Feeling Better, and Staying That Way When someone tells me they feel generally unwell and their tests were normal, my first question is which tests. It is usually fewer than they think.
What I want to see, through your GP: full blood count, iron studies including ferritin — haemoglobin can be normal with depleted iron stores and that is the commonest miss — thyroid function, vitamin B12 and folate, vitamin D, coeliac serology while you are still eating gluten, glucose or HbA1c, and kidney and liver function. Add a sleep study if there is snoring with pauses or daytime sleepiness.
Why I insist. I have seen people spend a year and a considerable amount of money on complementary treatment for tiredness that turned out to be a ferritin of 9, an underactive thyroid, or undiagnosed coeliac disease. Those are treatable in weeks with the right thing and untouched by the wrong one.
Once it is clear, what I assess is the shape of it: tired on waking despite the hours, or flat by mid-afternoon, or fine until exertion and then wiped out for two days. Three different problems. And what I treat is sleep, digestion, pain that is interrupting rest, and the physical side of a hard stretch — with a measure and a four-week review.
If the picture is mostly mood, a GP mental health treatment plan and psychology will do more than I can. The clinic is in Lane Cove, opposite the library.
At some point the sessions start to feel less necessary. That is worth saying out loud rather than quietly cancelling, because a planned ending is more useful than drifting off — it is where you work out what actually changed, what to keep doing, and what to watch for.
People who end deliberately tend to hold the gains longer than people who just stop coming.
Rarely a return to exactly how things were before. More often: the thing happens less, recovers faster when it does, and takes up less room in the week. For something long-standing that is a real result, even though it is less satisfying to describe than being rid of it entirely.
It is worth being honest that some things do not go away entirely. Age, old injuries and long-term conditions set limits that no treatment removes. What can change is how much of your life they decide.
Usually the same things that brought it the first time: a stretch of bad sleep, a return to a posture or a load, a month with no movement in it, or a period of high stress. Knowing your own pattern is most of the work — the people who manage these things well are not the ones who never flare, they are the ones who recognise the early signs.
A bad week settles within days and has an obvious cause. Worth paying attention to, not worth panicking about.
Worth getting back in touch if it has been building for a couple of weeks, if it is different in character from what you had before, or if it comes with something new — numbness, weakness, fever, unexplained weight change. New and different is the thing that deserves a look, and sometimes that look should be a doctor rather than us.
Plenty of people return for a handful of sessions around a particular event — a flare, a change of job, a pregnancy, a surgery. That is not beginning again from nothing: the history is already there and the work is usually shorter.
If you are reading this before anything else, the beginning is here, and it costs nothing to ask.
