The Burnout Puzzle (3): The “No Pain No Gain at What Cost” Ledger
We began this trilogy by examining how we can exercise more options before burnout if we consider it a form of poor psychological fit. If ego-driven burnout, or burnout fueled by shame, then pain is a debt that finally comes due — and a better understanding of these concepts might better protect us.
In our first piece, The Burnout Puzzle (1): The Role of Expectations, Boundaries, and Ego, Sreedhar Potarazu, MD, and I focused on our internal architecture — how burnout often stems from our own minds, particularly the ego’s constant drive to prove, please, or control. A self that is scrambling to meet, or escape, demands that it has often helped construct.
Managing the tension between expectation and capacity, whether as an employee or founder, our meaning-making habits, identity structures, and the personal stories we tell ourselves can exacerbate this misalignment, leading to dire consequences.
The challenge or approach is not always to cut back on hours or download another app, but to examine why we feel only as valuable as our output.
Then, in The Burnout Puzzle (2): How Managers Can Help Us Escape The Shame Trap at Work, we explored that our inability to deal with occupational stress in a way that might lead to burnout is not just from overwork or long hours, but also from shame, social comparison, and brains being forced to operate against their design.
Many high performers mistake exhaustion for excellence, turning over-functioning into an expectation. This mindset erodes energy, perspective, and self-worth, not only in themselves but also in the people they interact with at work and in the community. When employees feel constant pressure to prove their worth, they might become ashamed of falling short. Shame, left unchecked, can turn into withdrawal, perfectionism, and defensiveness.
That piece also explored how understanding attachment patterns and automatic reactions (attacking oneself or others) around the “shame compass” can help us better understand our own automatic responses.
Here, we consider burnout as a risk of a form of chronic emotional debt — pain paid in hopes of gain, but often with hidden costs and poor returns.
Does it Have to Hurt?
Pain is transactional — the loss of something in the hope of an eventual gain. Pain is a pendulum that swings between the anxiety of gain and the fear of loss. Every pain carries a cost — sometimes it buys resilience, sometimes it buys nothing but depletion and exhaustion. An original version of this piece was published in American Bazaar in September 2025.
When we are in pain, there is a loss, and we try to endure to build resilience, which is a gain. However, it comes at a cost, which is a detriment to health, sanity, family, and much more.
For entrepreneurs, athletes, politicians, and many others, pain is a currency. In each of these situations, we decide to “pay” with pain, hoping to gain wealth, improve performance, achieve fame, or better health. But there is a cost, whether it is conscious or not. There are profits and losses, as well as assets and liabilities. Sometimes we are profitable, and at other times, we are bankrupt. The pain is deliberate.
The Myth of “No pain, No Gain”
In the US, we often repeat the phrase “no pain, no gain” as though pain were simply the price of progress. In German, it becomes no prize without diligence (“Ohne Fleiß, kein Preis”). The French take is literally that one must suffer to be beautiful (“Il faut souffrir pour être beau/belle”). In Spanish, the summary is clearest: whoever wants something, it costs them something (“Quien algo quiere, algo le cuesta”).
In the US, the saying allegedly dates to Benjamin Franklin, who in his 1734 “Poor Richard’s Almanack” wrote, “There are no gains without pains.” Two centuries later, it resurfaced in the fitness world, urging athletes to push past discomfort.
By the 1980s, companies like Nike turned it into a cultural slogan and a marketing tool, with the famous 1988 “Just Do It,” sometimes paired with “There is no finish line.” What began as a reminder of hard work became a global brand of ambition and endless perseverance.
But pain, framed as a necessary debit in pursuit of glory, wealth, achievement, or recognition, sometimes obscures what gets lost along the way — often things that might be more important.
But at what cost? Every gain has a receipt.
So … what did you really pay? And was the gain worth the price?
What we pay: From Ambition to Immigration
To earn the big payout, there is always a price, but there comes a time of asking what it will be. For athletes, politicians, actors, or musicians, there is a price to pay. Sometimes the cost or “bill” is clear much later, and arrives in the form of strained health, lost relationships, and broken promises.
Firsthand experience, as shared by co-author Sreedhar, suggests that ambition and success can lead to substantial debt. And that debt was engulfed in a surge of endorphins (our internal opioids that mask the pain). We lose the ability to know when enough is too much. And then there is not only internal exhaustion but also collateral damage to others who came along for the ride, with their own expectations of pain and gain. By then, the question is not whether there was a gain, but whether it was worth the cost.
The immigrant ledger shows this clearly: generations traded proximity to family and peace of mind for prosperity, but the tax of ambition only grew heavier with time. The earliest immigrants came to America with an entrepreneurial spirit, but they endured enormous pain at home, at work, and in public. This involved loss of contact with family at the expense of the hope of economic prosperity.
That same zeal has been passed on to subsequent generations but magnified. Bigger houses, more expensive cars, more vacations, but at what cost? What was the tax that was paid, either in the form of health, relationships, or peace of mind, to achieve all that, and what was the net gain or loss?
The Hidden Balance Sheet
Whether the pain is physical, emotional, or intellectual, each form of pain involves some element of loss — real or perceived. But what if pain is more than just a temporary cost on the ledger of life? What if it is a state of losing something more important, like health, identity, security, or peace of mind, that is not always balanced by an equal gain?
Considering pain through the lens of finance reveals its hidden weight.
Every life has debits and credits, moments of loss and moments of fulfillment. Pain enters the account when expectations are unmet, when the return on effort falls short of the investment, or when outcomes fail to justify the sacrifices. In that sense, pain is not only personal but also transactional, tied to the deficits between what we give and what we receive. Sometimes that deficit is created by the difference between ego and expectation (as we explored here).
The difference in the balance sheet of pain is that some of the assets are intangible. There is no way to quantify what health, family, or peace is worth. So, while we pursue progress through pain with hopes of quantifiable gain, whether it be monetary, followers, likes, or wins, it’s hard to reconcile this against the cost of health, family, and peace.
Emotional Debt
That same dynamic — the gap between ego and expectation — shapes much of how we experience pain today. Across communities, the balance sheet of pain is growing heavier, and it extends far beyond biology. Mental health challenges like depression, anxiety, and stress-related disorders represent silent liabilities.
The American Psychological Association has documented how stigma prevents people, particularly immigrants and members of minority communities, from seeking help. These emotional debts accumulate, and because they remain invisible, they can be even more destabilizing. In fact, a part of the brain responsible for emotional regulation, the amygdala, fires not when we win but when we face a loss. Biology appears to overemphasize the pain side of the ledger.
Digital Distortions: False Credits, Real Withdrawals
In today’s world of ChatGPT and social media, the risk grows sharper. Tools like ChatGPT can become ways to deflect or ignore pain, while social platforms offer fleeting credits of validation that often create larger withdrawals of self-worth. They can also worsen the impact of cognitive distortions that can occur when we rely on AI and technology to fill in the blanks. From another perspective, our dependence on ChatGPT and AI may be a way of alleviating our pain, but it also reduces our gain. It is easier to delegate our work and avoid the pain of writing a condolence note or thinking about it. The increase in efficiency, then, is balanced by a loss in creativity and a literal loss of neural connections.
As we explored in our last piece, GenAI tools can also worsen the impact of cognitive distortions that occur when we rely on technology to fill in the blanks. How we feel depends on our genes and the environment, as well as every second of our exposure throughout our entire lives. The choices we make, our feelings about these choices, and the sustainability of these choices depend on these factors. An AI agent will always have vastly insufficient information to know what our most efficacious decisions are. Impossible.
And we will learn that when we follow the advice, like following the advice of somebody we admire but is not aligned with what we believe and think, of an AI agent, the outcome will fuel discomfort, and that will turn us back to people who accept us for who we are.
Social media presents a parallel trap. It is fleeting credits of validation but often results in larger withdrawals of self-esteem and belonging, as comparison fuels anxiety and inadequacy. Social media does not just help us mask pain — it encourages us to engage in it because it monetizes pain. Platforms reward outrage, comparison, and controversy, conditioning us to seek the very triggers that wound us. In a way, we “invest” in pain online, too. The cost is often much higher than the return. These feelings accumulate silently until they demand to be reckoned with.
Emotional Literacy: Spending Pain Wisely
Pain may be inevitable, but suffering in silence is not. Just as financial literacy helps us manage our money, emotional literacy helps us manage our emotions and pain. It is essential to understand the cost-benefit analysis of the situations we choose to endure. Being aware of the decisions we make deliberately to endure pain and the signals to slow down are critical. Like other liturgical texts, Hindu scripture is replete with the idea that controlling our thoughts and emotions is pivotal in how we manage pain and suffering. Both focus on awareness, control, and detachment.
Choosing not to swing on the pendulum but to give our best in every effort and then “let go” free of attachment to the outcome. Free of anxiety or fear. Of course, some debits in life are unavoidable, but others are self-imposed by the burdens of comparison, ambition, and pride, the ego’s hidden tax.
Our call to awareness is an invitation to consider what is in our control and how to balance our ledgers. Recognizing the debits and valuing the credits may not eliminate pain, but it can help us manage it more wisely, and with greater compassion for ourselves and for those around us. We cannot eliminate pain. But like money, we can learn to spend it wisely, with intention and compassion.
In considering burnout not merely as an outcome of overwork, nor solely as the result of social comparison or neurobiological misfit, we now arrive at a more nuanced understanding: burnout as the slow accrual of pain that is misunderstood, misallocated, or mispriced. Much like any currency, pain circulates. We pay with it — sometimes deliberately, often unconsciously — in pursuit of goals that may or may not yield returns. We tell ourselves the discomfort is temporary, the sacrifice necessary, the outcome inevitable. But the account does not always balance.
Better Accounting Before the Crash
Indeed, what we commonly call burnout might be a turning point at which the emotional, cognitive, and physiological debts we have carried — in the name of duty, ambition, or belonging — can no longer be deferred. It is not simply that we have done too much; it is that we have done so without examining precisely what we were spending and why. We treated pain as a resource without recognizing its limits. We accepted exhaustion as collateral damage, rather than as a signal of systemic imbalance.
There is, of course, instructive pain — the kind that builds resilience, reveals capacity, and clarifies values. But not all pain pays such dividends. Some is simply loss. Some is distortion. Some is inherited — passed on through generational ambition, institutional expectations, or cultural mythology. It accrues not only in individuals but also across entire organizations and communities. Left unexamined, it becomes structural. Left unmanaged, it becomes unsustainable.
To address burnout meaningfully, we must learn to assess pain not only as sensation or symptom, but as a signal with economic properties. What are we trading off, and for whom? What are we mortgaging in the present for a possible future that may never materialize? And what quiet costs are being borne — not just by the individual, but by those around them — in the name of performance or perseverance?
The remedy, if there is one, lies not in denial or avoidance, nor in shallow slogans of self-care, but in cultivating a deeper form of awareness. Not all pain must be pathologized, but neither should it be romanticized. As with financial literacy, emotional literacy demands clarity: where are we overdrawn, and where might we restore balance?
Perhaps burnout may not mark the end of capacity, but rather the end of misalignment and the beginning of acknowledging and addressing hidden costs — starting to reckon with them more honestly.
