The Tiredness Trap Week 3: The Mask That’s Draining You
A man in his 40s came to see me at the clinic.
Architect. Ran his own successful practice. Highly driven, highly focused, used to operating at a level most people couldn’t sustain.
But something had shifted. Making complex decisions was harder than it used to be. The creative thinking that made him good at his work was still there, but reduced, like a signal coming through interference. Everything was taking longer. He felt flat. He’d tried counselling, lifestyle changes, various other routes before ending up in front of me.
His blood tests were broadly normal.
If I’d been seeing him in a standard ten minute GP appointment, I might have sent him home reassured. Lifestyle advice. Maybe a referral.
Instead we looked at the whole picture. And what emerged was a man whose brain had been running at extraordinary capacity for decades, in ways and environments it wasn’t entirely designed for, without ever having a name for what that cost him.
The testosterone work helped. But the bigger shift came from finally understanding how his brain actually worked.
He was, I’m fairly certain, somewhere on the neurodivergent spectrum. Whether you call it ADHD, autism, or simply a high-performance processor wired for depth and intensity rather than the relentless demands of modern professional life, the description fits.
He wasn’t broken. He was running the wrong operating system for the hardware he had.
The Diagram Nobody Shows You
Here is something I wish someone had shown me earlier.
Burnout. Low testosterone. ADHD. Autism. High-performance processor wiring. These are not separate conditions with separate waiting lists and separate solutions.
They are a heavily overlapping set of experiences that feed each other, mask each other, and in professional men in their 40s, very often present as one thing.
Exhaustion.
Most men get sent down one corridor. One label. One treatment. The system misses the overlap almost entirely. And the man goes home with one answer to what is actually a systems problem.
What the Questionnaire Showed Me
My own journey into this territory wasn’t clean or linear.
I was well into my own burnout recovery when an ADHD questionnaire appeared somewhere online. I filled it in. It described my life in detail. Not aspects of it. My life.
That moment of recognition matters. The realisation that the way your brain works has a name, that other people share it, that it isn’t a character flaw: that is significant.
But knowing didn’t fix it. A year or two later I was still exhausted.
It was my therapist who introduced the highly sensitive person framework. Then I started reading more about autism. The overlap became visible gradually, not as a neat diagnosis but as a slow accumulation of: oh, that’s also me. The depth of processing. The sensitivity to environment. The way certain social and professional situations cost far more energy than they appeared to from the outside.
I prefer the term high-performance processor for this in the context of men’s health. Not because the clinical language doesn’t matter, but because it describes the actual experience more accurately. A brain that processes deeply, feels intensely, and picks up far more from its environment than it lets on.
That is not a weakness. It is expensive.
If you want to explore whether this fits your experience, start here: Do You Process the World Differently?
The Cost of Appearing Fine
What I’d been calling coping, what many of these men call coping, wasn’t quite masking in the clinical sense. It was something more like continuous adaptation.
Functioning in a GP consulting room. In a hospital. In back-to-back meetings. In environments that are noisy, high-demand, socially complex, and relentlessly outward-facing. Doing this every day, consciously managing responses that other people seem to handle automatically, without ever acknowledging that this is what you’re doing.
The details that stay with me from my own experience: not going to the toilet for hours because stopping felt impossible. Not because I was particularly busy in that moment. Because the system was so locked into output mode that basic physical needs didn’t register.
That is not poor self-care. That is a nervous system running a programme it was never designed to run, continuously, without rest, without acknowledgement.
And then coming home at the end of the day and having nothing left.
Why You Can’t Switch Off
The inability to switch off is something I hear from almost every man I work with at this level. And for a long time I didn’t fully understand my own version of it.
Here is what I’ve come to understand. It is multifactorial.
Some of it is wiring. The ADHD brain doesn’t have an off switch in the conventional sense. The thoughts keep going. The ideas keep arriving. The mental background noise runs continuously.
Some of it is learned behaviour. In families where worry was the primary mode, where a parent carried everything internally and silently, where threat-detection was the default setting, the nervous system learns that relaxing is dangerous. That something terrible is probably about to happen if you stop watching.
And some of it is a worldview built from years of operating in high-stress environments without the tools to process what those environments were doing to you.
In my own case, Deep Brain Reorientation has been an important part of the puzzle. Not a cure, not a single answer, but a way of accepting and processing the internal distress that past events had left behind, distress that had been driving the threat-detection system for years without me realising it.
It works differently to conventional therapy. There’s very little talking involved. Instead, you enter a meditative state through deep breathing, in a safe space with a therapist you trust, having done some preparatory work on the areas you’re going to explore. For me those areas included my upbringing, my relationship with my dad, my relationship with my mum, and the experience of working as a doctor.
The work is about paying attention to what your body is doing rather than what your mind is saying. A memory is introduced, just a few words describing it, and you notice what happens physically. In my case: pins and needles across the face, tinnitus, a feeling of being on edge, sometimes a jerk of the limbs.
Those sensations increase for a while. Then they gradually settle. Then you move to the next area.
The days afterwards require rest. The process continues after the session ends. Over time, what it has done is allow my brain to form new connections around these memories, associations that reassure rather than alarm. The threat-detection system has quietened. Not gone. But quietened.
What This Looks Like From the Clinic
In my testosterone and men’s health work, I see men who have been managing neurodivergent traits for decades with whatever was available.
Cannabis to get to sleep. Stimulants, sometimes prescription, sometimes not, to get through the day. Alcohol to decompress at the weekend. The whole coping toolkit assembled unconsciously over years, none of it ever connected to an underlying picture that would actually explain it.
The ADHD piece carries a specific burnout risk that doesn’t get talked about enough. The capacity for hyperfocus, the drive to compensate for perceived deficits, the ability to do extraordinary things in short bursts: these traits look like strengths from the outside, and they are, in the right conditions. But they also mean these men don’t stop when they should. Can’t stop, often. And the crash, when it comes, is proportional to how long the boom has been running.
The architect I mentioned at the start understood this when we finally named it. He wasn’t failing. He was a high-performance processor running without the maintenance schedule it needed.
That reframe changed everything.
Related: Burnout Isn’t Just Stress: It’s a Neurological Mismatch
The Tiredness Trap Case Studies
I’m opening a small number of Tiredness Trap Case Study sessions.
Eight places. Three hours with me, one to one. We take a deep look at your tiredness, what’s actually driving it, and solve the biggest blocker for you right now.
Each session is worth £625. If you’re not entirely satisfied with the outcome, I’ll give you free access to The Purpose Project course, worth £80.
This offer closes on Friday 16th May. If you’re interested, don’t wait.
Email ed@mensmindgp.com with the subject line “Tired” and I’ll come straight back to you with the details.
Change One Thing
Think about the environments that drain you fastest.
Not the obvious big stressors. The smaller, more constant ones. The open plan office. The meeting that runs twenty minutes too long. The social situation that leaves you needing two hours alone afterwards. The end of a day that should have been manageable but somehow wasn’t.
Your nervous system is trying to tell you something about what it costs to be you, in the life you’re currently living.
This week, notice one environment that drains you faster than it should.
Leave a comment below and tell me what it is.
Related Reading
- Burnout Isn’t Just Stress: It’s a Neurological Mismatch
- Do You Process the World Differently? Are You HSP?
- Your High-Performance Processing System Needs Different Operating Conditions
- Did I Upset Someone? The Mind-Reading Pattern That Exhausts High-Performance Processors
References
Raymaker, D.M. et al. Having all of your internal resources exhausted beyond measure and being left with no clean-up crew. Autism in Adulthood, 2020, 2(2), 132-143.
Arnold, S.R.C. et al. Confirming the nature of autistic burnout. Autism, 2023.
Andreassen, C.S. et al. The relationship between workaholism and symptoms of psychiatric disorders. Journal of Occupational Health Psychology, 2016.
WFSBP/ASLM Lifestyle Medicine Guidelines for Major Depressive Disorder, 2022.