How to combat fatigue: Why am I so tired all the time?

1. Am I getting enough sleep?

Getting good sleep does not necessarily mean getting a full night’s sleep. When it comes to resting, quality matters just as much as quantity. Irregular sleeping patterns, bad sleeping habits, having trouble falling asleep, and constantly waking up during the night can all contribute to feeling tired the next day. Reflect on your current sleep routine and see what you can change with a sleep diary, or refer to the six steps to a sound night’s sleep.

2. Am I under a lot of stress at the moment?

You might simply be tired because of stress. Work, school, money, family, and relationships are usually the main factors that cause stress and worry, but during these three years, the pandemic has also greatly disrupted everyone’s lives. Even positive events—such as getting married, receiving a promotion at work, or going on a vacation—can be nerve-wracking and exhausting. If these stressors aren’t effectively approached, they can take a significant toll on your mental health. You can try to work through your concerns using the worry tree.

3. What am I eating and drinking?

You are what you eat, and a healthy balanced diet and adequate hydration can help you feel less tired. Your body reacts when there is a lack of vitamins and minerals in your diet or glucose (sugar) in your blood, and that may be why you lack energy and feel foggy.

Iron deficiency—as in, when you don’t have enough iron in your blood—can also cause fatigue. If you are pregnant or tend to have heavy blood flows during your period, you can have a higher chance of iron deficiency. Your general practitioner may arrange a blood test and iron tablets if needed to combat this health concern.

When some people feel tired, they depend on caffeine to stimulate the senses, but that may interfere with their sleep and cause fatigue the next day, which consequently leads to even more caffeine, more fatigue, and the possibility of an endless cycle. Alcohol can also mess up your sleep pattern, since drinking before bed usually wakes you up during the night, so try to stay clear of these beverages if possible.

4. How active am I during the day?

When you’re tired, the last thing you want to do is exercise, but being active during the day actually fights fatigue and improves the quality of your sleep. Always start with just a small amount of exercise, then gradually work your way up to a regular routine.

If you’re not a gym rat, it might be hard to stay motivated. Choosing something you enjoy and exercising with friends or family are just some ways you can do to step up your game. But remember, don’t exercise in the four hours before you go to bed, and don’t overdo it!

5. Do I have an underlying health condition?

Although it isn’t common, your tiredness might be related to an underlying medical problem. Conditions such as depression and seasonal affective disorder (SAD), anaemia, underactive thyroid (hypothyroidism), diabetes, obstructive sleep apnoea, and vitamin D deficiency are known to cause fatigue. If you’re on certain medications like beta-blockers, then you might also experience TATT as a side effect.

Consult your general practitioner if you think your TATT is due to a health condition, especially if you have other symptoms as well (e.g., unintended weight loss, unusual bleeding, shortness of breath, or new lumps that aren’t going away). If you have had the coronavirus (Covid-19) before and still feel very tired, you might have long Covid.

There is also a condition called chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), which causes a range of symptoms including muscular pains, dizziness, difficulty thinking, and extreme tiredness. Again, ask the professionals when you are unsure of your condition, and they will explain whether CFS is a possibility. 

Talking to your general practitioner

If you decide to seek professional help, what exactly should you tell your general practitioner besides saying that you always feel tired? Dr Powles strongly advises you to think about the following questions so you can better describe the situation:

1. How would you describe your tiredness—is it physical or mental exhaustion?
2. Have there been any lifestyle changes recently?
3. Have there been changes in your sleeping pattern, diet, or activity levels?
4. Is it worse when you wake up? Do you feel tired all day every day, or at certain times?
5. Can you remember when you first noticed feeling tired?
6. Is there a particular event or time that it came on? Is it getting worse?
7. Have you noticed any other changes to your health?
8. How do your energy levels compare to how they were when you were feeling better?
9. Have you started or changed any medication recently?

Feeling better

Even though we all hope that tiredness can disappear with just a snap of the fingers, there is no magic cure for that. If you are going through TATT, it can take a while to get back on track. Understanding your needs, setting realistic goals, and following the advice your general practitioner gives you are crucial to facilitating your journey to recovery.

Sources

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_{15. Fatigue and TATT. Patient. patient.info, last edited 30 April 2019}

_{16. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Patient. patient.info, last edited 21 December 2018}