What causes constant tiredness, and is it physical or psychological? Learn the possible causes, telling signs and steps you can take to support your energy.
If you wake up after eight hours of sleep and still feel not at all rested, if your eyes close in the afternoon, and if you start Monday tired again even after lying in bed all weekend, it is only natural to wonder why. Constant tiredness has become one of the most frequently voiced complaints in recent years. The sentence "I'm always tired" has become so common that it is often accepted as an inevitable part of modern life. Yet long-lasting tiredness can be a sign that your body or mind is trying to tell you something. In this article I will try to explain the different types of tiredness, their possible physical and psychological causes, clues that can help tell them apart, and steps you can take to support your energy.
What Is Constant Tiredness?
Tiredness is a natural state that appears after intense physical or mental effort and passes with rest. Legs growing heavy after a long walk, or the mind becoming foggy after a busy exam week, are expected reactions. Constant tiredness, on the other hand, refers to a lack of energy that does not pass with rest, lasts for weeks or months and affects daily functioning.
To understand tiredness better it is useful to think of it in three different dimensions:
- Physical tiredness: Heaviness in the muscles, weakness, difficulty moving.
- Mental tiredness: Difficulty concentrating, forgetfulness, slowed thoughts, a fogginess described as "brain fog".
- Emotional tiredness: Exhaustion towards people and responsibilities, a feeling that everything is too much, impatience and numbness.
Most people experience several of these dimensions at the same time. Noticing which dimension is more dominant can be a guide when looking into the causes.
What Causes Constant Tiredness?
Considering the causes of tiredness under two headings, physical and psychological, makes the subject easier to understand. In real life, however, these two groups often affect each other and can be present together in the same person.
Physical causes
In long-lasting tiredness, the first step is for a doctor to assess the physical causes. This does not mean your tiredness is "not real" or "only psychological"; on the contrary, all the possibilities need to be reviewed so that you can get the right support.
Some physical factors doctors often assess are:
- Anaemia and some vitamin or mineral deficiencies
- Thyroid gland problems
- Blood sugar irregularities
- Conditions that affect breathing during sleep, such as sleep apnoea
- Weakness that continues after past infections
- Chronic pain and some long-term illnesses
- Side effects of some medications
This list is by no means a diagnostic guide, and it is not intended for you to have tests done and interpret the results yourself. It is only to show that tiredness can have many different causes. With long-lasting, unexplained tiredness it is important to see a family doctor or an internal medicine specialist. Decisions on vitamin or supplement use should also be made not on your own but on your doctor's assessment.
Psychological causes: can tiredness be psychological?
Yes, psychological states are among the very common causes of tiredness as well. What is more, this tiredness is as real and wearing as tiredness of physical origin.
Depression
Depression often shows itself not only as sadness but as a deep loss of energy. Some people first describe depression not as "I'm sad" but as "I'm so tired, I have no strength to do anything". In tiredness due to depression, feeling worse in the mornings, being unable to rest despite sleeping for a long time, and a decline in interest in enjoyable activities are common. You can find the other signs of depression in the article on symptoms of depression.
Anxiety and constantly being on alert
Although anxiety may look like an inactive state from the outside, it is intense effort for the body. A mind that constantly worries keeps the body on constant alarm too. Muscles tense, breathing becomes shallow, sleep is broken. This low-intensity alarm state lasting all day can be felt as heavy exhaustion in the evening. The sentence "I did nothing all day but I'm so tired" is often heard from people with anxiety.
Burnout
Burnout, which develops after long-term work stress, is one of the conditions in which emotional and mental tiredness is most pronounced. The person may become distant and cynical towards their work, and their sense of competence may fall. In burnout, tiredness usually eases a little on holiday but returns quickly once back at work. I covered this subject in detail in the article on burnout syndrome.
Suppressed emotions and grief
An unlived grief, unexpressed anger or a long-carried resentment can also quietly drain energy. Constantly suppressing emotions takes mental effort, and over time this effort is felt as tiredness.
Physical or Psychological? Clues That Help Tell Them Apart
In reality, physical and psychological causes are often intertwined. For example, a long-lasting physical illness can lead to depression, and depression can in turn increase physical tiredness by disrupting sleep and eating. It is therefore more accurate to think "which factors are present together" rather than "either this or that".
Even so, asking yourself the following questions can help you when talking with your doctor or a mental health professional:
- Did the tiredness start after a particular event, loss or stressful period?
- Does the tiredness ease a little during an activity you enjoy, or is it the same in every situation?
- Is the tiredness accompanied by physical symptoms such as weight change, fever, shortness of breath or pain?
- Is it accompanied by sadness, loss of interest, intense worry or feelings of worthlessness?
- How is your sleep? Do you have difficulty falling asleep or staying asleep, or do you sleep too much?
The answers to these questions do not give a result on their own, but they give important information to the specialist who will carry out the assessment.
Whatever the cause of your tiredness, what you feel is real and deserves to be taken seriously.
Sources of Constant Tiredness in Daily Life Specific to Turkey
For many people in Turkey, daily life is full of factors that feed tiredness. Spending hours in traffic or on public transport commuting in big cities, long working hours, second jobs, a constant sense of "not keeping up" created by the cost of living, and economic uncertainty are elements that tire both body and mind. For women there is also often the double burden of carrying household and caring responsibilities alongside working life.
In addition, screens play an ever-larger part in our lives. Watching news feeds, social media or TV series until late at night shortens sleep and reduces its quality. Attention interrupted by notifications all day increases mental tiredness as well. Constantly following an intense and worrying news agenda can cause the mind to keep tiring even while the body rests.
Say an employee gets up at six in the morning and travels for an hour and a half, deals with housework and the children on getting home in the evening, and watches videos on their phone at midnight to empty their head. This person's tiredness may come not from an illness but from an unsustainable way of living. Even so, we must remember that over the long term this arrangement can affect mental health too.
What Can You Do to Cope with Constant Tiredness?
The suggestions below are steps that can be taken once a physical cause has been ruled out by a doctor, or in addition to a doctor's assessment.
1. Keep a two-week energy diary
For two weeks, rate your energy from 0 to 10 each day, in the morning, at midday and in the evening. Next to it, note how much you slept that day, what you ate, how much you moved and the events that challenged you. By the end of the two weeks, patterns begin to emerge: perhaps it is not the day after nights of little sleep but two days later that is worse; perhaps your energy drops on the days when you see a particular person.
2. Fix your sleep routine
Try to get up at the same time every day, including weekends. Try spending the last hour before bed without screens. Use the bed only for sleep. If you have sleep problems, you can benefit from the suggestions in the article on how to overcome insomnia.
3. Increase movement little by little
Moving when you are tired can seem illogical; yet regular, light movement often does not reduce energy but increases it. Start with a ten-minute walk a day. Walks in daylight, especially in the morning, also support the sleep-wake rhythm. After keeping up these small walks for a week, you can increase the time by a few minutes. What matters is not intensity but regularity; moving a little every day is more sustainable than pushing yourself and collapsing in exhaustion the next day.
4. Manage your energy budget
Think of your energy as a bank account. A certain amount of money is paid in and spent every day. Which activities take a lot out of your account and which pay into it? Put demanding tasks in the hours of the day when your energy is highest, place short breaks between them, and plan at least one "deposit" activity during the day: a chat with someone you love, a short walk, listening to music.
5. Learn real rest
Scrolling aimlessly on the phone often feels like rest but does not rest the mind. Real rest can be closing your eyes and focusing on your breathing for a few minutes, spending time in nature, drinking tea without a screen, or simply looking out of the window. Try placing a few minutes of this kind of break into your day.
6. Use your right to say "no"
Constantly putting other people's needs first is one of the habits that drains energy fastest. This week, try politely saying "I won't be able to do it this time" to something you don't want to do, and then notice how you feel.
When Should You Seek Professional Support?
It is important to see a doctor or a mental health professional in the following situations:
- If the tiredness has continued for more than a few weeks and does not pass with rest
- If it is accompanied by symptoms such as unexplained weight loss, fever, shortness of breath, palpitations or pain (in this case, see a doctor first)
- If it is accompanied by sadness, loss of interest, hopelessness or intense anxiety
- If you can no longer carry out your work, studies or daily responsibilities
- If sleep problems have continued for a long time
These symptoms do not mean a diagnosis on their own; assessment is possible through meetings with specialists. Whether medication support is needed is decided by the doctor concerned. If the tiredness comes with thoughts that life is meaningless or thoughts of harming yourself, please call 112 (emergency services) without delay.
How Is Constant Tiredness Addressed in Therapy?
Once physical causes have been assessed, the psychological side of tiredness can be addressed in therapy. In cognitive behavioural therapy, the pattern of the tiredness in daily life is first examined together. Energy diaries, sleep routine and daily activities are reviewed. In tiredness related to depression, meaningful and enjoyable activities are gradually reintroduced into life through behavioural activation; in tiredness related to anxiety, work is done on worry cycles and the state of constantly being on alert.
Thoughts such as "If I rest, I'll be lazy" and "I have to do everything myself" are also important factors that maintain tiredness. These thoughts are examined in therapy, and a more flexible outlook is developed. The schema therapy perspective can help in some people to understand the origins of patterns of constantly neglecting oneself and always putting others' needs first. You can find information about individual work related to depression and mood on the depression and mood page.
Frequently Asked Questions
Is constant tiredness a symptom of depression?
It can be; depression often shows itself through a marked loss of energy. However, tiredness also has many physical causes. For this reason, a doctor's assessment first, followed if necessary by a mental health assessment, is important.
Why do I wake up tired even though I sleep a lot?
The quality of sleep matters as much as its length. Broken sleep, breathing problems during sleep, irregular sleep times, depression and anxiety can lead to unrefreshing sleep. If this has gone on for a long time, it is useful to see a doctor.
Should I take vitamins for constant tiredness?
It is recommended that you do not decide on vitamin or supplement use on your own. Whether there is a deficiency and what is needed can only be determined by a doctor's assessment.
How does psychological tiredness go away?
Psychological tiredness usually eases as the underlying stress, anxiety or depression is addressed. Sleep routine, light movement, real rest breaks and setting boundaries are supportive in this process. If your tiredness continues, knowing that it is possible to get support from a specialist can be a guide.
Bu yazı genel bilgilendirme amaçlıdır; tanı veya tedavi yerine geçmez. Yaşadığınız güçlükler için bir ruh sağlığı uzmanına başvurmanız önerilir. Acil bir durumda lütfen 112'yi arayın.
Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
Eğitimler