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In one of my study flashcards, I have this sentence:

疲{つか}れぎみだけど生{い}きてます。

Which should translate to something like, "[He] appears worn out but [he's] still kicking."

The main point is that in this instance, my understanding is that ぎみ means "appears to," or, "looks like."

This card just came up in the rotation, and I remembered seeing this question, where it is explained that がる also means something similar.

So similar, that I'm wondering what exactly is the difference between がる and ぎみ?

Obviously one difference is that がる can be modified ("conjugated"?) like a verb (maybe it is a verb of some kind?) to become がっている, and ぎみ doesn't look like it can be modified in any way that I'm aware of. So there almost certainly a difference in grammatical usage.

The definitions still seem to be pretty much the same though.

Can someone explain if they have different implications in meaning, and in what situations one would apply and the other couldn't?

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Honestly speaking, I do not find the suffixes がる and [気味]{ぎみ} anything similar to each other. This may mean that my explanation is not going to help you resolve your confusion, but anyway here is my attempt.

The two suffixes have different grammatical roles and different meanings.

がる is attached to the stem of an i-adjective or a word which conjugates like an i-adjective, and forms a verb. It adds the meaning “to act showing ….”

  • [痛]{いた}い (i-adjective; aching) → [痛]{いた}がる (verb; to act showing an ache)

気味 (Progressive Waei Chu Jiten, New Century Waei Jiten) is attached to a noun or the 連用形 form of a verb, and forms a noun. It adds the meaning “having the tendency of …” or “being slight ….”

  • [疲]{つか}れる (verb; to be tired) → [疲]{つか}れ[気味]{ぎみ} (noun; slight feeling of tiredness)
    Example: [最近]{さいきん}疲れ気味だ。 I am a little tired these days.
  • [風邪]{かぜ} (noun; a cold) → [風邪気味]{かぜぎみ} (noun; slight feeling of a cold)
    Example: 風邪気味だ have a touch of a cold
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Just in case it's not clear, the reason I ask for your translation is that for me, saying someone looks exhausted but still living implies that they look really, really exhausted. As in, they look near dead, which is why one clarifies they are still living (even though it's all probably just hyperbole). So when you say 気味 is only a "slight" indication, it seems to not fit with the rather extreme image I get from reading the sentence. –  Dave M G Oct 11 '11 at 4:40
    
@DaveMG: I think that 生きてます is a kind of joke. It does not really mean that the speaker is so exhausted that it has to be made explicit that he/she is alive. Let me think a little more. –  Tsuyoshi Ito Oct 11 '11 at 11:29
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No, ぎみ、まみれ and だらけ are roughly words to say "full of something".

I translate your sentence like tiredness got me, but I'm not dead yet.

疲れぎみ、 風邪ぎみ and friends would translate to "suffering from exhaustion" "having the symptoms of a cold" or something like that. It's not about appeareance, it really is the state of the persion.

For nuances in usage of the three words I gave above, any JLPT book for levels 1-2 will give you samples (or you can ask again)

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疲れ気味 does not mean or imply that the person has symptoms of a cold. –  Tsuyoshi Ito Oct 10 '11 at 11:29
    
@TsuyoshiIto err, indeed, I did not translate the right sentence :) –  Axioplase Oct 10 '11 at 11:55
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The suffix [気味]{ぎみ} is very different from the suffixes まみれ and だらけ, and it weakens the meaning. So 疲れ気味だ is “a little tired” while 疲れている is “tired.” –  Tsuyoshi Ito Oct 10 '11 at 12:07
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Hmm, I agree with @TsuyoshiIto. I don't see them as even close at all. But I've never thought of an overlap amongst them, so maybe they are easily mistaken by some people. –  istrasci Oct 11 '11 at 14:13
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Plain wrong. ぎみ does not mean "full of". –  dainichi Jun 15 '12 at 4:48
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