Your Body Doesn't Know You're Crushing It: The Hidden Cost of High-Functioning Stress (Guest Post Jacob Mergendoller, LCSW)
GUEST POST
Written by Jacob Mergendoller, LCSW. Jacob is a therapist and founder of LightLine Therapy, a psychotherapy practice in New York City. Jacob specializes in working with men, high-achieving perfectionists, and work stress/burnout.
I've had some version of the same conversation with clients many times. They walk into the office, take a seat, and I check in with how they’re doing.
"Honestly, not that bad! Work's busy, but I'm managing."
They’re usually successful at work and being busy is the norm. They're financially comfortable, they're dependable, and they have a lot of responsibility. And by most measures, they’re right: they are managing. They're meeting the deadlines, getting the promotions, taking care of their families, and generally doing everything they're supposed to be doing.
But then we move past the fluff and they mention things like they’re sleeping six hours a night because they can't turn their brain off. It’s been months since they’ve had a weekend where they weren't thinking about work. They have a hard time sitting through dinner without checking their email. They just started seeing a physical therapist because their shoulders are constantly tense.
Most of these high-achievers don't consider themselves particularly stressed because they're still getting everything done. But when I ask when they last felt genuinely relaxed, they usually struggle to remember.
Some of the people experiencing the most chronic stress are also the people who are best at functioning through it.
And when you're really good at handling pressure, it’s hard to recognize how much it's actually affecting you.
Being Good at Handling Stress Doesn't Mean You're Not Stressed
A lot of the high-achievers I work with have spent years, sometimes decades, developing an impressive ability to operate under pressure. And because they've been doing it for so long, it starts to feel normal.
Think about someone working in a demanding corporate environment. They're surrounded by people who answer emails at 10pm, work through lunch, and talk about how little sleep they're getting like it’s a badge of honor.
After a while, those things stop registering as signs of stress. They just become a natural part of having a successful career.
And if you're still performing well, what reason do you have to question it? This is where I think high-achievers can get themselves into trouble.
They're accustomed to evaluating how they're doing based on what they're accomplishing.
Did I get everything done? Did I meet expectations? Did I handle that situation well? Am I keeping up?
If the answer is yes, great! That means they're doing fine.
But there's a difference between being able to handle something and being unaffected by it.
You can be incredibly competent at your job while also being chronically stressed, anxious, exhausted, or disconnected from the rest of your life. Your ability to keep performing doesn't necessarily tell you much about what that performance is costing you.
Your Body Doesn't Care That You're Meeting Your Deadlines
One of the interesting things about stress is that your body doesn't evaluate your circumstances the same way you do.
You might look at your life and think, I have a good job. I'm making good money. I’m happy (for the most part). I have a lot to be grateful for. I really shouldn't be complaining.
And maybe all of those things are true, but your nervous system isn't particularly concerned with whether your career looks impressive on paper. It's responding to the demands you're experiencing.
When your brain perceives a threat or significant pressure, your body's stress-response systems become activated. Your heart rate may increase, your muscles tense, and hormones like adrenaline and cortisol help prepare you to respond.
This is useful when you need to deal with something challenging.
The problem is that for people in demanding careers, the demands don't really stop and even when the workday ends, the mental activity often continues. Your body may be physically removed from work, but your mind is still responding to it.
Over time, chronic stress can affect sleep, digestion, energy levels, muscle tension, and other aspects of physical health. Stress also interacts with immune and inflammatory processes, although those relationships are complex and don't mean stress is necessarily the cause of a particular medical condition.
For people already dealing with digestive issues, autoimmune conditions, or other chronic health concerns, ongoing stress adds another layer of difficulty.
And here's what makes this especially frustrating: you might be doing everything you're supposed to be doing. You're exercising. You're eating well. You're following your doctor's recommendations. But you're also spending most of your waking hours operating under pressure.
Your boss might think you're doing an incredible job. Your nervous system doesn't receive your performance review.
When Taking Care of Yourself Becomes Another Thing to Get Right
Something else I've noticed in my work is that high-achievers often approach their mental and physical health the same way they approach their careers. When there's a problem rooted in logic and rationale, they jump to solve it–generally, a pretty useful instinct.
But sometimes, the people who are most committed to improving their mental health can turn the process into another thing they're afraid of getting wrong.
They start monitoring and trying to optimize everything.
Am I getting enough sleep? Am I eating the right foods? Am I exercising enough? Should I be meditating? Is my cortisol too high? Am I doing enough to regulate my nervous system?
Before long, taking care of themselves is just like another full-time job. And if they're still not feeling better, they assume they must be missing something. Maybe they need to try harder. Research more. Find a better routine. Be more disciplined.
I think this is an important distinction, especially for people managing genuine health concerns.
Taking an active role in your health can be incredibly valuable. But there's a point where trying to control every variable can create its own kind of stress. You can become so focused on doing everything correctly that you lose the ability to experience any flexibility around it.
And for someone whose life already revolves around meeting high expectations, health can become one more area where they feel like they're falling short. Sometimes part of getting healthier involves examining the pressure you're putting on yourself to get healthier.
Sometimes the Stress Is Coming From a Life You Don't Actually Want Anymore
There's another layer to this that’s worth talking about.
Sometimes people come to therapy because they're stressed at work and want to learn how to manage it better. This usually looks like they want to stop overthinking, set better boundaries, improve their sleep, or feel less anxious.
Great, all reasonable goals.
But as we start exploring what's happening, we occasionally arrive at a more uncomfortable realization: they don't actually like their job anymore (or they just straight-up hate it).
Imagine spending your twenties and thirties going to the right schools, working the long hours, making sacrifices, all in the name of building a particular career for yourself. And then, somewhere along the way, you realize you're miserable. That's a really hard thing to acknowledge.
There's also the question of identity. If you've spent most of your adult life being the successful lawyer, the ambitious executive, or the person who's always moving up, what happens when you start questioning whether you want to keep doing it?
For some people, it's easier to keep pushing through than to seriously consider that question. So they focus on becoming better at managing their stress. But sometimes we're trying to become better at tolerating circumstances that deserve to be questioned.
That doesn't mean the answer is to quit your job or completely change your life. It just means being willing to consider whether the problem is entirely about how you're managing stress, or whether some of the things creating that stress need to change.
What Actually Helps When You're Used to Pushing Through?
I think one of the challenges with managing chronic stress is that a lot of the advice people receive assumes they simply need better habits (i.e. get more sleep, exercise regularly, practice breathing exercises–we all know them).
Sure, those things can be helpful, but if you're someone who already knows what you're supposed to be doing and still struggles to do it, another list of recommendations probably isn't going to change much.
I think it's often more useful to start by understanding the patterns that keep you stressed in the first place.
- Stop using productivity as your primary measure of well-being
If you're used to evaluating your life based on what you accomplish, try asking yourself some different questions.
How much effort does it take to keep everything running?
Can you disconnect from work without feeling guilty?
When you have free time, do you actually enjoy it?
Are you able to be present with the people you care about, or is part of your attention always somewhere else?
You can be getting everything done and still be struggling. It's worth paying attention to both.
- Get curious about what happens when you try to slow down
For some people, the hardest part of resting is tolerating what comes up when they finally stop.
Maybe you feel guilty because there's always something productive you could be doing. Maybe slowing down makes you anxious because you're worried about falling behind. Or maybe being busy has become a convenient way to avoid thinking about other things in your life.
If slowing down consistently makes you uncomfortable, there may be something more going on than simply having a busy schedule.
- Look at the patterns that keep recreating your stress
One of the things I focus on in therapy is helping people understand what their patterns are accomplishing.
Take perfectionism, for example. You might know you're a perfectionist. You might have read books about it, talked about it in therapy, and recognized that your standards are sometimes unrealistic.
But that doesn't necessarily mean you've stopped behaving that way.
Why?
Because perfectionism is probably doing something for you.
Maybe it helps you avoid criticism. Maybe it gives you a sense of control. Maybe you've learned to associate making mistakes with disappointing people or being seen as incompetent.
Until you understand what the pattern is protecting you from, simply telling yourself to lower your standards probably won't get you very far. The same applies to overworking, people-pleasing, difficulty delegating, and feeling responsible for everything.
These behaviors often developed for understandable reasons. Some may have even helped you become successful. But the fact that a pattern has been useful doesn't mean it needs to keep running your life.
Part of managing stress is learning when those familiar responses are genuinely helping you and when they're creating problems you no longer need.
You Don't Have to Wait Until You Can't Function
A lot of successful people wait too long to take their stress seriously. And it makes sense. When you're still getting everything done, it's easy to convince yourself that things aren't really that bad.
In the meantime, your body may be responding to a level of stress you've become so accustomed to that you barely notice it anymore.
You can be good at your job, proud of what you've accomplished, and grateful for the opportunities you have while also recognizing that the way you're living is taking a toll.
You don't need to wait until you're completely burned out or unable to function before taking that seriously. For many of the high-achieving professionals I work with in New York, therapy involves examining the patterns that have helped them succeed while also recognizing where those same patterns are starting to work against them.
Sometimes that means learning to set boundaries. Sometimes it means becoming more comfortable with uncertainty, letting go of perfectionism, or finding ways to motivate yourself that don't rely so heavily on anxiety.
And sometimes it means asking some bigger questions about the life you've built and whether it's still the life you want. The goal is definitely not to become less ambitious or stop caring about your career, but it’s to recognize that being able to handle everything doesn't mean you should have to.
If you're in New York and see yourself in this description, LightLine Therapy helps high-achieving professionals understand the patterns behind their stress and make meaningful changes.
Reach out for a consultation to learn more about working together.
Frequently Asked Questions
Can you be chronically stressed without realizing it?
Yes, people who have spent years operating in demanding environments may become accustomed to high levels of stress. They may continue performing well at work while experiencing poor sleep, persistent tension, fatigue, irritability, or difficulty relaxing. Because they're still functioning, they may not recognize these experiences as signs that stress is affecting them.
Can work stress affect your gut health?
Yes, the brain and digestive system communicate through what's often called the gut-brain axis. Stress can influence digestive processes, gut sensitivity, and gastrointestinal symptoms, particularly in people with certain existing digestive conditions. However, digestive symptoms can have many causes, so persistent or concerning symptoms deserve appropriate medical evaluation rather than being attributed to stress alone.
Why do I feel guilty when I'm not being productive?
For some people, productivity becomes closely tied to their sense of worth, competence, or security. If you've spent years receiving recognition for working hard and achieving things, slowing down may trigger feelings of guilt or anxiety. Understanding what productivity means to you psychologically can help you develop a healthier relationship with work and rest.
How can therapy help with chronic work stress?
Therapy can help you identify the beliefs, behaviors, and emotional patterns that contribute to ongoing stress. This might include perfectionism, difficulty setting boundaries, excessive responsibility, fear of failure, or tying your self-worth to professional achievement. Therapy can also help you develop strategies for managing anxiety, responding differently to stressful situations, and making changes to circumstances that are no longer working for you.
