Common Symptoms: Compared with previous level of energy -Tired all the time -Tired easily -Tired despite rest this leads to - disruption to work, social & family life - affects ability to carry about routine & other tasks. - Feelings of frustration. Common triggers: 1. Psychological triggers: - Depression - Anxiety / stress - Worry - Doing too much - Doing too little 2. Physical triggers:' Medical problems - Anemia - bronchitis - asthma - diabetes - sleep apnea - narcolepsy - thyroid disorder - influenza - alcohol/drug use - bacterial or viral infection - chronic liver disease - renal impairment - Addison Medications: à steroids, antihistaminics, Beta blockers Treatment: Supportive therapy (most often needed ): - Depression - Worry - Stress/life problems - lifestyle change - level of physical activity. Medication for: - other mental or physical disorders - Certain anti-depressants are sometimes useful. (Tryptizole 10 mg, anafranil 25 mg) - there are no effective medications specific to fatigue. Behavioral strategies: - Examine how well you are sleeping. - Have a brief rest period about 2 weeks, in which there are no extensive activities. - After periods of brief rest, gradually return to your usual activities. - Plan pleasant / enjoyable activities into your week. - Gradually build up a regular exercise routine. - Do not push yourself too hard, remember build up activities gradually & steadily. - Try to have regular meals during the day. - Try to keep to a healthy diet. - Use relaxation techniques, for example, slow breathing (see before).