Why You Feel Crummy, a Checklist

When you feel off, here's how to figure out why.

Written by Dr Alice Boyes

Every so often, I have what's now a familiar experience. I think "I don't feel right" and wonder if I'm getting sick. Sometimes I have a quick spiral into worrying I've got cancer.

This feeling has happened often enough, and I know what the typical culprit is; I've skipped one of the two coffees I usually have in a day.

If that's not the reason, the next most common cause is that I've missed a couple of doses of my thyroid medication. Or, sometimes I feel fried because I have not recovered from strength training.

If I slow down enough to pay attention, each of these scenarios is distinct. I can usually tell which kind of "off" I feel and then think back to confirm the cause.

When I can pinpoint a specific cause for why I feel out of sorts, it feels easier to manage, especially if the solution is having a coffee or taking my meds. If I'm still not sure what's driving the feelings, I have a longer checklist to figure out the cause.

How to Develop Your Own Checklist

The purpose of this post is to help you learn to suss out when there's a clear reason you don't feel 100 percent, but you haven't recognized it.

The goal is to identify the five to six main culprits for you. When you feel flat or unsettled, you can mentally scan through your checklist of common causes to help determine what to do next.

To start your own custom framework, browse the following common causes of feeling out of sorts and note which ones tend to apply to you.

If you'd rather not build your own, there's a template at the end of the post you can use as a shortcut.

Physical

Our first grouping relates to physical causes.

• Nutrition-related (low iron, ran out of your multivitamin a month ago, have been eating poorly)
• Dehydration
• Caffeine (more or less than usual)
• Medication changes (new medication, missed doses, or dosage that needs adjusting)
• Constipation
• Sleep disruption
• Schedule disruptions that affect your rhythms, even if they don't disrupt your sleep
• Pain or back-to-back minor illnesses (can wear you down)
• Increased or decreased physical load (you've exercised more or less than usual)
• Lack of sunlight

Emotional

Our second grouping relates to emotional causes.

When we experience an emotional injury (examples coming up), we often keep chugging along without acknowledging it has occurred; then it causes nondescript feelings of being worn down or stressed.

• A stress reaction. (something has happened that's causing objective stress, like a large repair or medical bill. Imagine a $700 trip to the vet.)
• A comment rubbed an emotional raw spot.
• An upcoming event is creating a sense of pressure.
• You're experiencing a heavy mental load (from the learning you're doing, projects you're undertaking for the first time, or task saturation).
• Rumination run amok (see below).
• A problem or task you're avoiding is weighing you down.
• A worry has been triggered, perhaps by a news article.

Quick story on rumination:

I rarely ruminate anymore, but recently I felt really crummy one evening. I looked back and realized I'd spent an entire hour-long run that morning rehashing two things that had happened weeks before. A different stress had triggered the urge to ruminate, but I'd let it roll like a runaway train.

I know that allowing yourself to ruminate is essentially digging a hole for your mood to fall into. Usually, I'm good at cutting it off, but on this occasion, I didn't. When I realized this, I knew I needed to not do it again and let my mood recover, which it did.

Develop a Memory Aid

When you've got your shortlist, look for an acronym or another type of memory aid to make it easier to do a quick mental scan and stop yourself from spiraling into worry.

If you'd like a pre-made version, you can use or adapt one of these:

• Pilots use the IM SAFE checklist to assess whether they're in a fit condition to fly. It stands for Illness, Medication, Stress, Alcohol, Fatigue, and Eating or Emotion. You can see this list covers most of the bases we've discussed. Instead of using it for assessing whether you're fit for a task, you can use it to pin down specific causes for vague feelings.
• You might've heard of HALT—hungry, angry, lonely, tired. I like to use my own Frankenstein version of it. I change the L to Lost, referring to purpose and goals, and I think of each word as representing a broader category:
  • Hungry (for any cause related to nutrition)
  • Angry (anything related to emotions)
  • Lost (anything related to a goal that's not going well, including work or money stress)
  • Tired (a catchall for anything else that might be wearing you down)

However you do it, the aim is a quick scan you can run when needed.

Caveats

Most things that go wrong in our lives are minor. However, of course, there's always a possibility we write off a serious or moderate issue as having a minor cause. Always get an immediate investigation when that's prudent. When you don't feel your usual self, note when it starts on your calendar and commit to investigating further if it hasn't resolved within a certain time period. Asking someone else to nudge you can help with accountability in keeping to that.

Vague Feelings Often Have Concrete Causes

When we don't identify why we feel out of sorts, we end up worrying or missing problems we should handle. Prompt identification allows for prompt intervention. Some issues resolve on their own, but some benefit from attention. Believe in your capacity to correct problems you identify.

If this article benefited you, I'd love to hear how. You can email [email protected].