Why rest doesn’t help when you are exhausted rather than anxious.
Someone offers to help. A friend says she will have the children on Saturday so you can get some rest. Your sister offers to sit with your mum for an afternoon. And somewhere underneath the thank you there is a small flash of irritation, and right behind it, guilt for having felt it.
I want to talk about that flash. I work in analytical psychology, the tradition that goes back to Jung, and in my consulting room that flash is one of the clearest signs that what a person is carrying is not only anxiety. They are also running on empty. The two overlap constantly, which is part of the trouble. But they do not respond to the same kind of help.
Two states that use the same words
Anxiety is a system on alert. It leans forward into the future: what if, and what then, and what have I missed. The body is loud. A fast heart, a tight chest, four in the morning with your eyes open.
Depletion is quieter. Nothing is going off, which is exactly why it gets missed: nothing looks urgent. Things stop mattering. The day gets got through. The evening goes on a screen that you are not really watching.
Both arrive at the same sentence: I cannot cope any more. That is why they are so easily mistaken for each other, including by the person living inside them.
So ask the body first, before you ask yourself anything. Braced, fast, hard to sit still? Or heavy, slow, hard to start? The body usually knows which of the two you are in before you do.
Why the techniques sometimes stop working
Anxiety UK’s own blog offers the APPLE technique for worry about world events: acknowledge, pause, pull back, let go, explore. It is a good technique and I teach things like it.
What it does is bring an alarm down. Which is why it can feel useless on a day when the alarm is not the problem, and getting up off the sofa is the whole difficulty.
The technique does not fail loudly. It just does nothing, and the person adds a line to a list they have kept for a while. Even this does not work for me. I have watched that list grow, and it does more harm than the tiredness it started with.
So before choosing a technique, ask a duller question. What is going on with me today: a system that will not switch off, or one with very little left?
Where I have seen it most plainly
I am a Ukrainian psychologist, and for the fourth year my clients have been living in a country at war. That gives me no special key to anyone else’s tiredness. It has meant seeing a great many people in one state, for a long time. For scale: in populations affected by conflict, around one in five people has a mental health condition at any given time, compared with about one in 14 people worldwide, according to a 2019 review carried out for the World Health Organization.
But the numbers are not the part I remember. What I remember is that people mostly do not arrive frightened. They arrive flat. What they ask for is instructions rather than comfort. Just tell me what to do next. And when someone offers to look after them, the answer is almost always the same. I have not got time to rest.
You do not need a war for this
Consider what Carers UK found among people in Britain looking after a relative. Seventy three per cent carried on providing care while feeling they were already at breaking point. Forty four per cent put off medical treatment they themselves needed. 65% said they felt overwhelmed because they had not been able to take a break.
That is the same shape, in ordinary British lives, with no war near it. Something has to be held, and the person holding it has quietly moved to the back of the queue.
Why being cared for can feel like a job
Because accepting care means stopping, and stopping is the move this system has learned to treat as the most expensive one available. As long as I keep going, it holds.
There is a second reason, less obvious. To accept help you first have to admit the state you are in, to yourself and then out loud to somebody else. That admission costs energy, and energy is the thing in short supply. Saying I am fine, honestly, is cheaper.
What actually helps
Look at the load before you add to it. Worn out people are usually told to add something: exercise, a hobby, a course, a supplement. I think of it as a jar. What you pour in is what you have got. But if the jar has a crack in it, pouring faster will not fill it. So the question is not what to add. What am I carrying that nobody has asked me to carry for a long time? I mean the invisible extras. The jobs you took on because nobody else would. Not your treatment, and not the person who depends on you. Those stay.
Take care in the smallest unit available. A weekend away often gets refused: it is too big, it has to be organised, and organising is another task. What gets through is smaller. A meal left at the door. An hour somebody has already arranged. If you are the one offering, offer something small and definite. Try not to ask what can I do. That question hands over one more decision.
One health note matters more than anything above it. You do not have to wait weeks to see whether this lifts, and you do not have to be in crisis to deserve help. Depression can look exactly like the flatness I have described, and it responds to treatment. Your GP is a good place to start, and if you feel unsafe, or you are having thoughts of harming yourself, please contact Samaritans on 116 123, free, at any hour, or call 999. Asking is not a failure of self management.
This is how I see it, and you know your own state better than any article does. But if you recognised yourself in that flash of irritation at the start, try one thing this week. Let one person do one small thing for you, and let it stay small.
By Anna Bulat, Ukranian psychologist