Mind Matters with Kyle MacDonald: Why am I tired all the time?

Sleep quality is important - not necessarily how much you're sleeping, but the kind of sleep you're getting. Photo / 123RF

Mind Matters psychotherapist Kyle MacDonald answers your mental health questions.

Q. I'm tired all the time. I've been to my GP, and they've done tests and said there's nothing wrong, and suggested I go on antidepressants. But I don't feel sad or depressed - just tired. No matter how much I sleep, I wake up exhausted. What should I do?

A. Talking about how it's been a tiring last couple of years has become a bit of a trope, but it is true. I think many of us are feeling that the grind of day-to-day life takes more effort, and there's also little question there are more pressures and expectations.

So I think you're not alone. And I am going to assume from your question that there isn't anything physical going on, although anyone reading this and thinking that they feel the same way should start by seeing their GP and ruling out medical causes - from low iron, hormone imbalances, to acute illness, or other more complicated conditions such as chronic fatigue or long Covid.

Having said that, not feeling depressed or sad doesn't necessarily mean that the cause isn't depression. Some people experience frustration, irritability and exhaustion as their most notable symptoms, and it can take some time and a few sessions with a therapist to figure out if what you're experiencing is depression.

I'd want to know if you've had any recent changes, adjustments or losses that may account for how you're feeling - or perhaps the things you tend to do in your life to "fill your cup" have slipped away?

The other area to consider is sleep quality - not necessarily how much you're sleeping, but the kind of sleep you're getting.

One of the lesser-known impacts of alcohol is on sleep quality, which can be a surprise because many of us drink to help us go to sleep, or at least feel like alcohol helps us sleep. But it actually interferes with our normal patterns of sleep, and can leave us feeling less rested.

Alcohol aside, one rough way to test if you're getting good-quality sleep is to reflect on whether you frequently dream. Going into REM sleep - the phase where we dream - is essential for deep sleep and feeling rested.

Tension, anxiety and stress can all impact the quality of our sleep. When we're stressed we can also end up tossing and turning, and feeling like we've been too active in our sleep.

A focus on what we call "sleep hygiene" can help with sleep quality. Think of it as a way of optimising your preparation for sleep.

Remove alcohol from the equation and reduce caffeine - ideally no tea, coffee or caffeinated soft drinks after midday. Set a bedtime and wake-up time, and stick to both. Allow around 30 minutes for winding down, getting into PJs, brushing teeth, etc. A warm bath or shower before bed can help, as can warm drinks - herbal tea or milk.

Avoid bright lights during that wind-down time, as well as devices. Read a book - not your phone - and make the room as dark as you are comfortable with.

Stick to a routine like this for at least a week, and see if it helps. You might also want to consider adding more exercise to your routine, if you haven't already, to ensure your body is tired.

If you're still struggling, reconsider the antidepressants, but also consider talking to a therapist. A busy mind can keep anyone awake, and talking about what's on your mind can also help us find more space for deep sleep.