Feeling tired all the time and a bit fed up is easy to put down to work, poor sleep or simply having too much going on. And, to a point, that’s normal - everyone has periods when life feels a bit relentless.

Irritability can be part of that too. You may find yourself less patient, more easily frustrated or shorter with people than you used to be.

Usually, these feelings pass. But if the tiredness, feeling fed up or irritability hangs around, feels out of character, or starts affecting your relationships, work or enjoyment of life, it is worth taking seriously. Men can be very good at brushing changes like this off and carrying on, often for longer than they should.

At H3 Health, our men’s health service includes dedicated Mental Health & Coaching support, offering psychological therapy and health and wellbeing coaching alongside our medical services. That matters because changes in mood, energy and irritability do not always have a simple physical or emotional cause - often the two overlap.

Two questions worth asking

Rather than simply asking, “Why am I so grumpy?”, it can be more useful to ask two questions: what’s changed, and what might be driving it?

What’s changed?

This is often the easier question to answer. Has your sleep got worse? Are you working longer hours, drinking more or exercising less? Has the routine that used to give you some balance - exercise, seeing friends, doing things you enjoy or simply having some proper downtime - gradually disappeared?

These fairly ordinary changes can make a surprising difference to energy and mood. Poor sleep, long days and relying more on alcohol, caffeine or nicotine can all leave you feeling more tired, tense and easily irritated.

What might be driving it?

The next question goes a little deeper. Why has your sleep changed? Why are you drinking more, working later or finding it harder to switch off?

There may be more pressure at work, money worries, difficulties in a relationship, bereavement or a significant change in your life such as redundancy, retirement or children leaving home. Sometimes there is no single event - you have simply been carrying too much for too long.

And sometimes what is driving the change is not obvious at all. There may be something physical contributing, or anxiety, low mood or burnout beginning to show themselves.

Address what you can

If you can see something obvious that has changed, start there. Getting your sleep back on track, exercising regularly, cutting back on alcohol, eating properly and finding some space away from work can all make a difference.

If there is something sitting underneath the irritability - worry, grief, relationship problems, feeling stuck or simply carrying too much - talking it through with friends or family can be useful. Sometimes understanding what is driving the change is the first step towards feeling more like yourself again.

Then notice what happens. If you still feel unusually irritable, or it continues to affect your relationships, work or day-to-day life, it is worth looking a bit further.

Could there be a physical reason?

If the irritability has been hanging around, feels out of character, or comes with other symptoms such as persistent tiredness, poor sleep, weight change or reduced libido, it is worth thinking about whether something physical could be contributing.

A medical review or medical MOT would usually start with some of the common things that can leave you tired, low in energy or not quite yourself - thyroid problems, diabetes or problems with blood sugar, poor sleep and sleep apnoea, as well as any other health problems that may be having an effect. It is also worth going through the medicines you take and any health problems that might be relevant. Chronic pain, long-term illness and some medications can all gradually affect sleep, energy and patience.

For men, testosterone is also worth considering if there has been a change in energy, motivation, mood or irritability, particularly if there are other symptoms such as reduced libido, erectile problems or poor concentration. The difficulty is that these symptoms overlap a lot with stress, poor sleep, anxiety and depression, so a proper assessment needs to look at the whole picture rather than assuming one cause.

If there is no obvious explanation, or things are not improving, a check-up with a doctor can help rule out physical causes and decide what is worth looking at next.

Could anxiety or low mood be part of it?

Not every man who is struggling feels obviously low.

For some men, anxiety or depression shows itself more as impatience, frustration, a shorter temper or simply wanting to be left alone.

Anxiety does not always feel like fear or panic. You may find it hard to switch off, constantly think ahead, feel tense or restless, sleep badly, or feel as though there is always something else that needs dealing with.

Low mood can be less obvious too. You may lose interest in things you normally enjoy, feel less motivated, withdraw from other people or find that everyday life simply takes more effort. Some men describe themselves as flat rather than depressed, or just say they no longer feel quite like themselves.

Sometimes irritability is simply the part that is easiest to see. Underneath it may be anxiety or depression, but there may also be grief, loneliness, difficulties in a relationship, worries about work or money, frustration with your health, or simply feeling stuck and not sure what needs to change.

Men can be very good at carrying on and hoping things will sort themselves out. But getting help earlier can make it easier to understand what is going on, make changes sooner and stop things becoming harder to deal with

Where should you start?

You don’t have to work out whether the problem is physical or emotional before asking for help. Making that first step is often the most important part.

At H3 Health, our doctors look at both physical and psychological factors that may be contributing. That can include checking for things such as thyroid problems, sleep disorders, medication effects, blood sugar problems and hormone health, while also asking about anxiety, low mood, stress and what is happening more broadly in your life.

Sometimes there is a physical problem that needs treating. Sometimes psychological or life factors are playing a bigger part, and sometimes both are contributing. The important thing is that one does not exclude the other.

If talking things through looks as though it could help, that is where psychological therapy or health and wellbeing coaching can come in.

Psychological therapy or health and wellbeing coaching - what’s the difference?

They overlap, but they are not quite the same. You do not need to decide in advance which one you need; part of the first conversation is working out what kind of support is likely to be most useful.

Psychological therapy is generally the better fit when there is something emotional or psychological that needs working through - anxiety, low mood, burnout, grief, relationship difficulties, or patterns of thinking and behaviour that keep causing problems.

Health and wellbeing coaching starts from a slightly different place. You may not feel that you have a mental health problem at all. You may simply feel stuck, worn down or know that something in the way you are living needs to change. Coaching is generally more practical and forward-looking - managing pressure, improving health habits, finding a better work-life balance, rebuilding motivation or getting clearer about what you want.

Amy’s approach

At H3 Health, our Mental Health & Coaching service is led by Amy Peach, a specialist psychotherapist with particular experience in men’s mental health.

There is no one-size-fits-all approach. Amy uses different types of therapy depending on what is going on and what is likely to be most helpful.

These can include Cognitive Behavioural Therapy (CBT), which looks at patterns of thinking and behaviour that may be keeping problems going; Acceptance and Commitment Therapy (ACT), which can help when avoidance or unhelpful habits have crept in; Emotion Focused Therapy (EFT), which looks more closely at the emotions underneath how you are feeling; and Compassion Focused Therapy (CFT), which can be particularly helpful when self-criticism has become part of the problem.

In practice, that might mean understanding why you are reacting in a certain way, dealing with a strong inner critic, changing habits that have developed under pressure, or finding a better way of responding when things go wrong.

What you work on will depend on what you bring to the sessions and can change as things move forward. The aim is not to put a label on you, but to understand what is going on and work out what is most likely to help.

And what about medication?

Talking therapy and coaching are not the only options. If anxiety or low mood is more significant or has been going on for some time, medication may also be worth considering.

A doctor can discuss whether an antidepressant might be appropriate, including the likely benefits, possible side effects and alternatives. For some people medication works well alongside psychological therapy; for others it may be used on its own. Not everyone needs it, and the right approach depends on your symptoms, how much they are affecting your life and what you feel comfortable with.

Working out what’s behind it

Men can be very good at carrying on. Tiredness, irritability or feeling less like yourself can easily get put down to work, getting older or simply having a lot going on - sometimes for much longer than is helpful.

The important thing is to notice when something has changed and not simply learn to live with it. You do not need to know whether the cause is physical or emotional before asking for help - working that out is part of the process.

At H3 Health, we look at both. Sometimes the answer is medical, sometimes psychological, and often there is a bit of both. The first step is simply deciding that it is worth finding out what is going on.

Book a Mental Health & Coaching consultation.

If you need urgent mental health support

If you are having thoughts of harming yourself, feel unable to keep yourself or somebody else safe, or feel that you are in a mental health crisis, please seek urgent help.

For urgent mental health support that is not an immediate emergency, contact NHS 111 online or call 111 and select the mental health option. You can also contact your GP for urgent help.

If you or somebody else is in immediate danger, call 999 or go to A&E.

You can also call Samaritans free on 116 123, 24 hours a day, if you need somebody to talk to.