Why Am I So Tired?

Carol Heffernan, a 43-year-old marketing writer from Wisconsin, Canada, regularly felt worn out from her busy life of working, shuttling her two kids to elementary school and play dates, and taking care of housework. But when COVID-19 hit last March and the kids were suddenly at home all day, learning remotely, she noticed that her run-of-the-mill weariness quickly turned into full-on exhaustion.

“All the extra responsibility and the mental load—it just added up,” she says. “I felt grumpy and tired—and it wasn’t due to lack of sleep.”

Heffernan didn’t have any time in the day to exercise off her stress. She was short on energy, and she started becoming short with her kids. “After I put them to bed at 8 p.m., I would just crash on the couch,” she says.

If there’s one thing many of us have in common, it’s that we’re tired. In fact, lethargy is so pervasive that it’s one of the issues people ask their doctors about the most. Doctors even have a name for it: ‘tired all the time’, or TATTfor short. The solution isn’t always as simple as getting more sleep; nearly a quarter of people who get seven or more hours of rest a night report they still wake up feeling tired most days of the week.

Here are eight reasons your energy is low—and what you can do to bring it back:

BECAUSE YOU’RE SPENDING TOO MUCH TIME ON THE COUCH

When you’re feeling sluggish, it can be tempting to plop down and binge-watch TV. But doing something active will actually give you more energy, not consume the little that you have. In fact, researchers at the University of Georgia found that just 10 minutes of low- or moderate-intensity exercise gave study participants a noticeable energy boost.

Starting a regular exercise routine is even more beneficial. In another recent study, people who committed to an exercise regimen—working out for20 minutes, three times a week—boosted their energy levels by 20 percent in six weeks. “When we don’t workout regularly, our muscles can become weakened, so when we do use these muscle groups in everyday activity, we’re more tired,” explains Dr. YufangLin, an integrative medicine physician at the Cleveland Clinic’s Center for Integrative and Lifestyle Medicine.

Exercise also works its magic at the cellular level: the mitochondria—the parts of your cells that provide energy to your muscles—actually grow more powerful and numerous after aerobic exercise, providing a continuous source of increased energy.

BECAUSE YOU’RE PUSHING YOURSELF TOO HARD

People who feel overcommitted—whether from volunteering for one too many causes or shouldering too much at work or at home—often try to squeeze in more tasks so they can get everything on their to-do list crossed off. But it might be wiser to take a break.“When it comes to optimizing energy over the long haul, it’s about getting into a rhythm of periods of exertion and rest,” says Dane Jensen, CEO of Third Factor, an organization that helps companies employees perform better under pressure. “In fact, to stay energized over the course of the day, you need a 15- to 20-minute break every 90 minutes.” Not all downtime is equal: a 2016 study looked at office workers in SouthKorea and found that those who looked at their smartphones during breaks were significantly less recharged than those who went for a walk or chatted with friends.

Jensen suggests choosing breaks that balance out what’s taxing you. If you've been working at a computer, take a walk outside. If you’ve been doing spring cleaning, sit down and call a friend. 

For more inspiration, Jensen suggests considering four categories of breaks, based on how they can benefit you: physical (walking or stretching); cognitive (crossword puzzles or Sudoku); emotional (phoning a loved one); and spiritual (walking in the woods or practising a religion).

“It’s just not enough to say, okay, I'm going to take a break every once in a while,” he explains. “You want to do it intentionally and spend that time on something that’s actually going to give you energy.

”BECAUSE YOU’RE ANXIOUSAnxiety is draining. When you're distressed, your body is on high alert and produces adrenalin. Your muscles might tighten up, and your brain shifts into overdrive to try to work through all possible scenarios. That all takes energy—and will leave you feeling tired.

And right now, the pile-up of global crises—political instability and the pandemic being the most notable—is having a measurable effect on many people's mental health. One study published in the British Journal of Psychology found that participants who watched a negative news bulletin were more likely than those who watched a neutral or positive one to feel anxious or sad—and to then feel worse about their personal problems, too.

One antidote to all the bad news is cultivating your friendships. Scientists have long known that socializing decreases the risk of developing mental health issues like depression, and avoiding loneliness also lowers stress hormone levels in your body. One study from researchers at Arizona State University found that university students who had spent more time socializing had lower cortisol levels the next day—and they slept better, as well.

Dr. Vincent Agyapong, director of the Division of Community Psychiatry at the University of Alberta, says that his research has demonstrated that nurturing relationships is a mood booster. “Maintaining social contacts is one of the ways to maintain your mental health,” he says. “It doesn’t necessarily have to be face to face—it can be via social media, telephone call or video conference.”

All that said, if you think you might have clinical levels of anxiety—for example, if you’re having panic attacks or completely avoiding doing everyday tasks—speak to your healthcare provider about talk therapy or medication.

BECAUSE YOU’RE LOW ON VITAMINS

Fatigue is often connected to not having enough of two key nutrients, says the Cleveland Clinic’s Lin: iron and B vitamins. When you don’t get enough iron in your diet, it can lead to iron-deficiency anaemia, which means your body doesn’t produce enough healthy red blood cells.

“When there are not enough red blood cells around, less oxygen gets carried to the cells to allow them to generate energy, which causes fatigue,” says Lin. People with anaemia might also experience shortness of breath, dizziness, and cold hands and feet.

Having a B-vitamin deficiency, especially B12, also affects energy levels, since vitamin B12 is another key to creating enough red blood cells. Since iron and vitamin B are commonly absorbed from red meat and shellfish, people who follow a vegetarian or vegan diet are at more risk. But anaemia can also occur during pregnancy or stem from gastrointestinal problems such as ulcers or Crohn’s disease. These and other less common vitamin and mineral deficiencies can all be identified with a blood test and treated with supplements and a change in diet.

However, Lin warns that supplements and drinks that are advertised as energy enhancers can be dangerous. “A lot of those ‘energy’ supplements are laced with caffeine, ginseng or other stimulants at a high dose,” she says. Lin also cautions that they can cause serious side effects, like heart palpitations, insomnia, and anxiety.

BECAUSE YOU’RE DEPRESSED

If you’re feeling excessively fatigued—dragging yourself through the normal tasks of daily living or are unable to complete them—it could be a sign that you've slipped into depression.

Some people are genetically predisposed to the condition, and others develop it as a result of difficult circumstances; rates of depression in the United States, for example, tripled after the coronavirus arrived, rising from eight per cent to 28 per cent.

“It’s expected that so much fear and uncertainty will increase people’s levels of stress, anxiety, and depression,” says Agyapong. “With how long the pandemic is going on, it’s becoming pathological for a lot of people.

”Other symptoms of depression include loss of appetite and irritability. If you’re feeling tired all the time and suspect depression might be to blame, ask your doctor for a mental-health screening. Talk therapy can help, as can antidepressants.

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BECAUSE YOU’RE EATING AN UNBALANCED DIET

We often think about how our diet affects our weight, but what you eat has a large effect on your energy levels, too. When your body digests food, it turns it into glucose, which is then sent by way of your blood to all of your muscles and organs, including your brain. Our blood sugar naturally fluctuates during this process, and when it’s low, we can feel sluggish.

A simple way to keep your blood sugar consistent is to eat regularly. “If you go more than several hours without a meal or snack, that’s probably too long of a stretch,” says Cara Harbstreet, a Kansas City–based registered dietitian.

Another common error, Harbstreetsays, is eating too many simple carbo-hydrates—juice, candy bars, or white bread. Those can lead to an increase in blood sugar, prompting your body to produce insulin, which then makes your blood sugar drop. “You get an energy spike and then you come crashing down and eat more of the same kinds of foods,” she explains. “And that cycle can repeat indefinitely.

”Instead, reach for complex carbs—like whole grains and non-starchy vegetables—which are more slowly digested than simple carbs, giving you a steady stream of energy. To make sure you’re getting enough nutrients to fuel your body, Harbstreet recommends trying to get three food groups at every meal and at least two at snacks.

BECAUSE YOU’RE NOT BREATHING WELL AT NIGHT

Before going to the effort of changing your lifestyle to deal with fatigue, it's important to make sure it’s not a symptom of a more serious, undiagnosed condition. If you’ve been unusually tired for more than a month, ask your doctor if an underlying problem could be behind it.

One common culprit is sleep apnea, a condition that causes breathing to start and stop throughout the night. Sleep apnoea affects more than 20 percent of Americans—and those numbers are on the rise, likely because of growing rates of obesity.

Since sleep apnoea causes sufferers to rouse multiple times a night to keep breathing—often without knowing it—they don’t get enough deep sleep. The condition, which often comes with daytime exhaustion and nighttime snoring, can also lead to other issues, including cardiovascular disease and diabetes. If diagnosed, sleep apnoea can be treated with a machine that pushes pressurized air into your nose or mouth during the night to make sure your airways stay open.

BECAUSE YOUR THYROIDIS STRAINED

Another underlying problem to watch out for is hypothyroidism, which affects about five per cent of the population and almost always includes tiredness as a symptom. The condition is caused when your thyroid, a butterfly-shaped gland inside your neck, produces too few hormones.

“Thyroid hormones control your metabolism, which is like the engine in your car,” says Lin. “When your engine runs too low, the car drives too slowly.”Along with fatigue, hypothyroidism may also result in weight gain, slow movement and speech, and sensitivity to cold. The condition is most common in women over 60 and can be treated by taking a medication that contains either natural or synthetic thyroid chemicals.

A few weeks after her fatigue set in, Heffernan knew she needed to do something to feel better. Finally, one day she decided to drop everything and go for a walk—something she hadn't done since the pandemic began. “I just wanted to be by myself,” she says. “I needed a break.” When she returned, she felt recharged and decided to make a habit of it.

Now, every afternoon, she leaves her kids and husband at home, puts on an uplifting podcast, and goes for a 45-minute stroll through her neighborhood. “The walks really feed me, spiritually, emotionally, and physically,” she says. “I have something to look forward to every afternoon. I’m in a better mood. And after putting the kids to bed, I have the energy to stay up, talk to my husband, and have some more time for myself.”