What Is Malaise, and What Could It Mean?
Post-exertional malaise (PEM) is a primary symptom of chronic fatigue syndrome (CFS). PEM occurs when symptoms of CFS — including severe fatigue, difficulty concentrating, and joint pain — become worse after physical or mental activity.
Doctors also identified PEM as a symptom of long COVID, also called long-haul COVID-19 or post-COVID.
This article will provide an overview of malaise, including conditions that may cause it and how doctors diagnose them. It will also discuss symptoms of malaise and COVID-19.
The medical term “malaise” refers to a general sense of illness or not feeling well. Many physical and emotional health conditions can have malaise as a symptom.
In some cases, there may not be other clear symptoms to indicate a specific diagnosis.
Malaise that may result from an acute condition, such as an illness due to an infection, may require emergency attention. Get immediate medical care by calling 911 if you experience malaise along with other symptoms, such as:
- abdominal pain or cramping
- fever of 100.4ºF or 38ºC
- chest pain or pressure
- muscle weakness or paralysis
- difficulty breathing
Get prompt medical care if you experience enduring malaise to determine whether your malaise may be due to a chronic medical condition.
Long COVID occurs when someone experiences new or ongoing symptoms after recovery from an initial COVID-19 infection. These symptoms can begin 4 weeks after recovery and last months or even years.
If you had COVID-19 and experience symptoms including PEM, talk with your doctor about the possibility of long COVID and available treatment options.
Malaise can be a symptom of several conditions, both long-term and short-term.
Chronic conditions that can cause malaise include:
- anemia, which is low red blood cell count
- hypothyroidism, which is an underactive thyroid
- long COVID-19
- chronic fatigue syndrome
- inflammatory bowel diseases, including ulcerative colitis and Crohn’s disease
- HIV infection
- diseases of the kidney, heart, liver, and lungs
- congestive heart failure
- sleep apnea
Acute conditions that can produce malaise include:
Malaise may also occur as a result of certain lifestyle factors, including:
- lack of enough sleep and nutritious foods
- heavy alcohol and caffeine consumption
- sedentary lifestyle
Medication side effects
Certain medications can have malaise as a side effect, including:
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- antiseizure medicines
- psychiatric drug treatments
- treatments that combine different medicines
Malaise may accompany other symptoms that vary depending on the underlying condition.
Symptoms related to malaise from a physical condition may differ from symptoms linked to malaise from a psychological or emotional condition.
Physical symptoms that may occur along with malaise
Malaise may accompany other symptoms affecting the body, including:
- abdominal pain and cramping
- enlarged lymph nodes
- fever of 100.4ºF or 38ºC
- joint pain
- missed or irregular menstrual periods
- severe fatigue
- muscle aches
- unexplained weight loss
- flu-like symptoms
Other symptoms that may occur along with malaise
Malaise may accompany symptoms related to a psychological or emotional condition, including:
- changes in mood, personality, or behavior
- difficulty with memory, thinking, talking, comprehension, writing, or reading
- irritability and mood changes
Serious symptoms that might indicate a life threatening condition
In some cases, malaise may be a symptom of a life threatening condition that requires immediate evaluation in an emergency setting.
Get immediate medical care by calling 911 for malaise that occurs with life threatening symptoms, including:
- chest pain or pressure
- difficulty breathing
- fever of 101ºF or 38ºC
- inability to eat or drink
- sudden muscle weakness or paralysis
- severe abdominal pain or cramping
By definition, malaise is a vague symptom that can occur with a wide range of conditions. Contacting your doctor for an evaluation is the best way to get an accurate diagnosis and treat the underlying cause.
When should I contact a doctor if I have malaise?
Sometimes, malaise can be associated with a temporary condition, such as a lack of sleep or missing a meal.
However, if your malaise is severe or lasts for more than a few days, or you experience additional symptoms, contact your doctor. This may indicate a more serious underlying condition that requires prompt treatment.
How will the doctor examine me for malaise?
To diagnose your condition, your doctor will review your medical history and perform a physical exam. They may order laboratory tests and diagnostic studies to identify or rule out certain conditions.
Your doctor will also ask you several questions related to how you are feeling, including:
- How long have been feeling unwell?
- Do you feel depressed or anxious?
- How are you sleeping?
- When did you first notice these feelings?
- Are you in any physical pain or discomfort?
- Do you have any other symptoms?
- What medications do you take?
Because malaise is a symptom of another condition, treatment depends entirely on the underlying cause.
Physical causes may respond to medications, physical therapy, or even surgery, depending on the condition.
Counseling with various forms of talk therapy can help address the causes of malaise related to your psychholoogical or emotional health. In some cases, doctors may prescribe medications, such as antidepressants.
Complications of malaise will depend on the underlying condition.
Malaise as a symptom of a psychological or emotional condition could lead to a difficulty participating fully in daily tasks.
Because malaise can be due to serious conditions, failure to get treatment can result in serious complications.
Once you have a diagnosis for the underlying cause, it is important to follow the treatment plan you and your healthcare professional design specifically for you. This can help reduce the risk of potential complications, including:
- difficulty performing daily tasks and participating fully in activities
- permanent or chronic pain
- severe discomfort or pain
- spread of cancer or infection
- withdrawal or depression
These are some other questions people often ask about malaise. Megan Soliman, MD, reviewed the answers.
Is malaise serious?
Malaise can have a wide range of causes, some serious. If you experience ongoing malaise or other symptoms that concern you, contact your doctor. They can diagnose the underlying cause and begin prompt treatment if necessary.
How long does malaise last with COVID-19?
PEM is a symptom of long COVID. Symptoms of long COVID can begin 4 weeks after the initial infection and can last for months or even years.
Can depression cause malaise?
Depression is a possible cause of malaise, along with other psychological or emotional conditions, such as stress or anxiety. While it is common to experience brief periods of feeling “down,” contact your doctor or other healthcare professional if you experience malaise that does not go away, gets worse, or interferes with your daily activities.
Malaise describes a general sense of discomfort or feeling unwell. It can be a symptom of several conditions, both physical and emotional.
Treatment of malaise depends on identifying the underlying cause. In some cases, lifestyle factors or certain medications can produce feelings of malaise.
Talk with your doctor if you experience malaise that does not go away or gets worse. They can work to diagnose the underlying cause and begin appropriate treatment.