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Fatigue referred to as tiredness, exhaustion, lethargy, and listlessness, describes a physical and/or mental state of being tired and weak. Physical and mental fatigue although different, the two often exist together – if a person is physically exhausted for long enough, they will also be mentally tired.

When somebody experiences physical fatigue, it means they cannot continue functioning at their normal levels of physical ability. Mental fatigue, however, is more slanted towards feeling sleepy and being unable to concentrate properly.

Fatigue is a symptom, rather than a sign. A symptom is something the patient feels and describes, such as a headache or dizziness, while a sign is something the doctor can detect without talking to the patient, such as a rash. Fatigue is a non-specific symptom, i.e. it may have several possible causes.

Types of Fatigue

Mental and physical fatigue

Physical fatigue – the person’s muscles cannot do things as easily as they used to. Climbing stairs or carrying laden supermarket bags may be much harder than before. Physical fatigue is also known as muscle weakness, weakness, or lack of strength. Doctors usually carry out a strength test as they go about diagnosing and trying to find out the causes of individual cases of physical fatigue.

Psychological (mental) fatigue – concentrating on things has become harder. When symptoms are severe the patient might not want to get out of bed in the morning, or perform his/her daily activities. Mental fatigue often appears together with physical fatigue in patients, but not always. People may feel sleepy, have a decreased level of consciousness, and in some cases show signs similar to that of an intoxicated state. Mental fatigue may be life threatening, especially when the sufferer has to perform some tasks, such as driving a vehicle or operating heavy machinery.

Why am I so tired?

The possible causes of fatigue are virtually endless. Most diseases listed in medical literature include malaise or fatigue as one of the potential symptoms. Causes are sometimes classified under several lifestyle problems and/or some broad disease entities.

Stay with us for the (by no means all) possible causes of fatigue:


  1. Mental health (psychiatric)

Grief (bereavement), eating disorders, alcohol abuse, drug abuse, anxiety, moving home, boredom, and divorce.

A certain amount of stress can invigorate us, in fact, most of us need some kind of mental pressure to get going. However, when stress levels become excessive, they can easily cause fatigue. Stress and worry are two emotions that commonly cause tiredness. Stress can reach a point in which the sufferer flounders and is “unable to see the light at the end of the tunnel”, which leads them towards despair. Despair is draining, and will eventually cause fatigue if it is present for long enough. Not being in control over a situation can be frustrating, annoying, and very tiring.

Having a baby in the house, especially if he/she wakes up a lot during the night, can interfere with the parents’ sleep.

Clinical depression can cause tiredness for several reasons. Fatigue may be caused by the depression itself, or one of the problems associated with depression, such as insomnia.

  1. Endocrine/Metabolic

Cushing’s disease, kidney disease, electrolyte problems, diabetes, hypothyroidism, anemia, kidney disease, and liver disease.

  1. Drugs/Medications

Some antidepressants, antihypertensives, steroids, antihistamines, medication withdrawal, sedatives, and anti-anxiety drugs.

Statin medications are among the most widely used prescription drugs sold worldwide.

  1. Heart and lung conditions

Pneumonia, arrhythmias, asthma, COPD (chronic obstructive pulmonary disease), valvular heart disease, coronary heart disease, and congestive heart failure.

  1. Sleep problems

Working till late at night, jet lag, sleep apnea, narcolepsy, insomnia, and reflux esophagitis.

Some jobs are more closely linked to a risk of fatigue than others. Examples include the police, doctors, nurses, firefighters, and shift-workers in general whose sleep patterns are “unnatural” for humans. The problem of fatigue is exacerbated if the shift-routines are regularly changed.

  1. Infectious diseases, infections

Malaria, various tropical diseases, TB (tuberculosis), infectious monocucleosis (glandular fever), Cytomegalovirus, HIV infection, flu, and hepatitis.

  1. Chemicals and substances

Vitamin deficiencies, mineral deficiencies, poisoning.

Consuming too many caffeinated or alcoholic beverages may make it harder to get to sleep, or stay asleep, especially if you drink them close to bedtime.

  1. Various diseases, conditions, states and treatments

Cancer, chemotherapy, radiotherapy (radiation therapy), chronic fatigue syndrome, fibromyalgia, systemic lupus, rheumatoid arthritis, obesity, massive blood loss, and weakened immune systems.

  1. Chronic pain

Patients with chronic pain typically wake up tired, even after having slept for a long time. For many, pain disrupts their sleep, which also leaves them tired. The combination of disturbed sleep and having to endure persistent pain can be extremely draining, leaving the patient exhausted for much of the time. Some diseases and conditions where pain is the main symptom, such as fibromyalgia, are also linked to other conditions, such as sleep apnea, restless leg syndrome, which further worsen symptoms of fatigue.

Breast cancer-related fatigue is a common condition. However, researchers from the Prince of Wales Hospital in Randwick, Australia, found that it runs a self-limiting course and is not as long-lasting as people had thought.

  1. Other possible causes of fatigue

Changes in neuronal structure interactions – a Swiss scientist demonstrated that there is an association between muscle fatigue and changes in the interaction between neuronal structures.

Fatigue can become self-perpetuating. An individual who feels tired may not exercise; lack of exercise can cause fatigue. Also, lack of exercise may eventually make it harder and more tiring to perform a physical chore.

Overweight and underweight – overweight/obesity is a rapidly growing problem in much of the world today. Obese people are much more likely to experience fatigue, for various reasons – having to carry a lot of weight is tiring, obese people are have a higher risk of developing diseases and conditions where fatigue is a common symptom, such as diabetes and sleep apnea. Being underweight may mean there is less muscle strength; the very thin person may tire more easily.


Fatigue signs and symptoms may be of a physical, mental or emotional nature.

Below is a list of some more possible signs and symptoms of fatigue:

  • Bloating, abdominal pain, constipation, diarrhea, nausea, possibly problems similar to IBS (irritable bowel syndrome)
  • Aching or sore muscles
  • Painful lymph nodes
  • Apathy, lack of motivation
  • Chronic (long-term) tiredness
  • Difficulty in concentrating
  • Dizziness
  • Hallucinations
  • Hand-to-eye coordination may be impaired
  • Headache
  • Impaired judgment
  • Indecisiveness
  • Irritability
  • Loss of appetite
  • Moodiness
  • Poorer immune system function
  • Short-term memory impairment – there may be problems organizing thoughts and finding the right words to say (brain fog)
  • Sleepiness, drowsiness
  • Slow responses to stimuli
  • Slower-than-normal reflexes
  • Some vision problems, such as blurriness



  • Try to go to bed and wake up at the same time each day
  • Set your bedroom’s temperature at a comfortable level. It must neither be too cold nor too hot
  • Do not have your last meal of the day too close to your bedtime – not less than 90 minutes or two hours before you go to bed
  • As bedtime approaches, physically and mentally slow down. Have a warm bath and listen to some soothing music. Clear your mind of stressful and worrying thoughts.
  • Many patients have found keeping a diary helps.
  • Eating and drinking habits
  • If you eat three regular meals each day, eat at the same time each day, and follow a well-balanced diet, your overall health will improve and so will your sleep patterns.
  • If you are underweight, add more calories to your diet, but make sure it is a healthy one.
  • If you are overweight/obese, follow a well-balanced diet and aim for a healthy body weight.
  • Do not crash-diet. Your sleep may be affected.
  • Drink alcoholic and caffeinated beverages in moderation, or not at all.

This piece was originally published by the Federal Road Safety Corps