In my current role, taking PTO is a legitimate punishment. If I take a day off, there is nobody else on my team who has capacity to pick up my work in my absence. When I return from PTO, not only do I now have double the amount of work to catch up on, but I also have 15 emails from angry managers upset that I didn't get to their request sooner.
"you should just take some vacation" is often a convenient escape hatch for managers that want to seem like they're helping, but without actually putting any effort into solving the problems that make people want to escape from work in the first place.