FATIGUE, ARE YOU TIRED OF IT? IT'S MORE THAN A GOOD NIGHT'S SLEEP CAN CURE...

Fatigue is a symptom – something you can feel and describe – not a condition or disease. To reduce your fatigue you first need to understand what the underlying reasons for your fatigue are. Fatigue is hard to describe. You feel like you don't have any energy and are tired all the time. But there's not a specific cause, such as doing errands all day, working out, or other exertion. When you're tired from exertion, if you get enough sleep that night, you usually feel better the next day. With fatigue, you feel generally tired all the time and lose interest in people and the things you normally like to do.

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It isn’t the same as simply feeling drowsy or sleepy. When you’re fatigued, you have no motivation and no energy. Being sleepy may be a symptom of fatigue, but it’s not the same thing.

Fatigue is a common symptom of many medical conditions that range in severity from mild to serious. It’s also a natural result of some lifestyle choices, such as lack of exercise or poor diet.

WHAT CAUSES FATIGUE?

The wide range of causes that can trigger fatigue include:

• Medical causes – unrelenting exhaustion may be a sign of an underlying illness, such as a thyroid disorder, heart disease or diabetes. There are a number of diseases and disorders which trigger fatigue. If you experience prolonged bouts of fatigue, consult your doctor.
• Lifestyle-related causes – alcohol or drugs or lack of regular exercise can lead to feelings of fatigue.
• Workplace-related causes – workplace stress can lead to feelings of fatigue.
• Emotional concerns and stress – fatigue is a common symptom of mental health problems, such as depression and grief, and may be accompanied by other signs and symptoms, including irritability and lack of motivation. Fatigue is a common symptom of anxiety, depression, and seasonal affective disorder.
• Chronic fatigue syndrome (CFS) is a complicated disorder characterized by extreme fatigue that lasts for at least six months and that can't be fully explained by an underlying medical condition. The fatigue worsens with physical or mental activity, but doesn't improve with rest.

Medical conditions that can cause fatigue. Examples include:

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anemia, arthritis, fibromyalgia, chronic fatigue syndrome, infections, such as cold and flu, Addison’s disease, a disorder that can affect your hormone levels, hypothyroidism, or underactive thyroid, hyperthyroidism, or overactive thyroid, sleep disorders, such as insomnia, eating disorders, such as anorexia, autoimmune disorders, congestive heart failure, cancer, diabetes, kidney disease, liver disease, chronic obstructive pulmonary disease (COPD), emphysema.

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Lifestyle-related causes of fatigue

Common lifestyle factors that can cause fatigue include:

• Lack of sleep – typically adults need about eight hours of sleep each night. Some people try to get by on fewer hours of sleep.
• Too much sleep – adults sleeping more than 11 hours per night can lead to excessive daytime sleepiness.
• Alcohol and drugs – alcohol is a depressant drug that slows the nervous system and disturbs normal sleep patterns. Other drugs, such as cigarettes and caffeine, stimulate the nervous system and can cause insomnia.
• Sleep disturbances – disturbed sleep may occur for a number of reasons, for example, noisy neighbours, young children who wake in the night, a snoring partner, or an uncomfortable sleeping environment such as a stuffy bedroom.
• Lack of regular exercise and sedentary behaviour – physical activity is known to improve fitness, health and wellbeing, reduce stress, and boost energy levels. It also helps you sleep.
• Poor diet – low calorie diets, low carbohydrate diets or high energy foods that are nutritionally poor don’t provide the body with enough fuel or nutrients to function at its best. Quick fix foods, such as chocolate bars or caffeinated drinks, only offer a temporary energy boost that quickly wears off and worsens fatigue.
• Individual factors – personal illness or injury, illnesses or injuries in the family, too many commitments (for example, working two jobs) or financial problems can cause fatigue.

Workplace-related causes of fatigue

Common workplace issues that can cause fatigue include:

• Shift work – the human body is designed to sleep during the night. This pattern is set by a small part of the brain known as the circadian clock. A shift worker confuses their circadian clock by working when their body is programmed to be asleep.
• Poor workplace practices – can add to a person’s level of fatigue. These may include long work hours, hard physical labour, irregular working hours (such as rotating shifts), a stressful work environment (such as excessive noise or temperature extremes), boredom, working alone with little or no interaction with others, or fixed concentration on a repetitive task.

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• Workplace stress – can be caused by a wide range of factors including job dissatisfaction, heavy workload, conflicts with bosses or colleagues, bullying, constant change, or threats to job security.
• Burnout – can be described as striving too hard in one area of life while neglecting everything else. ‘Workaholics’, for example, put all their energies into their career, which puts their family life, social life and personal interests out of balance.
• Unemployment – financial pressures, feelings of failure or guilt, and the emotional exhaustion of prolonged job hunting can lead to stress, anxiety, depression and fatigue.

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Psychological causes of fatigue

Studies suggest that psychological factors are present in at least 50 per cent of fatigue cases. These may include:

• Depression – this illness is characterised by severe and prolonged feelings of sadness, dejection and hopelessness. People who are depressed commonly experience chronic fatigue.
• Anxiety and stress – a person who is chronically anxious or stressed keeps their body in overdrive. The constant flooding of adrenaline exhausts the body, and fatigue sets in.
• Grief – losing a loved one causes a wide range of emotions including shock, guilt, depression, despair and loneliness.

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Chronic fatigue syndrome (CFS),

Also known as myalgic encephalomyelitis (ME), is an illness that affects a person’s nervous system (commonly called a ‘neurological illness’). It can occur at any age and can affect children as well as adults.

The term ‘myalgic encephalomyelitis’ means pain in the muscles, and inflammation in the brain and spinal cord. ME/CFS is a complex illness and we do not know the cause. For some people, the condition may be triggered suddenly by a viral infection, toxic exposure, anaesthetic, immunisation, gastroenteritis or trauma. In other people, ME/CFS may develop slowly over months or years.

There are many subtypes within the spectrum of ME/CFS, which means that a management plan must be developed for each person with the condition. Applying a particular treatment for one subtype can be very damaging to another subtype. An individual management plan must be developed for each person with ME/CFS.
 

Around 25 per cent of people with ME/CFS will have a mild form and be able to get to school or work either part-time or fulltime, while reducing other activities. About 50 per cent will have a moderate to severe form of ME/CFS and not be able to get to school or work. Another 25 per cent will experience severe ME/CFS and have to stay at home or in bed.

SHOULD I SEE MY DOCTOR?

You should make an appointment with your doctor if you’re feeling fatigued and you:

• can’t think of anything that might account for your fatigue
• have a higher-than-normal body temperature
• have experienced unexplained weight loss
• feel very sensitive to colder temperatures
• regularly have trouble falling or staying asleep
• believe you may be depressed

If you’ve made efforts to address the most common lifestyle causes, such as lack of rest, poor eating habits, and stress, without success, and your fatigue has continued for two weeks or more, make an appointment with your doctor.

In some cases, your fatigue might be caused by a serious medical condition. Go to the hospital immediately if you experience fatigue along with any of the following symptoms:

• rectal bleeding
• vomiting blood
• severe headache
• pain in your chest area
• feelings of faintness
• irregular heartbeat
• shortness of breath
• severe pain in your abdominal, back, or pelvic region
• thoughts of suicide or self-harm
• thoughts of harming another person

TREATMENT OPTIONS

Your doctor’s recommended treatment plan will depend on what’s causing your fatigue. To make a diagnosis, they will likely ask you questions about:

• the nature of your fatigue, including when it started and whether it gets better or worse at certain times
• other symptoms that you’ve been experiencing
• other medical conditions that you have
• your lifestyle and sources of stress
• medications that you’re taking

As fatigue can present a vast range of symptoms and be caused by many different factors working in combination, diagnosis can be difficult. Chronic fatigue can be persistent or come and go but will have lasted at least  four months before a diagnosis can be made. Your doctor may diagnose fatigue using a number of tests including:

• Medical history – recent events such as childbirth, medication, surgery or bereavement may contribute to fatigue.
• Physical examination – to check for signs of illness or disease. Your doctor may also ask detailed questions about diet, lifestyle and life events.
• Tests – such as blood tests, urine tests, x-rays and other investigations. The idea is to rule out any physical causes, for example anaemia, infection or hormonal problems.

Many people with chronic fatigue syndrome benefit from:

• Talking with a counselor can help build coping skills to deal with chronic illness, address limitations at work or school, and improve family dynamics. It can also be helpful for managing depression.
• Addressing sleep problems. Sleep deprivation can make other symptoms more difficult to deal with. Your doctor might suggest avoiding caffeine or changing your bedtime routine. Sleep apnea can be treated by using a machine that delivers air pressure through a mask while you sleep.
• Aggressive exercise regimens often lead to worsened symptoms, but maintaining activities that are tolerated is important to prevent deconditioning. Exercise regimens that start at a very low intensity and increase very gradually over time may be helpful in improving long-term function.

A lifestyle changes may help ease your fatigue To help boost your energy levels and overall health:

• drink enough fluids to stay hydrated
• practice healthy eating habits
• exercise on a regular basis
• get enough sleep
• avoid known stressors
• avoid a work or social schedule that’s overly demanding
• take part in relaxing activities, such as yoga
• abstain from alcohol, tobacco, and other illicit drugs

It’s also important to follow your doctor’s recommended treatment plan for any diagnosed health conditions. If left untreated, fatigue can take a toll on your physical and emotional well-being.

There are lots of alternative treatments for chronic fatigue syndrome. These range from acupuncture, chiropractic, therapeutic massage to nutritional supplements & diet, homeopathy, herbal remedies, and people get different degrees of relief from them.

Let's investigate some of them.

Mind-Body Healing

Your doctor or health care provider might recommend that you try acupuncture, gentle massage, deep breathing, relaxation therapy, yoga or tai chi. The goal is to boost your energy, curb pain, or ease some of your other symptoms.

Some studies show that acupuncture could reduce both mental and physical fatigue and depression in people who have ME/CFS. Researchers have done some experiments where researchers compare one treatment to another or to no treatment at all. They found that certain types of massage, including tui na (a type of Chinese massage) might help with some symptoms like depression, fatigue, pain, and insomnia.

"Mindfulness-based" stress reduction, which combines deep breathing and meditation, could help reduce anxiety and other symptoms and improve quality of life in general, according to a few studies.

Talk Therapy

Several studies have found that a particular kind of talk therapy called cognitive behavioral therapy (CBT) might reduce your symptoms. It can also help with the depression, stress, and anxiety that often go along with chronic fatigue syndrome.

Physical Therapy

Some research has shown that graded exercise therapy can help reduce symptoms of ME/CFE and improve stamina. This is a form of physical therapy that starts out with very little exercise and slowly adds more over time. The goal is to stop before you get tired, then go a little longer each time.

Homeopathy

Homeopathy intervention can be very effective in treating CFS, but it is important to remember that in most chronic fatigue cases it is highly likely that more than one remedy will be needed on different occasions. CFS is a serious and disabling illness, causing varying degrees of disability. In the past it has not always been given much recognition as a severe illness – mainly by doctors, it must be said – probably because the direct causes and pathology of CFS are not really known. To help patients with this illness more than one approach will usually will be needed, homeopathy being one, as well as physiotherapy and psychological treatments. Support groups can be useful.

Fatigue especially if it is a chronic can completely interrupt/ interfere with your life, leaving you too tired to do even the most basic things for yourself and your family. There is no magic bullet but changes to lifestyle and the incorporation of some alternative therapies could be just what you are looking for.