Rest - both sleep and non-sleep - is essential to help our overstressed bodies and minds repair themselves, but many of us remain in a constant state of ‘flight, fight or freeze’. In part II of the Listener’s Work out or wind down? series, Louise Chunn talks to clinical fatigue specialist Vincent Deary about the need to stop being blind to signs we are pushing ourselves. You can read Part I here.

In modern life, it can seem that we are all rushing to improve aspects of ourselves and our productivity, to reach what we believe is our potential, and to stand out from the crowd. If we don’t, we fear we’ll fail. But instead, many of us have become embroiled in a running battle with our own bodies, which can leave us at risk of far greater disaster: exhaustion, burnout and long-term fatigue.

Scottish-born Vincent Deary is a professor of psychology at Northumbria University and a clinical fatigue specialist at an NHS multi-disciplinary clinic in the north-east of England. He has just published How We Break: Navigating the Wear and Tear of Living, the second part of a planned trilogy (the first book was How We Are; the final book will be How We Mend), but it took much longer to complete because Deary’s own life story intervened.

One day, without warning, he woke up “in a state of exhaustion. I had no real ability to get out of bed. When I finally took myself for a walk, I was wiped out the next day. I was in a state of hopeless exhaustion. My mood went down as well. I was completely disengaged from life. It was a very difficult time.” Deary had become the story he was writing; he had been pushed to his limits.

His is just one of the stories he tells that help explain how we overload our “bucket of capacity” and are blind to the signs that we need to slow down. In his book, Deary uses a small number of composite patients from the clinic to illustrate what he means.

Some may suffer one huge physical or emotional shock that triggers a breakdown. More commonly, though, the trajectory is incremental, one thing after another, until suddenly, there is a last straw.

Deary writes about Anne, a stylish, serious-minded single mother with a successful career as a probation officer. In her late 30s, she came to his clinic “with her body, heart and mind completely out of kilter. She would awaken in the middle of the night already in the throes of what felt like intense anxiety … no conscious panic, just the pure physiology of alarm.” Most of all, though, she was exhausted, to the point where she could no longer work.

Deary unpicks the stresses that led to this state, ranging from her childhood as a carer for her ill mother, her father’s current illness and collapsing care package, caring for her son alone, and the changes a new, demanding boss had brought. There were many, many inflection points in Anne’s reluctantly told story – she didn’t want to seem a malingerer – but the allostatic load (the wear and tear of chronic stress) piled up until her body could no longer cope.

Work, says Deary, is very often a pressure point for people. Expectations of what should be achieved and how quickly, while also reducing the budgets or staffing, seem to be common scenarios in government, the health service and many businesses today. This kind of working means there is little time for resting between periods of work. As Deary says, “It’s very easy to buy into the narrative that your work equals your productivity. So, for people who are exhausted and can’t be productive, it’s very easy to go, ‘I don’t deserve to rest, I am worthless, I have done nothing to earn this.’”

He is happy to see that younger generations seem to be resisting the Stakhanovite work ethic. “I understand that this term ‘quiet quitting’ means that they will work only as much as they are paid to do, and will take breaks rather than risk fatigue through overwork. This is really progressive of them. I have seen too many people being really damaged by an unhealthy relationship with work. My mantra is, ‘Work needs rest and rest takes work.’”

Deary believes he would have written a different book 10 years ago. “So much has changed. The fundamental things we used to rely on, like consensus, truth, expert opinion – these seem to have been thrown up in the air.

“As I was writing, it seemed the outside world was having more impact on us. I saw friends and colleagues struggle with life, crossing the clinic line into anxiety, depression, problems with work, ill health, their status. Everyone around me, including me, seemed to be struggling.”

As a scientist, he is loath to make unfounded claims about the Covid pandemic and lockdowns, but he believes the period added to a long-term increase in perceived difficulty and danger in the world. “We all have a stress biology; we are attuned to threat. For a while, our world became very dangerous, and so people’s worlds shrank to stay safe. I think we have all become a little world-shy, a little distrustful. We have not returned to where we once were.”

Deary goes into detail about his own working-class family life and growing up gay in Scotland in the 60s and 70s – not to garner sympathy, but to explain how some of us start with a fearful, anxious view of the world.

This can make some people more prone to problems, but it doesn’t mean they can’t negotiate the difficulties of life. “We are all fragile,” he writes.

He is also more and more convinced that breaking is not just from mental and emotional pressures, but also our physical bodies. We get ill because we are under emotional stress; we have mental health issues because we have fallen ill.

“I am much more aware now that we are mind/emotion/body, all interacting with each other. For people in chronically stressful situations, and especially those with chronic illnesses, their whole being is affected. Nowadays, the field of psychology is beginning to see this, with greater focus on the embodied self.”

How should we deal with the struggle, and head off the burnout and fatigue? “Be kind to yourself. People should take time to rest and recover before things get to breaking point.

“Also, make sure some of your energy is devoted to something that pays you back, gives you uplift, joy, spiritual nutrition – that’s really key. Uncouple your own sense of self-worth with productivity.

“If you think of what you value in someone you love, it’s rarely their productivity. More likely it’s their kindness and empathy. So tap into that, too.”

How We Break: Navigating the Wear and Tear of Living, by Vincent Deary (Allen Lane, RRP $65)