Why do I always feel so tired?!

Why do I always feel so tired?

I don't work, go to the gym or do any strenuous activities. I always feel sleepy and weak. Why could this be? I am not pregnant. This I am pretty sure of.

At any given time, 1 in 10 people are suffering from persistent tiredness, with women more likely to be affected than men. Severe tiredness is a common reason for people visiting their GP.

With our stressful, busy lives, most people experience tiredness sometimes. Following some rest and relaxation and a good night's sleep, tiredness generally disappears, leaving us refreshed and ready to face our usual activities. For some people, however, tiredness becomes a chronic problem which severely affects their quality of life and their day-to-day functioning.

Causes of tiredness

There are many possible reasons for chronic tiredness. Usually, tiredness is due to a combination of causes. Tiredness can have physical triggers, such as a recent illness, pregnancy or breastfeeding. It can also be triggered by stressful situations, for example a recent bereavement, moving house, family or work problems.

As well as well-defined triggers, there are many factors that can increase your tiredness, or stop you from regaining your energy when you are tired and run down.

Physical causes

Being tired can lead you to avoid physical activity. However, as you become more unfit, you will be even more tired when you try to do something. When you are chronically tired, this can become a vicious circle.

Being too fat or too thin can cause tiredness. If you are overweight, your body has to work harder than normal to do everyday activities. If you are very underweight, you have less muscle strength and may tire more quickly.

Many types of illness can leave you feeling very tired, especially anaemia, an underactive thyroid and heart failure.

Sleep problems such as insomnia and sleep apnoea (abnormal breathing while asleep) can also stop you getting a good night's sleep, while pregnancy is another common reason for severe tiredness.

Emotional causes

Stress and worry are tiring emotions. Facing a stressful situation can be draining, especially when you cannot see a solution to your problems. Feeling that you have no control over a situation may lead to frustration, irritability and tiredness.

Mental health problems such as depression or anxiety can make you feel more tired and can prevent you from sleeping properly.

Lifestyle causes

People with unusual or disturbed sleep patterns such as shift workers, nurses, doctors and nursing mothers can find it difficult to get refreshing sleep.

Looking after small children is a particularly draining activity, especially if children do not sleep through the night.

Sleeping in the day can prevent you from sleeping at night. Drinking too many caffeinated or alcoholic drinks can also make it difficult to get a good night’s sleep, especially if you drink them close to bedtime.

What is tiredness or fatigue?

Tiredness is a subjective feeling. People who complain of tiredness sometimes say that they are experiencing:

* a lack of energy
* feelings of unwellness or discomfort
* sleepiness
* loss of motivation
* poor concentration
* difficulty in making decisions
* difficulty carrying out daily tasks
* feelings of depression

Self-help

You can often begin to overcome your tiredness with some simple measures:
Sleep

If you are having trouble sleeping, aim for a better sleep routine. It helps to:

* go to bed and get up at the same time every day
* ensure that your bedroom is quiet, dark and comfortable and that it is neither too hot nor too cold
* eat earlier in the evening
* find time to relax before bedtime – relaxing music or a hot bath can help
* try to get problems and worries out of your head, perhaps by writing thoughts down in a journal

Food and drink

What you eat and drink can have a big impact on how you feel. It can help to:

* ensure that you get a balanced diet and eat proper meals even if you don't feel like cooking
* if you are underweight, gradually increase your portion sizes and your overall calorie intake
* cut down gradually on caffeine and alcohol, especially in the evenings
* if you are overweight, try to get your weight under control by becoming more physically active and eating less. However, you should avoid crash diets

Physical activity

Being unfit makes you susceptible to tiredness – and being tired often means you don't exercise enough.

To break out of this cycle, introduce physical activity into your routine, gradually increasing the duration and intensity. Ten minutes a day is fine to start with; the most important thing is to keep it regular. If you exhaust yourself for some reason, don't give up. Just do a small amount of exercise again the next day, and keep going.

Walking is the often the easiest exercise to start with, but any physical activity that you enjoy and that fits into your life is fine.

For more about physical activity, see the BUPA factsheet titled Physical activity.
A balanced lifestyle

Think about what you could change to achieve a more balanced, stress-free lifestyle. Have realistic expectations about what you can achieve and aim to gradually increase what you can manage over time. Staying in bed all the time will not help you to get over your tiredness.

Learning to relax will help to improve sleep and to relieve stress-related symptoms such as frustration, irritability and tiredness. Your GP surgery or local library will often have details of local adult education classes, books or tapes.

Write down a list of any things that might have led to your tiredness, such as family or work pressures. Are there ways that you could avoid overburdening yourself in the future?
Seeking further help

You can seek help from your GP for tiredness that has no obvious cause. Anxiety or depression, a sleep disorder such as insomnia or sleep apnoea and iron-deficiency anaemia are all conditions that could cause tiredness. These conditions will need to be diagnosed and treated by a medical professional.

ME or chronic fatigue syndrome

A small number of people suffer from long-term, disabling tiredness without a clear cause. This used to be known as ME (myalgic encelphalomyelitis) and is now referred to as chronic fatigue syndrome (CFS). Although this sort of tiredness is now recognised as a medical condition, causes and treatment of CFS are not well understood in comparison to many other conditions.

If you are diagnosed with CFS, it is likely that you will be offered a combination of therapies, tailored to your individual needs. This can include graded exercise therapy, treatment with antidepressants or a "talking treatment" such as cognitive behaviour therapy. To find out more about chronic fatigue syndrome and its treatment, see the BUPA factsheet Chronic fatigue syndrome.

Conclusion

Tiredness is usually a temporary situation which can be helped with some simple measures. However, persistent tiredness can have a major impact on day-to-day functioning. Good lifestyle management should eliminate tiredness but if the problem persists you should seek further help.