she just showed me there's a whole chapter in her book on why boundaries matter. Yes. Oh, there we go. Yes. Amazing.

Neha Sangwan
Boundaries. And. And I did. I actually did a whole hour with Mel Robbins on her podcast on people pleasing. So, for women who struggle with this, I will hear me talk about not only how I figured it out, how it came about, because people policing started early.

It didn't start lately. Yes. Oh, yes. It's one of the. It's one of those things with deep roots, and.

And it can change. It can. You can shift. There are actual tools that you can actually develop your boundaries. And for some people, they've been crushed in their life, and their boundaries are more like armor around them.

That doesn't allow connection and vulnerability in. So sometimes boundaries are too rigid in reaction, oftentimes to trauma or pain. Sometimes boundaries are too porous because we want you to like us and many other reasons, but we not only do we need to learn boundaries, boundaries change for me. They've changed each decade. And what's important to me changes.

What I'm willing to do as an aspiring medical resident is different than what I'm willing to do in my forties and fifties. Right. And so to know how to do it and then adjust it to your environment and the context in which you are based on the values and your spiritual guidance system, you now can navigate the world. But to me it's an inner game. Now we got here with an outer game, but now it's really important to do the inner game.

Mindy Pelz
Yeah. And I do believe, you know, Doctor Lisa Moscone and I chatted about this, about how when you get on the other side of menopause, the way that she said it is like you just, you stop giving fucks anymore. Like you stop caring so much about that people pleasing, sort of, which was beautiful to hear this researcher say it that way. I'm like, yeah, you know, that actually has been my experience is that as my hormones have shifted and wisdom and years of exhaustion trying to people please, I've now hit a point where I'm like, yep, not gonna do that anymore. And I'm curious if that's on the backside of menopause, if that's what we tend to see more is because of the hormonal shift, because of the brain shift, setting boundaries become easier.

It's just a hypothesis that as I heard you talk, I thought that might be where we're going in our sixties and seventies.

Neha Sangwan
Yeah, I think the way that I experience that is there's external data, okay. Trials, double blinded, placebo controlled trials, research, knowledge we learn in school and other places, plus internal experience. So that's our lived experience. What we've experienced personally in the world, plus our physical body signals that no one but us can experience our own intuition. You know, when a mother has this gut knowing that something's wrong with their child or something's off that experience, so it's external data plus internal data equals integrated decisions.

Mindy Pelz
Ooh, I love that. And so how we going to navigate? How are we going to navigate this world? We need more data. So start getting to know your own self more, because that's how you're going to be able to make a decision.

Neha Sangwan
In a world where pandemics occur and unknown things occur and you have to make decisions and shift, suddenly you're in an office, now you're at home. The way we're going to have self trust and the ability to be agile and adjust to a fast paced world that we, by the way, all co created, used our brains to co create, agree faster is better, do more with less each year, right. The way we're going to do that is by knowing our internal data more and seeing where it matches and seeing where sometimes we have to draw boundaries, we have to do things differently, create new ways of doing things. Yeah. Oh, so.

Mindy Pelz
Beautifully said. Well, I could pick your brain for a very long time, so. And I. And I think this is such an important topic that so many people are going through. So before I ask you my last question, which always is just a personal one that I love, where can people find you?

And you have some really cool resources. Can you talk a little? I know you're doing a live event. If, depending on when people are listening, can you talk a little bit about that? Sure.

Neha Sangwan
So if people are interested in a live event, literally unpowered by me, five days of it, I try to do one public retreat a year. The one that I happen to be doing in the next couple months is at Omega Institute, June 9 to the 14th. But if you're listening to this and it's after that, my website is intuitive Intelligence, inc.com. So I n C at the end and go under events. And under the events page, you're going to be able to see this.

I have two books that are out. I have powered by me, and I have talkrx on audiobook. So this is Talk Rx on. I don't know if you can. Yeah, there you go.

That's about leaning into healthy conflict. That's about leaning into healthy conflict. And it's also about when physical symptoms have a physical cause and when physical symptoms sometimes have are because of unresolved mental, emotional, social, spiritual issues in your life showing up in your physical body to get your attention. So, like, sometimes someone will have migraines because they have a tumor in their head. Yes, that's.

Or they're, you know, they'll have a headache because they're dehydrated for sure. But if you get a clear bill of health, what if it's actually because you're somebody who's more introverted and doesn't express yourself, and your partner blows up and has, you know, expresses their anger all the time, and you're just absorbing it. So there's unresolved mental, emotional, social, spiritual issues that can show up in your physical body to get your attention. So if you're not getting the answers you need, there's something else going on on another level. So I want you to trust yourself and know that there are answers.

Nehasangone.com is another easy place that they can do it. And then we also promised them a burnout awareness prescription. And so where you get your prescription for burnout awareness is intuitiveintelligenceinc.com burnout rx. Rx like prescription. And there you'll get a mini video series.

You'll get the interactive assessment that we spoke about on the podcast. Amazing. Yeah. And we'll leave the link in there as well. So amazing.

Mindy Pelz
And I hope people go find all your resources because there's, what I'm learning from this conversation is, wow, there's a lot of pieces to this. There's a lot of things to look at and discuss. So this was amazing. Here's my last question. Just want to ask everybody, because I think it's a very interesting concept, which is, what is your definition of health?

I feel like we are always trying to move towards being healthy. We want health, but we don't really know how to define it. And then there's a second part of that question, which is, do you have any health goals that you're, that you're striving for right now?

Neha Sangwan
Always.

Mindy Pelz
You're like me, I'm just a continual work in progress.

Neha Sangwan
Yeah. Well, I told you that my greatest challenge for a long time was my physical health because I grew up being such a people pleaser that I was really vigilant and in tune with everybody else and what they needed, not so interested in what this body needed. And so what I would say is that, that my definition, so my challenges that I work on every day are my alignment around, making sure I take my supplements, hydrate and move my body. That is so hard for me. It should not be.

I'm a doctor. But it is my area of challenge that I am consistent with routine and self care is what I work on really hard. My definition of health is alignment. Because to me, health is me. We world.

And the alignment inside me on a physical, mental, emotional, social, spiritual level, that what I think is, what I say is that I show up aligned in the world for myself and with those I love and lead and with the bigger planet, so no other species would destroy their own home.

It's not even a thing in nature. No, it's so true. And I think that true health, I think true health is us creating, each one of us working to create inner alignment and then alignment with one another and to the larger world. So to me, that's what health is. So that was so definite work in progress.

Mindy Pelz
Yeah, no, but you have such a. That is one of the best definitions of health that I have ever heard. And I think it makes it a more inner experience. You know, it's not like you're not looking for a number on the scale or your blood work to be perfect or whatever, I mean, you really gave it a much more inner experience. So I loved that that was, and I think what you said about us being the only species that destroys our own home, like, you know, one of my big takeaways right now is that women's physiology is absolutely at an evolutionary mismatch with the day to day life that we're living.

And so if you use your definition of health, what you're doing is you're saying, okay, you're not looking without. You're looking within. And how do I line myself up? And then that internal navigation system that you've spoken of, it becomes much easier to read. So that was beautiful.

So thank. This was incredible. Niha, I really, really appreciate. Yeah, I really appreciate your depth of thought and how you've given a really wide view of burnout as opposed to just, it looks like this. Sit your ass down.

I really feel like you just gave it so much more context than I've ever, ever heard. So I just. Thank you. Thank you for. Keep up doing all the great work you're doing.

Keep writing books. I hope you're writing more books. So this was amazing. I really appreciate you. Not that I guess I shouldn't end a conversation on burnout to tell you to write more books, but your brain might need to be documented more.

So I really appreciate you. This was incredible. Thank you. Well, thank you. I have to say, the biggest, the funniest thing, the jokes that really, you know, launching a book, how enormous.

Neha Sangwan
Writing a book, completing a book, and launching a book is enormous. And that was the thing, right? Like, how am I going to do this and launch a book on burnout and not burn out myself? Like, what is the way to do that? So, you know, it's a constant.

I don't think we're ever there. I think that we're. It's, you know, people say to me, are you? Do you ever burn out? And what I say is there's underlying mechanisms of who I am and how hard I drive myself.

That will always be me. But what I will tell you is what's changed dramatically is how soon I pick up when I'm off track and how quickly I get back on track. And so it's not that I don't fall off track. I do. It's that I recognize it quicker and I'm back on in a day, in a week, you know?

Like, that is what I hope for. So don't. I'm not going to give you the answer where you're never going to be yourself or you're going to be some massively other person. But I will tell you how to expand your capacity, build your intuition, tune into your body, align. And now you're going to have the capacity to see it coming and make adjustments that are really effective for you.

So yeah, it's an incredible journey and I'm so glad we're on it together. Yeah, agreed, agreed. Thank you for all your work and I hope everybody goes and finds you and we'll have you back again. This was a beautiful discussion, so thank you. Thank you, Mindy.

Anytime.

Mindy Pelz
Thank you so much for joining me in today's episode. I love bringing thoughtful discussions about all things health to you. If you enjoyed it, we'd love love to know about it. So please leave us a review, share it with your friends and let me know what your biggest takeaway is.

Breaking the Burnout Cycle with Dr. Neha Sangwan MD

Primary Topic

Episode Summary

Main Takeaways

Episode Chapters

1: Introduction

2: Understanding Burnout

3: Personal Experiences and Strategies

4: Practical Advice for Managing Burnout

5: Conclusion and Reflections

Actionable Advice

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