The Invisible Build-Up: ADHD, People-Pleasing, and the Architecture of Early Burnout - Part 1

By: Sarah Donovan, LCPC, PMH-C | Perinatal Trauma Specialist | Certified EMDR Therapist & Consultant

The Early Roots: The Silent Architecture of Doing It All

We don’t just wake up one day completely burned out; we build the architecture for it over a lifetime. For me, it started with people-pleasing at a young age—always acquiescing to others' feelings and needs. Some trauma researchers call this "fawning." It is that constant, hyper-vigilant feeling that someone is mad at you, or that you are perpetually on the verge of being "in trouble."

If that feeling of walking on eggshells resonates with you, psychotherapist Meg Josephson wrote the definitive book on it: Are You Mad at Me?: How to Stop Focusing on What Others Think and Start Living for You. As Josephson beautifully explains, people-pleasing isn't actually a personality trait; it is a survival mechanism. It’s a childhood adaptation where we learn to become as agreeable, helpful, and unthreatening as possible to keep the peace and feel safe.

Back then, I didn't realize that’s what I was doing. Looking back, I see a pattern of fawning that was rooted in deep self-doubt and fractured self-esteem, passed down both implicitly and explicitly.

As a young girl, I watched the women around me. I watched them dote on men and shoulder the behind-the-scenes labor. Modeling my parents' relationship, I absorbed these roles without question. I now realize there was an entire ocean of unseen effort and emotion beneath everything my mother did—behind every single childhood meal, sports game, or holiday.

At the time, that dynamic wasn’t questioned; it was simply the cultural standard of the era. Society taught us that this level of intensive caretaking was just what was expected of women, making it easy to overlook how much energy it actually required. Today, I am flabbergasted by the silent, relentless ways my mother showed up—ways that went largely unappreciated and overlooked by the family structure.

It makes me sick to my stomach knowing how many times I took her labor for granted as a child. When that guilt creeps in, I try to re-frame it using a phrase I often share with my own clients: All information is good information. Now I know better, so I can do better.

Looking back, it wasn't a lack of love in my parents' dynamic, but rather a classic example of what author Eve Rodsky defines as the invisible "mental load" in her book Fair Play. In traditional partnerships of that generation, recognizing the sheer volume of invisible labor wasn't common practice—it was simply the baseline expectation. The staggering amount of behind-the-scenes domestic planning, anticipating, and executing that women performed often became completely invisible to their partners and families simply because it ran so seamlessly.

Now that I am a mother of two who has walked through the fires of deep burnout and grief, I recognize the crushing weight of that invisible load. It wasn't about malice; it was about the systemic defaults of the time. I see so clearly now what my mother needed: she just needed to be seen.  Both her and my father were also mourning their own mothers as they were parenting.

The "Reciprocal Idea" Fallacy & The Overcorrection

Growing up with that people-pleasing blueprint, I fell headfirst into what I call the "Reciprocal Idea" fallacy: the deeply internalized belief that if you behave well, do the right thing, don’t make a scene, and take care of everyone else, you are guaranteed a safe, comfortable future.  That your prince charming would know instinctively how to take care of your needs and your families.  I call BS.

Instead, that fallacy led me straight into an abusive relationship in my early 20s after college. I had tried to overcorrect my dating patterns by avoiding the "typical" guys I knew in high school, not yet realizing that a person’s superficial "type" (the athlete, the artist) doesn't matter. 

What matters is kindness, compassion and attachment patterns.. My parents didn’t intervene at the time, and now I understand why: I had to learn those devastating and painful lessons for myself.

After a traumatic breakup where my ex-boyfriend literally threw my belongings out of a second-story window of a Canton townhouse, I called my friend and fellow social worker. I knew it was finally time to move back home to finish graduate school.

I was living back with my parents just to survive basic daily maintenance. I was routinely ignoring fundamental bodily cues—like the simple need to eat regular meals—and I never once stopped to ask myself how my mental or physical health was actually holding up.

The Illusion of Connection vs. The Safety of Solitude

Personally, I learned early on that socializing and being part of a group felt way more important than being alone. I remember actually laughing at the idea of solitude. Yet, I watched my mom find solace in it during my whole life. She loved going on errands alone, hunting for deals in vintage stores, reading novels, watching old movies, and cooking in a quiet kitchen. Back then, I didn't understand that she was recharging and taking a break from the overstimulating demands of parenthood. I didn't grasp that alone time is the very thing that prevents burnout.

I had such a hard time being alone and navigating unstructured time. Today, I know exactly why: I had undiagnosed ADHD, low self-esteem, and an unsteady, external locus of control. I felt unsafe in my own body, but I lacked the language to name it.

I truly didn't see the depth of what my mom did when it came to basic needs and parenting until I lived with my parents as an adult and took it for granted. Then, I had a child of my own, and she stepped in to help with childcare—and I took it for granted again.

And then, she was gone.

Suddenly, I was navigating a deep, dark void. I had no idea how to mother myself because I had never learned how and I had always operated under the assumption that she would just be there. 

When that anchor vanished, I had to pick myself up and learn. (A massive shoutout to my amazingly domestic and emotionally supportive husband, who stepped into that gap for years after her death and continues to do so today. Thank you—and more to come on him later!).

Looking back, my pre-grief ADHD and burnout symptoms were screaming at me:

• Physically: I was driven by an internal motor; plagued by a chronic, itchy inability to sit still or be alone with my thoughts.

• Mentally: I lived with a constant, subconscious urge to dissociate the second I wasn't actively working or producing.

• Emotionally: I swung between incredibly low lows and temporary, high-octane highs, completely untethered from a stable center.

Prior to finishing graduate school, I decided it was a perfect idea to move into a gigantic city house with my newly graduated sister, college roommates, and three other friends. "But it’s all good, I’ll figure it out," I remember telling my parents. It surely wasn’t pretty or practical, but it was fun, and it became a massive crucible for emotional, relational, and professional growth.

This exact pattern is a common presentation among my clients today. They experience immense shame for getting into toxic relationships or chaotic roommate situations where they functioned as the default "caregiver," only to realize they were repeating old blueprints. 

When they finally escape those dynamics, they often overcompensate by pouring 150% of themselves into their careers or parenthood. This leads to a tremendous amount of professional burnout, where they endure gaslighting in workplace spaces for years before finally finding their way out.

The Hustle & The ADHD Engine

Looking back, my undiagnosed ADHD was the high-octane engine fueling my over-extension. In college, I thrived on extreme athletic structures, playing both varsity lacrosse and field hockey while majoring in Psychology. I was the captain, the head of student committees, and even got to cut the ribbon at the college’s brand-new gymnasium during my senior year. I was thoroughly conditioned to push my mind and body far past their limits—a survival trait that translated seamlessly into my career and academic life.

The Accumulation of "Yes" and Toxic Wellness Culture

In 2010, I took my first counseling job at a community mental health clinic. I was managing a staggering, unethical caseload of up to ninety clients a week of all ages, running therapy groups, and trying to complete my clinical consultation hours. (The only saving grace? That clinic is where I met my absolute best friend, parent and fellow couples counselor for Tilted Root, Hanna B!).

To add high-grade fuel to the fire, in 2011 I decided to get my Yoga Teacher Certification. I had originally started yoga as a personal stress reliever and naturally thought: Why not make a career out of this, too? (Again, hello ADHD brain). 

Before I had even finished my teacher training, I was hustling to teach yoga everywhere, all the time, sandwiching classes before and after my intensive "counseling day job."

I poured my depleted energy into low-wage and free yoga classes, running clinics in corporate offices, workshops, hospitals, and schools.

A couple of years into this dual-track marathon, the wheels finally started coming off. I was entirely hollowed out. Gathering every ounce of courage I had left, I scheduled an in-person meeting with the owner of the yoga studio to ask if I could step down from just one of my three permanent weekly classes.

During our meeting, she looked at me, smiled warmly, placed a hand on my shoulder, and said:

"Oh, honey. I am tired, too. But I'm sorry, you can’t drop the class. It’s bringing in really good business for the studio. Try and stick it out a little longer.”

Instead of standing my ground and saying, "Actually, I am resigning from this class to preserve my sanity," my childhood people-pleasing programming instantly took the wheel. 

I listened to my empty bank account and my dissociated body. I nodded, said I understood the assignment, and kept the class.

That interaction perfectly encapsulated how systemic exploitation masks itself as empathy and wellness culture. It wrapped my desperate cry for help in a toxic, weaponized "we are all in this together" mentality. I was driving excellent profit for their business at the direct expense of my central nervous system.

This was a theme that would resurface in multiple jobs throughout my career, planting the early, fertile seeds of my deep visceral rage against a capitalist system—and the bosses, both men and women, who uphold it—that exploits workers under the clever guise of "wellness" and "empathy culture."

Badges of Honor & The "Therapy Marathon"

Teaching yoga to Jason Williams of Charm City PT  until I was going to pop!

The hustle reached its absolute peak when I found myself working four ten-hour days at Johns Hopkins Bayview. I did it to keep full-time health and childcare benefits secured for my growing family, sacrificing my own daily well-being for systemic security.

This was when my mind and body learned how to endure what I call "therapy marathon" days. Because I felt like I had absolutely no choice, I was seeing anywhere from five to eight clients back-to-back in a single day.

Back then, and even as I eventually transitioned into private practice, I wore those marathon days like a badge of honor. I truly believed that meeting administrative deadlines, hitting billing numbers, and carrying the pain of others were far more important than my own nervous system.

I thought this martyrdom was simply what a successful, dedicated helper had to do. I didn't know it yet, but this sacrificial mentality was quietly, systematically laying the dynamite for a catastrophic, life-altering career burnout—a specific breaking point in time (2023 to be exact) that would alter the course of my life forever.

NEXT UP - STAY TUNED

The Breaking Point: Grief, Systemic Rage, and the Driveway Wake-Up Call - Part 2