It’s that time of year again. You know, when you can’t remember what day of the week it is. Or when you last ate anything that wasn’t spiced with cinnamon or soaked in booze. You also can’t remember when you last woke up feeling fresh. In fact, you’ve felt tired for a while now. Have you been sleeping badly? Drinking too much? Or are you just slowly getting used to a life where you’re constantly groggy?
Few things feel quite as debilitating or frustrating as fatigue. You can’t work, play, or even rest as efficiently as you’d like when you feel exhausted. And yet, it’s something all of us will deal with to varying degrees at some point, though it almost always strikes after Christmas – blame silly season.
There are countless reasons why someone might feel tired beyond the obvious factors, like illness, burnout, and disrupted sleep. But why is it that some of us always feel like this, no matter how healthy we are? And what can we do to combat it without spending a fortune on whizzy supplements and superfoods that might actually be little more than a marketing ploy?
“Fatigue is an extremely common symptom seen in general practice,” says Dr Angela Rai, GP at the Harley Street GP clinic, The London General Practice. “There are numerous causes of tiredness including poor sleep, dehydration and stress, especially around Christmas time, as well as medical causes.” Feeling tired all the time is referred to as “TATT” by medical professionals. Of the myriad reasons for TATT Dr Rai sees as a GP, one of the most common is anaemia, which is an iron deficiency that can be detected by a blood test and treated with iron tablets. Other common causes include diabetes, glandular fever, vitamin B12 and folate deficiency, and hypothyroidism, which is when the thyroid gland doesn’t produce enough thyroid hormone leading to slow metabolism.
Other physiological conditions that can cause frequent tiredness include long Covid, hormonal changes, and obstructive sleep apnea, which is a breathing problem that occurs when you sleep and causes the throat muscles to intermittently relax, interrupting normal breathing. For women, feeling tired can also be tied to your menstrual cycle, with some feeling particularly exhausted during the luteal phase, aka the run-up to your period when you experience premenstrual syndrome (PMS).
General lifestyle and health also play a major role in how tired we feel. “If you exercise regularly, you tend to be more resilient to both physical effort and psychological demands,” says Dr Sophie Bostock, sleep expert at Bensons for Beds. “A healthy diet also helps protect against lack of energy from poor nutrition.” Eating whole foods is a common recommendation for combatting everyday fatigue, with leafy greens, nuts, seeds, and lean proteins all contributing to a well-rounded diet that should make a noticeable difference in tiredness levels.
Something as simple as not drinking enough water could also be a major factor for TATT. “Dehydration is a common cause for fatigue and it is well known that most individuals do not consume enough water,” says Dr Rai. “Dehydration will decrease blood volume making it harder for the heart to pump oxygen and nutrients to muscles and organs leading to feelings of tiredness. Water is also essential for cellular functions and brain functions and helps us maintain our electrolyte balance, which is crucial for muscle function and energy.” The optimal water intake will depend on age and activity levels but generally, the NHS recommends drinking six to eight glasses a day.
Of course, some people simply need more sleep than others, which is why you might find yourself feeling envious of friends who manage to get by on just a few hours while you struggle if you don’t clock in your eight hours. “The general recommendation for sleep is seven to nine hours per night, however it is essential to listen to the body,” says Dr Rai. However, this could be affected by underlying conditions or chronic illnesses. “There are also genetic factors like short sleep syndrome, which is a condition where you need less sleep than most people,” she adds. “You can have six hours or less of sleep on most nights but wake up feeling energetic and completely rested.”
On top of all the physiological possibilities for causing tiredness, there are numerous psychological reasons, too. One of the biggest culprits is stress, which spikes our cortisol hormone, which can in turn lead to disrupted sleep. “The vast majority of people I work with experience fatigue due to an overactive nervous system,” says Chris Meaden, trauma and anxiety therapist at The Meaden Clinic. “Chronic stress, anxiety, and unresolved trauma can overstimulate the nervous system, leaving the body in a perpetual state of fight-or-flight. Depression can also sap energy and motivation, creating an ongoing cycle of exhaustion because people find themselves stuck in a hyper-vigilant state, constantly on edge.”
It’s important to point out that there’s a difference between feeling tired as a symptom of the aforementioned reasons and experiencing chronic fatigue, which is generally a sign of something more physiologically serious. “The condition is still poorly understood and is often not recognised by the medical profession with no clear pathway for management, especially for severe cases,” says Dr Deborah Lee at Dr Fox Online Pharmacy.
“Fatigue that lasts for six months or more is usually called chronic fatigue syndrome, or myalgic encephalitis [ME]. This is a complex, poorly understood, disabling illness that is often accompanied by muscle pain, muscular weakness and headaches.” Cognitive problems are common, too, and may include brain fog, insomnia, and hypersensitivity, for example to light or sound.
It can be incredibly hard to diagnose ME given how the symptoms could be linked to so many other conditions. However, if you find yourself struggling with tiredness that feels in any way abnormal, the best thing you can do is speak to your GP. They can help you determine whether your tiredness is being caused primarily by physiological or psychological reasons and take things from there.
Regardless of the cause, which may be difficult to identify, there are a few simple things all of us can do to feel less tired in our everyday lives. This includes cutting out alcohol and sugar, both of which cause spikes in blood sugar that lead to tiredness. “Sunlight exposure, even for just a short walk, can also reset your body clock and improve alertness,” adds Meaden. “A power nap of 20 minutes can also recharge you without interfering with nighttime sleep. And learning calming techniques, such as the physiological sigh, a method of deep breathing that helps reset the nervous system, can provide immediate relief.”
Working on ways to reduce your overall stress levels will help, too. For some people, that might be about spending more time with friends and family. For others, it could be increasing their exercise levels. “Activities like yoga, tai chi and gym classes can give you new ways to move your body and release feelgood hormones,” suggests Dr Luke Powles, associate clinical director, Bupa Health Clinics. “Talking about how you’re feeling with someone trusted can also help break down your thoughts. Whether it’s a friend, family member, charity or health professional, some evidence shows that this can help reduce fatigue.”
Ultimately, all of the advice boils down to the same thing: taking care of yourself, a simple instruction many of us let slide around the festive season, whether it’s by drinking too much and sleeping too little or stressing about the in-laws and spending hours cooking for your family. Remembering to check in with our bodies and minds at regular intervals is key to reducing tiredness levels. But there is a scale. And if you still have concerns come January, it’s best to speak to your doctor to rule out more serious conditions.
