What is malaise?

Have you ever felt a vague sense of discomfort or unease without being able to pinpoint exactly why? That feeling is known as malaise. It's a general term used to describe feeling tired, weak, or generally unwell.

What is malaise?

Malaise is a French word that translates to "discomfort" or "unease." In medical terms, it refers to a feeling of overall weakness or discomfort.

According to Dr. Robert Shmerling, Senior Faculty Editor at Harvard Health Publishing and former Clinical Chief of the Division of Rheumatology at Beth Israel Deaconess Medical Center, malaise can be difficult to describe because the symptoms are nonspecific.

"I define malaise as a sense of feeling generally unwell. People with malaise often find it hard to put into words. They may describe a vague sick feeling, or a sense that they're 'coming down with something.' It's often accompanied by feeling tired, but not always," Dr. Shmerling explains.

Malaise can vary in intensity. For some it might be a mild sense of tiredness, while for others it can be severe enough to interfere with daily activities. It is not a disease or condition in and of itself, but rather a symptom that something else is going on in the body. Because it is so general, it can be challenging to diagnose the exact cause of malaise without further medical investigation.

Common causes of malaise

Malaise is often one of the first signs that something is wrong in the body, even if other specific symptoms have not yet appeared. "I would never start out assuming it's 'nothing' or 'imagined' or 'just stress' or 'just getting older.' The symptom should be taken as seriously as any other and evaluated appropriately," says Dr. Shmerling.

Malaise can result from a wide range of causes, from infections to chronic diseases and even lifestyle factors. Here are some common causes:

Infections. Viral and bacterial infections, such as colds and flu and COVID-19, can cause malaise. It is often the body's initial response to fighting off an infection.

Chronic diseases. Conditions such as diabetes, anemia, and heart disease can lead to feelings of malaise due to the ongoing stress they place on the body.

Mental health issues. Depression, anxiety, and stress can contribute to malaise. These conditions can drain your energy and make you feel generally unwell.

Medications. Some medications have side effects that can include malaise. If you start feeling unwell after beginning a new medication, tell your doctor.

Nutritional deficiencies. Not consuming enough of essential nutrients, such as vitamins and minerals, can cause malaise. For example, deficiencies in vitamin D or iron are well-known causes of fatigue and general weakness.

Sleep disorders. Conditions like insomnia or sleep apnea can prevent you from getting enough restorative sleep, leading to feelings of malaise.

Lifestyle factors. Poor diet, lack of exercise, and inadequate sleep can all contribute to feeling unwell, which can worsen malaise. Our bodies need balanced nutrition, regular physical activity, proper hydration, and adequate sleep to function properly.

How is malaise managed?

Managing malaise involves a two-pronged approach of identifying and treating the underlying cause and addressing symptoms.

Addressing the underlying cause of malaise

The first step in managing malaise is to determine its root cause. This often requires one or more visits to a health care provider who can carefully review your symptoms, examine you, and perform various tests if needed.

Your doctor will likely ask you detailed questions about your medical history and symptoms to start to narrow things down. For example:

• How long have you been feeling this way? How would you rate the severity of your symptoms on a scale of 1 to 10?
• What makes your symptoms better or worse? Do they come and go or stay constant? Do they go away or improve if you are distracted or on vacation?
• Do you have any prior experience with, or episodes of, malaise?
• Are there any other symptoms such as cough, chest pain, fever, fatigue, pain, weight change, bleeding, changes in your stool or urine, rash, or loss of appetite?
• Do you take any medications or supplements? Are any of these new?
• Do you have a history of thyroid problems?
• Have you been feeling depressed or have any new stressors in your life?
• Have you traveled recently?
• Describe your sleep patterns, exercise, and dietary habits.

Your doctor will also perform a thorough physical examination and may order certain laboratory tests.

Treatment will depend on the underlying cause. If an infection is causing your malaise, antibiotics or antiviral medications may be prescribed. For chronic diseases such as high blood pressure or diabetes, managing the condition through medication, lifestyle changes, and ongoing medical care is essential.

In cases where mental health issues may factor into the malaise, talk therapy and sometimes medication can help alleviate the feelings of malaise. If a medication you are taking is causing the problem, your doctor might adjust the dosage or switch you to a different drug.

Lifestyle changes to manage symptoms

Regardless of the underlying cause, certain lifestyle changes may help manage and reduce malaise by improving your overall health and well-being. But according to Dr. Shmerling, you should be cautious about making drastic changes prior to getting your symptoms sorted out by a doctor.

"Sometimes, a lifestyle suggestion is premature. For example: exercise might be great for someone who is deconditioned and otherwise healthy; but it might be impossible or even make things worse (at least in the short run) if the person turns out to have new, untreated heart disease," says Dr. Shmerling. "That said, I would encourage other standard recommendations for a healthy lifestyle, which include a healthy diet, adequate sleep, and stress management, while the work-up is ongoing."

Healthy lifestyle changes you can discuss with your doctor include:

Improving your diet. Ensure you are eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Sometimes, supplements might be necessary if you have specific deficiencies.

Staying hydrated. Drinking enough water throughout the day is crucial. Dehydration can lead to feelings of fatigue.

Regular exercise. Incorporating regular physical activity into your routine can boost your energy levels and improve overall well-being. Even light exercises like walking can make a difference.

Prioritizing sleep. Good sleep hygiene is essential. Try to go to bed and wake up at the same time every day, create a relaxing bedtime routine, and ensure your sleeping environment is comfortable.

Managing stress. Techniques such as mindfulness, meditation, yoga, and deep-breathing exercises can help reduce stress levels and improve your sense of well-being.

Avoiding alcohol and smoking. Both can contribute to feelings of malaise. Cutting down or quitting can improve your overall health.