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Fatigue is a symptom of many different conditions, including:
Fatigue can also be caused by other issues, like stress, fear, or poor sleep.
Fatigue is sometimes explained as a tiredness that doesn’t go away, but there is a lot more to it than that. As well as feeling tired, fatigue can also cause:
Fatigue can be caused by all sorts of health issues, but the common factor is that people with fatigue have low energy and get exhausted more easily.
Fatigue is not a mental health condition, although it can sometimes be a result of mental health conditions. Fatigue does not mean that someone is “lazy” or “not trying hard enough”. Fatigue is a problem with how your body processes energy. There are measurable effects on how your body works when you are fatigued. Fatigue can affect all parts of your body – muscles, brain, nerves, and digestion – and can be difficult to manage. However, there are things that you can do to reduce your symptoms and manage your energy.
Many people with fatigue find that it improves over time, especially fatigue caused by a specific medical incident like a stroke or heart attack. Even if your fatigue does not go away on its own, you can manage your symptoms effectively, and people with even severe fatigue can live full and happy lives.
Fatigue responds to your level of activity. If you are very active, exercise heavily, or experience a period of stress, you may find that your symptoms worsen as a result.
Everyone has a limited amount of energy which they can draw on. In fatigue, this level is lower. One way of understanding this is through “spoon theory” – you can imagine that you have a set number of “spoons”, representing energy, and every activity you do throughout a day will take some spoons from your collection. When you run out of spoons, you will be unable to do any more activities. People with fatigue have fewer “spoons” – and, especially if there are other health problems, you might find that some activities take more “spoons” than they would if you were healthy.
People with fatigue often experience a “boom and bust” pattern. This means that there are times when fatigue symptoms are relatively mild, and you may feel well. This “boom” period often tempts people to overwork themselves, trying to catch up on activities which you may have missed while fatigued. As a result, symptoms flare up and you enter the “bust” period, where you feel much worse. This can last for days or weeks.
This “boom and bust” pattern can become a vicious cycle, since people who are in a “bust” period may feel frustrated and fall behind on the things they would like to be doing, which makes it even more tempting to overwork when they feel good.
You can’t “push through” fatigue. It can be tempting to think that if you just try harder, you can overcome your tiredness – but fatigue is a real medical condition, and trying to ignore it will only make it worse.
Mairead and her husband are both suffering from Long Covid and regularly experience fatigue, among other symptoms.
“A month after contracting Covid, we were both still floored by it. I’ve had flu before, but this wasn’t flu. We just lay for hours on end, me on the couch and him on the bed. The only thing that got us up was having to let our dog Betty out on to the balcony,” explains Mairead.
“I also have breathlessness and my heart has been constantly racing from the very start of Covid.
“I’ve got a Fitbit. One day I was on the couch for hours and my heart was racing. According to the Fitbit, I’d done five hours and 23 minutes of cardio exercise – but I never moved at all!
“My husband goes to work, then comes home and goes straight to bed because he’s so exhausted.”
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Fatigue is usually treated by making changes to your daily routine and habits. It may also be helped by treating the underlying problem – for example, if your fatigue is caused by heart failure, treating the heart failure directly may reduce your fatigue symptoms.
If your doctor or health professional suspects that your symptoms are affecting your sleep, or that they are a result of you not being able to sleep well, you may be offered medication such as melatonin to help you to sleep more easily. You can also buy these supplements in a pharmacy or chemists – however, you should always speak to your health professional before taking new supplements, and stop taking them if you experience unexpected side effects.
The main way to treat fatigue symptoms is through rest and energy management. By managing how you use your energy, and making sure that you get enough rest, you can make your fatigue symptoms less severe and reduce the chances of falling into the “boom and bust” cycle.
“Graded exercise” – a steady routine of gradually increased exercises – can help with some forms of fatigue, especially those associated with stroke or heart attack. However, graded exercise can also make fatigue worse, especially if your fatigue is caused by Long Covid or another post-viral condition. If you notice that exercise makes your fatigue worse, stop.
One of the most important things you can do to manage your fatigue symptoms is to make sure you get adequate rest.
This does not just mean sleeping. It is important that you build time into your day, every day, when you are not sleeping, but are doing things that replenish energy rather than using it. This can be difficult to begin with, but it can also have a huge positive impact on your mood and your energy levels as well as your general health.
A good way to make sure that what you are doing qualifies as “rest” is to ask yourself whether you could do it indefinitely without getting tired. For most people with fatigue, this means that some activities you may think of as rest – reading, watching TV, talking to people – actually aren’t rest.
Common things that count as rest include:
One of the best things you can do for fatigue is managing your energy to avoid “boom and bust” patterns.
There are two main aspects of this:
You can find a baseline for how much activity is safe for you by tracking your activity (you can use an activity diary or technology like a smart watch) over one or more weeks and seeing whether your symptoms get worse.
You could start off with a rough baseline by considering what you think you could do for five days out of seven without worsening symptoms. Most people overestimate their capacity – it’s best to halve what you think you can do. If, after a week, you don’t see any worsening of symptoms, you could start to slowly increase the activity you do.
You should never increase your baseline unless you have tried it for at least a week without your symptoms getting worse.
A key part of managing your energy is making sure that you know what is most important to do.
It can help to write down all the things that you want to do, and try to order them by importance and urgency. Consider, also, how much energy each task might take. You will have to let some things go. Learning how to prioritise can be a long and difficult process, but it gets easier with time.
It can be tempting to only prioritise work and chores, but it is important to make sure that you do some things which you enjoy.
It is also important to remember that energy isn’t just used on physical activity. Anything that needs you to think hard, to maintain focus, or which causes strong emotions may use up energy.
Another useful thing to do is to make sure you keep your activity levels reasonably steady. This may mean breaking up activities over hours or days to build in rest and recovery. Essentially, you should try and keep a similar activity level day by day, and avoid some days being much busier than others.
You should also try, where possible, to balance mental exertion with physical exertion – so if you have to do a day’s worth of desk work and a day’s worth of household chores, it is better to have two days where you do both, rather than one day of each.
Even with practice and support, it is normal for people with fatigue to occasionally experience symptoms flare-ups. There are some things you can do to help with fatigue symptoms when they are present, as well as trying to avoid them through energy management techniques.
You can make sure people with chest, heart or stroke in conditions Scotland get the support they need after returning home from hospital.
If you – or someone you know – needs help right now, we’re here for you.
Read our Essential Guides for more information.
A Charity offering support for post-viral fatigue.
View this page
NHS Inform also has more detailed information on fatigue on its symptoms page.
Visit our Services page to find out more about the support that’s available for fatigue.