Tiredness means you feel exhausted both during activity as well as rest,, even while sleeping as well. It is not a disease but could be a symptom of various physical and psychological ailments. It can alternatively be called as fatigue; exhaustion; lethargy or weariness. We all get tired normally as well but sometimes tiredness becomes problematic if it is severe and/or prolonged.

Why does it matter?

The drop in energy leading to tiredness at times can cause difficulty in our normal day to day activity especially in accomplishing physical and mental tasks. Tiredness leads to lack of motivation in work and family as well. Sometimes, tiredness and fatigue presents as a manifestation of serious systemic disease and which must be identified and treated.

Causes of Tiredness:

Fatigue / tiredness is usually caused by lifestyle issues which are rather harmless. Only a minority of the clients have a serious underlying medical condition causing fatigue. Otherwise psychological issues are more common than physical causes of tiredness.

• Psychological and psychosocial: various stressors in our daily life can cause tiredness like anxiety, loss, bereavement, work issues, family problems, change in environment, living conditions etc.
• Physiological and lifestyle: Factors like smoking, alcoholism, poor diet, and lack of sleep would also cause tiredness. Pregnancy, breastfeeding, overweight, strenuous activities also cause tiredness.
• Physical: Various medical conditions can cause tiredness like cancer, anemia, diabetes, fever, heart failure, respiratory problems, bone and joints related problems, eating disorders, nutritional disorders etc. Certain drugs used to treat diseases may also cause fatigue as their side effects e.g. drugs against cancer, high blood pressure, allergies etc.

When to seek Help?

Fatigue / tiredness is usually not harmful but if it is severe or is prolonged for more than a few weeks, then you should consult your doctor. If you could not identify the cause of tiredness, then also you should see your doctor. The doctor will take your detailed history and perform a physical examination as per requirement. Investigations are done according to the symptoms to find out the cause and treated accordingly, be it physical or psychological. A strong partnership and trust has to be built between you and doctor to work out with the problem especially if the cause identified is psychological or psychosocial. The doctor might ask personal questions regarding the symptoms, family /work relations, lifestyle, habits etc which you should answer honestly to identify proper treatment modalities.

Fatigue is usually not very harmful however it should be evaluated properly to avoid or early detect the complications. Consult your doctor immediately if you have any of the following:

• Dizziness
• Blurred vision
• Problems in urination
• Sudden weight gain or significant weight loss
• Swelling
• Thought changes like confusion or suicidal thoughts
• Sudden breathlessness during sleep

You need to see the doctor at your appointment if you have unusual tiredness associated with fever and weight loss, weight gain, inability to sleep at night, frequent sleep wake cycles at night, headache, constipation, feel sad and low, use of medications that cause fatigue.

Treatment Options:

Treatment is decided according to the cause of tiredness.

Physical: The underlying cause is identified and treated in order to treat fatigue. For example anemia is treated with iron supplementation; blood sugar level is controlled using medications for diabetes and so on. Treatment of chronic pain also helps relieve fatigue.

Psychological:  The underlying cause is identified and if you are motivated, the doctor will refer you for counseling or other types of psychotherapy like talking therapy, recreational therapy, relaxation therapy, sleep hygiene etc.

Lifestyle: If there are no obvious physical or psychological causes of tiredness, there are some general measures in lifestyle modification could be beneficial.

• Take a regular balanced diet and keep a check on your weight
• Eat frequent small meals  4-6 times a day
• Take Vitamin B12 and folic acid supplementation
• Get enough sleep regularly
• Indulge into regular exercise habit balanced with rest periods
• Reduce stressors from your day to day life through carefully balancing workload and schedule with family and relationships, relaxation through meditation, recreation etc
• Reduce caffeine intake and drink more water
• Avoid smoking, alcohol and drugs abuse
• Watch out for the side effect of drugs. If you feel tiredness is due to the drugs being taken, do not stop or change the dose or medicine. You should consult the doctor on time.

Prevention and treatment of fatigue hence largely depends on how you perceive health and well being. Thus you also have to make an effort to adopt active and healthy coping mechanisms.