Leading Anxiety Psychiatrist in NYC, Scott Shapiro, MD provides therapy + medications -Credit:Prostock-Studio

Anxiety and Burnout in High Functioning Adults

A NYC Psychiatrist’s Perspective

Many adults searching for an anxiety and burnout psychiatrist in NYC are not falling apart.

They are functioning. They are responsible. They meet expectations at work and at home. Yet internally, something feels off. Life feels heavier than it used to. Focus takes more effort. Sleep is lighter. Stress feels constant rather than occasional.

People often struggle to name what they are experiencing. Some wonder whether it is anxiety. Others think it may be burnout or chronic stress. Some worry it could be something medical. Others consider working with a coach because they are still performing but no longer feel clear or energized.

These questions are common. Importantly, they are also reasonable.

In my New York City practice, I work with adults seeking thoughtful, effective treatment for anxiety, burnout, chronic stress, and mental exhaustion. Many are high functioning and capable, yet feel worn down by sustained demands. They want clarity about what is happening and a plan that works.

When stress becomes chronic

Stress is not inherently harmful.

In manageable doses, it supports focus and performance. However, problems arise when stress becomes continuous. Over time, the nervous system remains activated for too long.

Many adults live in a state of constant alertness. The mind stays busy. The body stays tense. Even during downtime, it becomes difficult to fully relax.

As a result, people experience mental fatigue, irritability, and difficulty sleeping. Stress becomes the background state rather than something that comes and goes.

Anxiety and burnout in high functioning adults

Anxiety does not always appear as panic or excessive worry.

In high functioning adults, anxiety often shows up as constant mental activity. People may overthink, replay conversations, or struggle to turn their mind off at night. Sleep may be shallow or fragmented. Concentration may suffer.

In many cases, anxiety exists alongside burnout.

Burnout develops gradually. People may feel emotionally drained or less patient. Enjoyment decreases. Motivation becomes inconsistent. Tasks that once felt manageable begin to feel exhausting.

Importantly, burnout does not always involve collapse. Many people experiencing burnout are still performing well. The problem is sustainability.

A Case Example: Kevin*

For example, let’s take Kevin* who is a married man in his 40s who was preparing to welcome his first child. He came to see me after several years of increasing professional and personal demands. He felt tense most days and slept poorly. His mind stayed active late into the evening, and he had trouble turning it off.

Although he was functioning well at work, he felt worn down and less like himself. He had considered working with a coach but sensed that something deeper was contributing to his symptoms. He wanted help understanding what was happening and how to address it effectively.

Our work focused on identifying what was maintaining his anxiety and mental exhaustion. We examined thinking patterns, expectations, nervous system regulation, and how the structure of his days contributed to feeling constantly overextended.

Treatment included practical cognitive strategies, targeted behavioral changes, and when appropriate, medication used thoughtfully and conservatively. Sessions were structured and collaborative.

Over time, Kevin reported feeling calmer and more clear headed. Sleep improved. He felt more present at home. Work remained demanding, but it no longer felt overwhelming.

This is often the difference between managing symptoms and addressing underlying patterns.

Who treats anxiety and burnout

People frequently ask what kind of doctor helps with burnout or whether they should see a psychiatrist or a coach.

Coaching can be helpful for skill building and accountability. In contrast, when anxiety, chronic stress, sleep disruption, or mental fatigue are present, working with a psychiatrist offers a broader assessment.

As a psychiatrist and certified cognitive behavioral therapist, I evaluate both psychological and biological contributors. This includes anxiety, mood, sleep, stress physiology, and thinking patterns. When appropriate, medication can be used carefully alongside therapy.

This integrated approach is especially helpful for adults who feel overwhelmed, unmotivated, or mentally exhausted despite doing many things right.

A collaborative and structured approach

My approach is collaborative and practical.

Sessions are purposeful and focused on clarity, insight, and actionable steps. Many patients value understanding why they feel the way they do, not just how to cope.

In addition, treatment is tailored rather than one size fits all. The goal is steadier mood, improved focus, better sleep, and greater emotional flexibility over time.

Care in New York and New Jersey

I see patients in person in Midtown Manhattan and via secure telehealth for adults living in New York and New Jersey.

Many people seek care before things become unmanageable. Addressing anxiety and burnout early often leads to better outcomes.

If you are experiencing chronic stress, anxiety, burnout, or mental exhaustion that is starting to interfere with focus or well being, effective treatment can help.

*Disclaimer

The case example above is a composite based on clinical experience. Details have been changed to protect privacy and confidentiality. It does not describe any specific individual and is provided for illustrative and educational purposes only.