Does tiredness remain after rest?

Which activities have become harder?

Persistent fatigue is a sense of lacking physical or mental energy that lasts a long time and does not always go away after sleep or rest. Compare how you felt after ordinary activity before and how you feel now, and answer a few questions:

• When did the tiredness begin: gradually or suddenly?
• Does your energy change during the day?
• Do sleep or rest help?
• Have the length and quality of your sleep changed?
• Do you have low mood, loss of interest, anxiety or apathy?
• Has it become harder to concentrate and make decisions?

If the tiredness began suddenly or came with breathlessness, pain or other new physical symptoms, it is worth starting with a medical check: the section “Which doctor should check it first?” covers this.

If your energy has been fading gradually along with your mood, sleep and interest in activities, compare your state with the descriptions in the section “How is fatigue different from similar complaints?”.

What does fatigue look like in an ordinary week?

In all four stories rest does not bring energy back, but the circumstances differ: for Dasha the tiredness has no clear cause, Viacheslav has breathlessness as well, Yelyzaveta’s ‘rest’ with the news feed does not restore her, and Leonid has not got his energy back after an illness. New physical symptoms, as in Viacheslav’s case, are a reason to start with a medical check.

If at least one of these stories resembles yours, note what matches your week. If none of them fits, go back to the questions in the section “Which activities have become harder?”.

Which doctor should check it first?

With new or persistent physical complaints, start with a family doctor or GP. They will assess your physical health and decide whether investigations are needed: these depend on your symptoms and examination, not on a universal list.

If low mood, loss of interest and enjoyment, marked anxiety or a sense of hopelessness persist alongside the tiredness, it is also worth seeing a psychiatrist. They will ask how long your energy, sleep and mood have been changing and discuss help with you. How a first appointment with a psychiatrist works is described on the initial psychiatric consultation page: this can also be a second step after the family doctor.

You can explore the clinic’s specialists and their areas of work in the doctors’ directory.

Fatigue calls for a broader look at health

Sleep, overload, mood and physical illness can all affect tiredness. So it is not worth attributing it to depression straight away.

• Sleep. Too little or broken sleep does not restore energy, even if you spend many hours in bed.
• Overload and stress. Long-term pressure at work or at home is draining, and a short rest may not be enough.
• Physical conditions. For example, anaemia or thyroid problems, as well as recovery after an illness, as with Leonid in our example. Some medicines can also cause tiredness.
• Mood. If your mood and interest in life have also been low for weeks, this may be one of the signs of depression. Tiredness alone does not yet mean that you have this disorder.

How is fatigue different from similar complaints?

People call different sensations ‘tiredness’, and different causes can lie behind them. So it helps to understand which one is yours.

• Lack of energy. With fatigue, energy does not come back after rest. With low energy, the hardest part is starting a familiar task, even when you have rested. The page on low energy looks at how to describe this.
• Sleepiness. You do not just want to rest but to fall asleep, sometimes at the wrong moment. This is a separate complaint, described on the page about excessive sleepiness.
• Physical weakness. Your muscles struggle to carry out a movement even when you are not tired. If this is closer to you, see the page on physical weakness.
• Unrefreshing sleep. You sleep enough but wake up feeling worn out. There is a page on unrefreshing sleep.

These complaints often overlap, but their causes can differ, so it helps the doctor to hear which one is the main one.

Pacing yourself while seeking assessment

While the cause is being looked into, you do not need to return to your previous productivity straight away or push your activity while feeling worse. A few rules can help:

• Spread tasks across the day. Leave room between them for rest, meals and sleep.
• Set small goals. One task that is definitely manageable is better than three started ones. For Dasha, for example, a short walk instead of her usual loop of the park is enough.
• Try resting without a screen. If, like Yelyzaveta in our example, you rest with the news feed, try lying down without your phone and notice whether you feel any different after such a break.

If you feel noticeably worse after activity or rest does not restore your energy, tell your doctor. It is worth agreeing on a level of activity that takes the cause and your capacity into account.

When fatigue is a reason to check your health

1. If you develop sudden marked weakness, difficulty breathing, chest pain, loss of consciousness or other acute physical symptoms, you need urgent medical help: call 103 or 112 in Ukraine.
2. If the tiredness lasts several weeks, gradually gets worse, appeared for no clear reason or noticeably limits your everyday activity, see a doctor. You can start with a family doctor or GP, as described in the section “Which doctor should check it first?”.
3. If low mood, loss of interest, marked anxiety or a sense of hopelessness persist alongside the tiredness, also book a consultation with a psychiatrist.
4. If the tiredness began after a clear period of overload or an illness and is gradually easing, pace yourself using the rules in the section “Pacing yourself while seeking assessment”. If it does not ease, go back to point 2.
5. If what troubles you more is starting tasks or constantly wanting to sleep, compare your state with the descriptions in the section “How is fatigue different from similar complaints?”.