Upstairs, Magnus is supposed to be getting dressed. He’s nine. Instead, he’s resisting the idea of morning routines. It’s not exactly defiance. He just doesn’t like authority or schedules. I guess he gets that from me.

Tilda comes into the kitchen. She’s twelve, deep in puberty, and sure we don’t understand her at all. She’s probably right. I don’t remember being twelve with this much drama. She grabs some toast, sighs to show we’re letting her down, and disappears back to her room.

My phone vibrates with a notification. Something urgent, or so they say. Everything always seems urgent.

My wife and I exchange a look. The look that asks: Did someone sign the permission slip? Did Magnus’s swim kit get packed? Is Karla really leaving barefoot? Are we going to make it through this morning?

We’re in Cape Town for a sabbatical. All three kids go to Blouberg International, so in theory, logistics should be easier. One drop-off instead of three. But they still have different activities, new friends, and emotional needs that never fit the schedule.

This is Tuesday. Honestly, Tuesday is one of the easier days.

If you have young kids, you know this feeling. The details change, the chaos moves around, but the impossible math is always there.

If you don’t have kids yet, consider this your warning.

If your kids are grown and out of the house, send some love to those of us still in the thick of it. We could use it.

The Management Problem Nobody Warned You About

The universe hands you the children you can handle. That’s what people say. We ended up with three distinct operating systems running simultaneously in one household.

Tilda, our oldest, is busy figuring out who she is. That’s normal for her age, but it’s also exhausting. She needs space, which we give, and understanding, which she thinks we lack. Her eye rolls are famous. Her sighs could power a wind turbine. Underneath, she’s smart, kind, and working out her identity. But it means lots of closed doors and the feeling that her parents are from a much simpler time.

Magnus is the middle child, and in some ways, the trickiest. He’s the peacemaker, the calm one, the kid who settles things between his sisters. But he’s also a nine-year-old with endless energy and a strong dislike for being told what to do. Rules are just suggestions to him. Authority is something to test. I see myself in him... I was like this, and honestly, I still am.

Karla is the youngest and the wildest. At six, she runs on pure willpower. Her older siblings, who should be in charge, always give in to her. She’s learned that persistence wins over authority, that being intense helps her get her way, and that she can’t be fired from her role.

I spent years in management consulting, startups, and large companies. I’ve fixed dysfunctional teams and set up processes where none existed. But nothing prepared me for three kids who ignore every organizational behavior rule.

They listen to instructions, make eye contact, and nod. Then they do whatever they want anyway. Performance improvement plans work for about two days. Incentive frameworks get figured out and used to their advantage. And they know the one thing that makes them impossible to manage: they’re a protected class. They can’t be replaced.

My wife and I are supposed to split responsibilities. In reality, she’s the CEO. She keeps track of everything: which kid has which appointment, which friendship is in crisis, what each child will eat this week (which always changes), and dozens of other things I’m not even aware of.

I’m more like a board member. I show up for meetings, give advice, and sometimes think I have better ideas than the person actually running things. I’m usually wrong. My wife puts up with this, having long ago decided some battles aren’t worth it.

This setup is common. It’s also one of the things that slowly wears people down.

The Silence in High-Performance Circles

After years around ambitious professionals, I’ve noticed we talk about everything except this.

We’ll talk in detail about failed product launches. We’ll admit to imposter syndrome. We’ll share stories about exercising, meditation, and anxiety. These conversations are now normal. That’s progress.

But when it comes to parental burnout, there’s silence.

We don’t admit when we lose our temper over something small and the look on our kid’s face stays with us all day. We don’t say that sometimes our dream isn’t a vacation, but just a little silence. Just one morning when nobody needs anything from us. We don’t confess to sitting in the car for ten extra minutes before going inside, just to have a moment alone.

Challenge: The stigma is backwards. We’ve normalized discussing career failures because we understand they’re part of the game. But struggling with parenthood feels like a character flaw. Like something is wrong with us specifically. It isn’t. Parental burnout is a clinically distinct syndrome, defined by exhaustion in the parenting role, a painful gap between who you wanted to be and who you’ve become, a feeling of saturation, and emotional distancing from your own children [1]. Research shows it predicts escape ideation and neglectful behavior more strongly than professional burnout [2]. This is one of the hardest things humans do. We’ve just decided to pretend otherwise.

The physiological evidence is damning. Working mothers with high parenting stress and high job strain show elevated morning cortisol, their bodies chemically bracing for the day before their feet hit the floor [3]. Mothers who perceive higher parenting stress have measurably lower heart rate variability, indicating their nervous systems have lost flexibility [4]. The load isn’t imagined. It shows up in blood tests and heart monitors.

One statistic haunts me: roughly one in five mothers experiences postpartum depression [5]. It’s highly treatable. The outcomes when treated are good. But, untreated, the damage extends to both the parent and the child, sometimes for years [5]. We have solutions. We’re just not having the conversation that would lead people to them.

Whatever tough situation you’ve faced as a parent, I’ve been there too. No shame.

The Biology of the Breaking Point

Most advice for exhausted parents assumes resources that don’t exist. “Sleep when the baby sleeps” assumes you don’t have a job, other children, or a single responsibility beyond the infant. “Practice self-care” assumes spare time is hiding somewhere you haven’t looked. “Set boundaries” assumes you can explain boundaries to a six-year-old who has decided that shoes are optional and her opinion is final.

The advice isn’t wrong. It just doesn’t help people who are overwhelmed by the reality of modern parenting.

Challenge: Here’s what nobody tells you: fragmented sleep is neurobiologically worse than simply getting less sleep. Total duration isn’t the only variable. Continuity matters, perhaps more. Your brain runs a cleaning cycle during deep slow-wave sleep, a system called glymphatic clearance that flushes metabolic waste, including proteins associated with cognitive decline [6]. When sleep is constantly interrupted, you never stay in deep stages long enough for the cleaning to complete [7]. The “brain fog” parents describe isn’t a metaphor. It’s the literal accumulation of metabolic waste in your prefrontal cortex because the rinse cycle keeps getting interrupted.

This compounds with cognitive load. Every context switch, every interruption, carries what researchers call a “switching cost.” It takes approximately 23 minutes to fully recover focus after an interruption [8]. Three interruptions in a morning don’t cost you fifteen minutes. It costs you over an hour of deep cognitive capacity. And even after you’ve returned to the task, “attention residue” keeps part of your brain stuck on whatever you were pulled away to handle [9].

Then there’s the invisible work. The “Fair Play” research finally quantified what many parents (especially mothers) have always felt: the burden isn’t just in doing tasks but in thinking about them [10]. Conception (noticing something needs to happen), planning (figuring out how), and execution (doing it) are separate cognitive loads. Data shows mothers carry roughly 72.5% of the conception and planning work [10]. They’re running a background operating system that never shuts down, consuming working memory even during supposedly focused time.

The partner who asks “What do you need me to do?” isn’t sharing the load. They’re adding to it. They’re outsourcing executive function while keeping the management burden firmly in place.

What Recovery Actually Looks Like

This sits in the Recover pillar of my Upward ARC framework, and it’s here for a reason. Picture three pillars standing side by side: Activate, Recover, Capacity. Most people focus on Activate (sleep, movement, nutrition) or building Capacity (fitness, skills, cognitive reserve). But without genuine recovery, both collapse under sustained parenting load. Recovery isn’t what happens when you stop. It’s actively bringing your nervous system back to baseline between the hits.

Parents need this more than anyone, but they have the least time for it.

The insight that changed things for me: parenting resembles shift work more than normal professional life. The sleep fragmentation, the unpredictable schedule, and the chronic stress activation. Research on nurses, first responders, and shift workers applies directly [11]. We need their protocols, not lifestyle tips from people who sleep eight uninterrupted hours.

One principle matters most: humans can sleep in two consolidated blocks almost as effectively as one long stretch [12]. Two four-hour anchors of protected sleep preserve cognitive function better than seven hours of fragmented sleep, where both parents respond to every noise. If you have a partner, stop sharing every wake-up. Divide the night. One person owns 10pm to 2am. The other owns 2am to 6am. Earplugs. Separate room if possible. This guarantees at least one complete deep-sleep cycle per person. The parent whose turn it is doesn’t actually sleep.

Brief movement delivers returns far beyond the time invested. Ten minutes of brisk walking improves executive function and mood in sleep-deprived mothers [13]. Not an hour. Not thirty minutes. Ten. Before the difficult conversation. During the gap between meetings. In the parking lot before you walk into school pickup. The barrier is lower than you think.

The cognitive offload requires structural change. Pick one domain your partner currently “helps” with. Transfer complete ownership: conception, planning, execution [10]. Breakfast means they notice when supplies run low, decide what the family eats, buy the food, and prepare it. You delete “breakfast” from your mental operating system. You don’t get consulted. You show up and eat. This isn’t about fairness in task count. It’s about eliminating the background process that drains working memory all day.

Try This Today

The Split. Tonight, if you have a partner, divide the night into protected blocks. One parent owns the first half. One owns the second. The off-duty parent sleeps separately with earplugs. No “I’ll just check.” No shared monitoring. Actual protected sleep. One consolidated four-hour block preserves slow-wave sleep and glymphatic function [12]. Both of you half-awake all night preserves nothing.

The Micro-Walk. Tomorrow, before your most important obligation, take 10 minutes to walk. Outside is better. A hallway works. Brisk pace, not a stroll. This isn’t exercise. It’s a prefrontal cortex reset [13]. The research shows that it specifically works for sleep-deprived mothers. It will work for you.

The Full Handoff. This week, identify one recurring responsibility you currently share. Have the conversation. Transfer complete ownership to your partner. They handle all thinking, planning, and doing. You remove it from your awareness entirely. Start with something manageable. Build from there.

The 90-Second Reset. Before you transition contexts, before you walk through the front door, before you join the call after handling a crisis, take ninety seconds. Inhale normally. Exhale for twice as long as the inhale. Five rounds. Brief breathing interventions measurably reduce stress activation and improve emotional regulation [14]. This isn’t meditation. It’s paying the switching cost deliberately rather than crashing through and carrying your state into the next environment.

The Longer View

I want to finish in a different place than where we began.

The research on purpose and mortality is striking. Adults with the lowest sense of life purpose had more than double the death rate of those with high purpose [15]. Parenting, beneath all the chaos, provides exactly this. Not because it’s enjoyable every day. It often isn’t. But because it connects you to something beyond yourself in a way few other experiences can.

Population data shows parents tend to live longer than non-parents [16]. The mechanism isn’t magic. It’s probably healthier behaviors motivated by a sense of responsibility for others, combined with social connection as you age. But the finding holds. There’s something protective in this, something that compounds over years, even when the days feel impossible.

This is an endurance event. Not a sprint. Protecting yourself isn’t selfish. It’s the strategy that allows you to show up for the people who need you. You cannot pour from an empty cup. You cannot be present when you’re burned out. Taking care of yourself is taking care of them.

Karla eventually wore shoes that Tuesday. Not the shoes we suggested, but shoes. Magnus made it downstairs dressed, having negotiated his own terms with the morning routine. Tilda emerged at the last possible moment, sighing, but present. My wife and I got everyone to school and made our calls on time.

It wasn’t smooth. It never is.

But we made it, even if it wasn’t perfect. With a pre-teen who thinks we don’t get her, a middle child who resists authority, and a six-year-old running the show. With a partnership held together by shared looks in the middle of chaos. With days that go off track before 7am but still end with kids in bed and the house standing. And tomorrow, Karla will probably choose to go barefoot again, yet we’ll still stand ready, accepting the chaos with resilience.

This deep dive is for you. The ones doing the impossible math every morning, the ones who feel like they’re failing when they’re just being human. You’re the bravest of the brave.

Parents.

Stay healthy.

Andre

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References

[1] Roskam, I., Raes, M. E., & Mikolajczak, M. (2017). Exhausted parents: Development and preliminary validation of the Parental Burnout Inventory. Frontiers in Psychology, 8, 163.

[2] Mikolajczak, M., Brianda, M. E., Avalosse, H., & Roskam, I. (2018). Consequences of parental burnout: Its specific effect on child neglect and violence. Child Abuse & Neglect, 80, 134-145.

[3] Hibel, L. C., Mercado, E., & Trumbell, J. (2012). Parenting stressors and morning cortisol in working mothers. Journal of Family Psychology, 26(5), 738-746.

[4] Parisi, F., Høifødt, R. S., Wang, C. E. A., & Pfuhl, G. (2024). Perceived parenting stress is related to cardiac flexibility in mothers: Data from the NorBaby study. International Journal of Environmental Research and Public Health, 21(1), 545.

[5] Slomian, J., Honvo, G., Emonts, P., Reginster, J. Y., & Bruyère, O. (2019). Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Women’s Health, 15, 1745506519844044.

[6] Xie, L., Kang, H., Xu, Q., et al. (2013). Sleep drives metabolite clearance from the adult brain. Science, 342(6156), 373-377.

[7] Provided Research [A]: Bio-Behavioral Mechanics of Parenting and Performance. Section 2.1.1.

[8] Mark, G., Gudith, D., & Klocke, U. (2008). The cost of interrupted work: More speed and stress. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, 107-110.

[9] Leroy, S. (2009). Why is it so hard to do my work? The challenge of attention residue when switching between work tasks. Organizational Behavior and Human Decision Processes, 109(2), 168-181.

[10] Rodsky, E. (2019). Fair Play: A Game-Changing Solution for When You Have Too Much to Do. G.P. Putnam’s Sons. Research summary available at fairplaypolicy.org.

[11] Provided Research [A]: Bio-Behavioral Mechanics of Parenting and Performance. Section 6.1.

[12] Provided Research [B]: Parenting and Performance Report. Section on Split Night Duty protocols.

[13] Damrongthai, C., et al. (2021). Benefit of human moderate running boosting mood and executive function coinciding with bilateral prefrontal activation. Scientific Reports, 11(1), 19869.

[14] Hopper, S. I., Murray, S. L., Ferrara, L. R., & Singleton, J. K. (2019). Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults: A quantitative systematic review. JBI Database of Systematic Reviews and Implementation Reports, 17(9), 1855-1876.

[15] Alimujiang, A., Wiensch, A., Boss, J., et al. (2019). Association between life purpose and mortality among US adults older than 50 years. JAMA Network Open, 2(5), e194270.

[16] Barclay, K., & Kolk, M. (2019). Parity and mortality: Biological and social pathways in comparative perspective. European Journal of Population, 35(4), 873-897.

A note for new readers:

I’m a trained reconstructive facial surgeon, medical doctor, and dentist. Before launching this newsletter, I had a varied career: competitive freestyle wrestler, management consultant (McKinsey), entrepreneur (Zocdoc, Thermondo, and docdre ventures), and corporate executive (Sandoz). Today, I’m a Managing Director and Partner at BCG.

Husband of one. Father of three. Split between Berlin’s urban pulse and our Baltic Sea retreat. I’d rather be moving than sitting. Not just hobbies. Research. My body is my primary laboratory; I’ve been conducting experiments for decades.

If this is your first time here, welcome. I’m excited to share what I’ve learned and will continue to learn with you.

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DISCLAIMER:

Let’s get one thing straight: None of this, whether text, graphics, images, or anything else, is medical or health advice. This newsletter is here to inform, educate, and (hopefully) entertain you, not to diagnose or treat you.

Yes, I’m a trained medical doctor and dentist. No, I’m not your doctor. The content here isn’t a replacement for professional medical advice, diagnosis, or treatment.

If you have questions about your health, talk to your physician or a qualified health professional. Don’t ignore their advice or delay getting care because of something you read in The Upward ARC. Be smart. Do your research. And, as always, take care of yourself.