Marie Sullivan says that she knew something "wasn't quite right" during a doctor visit five years ago.
"I thought I might be anemic, but the results of my annual physical were fine," the Paramus, N.J., resident recalls. "All my numbers were in the normal range. The blood work turned up nothing. I said to my doctor, 'Are you sure? What's wrong with me?' "
Sullivan's doctor told her, "You're getting older." But Sullivan, 60, wasn't buying it. "I'm not that old," she says. "I used to have tons of energy. I know you slow down as you age, but I'm physically exhausted all the time. And I know I'm not the only person who feels this way."
Lassitude. Weariness. Fatigue. Whichever phrase you prefer, recurring tiredness is the new normal for a growing number of people.
Causes range from illnesses such as anemia, depression, hypothyroidism and diabetes to the increasing overuse of technology and its implications on our mental well-being.
Yes, Facebook, Twitter and Instagram can wear you out, says Dr. Patricia Bratt, a therapist and psychoanalyst with offices in Livingston, N.J., and New York City.
"Social media can run the gamut from being fabulously uplifting to being totally depressing and exhausting," says Bratt, who is also director of trauma and resilience studies at the Livingston-based Academy of Clinical and Applied Psychoanalysis. "And this applies to all ages."
Sleep apnea and poor diet are other common culprits of fatigue. And then there is the most obvious cause: not enough sleep, which often goes hand in hand with overwork.
In July, a National Safety Council survey found that 97 percent of Americans have at least one of the leading risk factors for fatigue, which include working at night or in the early morning, working long shifts without breaks and working more than 50 hours per week. Forty-three percent of respondents said they do not get enough sleep to think clearly at work and be productive.
Three years ago, Dominick "DJ" DeRobertis of Pearl River in New York's Rockland County was one of those people. Now 39, DeRobertis works in the construction industry. He drives trucks, operates other heavy machinery and was having problems staying awake.
"I was sleeping two-three hours a night, waking up frequently and was always tired at work," he recalls. "I was taking these 15-minute power naps every two hours. It was bad. Then I put on some weight, and that just made it worse."
DeRobertis took part in a sleep study and was diagnosed with sleep apnea.
He now uses a BPAP (bilevel positive airway pressure) machine, which helps people who need to get more air in and out of their lungs while they sleep.
While sleep apnea is relatively easy to diagnose, other forms of chronic fatigue are not.
Dr. Maria Vila, a physician at Atlantic Health System's Chambers Center for Well Being in Morristown, N.J., says fatigue is one of the most common complaints among her patients. And, no, she doesn't think "You're getting older" is a particularly helpful diagnosis.
"I hear this all the time," Vila says. "Patients are told, 'You're getting older ... you're a woman ... you're menopausal ...' and so on. That's not what we do here. I start by looking at the patient's history, their diet, exercise, sleep patterns and stress levels. Then I move on to blood tests. Almost everyone says they were told that their blood tests were 'normal.' But I'm not looking for normal. I'm looking for optimal.
"We look at the biochemical processes in your body," Vila continues. "Is there a vitamin deficiency? ... Do you have elevated cortisol levels? ... What about food sensitivities? Dehydration? All of these things can cause fatigue, and we address all of them, without medications. We use supplements, lifestyle changes, stress relief, massage, yoga ... until those numbers come up. Again, we don't want normal, we want optimal."
Gary Schulman, a certified fitness trainer from Oradell, N.J., who works with clients coping with chronic diseases, also favors a natural approach to fatigue and warns that people living with stress should not ignore it.
"People say stress can kill you, and they're right," he says. "In today's society, most people are on this disease continuum that I call stress without recovery. ... And if they continue on that course, it eventually leads to chronic disease, thyroid problems, high blood pressure and more."