Not the same tired

Specialist CBT therapy for anxiety, OCD, depression and more in West London

“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. It may also be useful to notice what tiredness has changed. Some people stop seeing friends, postpone appointments, lose pleasure in small routines or find that even decisions take more effort. Others keep functioning outwardly but feel increasingly detached. These are observations to bring into an assessment, not tests to pass or proof of a particular diagnosis. They can help make the conversation more precise. A person’s cultural expectations, household duties and employment conditions can also shape how easily fatigue is noticed, discussed or supported by others nearby in everyday life and shared spaces over time, with care always. 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 <a href="/therapy/burnout/">CBT support for burnout</a>, <a href="/therapy/depression/">CBT support for low mood and depression</a> and <a href="/guides/anxiety vs burnout differences/">the anxiety and burnout guide</a>. The Lyceum Clinic offers assessment led CBT online and in West London.