Dalai Lama's Exhaustion: FAQ

Are You Exhausted Too, or Just Tired?

By Miranda Hitti
WebMD Health News

Reviewed By Michael W. Smith, MD

Aug. 28, 2008 — The Dalai Lama is in hospital in Mumbai, India with "abdominal discomfort ... and there is no cause for concern," Reuters reports, quoting a hospital spokesman who called the Dalai Lama "cheerful."

A statement posted on the Dalai Lama's official web site yesterday attributed the Dalai Lama's discomfort to "exhaustion" and said the Dalai Lama has cleared his schedule for the next three weeks while he undergoes more medical tests.

The brief statement reads, in full, "His Holiness the Dalai Lama has been experiencing some discomfort in the past couple of days. His personal physicians attributed this to exhaustion and have advised him to cancel his engagements for the time being and instead complete the remaining medical tests that began earlier this month in Mumbai [the Indian city formerly called Bombay]. It has therefore been decided that all his schedules for the next three weeks, including the visit to Mexico and the Dominican Republic, are being canceled with immediate effect."

That statement leaves a lot of questions unanswered, such as the type of discomfort the Dalai Lama — who is 73 years old — has been having, what medical tests he has already had, and what additional medical tests he will get in Mumbai.

Most people don't have the religious and political responsibilities of the Dalai Lama. But feeling run down and exhausted is common. Where is the line between feeling frayed by the daily grind and being so exhausted that you need medical attention? And when exhaustion sets in, what can you do about it?

For answers, WebMD spoke with two doctors: James Krainson, MD, of the South Florida Sleep Diagnostic Center in Miami, and Erika Hyde Riley, MD, an internal medicine practitioner at Massachusetts General Hospital in Boston.

What is exhaustion and how does it differ from day-to-day tiredness?

Krainson distinguishes exhaustion from tiredness, with tiredness stemming from too little sleep and exhaustion tied to the muscles.

"Exhaustion and fatigue are typically problems that have to do with exertion," Krainson says. "If you feel as if you have to sit down to relax your muscles ... and you don't feel like moving or you can't move because your muscles are so fatigued that they have no further ability, then that's exhaustion," Krainson tells WebMD.

Riley also sees mental exhaustion as a real problem that's typically linked to overwork and sleep deprivation. Riley calls exhaustion an "extreme level of fatigue, an extreme level of tiredness."

What causes exhaustion?

That depends. If, like Krainson, you mean exhausted muscles, that's caused by exertion. But it may accompany other serious medical problems.

"With heart disease, with lung disease, with renal disease, with any chronic disease, you may be more easily fatigued — you may not be able to maintain the same activities as someone else," Krainson says.

Beyond tired muscles, exhaustion can be caused by nutritional deficiencies, illness, overwork, and too little sleep, Riley says.

"Here in the United States, everybody overdoes it," she says, and "most people don't get enough sleep." Riley's list of common culprits also includes anemia, especially in women, and hypothyroidism (underactive thyroid).

When should you see a doctor about exhaustion?

If exhaustion doesn't ease up in a couple of days or a week, or if it keeps getting worse, and there's difficulty just getting through routine activities, "it does require more of a work-up to make sure that it's not any underlying illness or disease," Riley says.

Krainson has similar advice. "If you're feeling exhausted going grocery shopping, if you're feeling exhausted doing mundane activities that you used to be able to do, then that should be evaluated," he says.

You'd probably get blood tests and, if you have other symptoms beyond exhaustion, those would get checked out, too, Krainson says.

The Dalai Lama is 73. Does age affect exhaustion?

"It probably does, because people in general tend not to be in the same physical shape, the same degree of conditioning as they age," Krainson says.

Riley agrees.

"Age can definitely play into it," she says, "particularly if he's trying to do his usual level of activity that he's been doing for many years but just can't keep up with it anymore."

How do you treat exhaustion?

"Sit down and rest," Krainson says.

Exhaustion, without other illnesses, doesn't require staying at a hospital or spa, he says. "Can you rest any more efficiently at those sites than at home? No, probably not. So if you need to rest, home is a good place to do it."

He also recommends building rest into the day and getting enough sleep — seven to eight hours per night. "Sleep is restorative, not only for mental functioning but also for physical functioning," Krainson says.

Riley also recommends getting enough sleep if you're mentally exhausted. "Many people say, 'Oh, I get four to five hours of sleep; I'm fine.' But it catches up to you," she says.

"Everybody needs a certain amount of sleep just to reach the sleep stages that are restful and help us rejuvenate and feel rested when we wake up. And if you don't get enough hours of sleep per night, you don't get enough of those restful stages of sleep," Riley says.

SOURCES: Reuters. Dalailama.com. James Krainson, MD, South Florida Sleep Diagnostic Center, Miami. Erika Hyde Riley, MD, internal medicine practitioner, Massachusetts General Hospital, Boston.

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