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Therapy is an essential component of mental health care—but for many patients with anxiety and burnout, symptoms are driven by biological factors such as stress hormone dysregulation, inflammation, metabolic instability, and nervous system overload. Without addressing these medical contributors, therapy alone may offer insight without resolution.
At Patients Medical in NYC, physicians combine medical evaluation with integrative care to treat both the mind and the body.
Therapy can be incredibly valuable.
It helps patients:
- Understand emotional patterns
- Process stress and trauma
- Develop coping strategies
- Improve self-awareness
Yet many patients still say:
- “I understand why I feel this way, but my body won’t calm down.”
- “Therapy helped emotionally, but I’m still exhausted.”
- “I’m doing everything right — why do I still feel anxious?”
These experiences point to a critical reality: not all anxiety and burnout originate in the mind.
Anxiety and Burnout Are Often Biological States
Anxiety and burnout frequently reflect physiological dysregulation, including:
- Stress hormone imbalance (cortisol)
- Nervous system overactivation
- Blood sugar instability
- Inflammation
- Thyroid dysfunction
- Hormonal shifts
- Mitochondrial fatigue
Therapy does not correct these biological processes.
When Therapy Works Best
Therapy is especially effective when:
- Emotional triggers are primary
- Trauma processing is needed
- Relationship stress is central
- Thought patterns drive symptoms
In these cases, therapy can be transformative.
When Therapy Alone Falls Short
Therapy may not fully resolve symptoms when:
- Anxiety feels physical, not emotional
- Symptoms occur without clear triggers
- Fatigue persists despite emotional insight
- Panic occurs “out of the blue”
- Sleep disruption continues
- Brain fog and exhaustion dominate
These patterns suggest medical contributors.
Burnout Is Not a Coping Failure
Burnout is often misframed as:
- Poor boundaries
- Lack of resilience
- Emotional fragility
In reality, burnout reflects:
- Chronic stress hormone activation
- Nervous system overload
- Reduced recovery capacity
- Metabolic and inflammatory strain
No amount of insight can override a body stuck in survival mode.
The Role of Cortisol and the Stress Response
Cortisol governs the stress response.
When cortisol rhythms are disrupted:
- Anxiety increases
- Sleep worsens
- Focus declines
- Emotional regulation falters
Patients may intellectually “feel fine” while their body signals danger continuously.
Why Insight Doesn’t Always Equal Relief
Patients often say:
“I know I’m safe — but my body doesn’t.”
This disconnect occurs when:
- Stress hormones remain elevated
- Blood sugar drops trigger adrenaline
- Inflammation sensitizes the nervous system
- Hormones amplify emotional responses
Therapy cannot normalize these signals.
Case Example: Therapy Without Resolution
Patient: 41-year-old NYC professional
Symptoms: Anxiety, exhaustion, insomnia
Care Prior to Patients Medical:
- Weekly therapy
- Mindfulness practices
Patients Medical Findings:
- Elevated nighttime cortisol
- Insulin instability
- Thyroid signaling disruption
Outcome:
Medical treatment stabilized physiology, allowing therapy to become effective again.
Why Medications Alone Aren’t the Answer Either
Psychiatric medications can help some patients, but they:
- Do not correct hormonal imbalance
- Do not repair metabolic dysfunction
- Do not reduce inflammation
- May mask symptoms without resolution
Best outcomes often occur when medical and psychological care are integrated.
The Brain–Body Connection in Anxiety
Anxiety is amplified by:
- Gut inflammation
- Immune activation
- Hormonal fluctuations
- Nutrient deficiencies
- Poor sleep quality
These factors influence neurotransmitters directly.
How Patients Medical Approaches Anxiety & Burnout
At Patients Medical, evaluation may include:
- Cortisol rhythm testing
- Hormonal balance assessment
- Metabolic and insulin testing
- Inflammatory markers
- Thyroid signaling
- Nutrient status
- Sleep and recovery evaluation
Care is physician-led, data-driven, and individualized.
Therapy Works Better When the Body Is Supported
When biological stressors are addressed:
- Anxiety becomes more manageable
- Therapy becomes more effective
- Emotional resilience improves
- Sleep and energy return
- Burnout recovery accelerates
This is not an “either-or” model — it is integrated care.
Who Benefits Most From a Combined Approach?
Patients who:
- Have persistent anxiety despite therapy
- Feel “wired but tired”
- Experience burnout and fatigue
- Have normal basic labs
- Want root-cause answers
- Prefer physician-led evaluation
FAQs
Q. Does this replace therapy?
Ans:No — it complements therapy by addressing biological drivers.
Q. Is anxiety always medical?
Ans: No — but medical factors are frequently involved.
Q. Do you prescribe psychiatric medications?
Ans: When appropriate, but never without deeper evaluation.
If you’ve done the emotional work but still feel anxious or exhausted, your body may be asking for medical attention.
At Patients Medical,
Dr. Rashmi Gulati, MD and Dr. Stuart Weg, MD combine integrative medicine with medical psychiatry to treat anxiety and burnout at their roots.
📞 Call 1-212-794-8800 to schedule your appointment.