“I am just exhausted” can describe many different experiences. It may follow poor sleep, caring responsibilities, shift work, illness, medication, grief, work pressure, low mood, anxiety, pain or a combination of these. Two people can use the same word and need very different kinds of support. A blog should not decide that fatigue is burnout, depression or a psychological problem. New, severe, persistent or worrying fatigue should be discussed with an appropriate medical professional. Changes in weight, sleep, mood, pain, breathlessness, fainting, weakness, fever, medication effects or daily functioning can need medical assessment. It is important not to assume that a physical cause is “just stress”, or that a person must choose between medical and psychological support. Assessment can explore the context of tiredness: when it began, what makes it better or worse, what is happening with sleep, food, work, care, relationships and health, and what the person wants to be different. This creates a fuller picture than a label. It can also clarify whether CBT, medical review, workplace support, social help, rest or another service may be appropriate. CBT may be considered after assessment. It does not promise to restore energy, resolve every practical pressure or replace medical care. If behavioural work is appropriate, it is planned collaboratively with a qualified clinician rather than taken from an article as a self directed instruction to push through exhaustion, change routines abruptly or ignore symptoms. Sometimes fatigue is accompanied by hopelessness, withdrawal, very low mood or thoughts about not wanting to be here. If someone is in crisis, has thoughts of self harm or cannot keep safe, urgent appropriate help is needed. No one needs to prove that they are “tired enough” before seeking advice. For related information, see CBT support for burnout at lyceumclinic.co.uk/therapy/burnout/, CBT support for low mood and depression at lyceumclinic.co.uk/therapy/depression/ and the anxiety and burnout guide at lyceumclinic.co.uk/guides/anxiety vs burnout differences/. The Lyceum Clinic offers assessment led CBT online and in West London.