I Inhabit An In-Between Place: Exhausted But Unable To Sleep, Tired But Wired

The days of the week are like an extremely bad bag of pick 'n' mix. Each one turning out to be the experience of a new kind of tiredness: exhausted but unable to sleep, bone tired but wired, barely able to lift my head up, lazy but fine. I never know which it will be. Must I really be expected to make so many plans – booking restaurants and pubs in advance – while I am still, so often, wondering what the future holds? My best friend had a baby in January, I have only seen him once. He’s grown into a tiny person. Already too big for the clothes I have yet to give him. The world is speeding up; we had too much time and now there is barely any. There seems to be a particular kind of fatigue attached to planning, to obligations. One that has me wondering: am I burning the candle or do I have long COVID?

"Are you still watching Grey’s Anatomy?" Netflix asks. I am and I am not. 

I constantly inhabit an in-between place. I am like an open drain. Too tired to go out, not tired enough to sleep. It’s not like it was before – in the great expanse of time before coronavirus. Then I knew that I was living in a city, a time in history and working in an industry that asked a lot of me. I wilfully participated in the circle jerk of late capitalism which wore me out and sold me expensive products which promised to make me feel better.

Now, I am not so sure. I don’t think I signed any contracts which stated that I would also have to navigate ever-changing lockdown rules, devastating death tolls, worrying about those I love, social friction, economic uncertainty, Twitter debates in which people who are not from low-income backgrounds and have never eaten a free school meal profess to understand class, all the while trying to work out what a better world might look like and just get a dinner reservation before July, too. 

We know that the pandemic has had a devastating impact on people’s wellbeing and mental health because we have all been through something. Earlier this year, psychologists warned that an increasing number of people report feeling worn out and unable to cope due to periods of sustained stress. 'Pandemic burnout', they called it.  

While our experiences of the last year vary wildly according to who we are, what we do, how much money we have and how unlucky we have been, our bodies have processed the heartache, anger, uncertainty and stress in a similar way. Dr Linda Blair is a chartered clinical psychologist. She explains that we have all been depleted, exhausted. "The brain has a danger detection system called the amygdala," she tells me over the phone. "For much of the last 14 months it will have been on high alert, what’s commonly known as fight-or-flight. But that’s meant to be a temporary reaction to an immediate threat, not something that’s sustained for this long. Many of my clients are exhausted, in a similar way to you. They are stuck in an in-between place because of the continuing fear of uncertainty and a sense that they don’t really know where to go or what to do next."

For over a year now, we’ve been forced to accept a rapid carousel of shifting and conflicting realities. If they have felt dangerous, it’s because they were. What, at first, was supposed to be temporary – a state of emergency – is now normal. Don’t wear face masks. Wear face masks. Masks might not help, actually. Wash your hands. Sing happy birthday while you do. The virus is probably airborne, though. Christmas will go ahead. Christmas is cancelled. See no one. Things are getting better. Try your best to see everyone. 

This, Linda says, will have impacted us psychologically and physiologically. "Whenever any mammal senses danger, our body prepares us to deal with that danger," she explains. "Part of the fight-or-flight reaction is that we produce cortisol and adrenaline which get us ready to fight off the thing posing a threat to us or to run away from it. If that is happening all the time, particularly if the threats become theoretical such as ‘you could die if you get this virus’, your cortisol is elevated too much of the time, which has consequences."

The end result of being on this hamster wheel of anxiety, Linda adds, is that you can experience physical burnout and stop being able to produce enough of the hormones you need. This is also known as hypocortisolism. Studies suggest that it could be associated with long-term psychosocial stress and burnout in some people. 

Linda is not the only psychologist who is concerned. Dr Heather Sequeira is a consultant psychologist. She says that, despite the proliferation of the term 'burnout', we must remember that it is recognised as a syndrome. It is real. 

Although burnout is not an official medical condition, it is defined as a syndrome by the World Health Organization (WHO). It results, WHO says, from chronic (workplace) stress that has not been successfully managed. Its symptoms are mostly feelings of energy depletion or exhaustion. 

"We know that a state of chronic exhaustion can result from being in a state of perpetual stress," Heather explains. "I personally think of it as like being in an ultra-marathon without a clear end point as opposed to a 100m sprint. Biologically as human beings we are built to manage 'sprints' – short-term intense stresses followed by a period of recuperation. Because of this we usually cope well with acute high stresses like exams or deadlines at work. They are generally time-limited and we can decompress, recuperate and detach afterwards. The demands placed on us by the pandemic, particularly in the work environment, have been very different and, crucially, long-lasting." 

If you, like me, find yourself stuck somewhere between exhaustion and functionality, there are things you can do. "Take a four-day holiday," Linda says. "We know that is the amount of time that you actually need to reboot." She adds: "Think of the advice you would give your best friend and take it for yourself!"

And if it feels counterintuitive to be so exhausted by the one thing you’ve been looking forward to – the world (sort of) opening up again – consider this: even things which we don’t think of as stressful, are. 

"It’s really important to note that we are still currently facing many pandemic phenomena that might not readily be thought of as 'stressful' in the traditional sense," Heather explains. "This extends to Zoom meetings, working from home and navigating the shift from not being able to socialise and then having to socialise again and, even, boredom."

We are all trying. Trying to cope, trying to re-enter the world, trying to figure out what that world looks like. And trying, all day, in every way, drains your resources. It makes your bones ache and your forehead hurt. What was once relaxing – a quick drink at the pub with your best mate after an awful day is now a process of scrolling various websites until you find somewhere with a table at which you can have a 90-minute slot – can now be an ordeal in its own right. So, go gently. 

"As we are now negotiating a return to non-lockdown but with conditions that are still markedly different from before, we have to adapt to further pressures: increased insecurity, increased socialising (that brings stresses as well as pleasure), new working conditions, a lack of clarity and certainty in many areas of life," Heather concludes. "All this is stress on top of stress in people who are already burned out by the previous 12 months. Some people will find themselves in a very vicious spiral of lowered resilience and non-optimal responding to pressures. One thing leads to another."