Many people suffer from constant fatigue, or are always tired. The causes of this phenomenon are very diverse and can often be explained by lack of sleep or overwork. Chronic fatigue is very exhausting for those affected, as it significantly limits their performance in everyday life and at work.
The reserves are used up and quickly results in mental and physical overload. Permanent fatigue can therefore also become the basis for illnesses, as those affected are less able to defend themselves. For this reason, a conspicuous drop in performance with persistent fatigue should definitely be clarified. Apart from comparatively harmless causes, which are usually behind it, more serious reasons can also be considered under certain circumstances.
Causes
The causes for persistent daytime tiredness are manifold. The most common are causes that directly influence the day-night rhythm, such as lack of sleep, constantly getting up early in connection with strenuous physical or mental activity or nightly sleep problems. Even if the daily routine is changed frequently and does not follow a constant regularity, increased fatigue can result and lead to you always being tired.
The body then has difficulty adjusting to the changing daily rhythm. In general, fatigue can be seen as a warning signal from the body that something is missing. Many physical, but also mental problems result in symptoms of fatigue.
In these situations the body needs a lot of energy to cope with these problems. This energy is then lacking for everyday situations, which the person concerned notices in early onset and persistent fatigue. In addition, a permanent state of fatigue can also be a sign of a serotonin deficiency.
Since the causes of fatigue are so varied, it is not always easy to quickly find the individual cause. The following causes can potentially be considered. In addition to those mentioned above, there are various other possible causes why you are always tired.
These should be clarified from patient to patient in each individual case.
- Life circumstances: lack of sleep, stress, excessive or insufficient demands, lack of exercise, lack of fluids, being overweight or underweight, high-fat meals (especially before bedtime), diets, strong sunlight, growth phases (children), cycle-related fatigue in women, pregnancy, menopause, psychological stress (worries)
- Organic causes: various infectious diseases (including, for example, Pfeiffer’s glandular fever caused by the Epstein-Barr virus), anemia, heart disease, lung disease, hormonal imbalances (for example, thyroid, parathyroid or adrenal cortex diseases), diabetes mellitus, autoimmune diseases, liver, kidney or gastrointestinal diseases, malignant diseases (tumors) or nocturnal breathing problems
- Mental illness: Depression, burnout syndrome, anxiety disorders, eating disorders, dementia, alcohol abuse, Parkinson’s disease, multiple sclerosis, and many more
- Medication: Sleeping pills, psychotropic drugs, blood pressure medication, migraine medication, antidepressants, medication for allergies (e.g. antihistamines), various painkillers, chemotherapeutics
People who are affected by daytime fatigue either feel a performance kink immediately after waking up in the morning or early in the day. This results in a lack of drive, the eyelids become heavy and fall repeatedly.
Those affected are significantly less resilient, react quickly with irritation and tend to have emotional outbursts. In a stressful phase of life, daytime tiredness need not always be a worrying condition. In such times, the body is often exhausted and requires more sleep and variety, which can manifest itself in frequent fatigue.
When this period is over, however, the tiredness should also subside again. A possible alarm sign is when the fatigue phase is not followed by an active, awake phase; the person concerned is therefore still constantly tired, although there is no obvious reason for this. It is also noticeable if the fatigue does not improve after sleep, physical activity or recovery phases, if the fatigue is much more pronounced and long-lasting than normal, or if it occurs suddenly without the person concerned having exerted themselves excessively beforehand.
Especially if other symptoms are added to the fatigue, a medical examination should be performed.These include, for example, nausea and vomiting, general malaise, fever, heavy night sweats, unintentional weight loss, pain, dizziness, shortness of breath, depressive moods and memory problems. In general, the cause of fatigue should be investigated if it noticeably interferes with everyday life and leads to a noticeable drop in performance. Since the causes of persistent fatigue can be very diverse, the doctor must first obtain an overview of the patient’s living conditions.
A detailed conversation at the beginning of the diagnosis is therefore part of the process. It is interesting for the doctor to know how long the fatigue has existed, at which moments it occurs and how long it lasts. It is also important to know whether it seems inappropriate that you are always tired, i.e. whether it occurs after activities that were not actually perceived as particularly strenuous or whether it even sets in early in the morning after waking up.
Factors that increase or improve fatigue can also be of interest to the doctor. Conditions of fatigue that do not improve after sleep or rest are more likely to be a cause for concern. The physician will finally also ask about habits, for example the sleep-wake rhythm and the quality of sleep, whether there are difficulties in falling asleep or sleep through, whether nightly breathing stops or snoring has been noticed.
It is also interesting to know whether the person concerned does enough sport, has gained or lost weight, how he or she eats, whether he or she smokes or frequently drinks alcohol. To clarify psychological factors, the doctor will also ask about problems in private and professional life. Is the person concerned in an exceptional stress situation?
Does he often have mood swings, self-doubt or a depressive mood? With regard to professional life, it can also be important to know whether the patient is exposed to chemicals or other harmful substances. Under certain circumstances, these can affect health and thus be the cause of fatigue.
In the same way, it is essential to know which medication the patient is taking and whether he or she has noticed other symptoms in addition to fatigue. After clarifying the basic information about the patient’s living conditions and the degree of fatigue, the doctor can carry out various examinations and tests to clarify the fatigue more precisely. Through the conversation, he may already have an idea of the direction in which he needs to investigate further, so that the subsequent diagnostic tests can be used more specifically.
After a general physical examination, the next step is often a referral to a specialist. The family doctor will select this doctor depending on the suspected cause. Possible specialists who can take care of the patient’s persistent fatigue are neurologists (in case of a suspected diagnosis of nerve-related fatigue), cardiologists (in case of suspected heart disease), diabetologists (in case of suspected diabetes), endocrinologists (in case of suspected hormonal cause of fatigue), psychologists or psychiatrists (in case of suspected psychological cause).
Other specialists can also be consulted. These specialists can then, depending on their area of expertise, specifically investigate what might be the underlying reason why you are always tired. For example, a (stress) ECG can be written, the blood can be examined for various metabolic disorders, an MRI or computer tomography can be done or an ultrasound examination of various organs can be performed. Through the various examination measures, the cause of the ever-present fatigue can be quickly determined in many cases.
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