Do I have chronic fatigue or am I just tired?

When you say “I’m tired” you frequently mean “I’m tired of it.”

This article deals with the common problem of chronic fatigue, also known as emotional fatigue, which is often mistaken for physical tiredness and tells how to overcome it.

Scientists have confirmed that when you say you’re “sick and tired” of something or somebody you aren’t merely using a figure of speech.

Both sickness and fatigue represent an attempt to escape from a situation that has become too difficult to contend with.

The “I’m too tired” of chronic fatigue is emotionally equivalent to the “I’m too sick” of psychogenic heart trouble, skin disease, gastric upset, or what-ails-you.

Why some people emphasize chronic fatigue, some anxiety, and others so-called physical diseases is still unknown.

There was a young man who bitterly resented his mother-in-law, but felt powerless to assert himself. Soon after she moved into his home he developed tired spells, began sleeping till noon, lost his job, took to drink, and developed tuberculosis.

A couple of years later when his mother-in-law died suddenly he immediately quit drink and recovered his health, his ambition, and his job.

This kind of tiredness, usually called “chronic fatigue,” is always unpleasant, doesn’t come from exertion, and doesn’t respond to rest.

It isn’t continuous in its milder forms, but comes and goes in spells of unpredictable intensity and duration.

Despite a strong desire to lie down, you sleep badly and usually feel worse in the morning than at bedtime. Besides feeling listless, with no pep or ambition, there’s an uncomfortable awareness of the weight of the body, and often headache or backache.

If the spell lasts a long time you procrastinate, find it hard to concentrate or remember names, take offense easily, blow up at subordinates, search restlessly for new amusements, tire of them quickly, smoke or drink excessively, and go to great lengths to avoid responsibility and making decisions.

You may never have all these symptoms at once and seldom have any of them severely enough to make you helpless.

But you can’t go through life without experiencing chronic fatigue to some degree, and the conditions of modern life make us all increasingly susceptible.

Machines now do most of the work that used to make our grandparents feel like going to bed early and getting a good night’s sleep.

When your work uses your muscles, the impulse to rest is overwhelming and you don’t carry your fatigue over to the next day.

But your body isn’t equipped to compensate for the kind of nervous exhaustion that comes from working under pressure at a desk.

Instead of making you sleepy, this kind of fatigue makes you feel like staying up and looking for the same kind of nervous excitement that first brought it on.

The result is you carry it over day after day.

Along with nervousness, chronic fatigue is the main complaint of most men and women who feel ill enough to consult doctors.

Most people like to blame their tired feeling on vitamin or iron deficiency, constipation, glandular malfunction, or low blood pressure. But only in exceptional cases can doctors blame it on a specific physical ailment.

On the other hand, whatever it is that produces chronic fatigue also seems to produce most of the so-called psychosomatic diseases.

Both have a direct relation to the patient’s way of living, his family, his problems, his anxieties, the pressures under which his life is spent.

In Harvard College, for instance, Dr. Bock notes that the rate of illness is highest for freshmen, whose problems of adjustment often lead to worry and frustration.

The tired feeling of which these young men complain more frequently than upperclassmen seems to be associated with the development of other symptoms like colds, headaches, digestive upsets, and even appendicitis.

Fatigue may have no other expression than the inability of the person to carry on the day’s work.

Or it may crystallize in such states as hyperthyroidism, duodenal ulcer, ulcerative colitis, chronic indigestion, dermatitis, so-called sinusitis, backache, repeated respiratory infections, rheumatoid arthritis, simulation of bowel obstruction, and frequent and varied cardiac disorders.

I doubt if we can eliminate fatigue as an important cause in premature coronary arteriosclerosis (hardening of the arteries).

In treating diseases associated with chronic fatigue, Dr. Bock suggests that physicians, should restrain their impulse to hand out prescriptions and should try a little harder to understand the underlying causes in the patient’s personality.

To those who doubt that emotional factors can cause disease symptoms, he asks:

How is it that a man who has been vomiting for three weeks can, on being sent off fishing, eat baked beans and bacon the morning after his arrival in camp?

Obviously the fatigue reaction is no way to handle a difficult situation. Tiredness only makes things worse.

Yet psychiatrists believe there is a motive behind even the most illogical behavior if only one can probe deeply enough to find it.

Once the hidden motive is brought to light, the person can subject it to reason and free himself of the need to obey it.

What is the hidden motive behind chronic fatigue?

The great majority of the people feel the symptoms after an important change in status, such as marriage, childbirth, the loss of an important member of the family, or a major alteration in occupation.

Another clue is that fatigue invariably occurred when the person felt rejected, angry, frightened, or enraged in circumstances which prevented any expression of these feelings.

One woman who lived in difficult circumstances with a tyrannical and talkative invalid mother often had to suppress a strong desire to shout, “Shut up!”

When her tension became almost unbearable she would be overcome by a feeling of lassitude and go back to bed for the rest of the day.

Another patient who had plenty of energy for work felt completely exhausted when he came home at night and saw his wife.

It developed that his immediate idea of seeing her was a murderous one, blocked and replaced at once by the feeling of tiredness.

It became apparent that the fatigue of which the subjects complained wasn’t just a lack of desire to act – but a positive desire not to act in a certain way.

In every case, the person seemed to be using fatigue as a kind of roadblock to prevent himself from expressing forbidden feelings in words or acts.

Human beings, Drs. Shands and Finesinger point out, are highly social creatures – so much so that your picture of yourself as a member of the group is more important to you than the way you stack up as an individual.

In growing up, you form an ideal picture of yourself in relation to your fellows which pretty much determines the way you feel and act.

But every now and then your self-esteem is threatened by an impulse to act in a way that’s out of character with your ideal self.

Fatigue resolves this unconscious conflict by rendering you too tired and weak to act on the forbidden impulse.

Since many impulses we suppress as out of keeping with our ideal selves are sexual in nature, you might expect guilt feelings about sex to make people tired – and this is the case.

Doctors and marriage counselors say one of the most common complaints of husbands and wives who fail to find sexual satisfaction is that one or the other is “too tired.”

The blocking of sex impulses as out of keeping with the ideal self may also explain, in part, the lassitude and inability to concentrate which can occur to everyone at all seasons but is associated with spring and warm weather.

It may also be a factor in the spells of moody, drowsy, vacuous behavior which suddenly descend on teenage youth.

Even danger has a lethargic effect on people when they cannot admit they are afraid.

If you’ve ever been on a plane that has hit an unexpected storm you may have noticed the’epidemic of yawning among the passengers. When the danger is past, the lethargy suddenly gives way to great animation.

Like any other psychoneurotic symptom, chronic fatigue is an attempt to solve a problem by pretending it doesn’t exist.

Often this kind of fatigue can be dispelled merely by dredging up the problem to the surface of consciousness, talking about it rationally, and trying to find a realistic solution.

In many cases, all this involves is admitting mixed feelings about persons for whom one is supposed to feel only the purest sentiments.

Next time you’re tired, remember: If it’s physical fatigue, you can sleep it off; if it’s chronic fatigue, try laughing it off.

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