Fatigue is epidemic because so many of us are knackered from working too hard. We don't listen to our bodies, expecting them to do our bidding.
Dr Jim Keely and his colleague are in practice in Malahide, Co Dublin, and have recently decided to end their weekday surgery at 6 p.m., rather than 8 p.m., because they have been spending too much time in the office and not enough time with their families.
That's the kind of decision more of us are going to have to make if we want to stop feeling tired all the time, Dr Keely believes. Tiredness, he explains, is a genuine problem for a lot of people: "Somebody will say to you, `I'm feeling tired, I can hardly cope, I can't get up in the morning to go to work'. Then you find out that this person is at work all the hours God sends, getting up at 6 a.m., getting home at 9 p.m. with 10 small deadlines every day and one big deadline every week. There are others in more ordinary jobs, who are working very hard by doing a lot of overtime."
These people are tired because they are overworked, not resting enough and not getting a good night's sleep, yet rather than face the obvious they feel that there must be something medically wrong with them. They tend to resist the advice that the only solution to their fatigue is a major life restructuring with more sleep and the occasional lie-in.
Those who persist on the treadmill lifestyle end up with chronic sleeplessness, which in turn leads to anxiety, heart palpitations and panic attacks, followed by depression, one symptom of which is a lack of insight. "They blame everybody else and will tell you the kids are too much, that the spouse is nagging. It's a slippery slope and goes on and on, until people learn to stand back from their situation," says Dr Keely.
Me, where the individual is physically incapable of getting out of bed and going to work because they have no energy, is a different kind of tiredness which is best left without an official label, Dr Keely believes. "We try not to label people because that stigmatises them, and then they meet somebody else with the same problem and hear all the bad things about the syndrome and the worst-case scenarios and that depresses them even more," says Dr Keely. To discourage his patients from becoming professional ME sufferers, Dr Keely encourages them to learn to be "a little bit more positive". A person with one or two bad days a week, may actually have more good days than bad, yet may have a negative attitude that makes them focus on bad days, he observes.
"The most important thing is seeing what the problem is, accepting that they do have a fatigue syndrome and understanding that for most it is not lifelong and that they will at some stage feel better. If you can help patients from a psychological point of view to feel better, they will get better," he says.