Show Notes:

In response to a topic that seeps into every aspect of our lives, I sat down with Dr. Melissa Cugliari, Naturopathic Doctor and expert in naturopathy dermatology, digestive health, and hormones, to explore the burnout cycle, the science behind it, and practical strategies that support personal and professional longevity.

Dr. Melissa is a wealth of knowledge in the world of well-being and also happens to be my naturopathic doctor. In our conversation, Dr. Melissa illustrates the key biomarkers of burnout from a clinical perspective, as well as its early indicators. We discuss the three stages of burnout and how boundaries can support burnout’s mental-emotional impact. She also shares how to add more “deposits” to your energetic bank account and the effect that protein, boundaries, and support have on aiding an overstressed, overworked nervous system. 

We also take a deep dive into intentional self-care and awareness around cycles and seasonality. Dr. Melissa details supplements and lifestyle tools to nourish the body and protect it against the burnout cycle. Finally, we discuss removing narratives in order to create a new reality for ourselves and others. 

 

Listen to the episode on Apple Podcasts, Spotify, or on your favorite podcast platform. 

Topics Covered:

• Neglecting of needs and the ability to recover from burnout
• Boundaries and the mental-emotional impact of burnout 
• Tell-tale signs and symptoms of burnout 
• The three stages of burnout and ways to add a “deposit”
• Key burnout biomarkers 
• The healthy relationship between diet + boundaries + support and burnout  
• Supplements + solutions to support yourself in a burnout cycle

Resources Mentioned:

• Use code THERAINBOPODCAST for 15% off at checkout on Rainbo products
• Research on Biomarkers of Clinician Burnout 

Guest Info: 

• Follow Dr. Melissa on Instagram: @drmelissa.co
• Learn more on Dr. Melissa’s website: drmelissa.co

Follow Me:

• Follow me on Instagram: @tonyapapanikolove 
• Follow Rainbo on Instagram: @rainbomushrooms 
• Shop Rainbo: rainbo.com 

Show Transcript:

Tonya Papanikolov  00:04

Hi, welcome to the Rainbo podcast. I'm your host, Tonya Papanikolov. Rainbo and I are on a mission to upgrade humanity with fungi and expand the collective conscious. This podcast builds a virtual mycelial network of bold, open minded thinkers and seekers. I chat with experts, thought leaders, healers, scientists, entrepreneurs, spiritual teachers, activists, and dreamers. These are stories of healing, human potential and expansion, tune in route and expand and journey with us. 

 

Tonya Papanikolov  00:45

Hello, hello. Welcome back to this episode, and welcome to 2024. Happy new day. We're here. And there is just so much so many blessings in this present moment that I want to remind you of. And I am really grateful to be sharing this conversation with you today with a dear friend of mine. And my personal naturopathic doctor, Dr. Melissa Cugliari. And today's episode is all about burnout. I guess it's you know, kind of an unexplored topic that touches so many of us, and also maybe doesn't really get the attention it deserves in some senses. And in our high speed, always connected world burnout is so common, I've spoken to so many people over the course of like founders and friends and creatives and whoever over the course of the past year. And everybody's kind of really engaged with it to some extent. And even Dr. M was telling me, I can't remember if it was in person or on the episode, but she has seen so many people crossover from Stage Two to stage three, since the pandemic, there's kind of a lot of people navigating this and I am personally I've been engaging with it for a little while. And it's been really empowering, because it gives you this opportunity to start to have more awareness and create some really good boundaries around work and life. 

 

Tonya Papanikolov  02:23

And the reality is that we're all so programmed and indoctrinated around hustle culture, and especially when you're engaging in the work and the path of entrepreneurship, you're going to be challenged in. I mean, for me anyways, like, it asks so much of you to walk that path. And it takes a lot of awareness to decide to show up differently and create better boundaries and fences for yourself so that you can ultimately be the best version of yourself in your business. And so basically, what burnout is, is a state of emotional mental physical exhaustion caused by prolonged stress, or, and over engagement in work or life activities. And what really resonates to me about that is that it's this over engagement piece of like being so passionately invested in your mission in your business, in the work you do in the world. 

 

Tonya Papanikolov  03:25

And that's such a good thing, right? Like, we associate that passion with so much energy and a wellspring of maybe whatever energy, creativity, the ability to create. And so it's, of course, like any other polarity in this world, there's just the edges that I've pushed myself to and I have to be really cognizant with myself to really know when to shut off. And I know that that's really deprogramming as well, because as I've explored more in my projector realm, I know that that is going against my nature, but it's also we know the culture that we exist in. It really affects not just our professional lives, but it seeps into every aspect of our well being. 

 

Tonya Papanikolov  04:07

And there's some telltale signs that you might tell in terms of being more anxious. Your mental health, rumination, overthinking fear, physical tiredness, fatigue, and, of course, a range of tons of other biomarkers like your cortisol levels or your hormone levels, and various pieces that were really enlightening for me when I did my my lab work with Dr. Melissa. And so we're diving into this really insightful discussion today, based on her perspective of what she sees in clinic on burnout, and we unravel kind of some of the science behind it. We share personal stories, and discuss some really practical strategies to prevent and manage it and Dr. M shares so much amazing stuff with us. It was packed full of just so much above and beyond the kind of classic stuff that you might hear about burnout. 

 

Tonya Papanikolov  05:01

And I really love this intriguing article that I found is around the role of oxytocin, this hormone associated with bonding and trust, and how oxytocin and creating more trust and bonding can potentially safeguard us against the effects of stress and burnout. And that is a kind of novel concept that I was really just excited to read this article on. I'm going to link it in the show notes for anybody who wants to read it. 

 

Tonya Papanikolov  05:31

I also just wanted to share on Rainbo side of things, we have an exciting update. We just launched our alcohol free or full alcohol free line earlier in January. So there's three new products, which is our reishi, Chaga, and Lion's Mane, that are now available in alcohol free varieties. And we previously have always had our 1111 and Turkey Tail available alcohol free. Now we have three new additions, Courtney steps will join in its alcohol free version in spring of 2024. And they are still duly extracted in water and alcohol. We've then evaporate the alcohol out and stabilize it with a organic USP pharmaceutical grade flax based glycerin. It's super tasty. And we're just really excited to offer this because our community has been asking for it for many years. And we're excited that it's here. 

 

Tonya Papanikolov  06:31

You can use the code, the rainbo podcast, the the whatever, the rainbo podcast for 15% off at checkout for you to enjoy some rainbo products. And that's it for this intro, let's dive into this amazing episode with Dr. Melissa Cagliari. And I'm really excited for all the takeaways that you'll get from it. Hi, Melissa. Hi. I'm so so grateful to be with you today. Thank you for taking the time from your busy, busy days with no patients and your business and everything. So I'm so so grateful to be chatting with you today.

 

Dr. Melissa Cugliari  07:13

Oh god likewise. I mean, it's such a pleasure and an honor. And I'm really excited. I love our chats.

 

Tonya Papanikolov  07:19

Me too. I really. And so yeah, so I guess for those that don't know, this is Dr. Melissa Kook, Larry, you and I have been working together I've been seeing you as my nd for I mean, I think a while, like three years, you know, when my first my first touch test was in 2020. But why don't you start by telling us? Well actually, I start most conversations by setting into some gratitude. So let's, what's one thing that you are feeling grateful for today before we dive in? Today,

 

Dr. Melissa Cugliari  07:51

in particular, I mean, the weather's been kind of dreary here in Toronto, and it's a beautiful sunny day. It's still cold, but I'm always grateful because that sun man, it really does improve so many things mood, or hormones, so I'm feeling really grateful for that today.

 

Tonya Papanikolov  08:10

Yeah, that's such a good one. I so echo that it's been like sunbeams in the house and like the way it really lights lights up your mood and your day is just so different. 100% Yeah, I am feeling grateful for I think just being back in Toronto, like I was walking down Young Street yesterday. And I was like, Oh my gosh, like wow, there's just so much nostalgia. It's so nice to be here. I think with everything there's like the polarities and enjoying the enjoying both sides of like forest life and like, you know, being in the city with ease to and being around people in the energy and it just felt really nice to like, be back in the, in the big city. Like with all these memories of of such a familiar place.

 

Dr. Melissa Cugliari  08:56

I love that. It's nice to like you said the polarity right? They each one makes you appreciate the other 100% Yeah,

 

Tonya Papanikolov  09:04

yeah. Yes. Okay, so why don't you let's I know, we're gonna dive into lots of burnout topics kind of spurred by our last session together and my recent blood work. And so I guess Yeah, I want to kind of dive into burnout with you, which is like a, you know, also, I think you can call it whatever, whatever you want to call it. I was kind of doing some research on like, these stages of burnout. Yeah, to, which a lot of them. I mean, I think there's Yeah, you probably see so much of it, like you could, it could be elicited from trauma or like that could be the icing on the cake, or it could be really come from like the sense of purpose, and the sense of like being so internally driven to achieve, that can be the like impetus of the cycle. And so it's also natural, right? Like there's, there's there's so many, there's such a natural progression to this, that we'll dive into But yeah, why don't you tell us just like briefly a bit about you and your practice, and maybe some of the areas that you love to specialize in? I know you offer so many amazing services and like, yeah, diverse ranges of topics that you kind of cover in your practice, too.

 

Dr. Melissa Cugliari  10:14

Yeah, absolutely. So I have a naturopathic medical practice in Toronto, I have a clinic space here. And the goal of starting this space back in 2017, was really to create a place where patients could come and learn more about themselves to deepen their connection with their health, and ultimately draw from the visits tools to help them live like a more fulfilled, healthy life. And that comes in so many shapes and sizes and forms and ways. And I think my practice in particular, I focus a lot on digestive health, skincare, and dermatology, and hormones. 

 

Dr. Melissa Cugliari  10:56

And I would say like, the burnout piece has become bigger and bigger, it's always been kind of there. I mean, we're all burnt out at some point in our lives and in different degrees at different times. But those are kind of the main areas I treat, I do notice a lot of the digestive disturbance, I see a lot of the skin concerns I see are either caused or exacerbated by burnout. I'm excited to chat more about that today. Because it's certainly something I treat a lot. And natural empathy is really strong. supporting patients kind of to prevent burnout, but also to recover from it. Because that can be really challenging without the right tools and support. So yeah, that's kind of like a bit about my practice. And what I treat. Beautiful.

 

Tonya Papanikolov  11:42

Thank you. It's so interesting, because in my last kind of bout of just, you know, navigations, I have

 

Dr. Melissa Cugliari  11:53

Should we call this navigations? Yep.

 

Tonya Papanikolov  11:58

Yeah, yes, I've been getting so much jaw tension, and actually like grinding my teeth a lot at night, and I wake up with headaches. And that's always how I know because every transition, I've got literally every transition I've gone through in life, I specifically remember when it first started to happen, which is right when I finished university when I was 21. And I started to grind my teeth, and I actually would like lock my jaw at night. And like I would have all these dreams about teeth and like I am my smile, but like my dentists have also kind of seen some of that. But anyways, I I just find it. So interesting that in our subconscious on like, you know, sleep state that that expression, like whatever is unresolved will show up there, whether that is a dream, or it's actually like grinding your teeth or like, we know this tension and like, Yeah, I know that you do a lot of that, like, the Bukal. Like just everything getting in there. And I've been trying to like do the self massage, and it's getting better. But I'm just like fascinated by the

 

Dr. Melissa Cugliari  13:01

body. Oh, yeah, we get we get all these physical manifestations of kind of like things we're moving through emotionally or spiritually even right. And one of the things I started to offer my practice a couple years ago now is a sculpting facial that is like essentially a really deep facial massage that includes fuchal, massage, run, massaging the muscles of the face from kind of like inside the mouth and outside the face as well, same time. And it's a really nice, thank you. It's a nice release. Because these emotions, we hold them in our bodies in different ways in the face, especially because we're constantly emoting with the muscles of the face. And those muscles hold patterns. And what I've noticed kind of bringing this back to burnout is since the pandemic that service has been so it exploded in popularity, because people want that reprieve. They want that moment for themselves, where they're choosing to engage in self care to come in and to just rest while someone helps them kind of like rebuild their energy and also maybe release some of that tension or built up kind of like emotions that that may occur, especially during transitions or big shifts in the lifespan for sure. Totally.

 

Tonya Papanikolov  14:14

Why don't we start a bit about what is burnout from a clinical perspective? I mean, they know there's so many dimensions of it. And there's various stages as well. Yeah. And let's kind of let's maybe start there with what is it? I think one of the really interesting things that I just want to highlight too is that I feel like part of the key is awareness because I had the session with you and we got these like biomarkers back and I'd love to talk about some of those key biomarkers that you see. And that would indicate burnout to you. But it's just interesting because it's just it's awareness, right? 

 

Tonya Papanikolov  14:54

And that it's just such an essential element. Because even if we're healthy what No matter where we are on our, on our journey of, of health and our knowledge level, it's such an interesting thing to work with burnout, because sometimes you don't even know and you can be like pretty far down that path and ignoring some of the like, like, Oh, I'm kind of neglecting reading regularly or like, you know, there's like these little signals. And it's just like just the simple awareness, which is really what I hope this podcast like, does for people, which is just like did the knowledge and the awareness to help us check in with ourselves more like sooner, sooner than later on, some of these things go

 

Dr. Melissa Cugliari  15:34

completely, completely. And, you know, I'm so grateful for the work you do, because it has such a large reach. And it brings that that awareness, that mindfulness that sometimes, you know, when we're just going about our day to day, we don't realize, and this is a part of the issue with burnout, too, like most of the time I see people when they're quite far on that spectrum. They're just so exhausted that now okay, I have no choice, I have to go see somebody about this. But I mean, in general, like burnout, it's been studied for a long time, it's actually been studied since the 50s. So this is like, obviously not a new phenomenon. We all burn out at some point in our lives, but the degree to which we burn out very dramatically. And it's really like burnouts, kind of funny. It's not a diagnosis, per se. It's not like a diagnosable disease, it's more like a syndrome. 

 

Dr. Melissa Cugliari  16:22

So what that means is like, we don't die from it, and we have to exclude a lot of other medical diagnoses before we can say, Okay, this is burnout. But burnout itself really is, essentially, when you're so drained, and you're unable to properly recover from being so drained. So it's like really this cumulative burden of chronic stress without recovery. So it's really like, that's the key, the ability to recover, because we're all going to have moments of stress or even prolonged moments of stress. It's all about how we perceive the stress, and then what we're doing to help our systems recover. And also, like maybe some of our lifestyle factors are actually contributing to this stress. So it's really like you said, it's a really broad category. It's a really broad syndrome, that some people throw around, oh, I'm burnt out, I'm burnt out. 

 

Dr. Melissa Cugliari  17:21

Maybe you are, maybe you aren't, it's important to look for other things first. And then if it is, in fact, burnout, there's really, really great ways we can actually go in there and provide support to your systems so that recovery from stress occurs. And then we think about, okay, how do we prevent this from happening again, because that's a really key component to and exercising, like you said, that awareness, that mindfulness so that we're able to pick up on those cues. Oh, I'm noticing I'm feeling that way I did when I was burnt out before. I gotta get in there and see Melissa, or I've got to, you know, make sure I'm eating the right nutrient groups, I need to make sure that I am going to bed by 10, or whatever it is, so that we prevent that from happening again.

 

Tonya Papanikolov  18:04

Yeah, I think that's, that's one of the key. This, like, neglecting of needs, is one of the key points of when you're in it, where you're like, working so hard, and you trick yourself into thinking that if I work harder, yeah, it's gonna help. Like, it's gonna. Yeah, like, it's gonna make me like, I'm

 

Dr. Melissa Cugliari  18:28

gonna get even better. Yeah, well done, I'll be able to write when it's done.

Tonya Papanikolov  18:31

When I accomplish, like, yeah, totally.

 

Dr. Melissa Cugliari  18:36

I'll get to my vacation, and then I'll be good after my vacation. But those little, I always tell patients, it's not necessarily about saying no to things, like work, or, you know, I gotta, you know, ditch this job, because I gotta, I gotta find a new one. But if like those real foundational factors aren't addressed, and that neglect of self and self like true self care, I'm sure at some point, this conversation, we'll talk about what that means. But you know, that true self care, it will happen again. Right? So it's really about like True, true mindfulness of self, your own needs, and then actually stepping up and meeting those needs. Yeah,

 

Tonya Papanikolov  19:16

I was reading something before our chat that I wanted to share. There's like, I mean, so many things on the internet. I'm curious to know if you have any, like specific stages that you look like, but I think, just to share my own experience in this a little bit, is that, you know, because I consider myself a mindful person. I have, like so much training as a nutritionist and like a background in this and yet, it's, I can fall into patterns, right? Like, just like anybody can and it's just, I read this, which is one of the like, stage one. I don't know if it will resonate with everybody, but it's around excessive ambition. 

 

Tonya Papanikolov  19:54

And I've really had to check myself on this this month in December specifically. So it's burnout. begins in a seemingly seemingly harmless way with enthusiasm towards your work. Well, many people can relate to their ambition being a positive trait that supports their career growth, inner drive, and excess can stifle you, it morphs into a compulsion to prove your worth and yourself to others, you don't feel good enough. So you have to take additional responsibility and always feel like you need to be doing more faster. And that just like resonated so deeply with me. Because I have to check myself on that all the time. Like, I was just chatting with Simon, my husband last night, and I was just like, wow, I really, like I just need to rest in December. 

 

Tonya Papanikolov  20:40

And yet there's this inner voice in me that's like, no more faster, like, what about all of the things? What about, like, all of your planning for 2024? And I know, we all experienced that to some degree. And so I think like, really recognizing, really recognizing and so I've been like, asking myself why, like, Why do I feel like I need to do this? And, and then you kind of get into some really, like, you know, deep parts of like, oh, okay, cool. Like, sure. Yeah, maybe I Oh, I see this part of me that feels like it wants approval or, or that it needs X, Y and Z and like, can I just sit with that and be like, it's okay, like, Can you just be so fulfilled in the here and now? And like, pressed? Yeah. And it's hard. And it's hard.

 

Dr. Melissa Cugliari  21:26

It's so hard. And I will say to in the research, women are at higher risk of burnout. And then you are in entrepreneurship. I don't even know their thoughts on that. But I'm, like, you know, where it's me too. And I see it in clinic as well, like, I mean, it's a lot. It's a lot. And I think sometimes what the best thing can be is like that mindfulness and maybe that's surrounding yourself with the right people or practitioners that can help point that out for you. Like you mentioned, your support system, your husband, right, we see one another like, because sometimes we don't even realize it like just snowballs. And I always I like to use this analogy, I can't remember if I've used this and when we've spoken in the past, but it's like, your energy systems are like a bank account. 

 

Dr. Melissa Cugliari  22:19

Right? So we want to be thinking about how many deposits Am I putting in? How many withdrawals Am I taking out? And like, what's my balance? And it's about kind of like tuning into those things. And it sounds like your awareness has increased tremendously, right? And that's like through years of kind of like personal work and your health training all these things. But it's like, okay, what are these deposits? What are these withdrawals and actually, like, then executing, you know, like, Okay, I'm really going into withdrawal here in my bank account, December, I need to take my foot off the gas, and maybe focus more on depositing, depositing. Yeah, and like, I know, we've talked about, like, eating breakfast every day, huge deposit, especially if there's protein in it, right.

 

Tonya Papanikolov  23:00

I'm honest. Doing it. Yeah. Oh, good. Yeah. are like, okay,

 

Dr. Melissa Cugliari  23:05

you know, I have a busy business, I can't necessarily step away from, but maybe that means, okay, I am getting into bed at a reasonable hour and ensuring that I'm not like causing sleep debt. Right, so that I can kind of keep going. And then also, ideally, like, have the energy to step back. Because sometimes we're so far into burnout. We don't even know, like, we're saying, I need to take the time off. I need to I need to chill out this month. Sometimes if we're just so burnt out, we're in this kind of locked in fight or flight adrenaline response. And the system just says so. Exactly, exactly. And it's just fried. We can't even see it. So I mean, I think it's great. Like you're saying like I'm able to kind of, you know, see for myself that I need to take a minutes, because otherwise like that quote, you read, it's so easy to get into that. Yeah,

Tonya Papanikolov  23:53

yep. And it's societal reprogramming. And it's, you know, one thing that we focused on feel like we're like going a bit all over the place, but it's totally fine. One thing that we focused on when you and I chatted last was like boundaries. And it's really interesting, I'd love to maybe chat about some of the emotional, the embedded, emotional side of burnout and maybe boundaries or more mental emotional, let's say, but like, I think that that's a really interesting approach. Because I, literally the next day, and I just want to say so I did a Dutch test with you. And I got the results back from that we had a session.

 

Tonya Papanikolov  24:33

 And it was just like, it was so so fascinating. And those cortisol salivary cortisol results were like, just they gave me so much to work with. And so much I don't know if I would have recognized what stage I'm in otherwise. And I started to make some really big changes after our session around my scheduling and my time blocking and just like being way more realistic with like, what my outputs are and like, oh, going on back to back back for a few hours, like, without a lunch break or five minutes, like, why, like I, you know, like, but why? Who said that? I should do that. And like, so it's it's really just been an interesting process to like question some of how and why we do what we do. And yeah, just wondering if you could speak to maybe some of that that emotional work that corresponds with it or the boundaries? Yeah,

 

Dr. Melissa Cugliari  25:25

I think something you said was so interesting, like, Is this realistic for me to be going back to back maybe not having the proper fuel or food or the proper rest in between days or whatever? Like, it really is, like, what I do with patients is we really sit down and take an inventory of like, okay, what is your lifestyle? Like? What are you eating every day? What time? Are you waking up? Are you caffeinated? What time do you go to sleep? What's your sleep hygiene? Like? Like, what's your nighttime routine? What's different on the weekends, etc, right? Because this really lays the foundation for understanding, again, going back to that bank account, like what are we doing with respect to withdrawals and deposits, and where are our personal boundaries, maybe not there at all. 

 

Dr. Melissa Cugliari  26:12

Maybe they're flexible, maybe they need to be stronger. And really like this boundary work this kind of like physical emotional boundaries, that sometimes we just let go of in the quest to succeed or to do more like that really, is absolutely foundational. And some people go their whole lives without even addressing any of this. And they come to me later in life, and they're just exhausted, I'm seeing younger and younger people become more and more aware of this, which I think is wonderful, because it really does create longevity, and not just like longevity, but like, optimal longevity, like you're actually going to be living in a way that you're enjoying your life. To and you feel more balanced, you feel more healthy overall. So I think boundaries. I mean, it's it's a challenging conversation, some people don't want to talk about it, because it's, that's the hardest part, I think, like the supplements, you know, right? 

 

Dr. Melissa Cugliari  27:13

Like you put them in a in on your counter, or you take them every day, or most even most days, I always tell people, you know, five out of seven days, it's great. Even die, it can be kind of like one of our quote unquote, easier things to do. Because with burnout, the dietary intervention is very simple, does not have to be complex. In fact, we don't want it to be complex, because that just adds more stress. But it's really like the emotional discussions, the where are you not asking for health? The conversations you need to have with your boss about I'm not available after 6pm during the week, and I'm not available on weekends, the conversations, you know, with your partner, this isn't working for me, I need your help here. All of that those are the hardest, the hardest things to ship, but often the most impactful. So it's certainly counseling is a big part of my practice. A lot of patients leave saying, Oh, my God, I felt like I just had a therapy session. But, you know, in reality, like, these are the really important things. And often I will refer patients to to speak with therapists or certain types of practitioners that suit them so they can do this deeper work. Because without that, yeah, like, not only are we going to get into burnout again. Yeah, but it's, it's going to be hard to recover from. Totally.

 

Tonya Papanikolov  28:32

And also, like, Where can I be? Where am I not being honest with myself? Like, what do I need to hear that I haven't been honest with myself, or that I'm scared to say, or one that I asked myself is? Like, what do I need to say that I haven't been able to say? It's, for me, it's been like, really a new, just reestablishing my connection to time, my connection to like, how do I like want to feel at the end of my day? How do I don't want my experience of time, which is experienced with my life and my day? How do I want that to be? How do I like, I can make those rules. And you know, to some degree, right, like, we have our responsibilities, we have work and our jobs, and we may be able to control those to some degree, but I think I remind myself, like having a business is, it's so lucky. And we can also provide a new working experience for ourselves and for people that we work with our employees. And like that's just a really beautiful, impactful and empowering thing to remember that we can shift that. But why don't we move into like, what are some of the telltale symptoms that you see for burnout? Yeah,

 

Dr. Melissa Cugliari  29:46

yeah. I mean, also, I just want to say I think that's so lovely, like, especially as a female entrepreneur, leading by example that way and showing future generations of women that you don't have to be, you know, doing it all at once. Since we can still care for ourselves and still be successful, I just think that's

 

Tonya Papanikolov  30:03

like 100%. I love from the rooftops.

 

Dr. Melissa Cugliari  30:09

Absolutely. So back to your question. So like, what is burnout look like? I mean, there are all the symptoms are vast. They are like it's it's one of these syndromes, it's again, we have to exclude other issues because burnout can look like certain health conditions and certain health conditions can look like burnout. But really like when someone comes into my office, and eventually I'm like, okay, yes, this is total burnout. It's like, the first thing is like full energy, just total depletion. And that could be like, I'm exhausted. When I wake up in the morning, I'm snoozing my alarm. But at night, I'm super wired, I get that second wind, I have trouble maybe falling asleep or staying asleep. 

 

Dr. Melissa Cugliari  30:47

Maybe it's like, in terms of depletion. It could be like a mid afternoon crash. Maybe it's also like decision fatigue, like you just feel too tired and decision comes into your lap. You're like, I can't even begin. And it could be simple things like what am I making for dinner? It's like, and I've been there where it's like, I can't even I don't even know where to start with. Like that type of like energy depletion is a real telltale sign. Yeah. But it could also be other things like, maybe we see metabolic changes. So like, one big one I hear is like, oh my god, I have cravings, fats, sugar, salt, like those three, just the way our adrenal glands work. Adrenal glands are what excrete adrenaline and cortisol, they like look like little glands, they look like Santa's hearts that live on top of our kidneys. So when those are constantly pumping out these hormones, they begin to deplete things like our minerals. So salts, it looks and we've been degraded, we begin to crave all these things. Sometimes it's like, oh, I'm gaining weight, and it's harder to lose it. It's kind of like maybe midsection weight gain. It could also be like, our hunger cues are off. 

 

Dr. Melissa Cugliari  31:51

Maybe we're during the day, like we've talked about this, right where it's like we go all day and donate, I just don't have an appetite. I gotta get my work done. No time for lunch break. I'm not even hungry. But then at night, the cravings hit a hunger hits, and we just want to eat all evening. It could also be like digestive disturbance. Because what happens with stress hormones is it maybe makes your digestion either slow down, or move more quickly. So we start to get like the quote unquote, irritable bowel syndrome, sort of symptoms, which then changes like how we absorb our nutrients, how foods moving through the gut, we're also more likely to have certain gut infections when we're in burnout, things like H Pylori is a big one. Other symptoms would be like mood disturbance, like irritability. Maybe it's like you're feeling more cynical, or you feel maybe like jumpy, panicky, jittery. Other things are like, if one that I see a lot that people are like, I just don't understand puffiness, when people come in, they say, Oh, I'm just so puffy. I'm retaining water, you know, my socks, leave a ring around my ankles, my rings are hard to get off. 

 

Dr. Melissa Cugliari  32:56

My face looks puffy. I mean, I see this a lot. Because a lot of people come into me for facials, like, I just want a more sculpted look. And then on further inspection, we realize, Oh, you're puffy, because you're plucked out. And we need to work on that. Otherwise, you're going to be suing me for facials. Forever, because we're not addressing the root cause which could be this burnout. Other things are like hair loss, maybe, or changes to your skin, again, things I see a lot. And it's really interesting. During the pandemic, we've had this unique look at how a population and how a population suffers from like major chronic stress. And a lot of people report to me, You know what I feel like I've aged a lot in the last couple of years. And that has to do with collagen synthesis and things like that, when our stress hormones are higher, that's not as effective. So change it to skin hair loss, also like a zine system dysfunction. 

 

Dr. Melissa Cugliari  33:47

And people are like, Oh, either I'm sick all the time. Or oh, I never get sick. Like it's a badge of honor. And it's like actually, that probably means your immune system is either is over functioning or maybe unable to function at all. And then when I see a lot too, would be like changes to reproductive health. So with women, obviously, our cycles are really a good window into our health overall. So sometimes we see like cycle irregularity, maybe the flow is heavier, maybe like PMS, all of a sudden, you're like I've never had PMS like this before in my life. Or maybe we even move into what's called PMDD which is like a more severe form of PMS. Now there's not like a ton of research with how burnout presents us fertility issues or reproductive health issues in women.

 

Dr. Melissa Cugliari  34:31

 But there is research to suggest that in burnout we see a change to sperm quality decrease in sperm quality for males so that could be a part of it too. I think I hit most of them but like exactly everything so honestly when I'm whenever someone comes in to see me with a specific concern, burnouts, always in the back of my mind, if it maybe isn't the total end all be all cause like maybe it is actually like a blood sugar dysregulation issue or maybe it's a thyroid disease or maybe It's, I mean, maybe you're postpartum, like there could be all these reasons for the symptoms. But certainly, there are always kind of like whispers of burnout in every case. So I'm always looking for that, as well as some of the kind of like other major things that can be causing the symptoms I just mentioned,

Tonya Papanikolov  35:17

under percent, and I guess, like anxiety, depression, mental instability, right like that. Yeah.

 

Dr. Melissa Cugliari  35:24

And that was challenging, too, because it's kind of like, what came first. My anxieties, for the anxiety, I shouldn't say, my anxiety, the anxiety I experienced then leads to burnout, or did I get really burnt out, and now I'm feeling anxious, because my adrenaline and cortisol are totally dysregulated. Right. So like, really kind of like, teasing these things out with patients, and then also ensuring that they're getting the proper care, especially when it's mental health related to addressing these concerns, so that they can feel better overall.

 

Tonya Papanikolov  35:54

Yeah, that was so comprehensive, thank you. That's literally, I was like, that's all all of them. So, so fascinating. So what do you see then is, how do you really because like, at the core of all of that sounds like cortisol is, you know, essential, but also so important to like, keep within balance, and what do you kind of see the difference? Then is between? Or is there a difference between just like the stresses of everyday life? And how that builds up? And, you know, the experience of actually like getting into into, like, are we all burned out, then just because like, this is just, you know, that's a trick question. And I know, from every direction at this point,

 

Dr. Melissa Cugliari  36:46

it completely, I mean, the way we live in North America, we don't really have the built in rest that some other cultures have. So we certainly see a lot of this right. And then I would say, like everybody is stressed. But not all of us are burnt out. And it's really again, going back I think I mentioned this earlier, where it's like, what is your capacity? And are you recovering, because like cortisol actually is an incredibly helpful hormone in the body, it helps us to wake up in the morning, we see a steady rise in cortisol, around the time we wake up every day, it's called the cortisol awakening response. And then throughout the day, it allows us to have energy, it allows us to kind of rise to the occasion get things done. So it's good, like it certainly has a place, it's when it kind of gets imbalanced, that it becomes a problem. 

 

Dr. Melissa Cugliari  37:37

And that could be imbalanced as in too much or too little. Usually what happens like, essentially, when we the body perceives a stressor, because it's all really kind of like perceived threat. I mean, there are immediate stressors, like our ancestors dealt with, like predators, lack of shelter, the elements, right? Those are like true stressors to our survival. Now, the stressors are more about perception, right? Like, oh, it's an email from my boss, or like, Oh, I'm stuck in traffic, I'm running late. So these perceived stressors, cause like, there's kind of like three stages of how our bodies respond to stress. So the first stage is kind of like your alarm reaction stage. So that's when like the adrenaline kicks in this is like your initial reaction to a stressful event. So like, you know, you're about to go give a presentation, you're sweating. Maybe you have to, like you have a bowel urgency. Some people feel nauseous, like, it could be all these things that set like initial alarm state to a perceived stressor. So that stage, we all get it. It's normal, it can be helpful, it can help, like, get you going for that presentation and carry you through. So it's helpful. And it really it's like that adrenaline that the hormone there is adrenaline. It's not so much cortisol. 

 

Dr. Melissa Cugliari  38:48

And adrenaline going back to that bank account analogy. Adrenaline is a huge withdrawal from the bank account. So the key in this alarm is it's not that it's a bad phase. But the key there is recovery. So like, let's say, you know, yes, it's let's go back to the presentation of a big presentation, the key there afterwards would be like, eat a healthy meal, and like, make sure you go to bed early, you know what I mean? So that's going to kind of like rebalance your adrenaline response, and get you into a hormone really harmonious place. The second stage though, this is where most of us live. It's called the resistance stage. So you have this alarm stage. So then what happens is if you get like kind of chronic stressors, this is when cortisol is called on a bit more. So this is like your day to day getting into work on time. You know, dropping your kids off at school, making sure your meals are made, like all the little things you have on the go at all times. So cortisol is called on to help you do these things. It gives you the energy to do them and it kind of shifts the brain chemistry so that you can be focused to do these things. 

 

Dr. Melissa Cugliari  39:52

Again, with this The key here is this isn't really burnout per se. This can be very functional state to live in, as long as we have the recovery Free. Again, it's all about the recovery there, we want to prevent it from going deeper. So again, you know, adequate sleep, right support system, right supplements for you the right diet for you eating regularly moving, but not over exercising. If we have those sorts of preventative tools in place, we can live in this stage for a very long time and live very happily. It's when we get into a stage three, which is called our like exhaustion stage. This is this is like burnout, this is when the body can no longer cope. It's when we can't differentiate anymore between an actual stressor and perceived stress, like so. So in this phase, actually, instead of cortisol kind of gets too tired, essentially, it kind of stops, the body doesn't really, how do I put it, you become less sensitive to cortisol. So what happens is your adrenaline, your body's just throwing adrenaline at everything. This is why like, all of a sudden, we're wired, and then we're exhausted. And then we're wiring. 

 

Dr. Melissa Cugliari  41:02

And so it's like these fire alarms going off in your brain at all times. And when you think back to the bank account, you can imagine if if adrenaline's hitting so many times during the day, it's like withdrawal, withdrawal, withdrawal from the bank account. And often when we're in this state, it's hard to engage in recovery, where we think, Oh, maybe I have to go do self care, I have to go do the yoga and meditation that are too far gone. So I find this tough stage to live in as well. Because what we're told culturally is like, Oh, just go do self care. Go on a walk, talk to a friend, like, yeah, those are helpful. But are they actually going to help you recover? Are they going to deposit enough into the bail out? If they won't? So this is kind of like the problematic phase of the stress response? 

 

Dr. Melissa Cugliari  41:50

So going back to kind of the initial question, like stress is good, if we all need it, it helps us stay balanced, helps us get things done. But it's when it becomes super chronic. And we don't have the recovery, that we go into burnout, and it becomes really like deleterious on your health. Now, like, you're obviously not gonna enjoy your life when you're in burnout. But also long term, we see a lot of long term issues, and health concerns that that increase variety increases the risk of Wow,

 

Tonya Papanikolov  42:22

so, so fascinating. Thank you so much for that that's so in depth and like, what does happen after it? Is there a stage four and five? And how far have you seen? Like, how far does it go? What does stage four look like?

 

Dr. Melissa Cugliari  42:35

Within this particular model? There's the three stages, that third stage exhaustion is like, really, you're just, that's it? And I really see I've seen patients on all sides of the spectrum, you know, and there were a lot of factors at play there, lifestyle, medical history, life experiences. And it's actually incredible the recovery I've seen as well, with very simple things like it doesn't need to be some elaborate, sexy health plans that has to have like these beautiful recipes every day. And you know, all these wonderful self care deposits each day, like it can actually be really simple. And have a huge impact and get people out of that exhaustion phase, kind of back into the resistance phase, or like a comfortable phase for them. Yeah,

 

Tonya Papanikolov  43:25

and what is part of stage three look like? Like you mentioned? No, no, picking up the phone and talking to a friend or going for a walk once a day might not cut it. So what is it like? Is it true time like? Like, you know, week? Or what is that? Like? Maybe you know, I'm so it's such an arbitrary term a week, but like, time off? Like, it's different for everybody. But what do you you mentioned true self care at the beginning, like what is? What does that stage really require of us?

 

Dr. Melissa Cugliari  43:55

Yeah, that's a good question. So like, when you're in stage one or two, it's more about prevention from it getting worse. But when you're in stage three, it's like, okay, we need to engage in like major recovery in order to deposit back into the bank account. So going back to that analogy, like when you're in that reactive stage, or like those initial stages of stress, it's like, okay, let's prevent more withdrawals from the bank account. Like, okay, you gave that big presentation. So like, let's add it, that was a big withdrawal. Let's add a deposit. So you go to bed a bit earlier. Or like, let's add a deposit, eat like a really protein, rich dinner, Grace, you know, like, those are little deposits. But like, we're really thinking about, like, let's maybe minimize the withdrawals, like maybe you don't do a presentation again, the day after, maybe you take the weekend and you don't make any social plans and you just kind of let you feel it out. See how you're doing. 

 

Dr. Melissa Cugliari  44:45

You don't want to be withdrawing constantly, when we're already in withdrawal when we're in that stage three. We're just like so deep into the bank account. We're in such like, we're in major, major negatives. We got to think about how do we add some positives to Back in what are those deposits I can make? And so there's like a few things. I mean, supplements are a part of that supplements aren't necessary. But they can kind of shorten the time to benefit. If that makes sense. It can kind of make the recovery process faster. But supplements are a band aid, they're not going to actually be curative, they're not going to take you entirely out of withdrawal. Like, yeah, exactly. Maybe they'll take you from like a negative 10 To like, a negative five or negative two. But it's really diet and lifestyle factors, maybe even more lifestyle factors that are going to kind of bring us into full recovery. 

 

Dr. Melissa Cugliari  45:44

Like I always say, it really is like diet wise, protein is super important. We've talked about this together, right? Protein is such a critical macronutrient it really is like one of those things where if you do nothing else, if you're so burnt out, just focus on adding more protein, I don't even care so much about like healthy fats and a beautiful grain and all your greens on your plate like protein is key, because it's often one of the things that we cut out first or burnt out. Because we don't crave it as much. Like I said earlier, we're craving like the carbs, we're craving sweets, we're craving the saturated fats. So protein is a really key thing, we also burn more protein when we're stressed. So making sure that we're replenishing that. 

 

Dr. Melissa Cugliari  46:29

So usually the mark, the measure is kind of like, around at least one gram of protein per kilogram of body weight. I've been reading some other literature that suggesting now maybe it's one gram per pound of body weight, which would really drive those numbers up. I just say to people, like, make sure there's protein with every meal and make it easy for yourself. So if you eat meat, maybe that's like, go to your local grocery store and get a rotisserie chicken that's pre made, there is some protein for a few meals, you know, or like adding eggs to breakfast, maybe some people aren't even eating breakfast. So it's like maybe bring breakfast and add a couple of hard boiled eggs. Make them for a couple of days, have them in your fridge. So you can just grab them keep it super easy and doable for yourself. I like to start there, and then maybe a couple of supplements. 

 

Dr. Melissa Cugliari  47:21

And then we have the conversations a bit more about like boundaries, the emotional side. Because when we're so burnt out to have those conversations, I see people's faces, they glaze over, they leave my office, they never come back. Because they're just like that was overload. Yeah, they come back like five years later. And they're like, yeah, so now I feel Yeah, we can actually talk about some of those things you mentioned in our first session. So I always start there, nutrition. First, a couple of supplements go off at least four to eight weeks there. I know you asked about kind of like timeline.

 

Dr. Melissa Cugliari  47:57

 And it is a slow process. So I always try to manage expectations for people because I think kind of like you're alluding to with like our work, we always want to do more, do more. I think we also want results really fast for everything. It's kind of this instant gratification culture we find ourselves in, and it's really about, okay, we got to recognize this is gonna take time, it's gonna take some consistency, but let's do super easy things that are eligible on a consistent basis. And that's where we're going to see the biggest result.

 

Tonya Papanikolov  48:28

Yeah, yeah, that's so insightful. And wow, so much, so much information. And that was so helpful. Thank you. So speaking to, I guess, some of the key biomarkers, what do you look for? And I know, it's Yeah, so salivary cortisol. And you use the Dutch testing? Move. I tell us a bit about that. And, and I also saw a really cool study about oxytocin. And, yeah, and so. So there's a study that was looking at the connection between trust and connection, that are emerging as potential protective factors and moderators of burnout. And that's like, do I trust my team or my boss or the people that I'm working with? And do I feel connected to this community? And they've started to do some like oxytocin testing as well, which I thought was so that was so fascinating. Yeah. I love that

 

Dr. Melissa Cugliari  49:30

I read a study not too long ago as well. It wasn't looking directly at oxytocin markers. But they were studying burnout and parents, because they usually study burnout in specific populations. So in this particular study, it was in parents because we see a lot of parental burnout in our culture. And one of the protective factors from burnout was loved, select supportive partnership, where each individual felt loved Have to be engaged in intimacy regularly. Physical Touch, you know, they felt like they were on the same team. So like you said, kind of like trust that so protective those parents in the study who had that in romantic relationships or like supportive family relationships, where they felt that love and trust, were more protected against burnouts. And those who reported not having those sorts of relationships.

 

Tonya Papanikolov  50:27

Yeah, that's, that's really interesting, too, because then it kind of you bring in, like, the aspect around isolation, right, which is like pretty key in burnout to other that is, you know, a mental perception of isolation, or the inability to ask for help, or the reality for a lot of parents or whoever it may be that like, I'm in this alone, I'm a single parent, or I don't have the network helping, like the village helping me raise business or child or whatever it may be. That like support system might be like, real or it might be, there's just so many, so many ways to look at that. And I guess reality is for different different folks. Completely.

 

Dr. Melissa Cugliari  51:06

Yeah, it's huge. It's huge support system is massive. And so that's something I certainly, I screened for that like and what we like what we're talking about a second ago. And I find that as important as biomarkers, and doing the lab work and all of that. So it really kind of depends on the person, but sometimes we can figure it out just based on a really good case history, asking things like yeah, what are you eating? What's What's your lifestyle? Like? What's your work balance? Like, you know, what are your responsibilities or your your caretaker or your parent, etc. And then adding the biomarkers to that can be very, like a really, really great tool also. But yeah, support system is key. But going to your question about biomarkers like, I find this like, it's an interesting conversation, the research is interesting. So cortisol, like I was kind of saying earlier, burnouts, more of an adrenaline problem. So it's not actually like people think, oh, I want to look at my cortisol is my cortisol high. Right,

 

Tonya Papanikolov  52:04

right. Oh, yeah. Cuz, yeah, yeah, it can go high, and then go low, exactly,

 

Dr. Melissa Cugliari  52:09

like we've talked about, right. So like, it doesn't actually, it's not always valuable to look at cortisol. Now I do sometimes run it, you can run cortisol, in blood testing. And you compare it to other hormones and specific and you observe the specific ratios. That's where it's key, because typically, most people, unless you have a chronic or genetic inherited disease, your cortisol is going to be a normal limits on lab work. It's still good to screen because some people do have these diseases, and we need to rule those out. Because they may be feeling quote, unquote, burnt out. But in reality, they actually need much deeper medical care to assist their symptom system. So we can do it through bloodwork. 

 

Dr. Melissa Cugliari  52:50

But also there are other great tests now like the Dutch, for example, which is dried urine testing, when we look at different hormones that way, and we can observe those hormones. And when we see shifts or imbalances there, we can kind of extrapolate. Okay, you know, like the adrenaline's probably out of control here, or, you know, maybe this is a newly stressed person, or maybe this is someone in a chronic state of stress, because cortisol patterns and the patterns throughout the day. That's why I like Dutch, because certain Dutch tests, you can actually capture the hormones at multiple intervals throughout a specific day, when you take one measure, it's not necessarily going to tell us that much because these hormones are fluctuating. 

 

Dr. Melissa Cugliari  53:28

But anyway, it can these these tests can give us a clue as to where on the spectrum of burnout someone might be at if they're kind of like burnt out in general. So I do like to use them. I don't always though, like people are always like, Oh, my gosh, this process is gonna be so expensive, all the testing all the supplements, but like I said, we can kind of discern burnout pretty easily through a case of three and then we don't even need supplements to treat it as long as someone's like, willing to like do those little things that are more lifestyle and dietary in nature.

 

Tonya Papanikolov  53:59

Yeah, that's, that's really great to hear. That there's like lots of kind of inroads and approaches that can be can be taken. Is there anything you feel like we haven't touched on or that's an important part of the conversation around burnout yet? I mean, I think like

 

Dr. Melissa Cugliari  54:17

we kind of started chatting a little bit about

 

Tonya Papanikolov  54:20

self care. Yeah, that's where I wanted to go to mention

 

Dr. Melissa Cugliari  54:23

Yeah, like, if you if you're keen, I like talking to people about this, because often now we equate self care, to kind of like self indulgence. You know, like, oh, just do what feels good. Treat yourself, which has its place. Don't tend to present Yeah, wrong. But when we engage in those behaviors, as a way to avoid effort, or as like a substitution, like a quick easy antidote right to our problems. It's not a long term solution. It To not and maybe it gives us like that immediate relief, but it's not going to give us long term benefit and kind of pull us out of burnout. So self care, like the way I see it, it's really, it involves effort. 

 

Dr. Melissa Cugliari  55:13

Now, it should be simple enough, though, that you can do it consistently, again, like bank account was deposits into the bank account. Consistent, easy. And it's really very individual like this can look totally different from person to person. But I think one of the biggest things going back to our boundary conversation, so best piece of self care we can do for ourselves, especially as women is to ask for help. Like that is self care, right there like then it that's often challenging to do. So this is usually something I literally put in, in the treatment plans for patients, we talk about ways they can do that. In areas where they feel safe, we start small. But real self care is like this ability to truly care for yourself, like with awareness, like we were talking about, so that we can then maintain optimal health and like promote health long term.

 

Tonya Papanikolov  56:05

Yeah, that's, that really, really resonates. The idea of like reaching out, and the vulnerability that's that's required in that write, that admitting that we need support is, it's Yeah, that's a big deal.

 

Dr. Melissa Cugliari  56:25

Yeah, it's hard. And I think self care, too, is like that recognition, like you were talking about personally before, like that recognition of like, where am I doing too much? And where can I make an effort to scale back a little bit like I know, for me this year, I don't know, like the pandemic, like all of that. It really hit me like that, that kind of burnout from it. I think it me about, I would say a year, almost a year ago. And it got to the point where, you know, I was like, That's it. Notification time. Yeah. And not to say vacations curative, right. Like I said earlier, it's not curative. But that effort that I took that that moment of like, I need to reassess, I need to kind of bird's eye view of my life. 

 

Dr. Melissa Cugliari  57:10

And figure out when I can schedule in that recovery for myself, that time with family. Maybe it is asking my assistant to help me with certain things that I just need to take off my plate. Right. So I really did like a role, not overhaul, but like I really took a hard look at my habits. And that was like not taking time off. Asking for help. Maybe like not Oh, this was a big one scheduling on your lunch break. We've talked about this, making sure every day I blocked it. I was like, That's it every day, one to 2pm. Five, I'm not available. Like if I don't do that. If I don't make that effort for myself. A no one else will be I can't live the life I want to live kind of like you said, like, how do I want? What do I want? deserve? I can't serve others if I'm depleted? Totally

 

Tonya Papanikolov  58:09

100%? Yes, I sometimes think about one of my best friends who's he's so good at working for a few hours. And that's it. He's a business owner. And then he goes and, you know, like, does, he's super active. And that's it like, but that's it. And he's extremely successful in that. And I'm not saying like, you know, has had big teams has also had small teams, but you train the people around you to know what they can expect from you, right? And so one thing I've been starting to think about for myself, and how I'm organizing my time is like, okay, so I probably have like three to four hours a day of like, prime. Like, where is that in my in my day with my energy levels? 

 

Tonya Papanikolov  58:58

And what are some other small things that like, maybe I can like email or other kind of like tasks that I can do, but it's kind of so much of this, in my experience has been like, so perception based. And it's like, well, I will train people to know what to expect for me. Like whether that's like 16 hours a day, or whether that's for really focused, yeah, focused hours where I'm not distracted, but I'm like really giving myself to like, a few important tasks. And so one thing in that like time mastery that I've been kind of working on, which is always a work in progress, but like it's really just like, I used to write to do lists of like, 100 things. Oh, yes, I've been there. Yeah. And now I'm like, No, I got like three things. Like, I've probably got like three to five things that I can really do in a day. 

 

Tonya Papanikolov  59:52

And what are those most important things and let the rest go and just like Nobody's expecting, like Right, who says we set the expectation and then that's, that's what people get from us. And it's not that it is a good thing or a bad thing. It's just, it just is. And you can create more in three hours of focused effort and good mindset and flow and showing up as your best self than you can in 16 Miserable hours, where you're really exhausted and grumpy and like making it kind of suck for everyone. So Exactly,

 

Dr. Melissa Cugliari  1:00:24

exactly. And it's like, it's like what you said, creating an expectation that we can't wait, like how, of course, we're going to burn out, if we have our expectations that are just so massive, that 100 list and 100 item to do list. And we don't get 95 of those done in a day, we're setting ourselves up for a lack of satisfaction. Yeah, we're going to doubt ourselves, we're going to start to get cynical, we're not happy. And that is going to lead to burnout, it really is about perception to versus you know, maybe have three things on your to do list. And I mean, granted, I like, it's very easy for me to say this, some people do have to have other items on their to do lists, and we kind of work on supporting them through managing these items that they can't take off their plate, right. But if you can do the ones, you can manage the controllable factors, like maybe you put two or three on that list. And then day after day, maybe you get them all done, and you build that confidence. And you reset those expectations. And that creates satisfaction and itself too. And then we perceive life is more enjoyable, or work is more enjoyable, whatever it may be is more enjoyable. We can show up differently and not in itself to it that's like burnout prevention.

 

Tonya Papanikolov  1:01:48

Yeah. And it also kind of leads me to the idea of like, truly what leadership and highperformance are and what they mean. Right? Because I think regardless of how one defines themselves, if they resonate with being a high performer say, what does that really look like, if I've ever read this amazing book on on high performance, and at the core of it is satisfaction and is an is health and the ability to like, take care, because there is no leadership there, there is no ability to serve your family, or your business or your friends or your community or whoever, without, like you said, putting your oxygen mask on like, like fully in your state, like embodied and in the best possible state. 

 

Tonya Papanikolov  1:02:43

And every organization should want people in that state. And like, look, I totally, totally get there's hard times and businesses like I've gone through it. There's ups and downs, it's way easier said than done. But there's definitely like the possibility to create those cultures, where like, and we can recognize that, like highperformance is also space. And it's like space, it's like, there's space to decide how to show up. There's like, yeah, there's reaction. And then there's like, you know, the stimulus, Reaction Response. There's like all of these decisions that we make. And there's maybe even also like the reframing, like if you want to call it like, Oh, I'm actually a high performer. And this is why I'm burned out and like, that's like maybe a fun reframing way to be like, Look at how much I can do. And now I just get to really decide how how to work smarter, not harder, and be more effective, like truly be more effective for myself and others. Exactly.

 

Dr. Melissa Cugliari  1:03:44

And I think like, on that note, too, there's so many little lifestyle factors that contribute to this feeling of burnout, there are like, easier fixes to continue being high performer, right. Like, let's say you're a high performer at work, and you want to continue to be when you get there. I mean, that can look different for each person, and we can shift how that looks for yourself to a lifespan through career span. But it's also like, Okay, if I want to do that, then I can't under eat. Or, you know, I can't over exercise. Yeah, or I can't under sleep. Like maybe sometimes you have deadlines, whatever it sure occasionally. But it seems like consistent patterns that are draining, they're withdrawing from the bank account, and other things are going to suffer. And then our perception of other things suffer too. Like we start to see work as more of a drain and this highperformance this way of being is harder than maybe we do at other times. 

 

Dr. Melissa Cugliari  1:04:44

And really when we're depleted. The research shows like we are different. We're different people when we're depleted than we are when we are replete, and we feel like we have energy. So the little things can make a big shift Eat. And yeah, ultimately like taking stock of of you and what works for you. And sometimes listen, I know there's maybe people listening to this who are like, I don't have time for I'm exhausted, I don't have the energy to even take stock of like what I'm doing to deplete myself. And that's where you start really small. Like I said protein, make sure you're having protein with each meal. Maybe that's, I mean, if we're going to talk supplements for a second, I don't know if that's something you're interested in at all. But yeah, we like vitamin C, 2000 milligrams a day. Vitamin C is actually really cool. I don't know, like, I know, we talk a lot about supplements. And I'm always hesitant to like, generally prescribe anything. So of course, check with your medical provider before adding anything that Vitamin C is like a pretty easy one. 

 

Dr. Melissa Cugliari  1:05:47

Most people are okay with it, and people do it anyways. And it's a really nice tool to help with burnout recovery. Because the way the adrenal glands work is they have a really high such like they require a lot of vitamin C. So when we take enough, it can help us recover from that burnout state give us more energy over a week, like let's say four to six to eight weeks. So that then we can step back and say okay, like how do I now I have a bit more energy, how do I want to structure my life so that this doesn't happen again, or that I enjoy it more, etc. So like simple things, protein, vitamin C, 1000 milligrams twice a day, that alone will will move the needle. A lot of people don't want to give permission to the simple things like they don't want to say oh, it's that simple that there's no way right like there's no way backboard. But it works. And I see it in practice. And I've seen like some people really far on the burnout, like range, where they've been hospitalized for various symptoms, you know, they they are not in touch with fat, like, it's like really can get really intense. But the simple things can make such a shift and other ones like magnesium. 

 

Dr. Melissa Cugliari  1:06:58

Magnesium is a great tool. glycinate form is what most of the research and burnout is done on. And when we're more stressed or body liberates more magnesium, we urinate more magnesium out, we're already most most most of the population is already deficient. So like a simple supplement, magnesium glycinate each day 200 to 400 milligrams can be super helpful. So even like those three things, have a bit of protein in each meal, vitamin C, some magnesium and then do that for a month. Then that'll build your energy. So just talking to those people I was saying like who are just so burnt out, they can't even think about some of that stuff. Start small. Start small and it's it's possible it's always possible to come out of that state. That's

 

Tonya Papanikolov  1:07:43

perfect. Perfect bite size. I feel Yeah.

 

Dr. Melissa Cugliari  1:07:49

I don't like making it too complicated. Simple I find for now we'll just with the complexities of our own health care and and all the things right so it can it can be really simple. Yeah.

 

Tonya Papanikolov  1:08:02

Yeah, that there's there's so much in this I could like yeah, you're such a wealth of a wealth of knowledge. Is there anything? Anything that you're doing right now, just on a personal note to support yourself through this?

 

Dr. Melissa Cugliari  1:08:16

For sure. I mean, I think one thing I think for me, I've done the supplements I've done all the like, surface level stuff. I'm very good at doing that. But for me right now what I'm working on are some of these like deeper patterns and boundaries. We've talked about one thing I'm working on is my screen time. So I don't sleep with my phone next to my bed. So that's good. I'm usually quite good like you know before bed, but I just find my evenings like I've been reading a lot about this kind of like revenge procrastination trend about that, you know, we're at the end of people's days, they finally feel like they have a bit of time for themselves and it's like, Well, I gotta watch one more episode because well screw it, you know, like I've been busy all day and it's 11pm but too bad I'm gonna do this for me. 

 

Dr. Melissa Cugliari  1:09:11

And I fell into that where I'm like, oh my god, I'm just exhausted. I just want to watch another episode or I want to scroll a bit longer oh, five more minutes, which turns into half an hour. So anyways, I've been really trying to be impeccable with my screen usage. Setting timers like like urns rather than me not setting the timer but having those kind of fail safes on my phone where it like notifies you after 15 minutes of use, and really trying like I don't use like I try not to use my screens within an hour of waking in an hour before bed, because certainly that impacts all of our normal melatonin production cortisol there. Those are kind of like they have an inverse relationship. So when you're using screens too close to bed, the melatonin production, that hormone that helps you fall asleep is not as Strong already, that's naturally decreasing as we age. So I'm like, Okay, I don't want to. Yeah. 

 

Dr. Melissa Cugliari  1:10:06

So I'm trying to be very clear about screen tech, like screen uses. But also what I'm looking at, I think is huge. And there's some interesting research too, that I came across not too long ago about burnout, and how what we see around us can impact that. So for example, people who didn't have screens, you know, a few decades ago, the way we do now, they live in a certain neighborhood, within a certain cultural community, whatever it may be. And those are the people you see, those are the people you spend your time with. Those are the people that you relate to. Now, with social media, we see all different types of lifestyles, we see all different types of people from all over the world living in different cultural areas, and of different backgrounds, of different socioeconomic status, educational backgrounds. 

 

Dr. Melissa Cugliari  1:11:00

So now the point of comparison, because it's human nature to kind of compare, because we do want to fit in, that's a way we, you know, it's a survival mechanism. It's a mammalian brain, so we're naturally going to do that. But now the comparison pool is just so broad. And I see this with patients too, right? Like the social media creep can really, that that person is happening subconsciously, so many hours of our days is we're consuming media, the more we do that, and this comparison to others, kind of outside of our natural communities, is causing burnout in itself. So for me, I'm thinking, Okay, if I want to preserve my energy, and preserve my energy to serve people in a real way, like in my work, and my family, etc, like social media is one of those if going back to the bank account, that's a huge withdrawal. 

 

Dr. Melissa Cugliari  1:11:51

For what? Right? Like, of course, there's benefits to social media and having access to information, everything, but it cuts both ways. So I think for me, right now, I'm really just trying to tease out what works for me and what doesn't, and really trying to be mindful, like, Oh, how did I feel after I was just on my phone for 10 minutes on my lunch break? Or, you know, before bed, like do I feel overstimulated, you know, in the morning, those types of things, so not just like my screen time, but also like what I'm consuming, it's been a big focus for me lately.

 

Tonya Papanikolov  1:12:26

That's so helpful. Such a good reminder to hear and I think the made a little list of like, things I'm leaving behind. In 23. And a year I'll share them because I, you know, what, like, they're just, it's good. It's

 

Dr. Melissa Cugliari  1:12:46

okay, as what you're doing, I'm curious to okay, this is why I'm cast, but I want to

 

Tonya Papanikolov  1:12:52

share, okay, so letting go of these three, three things in 2023. Number one, people pleasing. Oh, yes. We get lost, we get lost in the other in the other person, especially as, like, in human design. I'm a projector. And so I have to, like, particularly be pretty aware and cognizant of this. But like, the ability, you know, and like I have, I have good boundaries. This is not to say like, I feel like, yeah, it's been a work in progress, but there's dynamics, where it plays out, right? Peoples, whatever, specific situations. So no more, no more. Yeah, being nice. With simultaneously displacing myself, Yes, owning who I am owning my voice. And in that, like, the, my feminine way of, of being, of being letting go of anger, which is, like just moving energy out productively, and I would not like I don't have an I'm not I'm not like, I don't have an anger issue specifically. 

 

Tonya Papanikolov  1:13:55

But I just think it's, it's such a productive emotion. And I've experienced a lot of frustration. And yeah, just like, calling that out and, and having productive ways to move my body, use my breath, move that out. And then the other one is comparison. So really like looking within understanding myself, and not comparing myself and my journey to the rest of the world, because what I what I like, you know, if I'm using human design, specifically in in writing this and in kind of like, these, like aspects of what I'm letting go of, it's not comparing myself to a world of generators that just operate in a different way. And I think what I'm working with on all of this, like, those are kind of like, yeah, people pleasing, anger comparison, like really being aware and journaling and just like diving into those. And then the other part of it is really like analyzing narrative, right? Because like, all of this, all of this way of being and And like what you said earlier about facial patterns. These are perception patterns, mental patterns, behavioral patterns. 

 

Tonya Papanikolov  1:15:10

And I'm just like, I have fallen into things as we all do. We're in new situations we're coping, we're dealing with all sorts of things. And I simultaneously I'm like, no, like, that's not the narrative that I want to subscribe to, like, okay, yes, I've like, I'm so much stronger. And I've gone through this. And I've, I'm working through things and challenges and like growing from them, but also, what is the true narrative of how I want to live. And if I'm a role model, a true role model, then it's like, well, a being honest, that I that I'm going through, like our time, or that, you know, the issues that I'm want to share a go or, you know, like, open up conversations around just because I think they're necessary for all of us so that we can all like heal and learn and grow together. But it's like really being like, Oh, well, that's not the experience that I was here to create in my business. 

 

Tonya Papanikolov  1:16:07

And it's totally okay, that I fell into that pattern, because we all do it. And it's very natural. But I also have the awareness to say, like, let's make this as good as we can. And you kind of have to go there to know that you don't want it. But I'm feeling like that whole net, this whole narrative around time is just really something I'm digging so into right now. And, you know, we've all we've come out of this like collective phase of these past three years, and also, the series of eclipses that I believe there was like the series of eclipses in Taurus Scorpio, teaching us something like quite profound, and these past two years, and November marks the passage of the end of that period. And I feel that there's this sense of being on a precipice of new change, at least for myself, personally, and a way of looking back and saying, Wow, everything I've done up to this point has gotten me here. And I'm so grateful for that. But now I have the opportunity to write a new story forward, and how can I learn from my mistakes and create a new reality for myself and others? And that's what I want. That's what I'm stepping into in 2024. And I'm not saying it's gonna be perfect by any means, but like, that's helping me with, I think fueling some like regenerative spirit and energy in me, that is helping craft a new version of things.

 

Dr. Melissa Cugliari  1:17:36

I love that. That makes me feel hopeful. Yeah, I really felt that shift in december two away from whatever was brewing a couple of years, astrologically, whatever, what have you. But I think that's so lovely, like really just reflecting like we were talking about at the beginning, having awareness. What types of things? Would you like to move through anger, comparison, people pleasing? And ultimately, like, what do you want your life to look like? Like, what are the values you have? Now? What are the what's the narrative? Like you said, How do I want to feel? I think that's so important to take that time to do that. 

 

Dr. Melissa Cugliari  1:18:25

Now, as an entrepreneur, I always talk about kind of phases of nature cycles and seasonality. And when we look at nature, right now, we're entering kind of like a hibernation moment to nature. And I think as humans, it's important to honor that as well. And kind of like, go inward, do a bit of reflection. Journaling is a great thing. I've been doing that a lot to myself lately, leaning into that. It's a great way to process things. Because sometimes we like we're talking about holding things in like into in the face or having these patterns, perceptions that we hold on to having things to kind of move through that journaling, or, you know, physical movement is another good one, talking to, you know, a competent, a support system, whomever these sorts of things help us. And now, like, that's the best time of the year to do them. So I love that it feels right. You know, you just Yeah, yeah, totally.

 

Tonya Papanikolov  1:19:22

Well, I love love chatting with you, as always, and I'm so grateful for this conversation and our time together. Thank you so much for sharing this, like just I feel like you just wrote a novel in this episode, but like, that was so much and I'm so grateful. What is one prayer wish intention, parting words you would like to leave with the audience.

 

Dr. Melissa Cugliari  1:19:53

I think the thing that stands out to me most especially after this conversation is just keep it simple. I think that is a prayer for myself for those around me not feeling the pressure to overextend. Add more in necessarily, and just keep it simple. Do what feels right for you. I think that would be my beautiful.

 

Tonya Papanikolov  1:20:19

Oh, yeah, that resonates very deeply. Thank you. Yeah. Thank you so much. Dr. Melissa,

 

Dr. Melissa Cugliari  1:20:25

thank you for having me. It was such a pleasure. This is the best. It's

 

Tonya Papanikolov  1:20:29

the best I love. I love the podcast. How can people find you and reach you?

 

Dr. Melissa Cugliari  1:20:35

Yes. So you can find me on my website or Instagram. Same thing. Dr. melissa.co. Yeah, that has more about me my services, we're gonna launch some fun things in the new year, a product and an online shop. So that'll be nice so that people can access some of what I offer that

 

Tonya Papanikolov  1:20:57

way. Yeah. It's so exciting. And you offer virtual sessions as well. So I do yes, various places. You got

 

Dr. Melissa Cugliari  1:21:05

it in person or virtual. That's one thing from the pandemic. I'm so grateful I did virtual care before but it wasn't, you know, it definitely didn't have the steam it has now and it's just makes it so much more accessible for

 

Tonya Papanikolov  1:21:17

people. Totally. Okay, well, thank you so much again, and I look forward to seeing you very soon.

 

Dr. Melissa Cugliari  1:21:26

Likewise, thank you again for having me. It's such a pleasure.

 

Tonya Papanikolov  1:21:31

With deep gratitude. Thanks for tuning into this episode. If you liked it, hit subscribe and leave us a review that is always very appreciated. Mushrooms transformed my mind and body. And if you're interested in bringing medicinal mushrooms into your life and health journey, check out rainbo.com for our meticulously sourced Canadian fruiting body mushroom tinctures. Until next time, peace in and peace out friends.

 

Keywords:

burnout, cortisol, balance, burnout recovery, healing burnout, self improvement, hormones, supplements, nervous system, stress, adrenaline, energy, protein, naturopathy, naturopathic doctor, lifestyle, mindfulness, personal boundaries, prevention, Dr. Melissa Cugliari