Here’s why you’re so tired

Here’s why you’re so tired

The daily grind is wearing us down.

Studies indicate that about one in three Americans — almost 107 million — experience significant fatigue. That lack of energy can be the cause of diminished productivity and a general dissatisfaction with our jobs and even our personal relationships.


"Fatigue is an issue when you look at your life, and you see that you are not accomplishing the things you want to do in your everyday life because you are tired," says Marc Cesari, D.C., a chiropractor with Ultimate Health who treats fatigue by addressing pain and teaching stress management.

Pain is often a major contributor to fatigue. Specializing in lifestyle management, Cesari works with a variety of tools and treatments to restore normal function, optimize body symmetry, improve strength and nutrition, and maintain the body with supportive treatments.

The best way to manage fatigue — or even eradicate it — is to work with your doctor to find the right course of treatment. In two-thirds of cases in which patients report significant fatigue, doctors can identify and address contributing causes, says Melissa DeLong, M.D., medical director for Evergreen Health Care.

"The causes of fatigue are many," Dr. DeLong notes. Identifying the cause of fatigue is not always a simple diagnosis. "Unfortunately it's often not as easy as strep throat," she adds. "There's no rapid test."

What will a doctor look for?

Some of the most common causes of fatigue include:

  • Poor sleep.
  • Side effects from medication.
  • Endocrine disorders such as diabetes or thyroid conditions.
  • Mental health illnesses such as depression and anxiety.
  • Infections

In some instances, frequent fatigue can be caused by larger health problems, such as lung or heart conditions or autoimmune diseases. A full medical screening helps identify sources of fatigue and determine whether it is a symptom of a more severe condition.

"We want to make sure we have an opportunity to evaluate the patient," Dr. DeLong says. "It's very important that we see someone in the office where we can perform a detailed history, a full physical exam and begin to do some diagnostic blood work and testing."

How is mental health connected?

Some patients experiencing fatigue are suffering from a concurrent mental health disorder such as depression. Treatment requires a holistic approach to health care. Evergreen Health Care's primary care offices, for instance, have behavioral health teams at all locations to determine the best treatment for each situation.

"Mental health issues may be the source of the fatigue, or they may be the result of dealing with persistent fatigue," Dr. DeLong says. "Though we might not be sure which came first, we do whatever is needed to support patients as they are learning to manage their symptoms," she adds.

How can I fix this?

If we don't get enough sleep at night, most of us won't feel rested during the day. Our lifestyle choices have a significant impact on the quality and quantity of our sleep. For example, excess use of alcohol can disrupt sleep patterns.

Additionally, excess weight is one factor that can contribute to a condition called sleep apnea. Those suffering from this condition have micro-awakenings throughout their entire sleep cycle due to a closure of the airway as they sleep. Only a doctor can tell you for sure if you have sleep apnea.


Small adjustments like drinking more water, taking breaks throughout the workday, and stretching can help with energy levels, says Cesari. Larger changes to lifestyle habits — such as to diet, reducing stress or adding an exercise routine — can also yield near-immediate effects. Changing those habits can also help to manage medical conditions that cause fatigue, such as diabetes, obesity and depression.

"A person has to take a step back to analyze their life and ask, 'Where can I make changes?'" Cesari recommends. "Look at all aspects of your life and break them down. Diet, sleep and family life management are things you should look at."

"Our society puts a big demand on us," he continues. "If you don't allow for ways to refill that tank, you're going to go through life on empty."

—Brendan Murphy for Evergreen Health