TIRED OF BEING TIRED
Between work, studies, family life, keeping fit, and making time for friends, many of us will find there’s very little left in the tank at the end of each day. Are you tired before you even begin?
Between work, family life, keeping fit and making time for friends, many of us find there’s often very little left in the tank.
Our modern existence could be characterised as a revolving, never-ending to-do list. The obligations on everyone’s list might differ, but the result is often the same – a feeling of being overwhelmed as items seem to jump onto the list faster than we can check them off. No wonder we’re all so exhausted.
More frustrating still are those items that no sooner do we complete them than we have to start them all over again (making the bed, cleaning the toilet and putting away laundry, I’m looking at you!).
Is it a case of us piling more onto our plates than we can handle or are there other factors at play?
SWEET DREAMS
It’s no surprise that sleep is vital to feeling refreshed and alert during the day. According to sleep medicine research scientist and author Dr Carmel Harrington, tiredness is a widespread problem, as many of us are getting an inadequate amount or poor quality of sleep. “One in four are not getting enough sleep and almost half of adults have trouble sleeping at least three nights a week,” she says.
“The average adult requires somewhere between seven and nine hours sleep per night in order to function properly, but it’s not just how many hours we sleep that’s important, it’s also about the quality of our sleep.”
Those skimping on sleep might be surprised to learn that there can be far more serious health consequences than simply feeling red-eyed and sluggish during the day.
“People who don’t get enough sleep have less energy and slower reactions, they are less focussed and they struggle to make decisions,” says
Harrington. “There’s an increased risk of being obese, developing cardiovascular disease and even cancer. Similarly, there’s a greater chance of developing depression and dementia. And then there are the general effects like moodiness, lethargy and a tendency to make [frequent] mistakes.”
Even if you think you’re getting enough sleeping hours in each night, Harrington says there can be a number of underlying conditions such as sleep apnoea or restless legs disturbing your slumber. In addition, many of us may be sabotaging ourselves through unhelpful habits that make it tricky to get our night’s rest. “A recent ResMed survey revealed that two in five adults are on their mobile phones the hour before bedtime and 50 per cent have trouble going to sleep at night,” says Harrington. “When it comes to sleep, this is problematic as the bright light of the screen prevents our brain from producing the sleep hormone, melatonin. If we don’t have enough of this in our brain, we will struggle to fall asleep and/or stay asleep.”
Once mental health problems such as depression or anxiety and lifestyle factors such as a poor diet and lack of sleep have been eliminated as possible sources of tiredness, endocrinology doctor Isobelle Smith says the most common illnesses causing lethargy are generally thyroid issues, anaemia, and sleep apnoea.
CHRONIC FATIGUE
Chronic fatigue syndrome (also known as myalgic encephalomyelitis) is a condition characterised by severe and persistent fatigue experienced by its sufferers. In particular, people with chronic fatigue syndrome experience post-exertional malaise, which means their symptoms worsen after physical or mental activity out of proportion to the usual level of effort involved.
For those with CFS, a short walk or doing a homework assignment could lay them up in bed for days or weeks afterwards. Frustratingly, their reaction to the same triggers can differ from one day to the next, and the response can be delayed.
Other symptoms include problems with light-headedness, difficulties with temperature regulation, sleep dysfunction, muscle and joint pain, gastrointestinal issues, problems with concentration and memory, and sensitivity to light and noise. Medical science has yet to identify the exact causes of the condition, although a number of factors are believed to be involved, including infection, environmental toxins, genetics, physical trauma (such as a car accident), and stress.
Unfortunately, Smith says, there is no definitive test available to determine whether a patient has chronic fatigue. Instead, it is diagnosed by observing a collection of indicators such as changes in gut bacteria, and abnormal physiological responses to exercise and immune function.
The condition is estimated to affect 0.4 to 1 per cent of the population, around four in five of those being women. A quarter of those experience severe symptoms, leaving them house- or bedbound.
Another term you might have heard bandied about is ‘adrenal fatigue’, often used by naturopaths and alternative health specialists. However, it’s not an accepted diagnosis in mainstream medicine. This doesn’t mean your symptoms of fatigue aren’t valid – only that the explanation doesn’t lie in your adrenal system, says Smith.
Those seeking answers might be experiencing an underlying physical illness or a stress-related condition such as burnout.
“Burnout is an epidemic,” says Smith. “For mothers, we expect women to raise children like it’s their job. And then to go to work like they don’t have children. We have people connected 24/7 to their phones, their laptops, they’re getting emailed by their bosses at all hours. I would say burnout, especially amongst professionals and mothers, is really common and that would present with symptoms of adrenal fatigue.”
Feeling fatigued is known to be associated with mental health conditions such as anxiety and depression. “Poor sleeping patterns – too little or too much – fatigue and low energy are common symptoms of clinical depression,” says clinical psychologist Dr Lillian Nejad. “Chronic anxiety can also lead to fatigue due to the constant activation of the fight-or-flight response.”
HUSTLE CULTURE
Another cause is simply working ourselves to the bone. ‘Hustle culture’ has emerged as a term to describe the growing trend of glorifying slaving away for long hours and never switching off from the work mindset. The theme is around loving what you do so much that you never want to stop.
This ‘rise and grind’ mentality is a recipe for mental overload, says Nejad. Not taking the time to refresh, relax and get enough sleep will take its toll on our physical and mental health in the long run. “Chronic stress and a routine that does not include adequate recovery time is a recipe for persistent fatigue.”
The amount of time it takes to recover depends on how hard you’ve been working yourself and for how long. Feeling tired can be a shortterm issue, but if it sticks around for longer and becomes the norm, then it’s time to take a deeper look at what’s causing it and that is likely to require a longer recovery period.
“A general sense of tiredness can usually be improved fairly quickly and easily through more attention on self-care, especially adequate sleep,” says Nejad. “More persistent or chronic fatigue may take longer to improve as a person adjusts to a healthier lifestyle and addresses issues that may be contributing factors like physical or mental illness, side effects from medications, or burnout.”
“FEELING FATIGUED IS KNOWN TO BE ASSOCIATED WITH MENTAL HEALTH CONDITIONS SUCH AS ANXIETY AND DEPRESSION.”
BURNING OUT
If you keep pushing yourself outside of reasonable bounds in the workplace, eventually you’ll reach breaking point, in some cases triggering or exacerbating psychological conditions and causing burnout to occur.
A 2019 study in New Zealand found that a quarter of employees frequently feel depressed. Psychological risk factors for workrelated stress, depression and burnout
“THE FOODS WE EAT HAVE A LARGE INFLUENCE ON OUR ENERGY LEVELS.”
DR RAJSHRI ROY
include the content of tasks and responsibilities, relationships and aspects of management in the organisation.
So how can you tell if your ongoing feeling of exhaustion has reached the stage of qualifying as ‘burnout’? Officially recognised by the World Health Organization as a syndrome “resulting from chronic workplace stress that has not been successfully managed”, burnout is characterised as low energy or exhaustion coupled with negative feelings towards your occupation and a reduced capacity to perform on the job.
“Burnout is generally referred to as a condition brought on by chronic stress in the workplace,” says Nejad. “Burnout can lead to a number of issues including low mood, insomnia, feeling overwhelmed, and a sense of frustration and hopelessness. All of these factors can result in fatigue, low energy and low motivation.”
It’s important to recognise that you’ll need both time and support to assist you in recovery – it’s not a process that can be rushed, even if there’s the temptation or perceived pressure to quickly shake it off and get back on the horse, says Nejad.
“Burnout is a condition that often has built up over a long period of time and, therefore, it can take some time to recover,” she advises.
“It is important to have open communication with workplace supports and it can also be helpful to consult a mental health professional.”
THE FOOD FACTOR
When it comes to food, New Zealand Eating and Activity Guidelines recommend eating a range of foods from the four main food groups of fruit and vegetables; meat and other sources of protein; dairy; and carbohydrates such as potato, pasta, rice and bread. The foods we eat are not only vital for preventing disease and maintaining our overall health, but also have a large influence on our energy levels, says lecturer in nutrition and dietetics at the University of Auckland, Dr Rajshri Roy. Fad diets that recommend skipping meals or eliminating your main healthy source of energy (ie. carbohydrates), can force the body to strictly allocate its energy supplies when it’s running low, and your mental alertness may be lower on the list than other functions.
“It comes down to the type of carbohydrates you’re selecting,” says Roy. “So if you’re selecting something like a complex carbohydrate – your whole grains, wholemeal pasta, things that are more rich in fibre – they are going to release glucose much more slowly into your blood system. That’s going to keep you sustained for much longer.”
When looking at diet as a possible cause of feeling tired, a dietitian would look at factors such as what types of nutrients are being consumed, eating times and whether any meals are being skipped, as well as the overall calorie intake compared with the appropriate amount for the individual.
The aim is to maintain a steady flow of energy to our body across the day, rather than spikes followed by crashes that have us reaching for a slice of cake when we hit midmorning or the three o’clock slump.
Wholesome foods that are low GI will release energy slowly and keep us feeling full for longer, while certain nutrients are particularly important in preventing a feeling of fatigue, says Roy. “Iron, vitamin D12 and omega-3 fatty acids are some of the key nutrients we would look out for if we are concerned about someone’s intake and how that relates to tiredness.”
A dietitian would look to address any deficiencies by a change in diet first before considering bridging the gap with supplements, if necessary. The other side of the equation is remembering to drink enough water, as this helps keep us alert throughout the day.
“Water is very important for keeping you hydrated, and hydration is key for making sure you’re not tired,” says Roy.
“Dehydration leads to fatigue, because if you’re dehydrated, the oxygen in your body is not flowing well enough to your brain and your heart is having to work a lot harder to pump oxygen around your body. So that makes you feel more tired and less mentally alert.”
DRINKING UP
Many of us are very attached to our cup of coffee or tea to jump-start us in the morning, and one or more further cups to keep us going when we start to flag later in the day. In a 2018 New Zealand survey, more than 66 per cent of respondents said they drink coffee regularly.
Unless you have certain illnesses aggravated by caffeine such as anxiety, high blood pressure or tachycardia, these drinks can be enjoyed in moderation to give you a short-term boost.
Roy says caffeinated drinks may play a part in a balanced diet, but three cups of coffee per day should usually be enough to keep you on your toes. Anything more, and you’d be starting to question why you need so much caffeine to keep you going. “When used in the short term and appropriately, it can increase our mental alertness and enhance our performance.”
Energy drinks, on the other hand, certainly have the ability to deliver a decent dose of energy from stimulants such as guarana (an ingredient derived from an Amazonian berry) and caffeine. However, they also contain a large amount of sugar that sends your energy spiking and then plummeting fast. “The added sugar is quickly jumping and spiking in your blood, but then dropping really fast as well, so it’s not a sustained release of energy,” says Roy.
Overall, maintaining a balanced diet, getting enough sleep, and achieving a reasonable balance between work and rest will help keep you energised. If not, it may be time for a trip to the doctor to restore the pep to your step.