Possible contributors: depression, grief, current stress, illness, pain or medication effects.

One support: ask for help if this persists or affects daily life. You can seek support before symptoms become severe.

Possible contributors: dissociation, trauma, depression, exhaustion or overload. New confusion can also have a medical cause.

One support: if you are presently safe, notice where you are and one familiar object. Seek care for recurring episodes; sudden confusion needs urgent assessment.

Possible contributors: trauma-related alertness, anxiety, lack of sleep or sensory overload. Racing heart or dizziness can also involve autonomic or other physical conditions.

One support: reduce one demand and check what is happening now. Do not assume a physical symptom is psychological.

Possible contributors: stress, grief, depression, trauma reminders, pain, sleep loss or hormonal changes.

One support: pause a difficult interaction if possible. Ask for space or help. If anyone is at risk, prioritise immediate safety.

Possible contributors: depression, nightmares, sleep disorders, anaemia, medication effects or other illness.

One support: seek assessment when symptoms persist. Delayed worsening after effort may need consideration of PEM; do not treat it as lack of motivation.

Possible contributors: mania or hypomania, medicines, substances or another medical condition. Irritability, racing thoughts or risky behaviour may accompany this change.

One support: seek prompt medical assessment. Urgent help is needed if there is unsafe behaviour, severe agitation or loss of contact with reality.

NIH tip: prioritise essentials and let some tasks wait.

Try: postpone one job or ask for practical help.

Make it fit: smaller steps and shared tasks count; you do not need to earn rest.

May also help: pain, anxiety and sensory overload by reducing demands.

NIH tip: protect sleep and a comfortable setting.

Try: choose one familiar wind-down cue.

Make it fit: nightmares or persistent insomnia deserve care. A rigid routine may not suit everyone; daytime recovery can still be needed.

May also help: pain and coping with sensory demands.

NIH tip: support nourishment and physical wellbeing.

Try: make tolerated food or drink accessible; choose comfortable movement only if it suits you.

Make it fit: with PEM, stay within energy limits. Autonomic symptoms, pain and joint instability may need adaptations.

May also help: comfort and participation. Avoid fixed exercise targets for everyone.

NIH tip: try a manageable mindful activity.

Try: notice a neutral object or a familiar view.

Make it fit: eyes can stay open. Breath exercises and inward body focus are optional. Stop if distress or disconnection increases.

May also help: anxiety and coping with pain; sensory preferences affect what feels tolerable.

NIH tip: draw on trusted support.

Try: ask for one kind of help, or use text rather than a call.

Make it fit: choose people who respect your limits. Contact with someone unsafe is not a self-care requirement.

May also help: low mood and overwhelm by sharing the load.

NIH tip: make room for self-compassion and meaningful or enjoyable moments.

Try: a familiar song, a valued activity or a brief moment outside, if tolerable.

Make it fit: you do not need to find a positive side to harm. Grief has no required timetable.

May also help: emotional wellbeing and participation without replacing care.

Depression can affect interest, sleep, appetite and concentration. Treatment may include therapy, medication or other options based on individual needs.

PTSD can include intrusive memories, avoidance and feeling persistently under threat. Complex PTSD includes additional difficulties with emotions, self-worth and relationships. A clinician considers the full pattern.

Loss may bring sadness, anger, numbness or waves of distress. Grief and depression can coexist. Ask for support when daily life is difficult or distress feels unmanageable.

Dissociation can occur with trauma and other conditions. Recurring episodes deserve assessment. Sudden confusion or new neurological symptoms require medical attention.

Bipolar disorder can involve depression and periods of unusually elevated or irritable mood with increased energy. Ordinary mood fluctuations do not establish this diagnosis; assessment guides treatment.

Overload and exhaustion can resemble or coexist with depression or trauma-related symptoms. Assessment should consider demands, capacity and support needs rather than assuming one explanation.