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Continuous and daily lack of energy



Dear Sir/Madam, I am a 20 year old female, who for the past 4 years has suffered from lack of energy on and off, but for months at a time. At age 16, I was sitting significant exams and was constantly exhausted. The doctor put this down to stress, but took a blood test to rule out any other possibilities. The results showed a slightly low white blood cell count, but I was told it was nothing to worry about. The tiredness was never eleviated by more sleep; most days for months at a time I felt like I could spned all day sleeping and would still be tired. I eat relatively healthily and have always been active, participating in different sports at school and college, etc. Since I was a kid, I have always been an early-riser but often at 10 or 11am I will be feeling significantly lethargic. My most energy comes in the evening. I do not have any significant sleep problems - I sleep pretty soundly. I have recently been diagnosed with depression and have, for 4 months now, been taking a mild anti-depressent (fluoxetine). I feel this has worked in improving my attitude and reducing the occurence of my blue days, but the tiredness I previously had put down to depression seems to have made a return! I have down days still, but I am reluctant to put this down to depression still, because my suicidal feelings and darker days are so much less frequent and insistent. I attend college in London, and have a fairly active social life, of course often having nights of little sleep but it often feels like my energy is much higher on the days I get less than 8 hours sleep. I`m on a two-month stay in the United States at the moment, and the heat affects me to some extent, but I am being careful to drink plenty to fluids. I feel I have little energy to stay active all day, like I have done as a kid. Please help - it is affecting my enjoyment of activities I would normally be able to enthusiastically participate in and I don`t feel able to spend a whole day doing anything, but sleeping or resting.


Tiredness can occur due to myriad of physical and mental problems. It would be difficult to make any recommendations without proper history and examination. A thorough and detailed evaluation by an internist would be helpful.

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Response by:

Ram Raj   Singh, MD Ram Raj Singh, MD
Associate Professor of Clinical Medicine
College of Medicine
University of Cincinnati