The day`s just starting and I`m already exhausted… Why am I feeling so drained all the time??


Do you often ask yourself “Why am I so tired all the time?” If so, then this article could be the perfect read for you. Attempting to describe your fatigue to someone who has never experienced it before can be a difficult job, frustrating sometimes. Ironically, from others` point of view, you seem fine … You look at yourself, maybe a bit lazy that`s all! People usually don’t comprehend the sheer scale of what you’re going through. Apart from some dark circles under your eyes and yawning frequently, everything about you appears the same. You don`t feel being sick, there are no symptoms suggestive of flu and you don`t look pale. However, you feel insanely tired with zero energy all the time!


It`s true that getting out of bed in the morning isn’t the happiest moment for anyone. But for you, this seems like an agony. You wish someone would help peel you off the bed. Snoozing the alarm until the very last moment is a daily ritual for you, and you fall back into a deep sleep within few seconds because you`re still feeling so tired morning after morning despite going to bed early every night. You`re dragging through the day, any simple physical effort is a burden and you feel unable to focus or concentrate.


If the above or some of it is your story to tell, then please don`t fret, for you`re not the only one!


What is fatigue?


A symptom rather than a disease, Fatigue is a state of physical and/or mental exhaustion that results in reduced alertness, constant tiredness, lack of energy and reduction in performance capacity. With millions of people worldwide struggling, Fatigue is one of the fastest-growing health issues globally. It can affect anyone and most adults will experience fatigue at some point in their life. For many people, it is induced by a combination of lifestyle, social, psychological and general wellbeing issues yet still, an undiagnosed medical problem can be lurking under the surface.


Although sometimes described as tiredness, Fatigue is not just sleepy tiredness… It is different! It won’t be sorted out by having a good night’s sleep or a nap in the afternoon. Fatigue can worsen for some people than others. Bad fatigue for one person might be struggling at work, but for others, it could be even worse; upon getting from the bed to the toilet they have to cling on to furniture and door frames. Some people would describe it as “Fatigue feels like being weighed down as if you are trying to walk up to your neck in a deep, muddy river with bags full of rocks on your shoulders”.


When Fatigue really sets in, common symptoms include any of: trouble waking up in the morning, sleeping a lot and still feeling tired, feeling depressed, anxious, or overly critical of oneself, energy crashing early during the day, headaches that are too difficult to shake off, sore or aching muscles, dizziness, impaired-decision making and judgment, short-term memory problems, loss of appetite, poor concentration and trouble focusing. If this sounds like you, it’s time for some foundational work.


If you are getting enough sleep, good nutrition and exercising regularly but still find it too hard to perform daily life`s routine, concentrate or feel energetic and motivated at your normal levels, you may be experiencing Fatigue that necessitates a more in-depth professional medical assessment.


What causes Fatigue?


Truly, the list of suspects is considerably long. It includes:


  • Medical causes: insistent exhaustion and lack of energy may be a sign of an underlying illness, such as hormonal disturbances (e.g. thyroid disorder), anaemia, heart disease, vitamin deficiency (e.g. Vitamin D), diabetes, viral infections, or liver disease.
  • Lifestyle-related causes: lack of regular exercise, sedentary lifestyle and sleep disturbances can lead to feelings of fatigue.
  • Workplace-related causes: workplace stress, burnout, and stress accompanying prolonged unemployment can lead to feelings of low stamina and fatigue.
  • Diet-related causes: low carbohydrate diets or high energy foods that are nutritionally poor don’t provide the body with enough nutrients for optimum function. Caffeinated drinks, in particular, only offer a temporary energy boost that quickly wears off and worsens fatigue.
  • Emotional concerns and stress: fatigue is a common symptom of certain psychological issues such as depression, despair and grief, and may be accompanied by other signs and symptoms, including irritability and lack of motivation.


Inhabitants of countries with a hot climate, such as the UAE, are more prone to suffer from weariness, lethargy and fatigue as the body clock strives to cope with the hot summer months and ensuing humidity. Interestingly, one study examined the factors which were associated with fatigue in the UAE and among these; stress and anxiety posed as significant factors especially among adolescents and young adults who are more susceptible to anxiety-inducing effects. The study asserted the high prevalence of fatigue (more among females) and attributed this to the rapid social transformation, stresses associating modern life and the westernization of the traditional lifestyle.


How to diagnose Fatigue?


Fatigue can present with a wide range of symptoms and is caused by various factors that may act individually or in combination, and this makes diagnosis quite a challenge. If you`ve been suffering from an unremitting feeling of unexplained fatigue, it is advised to consult your trusted doctor for proper assessment which includes detailed history taking, a thorough clinical examination and certain laboratory investigations (e.g. blood testing, urine analysis, imaging, etc.) to rule out undiagnosed health-related causes.


How to manage Fatigue?


Fatigue is a symptom –something you can feel and describe – but not a disease by itself, but it is one of the most common health symptoms worldwide and can be a sign of an array of medical problems. Treatment of fatigue depends upon the cause; treatment of the underlying cause(s) is your key to effective treatment of the symptom of Fatigue.


If it is because of an underlying medical cause, the good news is that many of the causes are relatively easy to treat. Chronic fatigue can impair your health and happiness, and there is no one-size-fits-all solution. If fatigue is having its toll on your quality of life or causing you distress, then consider speaking to your trusted medical professional. Through proper assessment, they will work out why you are experiencing fatigue and formulate the appropriate management plan to help you get your energy back and reclaim your health and wellbeing.


Wishing you everlasting health and wellness,


Dr. Seema Anand

Specialist Internal Medicine

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