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     Volume 5 Issue 109 | August 25, 2006 |

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Beating Tiredness

At any given time, one in 10 people are suffering from persistent tiredness, with women more likely to be affected than men. With our stressful, busy lives, most people experience tiredness sometimes. Following some rest and relaxation and a good night's sleep, tiredness generally disappears, leaving us refreshed and ready to face our usual activities. For some people, however, tiredness becomes a chronic problem which severely affects their quality of life and their day-to-day functioning.

Causes of tiredness
Physical: Being overweight.
If you are overweight, your body has to work harder just to do everyday things.
Being too thin
If you are too thin, you may not have enough strength in your muscles to do everyday things without becoming tired.

Physical illness
Any serious illness can make you tired, especially painful ones. Some less serious illnesses, like glandular fever, can leave you feeling worn out.

The following treatments can tire you out:
* Serious operations on your abdomen or chest
* Certain drugs, such as beta blockers and strong pain-killers
* Treatments for cancer, such as radiotherapy and chemotherapy

Being unfit
If you feel tired, you don't do as much as you normally would. If you cut down the amount you do, your body becomes unfit. We know that just one week of resting in bed reduces your muscle strength by 10 percent. The more unfit you get, the more tired you will be when you try and do something.

Pregnancy and breast feeding
Both of these can sap your energy.
Having your sleep disturbed
Anything that troubles your sleep can leave you tired in the morning and affect your concentration.

Worries and stress
If you have a lot to worry about, you are more likely to feel tired - especially when you cannot see a way out of your problems.

If you don't sleep well for a long time, you can start to feel tired, irritable and fed up.

Depression tends to make you feel tired all the time. It can also wake you early, which can make you feel even more tired.

Everyday difficulties
We all know that we can be stressed and exhausted when bad things happen to us. It's worth remembering that even positive events, like moving home or getting married, can be exhausting. Being faced with a difficult decision, especially “no win” situations, are exhausting.

Emotional shock
Bad news, bereavement or the break up of a relationship can all make you feel drained.

Expecting too much of yourself
We all set ourselves standards to aim at. We need them to give us a sense of direction. Sometimes we can expect too much of ourselves. If we do this, we set ourselves up to fail, leading to frustration and fatigue.

If you are feeling tired, you may sleep in the day. If you do this, you may find that you can't "switch off" at night, and so can't get to sleep.

Sleeping too much
Remarkably this can cause fatigue, if it becomes a habit.

A "roller-coaster" of too much activity followed by too much rest; If you do too much on a good day, you may overdo things and feel even more tired the next day.

Work and family
Continuing difficulties
There are some things in our lives that we find it hard, or impossible to change. When we don't feel in control of our life, we will often feel frustrated and tired.

Looking after small children
No surprises here! If your child doesn't sleep through the night, neither do you. It can be really hard work just to keep going with your daily routine.

Night-workers often find that they get tired easily. This is more likely if the timing of their shift is constantly being changed.

Work stress
Not working when you want to can tire you out through frustration. On the other hand, either too many demands at work with little control, or making a big effort with inadequate rewards are both stressful and can cause fatigue.
What we drink

Coffee and tea
Six cups of coffee a day or ten cups of tea (or six mugs) are enough to upset the average person's sleep and make them wound-up and tired.

If you drink alcohol in the evening, it may wake you up in the middle of the night. If you drink quite a lot regularly, it can make you depressed and affect your sleep.

'The last straw'
It will often take several things together to make you feel tired. For example, if you feel stressed for a long time, you will probably sleep badly and feel 'below par'. You might then get the 'flu. This can be the 'last straw' which finally exhausts you. You feel that you have to rest to get over this, but then quickly become unfit. You will now find that just doing everyday things can make you even more tired. If you can't get back to your normal routine you will probably feel worried and frustrated. This gives you more sleepless nights and makes you more tired ... and so a vicious circle is set up.
Beating tiredness

1. Improve your sleep
* Go to bed and get up in the morning at the same time every day, no matter how you feel.
* Make sure your bedroom is comfortable: not too hot, not too cold, and not too noisy.
* Don't eat or drink a lot late at night. Try to have your evening meal early rather than late.
* Try to gradually reduce the time you spend 'napping' during the day.
* If you can't sleep, don't lie there worrying about it: get up, leave the bedroom and do something you find relaxing. When you feel tired enough, go back to bed.
* Pick a way to relax before going to bed - such as reading, listening to music or using a relaxation technique.
* Have a hot bath before bed. This should be as hot as you can bear and last a good twenty minutes.
* If something is troubling you, and there is nothing you can do about it there and then, try writing it down on a piece of paper. Tell yourself you will deal with it in the morning, and then go to bed.
If none of this works, go and see your doctor.

2. Take some exercise
Many people feel too exhausted to start doing any exercise. However, in the long run, regular exercise will make you feel less tired and more energetic. So what can you do about this?
The best answer is to start with a small amount of exercise -- it doesn't matter how little, as long as it is regular. You can then slowly increase the amount you do over a period of weeks or months, depending on what you can tolerate. You need to start with something really easy which you can do regularly -- every day, if possible. Over time, you can increase the amount of time you exercise without increasing the intensity, aiming at half an hour a day (divided if necessary).
Walking is the easiest exercise to try, but any exercise that you enjoy will do. Many people like to swim or cycle regularly. What you are trying to do is to gradually improve your fitness and strength. You may also find it useful to get advice from someone who knows how to help unfit or ill people to get fit.
Once you are managing half an hour a day, you should gradually increase the intensity of your exercise so that you start to get a bit out of breath.
If you find that you are doing too much, and feeling worse, don't give up! Carry on with some regular exercise, perhaps for a shorter time each day. Don't do anything more energetic until you have got used to the amount of exercise you are doing at the moment.

3. Cut out caffeine
Gradually stop having all caffeine drinks over about a three-week period. Everyone knows that coffee and tea contain caffeine, but watch out! There are many other drinks and products that have caffeine in them, such as energy and cola drinks, some painkillers, and energy boosting pills. Some herbal remedies also contain a lot of caffeine. If you are in any doubt, read the ingredients list on the packaging.
Try to stay off caffeine completely for a month, to see if you feel better without it. You may find that stopping caffeine gives you headaches. If this happens, just cut down more slowly the amount of caffeine you are drinking. Stop eating chocolate if you eat it every day. Chocolate contains stimulants.

4. Sort out your weight problems
If you are overweight, you will feel a lot better if you lose some weight gradually. A crash diet is not helpful and in fact can worsen fatigue. Apart from a diet, the best way to lose weight is to gradually do more activities and exercise.
If you are too thin, you will not recover your full energy unless you start to get back to your normal weight. By doing this you can start to re-build your muscles and your strength.

5. Plan your day/week
Try and plan your day and your week. Try to make sure that you don't have any really hectic, tiring days. Organise it so that you do a little every day. If you cram everything into one day, you may be too exhausted to do anything for the rest of the week. Try to do your chores when you think you will have the most energy.

6. Have realistic expectations
Be kind to yourself. If you have been tired for a long time, don't expect to be back to your normal self overnight. Set realistic goals for yourself and your recovery. Don't expect too much too soon. Remember -- all progress is good, however small or unimportant it may seem at the time.
Learn from your tiredness: were you demanding too much of yourself before you got tired? Was there sufficient balance between work and play? Should you reconsider what you want from life?

What doesn't help
We'd all like a magic cure to take away our tiredness. There isn't one. There are many products on the market that claim to do this. Unfortunately there is no good evidence that any of them help for very long: This goes for vitamins, minerals, stimulants, total rest and sleeping, and exclusion diets.


Source: bupa.co.uk and rcpsych.ac.uk


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