Chronic fatigue is a very different experience than simply feeling tired at night before bedtime. The word 'chronic' means recurring and constant. Chronic fatigue is an unshakeable tiredness no matter what the situation, stress level, or circumstances surrounding a day or week.
This type of fatigue is a constant unwelcome companion for those who struggle with it. Here is the main gist of chronic fatigue in a nutshell:
Sounds kind of tiring, huh? If energy is low all the time, where is it going? In fact, a key to understanding the Fatigue Cluster is to think of it as both a physical and a mental-emotional syndrome. Let's explore how low energy can come about, how it contributes to fatigue, and what other symptoms usually travel with the tiredness.
It makes sense that fatigue can enter people’s lives at times, especially under stressful circumstances. But a period should not dot the statement “I’m tired all the time” in a doctor’s office. Depending on how long the fatigue has been around and what impact it's making on lifestyle, someone's constant tiredness could be a case of chronic fatigue.
Whether or not all healthcare practitioners agree on the term “chronic fatigue syndrome” existing, it is common sense that treating and alleviating a person’s fatigue can help improve overall health and contribute to healing other existing symptoms as well. Many times, the fatigue is the underlying foundation on which all the accompanying symptoms have built themselves.
But what is chronic fatigue, or fatigue in general? Does everyone experience it the same way, or does it differ depending on who you are? Read the next tab to explore fatigue in depth.
What is fatigue? Fatigue is mainly a symptom of deficiency, or not having enough. The primary deficiency during fatigue is one of little or no energy. When energy is lacking, either not enough energy is going into the body, too much energy is being drained from the body, or both as is often the case.
Juxtaposed with the energy drain, there is often less energy entering the body with disrupted diet and meal schedules, more coffee and junk food, less sleep or poor sleep quality, and less time to relax.
Energy is what the body and life rely on to get through the day, and then many days strung together. Metaphorically, you can’t drive a car without fuel in it, you can’t use your computer unless it’s been charged or has enough battery power, and a baby won’t grow without fuel. So of course the human body when relying on little to no energy will start showing that it’s not happy with the state of affairs. The body’s protest will look different for each person.
Sometimes energy it's not a case of energy draining out or not coming in. Energy can simply be stuck. Many people can relate to the idea of a "rut" in life. It's a prolonged period of time where the desired changes in life are not happening. During a rut, energy can just stagnate and feel stuck. This stuck energy can also lead to chronic fatigue-like symptoms.
And while he feels stuck, it’s almost as if the energy is stuck inside his body and unable to be expressed outwardly. Without an outlet, he starts feeling very tired, also becoming uninterested and bored regarding other areas of his life.
In this case, our imaginary person has energy reserves inside, but without the energy being able to flow outward it is becoming suppressed, stagnant, and tiring. He starts to experience typical fatigue-related symptoms.
Whatever the case, chronic fatigue feels like an energy switch constantly in the "off" position that's difficult to turn back on. What factors contribute to it? It's impossible to talk about chronic fatigue without first acknowledging the mental-emotional factors that are often tied in with this condition. Let's look at that next.
Mental-emotional shifts can happen during chronic fatigue syndrome, including depression. Not everyone with chronic fatigue suffers from depression, but for those who do, that component must also be treated for full recovery. Depression can cause extra amounts of fatigue for someone who is already chronically tired, and the whole experience can feel like a black hole where energy is sucked in never to return.
The fact that depression frequently accompanies chronic fatigue makes sense if you think about it. Both conditions can make you feel like a weight or a burden is pressing down on you, making it more difficult to live the way you want. Depression brings this feeling into the mental-emotional realm, while chronic fatigue symptoms make the body feel tired and older than it is age-wise. It may seem like taking on the mental-emotional aspects of depression will make a chronic fatigue sufferer even more tired, but it is actually the opposite.
Alleviating the effects that any existing depression has on the body will free up energy for someone to explore the root causes of his or her chronic fatigue. Have you ever heard the expression "Life sucks"? Well, depression that is ignored can suck energy out of life too. The relationship between depression and chronic fatigue is important to explore so they do not create a vicious cycle with each other.
What are some contributing factors to chronic fatigue syndrome? We'll explore that in the next tab.
Life is full of challenges for most people, ones that are desirable but also many that aren't. It's often hard to pinpoint just one cause underlying chronic fatigue, as most theories would fall short and be too simplistic. Here are some factors that the medical community typically considers first:
- Anemia caused by low iron
- Viral infection
- Weak immune system
- Low blood sugar
- Autoimmune condition
- Hormonal imbalance (especially cortisol)
What is difficult is when lab work and evaluations are done to test for all the above factors and none of them come out with positive results. What then? It doesn't always make sense to spend tons of money to do every test under the sun waiting until one of them comes out positive. A doctor may act like all the tests are important to do, but what if a gamut of tests are being done because the doctor just doesn't know what's going on? This is the kind of critical eye that is important to maintain when getting checked out for what is typically considered a "vague" diagnosis in the medical community.
One statement that might be important to explore during a case of chronic fatigue is "Life is hard." It can be trying for people to act like life is not hard, and society often implies this expectation in day-to-day functioning. But sometimes admitting that hardships do exist rather than trying to ignore or belittle them can create a powerful experience for someone going through chronic fatigue. Of the more medical explanations above, most of them are brought on by wear and tear on the body and mind in the process of living life and facing its challenges. They do not exist isolated in test tubes in a lab.
Next, let's check out the typical symptoms that accompany chronic fatigue syndrome.
Chronic fatigue mimickers are conditions that typically present in a similar way to chronic fatigue syndrome. They are important to ask about or rule out before proceeding with treating symptoms, and that is what most doctors will do before starting treatment. These other conditions include:
- Sleep apnea (snoring during sleep)
- Eating disorders
- Relapse of an illness that was treated before
- Heavy substance use or abuse
- Being overweight
These conditions can exist alongside chronic fatigue, but tending to them first can often help reduce symptoms. No, on to chronic fatigue itself, how does the medical community decide if you have it. Their criteria go as follows: You would need to have severe fatigue for at least 6 months that's not caused by another diagnosis (such as one of the ones above) and that does not get better with rest. You also would have 4 other specific symptoms that occur at the same time or after the fatigue sets in. These symptoms include:
- Impaired mental function (increased brain fog, forgetfulness, difficulty concentrating)
- Muscle and/or joint pains
- New types of headaches
- Tender lymph nodes
- Sore throat
- Non-refreshing sleep
- Feeling unwell and tired after exercise
Typically the majority of chronic fatigue happens to adult women in their 40's and 50's, but men experience it too. Some of the symptoms above sound similar to a cold, don't they? Let's explore the symptoms of chronic fatigue in depth, how they affect the immune system, and how they are interrelated. Read the Fatigue Stars to find out more.
Click through the symptoms below to find out more about the stars that make up the fatigue cluster. You'll notice how one star can easily affect other stars. For example, low energy can cause lowered immunity which can then lead to sore throats and tender lymph nodes. See how many connections you can spot among the fatigue stars. For more information and help on how to resolve fatigue that may be affecting your health, click on the button below to take the Fatigue Survey and visit our Services page.
Impaired Mental Function
Most of us don't consider how much energy goes into remembering where our keys are, concentrating on punching the right phone number into a cell phone, or just feeling generally prepared to think during a day....until we don't have that energy anymore. For people who experience chronic fatigue, physical exercise becomes more difficult and easily zaps energy, but so do the simple mental exercises required for daily living. All of a sudden where mental or physical exertion used to feel smoother and easier, now they are more like obstacles not worth doing unless you have to.
There are a couple reasons why mental function can be impaired during chronic fatigue syndrome. For starters, the digestive and immune systems are often compromised during chronic fatigue. The triggering event, whether clinical, emotional, or stress-related will compromise the immune system and more easily allow unwanted pathogens into the body. A majority of immune tissue lives in the gut, making the digestive system more susceptible to weakness as well. Without proper digestion, nutrients are not assimilated into the body to give us--and our brains--the energy we need.
The second reason why mental function can be impaired during chronic fatigue syndrome involves the triggering event itself. Often, there is an underlying component of mental-emotional stress that propels the chronic fatigue to set in or to get worse. In fact, depression and chronic fatigue do occur together in many people who deal with this condition. While these emotional burdens exist at the forefront of life, it can be very challenging to key in to the most simple mental tasks, such as remembering a name or where you keep your checkbook.
The key to improving mental function in chronic fatigue cases is to address both the immune system's health and any underlying mental-emotional factors that have played a part in bringing on the condition in the first place.
Muscle and Joint Pains
How do muscle and joint pains come about in chronic fatigue syndrome? Most people with chronic fatigue will report these pains for a prolonged period after exercising. Exercise is good for the body, but it can also be a nuisance for a body that doesn't have enough energy for it. How?
Exercise puts the body through wear and tear. For someone with strong health and immunity, the minor soreness that the muscles and joints experience is no big deal. The musculoskeletal system will feel piqued for repair, allowing the active individual to experience the benefits of weight loss, increased muscle tone, and overall vitality.
For someone with chronic fatigue, the musculoskeletal system is not piqued for repair and the body is not prepared to endure any large dips in energy, a resource it already feels deprived of. Additionally, exercise form and execution is typically poorer for those who have less energy to expend, resulting in a higher chance of injury. So, the little irritations in a muscle or joint following exercise for a person with chronic fatigue become a big deal.
The weaker immune system will not follow up at the injury sites quite so efficiently as someone without chronic fatigue. Normally, the immune system would send an army of white blood cells to the site to release chemicals that help heal any damage. It is normal for healing tissue to experience inflammation and pain, but in someone whose immune system is weak, the pain will be prolonged, the healing slower, and the setback to physical activity greater.
Chronic fatigue sufferers may often feel like they are enduring a lingering cold that just won't go away. Typical common symptoms include:
- Sore throat
- Tender lymph nodes
- New types of headaches
These are all symptoms that someone who has in fact caught a cold bug would experience. So why does it happen during chronic fatigue. If there is one major system in the body that you can point at in chronic fatigue, it is the Immune System. Whatever triggers an individual's chronic fatigue, whether the ultimate cause is physical duress, mental anguish, a previous illness, or other underlying clinical explanation, almost always the immune system is primary among organ systems affected.
When the immune system is thrown out of whack, it not only makes exercise harder, thinking harder, and energy scarce, but it also predisposes the individual to exposure. What does exposure mean? Normally the immune system is effectively guarding and blocking against pathogens like bacteria and viruses, toxins, and even intangible threats from entering the body. What if it can't do that anymore? The body will start to feel more delicate, easily catching bugs from the environment. There are germs everywhere, it's the world we live in. So this person will start to feel a little ill, and the body will respond with sore throats, sore lymph nodes, unusual foggy headaches, and even other cold-like symptoms.
To eliminate the cold-like symptoms and susceptibility to overexposure to the environment, the immune system must be treated and healed.
Sleep helps restore the body's energy, assuming that the body is not in an energy deficit. For people who deal with chronic fatigue, the body is almost always in an energy deficit to some extent. The sleep that should normally restore that energy becomes ineffective at doing so.
The person will find that they drag themselves out of bed with every little energy and motivation to do so. Oftentimes, depression may play a part as well in chronic fatigue sufferers, and depression itself has an effect on disrupting sleep patterns.
Without refreshing sleep, a person's natural cortisol curve will be less robust and less able to handle the stresses of the day. That is also one reason why exercise becomes harder for those with chronic fatigue. Without a natural cortisol curve, it is also harder to prepare for restful sleep the next night, leading to a snowballing effect of fatigue and poor sleep.
Fatigue that is not made better by sleeping is one of the hallmark signs of chronic fatigue, and addressing sleep concerns should be part of the package of healing from chronic fatigue.
Lack of Motivation and Enjoyment
A lack of motivation and enjoyment for activities you used to like can't be called a symptom, can it? Sure it can. People don't often realize how much doing what they love fuels them until those urges aren't there anymore. Many chronic fatigue sufferers are plagued with the feeling that they no longer love to do anything and the lack of motivation can be as painful as muscle and joint pains for someone with this condition.
Usually, it isn't easy to spot at first. Life changes, and so do habits so at times it can look like "not doing anything" just means not doing anything for now. But the hard part comes when days string together into months, months string together into years, and years string together into a long time. Remember the part of Newton's First Law of Motion that states: A body at rest will remain at rest unless an outside force acts on it? Chronic Fatigue's Law of Motivation states: The person will remain unmotivated unless an outside force acts on it. Chronic fatigue doesn't naturally offer a window of relief like a cold or flu will. A person with chronic fatigue must play an active part in getting better or life will keep looking lusterless.
Fortunately, whether with little steps or broad strokes, it is possible to get better from chronic fatigue and to once again enjoy the activities you used to and you may enjoy in a brand new way after recovery.