Many people don’t realize fatigue is a symptom, not a disease, and proper treatment depends on establishing its real cause. We all feel it. For some, it’s the chronic complaint that has been nagging them for years. For others, it’s the temporary yet annoying phenomenon that keeps them from feeling in top condition.
What triggers chronic fatigue syndrome?
Fatigue can be physiological – caused by overwork, lack of sleep, faulty diet, inadequate exercise, or even noise.
There is also the pathological sort of fatigue where tiredness may be an early warning for such problems as hepatitis, anemia, or other medical disorders. Naturally, you should have checked with your doctor before now, to make sure that there is no physical reason for your fatigue.
But fatigue’s most common cause is emotional or psychological – the results of frustrations, guilt, anxiety, boredom, of the tired housewife syndrome.
Dr. S. Howard Bartley, one of America’s foremost authorities on fatigue, offers these observations about it:
- Fatigue comes and goes through the day, and one does not always feel as tired at night as in the morning.
- A person can wake up in the morning after a full night’s sleep and feel more tired than when he or she went to bed.
- One becomes more tired doing something unpleasant than something enjoyable.
- Although worn out from a day at work, one can dance energetically all night or play nine holes of golf the same evening.
- If a particular chore is tiring the first time one attempts it, it will be tiring the next time, too.
- People cannot always pinpoint exactly what it is that makes them so tired.
A mental attitude is crucial. According to studies currently in progress at the University of Wisconsin, different individuals use up various amounts of energy doing the same thing, depending on how they regard the task.
If Harry believes that push-ups are exhausting, he may exert the same amount of energy to perform ten push-ups that Ernest, a sports enthusiast, uses to push himself up and down 15 times.
If a man is doing a job for which he feels poorly qualified or doesn’t enjoy, he will find it tiring no matter how little physical effort is involved.
Energy is the vital ingredient without which we do not feel quite alive.
To the person who is tired, a lively book may be boring, a delicious meal mediocre, a beautiful day uninteresting.
And the person whose energy level is low and whose spirits are faded is not very much fun to be with.
Most people don’t need to be told that life would take on brighter colors if they could inject more vitality into it.
But is such a transformation possible?
Yes, it is possible to replenish your personal fuel reserves, to work a harder day and yet enjoy leisure time more.
The first prerequisite for freedom from fatigue is a healthy body. The second prerequisite, often closely tied to the first, is a healthy mind.
Doctors estimate that perhaps 80 percent of the legions of patients who complain of fatigue are talking about an emotional and not a physical problem. To a large extent, this psychological fatigue reflects the special stresses of 21st-century living.
Many of us live in crowded urban conditions and work in high-pressure situations; unlike our rural ancestors, we cannot go out and hoe a row of beans or walk through an apple orchard when the going gets tough.
For many people, exercise is the crucial missing element in their health picture and the one that is depriving them of a sense of well-being.
First, hard physical exercise and the fatigue it produces have a tranquilizing effect on the body. Second, exercise stimulates the circulation of blood to the brain, enhancing a sense of well-being. Third, exercise is a form of enjoyment and a person who is having fun is seldom fatigued.
For busy people, getting the daily half-hour minimum of exercise which doctors prescribe need not involve setting aside a special time. The cheapest and most practical form of exercise is walking. If possible, walk to work or to the train or bus. Walk to the local shops instead of driving. And walk upstairs instead of taking the lift.
A proper diet is another essential requirement. This means knowing the basic four food categories and how much of each is required; knowing what is a sensible weight-loss diet and what is merely fatiguing and unrewarding; drinking in moderation.
Very possibly you can make the diagnosis of the cause of your fatigue yourself. If poor circulation from lack of exercise is mainly at fault, you can easily set up your own exercise regimen, if fatigue is the consequence of an overburdened emotional life, professional counseling may be the answer.
There could be other obvious possibilities. Is your tiredness due to the fact that your shoes don’t fit properly, or your office chair is the wrong height?
Lack of oxygen can produce fatigue or high temperatures. People who work in poorly ventilated places tire more quickly.
It can be due to the way you stand or sit, unnecessary fatigue often troubles people who have “occupational posture” – like barbers, cleaners, truck drivers.
But the answer may not necessarily come at once, or so easily. Fatigue may result from a complex combination of factors. So prepare to take the long view, regarding fatigue not as an isolated phenomenon, but within the context of your internal and external life.
The crutches of drugs (unless under medical instruction and supervision) and alcohol are NOT the solution. They are temporary palliative, and, in excess, may aggravate the situation.
Our sense of well-being is influenced not only by mental and physical health but by the time of day.
Many misunderstandings occur and false accusations are hurled as a result of failure to appreciate the wide variations in individual body rhythms.
For example, George discovers that his new wife Gerry has absolutely no intention of making breakfast for the two of them in the morning. She dozes away until he has finished shaving, staggers out of bed, and throws herself together to go to work.
George, on the other hand, is always the first to start yawning at a dinner party. Almost the minute the last bite of dessert has been swallowed, his eyes turn towards the door.
George is not antisocial, nor is his wife lazy. Their circadian rhythms – the built-in timing device that is attuned to the 24-hour turn of the earth – are very different.
The circadian rhythm is set slightly different for each person.
Understanding your own body clock can be a very effective way of fighting fatigue. If you understand your cycle, you will plan to be most active during the high periods and try to avoid knocking yourself out at the low points.
Obviously, the circadian rhythm influences us when we go to sleep. It also influences the body temperature (which goes up during the day and drops a degree or two at night) and body functions. Blood pressure, mood, pulse, respiration, blood sugar levels, amino acid levels, and the ability to metabolize drugs, all follow a rising and falling pattern.
The relation between how a person spends his time and his energy levels is a crucial one.
According to Alan Lakein, a time management consultant, there is always time to do what is important and still have plenty of time for relaxation.
“Most people don’t look ahead to a whole year or a whole lifetime. Essentially they start over every week and spend another chunk unrelated to their life goals. They are doing a random walk through life, moving without getting anywhere.”
Lakein feels that a pencil and paper are essential to any long-range planning and reorganization of life.
First list your priorities.
What are your lifetime goals? Fill up an entire sheet of paper with everything conceivable you would like to do – money, career, family, social, community, and personal goals. “Lose five pounds, visit Russia, get a new job, paint the kitchen.” might all go at random, on the same list.
When you have finished your list, place an “A” in front of three goals that seem most important. With a new sheet of paper, allow two minutes per item for writing down as many subgoals as possible: How will goal “A” be accomplished? What is the first step?
Next, select one item from each “A” goal and force yourself to start the wheels in motion the following week.
Every month, make a new list. Only by having a few clearly identified goals in life can you hope to make headway in achieving them.
The second question in the pencil-paper game: How would you like to spend the next five years?
Think about the things you really want to do. Be honest.
lt is easy to let the next five years roll along in their predictable fashion, but it is also possible to give some shape to your life despite obligations and limitations. If you can recognize certain things that you want, you will be much more likely to take them into consideration when making decisions.
“You look tired – you need a good eight hours of sleep.”
This is a time-worn and apparently logical piece of advice that is becoming more and more suspect. Recent research suggests first, that fatigue is frequently no barometer of lack of sleep, and second, that eight hours is no magic number in any case.
Some people sleep too much. Whether from boredom, emotional upset, or laziness, they fall into the habit of drifting back to sleep even when they are quite ready to get up. Consistent oversleeping can have as adverse an effect on the performance of the day’s duties as sleeping too little.
Oversleepers often feel sluggish for the entire day, because their basal metabolism has dropped so low.
Certainly, many people spend more time than they need to in bed, simply because they do not like the prospect of getting up to face what lies ahead.
Certainly, the basic antidote to fatigue is sleep, although chronic fatigue and lack of sleep are not necessarily related. Loss of sleep impairs judgment, slows down reaction time, and makes people jumpy and moody.
Today, scientists are constantly uncovering evidence of the relationship of noise to irritability, inefficiency, and fatigue.
The best way to combat noise pollution is to prevent it. Before casting stones at others, it might be wise to check whether you are making unnecessary noise. Here, a few reminders.
- Walk across the floor, don’t stamp. Spare the neighbors underneath and your own family.
- Put carpets on the floor.
- Don’t shout when you’re angry.
- Use plastic garbage cans.
- Don’t slam doors.
- Keep the radio, TV, or stereo at a level high enough to hear, not louder.
Fatigue is a frequent by-product of poor eating habits.
Both obese people and excessively thin people become tired more quickly than the rest of the population.
The fat person needs extra energy to move his bulky frame round, the thin person may have enough reserve fuel on his body to take him over long periods without food and rest.
The obvious answer is to lose or gain weight whichever is necessary. But pick a sensible, well-balanced diet. Poorly conceived, nutritionally unsound regimens leave the dieter mentally and physically run down.
So much for physical fatigue.
Family physicians were reporting, almost with unanimity, that in addition to whatever medical problems their patients might bring, well over 50 percent were suffering from varying degrees of emotional depletion – boredom, loneliness, and absence of purpose and direction in their lives. Chronic fatigue was the common manifestation of this new problem.
Potentially more dangerous, because less easily treated, psychological fatigue is the expression of inner tension, frustration, conflict. It is also the result of a permanent or temporary inability to deal with life in a productive way.
Depressed and bored people are particularly susceptible to fatigue. The fatigue produced by the stresses of 21st-century living is perhaps best exemplified by.
Exhausted mother syndrome
Every tired housewife is tired for different reasons. The one characteristic they share is genuine physical fatigue, sometimes experienced from the moment they wake up.
Superimposed on that fatigue are many possible layers of symptoms: anger, frustration, boredom, anxiety, depression.
One doctor said. “I see the tired housewife syndrome at various ages and stages… the trapped twenties, the trying thirties, the fearful forties, the frantic fifties, and the sad sixties.”
“There are reasons in each decade why women have difficulty coping with their roles which may be manifested by fatigue. I see the 4-F female: she’s furious, frantic, futile, and frustrated.”
Lack of money
Nothing is more fatiguing than a chronic lack of money. With an empty purse, the world is a dreary and burdensome place.
Many women who suffer “tired housewife syndrome” cannot make ends meet despite careful planning, or an unforeseen expense has thrown the budget out for several months, or a husband is difficult and refuses to believe how quickly the expenses add up.
Many women envision themselves as the central figure in a drama without whom the play cannot go on. Naturally, it is fatiguing to be on stage all the time.
“I always felt that if I retired to my bedroom and flopped with a book, the household would go to pieces.” one woman confessed.
“The minute I got upstairs and shut the door, somebody would start whining somewhere. My son would be looking for his sweater and calling to me to find it, or my daughters would start an argument in the kitchen.”
“One day I sat them all down and explained to them that mothers are not superhuman, they have needs like everybody else. I instituted a policy – for half an hour after dinner, no one was to disturb me, and any problems that couldn’t wait to be solved should be taken to Dad.”
“The children did not run to their father as quickly as they did to me – they knew better. Once I established the fact that I meant business, they left me alone. It’s made quite a difference in my mental and physical state. That half-hour of solitude gives me a chance to recharge my energies.”
Another woman who complained of frequent fatigue led what she considered a thankless existence.
She held a full-time job in a local store, and when she got home, ready to collapse from being on her feet all day, she had to get dinner for a husband and three teenagers. Since she made a point of not complaining and, in fact, rather enjoyed playing the martyr, the family took her efforts for granted.
Some doctors maintain that the “tired housewife syndrome” has become endemic largely because of cultural patterns.
The speed of social change in the past 60 years has far exceeded that of the preceding 600 years, and women have felt these changes even more than men. In this society, they play a multiplicity of roles.
The modern woman is a girlfriend, mother, and homemaker; her husband’s lover, housekeeper, companion, and friend. She’s also a part-time intellectual, a woman of the world, a community worker, property owner, and possibly has a job, too.
Theoretically, a variety of demands should spell challenge, not fatigue, yet a woman is more likely to feel that somehow her own identity has been submerged in all the roles she is obliged to play.
The result can be a sort of depression brought about by an upset of the give-get balance.
Empty nest syndrome
Just as her children reach the age where they can be enjoyed as individuals, she finds them looking beyond the home for stimulation. This is the beginning of the empty nest syndrome.
A few years later her children do leave the house and the woman is totally unprepared for the loneliness and the inevitable depression which fills it like water fills a sponge.
The best solution to the situation, doctors feel, is not to let it develop in the first place. A woman should not wait till her children are grown up to develop outside interests but should start from the early days of her marriage.
As the children grow older, she should spend an increasing amount of time away from them on things that interest her – like doing volunteer work, having lessons on some subject that absorbs her, learning a craft, taking up a hobby.
Although the tired housewife’s problems are receiving a wider airing today, not all listeners are sympathetic.
Dr. William A. Nolen, a well-known author-surgeon, tells women that “Most of you are tired for only one reason. You’re bored. Your kids are in school and off your hands for several hours a day.”
“You’re not fascinated with the job of cooking two or three meals a day. Your husband is a nice fellow, but after all, he has been around for a while. It seems as if all the challenge has gone out of your life and you’ve nothing to look forward to but more years of the same.”
For some or all of these reasons, he maintains, women demand a pill, an injection, or even an operation that will make them feel 15 years younger.
Unfortunately, however, “for the great majority of you, there is no pill, injection, or operation that’s going to help. Your tired-out feeling has psychological, not physical, causes. No doctor can cure it, you have to do it yourself.”
How to get over chronic fatigue
The important first step is to break your monotonous routine one way or another.
So it is up to a woman herself to make the first move toward creating a more satisfying lifestyle, whether she is married or single, a housewife, or a career woman.
The first step is to get over the mental attitude that life is passing her by. They think their youth is gone: they begin to see a few bulges here and there. They’ve lost their initial drive and push.
Many women have unrealistic expectations of life, and consequently, react with frustration and unhappiness when they see that their lives have little in common with TV commercials or movie stories.
Disappointment is particularly a problem for women who reach the age of menopause, and who fear the passing of their youth, their family life, their femininity.
Unfortunately, some women are so used to their fatigue that they are afraid of change. They don’t like being tired, but at least it’s a familiar feeling.
Children are not the only people who are entitled to have fun. Adults bogged down in responsibility, may forget that they, too, have the right to play and to enjoy.
We live in a world in which we are very conscious of things that produce stress: the competitive pressure on business executives, the difficulties of modern marriage, and so on.
Not that stress is a new problem, although today it is surfacing in more recognizable ways. Also, the term is now used in a sort of wastepaper basket sense to apply to virtually any emotional or mental problem after the event.
One reason which has been offered for the growing incidence of stress is that modern societies have largely lost the supports that helped people of earlier ages to endure physical and mental toil and hardship.
These include religious faith, sustaining frameworks of tradition and custom, a sense of place in the social order, a sense of worth derived from the exercise of craftsmanship, and awareness that toil, hardship, and suffering were likewise endured by the other members of the same community and the same social class.
And in today’s urban environment, the communications media remind us constantly of what everybody else is doing and how well.
A person who grows up with the idea that “any farm boy can become President” can create terrible pressure on himself. He is constantly wondering whether he shouldn’t be striving harder to make it to the next socio-economic plateau.
The world’s leading authority on the abject of stress, Dr. Hans Selye. of Canada, points out that human beings are like car tires: they last longest when they wear evenly.
People who notice they have been keyed up for days on end should stop whatever it is they are doing and take a rest, even if it means deferring certain musts.
Dr. Selye explains that the hormones produced during acute stress are meant to alarm the individual and gear him for peak accomplishments. Although they make a person alert for short periods, they cannot be used for recharging all day long.
In the end, it’s the strain, not the stress, that makes for problems. The strain is the sum total of all the little stresses that a person didn’t deal with too well or used up a lot of adrenalin getting through – in other words, the wear and tear of life.
Be aware of where the stress is in your life and try to adjust to it. In other words, if you are changing jobs, put off buying a new house. If you have just lost your job, it’s not the time to experiment with marital separation.
Occupational stresses can include insecurity over having to do a task beyond normal scope: difficult bosses or subordinates; worry over responsibility for other people; feeling of non-participation in decisions affecting the job.
Nobody escapes occasional waves of anxiety when for no apparent reason a vague, unpleasant sense that something is amiss or that something is about to go wrong comes over one.
Fatigue is one of the most common symptoms of anxiety. It is very tiring to live constantly with ill-defined fears or tensions. The chronic anxiety sufferer is often irritable, tense, nervous, restless, a poor sleeper. Some sufferers eat too much, others find they have no appetite.
Frequently, feelings of anxiety rest on the unanswered question: “Am I good enough?” We are constantly measuring our attributes and achievements against those of others, taking inventories of ourselves.
Few come out on top all the time and in every respect. Yet many people cannot face this fact.
Here are a psychologist’s suggestions for coping with this situation.
1. Identify your feelings
Admit that you, like everyone else, are vulnerable to disappointment, anger, conflict, sadness. Recognition of “I feel hurt” or “I feel resentful” can prevent it from turning into a mysterious ailment or into an attack on people around you, and releases tension.
2. Don’t expect too much of yourself
Perfection is not a normal human condition. Learn to live with an occasional unmade bed, an unfinished pile of correspondence, a sister who doesn’t always approve, a husband who sometimes complains about dinner.
Accept that there are always people who are more intelligent, more attractive, more successful, and stop making comparisons. Instead take stock of your own resources and capabilities and learn to value them.
3. Recognize that occasional anxiety is an inevitable part of life
You might feel anxious when facing a problem at work, before taking a test, or before making any important decision. Even if you take up residence in an African jungle, far from the stresses of civilization, you will not escape it.
4. Brace yourself and plan for ways to soften the blow
For example, when you get home from a fabulous three-week holiday start taking piano lessons or do something that has a sense of purpose.
Self-help requires courage, dedication, and strength.
Once you take the first steps, however, the rest follow much more easily. Make a conscious effort to get yourself out of yourself. Go to a party even though you are tired: attend a meeting even though you don’t feel like talking to anybody.
For many people, the antidote may be to throw themselves into physical work – to weed the garden, polish the car, clean out a cupboard.
There is no state of nervousness, worry, irritability, hate, aggression, impatience, self-pity, resentment, or jumpiness that is not dependent on tense muscles. So learn to relax them.
Clench your fingers tightly, then loosen them very slowly. The more slowly you relax, the more deeply you will be conscious of the feeling of relaxation, and your control of it.
Patience is required: the technique cannot be learned in a day.
Finally, remember that anxiety is not always bad for you and that it can be the prelude to periods of growth. You feel tense when you key yourself up to do something important or intimidating, but often you have the sensation afterward of a pole vaulter who has just beaten his previous record.
It should be noted that, at times, symptoms indicate not difficult life situations or psychological pressures, but simple changes of mood. Everyone has his own internal clock; some people are edgy and fussy early in the morning, while others bound out of bed with a smile on their faces.
People’s moods also fluctuate on a long-term basis, shifting back and forth from periods of relative contentment to relative depression. Most mood cycles run on a four-to-five week basis, but they can run as short as two weeks, or as long as several months.
In women, mood changes are often closely tied to the menstrual cycle.
In addition to biological factors, we are constantly reacting to our environment: the sight of a park full of flowering trees on a spring morning can gladden the heart.
Many working people drag themselves gloomily to the office on a Monday morning, then their spirits rise gradually as the Friday afternoon liberation approaches.
Unfortunately, many people equate cheerfulness with virtue, a broad grin with a good personality, a happy frame of mind with the way things ought to be.
Anybody who is perpetually cheery has to be pretty insensitive to the way things are in the real world. In fact, feeling bad about the way things are is good – if it inspires us to work at making things better.
So it is natural and human to feel low at times.
Perhaps your tiredness is based not on over-exertion, but on just plain boredom.
Even interesting things become boring if overdone. Variety is not the spice, but the very stuff of life.
Occasional boredom is an inescapable part of the human condition, and people who claim they are never bored are rare.
Not everyone is convinced that boredom is entirely a bad thing, however.
In “The Conquest of Happiness” Bertrand Russell maintains that in order to accomplish something worthwhile, a person must have the capacity to endure boredom and monotony. Modern man, he feels, is probably less bored than his ancestors, but more afraid of boredom and less willing to accept it as a part of life.
Dr. Martin, a former chairman of the committee on uses of leisure time of the American Psychiatric Association, said:
“Millions of people are tragically bored, jaded. They miss the subtleties of life. They will travel miles to see the Cape Kennedy rockets, but overlook the firefly in their garden.”
Conclusion on chronic fatigue syndrome
The prescription for fighting boredom is the prescription for fighting almost any kind of emotional fatigue. Try to develop your inner resources – imagination, perception, contemplation. Open the windows of your mind.
Chronic fatigue can be cured only by understanding and attacking its deep, rooted causes, but various emergency measures can give you the quick energy boost you need to get through a morning of meetings or a long boring evening.
- Lie down with your feet up for ten minutes, eyes closed.
- Take a cold shower. If you are tense as well as tired, take a warm bath first, then a cold shower.
- Walk quickly or run around the block, taking deep breaths of air. Or just open the window and breathe deeply.
- Start thinking about a pleasant event scheduled for the future – a dinner party, a wedding, a trip.
- Break your daily eating patterns – have pizza for lunch instead of cottage cheese.
- Call an old friend you’ve been meaning to talk to for a long time.
- Get the chores you dislike out of the way early in the day.
Although these simple measures can provide the necessary jolt, essentially they represent only patches on the threadbare lyre. Take a look at the real problems and how to deal with them on a long-range basis. An understanding of fatigue demands careful self-appraisal.