Secret Signs of Struggle
During a recent conversation about the increasing prevalence of mental health screenings, when my therapist mentioned that they didn't seem to work well as a gauge for me anyway (so he takes a different approach), I wondered why.
Truthfully, I had already noticed that the typical depression and anxiety screening questions seemed to miss for me but, since I have a great relationship with my mental health providers, I hadn't given it much thought —So I started paying attention.
A Quick Head's Up
While I won't go into too much detail, I am going to talk briefly about disordered eating and some other forms of self-harm. If topics like this can be triggering or make you uncomfortable, you may want to skip this one or have someone you trust read it first.
What You'll Find in this Article
This exploration follows a predictable pattern I've observed in myself over the years —a roadmap of sorts that traces the journey from early warning signs to full burnout. I've organized these observations into four distinct phases:
Phase One: Vanishing Rituals - When the small, soul-feeding habits quietly disappear
Phase Two: Sounds of Silence - The gradual elimination of joy and pleasure
Phase Three: The Box Trap - Frantic attempts to regain control that backfire
Phase Four: A Healthy Disguise - When harmful behaviors masquerade as wellness
How to Start Your Self-Anthropology Practice - A gentle beginner's guide to recognizing your own patterns
Each phase represents a deeper level of disconnection from myself, and understanding this progression has become crucial for recognizing when I need to pause, reassess, and reach for help before I'm too far down the road to find my way back.
In general, I'm fortunate to have a relatively positive disposition, a characteristic that I think has pulled me through many hardships where I might otherwise have gotten stuck and done some real damage. I'm both observant and silly, and a natural curiosity keeps me easily amused by finding joy in little things —which helps a lot when all the big things seem bad.
I've always been an observer of sorts. Being the eldest sibling in a large family, combined with a homeschooled upbringing where I (happily) spent the majority of my time with books, meant that writing quickly became my primary mechanism for making sense of it all. I've been practicing self-anthropology since long before I learned the term.
Imagine my bewilderment at the realization that the tools designed to do this very thing —observe signs of distress— were missing the mark.
These screenings cast a wide net to catch the most universal indicators of a mental health decline, with the goal being early detection and intervention to prevent crisis. But what happens when your personal warning signs aren't on the universal checklist?
Well, you make it to your thirties before anyone realizes you're neurodivergent, for one.
But why did this wide net let my struggles slip through for so long? Why does it still?
The answer lies in understanding how a neurodivergent nervous system responds to overwhelm differently than the textbook samples are designed to catch. My personal warning signs don't look like the universal indicators because they're filtered through the unique ways my neurodiverse brain processes stress, time, and self-worth.
Finding the Answers
I began to observe my symptoms during tough periods, and looking back across the span of my life for patterns —the reasons why they slipped through the net became clear rather quickly.
All of them are rooted in two deeply connected narratives that grow like weeds in the ashen soil of burnout, until they run on a constant loop in my brain:
The Now: "I don't have time. I don't have enough time. I can't have enough time. I'll never have enough time."
The pervasive feeling that I am behind, that I have always been behind, and that I always will be behind unless I keep going. I must push forward, push through, work harder, be better, be faster, be stronger, be smarter, want more, do more, be more.
No pain, no gain becomes literal as physical and emotional exhaustion escalate until I find myself somehow racing and against —and chasing— the clock in an anxious and thoroughly time-blind cycle I now refer to as The Panic Loop.
The Not-Now: "I don't deserve to. I don't deserve this. I'm not worth the effort. I'm not worth the energy. I'm not worth the trouble, because all I am is trouble."
An insidious, shame-fueled belief that I don't deserve to rest or experience pleasure —especially when there is always, always, something I "should" be doing. Something productive. Something that will help me be more, faster, stronger, better, or smarter. Something that will make sure no one ever finds out how lazy I secretly am.
And I am lazy. That's why I don't have time to rest, I haven't earned rest. Worse: I've probably used up all the resting time I get, I overindulged somehow, and this exhaustion is my penance. Exhaustion is what I actually deserve. I call this The Worthiness Gap.
Notice there are no questions in these narratives. Curiosity has been snuffed out, tamped down by the weight of anxiety. For me, this is a dangerous road. Without curiosity to light my way through the crooked darkness and back to myself, I am much more susceptible to following the fork in the road that leads to despair.
Of course, these particular narratives are mine. Your internal soundtrack of struggle might sound entirely different —perhaps it's a voice that whispers "you're too much" instead of "you're not enough," or maybe your panic shows up as perfectionism rather than time-blindness.
The specific content matters less than learning to recognize when you brain has switched from curious observer to harsh critic, and when hope has been replaced by that relentless internal pressure to just keep going.
What matters is that you begin to notice your own patterns, because the earlier you can spot yourself on that familiar road to burnout, the easier it is to take a different route.
Signposts
My personal Road to Burnout follows a predictable path, I've gathered the sneaky indications that I'm on that road into four phases: from warning signs to end-stage burnout —which you might consider "survival mode."
Phase One: Vanishing Rituals
Waking Up Early
The earliest warning sign. I wouldn't say I've ever chronically dealt with "trouble sleeping," as I typically fall asleep easily and don't do much tossing and turning, though I do need quite a bit of sleep (8+ hours) to feel my best. I seldom get this much, averaging around seven hours, but I can always tell a difference when I do.
As my base-level of anxiety increases, however, rather than struggling to get to sleep, I start waking up early. I mean like three in the morning. Wide awake, and unable to be still. With A Thing™ I must have forgotten tugging at the tip of my consciousness, a shoe full of consequences waiting for its chance to drop.
This sign is missed by questions that focus on "troubled" sleep. To my logic brain, waking up early doesn't register as having a tough time sleeping, as I sleep just fine, even for the shortened duration. And, here's another sneaky reason: I've been like this my whole life. It's not really that weird for me to wake up early at least once a week, even during less-stressful times.
Not Painting My Toenails
Okay what? Don't worry, you read that right. As a general rule I'm relatively well-manicured, though this is hampered a bit by BFRB stims like nail-biting and cuticle picking. But there have been few periods in my life during which I was not well-pedicured.
The rituals of caring for these extremities myself are among the few positive habits I gained from my mother. Who admonished my sister and I early on to do so, not just because we only get a single set of each, but also because they betray your age the soonest. I don't know if that's true, but I do find the rituals of massaging lotion into my feet and cuticles, and the mindful stillness of waiting for polish to dry, soothing.
This sign is missed because the typical screening questions focus little on self-care outside of the really important stuff like eating and sleeping.
Movement Without Recovery
My natural activity level gets me an average of six-thousand steps a day without trying. That's keeping house, running errands, using a desk treadmill while I'm working, walking my dog, and so on. (Trying usually gets me well over ten-thousand.) When my activity level dips below that number on a regular basis it's a sign that my priorities have fallen out of balance.
While some occasional shifting is normal and healthy in order to maintain balance, less overall physical activity is more often a red flag than a green one. It's an indication that a Panic Loop or Worthiness Gap has taken root and begun to grow, consuming the cognitive resources necessary to Do All The Things™ —and the first activities to fall off are usually the most important.
Why? Because they are the things I do just for myself, the things that feed my soul or give my brain the stimulation and dopamine (motivation) I need to do everything else.
Phase Two: Sounds of Silence
No Music
Silence is the herald of phase two. I have always been one of those people with such a reverence for music that it feels almost religious. It can transport me to a moment in time, or keep me grounded in the present. Even sad music can lift me out of the blackness of a bad day quicker than a pair of angel wings.
When anxiety and time-blindness have gone unchecked for long enough that a Panic Loop has started gaining traction, when every moment must be filled with productivity because I'll never catch up otherwise, I stop listening to music. Podcasts, audiobooks, and transcripts of educational materials quickly fill its space as I push to "optimize" every minute of the day.
It eventually reaches a point where it upsets me to listen to music for pleasure, because the joy it brings only sheds light on how disappointing it is to feel like I don't have time to savor it —making me feel even more powerless or ashamed.
This sign is missed because I never stop enjoying music. The comfort, joy, and energy of my favorite songs never lessens —they simply fall into the Worthiness Gap.
Inside Only
There is one exception to the no-music phase, and the gravity that pulls me toward this particular album can be a harbinger that arrives before other music stops. It's funny to explain, but there has been a clear pattern over the past few years that I can neither figure out nor deny.
The album is Bo Burnham's "Inside", which I will listen to on a loop. (If hamsters appreciate music I bet "Any Day Now" is one of their favorites.)
My relationship with this album is complex. "Content", "White Woman's Instagram" and "Welcome to the Internet" always make me smile (or giggle) in spite of myself. "1985" (from the Deluxe Edition) legitimately cracks me up every time and, along with "Feel Good", has made it onto several of my favorite playlists. Sometimes I do just listen to it for fun, and others it's even how I find my way back.
But when I start listening to it on a loop, or favoring the more emotionally charged tracks (even when it's ironically) like the "Bezos" series, "Look Who's Inside Again", "Goodbye", and "That Funny Feeling", I know I need to look for other signs.
I realize it's strange to put so much weight on a single album, but I decided to share this sign because it exemplifies the whole point of self-anthropology: to notice our own patterns, no matter how unique, and learn to read the secret signs they bear.
No Fun Books
The same thing happens with books as with music. Typically I read quite voraciously across a wide range of genres. As a lover of stories I feel no shame in going from a psychology textbook, to Emily Henry's latest, to Jeff Vandermeer's Area X series, Jane Eyre, Norse Mythology, or social media's current favorite smutty fae series —and back around again.
But, once I'm caught in the hamster wheel of a Panic Loop, everything but the textbook falls off. If I'm not consuming to learn, then that consumption is a waste of time. Time that I don't have because I'm lazy, and I've already squandered it elsewhere. On top of that, I'm so exhausted from constantly being on the wheel that, when I do finally have a window of opportunity to be still and read for pleasure, I fall asleep before I finish a single page.
This sign is also missed because I never stop enjoying any reading that feels fun. It just feels too indulgent to allow myself the time.
No Games
Video games have been a constant in my life for as long as I can remember. Strangely, unlike the presumably positive habits I will discuss in phase four, I have never developed an unhealthy relationship with video games. Counterintuitively, games have been the most accessible way to keep my mental health afloat through some of the darkest periods of my life.
In 2016 I started playing Stardew Valley, and found my spiritual home. It quickly became, and has remained, the first place I go when I need to pause and reset ever since. The pilgrimage to peace always begins on my couch, and most of my friends will tell you I "always go back to The Valley."
When I stop going there, it's a clear indicator that things are bad. I have hit the slippery part of the sloped road to burnout, who waits patiently just around the bend.
Many of the most common screening questions focus on the reduced enjoyment or interest in activities usually done for pleasure, clinically known as anhedonia. This is not the problem for me, time is.
Phase Three: The Box Trap
Over-Planning (and then not following the plan)
By the time I catch myself thinking "I don't really have time" for the soul-feeding activities in phase two, I know I need to do something. I know I'm on the treadmill of anxiety and the speed has exceeded my comfort level.
My first instinct is to reach for the controls. So I start planning, take way too much time to make an overly-ambitious and highly detailed plan, and then promptly fall flat on my face trying to execute it because the Panic Loop has sapped the energy I need to see it through.
It's not the worst strategy, and at least it's doing something rather than giving up, right? But the times I have caught myself doing this and instead taken a purposeful pause, to evaluate the situation before taking one small action at a time, have been immensely more successful.
This sign is missed by screening questions that focus on the outcome more than the catalyst. During the planning process I don't feel depressed or hopeless, planning gives me hope! I'm going to fix this! Hope gives me energy, so I don't feel lethargic or have a tough time focusing on the plan.
"I just need to make a list."
There's a special place in my heart for lists, and I love a good brain dump. But —when reeling from The Grand Plan's failure to launch— I have a tendency to overcorrect. I'll make a list that is either too detailed or too vague, one activates Major Minor (decision fatigue) and the other The Gatekeeper (task paralysis). Without the cognitive energy to prioritize the list I'm likely to either just start swinging wildly in the hopes that something gets done, or not start at all. Both leave me feeling exhausted and ashamed.
This sign is missed because, again, I'm doing something rather than nothing. Trying a new tactic is still trying. My activity level also tends to stay relatively static during this phase.
Mean Girl
As things stop falling into place, or start slipping through the cracks, my tendency to internalize blame creeps back in and slowly escalates the negative self-talk I have battled since my youth. Feeding an insidious cycle of shame.
This cycle typically peaks right around the time someone who cares for me decides I need a "tough love" pep talk, which unwittingly throws me into the pit of the Worthiness Gap. I isolate with my struggles, and stop reaching out for social support. The narrative that no one can help me anyway (and even if they could, why waste the resources on someone contributing so little to society?) begins to solidify.
This sign is hidden on purpose. By fully masking my struggles I can project an image of wellness that fools almost anyone, even convincing myself that everyone cries during their commute or in the shower most days. That it's not only normal (yay, normal!) to live at your maximum capacity for exhaustion, but totally okay! Relatable!
Phase Four: A Healthy Disguise
Not Eating
Stress does weird things to my body. But one of the most normal things that happens to me is stress-eating. So, when that mechanism boomarangs back around and I just... Stop getting hungry...? It's often a welcome surprise.
Having to fuel this meat mech so often is exhausting. Aside from the eating itself, there's the planning, shopping, storing, preparing, and cleaning up. It never ends. By the time I reach phase four I'm cutting out anything I can to save the precious dregs of my time and cognitive energy. So cutting back on all of the above without it feeling restrictive feels like a win.
Don't worry, I know it isn't. It contributes to a range of compounding symptoms, especially emotional dysregulation.
This sign is willfully ignored. Sure, my appetite has changed, I can answer the question truthfully. But, in a society that places significant value on slimness and self-discipline, eating less is easily spun into something positive —even admirable.
Running
By this point I'm so crippled by anxiety and poor self-worth that I feel stuck. Caught in a trap of my own making. Depression sidles up and begins to make itself at home. The light of hope dims as the tunnel of existence stretches to unfathomable lengths. A life in which I see myself generously helping others while honoring my capacity feels like a frivolous dream.
Faced with the reality that I may never be allowed even a small portion of this life, and that somehow I failed to get myself onto the correct path, I spiral. Bursting with the manic energy of an animal caught in a trap, I do the only thing I can. I run.
Literally. Until it hurts to keep going.
There are elements of self-hate and self-regulation at play here. A desire to make the mental anguish physical so I can feel something that makes sense, and then be too physically exhausted to care —but also the illusion that I deserve this pain.
This sign is missed because it looks healthy. Compared to many other coping mechanisms it also feels healthy; I'm hurting no one but myself and getting physically fitter in the process, so it can't be all that bad. Soon, people stop asking how I am, and start commenting on my body: "Hey, you look great! What have you been doing?" and "Oh I wish I were a runner, but I could never be that disciplined —you look incredible though!"
Again, societal expectations make sure no one's the wiser.
Checking Out
The Final Narrative: I'm overwhelmingly busy and have so many things on my plate that I don't have time for connection, no matter how good it might be for me or the people I care about. I can't help anyone anyway, I just need to get through this —so I can't let anything distract me.
Phase four is end-stage burnout, and its signs are all the most dangerous because they are socially acceptable forms of self-harm.
Staying in this phase means losing supportive connections, and isolating in survival mode. Existing on autopilot because that's all I can do.
So far, I've always eventually found a way out, but the heartbreaking reality is that not everyone does.
What does all of this mean? Why do these hyper-specific, but nearly undetectable, signs emerge?
These symptoms are indications of a profound mismatch between a neurodivergent nervous system and a world that wasn't built for it.
Many of these signs are rooted in a disconnect from the self.
A muted sense of interoception means my body's internal distress signals —like hunger, fatigue, or pain— go unheard, like a smoke detector with a dead battery.
At the same time, alexithymia can make it difficult to accurately label the emotions I do feel, often translating a complex state like "overwhelm" into a simple and harsh judgement like "I'm lazy."
That internal confusion is then managed by my brain's swamped "front office" —my executive functions. Which, in this heightened state, default to the unhelpful spirals of planning-paralysis and avoidance in the Box Trap of phase three.
This all plays out on a distorted stage set by time-blindness, a warped perception of time that feeds the constant, frantic panic of feeling behind.
The standard questions can't possibly measure the intricate workings of this internal storm, they can only ask about the weather after the house has already been washed away.
Your Self-Anthropology Practice
You don't need a psychology degree or years of therapy to begin observing your own patterns —you just need curiosity and patience with yourself. Becoming more aware of our impulses, focus patterns, and emotional triggers helps us regulate our actions and behaviors, but they key is starting small.
Here's how to start:
Track the small stuff: Start by noticing one tiny habit that typically brings you joy or comfort. Maybe it's your morning coffee ritual, listening to a particular playlist, or the way you arrange your workspace. When the small thing starts feeling like too much effort, or gets skipped repeatedly, pay attention.
Notice Your Energy Patterns: A practice like this — pausing to reflect and evaluate your coping strategies — helps you anchor yourself in the present and make choices from a place of agency, rather than urgency. Keep a simple note in your phone about your energy levels at different times of day, or how certain activities leave you feeling. You're not looking for perfection, just gathering enough data to spot patterns.
Listen to Your Narrator: What story is your brain telling you about why you feel the way you do? Is it curious (I wonder why I'm so tired today?) or critical (I'm being lazy again)? The shift from wondering to judging is often a sign that something needs attention.
Find Your "Inside" Album: That thing that draws you in when you're struggling, even if you can't explain why. It might be a specific show you rewatch, a particular type of content you consume, or an activity that feels simultaneously comforting and concerning. There's not shame in having these patterns —they're information.
Avoid focusing on stopping these patterns from happening (spoiler alert: you won't), just recognize them as the early warning system they are. For those of us who are neurodivergent, self-monitoring can provide a sense of control and stability, especially when the world feels like it's moving to fast or asking too much.
Remember: this process is about understanding yourself, not fixing. There's a massive difference. Start by approaching your own patterns with the heartfelt compassion you'd offer a dear friend in need. Because that's exactly who Future You is.
I decided to share this today because, for countless reasons, it is more important than ever for us to observe our own signs and learn our unique patterns. We need to arm ourselves with knowledge that it would take too long for someone else to glean, so we can lean on our strategies and ask for the right kind of help when we need it.
We need to learn to advocate for ourselves, and one another, before it's too late.