Understanding fatigue, brain fog, aches, mood changes and overwhelm.
Have you ever woken after a full night in bed and felt as though you have not rested at all, or you could just sleep forever.
Not simply sleepy, but ‘bone tired’. Your body aches, your head feels foggy, ordinary decisions feel difficult and the words you know are sitting on the tip of your tongue refuse to appear. You may feel irritable, emotional or completely unmotivated. Even beginning a simple task can feel enormous.
And yet you continue. You put on the capable face, go to work, care for other people and push through because life still needs to happen.
I understand this from both sides of the treatment room. I am a craniosacral and clinical massage therapist, but I also live with menopause symptoms, migraines, TMJ problems and ME/CFS, so I understand personally that fatigue is not always resolved by rest.
Alongside treating clients, I run two businesses, NP Therapies and Thanda Wena Escapes. I have rebuilt my work after moving from West Sussex to Derbyshire, navigated the disruption of Covid and experienced the profound illness and death of my best friend. Every person's story is different, and fatigue is not caused by one condition alone.
I understand this from both sides of the treatment room. I am a craniosacral and clinical massage therapist, but I also live with menopause symptoms, migraines, TMJ problems and ME/CFS, so I understand personally that fatigue is not always resolved by rest.
Alongside treating clients, I run two businesses, NP Therapies and Thanda Wena Escapes. I have rebuilt my work after moving from West Sussex to Derbyshire, navigated the disruption of Covid and experienced the profound illness and death of my best friend. Every person's story is different, and fatigue is not caused by one condition alone.
I have reached the point of absolute overwhelm myself. I know what it is like to want to stay in bed and do nothing, but feel that you must keep going. I also know the strange cycle of having no capacity for meaningful self-care, but knowing it is essential, then finding yourself doom scrolling because it is the only thing that feels manageable.
If this sounds familiar, you are not lazy, weak or failing. Your symptoms are real, but there may be more than one reason for them.
Tiredness and fatigue are not always the same thing. Ordinary tiredness will often improve after sleep or a quiet day. Fatigue can feel very different. It may affect your physical energy, concentration, memory, emotions and ability to complete everyday activities. Rest may help only slightly, or not leave you feeling restored at all.
Fatigue is a symptom rather than a diagnosis. It can be associated with prolonged stress, grief, poor-quality sleep, perimenopause or menopause, pain, migraine and mental health difficulties, to name but a few. It can also have medical causes such as anaemia, thyroid problems, diabetes, sleep apnoea, infection or medication side effects.
This is why persistent or worsening fatigue deserves proper attention rather than being dismissed as ‘just stress’, as it so often is. We don’t like to show / think that we are not coping as well as everybody seems to think we are.
Your system may have been carrying too much for too long
The stress response is designed to help us respond to an immediate threat, (like a tiger about to chase and eat you – not an email we just can’t face!)The body releases stress hormones, breathing and heart rate may change, muscles prepare for action and attention narrows towards what feels urgent.
This response is useful when there is a genuine danger. The difficulty comes when work pressure, uncertainty, caring responsibilities, grief and an unrelenting to-do list repeatedly activate it without enough opportunity for recovery.
You may notice some of the following things:
- Tight shoulders
- Headaches
- Jaw clenching
- Difficulty falling asleep or staying asleep
- Digestive changes
- Irritability, anxiety or mood changes
- Reduced concentration and decision-making capacity
- Small mistakes and forgetfulness
- Increased sensitivity to pain
- Feeling simultaneously exhausted and unable to switch off
- Wanting to run away and hide but know you can’t
I often describe prolonged stress as continuing to drive your car after the red engine warning light has appeared- at some point you will need a tow truck.
You may keep the car moving for a while, but ignoring the signal does not resolve the problem. Eventually, something has to change.
Why these symptoms can arrive together
Fatigue, pain, poor sleep, low mood, brain fog and overwhelm rarely sit in neat, separate boxes. Each can affect the others and create a cycle that becomes difficult to interrupt.
Poor-quality sleep creates a domino effect
Time in bed does not always equal restorative sleep. Pain, migraines, jaw tension, hormonal changes, night sweats, worry and an activated mind can all interrupt sleep or reduce its quality.
After several nights of poor sleep, it may become harder to concentrate, regulate emotions, make decisions or motivate yourself. You may feel more sensitive to discomfort and less able to cope with demands that would normally feel manageable. Stress and pain can then make it harder to sleep again.
Perimenopause and menopause may affect far more than periods.
The NHS recognises sleep problems, low mood, anxiety, mood swings, problems with memory or concentration, and muscle and joint pain among the possible symptoms of perimenopause and menopause. Headaches or migraines may also become worse than usual.
When several of these symptoms appear together, women may feel as though they have suddenly lost their resilience, sharpness or motivation. They have not become less capable. Their body may be navigating hormonal change alongside the same workload, responsibilities and expectations they were already carrying. Fighting to be heard and understood also adds to the stress and overwhelm and as most women (in particular) who are trying to navigate the menopause era are well aware.
Pain, migraine and TMJ problems use energy too
Ongoing pain is tiring. A tight or painful jaw, clenching, disrupted sleep and recurring headaches or migraines can make it difficult for the body and mind to settle fully. Pain demands attention, even when you are trying to work through it, and that constant background demand can reduce the capacity available for everything else.
TMJ problems may include jaw pain or tightness, clicking, difficulty opening the mouth, headaches and disturbed sleep. Stress may make jaw tension worse, while the resulting discomfort adds another layer of stress. This can become a self-reinforcing cycle.
Grief and emotional pressure are physical loads.
Grief is not confined to thoughts or feelings. It can affect sleep, appetite, concentration, motivation and the way tension is held throughout the body. Uncertainty at work, financial pressure, caring for others and repeatedly having to start again can also consume enormous mental and emotional resources.
Decision-making becomes harder when your capacity is already stretched. Small mistakes slip in, familiar words disappear and minor problems can feel disproportionately upsetting. This does not mean you are failing. It may mean there is simply too much competing for too little remaining energy.
Fatigue can also have an underlying medical cause
Persistent fatigue can be associated with conditions such as anaemia, thyroid problems, diabetes, sleep apnoea, vitamin deficiencies, infection, depression, anxiety or medication side effects. ME/CFS is another possible cause and can involve debilitating fatigue, unrefreshing sleep, brain fog, pain and worsening symptoms after activity.
ME/CFS is part of my own lived experience, but it should not be assumed to explain somebody else's fatigue. There is no single test for it, and similar symptoms can occur in several conditions. A GP can consider the whole picture, arrange appropriate checks and help identify the right support. If activity causes a delayed and significant worsening of your symptoms, avoid simply pushing through and mention that pattern when seeking medical advice.
Why capable people often miss the signs
Many of the people I see are active women experiencing perimenopause or menopause. They may be running businesses, leading teams, managing a household or supporting family members, or doing all of the above an trying to juggle it all and have a life too.Their lives look successful and organised from the outside, but maintaining that appearance is using every reserve they have.
They are accustomed to being the dependable one. Everyone else comes first, while their own needs are postponed until there is more time. Of course, that quieter week rarely arrives.
When capacity becomes very low, even helpful activities can feel like more work. Doom scrolling, withdrawing or staying in bed can be the mind's attempt to choose the lowest-effort option available. It is not necessarily a lack of care or ambition. It may be a sign that your resources are depleted.
An example from my treatment room
One client came to me while facing significant and uncertain changes at work. They felt insecure about what might happen and were experiencing migraines, a tight jaw and increasing overwhelm.
Our work considered both the physical tension and the wider pressure they were carrying. Alongside regular hands-on treatment, I offered practical coping methods that helped them slow the overwhelm, consider the situation more clearly and identify the decisions that remained within their control.
Over time, the client reported that their migraines had eased. They also began making decisions more confidently and felt more in control of their situation.
This is one person's experience, not a promise that the same approach will produce identical results for everyone. It does, however, illustrate why supporting the body and the person's wider circumstances can be more helpful than viewing each symptom in isolation.
How hands-on therapy may support you
My approach begins by listening to the whole picture: your symptoms, sleep, stress, pain, responsibilities and what you need from treatment.
Craniosacral therapy is a gentle, hands-on approach. My intention is to create a calm, supportive space in which the body can settle and the client can reconnect with what they are feeling. Some clients describe deep relaxation, greater ease or feeling lighter afterwards. Experiences vary, and craniosacral therapy should not replace appropriate medical assessment or treatment.
Clinical massage focuses more directly on painful or tense muscles. It may help to ease muscular tension, support relaxation and make movement feel more comfortable. Treatment is adapted to the person rather than delivered as a standard routine.
Neither approach is presented as a cure for menopause, migraine, fatigue or an underlying medical condition. They can form part of a broader, personalised plan for comfort, pain management, rest and reconnection.
Five gentle things to try when you have very little capacity
You do not need an elaborate wellbeing routine. Begin with something small enough to feel possible.
1. Lengthen your out-breathBreathe gently, without forcing a deep breath. You might breathe in for a count of three and out for a count of four, five or six, choosing a rhythm that feels comfortable. A slower, longer exhalation can be used as a calming technique when you feel tense or overwhelmed. Stop and return to normal breathing if you feel dizzy or uncomfortable.
2. Bring your attention into the roomIf panic or overwhelm is building, name three things you can see, three you can feel and three you can hear or smell. This simple grounding exercise redirects attention towards the present environment. You could also use the familiar 5-4-3-2-1 senses method.
3. Give your body the basicsHave some water and, where possible, eat regular, nourishing food. Coffee and tea still contribute to fluid intake, but water is a simple caffeine-free choice. Avoid judging yourself if your meals are not perfect. Consistency is more useful than perfection.
4. Step outside, within your limitsA few quiet minutes outdoors may provide light, fresh air and a change of focus. If it is safe, comfortable and within your energy limits, you might sit outside, take a very gentle walk or stand barefoot on the ground. The goal is not to reach a step target. If physical activity tends to worsen your symptoms, choose rest or simply sit outside instead.
5. Allow some ‘personal sympathy time’Someone recently used this phrase with me and I loved it. Self-care can sound like another task to complete. Personal sympathy time feels softer. It is permission to acknowledge that something is difficult and respond to yourself with the understanding you would offer somebody you love.
When to speak to your GP
Please arrange a GP appointment if your fatigue has continued for a few weeks without a clear reason, is affecting daily life, is getting worse or is accompanied by other symptoms. You are not wasting your GP's time.
Seek medical advice for persistent or changing migraines, frequent severe headaches, significant jaw pain or locking, or symptoms that concern you. A sudden extremely painful headache, new weakness or numbness, problems speaking, confusion, a seizure or sudden loss of vision requires emergency assessment.
Your emotional safety matters too. Reach out if you feel unable to cope, have thoughts of harming yourself or do not feel able to keep yourself safe, please ask for urgent help. In England, call NHS 111 and select the mental health option. If there is an immediate danger, call 999 or go to A&E. Samaritans can also be contacted free at any time on 116 123.
You do not have to keep pushing alone
The most important thing I want you to take from this is that you are not alone and help is available.
I cannot promise that one treatment or one lifestyle change will remove every symptom. I can tell you that there are ways to reduce the load, understand your patterns, seek appropriate support and begin working with your body rather than continually forcing it through another day.
Be kind to yourself. Notice the warning light. Give yourself some personal sympathy time and ask for help.
If you would like personalised support, I offer craniosacral therapy, clinical massage and my Reset, Restore, Reconnect approach through NP Therapies. Treatment can complement, but does not replace, care from your GP or other healthcare professionals.
Find out more at NP Therapies
https://www.nptherapies.co.uk/
or book an appointment
https://clientportal.powerdiary.com/clientportal/nptherapiesbooking
Helpful UK information
NHS: Tiredness and fatigue
https://www.nhs.uk/symptoms/tiredness-and-fatigue/
NHS: Symptoms of menopause and perimenopause
https://www.nhs.uk/conditions/menopause-and-perimenopause/symptoms/
NHS: ME/CFS
https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/
NHS: Migraine
https://www.nhs.uk/conditions/migraine/
NHS: Temporomandibular disorder
https://www.nhs.uk/conditions/temporomandibular-disorder-tmd/
NHS: Urgent help for mental health
https://www.nhs.uk/nhs-services/mental-health-services/where-to-get-urgent-help-for-mental-health/
*This article provides general information and is not a diagnosis or a substitute for individual medical advice.*