Modern life can wear out the best of us. A YouGov survey found that one in eight Britons are “in a state of constant exhaustion” and a quarter feel tired most of the time.
Another poll found that 55 percent of us describe ourselves as “hyper-fatigued” – a phrase taken from a 2023 trends report by market research firm Mintel, which relates to consumers being bombarded with too much information. “The pandemic, rising cost of living, energy crisis, geopolitical unrest and climate crisis are taking their toll,” it warned.
But when does fatigue become a medical issue? And what can you do about it? Here are some questions to think about…
WHAT IS FATIGUE?
Vincent Deary, professor of applied health psychology at Northumbria University and author of How We Break: Navigating the Wear and Tear of Living, says: ‘One way to think of fatigue is as a physical, emotional and/or mental response to excess demand or reduced capacity. It’s a signal that things are too much.’
Fatigue is different from tiredness, which usually resolves with sleep, and is seen as a physical, emotional, and/or mental response to excess demand or reduced capacity.
GPs prefer to use the term ‘TATT’ (always tired) rather than ‘hyper-fatigue’, says David Strain, senior lecturer in cardiometabolic health at the University of Exeter Medical School.
There could be a number of causes, from lifestyle issues to serious health problems.
DO YOU TAKE GOOD CARE OF YOURSELF?
To prevent fatigue, first of all, make sure you eat regularly, drink enough water, exercise regularly, get enough sleep, and keep stress to a minimum.
The NHS advises to drink less alcohol, especially before bed. Ideally you should avoid caffeine for seven hours before bed.
It also warns that obesity can cause long-term fatigue by ‘putting extra strain on your heart, which can make you tired. Lose weight and you’ll feel much more energetic’.
WHEN DOES IT BECOME A MEDICAL PROBLEM?
Expert Karin Orman says patients may have an energy boost but then be ‘exhausted for days’
Fatigue is different from tiredness, which usually goes away with sleep, says Karin Orman of the Royal College of Occupational Therapists. ‘People with fatigue may have bursts of energy but then feel drained for hours or days.’
Professor Strain says, ‘If it is constant, unrelenting, and out of proportion to activity, then we begin our investigation.’
See your GP, who may offer you blood tests to rule out anaemia, vitamin deficiencies (particularly vitamin B12), kidney disease, liver problems, an underactive thyroid and diabetes, all of which can cause fatigue. Your fatigue could also be ‘post-Covid-19 syndrome’ – persistent symptoms of the infection that last for at least two months. Your GP may refer you to a specialist ‘long-Covid’ clinic.
Could it be me?
The cause of myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome, is unknown, but the most common symptom is extreme tiredness. It also causes sleep problems, difficulty concentrating and ‘post-exertional malaise’, where a daily activity leaves you feeling exhausted.
Professor David Strain says extreme fatigue is a common symptom of ME
Professor Strain says: ‘For example, you make dinner for the family and then you have to rest as if you’ve just run a marathon.’
A diagnosis is only made once other conditions have been ruled out. You may be referred to a specialist ME service, which can provide cognitive behavioural therapy, advice on how to make the best use of the energy you have without making your symptoms worse, and medication to manage pain or sleep problems.
Unfortunately, there is no cure. However, there are treatments that can help you manage the condition and relieve symptoms.
DO YOU PRIORITY JOY AND PEACE?
Professor Deary says it’s also important to identify what makes you happy. ‘Look at the things that are taking up your time. Are they nourishing you or are they just draining you?’
You also need to give yourself permission to rest. Professor Deary says that one of the biggest obstacles he saw in his 10 years of working in a clinic seeing patients with fatigue was “people who believed that rest had to be earned, that rest was for the weak, or that ‘doing nothing’ was associated with guilt and shame.”
He adds: ‘Rest is not a luxury. The important thing is to find what works for you, whether that’s reading, being in nature, meditation, culture, gardening, walking, connecting with a friend, gaming or crafting.
“What simple but essential activities leave you better than you found them? Do more of them.”