"I'm too tired." "I'm so stressed out!" If you have been saying these words far too often lately, you're among the millions of Americans who are crippled by daily fatigue and stress. The good news is that you can do something about it, and it might be as simple as changing your sleep habits, cutting sugar out of your diet or taking up a new creative hobby.

First, see your physician to rule out any medical causes for fatigue, which can be a symptom of diseases such as hypothyroidism, anemia, heart disease or sleep apnea. If you get a clean bill of health but still feel tired and run down, depression or anxiety might be the cause.

"A lot of times, fatigue is related to anxiety, because carrying around a load of anxiety can suck the energy right out of you," said Annette Vaillancourt, a licensed clinical psychotherapist and motivational speaker in.

"Anxiety is also one of the symptoms of stress," Vaillancourt said. "Persons with anxiety either need to change the circumstances that are making them anxious or change their mental attitude toward the situation that is stressing them out. One way to do that is reframing, or looking at the situation as an opportunity rather than a challenge."

Vaillancourt also said that if fatigue accompanied by a blue mood persists for more than two weeks, a person should consult with a physician or psychotherapist to either confirm or rule out clinical depression.

"Another thing I've learned recently is that fatigue or tiredness can occur when we're not hydrated, so drink more water when you feel tired," Vaillancourt said. "Also, stay away from sugar as a quick energy fix and choose more nutritious foods like broccoli that are rich in antioxidants. If you put bad gas in your car, it's not going to run right. It's the same with the body. It needs good food to make it perform at its best."

Breathe deeply and relax

Barb Elam, interim director of the Wellness Center at Southern Illinois University Carbondale, agreed that nutrition is important for overcoming fatigue and stress. Sometimes people aren't getting enough calories or enough protein in their diets or, in contrast, are consuming too much fat or sugar. Elam said good nutrition and exercise go hand in hand in reclaiming one's energy.

"Exercise is always an excellent way to both relieve stress and give you more energy," Elam said. "Often people think they're too tired to exercise, but even if they can do a little bit, they'll gain some energy back just from making that small effort."

The Wellness Center offers a variety of stress management strategies.

One is diaphragmatic breathing, commonly known as deep breathing, which research has shown to help lower blood pressure and reduce overall stress.

"It's as simple as learning how to expand your diaphragm on the inhale and contract it on the exhale for about two minutes," Elam said. "This can get your heart rhythm in a more even pattern and help you feel more relaxed and get rid of the muscle tightness that often comes with stress."

Anyone can get started with deep breathing for stress relief by listening to a free 15-minute relaxation exercise by Dave Elam on The Wellness Center's web site at http://shc.siuc.edu/wellnesspages/wellness_home.htm. Click the link to "Stress Management," then click the link to "Resources." You can also download the file to your iPod or computer.

"There is soft music in the background as a psychologist talks you through a relaxation activity," Elam said. "It guides you through deep breathing, progressive muscle relaxation and guided imagery, which is simply having a pleasant thought or image in your head of a person or place you love or a favorite experience. Many people use this exercise to relax during the day, while others use it at night to help them get to sleep."

Practice good sleep habits

Getting good, restful sleep is key to fighting fatigue and overcoming the stressors that bombard our daily lives. Sometimes, unexplained fatigue is caused by sleep apnea or other sleep disorders, but in many cases a change in sleep habits can help restore your energy.

According to Dr. Terry Brown, medical director at St. Joseph Memorial Hospital Sleep Disorder Center in Murphysboro and Marion, the first thing to do is to rule out any medical cause for fatigue, including sleep apnea, a sleep disorder which causes a person to experience shallow breaths or pauses in their breathing during sleep.

Because these disruptions result in poor sleep quality, people with sleep apnea wake up tired and often experience profound sleepiness during the daytime. If you suspect sleep apnea, or if your spouse has commented that you "stop breathing" several times a night, it's time to consult with a sleep disorders expert.

Sometimes, though, people who do not have a sleep disorder simply burn the candle at both ends constantly and don't spend enough time in bed. Brown offered several tips for good sleeping habits.

"The healthiest thing to do is what most kids do, and that is getting up at the same time every day," Brown said. "It's good to have a regular bedtime, too, but it's not as important as having a set time for getting up. I advise people who have problems sleeping to not vary their getting up time by more than 15 or 20 minutes, even on the weekend. That's probably the single most important point for people who are trying to get more out of their sleep."

Brown also noted that a feeling of fatigue with muscle aches, similar to fibromyalgia, can be brought about in a sleeping environment in which you get woken up frequently during the night. People whose pets sleep with them, for example, may be unaware that they wake up several times a night for a few seconds whenever their pet moves around the bed or walks over them. All of those interruptions reduce the quality of your sleep and can make you feel fatigued the next day. Taking away the distractions can lead to a better night's sleep.

"We have some new drugs, Provigil and Nuvigil, that help keep people with sleep disorders more alert during the day, and some studies have shown that they many improve fatigue, as well," Brown said. "They're not like the traditional stimulants like amphetamines and Ritalin. Also, don't rely on too much caffeine to keep you awake because you can build a tolerance to it. Lastly, alcohol can interfere with sleep, especially if you drink too much."

Follow your passion

Even with the best nutrition and sleep habits, a stressful job can bring on the physical aches and mental distress of fatigue. When award-winning Southern Illinois artist Kris Killman was working as a prison guard before retiring several years ago, he pursued his art as a way to relieve the stress of his job.

"Once a correctional officer sees the outright cruelty of human beings savagely attacking one another, inmate on inmate, or worse, inmate on staff, they quickly realize at the end of their shift that those visions don't easily go away," Killman said. "Therefore, it became apparent to me that I needed a passion to pursue that would ease the pressure building in me by shift's end. In my case it was the fine arts, painting in particular. Since it is a creative endeavor that involves problem solving in order to make a painting work, I found myself constantly challenged."

Vaillancourt said resting and taking a "mental vacation" from a stressful job or relationship is a good strategy with physical and mental benefits.

"If you're working on leftbrain tasks or analyzing things, take a break and do some right brain activity, like listening to music," Vaillancourt said.

Vaillancourt also recommended making a list of the things you love to do and then giving yourself some time each day to do one of the things on your list.

"Choose something that energizes you and fills you back up," she said. "It can be as simple as closing your eyes and recalling something pleasurable or a happy time in your life."

Banishing negative thoughts, whether of a difficult job or relationship, and replacing them with positive thoughts and images is an excellent way to de-stress after a long day. Positive thinking actually has a good physical effect, too, according to Barb Elam.

"Researchers asked a group of people to think about something negative and then measured their immunoglobulin A in their blood, which is a measure of your immune response," Elam said. "After five minutes of negative thinking, the subjects' immune response was down for six hours. The good news is that the opposite is true for positive thoughts. After five minutes of holding positive thoughts or images, the subjects' immune response was up for six hours."

"The best news is that positive thinking is a strategy against stress that anyone can do anywhere," Elam said. "It doesn't cost anything, and there's no downside or negative side effects. It's a simple strategy, but very profound and effective."