Constant tired/exhausted feeling
August 6, 2014 9:31 AM   Subscribe

Hey everyone. I don't know what's going on with me. For a while now, I've had this worn down feeling where I just want to sleep, even during the day.

I have had depression before, and I would describe it as mild to moderate depression without the depressed negative feelings. It is extremely hard for me to get up in the morning, and it extends way beyond not being a 'morning person'. I am not feeling 'normal' sleepiness in the morning. As in the title for this post, I would label it as more 'exhaustion'. Something that more sleep would definitely not remedy. To be fair, I would not say my sleep schedule is that good, as I tend to fall asleep past 12, and I hear that's not good for the internal clock. Do you think I should be seen by a doctor? Sleeping right now seems to be an escape for me and I don't want it to feel like that. I don't know what brought this feeling on, but I want it to go away. Any advice is welcome and appreciated!
posted by Thanquol180 to Health & Fitness (28 answers total) 11 users marked this as a favorite
how many hours of sleep are you getting a night?
posted by gatorae at 9:33 AM on August 6, 2014

Is it possible you have mono?
posted by Grither at 9:34 AM on August 6, 2014 [3 favorites]

1. Sleep doctor, to make sure you don't have sleep apnea or something

2. Get evaluated for CFS

That said, in my and others personal opinion, there's nothing wrong with going to bed after midnight if that's just when you naturally do... assuming there's no other problems. I've naturally fallen asleep at 12 or later since i was probably 10 years old. A lot of people act like it's something terrible, but if it's just your natural thing and you're not forcing yourself to stay up or laying in bed trying to sleep and practicing bad sleep hygiene or something then meh.
posted by emptythought at 9:34 AM on August 6, 2014 [1 favorite]

When is the last time you had a vacation? If it's been, like, a couple years, that could be the problem right there.

And I don't only mean a "travel to some exotic place" kind of vacation, even just a "I stay home for a week and watch Josie In the Pussycats reruns in my underwear" thing counts.
posted by EmpressCallipygos at 9:36 AM on August 6, 2014 [3 favorites]

Happened to me and it was Vitamin D deficiency, very easily tested for and easily fixed!
posted by emilyw at 9:37 AM on August 6, 2014 [5 favorites]

It could have a physical cause, or a mental one (and often the two are interrelated). Go now to the doctor. In a few more weeks you won't have the motivation/energy and it will start a downward spiral that will be very difficult to get out of.
posted by saucysault at 9:38 AM on August 6, 2014 [4 favorites]

There are a lot of medical things that could cause this so getting checked out by a doctor is probably not a bad idea.

Other ideas:
- Are you consistently going to bed and waking up at the same time? A regular sleep schedule does wonders for my sleep quality.
- Have you tried reducing/cutting alcohol?
- Are you eating a lot of carbs/sugar? I used to be SO DRAGGY and then I switched to a very low carb diet (keto) and my energy is absolutely insane.
- Are you eating enough?
- Are you eating too much?
- Are you drinking enough? Dehydration can really sap the energy out of you.
- How active are you? Sort of like the low-carb, the more active I am, the better I sleep, the more energy I have, the more awesome I feel, etc. It can feel impossible for the first bit (exercising when you're exhausted to start with) but it can really help.
- Any major life changes? I know when I am stressed or worried or scared my body shuts down and all I want to do is SLEEP. Really effed up self preservation or hiding from reality or something, I don't know, but being sleepy is my #1 focus when times are tough.
posted by PuppetMcSockerson at 9:42 AM on August 6, 2014 [10 favorites]

Sounds a lot like anemia, another reason to see a doctor.
posted by lab.beetle at 9:50 AM on August 6, 2014 [2 favorites]

Vitamin deficiency? Vitamin D? Anemia? Potassium? Any of those could cause these symptoms.

Vitamins are a pretty cheap solution you can try before investigating more serious causes. Try taking 2x RDA megadoses of each of these for a few days, see if you feel better.
posted by zug at 9:51 AM on August 6, 2014

Have you started or stopped taking any medications during the period this has been happening?
posted by XMLicious at 9:55 AM on August 6, 2014

This could be any number of things. I'd go to the doctor and tell them that you're exhausted. They'll probably run a few blood tests and try to pinpoint if there's a medical cause for how you feel. I'm sorry you're going through this.
posted by sockermom at 10:09 AM on August 6, 2014 [2 favorites]

Could be lots of things, but just another idea- if you spend lots of time outdoors and live somewhere that the disease is present in ticks, you might look into Lyme disease.
posted by geegollygosh at 10:21 AM on August 6, 2014 [3 favorites]

Could be mono, or another recurring Herpes virus like CMV. Both EBV and CMV lie dormant and can reactivate occasionally, and both cause extreme fatigue. We never get rid of these viruses and they can wreak havoc not only during the primary infection but during reactivation. Maybe your Dr. can prescribe and antiviral.
posted by waving at 10:28 AM on August 6, 2014

Go to your doctor, get checked out. You could have Vit. D deficiency (v. common), low thyroid, or some other thing. I have had low energy that is helped by anti-depressants, even when I don't think I'm depressed, and I know depression quite well.
posted by theora55 at 10:30 AM on August 6, 2014 [3 favorites]

I had a protracted battle with mono during my first year in grad school and chalked it up to stress instead. One sign of mono is that the acute phase includes a painful sore throat. In my case I went undiagnosed for a protracted period because all the health clinic did was test for strep throat (which was strange because mono is one of the top infectious diseases on most campuses). I kept cycling in and out of the acute phase never quite being able to shake the illness until I took leave.
posted by srboisvert at 10:34 AM on August 6, 2014

You might want to look into food intolerance. I recently experienced symptoms very similar to yours and suspected they were related to the soy I had been consuming the last several months, which coincided with the symptoms. When I stopped consuming soy, I felt so much better. Soy has been linked to disrupted thyroid function.

Wheat and dairy are also very common food intolerances. You may want to try an elimination diet
posted by bearette at 10:42 AM on August 6, 2014 [1 favorite]


Caffeine withdrawal? Did you change brands or brew methods recently?
posted by St. Peepsburg at 10:42 AM on August 6, 2014

Hey! I had/have this, and you might find the answers to the question I asked about it instructive for you as well.
posted by ClaireBear at 10:56 AM on August 6, 2014 [2 favorites]

I would talk to a doctor. Could be any of the following:

Vitamin D deficiency
Thyroid problems
Low blood sugar
Poor sleep hygiene
Sleep apnea
Herpes/other recurring viral condition

Hope you feel better. :(
posted by Hermione Granger at 11:03 AM on August 6, 2014 [3 favorites]

Do you have a cat?

I have one that wakes me up every morning around 3:45 yelling to be let outside. All summer long, starting with the first warm day and ending shortly after first snowfall. Keeping my door shut at night in the summer has improved my quality of life immensely.

Other low-level but sleep-disruptive noises are possible too. Sirens from police/emergency vehicles, loud people on the street at night, dogs barking... etc. Depends on how light a sleeper you are.

Just something to consider - but if none apply, I would nth going to a doctor and getting some blood tests to see what vitamins or minerals you might be running low on.
posted by kythuen at 11:11 AM on August 6, 2014

It could be just about anything already mentioned, so it wouldn't hurt to get a doctor to check you out and get some bloodwork done.

One thing not yet mentioned: the seasons might be futzing with your sleep. If you're in the northern hemisphere, the extra sunlight in the early morning may be preventing you from getting restful sleep; if you're in the southern hemisphere, you may not be getting enough light during waking hours. Get some outside time in the middle of the day and make sure your bedroom is comfortable and dark at night.
posted by Metroid Baby at 11:13 AM on August 6, 2014

Your post described me to a tee before I was treated for hypothyroidism. For years, I was exhausted all the time, couldn't sleep before midnight, and felt like I had depression without the depressed mood. The whole nine yards.

I'd been to my family doctor about it multiple times, and they'd checked my thyroid and vitamin D and iron etc. over and over. Then, after one test, they sent me a copy of the lab work. Next to my TSH test, there was a note that said that even though my thyroid levels were "normal," they were in the range where some patients felt symptomatic, and if I was having symptoms I should be treated. I made an appointment with an endocrinologist, who put me on a thyroid hormone replacement. I felt noticeably better hours after my first dose.

Definitely go see a doctor, get bloodwork, and make sure to double check your test results!
posted by blandarchy at 12:15 PM on August 6, 2014

Go to a PCP for a checkup, including bloodwork. Tell your PCP about the exhaustion, and ask to have blood work done related to that, as well (probably things like TSH for thyroid function, Vitamin D levels, maybe B-12, etc).

Exercise for at least an hour a day (get your doctor's OK first, if you think you need it). If nothing else, that will give you a feeling of mastery over your body and a greater sense of well-being, and it'll likely help with the sleep and energy issues over time as well. If you're not sure where to start, Couch-to-5K or your own version of that (I just went out and started running) is good.

Get really great/obsessive about your sleep hygiene. It's not a bad thing in general to go to bed after midnight, but if you personally don't like going to bed that late, that's something you can change. I've been advised that the pace to go at is to push your bedtime/wake-up-time back by 15 minutes per week. Also, things that have *really* helped me are: don't eat or exercise within three hours of your bed time, have a wind-down ritual before bedtime that takes between half an hour and an hour that *doesn't involve any screens,* wake up and go to sleep at the same time each day, use the bathroom immediately before you go to bed, make sure your bedroom is as dark and silent as possible for the time you're going to be sleeping (this may mean you need to do semi-goofy stuff like wear an eye mask). I also take melatonin and find it *really* helps. The trick is to take it an hour or two before you plan on actually going to sleep.

Eat nourishing food, and enough of it! Keep regular mealtimes and eat real meals. If your doctor gives you the OK to take vitamins, some that you might want to consider taking: vitamin D, B-complex, iron. But do get your doctor's OK first, especially/at least for the iron, so that you don't end up getting too much!

Are you breathing OK? Not being able to breathe takes a HUGE toll on sleep quality. If you have sinus/allergy/lung issues, please try to get referrals from your PCP to get those checked out and fixed. There's some holistic stuff you can do, but those are medical problems that probably require medical professionals' help to solve (not least because they may require surgery or prescription medication).

If you're still having trouble with sleep despite your bloodwork and checkup coming through fine, good exercise, nourishment, vitamins, sleep hygiene, and breathing, then something more than just getting run-down might be going on. Personally, I think that you're probably having trouble in one or more of those areas, because you'd probably have other symptoms if that weren't the case (GI issues, low mood, something), so I wouldn't worry too much yet. Of course, I'm not a medical professional, grain of salt, etc etc etc.

Also, if you're going through a stressful period at home/at work/just because, it's actually really normal to want to escape from that stress, and sleep is one of the less-destructive methods of escapism out there. So don't be hard on yourself just because you're feeling a bit overwhelmed and wish you could just escape for a few hours, and are feeling run-down and exhausted and want to crawl under the covers for a bit, that's actually really normal. Take a vacation if possible and make sure you're taking care of yourself in terms of relaxing/socializing/hobbies, and giving yourself permission to -- for a part of every day, at least -- not worry about the (maybe hypothetical, lol) stressful thing going on right now. And TAKE THE TIME TO TAKE CARE OF YOURSELF. Taking care of your body's needs, by making sure you're sleeping/eating/exercising enough/properly, is vital to your well-being. Decompressing and socializing and spending time on other aspects of yourself/your life is also fairly essential to your well-being. Don't push those things off, they have to be daily priorities to a certain extent, or you're going to exacerbate any present problems and maybe even create more.
posted by rue72 at 12:43 PM on August 6, 2014 [3 favorites]

The problem isn't when you go to bed, so much as if you consistently go to bed at that time. You should always strive to go to bed no more than 30 minutes earlier or 30 minutes later than a certain time. Meaning, if you go tend to go at midnight, always go to bed between 11:30pm and 12:30pm, no earlier and no later. Set a timer to remind yourself and take a melatonin capsule if you need help getting in the 'sleep zone' at first. (Note: I do not recommend taking melatonin more than once or twice a week at most - it should be used only for 1) overcoming jetlag or 2) minor 'tweaks' to one's sleeping schedule. Taking it daily can lead your body to stop producing it naturally because it becomes adjusted to getting it from an external source - you don't want to impact your body's natural melatonin production that drastically).

I realize your exhaustion may stem from something more complicated than an inconsistent bedtime, or not extend from that at all. I will echo the others' recommendations to see a doctor, but get a referral to a sleep doctor so an expert can really look into your lifestyle factors and figure out what's going on (this is no job for a primary care physician - it's too specified).

If you want to try dealing with it without a doctor at first, attempt the guidelines I highlighted above. Or, start keeping a journal that documents what you did, what you ate, what you drank, and how you felt before and after all those events. After a week or two, look for patterns.

Then, the matter of depression. It could be this. At my most depressed, I lingered in bed all morning and never wanted to leave. You'd have to drag me out. I felt exhausted physically, and mentally, and also felt there was no reason to leave the bed. Sleep, indeed, felt like the escape. This could also be as simple as making lifestyle changes to help alleviate depression symptoms, including but not limited to: regular exercise (no one likes this at first, but it changed my life for the better), a clean eating diet (start small - you know, an apple a day), forcing yourself to join a meet up group for something that interests you (it will provide structure and something to look forward to/engage in), and possibly seeing a therapist to discuss your issues. Do things to help you understand yourself first, then consider medication. Medication is a great tool for mental health, but tools are only as good as those handling them.

It's also possible that you could have a sleep disorder like sleep apnea. My father had it for decades and it made him exhausted/unhappy, because he never got a good night's sleep. Once he was diagnosed and treated for it his sleep and quality of life improved. So, it could be a sleep disorder causing the depression, as opposed to the other way around.

It could be so many things. I think a careful balance of self-exploration coupled with a doctor's input will be the best approach.
posted by nightrecordings at 3:06 PM on August 6, 2014

This happened to me too and I was deficient in vitamins b and d. Enough so that I needed shots, so definitely see a doctor to get screened for that sort of thing.
posted by lollusc at 4:06 PM on August 6, 2014

Oh and my doctor didn't figure it out right away because I have a history of depression and I described it as "like depression without the sadness" so it wasn't until after I (probably unnecessarily) went back on antidepressants and they weren't helping that he did the blood tests. So definitely don't assume it's depression-related without ruling out other things first.
posted by lollusc at 4:09 PM on August 6, 2014

Yes, absolutely see a doctor! This could be caused by so many different things, getting checked out by your PCP will at least get you headed in the right direction.

Better sleep hygiene will be helpful irregardless of what's causing your exhaustion. At the minimum you should not spend time in bed unless you're sleeping (or having sexy times) and you should get up and go to bed at the same time every day.

As a personal anecdote I went through a period of feeling like I had depression without feeling depressed, during which I studiously explained away my fatigue, memory issues, and changes in eating and sleeping as being caused by any number of things other than depression. It took a while for me to acknowledge that even without the depressive thoughts it was enough of a mental health issue for me to start seeing a therapist again short term to get back on my feet. Not saying this is true for you, but it's worth thinking over.
posted by fox problems at 4:25 PM on August 6, 2014

Response by poster: Thanks for all your advice, guys! I feel comforted that I am the only one that has felt this way. I am trying to stay physically active by jogging every other day, and it makes me feel much better. I will definitely get a blood test done. I don't like living like this, constantly sleeping til 12 and stuff. Again, thank you so much!
posted by Thanquol180 at 5:30 PM on August 6, 2014 [1 favorite]

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