The Tiredness Trap Week 2: Where Did Your Exhaustion Really Come From?

There is a GP acronym that most patients never hear.

TATT. Tired All The Time.

It accounts for up to 15% of GP consultations. Millions of men sitting across a desk, describing a low, grinding exhaustion that won’t shift, hoping someone will find the answer in a blood test.

Here is what usually happens. Investigations are carried out in only half of those patients, and few of those tests show anything abnormal. A diagnosis is made in less than half of cases.

So men go home reassured that nothing is wrong. And carry on being exhausted.

I’ve been that GP, running those tests, finding nothing, sending men away with lifestyle advice. And I’ve been that patient, sitting on the other side of the desk, wondering why the numbers looked fine when nothing felt fine.

The blood tests aren’t wrong. They’re just looking in the wrong place. And there’s one test most GPs, including me in standard practice, don’t run at all: testosterone. More on that in a few weeks when we get to the physical layer.

The more important question, the one that rarely gets asked in a ten minute appointment, is this: how long has this actually been going on? Not months. Not years. How far back does it really go?

It Started Before You Think It Did

For most of the men I work with, the exhaustion didn’t begin with the current job, or the kids, or the mortgage.

The pattern started earlier. Much earlier.

For me, it goes back to childhood. I remember lying in bed unable to sleep unless I’d physically exhausted myself. Needing to have walked far enough, moved enough, to force the system to shut down. Not a sleep problem exactly. Looking back now, the first signs of a nervous system that hadn’t learned how to rest.

Then came the exams. A-levels, first degree. Getting tired quickly under pressure. Taking myself to my mum’s house to revise, away from the alcohol that had already become part of how I coped. Already, before my career had even started, managing and controlling rather than understanding.

Medical school: Coke to stay awake through lectures. The coping toolkit already forming.

If you recognise yourself in that, you might find this useful: The Burnout I Didn’t Know I Had: How It Started at Age 8.

The Man I Watched

From about the age of twelve, my dad sort of disappeared.

He was still there. He drove me to the bus stop in the mornings. Early starts for both of us. We sat in silence, mostly. He was part of my life in the sense that he was physically present. But I have very few memories of him from that period. Evenings he’d sit on the sofa or disappear to his room after work.

A few years ago, a primary school teacher told me she used to see my dad walking to work past the school. She said he always looked worried and deep in thought.

He was twelve years into that walk before he died.

I didn’t know any of this at the time. He never said a word about what he was carrying. Five years of threatened redundancy. Worry about the mortgage. About losing his identity. About what he’d be without his job. He tried to talk to one of his brothers about it once, asked about borrowing money, had some idea about investing in a post office. They had an argument. Nothing came of it.

He had no friends. He kept it from his wife right up until the redundancy actually happened. The full story only came out after the funeral, when his brothers finally told us.

He took it entirely alone.

And I watched all of that as a child and filed it under: this is just what men do when things get hard.

Not a warning. A template.

The Warrior Who Forgot Everything Else

There is a framework I find useful here, from the work of Robert Moore and Douglas Gillette. They mapped four core masculine archetypes: the King, the Warrior, the Magician, the Lover.

Healthy men draw on all four. Burned out men are almost always running on Warrior alone.

The Warrior in its healthy form is focused, disciplined, capable of sustained effort. Useful in short bursts. But when it becomes the only mode available, it turns compulsive. You push because pushing is the only thing you know how to do. Rest feels like failure. Play feels pointless. Presence feels self-indulgent.

The Lover is the part that enjoys things for their own sake. Connection, pleasure, being somewhere without an agenda. It’s also the part that gets buried first under performance pressure and financial worry.

My dad lost the Lover entirely in those last five years. The worry, the grind, the quiet shame of a problem he couldn’t solve. All Warrior, and the Warrior was losing.

I did the same thing twenty years later. Different circumstances, same architecture.

The Pattern You Inherited Without Knowing

Here is the thing about inherited patterns. They don’t feel like patterns. They feel like reality. Like the weather. Just how things are.

The dad who came home and went quiet. Who you learned not to ask too much of after a long day. Who you assumed was just tired from work. Who seemed fine from the outside.

The most common driver of this kind of fatigue isn’t a blood test finding. It’s psychological distress, often without any formal diagnosis, built from the accumulation of life pressures: long hours, financial worry, family responsibility, the slow erosion of anything that isn’t work.

That was my dad. That may be you.

And the reason it matters is this: you can’t fix a pattern you don’t recognise as a pattern. If you think exhaustion is just what life feels like in your forties, you’ll manage it the way my dad managed it. Quietly. Alone. Getting used to it.

Coping and recovering are not the same thing. My dad only ever had access to one of those.

What’s Coming in Week 3

Next week we go deeper into the hidden layer: the men whose brains are wired differently, who have spent decades paying an energy cost nobody ever told them about.

If you want a preview, this is worth reading first: Burnout Isn’t Just Stress: It’s a Neurological Mismatch.

And if you want to work on your own exhaustion pattern directly, I’m offering a free one hour Tiredness Trap audit for a small number of men. Reply with the word TIRED and I’ll come straight back to you.

Change One Thing

Think back to the earliest version of this feeling. Not last year. Not your thirties. As far back as you can go.

When did you first learn that pushing through was what you were supposed to do? Who showed you that?

It might be a parent. A teacher. A coach. A moment that didn’t feel significant at the time.

Leave a comment below and tell me what comes up. The pattern usually starts there.

Until next week
Ed

References

Moore, R. & Gillette, D. King, Warrior, Magician, Lover. HarperCollins, 1990.

Stadje, R. et al. The differential diagnosis of tiredness: a systematic review. BMC Family Practice, 2016, 17, 147.

Maukonen, M. et al. Chronotype and energy intake timing in relation to changes in anthropometrics. Chronobiology International, 2019.

WFSBP/ASLM Lifestyle Medicine Guidelines for Major Depressive Disorder, 2022.