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I was a 35-year-old global head of communications who landed in the hospital from extreme stress and burnout. It was the push I needed to finally leave agency life and put my wellness first.

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Elizabeth Rosenberg
Today, Elizabeth Rosenberg says she is aware of her triggers and can see the stress coming on and act on it.

  • Elizabeth Rosenberg was global head of communications for a large ad agency.
  • Intense stress at work brought on a severe migraine that sent her to the emergency room.
  • She returned to work later that night to 35 missed texts, missed phone calls and 150 emails. She shares how she manages her stress levels today.
  • See more stories on Insider’s business page.

I was working in marketing as the global head of communications for a large advertising agency. I oversaw internal and external PR for offices on 4 continents and on some of the most iconic and influential brands in the world.

My typical work week was 60+ hours long (which is unfortunately quite common in our industry), but I loved my job and the work I was doing, and I genuinely loved the people I was working with, too.

But PR is a demanding, “always on” role that thrives in high stress situations and can very easily lead to burnout.

The day I experienced extreme burnout started out like any other day. I had a new C-level executive to introduce to the office, and like all good comms people, I had the entire event orchestrated to a T.

But like all things in PR (and life), nothing went according to plan.

This new executive was 30 minutes late to his own team meeting, the approved presentation I had already prepared was being hastily rewritten by others behind closed doors, and the all-hands meeting started 45-minutes late and went over an hour long.

Everyone was annoyed.

I was internalizing all of this: Would everyone blame me for the meeting not going according to plan? Was there a plan anymore? Did anyone besides me really even care?

A pain in my head and behind my eyes crept in quickly. (I realize now that I bring on migraines subconsciously as a way to relieve my stress, to remove myself from threatening situations, or to punish myself for not doing my absolute best.)

Thirty minutes after the meeting, I told my boss I had to leave and packed up my bag and headed home.

While driving through LA traffic, my pain level was at a 10.

I’ve had kidney stones, ruptured ovarian cysts, and pinched nerves in my neck. For me to say that I was at a pain level of 10 has happened less than a handful of times in my life.

The migraine was so bad it was making me nauseous. I pulled over twice and threw up on the side of the road. Getting back in the car, I started to panic: “This pain feels different. Am I dying?”

So, I did what any single, 35-year-old woman would do: I called my mother.

By the time she answered, my tongue felt numb and swollen, my hands could no longer feel the steering wheel. “Do I even have legs?”

In between hysterical sobs I told my mom that I didn’t feel like I could talk and that things were starting to go numb. She told me to pull over and call an ambulance. “I think you’re having a stroke. Go to the hospital now.”

At this point, I could no longer talk. The panic and pain had taken over and now that my mother had planted the seed, I was convinced I was having a stroke.

I hung up the call, somehow got off the freeway and pulled into Saint John’s emergency room parking lot. I was still hysterical, gasping for breath and crying in pain. I’d also sweated through my clothes and had vomit on my sweater.

I got into the waiting room and collapsed onto the ground.

Within minutes I was strapped to a gurney and brought to the back.

As soon as we landed in a bay, they checked my arms and in between my toes for needle marks and beamed a flashlight in my eyes. They drew blood from me to find out exactly “what I was on,” and a very sweet nurse rubbed my head for a few minutes and told me I needed to calm down before she left me alone.

I laid still for a few minutes, and then I went into shock. I had stopped crying, but I was now freezing and shaking uncontrollably. The nurse came back to check on me and wrapped me in several heated blankets and told me the blood tests would be back soon.

A doctor appeared in my bay and told me, “Well, you’re not on any drugs. What’s going on with you?” By this point I had calmed down enough to start to talk. I told him about my migraine. He gave me a shot of something and I ended up falling asleep.

I woke up with my dad by my side. My mom had called him and told him to meet me at the hospital. I was so grateful that I wasn’t alone as I was coming to. We talked for a few minutes and I fell back asleep, hoping the drugs would work their magic.

Three hours later, I emerged from hell.

I felt like I had been hit by a truck and was foggy and out of sorts. I lived about a mile away, so my dad followed me and helped me get inside.

It was 5pm when I got home, and I did exactly what you would think I would do. Go to bed? No. Eat dinner? No.

I turned my phone on to 35 missed texts, a dozen missed phone calls and nearly 150 emails, many needing things immediately.

And then I did exactly what I shouldn’t have done.

I dove back into work, back into the stressful chaos that had just caused one of the worst experiences of my life. I went back to work to prove to everyone and myself that I was fine. I was better than fine. I was reliable. I was great at my job. And I was always there for them when they needed me.

The next day I returned to work like nothing had happened.

I worked 12 hours that day. I came home around 8:30pm, had a glass of wine, checked emails a few more times and went to sleep to relive the next day the exact same way.

The months following I saw everyone from neurologists to ENTs to allergists in an effort to explain this episode. I couldn’t accept that stress alone could be the catalyst for something so physically severe. No one could find anything wrong with me, yet they all strongly recommended that I work less.

After several years of working on myself, I’ll tell anyone who will listen that burnout is real. Stress isn’t just a word – it’s an individual, physical manifestation of mental or emotional strain resulting from very demanding circumstances.

And if the last year has taught us anything, we’re continually surrounded by demanding circumstances in work and life.

And my wellness journey continues. I’ve experimented with and educated myself on dozens of forms of treatment in the physical, mental and spiritual spaces. I’ve tried exercise, craniosacral therapy, mediation, life coaching, and almost every spiritual experience LA has to offer.

And the truth is, there isn’t a one-size-fits-all answer for burnout and stress.

The treatments that have proven the most effective for me have been therapy, executive coaching, and simply learning when I need to take time off and then actually taking it – without the guilty feeling like I’m missing out or letting people down. A nightly digital detox (no phone in the bedroom) and an exercise routine are also things that I feel have helped manage my stress levels.

Today, I’m aware of my triggers and can see the stress coming on and act before I reach total burnout. I know that long hours and high stress lead to my migraines, and I’m also physically tipped off by restless sleep and mild cluster migraines that become frequent and more painful. I take a timeout when I can no longer power through the burnout and stress.

In early March 2020, right before the world locked down because of COVID-19, I quit agency life for good. I founded my own communications consultancy, The Good Advice Company, where I advise brands and agencies in strategic communications, marketing, and senior-level thought leadership.

I recognize the privilege I have of being able to quit my job and start my own company. I’ve done it twice, once in 2008 and again in 2020. Entrepreneurship definitely has its own unique versions of stress (managing a new business, finances, and legal issues come to mind), but it’s also allowed me a more flexible schedule, empowered me to work with clients and partners who respect my boundaries, and brought on a new focus to my work.

I know after more than a year of living at work 24/7, many feel like they’re at their breaking point. At the time of my rock bottom of stress, I honestly would have preferred that the doctors had found something physically wrong with me. Instead, I ultimately discovered that my episodes were self-inflicted manifestations of intense stress and burnout.

The reality that I was doing this to myself was the truth I needed to make a change.

If I was doing this to myself I could undo it as well. And you can too. Self awareness is the starting point of change.

Everything from setting boundaries around your health and not apologizing for it, to speaking up to your supervisor before you get to your breaking point will help you. I truly believe the world has become more empathic during the pandemic, and I’m hopeful that that empathy continues as we slowly return to our physical workplaces.

We shouldn’t have to prove we’re good at our jobs by the amount of hours we put in, or how much we can push ourselves to the breaking point. We shouldn’t have to reach a breaking point to feel valued, appreciated and be told that we’re good at what we do.

There is no job on earth that is worth putting your mental and physical health at risk.

Elizabeth Rosenberg is a strategic communications consultant and founder of The Good Advice Company.