What Women Need to Know About Burnout and Menopause

So you've read the menopause books, you had your hormones tested, you're eating right, you're doing all the same things, you're eating protein as if your life depended on it, and you even started on hormones, but you still don't feel well. Well, you might be doing a lot of the right things, but you're missing a big part of the picture. And today we're going to get to the nitty-gritty of what you're probably missing. I am spending part of my day today with Dr. Tonya Destang-Boberan, this author of Held and Healed. And we're going to talk about the missing link in your perimenopause, menopause, and beyond journey that you're probably not aware of. So, Dr. Tonya, I'm so happy to have you. I'm going to call you Dr. Bubbles because that's how I know you. That's fine. Yes. So, I want to get into the nitty-gritty because You know, everybody I know that's in the kind of functional medicine community, the alternative health community, it's mostly 'cause we ran into a wall. But your wall was a big wall, and I think it's what most women are experiencing today, and they don't know it. So tell me, take me back to that.

So that was my first experience with burnout. At the time, I did not know what it was. I just knew something wasn't right, and all my tests were normal. Mm-hmm. And physicians I'd seen with couldn't figure it out. And I found myself at the other end of a stethoscope, looking up at some of my colleagues and thinking, they're looking at me with that look. They've ticked off all the boxes, the tests are normal. I don't fit the mold of any other disease pattern, and they just, Can't figure it out. So guess what? The problem must be me as the patient. And 2 things happened then. I realised it was a little bit of a shame that I too had looked at patients that way, 'cause that's how we had all been taught. Yes. Disease first. The patient comes after, but the disease has to fit all the boxes. You tick them off and you write the prescription based on that. And the prescriptions weren't working, so something was wrong with me. Not anything else. And then I realized as well that the only person who would end up healing me was me. I had to take charge of my health, which I did. That's how I found functional medicine. That's how I realized I was in burnout. I found a doctor who actually had burnt out herself. Yeah. I'll never forget telling her that I finally, by divine guidance, I had found the last test I don't know where I had got it. It was in my office for adrenal health, HPA axis dysregulation. And it hadn't expired. It was like, I'm like, my gosh. I sent it out and I had flatlined. And I'm like, I was so happy.

You're like, yay, finally.

I was so happy. I'm like, so it's not in my head because, you know, if your labs are normal and the medication isn't working, something else is wrong with you. And I'm like, it's not in my head. I'm not going crazy. But then I have a diagnosis. What do I do? I didn't know what to do. So I found a functional medicine doctor and she looked at me, she says, it's gonna take you 3 years. And the nice, perfect Virgo looked at her. I'm like, I don't have 3 years. I've got, you know, we get cracking. We have things to do. I have life to live. I have patients to see. I have kids to raise. And she started me on— she just laughed. She just looked at me and laughed. Now I know why. And she looked at me with such compassion and having gone through it herself, she knew. And I started to cry. As soon as she said she'd burnt out, I thought, okay, so I'm not alone. 'Cause I was so ashamed that I had burnt out. Like, how could I have allowed myself to burn out? You know, I was a doctor, I should have known better. And this took me on a path of changing how I looked at healing. As well as changing how I looked at medicine. And functional medicine healed me, transformed my health and my life, and by extension, the lives of my patients.

Absolutely. So I wanna go into 2 things that you said there that's really important. And I think, you know, a lot of people perceive kind of functional medicine or integrative medicine, it's like, oh, I'm not gonna do medications. I'm gonna get this supplement 'cause the supplement is magical and it's gonna help. But when we're talking about burnout and adrenal, you know, dysfunction, And HPA axis dysfunction, it's not something you can supplement away. You have to do the other things that are really hard, especially for a midlife woman in particular to do, because we've got so much on our plate.

Yeah.

You know, and so what are some of the things that you personally did that you really feel like made major impact?

One, I had to acknowledge that I was not perfect and that I needed help. And I had to slow down and I had to rest, which was not in my vocabulary. I was going and I was juggling everything. I was Superwoman and I had to ditch the cape. And I then had to come to terms with the fact that I was living up to society's expectations of what I thought was expected of me. Nobody else had, they didn't actually said it, but I had bought into— The pressure. the myth of Superwoman. And I had to give myself grace. I had to forgive myself for doing instead of being. And I had to learn a whole new way of looking at life, which was hard. It was so hard for me. I mean, I would work half day and come home and nap in the middle of the day. Mm-hmm. And I kept thinking, somebody's watching.

Mm-hmm.

You know, somebody's gonna come after me and say, why are you sleeping? I just couldn't understand what was going on. Why couldn't I get better? I was in my 30s, I was late 30s. But what, it was the biggest blessing for me because it helped me become more in tuned with my body.

Mm-hmm.

I had to listen to the whispers because they had become screams by then. But once I started to heal, I started to listen. And I started to pay attention to what it was saying. And it was rest, and it was diet, and it was exercise in moderation, 'cause I was used to pushing myself. And I thought, I'm gonna exercise my way back to my weight, you know, my goal, and I'm going to diet. And, you know, the old myths that everybody would bought into. And I'm like, no, you have to sleep when you need to, and you need carbs. Mm-hmm. Carbs are gonna heal you, and carbs are not, you know, that bad for you if you have good carbs. And you need to give yourself grace. And if you want a bite of a cheesecake or a cupcake, which was my thing, then you're going to have some.

Chips and queso for me.

Yeah.

Or salsa.

Yeah, I've had that.

That's going to be one of the dinners on my last day on the planet. All right. I also want to go back because I think high cortisol, I know after 22 years in practice and everywhere I've been in my own experience, people are kind of aware of too much stress and cortisol being high. I think that's in the kind of, especially the American sort of mindset. But burnout is a different situation altogether, and it doesn't get the attention it needs because often the symptoms are what you would think would be high cortisol. You feel wired and tired, but you can't sleep, you can't recover. So you think, oh, I need to double down because I'm wired. And so let's talk about what's really happening with the HPA. And truly, when you say flatline, what does that mean? Because I think most people don't realize that that can happen.

So I had been going For so long, so hard and so fast for so long that my poor adrenal glands had just, there was no cortisol being produced. They had gone through stage 1 where they were firing on all cylinders and I was going, going, going. And it was doing what it was supposed to do to save my life.

Right.

Right? I was fight or flee. But what was happening is that I was continuously fighting. And society now has everything coming at us 24 hours a day. So we're constantly fighting. We don't know how to flee. We don't know how to rest and digest. We're just fighting it all. And I had, I honestly, I can't tell you if I felt anything in that, for that phase.

It

wasn't until the poor adrenal glands got so tired and couldn't produce and do what the work it was supposed to do, that literally one day I couldn't get out of bed. Mm-hmm. And there was no cortisol going through my body, but I didn't know that. And I didn't understand the insulin and pancreas with the thyroid and adrenal axis. I didn't know anything about that at the time. So I thought it was my thyroid and I tested TSH and it was normal. So that's what we've been taught. So nobody told me how to test T4 and T3 and the other thyroid hormones.

Mm-hmm.

And then It never occurred to me. I thought I was anemic, you know, the usual.

Yeah.

But everything came back within the normal range. Now I know that they were not optimal, but it wasn't flagged red on my lab report, so nothing was wrong. So I started, okay, am I depressed? And I started to do these quizzes. Okay, no, I don't think I'm depressed. I was so tired, I couldn't even finish the quiz. You know, they'd give, I couldn't even, I mean, I couldn't even think. And I now wonder, I used all my energy during my days in the office to see patients. And then I'd come home and have homework with the kids, and I used that. By the time that was done, I was out, but then I couldn't sleep. But it never occurred to me. I mean, at 3:00 AM, I solved everybody's problem. In fact, I solved all the problems in the world.

Yeah. Oh, yeah.

I thought, at 3:00 AM, I solved that. But then at 6:30 AM when I had to get up to get the kids ready for school, I couldn't remember. I mean, I knew I had these amazing solutions to all the world's problems, but I'd get up and completely forget all these amazing solutions. And then I was dragging myself through. And it was, when I think about it, I did it for years.

Yeah.

Years.

Yeah. Well, and I think you pointed out something. So for a lot of women, They end on this habit trail, this sort of hamster habit trail. And if they're lucky enough to go, okay, whatever the traditional labs are that look normal, I'm going to go a little deeper. And then, so they get deeper thyroid testing and deeper other sex hormones, all of those things. But when the adrenals have gone through this scenario where basically the brain is now like, we're done.

We're done.

You need to lay your butt down and you need to go to bed for a while and we need to recover. That symphony, because I always think of it as symphony and that HPA is the conductor and the director, at that point, everything else is changing. Your thyroid hormones, even T3, can look normal, but that metabolized cortisol, wherever it's at, can alter the actual receptor activity and we can't test for that.

No.

And so, so many people end up on this habit trail and they keep looking for the next pill, the next doctor, the next lab test. Maybe it's this, maybe it's the antibodies, and I'm like, eh, it's Probably the stuff you don't wanna do, which is you gotta get the lifestyle down.

The lifestyle.

Yeah.

And many of us are so busy. We wear this busyness as a badge of honor.

Yeah.

And stress is, everybody's stressed, but it's almost like it's, I'm stressed and I'm more stressed than you.

Oh yeah.

You know, and I'm busier than you are.

Yeah.

And I can function on 5 hours sleep. And I'm like, this is not what we are meant to do.

You know, my favorite statement, this is my favorite statement, is, I'm sorry, I'm unable to prioritize that at this time. It's the best no.

I like that. I'm going to steal that.

Okay. Now I want to talk about something else that's really important because, you know, as a women's health researcher and building a tech platform, this is part of the reason why I'm building it. Women's health has largely been unstudied. We don't get funded. We've extrapolated men's, predominantly male white men's, research and said it applies to all women. Then we have just zero or underrepresentation in healthcare studies, healthcare activities, and also just representation. We were having this great conversation about that because you were talking about your book and how you were looking and it was like, wait a minute, I'm at this women's conference with hundreds of women and there's nobody like me.

Nobody sounds like me, nobody looks like me. And I heard myself stand up, like I stood up and I heard myself say, there's nobody in the room who looks or sounds like me. I'm from the Caribbean. Where's our representation? You know, we have a very high population of women of Afro-Caribbean origin, not only living within the Caribbean, but living outside. There may be more of us living outside the Caribbean than within the Caribbean islands. And where's the representation? How do we know that this drug works for our bodies from a genetic perspective? And we are not African American. Genetically, we're different.

Yes.

So we're barely getting white women into research. I think when it opens up, it's probably gonna be in North America. I'm sure they're gonna have African American women. Where are the Afro-Caribbean women? And then I thought, well, it's gonna take a long time for us to get into the research and be represented and for us to have a voice. So what tools do we have? So I thought, we're going into battle and it's a war and the only way to fight it is for us to stay healthy. Mm-hmm. But first we have to have the information. So that's one of the reasons the book was written so that I could get the information out there in, and I wrote it in, very easily digestible bits. Yeah. Because I'm thinking nobody has time to read it. You know, you pick up these books sometimes and you start to read all these medical terms and you're like, I don't understand that. So I wanted to write it so women could understand. And then they get the information, but then also give them the actionable tips. But you don't want heavy action. You want tidbits. 'Cause you don't wanna tell a woman you need to change your diet, and you need to exercise, and you need to drink enough water, and you need to make sure you manage your stress, and then sleep 8 hours all at once.

You mean my Instagram feed's wrong?

No, you're not telling everybody that. And then they're going to look at you and like, I don't want to follow.

No, no, but that's what we get bombarded with. Like, you have to do all of this, like your job depends, like this is your job.

This is your job. It actually becomes your new job to stay well.

Exactly.

And so I need to get this message out, and I wanted to to represent the Caribbean's voice. And it became almost like passion. I almost burnt out writing it, I'll tell you. But I have now become very in tuned and I can figure out, okay, you need to back off. So there were days when I had a deadline, I'm like, I'm not gonna make that deadline.

Yeah.

I'm not gonna make that deadline. I'm so sorry. I'm gonna need another week. And that was it. It was, that was it. Because you begin to realize the value of health and the value of feeling well and the value of feeling joyful.

Yeah.

And I prioritize that right now. 'Cause what else is there?

Yeah.

You know, we have healthspan and we have lifespan. And I wanted to, for a better term, joyspan. How are we making more, taking, whatever we have in our life and bringing more joy into our lives. Because to me, that's what life is all about.

Yeah.

These pockets of joy.

You know, it's funny 'cause, you know, I think, you know, after 22 years of speaking to women just like you in the room, so many women get to their 50s and if you start talking to 'em, it's like they've been grinding. Like all they can talk about is, oh, I was raising my kids and I was doing this job and then I was taking care of my family member. And then, you know, I had to babysit my husband.

Yeah.

And when you go sit down, you're like, well, what do you do for joy? And they'll go,

what's

that? Yeah, like, I don't know. I mean, for me, that was a wake-up call. I was like, oh my God, I don't even know what I find joy.

I could not answer that question maybe 5 years ago.

Yeah.

I couldn't answer it.

Yeah.

And it saddened me when somebody asked, what makes you happy? Or when was the last time you were happy? I'm like, oh, I found that I had to pause far too long To answer that question.

Yeah. You know, it made me think of something. I was— so I had a starter marriage, you know, one of those where you're like, I probably should have just lived with him. But the reality is, is, is the day that I realized how kind of dysfunctional our relationship had gotten, my friend drug me to the movie and it was Liar Liar, you know, and it was Jim Carrey. And I sat in that movie and I started laughing. Then my friend looks over at me and tears are rolling down my face. And it wasn't 'cause I was laughing so hard. It was because I just realized for the first time That I hadn't laughed in as long as I could remember, right? And so, like, you're really talking to this thing that we do to ourselves where it's like, when was the last time you belly laughed?

Yeah.

When was the last time you were just like, oh my gosh?

When was the last time you felt joy? And I think we need to ask our patients that more often. Like, when was the last time you felt joy, or what brings you joy? And for some people, they don't even know what it is. I'm like, okay, so when was the last time you felt, not sad, you know? 'Cause I remember once I went to a workshop and it was on parenting, and the facilitator said, the opposite of happy is not sad, it's not happy. So the opposite of happy is not happy.

Right.

Not necessarily sad. And it was like an aha moment for me. And I thought, well, I've been living in the not happy zone for a long time. Because I haven't had a chance to do anything for myself. I'm either working or doing stuff with the kids or for my family, and then I'm doing very little for me. And then I realized the only time I was truly happy was when I was working out, the 60 to 70 minutes I took for myself 3 or 4 times a week to work out.

Mm-hmm.

And I thought, I need to get more of that in. And I started to figure out what it is. I found art and I did journaling and different things, and it would come and go. And there were times when you had to prioritize family and other things. But now, for instance, in the Caribbean, we have Carnival. And last year, I, for some reason, I did not participate as much as I should. I spent the whole year regretting it.

Oh.

So as soon as they have these bands with costumes, as soon as they opened up, I called a friend. I said, I don't care what you do, wherever you're going to be, because it's held up her husband owns the band. I'm like, wherever you are, tell him, just put my name down and I'm doing everything. And she says, what? I'm like, I'm doing everything. Like, I'm wherever you are, whatever I need to do, and just send me the costume. I was so happy going to pick up that costume.

Oh, yeah.

I was one of the first ones.

I've seen you in one of those gorgeous—

And I put on the costume and I'm like, oh, that's it. I missed it for a whole year. And I went to all the parties and I danced and I And I thought, I am never missing this again. So I got, as soon as it ended, I'm like, sign me up for next year, please.

Yeah. You know, it's funny because if you think of little kids, they never, like, they don't know how not to have joy unless something happens that hurts them, harms them, whatever. Kids pretty much live in that existence, but somehow or another over schooling and everything else, we sort of take ourselves out of that zone.

I tell you, when, because the carnival is in July, when it ended, I'm like, Oh, I lost my chance. Literally, it ended on that Tuesday. I'm like, I lost my chance. They said, look, is there any other island I could go to? Can I do— I'm like, no, I wanna do it with my friends at home.

Yeah.

So as soon as it was ready, I'm like, I'm doing this.

Okay. So if you're the woman listening at home, you know, whether you're watching it on YouTube or listening to the podcast, and you're like, okay, I'm really thinking this is kind of talking to me, If you can give them one nugget, like one nugget to walk away, obviously they need to buy the book, Shameless Plug. You need to buy the book. I got an advanced copy and I was so moved by the conversation. And really, this is the stuff that it's not just about your labs. This is the stuff that's really important. What's a nugget you would tell these women to like, just go here?

Give yourself grace. Give yourself grace and meet yourself exactly where you are. You're not broken. And you are perfectly imperfect if that's what you're thinking. Everything is happening and unfolding as it's supposed to. So start where you are because everybody thinks we have to start with everything. Start with one thing. If you read the book and one thing sticks with you, start with that. You can't fix everything one time. And that's why I had to learn that the hard way. I was trying to do everything. I was taking the supplements and I was trying to rest and I was trying to sleep. And you know, you're like, I need to have— 8 hours sleep. And if I didn't have it, it was like, no. I had to meet myself where I was. If there were nights where I had 6 hours, then I would try and make it up in the day. And if I needed a nap, then I would take the nap with no guilt. And that's the other thing. We need to stop feeling guilty for taking care of ourselves.

Yeah.

And I would like women to start taking that in as early as their 20s. Don't wait until you're 50 like me to do this, or when I burnt out in my late 30s, because I went straight from burnout into perimenopause and into menopause. But burnout was such a blessing because it allowed me to get in tune with my body that by the time I had gone into perimenopause, I think I've had a total of 4 hot flashes. Because as soon as I felt it, I'm like, okay, something's not right. I was so in tune, like, oh, that feels like a hot flash. The second one, I'm like, okay. We need some to check and we need to do our hormones. And I went back to the doctor and I'm like, I think I'm ready for HRT. And she looked at me and she says, you're young. I'm like, well, I have had 2 hot flashes, so let's test and let's see what's going on. And there it was.

Yeah.

But had I not gone through the burnout, I probably would've ignored it and like, oh, it's hot. But I was like, no, this is wrong. This has not happened before. This is a new symptom in my body, 'cause I was so in tune. And I think I was so afraid of burning out again.

Yeah.

Which incidentally I did 2 more times and the last one after COVID.

Yeah, that's true. So if somebody wanted to buy Held and Healed, tell them where they can find you.

It's available on amazon.com and you can get it on my link to my website, taniabolbrun.com, and also Instagram, Dr. Tania Bolbrun.

Yes, Dr. Tania, you know, I love you. So I wanna thank you for being on Menopause Mastery.

And thank you for having me, and thank you for contributing to my book. Your words made such a difference.

Oh, fantastic. Fantastic. And for everybody that happens to be watching on your favorite platform or listening on your favorite platform, don't forget to subscribe and leave us a 5-star review. Thank you. It's Dr. Betty Murray, and we'll be back with you next week on Menopause Mastery.

Thank you.