Burnout Symptoms and Recovery: Dr Claire Ashley on Stress, Sewing and Wellbeing

In this episode, I’m joined by Dr Claire Ashley, (a GP and passionate sewist) for an honest and informative conversation about burnout, how to recognise the symptoms, and what recovery can really look like.

Claire shares her personal experience of burnout alongside her medical perspective, explaining the science behind chronic stress and how it impacts both our physical and mental health. 

We talk about the early warning signs that are often missed, why burnout is more than just “feeling tired,” and how high-achieving, caring professions can be particularly vulnerable.

We also explore the role creative hobbies like sewing can play in burnout recovery - offering structure, focus, and a sense of progress during periods of overwhelm.

This episode blends medical insight with lived experience, and offers practical, compassionate guidance for anyone navigating stress, burnout, or looking for healthier ways to support their wellbeing.

Claire discusses: 

• What burnout actually is and its core components
• Signs and symptoms of burnout
• The impact of burnout on brain and body
• The role of creative hobbies in recovery
• Practical tips for preventing burnout

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Guest Details: 

Instagram: @thesorbelloedit

Book: The Burnout Doctor 

https://www.amazon.co.uk/dp/1399412809

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Chapters

00:00 Introduction to Claire Ashley and the Podcast Format
02:26 Understanding Burnout: Definition and Symptoms
08:21 The Journey Through Burnout: Personal Experiences
11:04 The Role of Creative Hobbies in Recovery
17:24 Sewing as a Therapeutic Tool for Anxiety

Transcript

Gemma Daly (00:10)
Claire, welcome to the Sewing Social podcast. I'm so happy to have you on today.

Claire Ashley (00:15)
Hi Gemma, thank you so much for having me here today.

Gemma Daly (00:18)
You're welcome. Would you mind introducing yourself to the listeners?

Claire Ashley (00:23)
Of course. So for those of you that don't know me, my name is Claire. I am a GP by background and I have been sewing now for five years. In terms of my professional background, actually I've had quite a varied career. So I qualified as a doctor back in 2008, but I also have a degree in neuroscience and I also have an interest in public health. So I'm previously a health and equalities fellow and I've done a lot of work in deprivation.

particularly in my earliest kind of career as a GP. But about, I think it's six or seven years ago now, so quite a long time, we actually went through a very difficult period at work where I burnt out and off the back of that...

I made a lot of changes to how I work and I started documenting my journey online. That has led to what we call a portfolio career. So I do lots of different things now, including doing a lot of teaching and medical education. I've written a book called The Burnout Doctor, which is basically the biggest literature review of my entire career, which draws on my own experience with burnout, but really talks about the evidence base around what it effectively means to prevent and recover from burnout.

A lot of my work now is doing webinars and workshops in both the NHS and the corporate sector, upskilling people on what it is that they can effectively do to help themselves. And then about, I think it's five years ago now, whilst I was still quite burnt out, but was starting to get there, I started sewing.

And I had a burner account on Instagram for a while where I shared a few of my makes, but I wasn't that engaged. And it really became like my safe space away from all of the stresses of the day to day and my work. And then I think maybe like nine months ago or so I decided that actually I was in a position where I wanted to start sharing a little bit more about what I was making and also some of my knowledge around.

the science of sewing and particularly the neuroscience of sewing and it seems to be resonating with people and so hence why I'm here talking to you today.

Gemma Daly (02:26)
Absolutely, and I'm

very excited to pick your brains. Now we're doing a special this because we've got Claire on with us and she's so knowledgeable. We're going to do what's called a Wellness Week where we focus on general wellness and mental health within the sewing community. So today I wanted to focus the topic of burnout because as you mentioned you've written a book

called the Burnout Doctor, and you've had firsthand experience of burnout as well. Now, it's a term that a lot of us will have heard of before, but what actually is burnout?

Claire Ashley (03:03)
So it's a very dry definition of burnout, which I will share with you. The World Health Organization didn't actually recognize burnout until 2019 when they gave it an official definition, but we've known about burnout for many more years than that. It was first documented in the scientific literature in the 70s actually by a psychologist that was working in a free HIV and AIDS clinic in New York. And you can well imagine at that particular point.

Gemma Daly (03:06)
You

Claire Ashley (03:27)
in time, in history, that was a very stressful place to work. And they realised that the healthcare workers that were working there were presenting with a stress-related problem that was different to anything that had previously been documented. But I think prior to that, it was probably just time to break down more than anything else. And so I think it's always been around because burnout is effectively what happens to the brain and the body when you have been subject to prolonged stress and prolonged intense stress.

Gemma Daly (03:44)
Hmm.

Claire Ashley (03:54)
So the official definition is that it is an occupational syndrome that arises as a result of unsuccessfully managed workplace stress. And there are three core components. The first one is depersonalization. So that's the medical term for cynicism, apathy, and detachment. The second component is emotional exhaustion. So that's pretty self-explanatory. That's when you're just absolutely exhausted from caring for too much for too long and working as hard as you have for as long as you have been.

And the third component is reduced performance at work in whatever form that takes. And so without all three of those core components and outside of the context of prolonged stress at work, the World Health Organization doesn't recognize it as burnout. However, we do know that burnout happens outside of the workplace. There are groups of people that are at higher risk. So parents, caregivers in particular, are at high risk of burnout and that's not related to paid work.

Also people that are neurodivergent. So if you're autistic or you have ADHD, then you're more likely to go through rapid cycles of burnout. And in terms of what it feels like to experience, there's a whole range of symptoms. So it's very physical experience. The most commonly reported symptom is muscular aches and pains, but you can get all sorts of physical symptoms, headaches, stomach aches, palpitations, chest pains, ⁓ you name it, know, stress can cause it, right?

Disproportionate fatigue is very common with people who experience burnout. And then you have your emotional and mental symptoms. There is a lot of overlap with some commonly experienced mental health problems like anxiety and depression, but burnout is considered a separate problem to those issues. So in terms of your executive function as well, that can be affected. So you might have difficulty with concentrating, focusing your memory. That tends to go quite early actually on the slide into burnout.

Then you've got like your emotional and ⁓ mental health type symptoms. So panic, worry, low mood, poor self care, difficulty sleeping, nightmares, flashbacks, intrusive thoughts. There's a whole range of quite significant symptoms that people can experience. Other hallmark features, emotional dysregulation. So not being able to control your responses to stress in the same way that you used to.

flying off the handle over the smallest of things, it's because you can't control it. It's because of the changes that have happened in your brain that that happens. And there's also a lot of guilt. So people blame themselves when they're going through this. And in fact, some researchers argue that the experience of guilt is so pervasive that it should form part of the definition, but there's also a lot of denial. So until you end up in a crisis point, and if you end up in a crisis point, then it's a one to three year recovery period.

an average of three and a half months off work sick, then most people will not realize it. They'll know that something's wrong, but they'll not quite get it because again, that's part of the process. So we have our very dry definition on one hand and then all of the stuff that it feels like to it is a very significant thing to experience.

Gemma Daly (06:59)
Yeah, absolutely. And a lot of the symptoms that you describe obviously could be related to other things. So do you think people don't actually realise that they're going through burnout initially?

Claire Ashley (07:11)
Yeah, absolutely. And that's what happened to me. I knew that there was something wrong, but I had never been taught about burnout. I didn't know what it was. even, like the name didn't mean anything to me. And that's really ironic because I was a GP. And you know, and I spent years at medical school and in postgraduate training and no one had ever mentioned the word burnout. I didn't even know what to look for in patients, let alone myself. So I think...

The things to remember here is that, first of all, denial is part of the process, unfortunately. So that lack of insight is part of the journey, which is tricky because that works against you and prevents you from knowing what's happening. But second, I think there is a lack of knowledge about those stages of burnout, like that lead-up period. So there are defined stages of burnout that the majority of people go through before they end up hitting burnout itself or having a crisis moment.

And these stages are very distinct. part of the work that I do now is helping people to understand what these stages are so that they can take some time to reflect and to think about where they might sit in terms of their stress levels. So I think that lack of knowledge as well is something that plays into it.

Gemma Daly (08:21)
talking about this, I feel like I had a period of time where I was possibly burnt out as well, because like yourself, I work in the NHS, constantly caring for people and then other things happen in your personal life, don't they? And they often sort of add up and add up and add up. But it was interesting what you said about we should have this set period of time to try and recover.

because I think I gave myself about six weeks and then I was back to work because I felt guilty. know, often I think when it's more of a mental health problem and people can't see it, you feel like, well, I felt, I'm talking for other people potentially, but I felt yeah, the guilt was more because people couldn't actually see what was going on with me.

Claire Ashley (09:10)
I think as well working in the NHS, there's definitely a pressure to not, I think it's changing the culture, but I think there is a pressure to not show that you're any outward signs of struggling. And also there's an expectation that you go to work, you know, people who work for the NHS, they don't want to take time off work sick. And I didn't because I really didn't feel, in fact, my surgery said to me, we don't want you to take time off work because they knew that it would impact directly on my colleagues. And then I felt this huge guilt. was like, well,

Gemma Daly (09:25)
Yeah.

you

Claire Ashley (09:40)
of course, I'm not going to take time off work because I don't want to land my colleagues in it. And I also didn't want the patients to suffer. But the ultimate irony being that that did jeopardize my recovery, unfortunately. So there is that kind of weaponized guilt that you experience working in the NHS and I'm sure in other jobs and other sectors as well that you should continue to go to work even when you're not well enough to be able to do so. But I think there is this idea, you know, about, especially when it comes to

Gemma Daly (09:40)
Yeah.

Mmm.

Claire Ashley (10:10)
burnout and mental health problems that, you know, a couple of weeks off, that'll do the trick. And actually, unfortunately, that's not the case. And the reason being that the changes that happen in the body and the brain, you know, having been experienced to such high levels of cortisol and adrenaline for a long period of time, that does cause structural and functional changes in your brain. It does cause low grade inflammation in the body and it takes time for your body to recover from that. And people do recover and

everything goes back to where it was before and there is hope at the end of the tunnel and all of that sort of stuff. Or even though it doesn't feel like it at the time, but it does take a huge amount of time and so much more than you might hope or expect. And so it's really important that you have that self-compassion as you go through that process because I got so frustrated that I wasn't recovering on a timeline that felt appropriate to me.

Gemma Daly (11:04)
Yeah,

absolutely. I completely know where you're coming from with that. Do you think that ⁓ creative hobbies like sewing can genuinely help with burnout?

Claire Ashley (11:15)
Yes, the answer is yes. So I've done a lot of reading around this and it's only very briefly mentioned towards the latter parts of the book in the recovery process. I don't go into it in too much detail, but yes, there is a lot of evidence around how creativity ⁓ and mastering a new skill can really help in burnout. I would say there's a big caveat, which is that you shouldn't do it too early on in your recovery process. for anyone that has experienced burnout and Gemma I know you were saying that

that you've been there, when you're in the middle of it, you have such little capacity to even do the most basic things, Like basic self care, like having a shower, washing your face, brushing your teeth. You know, I didn't go to the dentist or the hairdresser or the opticians, but I got to the point where my opticians actually were withholding my contact lenses because I hadn't been for so long. They sent so many reminders, but I just wasn't prioritizing it. And so when you're in that kind of survival mode,

Gemma Daly (11:54)
you

You

Yeah.

Claire Ashley (12:11)
You can't do anything extra. You know, it's just about getting through the day to day and preserving what little energy you have for the things that really matter. But as time goes on and you start to have a little bit more energy about you, you know, maybe you're a few weeks, a few months into it. At that point, there is quite a bit of work around how engaging in a creative hobby is helpful in two ways. First of all, mastering a new skill
outside of work, so completely uncoupled to work, is really helpful for rebuilding your confidence and that can really help with your recovery. But second, any creative hobby that gets you into flow state is incredibly helpful as well. So flow state is that feeling when you're so absorbed in a task that you're doing or a hobby that time doesn't exist anymore.

You you start doing something and then you look up at the clock and you realise that a few hours have passed and you haven't eaten, you've not been to the bathroom. But that state of getting into flow where time disappears from you is actually really healthy. Actively lowers your cortisol levels, your adrenaline levels. It has a profound impact on your mental wellbeing. It is a form of mindfulness. And so sewing offers those two opportunities for getting into flow state, but also mastering a new skill. Very helpful, but don't do it too early on in any burnout.

Gemma Daly (13:29)
That's really interesting. Now, how do you think we stop our hobbies becoming like another thing that we feel we need to optimize or succeed at?

Claire Ashley (13:39)
Yeah, that's a great question because I think the sorts of people that end up feeling stressed and burnt out are probably the sorts of people that might start to see their hobby as something where you're very outcome driven, right? And I know, and I'm not judging because I'm 100 % one of these people, right? And so there's something there about personality types, isn't it? But there's also something about just modern society and culture and how there's this expectation that

unless you're doing something that has an outcome, it's not worth doing. And so I'm very much guilty of seeing my hobbies sometimes as not being worthwhile unless there is something that you've made at the end of it, like a piece that you're going to wear, or you've learned a new skill, you've challenged yourself maybe to learn a new technique or to try a more advanced make or whatever it is that you're doing. And it's really hard to uncouple yourself from that expectation. And so I think it's just about

if you can, like trying to make something for the sheer joy of it and the process rather than the outcome and uncoupling the outcome from your enjoyment of that hobby, easier said than done. And I a hundred percent admit that I fall into this. And so for instance, I've been doing it this I've really reigned back my expectations of the numbers of what I want to make. And I've tried to go for a make this month. I'm just...

numbers are down, I'm just going to do it for the sheer joy of it and not necessarily to make something at the end of the day that I'm going to wear on the daily or measure any sort of outcome and it is making the process more enjoyable luckily. I did pick a fabric that doesn't press and so I am regretting that but I am enjoying the process.

Gemma Daly (15:21)
That's

really good. I think, like you say, sometimes there is a societal element to it, isn't there as well? Because the number of people that have said to me, you should make sewing like a business. And to be honest, I do want to go down that path, but you don't have to make your hobbies into a job or have an outcome. Like you say, you can just enjoy the process.

Claire Ashley (15:47)
Yeah, absolutely. And coming back to burnout as well, in the earlier days as well, it's really important that you're doing activities just for the sheer joy of it and not for an outcome. In the early days as well, it's really important that the activities that you're doing are also low energy activities, so you're not requiring too much brain power. So I think if you're doing something that's like repetitive movements,

Hand sewing, instance, or embroidery could do that. But actually, dressmaking probably does come a little bit later. But you're right on that societal expectation. mean, you just, all you have to do is open up social media and there's all this stuff about how you should be monetizing your hobbies and, you know, all hustle culture and all of that sort of stuff. To that point, shut it down, you know, cultivate your feed. I don't know if you're aware on Instagram now, you can, you do have a degree of control over your algorithm. So,

Gemma Daly (16:25)
Yes.

Yeah.

Claire Ashley (16:38)
There's a button that you can press and you can select the topics that you want to see more of. Like don't engage in the stuff on hustle culture. Don't follow people that promote that sort of content if it is affecting your enjoyment of your hobby. And just move away from that societal pressure that I think is compounded by social media as well. There's so much, so much stuff on there about how you should be doing more, making more, making more money.

Gemma Daly (16:46)
Mm-hmm.

Claire Ashley (17:08)
And it doesn't have to be like that.

Gemma Daly (17:09)
Absolutely, absolutely. Now, the reason you wrote your book, The Burnout Doctor, was because you obviously, like you say, had first-hand experience of burnout. How did sewing help you specifically through this?

Claire Ashley (17:24)
Mm-hmm.

So I started sewing, I think it was probably maybe a year or 18 months into my recovery journey. But as it happened, I was actually going through quite a difficult time period then, and my anxiety was starting to get really bad. So I was under NHS practitioner health, you might have heard of it Gemma, so it's the service that supports healthcare professionals if they're suffering with a mental health problem. So I had a GP looking after me and I had a therapist, and so I was engaging in all the stuff that I needed to be engaging with to be getting better.

And I starting like I had a little bit more about myself. My husband works away a lot and he was abroad for three months at the time. I had very young children at that point. So I was basically under house arrest in the evenings. And I wanted something to do that wasn't...

bed rotting basically, like I wanted to do something that engaged me and not just sit there and watching Netflix or there's nothing wrong with that, that has its place where I didn't want to do that every evening. And I happened to be walking past a sewing shop in Bristol, my home city, and it was a fabric shop and I just looked through the window and I was like, I have to, I want it, I saw some leopard print fabric and I was like, I want this fabric. So I went home and I started Googling.

Gemma Daly (18:30)
You

Claire Ashley (18:38)
how to start sewing, I found one of the Tilly and the Buttons books, I bought a sewing machine from John Lewis, like the cheapest one they had, and went back to the shop, bought some fabric and got going. And I think for me, it came at a point in my journey when I had enough energy to be able to engage in it, first of all, enough mental capacity to learn a new skill. But also for me, having been through that process,

I felt very lost. didn't know who I was anymore. I had to make some big career changes. There was a huge identity shift. I also had to go through a, it was a bereavement actually. I had to go through a period of grieving the career that I thought that I was going to have and I'd worked incredibly hard to achieve. And in sewing, not only did it help me in terms of like learning a new skill and getting into flow state and also

I was very much dopamine dressing, like I was picking the brightest colours you could find, the boldest prints, I loved it. It was definitely giving me something that, you know, that was therapy in and of itself, you know, I was definitely self-regulating. but in doing that as well, it also helped me to carve this new identity. Who was I after all this? I didn't know, but in experimenting with clothing and making stuff that wasn't available on the high street, I...

Gemma Daly (19:51)
Mm-hmm.

Claire Ashley (19:58)
was basically trying to find myself and it just yeah it just came at exactly the right time.

Gemma Daly (20:04)
That's amazing.

And I'm so glad that it has helped you. think, you know, through, through interviewing so many people on the show, feel like sewing has so many different meanings to different people and it's helped them all through different parts of their life. So I think it's an amazing hobby for that.

Claire Ashley (20:22)
Absolutely. ⁓ And I think for me, yeah, that bit around the carving of identity was so, so important. And also very interestingly, now that I'm doing more reading into it from a scientific perspective, there's a lot around that too, and all of the benefits that sewing has. And I would say there's less out there on sewing than other fibre arts.

a lot of the evidence is around knitting, for instance, and less so around sewing. But was robust enough data, I would say, to say that sewing has profound effects on your mental wellbeing, your emotional state, ⁓ and also healthy longevity as well. It's fascinating.

Gemma Daly (20:50)
Mm-hmm.

Yeah, well you'll have to make some more research Claire because it's obviously needed. Brilliant, well thank you so much for joining me today. This was just a mini episode on burnout today but tomorrow we're going to be talking about anxiety. Claire's with me all week on the show so I really hope you do tune into that episode. So we'll see you tomorrow.