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Turn off the Tiredness

There used to be times when I would stand with my back arched stiffly. My eyes burned and by afternoon, I would feel like flopping in my bed. My ringing cell phone, my daughter's homework and my two dogs could all go for a walk. By the end of the day, I would have no energy left in me to attend to any of these. I realised it couldn't go on like this. In order to meet my responsibilities at home and at work, I sought medical help. It was nothing serious, just burnout. The doctor suggested changes in my lifestyle. I took his advice seriously and I'm doing much better.

But something he said came as a surprise: 20 out of every 100 patients he sees suffer from exhaustion; a lot of them are women. Dr. R K Luthria practices in South Delhi and treats patients of all groups. He pinpoints the reasons behind fatigue. "Tiredness is generally associated with ailments such as anaemia, thyroid imbalance, heart disease, diabetes, hypertension and depression. Other conditions such as insomnia and burnout also sap you off energy." Tracking 1,741 people in their sleep, lab researchers at Penn State College of Medicine, US, found that depression was the reason why people felt tired during the day. Weight and age-related sleep problems came next, followed by insomnia and then diabetes-related conditions.

Climbing stairs will help you stay active and agile
If you feel fatigued like I did, give your lifestyle a hard look. All you need to do is make small changes in your daily routine that add up and help you get back your energy like a shot.

Don't let it bring you down
The more you complain about tiredness, the more it is likely to get you. Sit down and think of how you can re-arrange your routine to find more energy. Stop working continuously without small breaks and don't sacrifice that little spare time for exercise and leisure. Don't keep complaining about too much work.

Change your work style
Don't obsess about doing your work perfectly all the time. Ignore the things you cannot change, and focus on what is doable. Delegate, and more importantly, trust those you pass on the responsibility to. Take short relaxation breaks during office hours. Practise deep-breathing for 5 minutes; close your eyes and meditate on a beautiful inner picture like your next holiday trip to Goa.

Make small changes in your routine
Don't pack in too much into your day-weed out activities that add to your stress. You insist on dropping your daughter to school each day? Get her on to the school bus (and without guilt pangs). Make it a point to get at least 20 minutes of light exercise in a day. Lift light weights while watching your favourite TV show, walk up and down the stairs at least five times a day, step out for a walk whenever you get the time.
Spend time with people who cheer you up. Do things that you never have the time to do - start a book club or watch a DVD with your friends.

Eat and drink healthy
Deeksha Kapoor, Associate Professor of Food and Nutrition, Indira Gandhi National Open University, finds that the major cause of tiredness among Indian women is the lack of iron in their diet. "We know that spinach and other green leafy vegetables give us iron, but our diet is rich in cereals which act as inhibitors of iron absorption. So we need to add vitamin C, from citrus fruits or amla, to enhance absorption," she says. Of course, don't ignore the calcium and other vitamin supplements too.

Other practical tips on nutrition are:
  • Eat regular meals and don't snack on high calorie foods like chips and chocolates. Instead, have murmura (rice puffs) or dry roasted peanuts and gram.

  • Pack your meals with fresh fruits and salads, pulses, bean sprouts and nuts.

  • Carbohydrates should make up at least a third of your diet, but they should be high-fibre and non-processed. Go for brown bread sandwiches, atta cookies, chappati wraps, poha, and upma.

  • Cut down on fats. Eat lean meats, fish, skimmed milk and yoghurt dip instead of butter.

  • Replace energy drinks with nimbu pani. Avoid cigarettes and alcohol.

  • Hobbies that create energy
    Find a hobby that is both recreational and rejuvenating. Yoga is a good option. As Arun Pandala, of the Shivananda Yoga Centre in Gurgaon sums it up: "Yoga is a form of exercise that cultivates energy. It disconnects your mind from daily activities and stress. It brings oxygen into your blood and gathers energy through concentration." Yoga maestro B K S Iyengar suggests Uttanasana to relieve tiredness and build up energy reserves. This is one of the simpler asanas that you can do on your own-it's not advisable to do the more difficult ones without guidance, however. How to do it? Read on.

    Step 1: Stand with your body straight and feet joined and flat on the floor. Raise your arms straight above your head with palms facing outwards.
    Step 2: Exhale and bend forward from the waist till your body is a right angle from the waist and your hands are pointing to the floor.
    Step 3: Bend further and place your palms flat on the floor in front of your feet. Now, stretch the back of your knees and thighs.
    Step 4: Slide your palms to take them to the back of your heels. Raise your palm and bring the pressure on your fingers and thumbs.
    Step 5: Exhale and move your torso closer to your legs, stretching and taking your head down to touch your knees. Hold the pose for 20-30 seconds, breathing evenly.
    Repeat the asana 2-3 times-and remember: stretch, stretch, stretch.

    Seek alternate therapies
    Many of us are wary of over-medication and the side effects of allopathic medicines. For a general problem such as tiredness, alternative treatments like reflexology can be equally effective. Namita Unnikrishnan, a Delhi-based therapist, says, "Reflexology induces deep relaxation and makes the body disconnect from daily stress factors. The nervous and hormonal systems perk up, leading to an overall energetic feeling." Other such treatments that you could try are herbal oil massages and aroma-therapy where you light essential oils (lavender and patchouli are good) in a burner in your room. This relaxes the mind and body. Hydrotherapy is another option. In this you soak yourself in a hot tub with soothing salts or oils added to the water to relax your muscles.

    Other clinical reasons behind fatigue
    Sometimes, the tiredness doesn't go away, not even after a relaxed weekend and plenty of sleep. This is when you have to sit up and seek medical help. You may be suffering from Chronic Fatigue Syndrome, a disorder that often comes after a viral infection, a traumatic mental experience, or is due to deep-rooted physiological ailments. Dr S P Byotra, Senior Consultant, Department of Medicine at Sir Gangaram Hospital in Delhi, says that this is a common ailment in India. "Patients complain of tiredness, acute anxiety and insomnia. Some say they work just for 10 minutes and want to lie down or simply cannot go through the entire day's work. About 15-20% of such cases are associated with diabetes, thyroid or obesity. Many cases are of women in the menopausal stage. This condition needs counselling as well as medical treatment."

    Another clinical condition that is often behind chronic tiredness is sleep disorders. There are specialists to treat this. I spoke to one of them, Dr M S Kanwar of Apollo Hospital, Delhi. "Fragmentation of sleep and not getting deep, deep sleep can lead to grave tiredness," he says. "One of the reasons is insomnia, usually due to anxiety and stress. The reason is completely physical, generally due to some orofacial (relating to the face and the mouth) abnormalities or obesity, which leads to obstructive sleep apnea." Though more men suffer from apnea, women should also practise caution. Watch out if a sleep disorder or depression is making you perpetually tired. If you suspect you are tired because of anaemia, thyroid imbalance, heart disease, diabetes, hypertension or depression, see your GP at once. He might recommend some tests to rule these out.
    Yoga teachers will tell you: "Where goes the mind, goes the energy." A lot of the success in tackling tiredness is how much control you have over your mind and the determination with which you energise it. Of course, the way you treat your body goes side-by-side in adding up to the energy reserves.

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    Prevention (Sheema Mookherjee); Photographed by Anshuman Sen; Make up by Dipali Sarin; Model Himani Tokas;Sourcing by Amrita Kaur Bal; Clothes courtesy Cottons; Location courtesy Fabindia