Living with Tiredness

What This Kind of Tiredness Is Like

When most people talk about being tired, they mean something that can be solved by rest: a good night’s sleep, a quieter day, a chance to recharge. What I experience is something different. It isn’t a temporary depletion but a steady state — a background condition that shapes how each day feels before it has properly begun.

Living with liver disease brings a physical exhaustion that doesn’t behave like ordinary fatigue. The body feels heavier, slower to respond, as though it is working with reduced reserves. Rest helps, but only partially; the tiredness never fully clears.

Alongside this is the mental tiredness that comes with hepatic encephalopathy. Thinking can feel slowed and softened, clarity less reliable. It is tiring not only to think, but to notice oneself thinking less clearly than before.

These forms of tiredness overlap and reinforce each other, creating a cumulative exhaustion that is hard to explain and easy to underestimate.

Cognitive Fatigue & Hepatic Encephalopathy

One of the most frustrating aspects is how even simple, automatic actions stop being automatic. Correcting a typing error can become a multi-step thought process, requiring conscious effort to decide what to do and why.

Everyday decisions can also become fragile. When ordering food, I sometimes find myself choosing what someone else prefers rather than what I do, unless I concentrate deliberately. What should be casual becomes a task requiring rehearsal.

Words can slip. Even familiar medication names like lactulose often come out as near-miss versions, requiring effort or checking. Names and professional roles behave similarly — partial recall, followed by effortful correction.

The Tiredness of Doing Things

There is also a simpler tiredness: the effort involved in doing things at all. Tasks accumulate not because they are forgotten, but because starting and finishing them requires more energy than is available.

Routine garden jobs, rearranging a study, or setting up a new PC stall part-way through. Workarounds replace proper solutions. Eventually, some tasks have to be handed over to others, including my son. Each handover is a practical necessity, but also a quiet reminder of narrowed capacity.

When Physical and Cognitive Fatigue Converge

A recent example brought these strands together. I went to Asda late in the evening, when there were fewer people, to buy a two-litre bottle of milk. I chose a staffed checkout because I didn’t have the energy to use self-service.

By the time I reached the checkout, I was so exhausted that I had to sit down. Staff asked if I needed an ambulance, then whether someone could drive me home. After resting, I was eventually able to drive myself.

From the outside it may have looked like a sudden crisis. From the inside it was cumulative fatigue reaching its limit.

When the Body Clock No Longer Keeps Time

Sleep and wakefulness no longer align reliably. I may feel alert at odd hours and depleted during the day. Quiet times feel easier because there is less to process, but ordinary tasks often arrive when energy is lowest.

This out-of-sync living becomes part of coping, but it also deepens the sense that tiredness is a constant background condition rather than something that comes and goes.

Wanting to Go, Knowing You Can’t

I may want to go shopping, but know in advance that I can’t. Longer drives are out of the question. City breaks — Glasgow, Paris, New York, Interlaken, London — remain vivid ideas rather than realistic plans.

The desire hasn’t disappeared; capacity has narrowed. Living with that mismatch is quietly exhausting.

Living Alongside Illness

Living in close proximity to serious mental illness brings its own form of emotional fatigue. It requires steadiness, predictability, and a careful regulation of one’s own responses, particularly when physical and cognitive reserves are already reduced.

This does not arise from conflict or strain, but from the sustained attentiveness required to remain supportive while managing one’s own limitations. Emotional energy is expended quietly and continuously, often without visible markers.

Emotional Self-Regulation

Frustration and sadness do occur, but they are directed inward rather than outward. The effort lies in maintaining emotional balance, preserving patience, and preventing transient feelings from shaping behaviour or atmosphere.

This self-regulation is not driven by blame or resentment — it reflects an understanding that depression is an illness rather than a choice. Nonetheless, the ongoing need for emotional containment adds to overall fatigue.

When Systems Add to the Load

Repeated administrative problems around medication can multiply tiredness. Errors require follow-up, correction, and vigilance.

None of this is dramatic in isolation, but when reserves are already low, small system failures make coping far harder than it should be.

Switzerland

There is one exception to restraint, and that is Switzerland. It is not just a destination but a fixed point of identity and continuity.

Even if it must be adapted and carefully planned, it represents something enduring — a sense of self that predates illness and persists alongside it.

Switzerland is continued in another note.