Describing Your Symptoms - When To See A Doctor: Chronic Fatigue

Content provided by the Faculty of the Harvard Medical School

Describing your symptoms

Start with your internist or family doctor to find out if you have an underlying medical or psychological illness. Because fatigue is a characteristic of many illnesses, you should describe your symptoms in detail to help your doctor narrow down the possible causes. How, exactly, does the fatigue feel to you? Do you have trouble concentrating? Are you mentally fuzzy, that is, do you take longer to think of words or compute simple math problems than you used to? Do you tire more quickly? Do certain activities take more effort than they used to? Answers to these questions indicate how severe your fatigue is and whether it mainly involves muscle fatigue, central fatigue, or both.

Your doctor can often diagnose the cause of your fatigue.

Be prepared to tell your doctor which activities you've had to limit. For example:

• You used to enjoy going out to dinner and the theater with friends, but now you can't stay awake during an evening performance.

• You no longer wake up feeling refreshed, even after you've slept all night.

• When you exercise, your muscles feel achy and weak in less time than they once did.

• You've done the newspaper crossword puzzle for years, but now your mind wanders, and you lose interest before finishing it.

This information yields further clues to the nature and severity of your fatigue. Timing is also important. Tell the doctor when you started noticing a decrease in your physical or mental energy level. Was the change gradual or sudden? When fatigue involves stress, overwork, or psychological problems, it usually comes on gradually. However, when the cause is chronic fatigue syndrome, fibromyalgia, or a side effect of medication, fatigue often starts suddenly. Did the onset of fatigue coincide with any other significant change in your life: Had you been ill? Did you have an injury? Did you start taking a new medication? Was there a death in the family or among your friends? Are you under an exceptional amount of stress? Your symptoms could be related to any of these factors.

Last but not least, make sure to tell your doctor about any other symptoms you might be experiencing. Give details about when the different symptoms began and whether they started together or at different times. Mention physical as well as emotional symptoms. Do you get out of breath easily? Do your muscles or joints ache? Do you have trouble sleeping? Are you feeling unusually sad or anxious? Different symptoms accompanying fatigue suggest different causes. For example, feeling blue and having trouble sleeping are two signs of depression. Shortness of breath can be a sign of heart disease.

Last updated:	January 23, 2007