Why wired?

First, let's consider what is going on in the body/mind when we are tired and wired. The exhausted and collapsed state is not rested. In fact it is state of activation as the bodies protective system comes on line to protect us from external threat or internal threats (e.g. viruses).

A metaphor that can help articulate these complex physiological processes is of an alarm system (e.g., fire alarm) that is set off initially by smoke, but once the smoke has gone it can keep being set off for no apparent reason. The reason there are no clear physiological markers could be that this is a normal, healthy response, but it is happening at inappropriate times and to an excessive degree. Another metaphor is to see the symptoms as a software problem as opposed to a hardware problem – a lot of computer problems would not show up if we scanned the hard drive, rather it is due to some of the processing and communication between the systems.

These metaphors are not perfect, but they go some way to explaining the multitude of symptoms that come with fatigue. They make sense of post-exertional malaise – people report being able to do something but then being hit by symptoms. The alarm model would see that when we do something we are engaging the whole body activating all the systems, including the nervous, endocrine and cardiovascular systems. In other words, the whole body is involved and is aware that ‘something’ is happening. However, the communication between the systems becomes akin to an emergency, so the protective elements of the body come on board. These increase heart rate, circulation, and autonomic activity, readying the body for action in a reactive pattern (fight/flight).

This activation means other physiological systems that allow us to be more reflective and responsive in a sustaining way cannot easily be engaged. This is exhausting and significantly disrupts sleep and activity patterns. The anxiety response is understandable when the body is in this reactive state, and anxiety understandably exacerbates the sense of ‘emergency’ in the system.