Asking for a friend Your problems solved by The Midults

Annabel Rivkin and Emilie Mcmeekan

Do not lie down and play dead, because there are answers out there

Q:Dear A&E, I’m always exhausted. No matter how much sleep I get (although generally I wake up at 4am). Even after a holiday I’m shattered. It’s not ME, it doesn’t seem to be linked to my menstrual cycle and I’m only 44, so I shouldn’t be this tired. I can work, exercise and function, but it seems to be getting worse and I feel more and more isolated. I’m full self-loathing, as part of me believes I’m just lazy and ought to pull myself together –Shattered

Dear Shattered, People don’t tend to take tiredness seriously unless they’ve experienced it. One of us was in the same boat for many years and is just emerging from the fog. The other has had to witness the frustration, misery and life-flattening effect of unexplained tiredness. It’s a rubbishy way to live.

In our experience, in the end, people just go floppy, give up and wait for a major depressive episode that is probably in the post. We have not consulted any doctors for this particular answer because we have consulted so many in the past and only a few have had anything useful or empathetic to say. You’re not lazy, Shattered, you’re... shattered.

To get to the bottom of this, we are going to give you a lot of boxes to tick, so brace your tired self:

1. Sleep hygiene. Worthy but effective. No screens for 90 minutes before lights out. A long bath with Epsom salts. A coldish bedroom. Preferably no booze at all and definitely no caffeine after midday.

2. Meditation. It can help energise the brain and get the metabolism ticking over. Try the Headspace app every day for a month. It may not make you less tired, but it could give you some air...

3. Get your hormones checked.

At 44 you’re in your peri-menopausal prime. Are you more depleted at certain times of your cycle? You may, for example, be low in testosterone or your oestrogen may be falling off a cliff. We are not experts, but we do know that lady chemicals are powerful things and that if approached proactively their rebalancing can prove to be a power surge...

4. This is obvious, but have you had your thyroid checked? Make sure both your T3 and your T4 levels have been looked at (doctors will often only look at T3). One specialist told us recently that getting the T4 right can be like ‘turning on a light bulb’, which is exactly what you need right now. 5. Get your mineral levels

looked at, too. You’ll need a good practitioner to do a deep dive into them, because there are a few magic ones when it comes to both sleep (magnesium) and energy (vitamin D and some of the Bs).

6. Gut. Gut. Gut. If you’ve got candida or some other kind of gut fungus (sexy), then nothing else really stands a chance, because all those virtuous supplements and healthy nutrients from mindful eating cannot be absorbed so – boring alert – you need to support your microbiome. You can easily get tested for candida but, in the meantime, a prebiotic/probiotic like Symprove is a great place to start. If diagnosed with candida you would then embark on a monumentally dull diet that also boosts energy levels – from zombie to semi-fully-functioning human woman in a week. Potentially.

7. Therapy. Sorry to bang this drum when you’re already so weary, but it’s hard to keep perspective when you are this compromised. And, clearly, you are moving into self-blame, which is unhelpful. Not to mention the loneliness that goes hand in hand with exhaustion-based seclusion.

And lastly, dear Shattered, you are not alone. We are living in a pandemic of tiredness and burnout. So treat this like a boardroom takeover. Do not lie down and play dead, because there are answers out there and, with your last scraps of energy, you will find them. Because you want a better, fuller, more awake life. Some of the things we have suggested can make people go a bit eye-rolly. A bit, ‘bloody LA nonsense’. Ignore them. Ignore your own eye-rolls. And dive into the incredibly exciting prospect of feeling better.

Do you have a dilemma that you’re grappling with? Email Annabel and Emilie on themidults@telegraph.co.uk. All questions are kept anonymous. They are unable to reply to emails personally