HEALTH : WHY I AM TIRED ALL THE TIME?

FEELING EXHAUSTED IS SO COMMON THAT IT HAS ITS OWN ACRONYM, TATT, WHICH STANDS FOR 'TIRED ALL THE TIME'

Dr Rupal Shah, a GP in south London, says tiredness is one of the most common complaints she sees in her surgery. "I see loads and loads of patients who complain of feeling exhausted, even though they're sleeping well. Often it's been going on for several months."

At any given time, one in five people feels unusually tired, and one in 10 have prolonged fatigue, according to the Royal College of Psychiatrists. Women tend to feel tired more often than men. "It's unusual to find anything physically wrong. Most of the time, fatigue is linked with mood and the accumulation of lots of little stresses in life," says Dr Shah.

Dr Shah says she routinely takes a blood test from patients complaining of tiredness to rule out a medical cause, such as anaemia or an underactive thyroid gland.

"There's more chance of a medical reason for tiredness if there are other symptoms as well, such as heavy periods, weight loss, a change in bowel habits, hair loss, extreme thirst and so on."

If you want to work out how you became tired in the first place, it can help to think about:
  • Parts of your life, such as work and family, that might be particularly tiring
  • Any events that may have triggered your tiredness, such as a bereavement or relationship break-up.
Physical causes of tiredness

There are lots of health complaints that can make you feel tired. Not just the well-recognised ones like anaemia and thyroid problems, but also more surprising ailments, such as diabetes, food intolerance and a sleeping disorder called sleep apnoea.

Being overweight or underweight can cause tiredness. That's because your body has to work harder than normal to do everyday activities. If you're underweight, you have less muscle strength, and you may feel tired more quickly.

Pregnancy, especially in the first 12 weeks, can also sap your energy.

Psychological causes of tiredness

Psychological tiredness is far more common than tiredness that's caused by a physical problem.

One key reason is anxiety, which can cause insomnia and, in turn, lead to persistent fatigue. A survey by the Mental Health Foundation found that nearly a third of the population are severely sleep-deprived, often because of job and money worries. The Foundation's report, Sleep Matters, suggests a link between insomnia and low energy levels.

The worries and strains of daily life can be exhausting_even positive events, such as moving house or getting married. Emotional shock, such as bad news, bereavement or the break-up of a relationship, can make you feel drained.

Mental health problems such as depression or anxiety can make you feel more tired. They can also prevent you from getting a proper night's sleep.

Lifestyle causes of tiredness

Tiredness can often be attributed to lifestyle factors, such as drinking too much alcohol, or having a bad diet. If you drink alcohol in the evening, it tends to wake you in the middle of the night. If you drink a lot regularly, it can make you feel depressed and affect your sleep. "I'm always surprised to find how often patients who complain of tiredness are drinking far too much," says Dr Shah.

If you have a disturbed sleep pattern _ for instance, if you work in night shifts, sleep in the day or look after young children _ it can be difficult to get a good night's sleep, and you'll feel tired during the day.

How to tackle tiredness

It may be common to feel tired all the time, but it isn't normal. If you're worried, see your doctor for advice and reassurance. "We can rule out anything serious," says Dr Shah. "Just knowing there's nothing wrong can be reassuring in itself."

SELF-HELP TIPS TO FIGHT FATIGUE

Many cases of unexplained tiredness are due to stress, not enough sleep, poor diet and other lifestyle factors. Use these self-help tips to restore your energy levels.

DRINK MORE WATER FOR BETTER ENERGY

Sometimes you feel tired simply because you're mildly dehy-drated. A glass of water will do the trick, especially after exercise.

CUT OUT CAFFEINE

The Royal College of Psychiatrists recommends that anyone feeling tired should cut out caffeine. It says the best way to do this is to gradually stop having all caffeine drinks (this includes coffee, tea and cola drinks) over a three-week period. Try to stay off caffeine completely for a month to see if you feel less tired without it. You may find that not consuming caffeine gives you headaches. If this happens, cut down more slowly on the amount of caffeine that you drink.

EAT OFTEN TO BEAT TIREDNESS

A good way to keep up your energy through the day is to eat regular meals and healthy snacks every three to four hours, rather than a large meal less often.

LOSE WEIGHT TO GAIN ENERGY

f your body is carrying excess weight, it can be exhausting. It also puts extra strain on your heart, which can make you tired. Lose weight and you'll feel much more energetic. Apart from eating healthily, the best way to lose weight is to be more active and do more exercise.

PERK UP WITH EXERCISE

You might feel too tired to exercise, but regular exercise will make you feel less tired in the long run, and you'll have more energy. Even a single 15-minute walk can give you an energy boost, and the benefits increase with more frequent physical activity. Start with a small amount of exercise. Build up your physical activity gradually over weeks and months until you reach the recommended goal of two-and-a-half hours of moderate-intensity aerobic exercise, such as cycling or fast walking, every week.

REDUCE STRESS TO BOOST ENERGY

Stress uses up a lot of energy. Try to introduce relaxing activities into your day. This could be working out at the gym, or a gentler option, such as listening to music, reading or spending time with friends. Whatever relaxes you will improve your energy.

SLEEP WELL

It sounds obvious, but two-thirds of us suffer from sleep problems, and many people don't get the sleep they need to stay alert through the day. The Royal College of Psychiatrists advises going to bed and getting up in the morning at the same time every day; avoid naps through the day, and have a hot bath before bed (as hot as you can bear without scalding you) for at least 20 minutes.

TALKING THERAPY BEATS FATIGUE

There's some evidence that talking therapies such as counselling or cognitive behavioural therapy (CBT) might help to fight fatigue. See your GP for a referral for talking treatment on the NHS or for advice on seeing a private therapist.

DRINK LESS ALCOHOL

Although a few glasses of wine in the evening helps you fall asleep, you sleep less deeply after drinking alcohol. The next day you'll be tired, even if you sleep a full eight hours. Cut down on alcohol before bedtime. You'll get a better night's rest and have more energy. The NHS recommends that men and women should not regularly drink more than 14 units a week, which is equivalent to six pints of average strength beer or 10 small glasses of low strength wine.

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