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Exhaustion is creeping back but managing it is in our control, says fatigue physician

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By Katherine Feeney and Alicia Nally of ABC

tired woman

Exhaustion and a lack of energy can be categorised as either pathological or non-pathological.
Photo: Cottonbro / Pexels

Collapsing in a heap each evening? Struggling to haul yourself out of bed in the morning? You’re not alone if you feel a curious case of fatigue creeping back into your life.

After pandemic-induced stress and government-sanctioned time at home away from social events, ubiquitous family gatherings and – for some – even the office, humans are struggling to recalibrate to our old way of life.

But Andrew Lloyd from the University of New South Wales fatigue clinic says the cure is well within our control.

The infectious disease epidemiologist says exhaustion and a lack of energy can be categorised as either pathological or non-pathological.

That is, there is something wrong with your physiology, like an infection, or you just need to rest.

“From a medical perspective when we’re talking about fatigue, it’s important we’re talking on the same wavelength as the patient,” Lloyd said.

“Just the word ‘fatigue’ or ‘tired’, it’s not very precise in the English language.

“Some patients will talk about being tired when they’re actually referring to feeling stressed, or sleep deprived, or [they] have had a recent illness.”

Doctors try to tease out whether fatigue “raises concerns” about someone having an underlying medical condition, Lloyd said.

“If the fatigue is going to be pathological we expect it’s not going to be relieved by rest and relaxation.”

Fatigue after illness is common

About one-third of people can experience lingering fatigue after an illness, according to Lloyd, and in the first week or two after sickness, that figure rises to about half.

Physicians don’t know exactly why tiredness and exhaustion can stick around for so long, but Lloyd said fatigue was a “very well-recognised entity within the context of acute infection”.

“If we survey fatigue in general practice, by far the majority of patients’ [conditions] will be explained by minor infectious diseases like a cold or flu, or a transient mental health condition like stress or having a tough time at work,” he said.

“That separates the circumstance where it might go on for weeks or months or longer, where something else might be going on.

“If we follow patients from acute viral infection over time – weeks or months later – what we recognise is that ongoing symptoms with fatigue … are very common.”

Non-pathological fatigue requires rest

Sometimes fatigue after illness persists to the point of limiting a person’s ability to do activities like going to the gym or getting through a work day.

Lloyd said in that context, patients should pay attention to the message their body was giving them.

“When we talk about this sort of fatigue where symptoms persist over weeks and months, we’re talking about fatigue not helped by rest,” he said.

“If [patients] say, ‘I’m going to push through this’, it does have the potential to exacerbate the symptoms.”

But “minor, transient, complaintive fatigue” that is caused by busy work and personal lives “is in our control to balance”, he says.

Lloyd recommended rest, eating plenty of healthy foods, drinking water and gentle exercise.


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