Surviving Chronic Fatigue
As a chronic fatigue survivor myself, I understand what it's like to be so incredibly tired that you cannot remember what it felt like to be you. As though your very bones are tired. As though someone took your batteries out and you have nothing left at all. Empty.
People used to say, "Maybe you just need to rest", but I knew there was something wrong. I got so tired I would have to sit down right where I was, because there was no choice. I've sat down in Safeway, on the floor of the produce aisle, like a wilted vegetable. I've sat on the curb of sidewalks and on the tarmac in parking lots. When a friend said, "One day I watched a towel drop off the towel rail and I cried because I had no idea how I would pick it up again", I knew she got it. Chronic fatigue makes you that tired. I estimate that at the peak of it, I was sleeping up to 18 hours a day.
But it's not just the fatigue. Your brain stops working too. During a bad week, at the doctor's, when they asked me to fill my own name and address out on a form, I wept because it was so difficult.
It takes time to get better, but it can be done!
All in all, it took me five years to come out of chronic fatigue. Now, a further five years on, I'm grateful for everything: for hiking, dancing, swimming and being able to lift things. For a brain that works (even if it doesn't feel quite as sharp as it once did). For restful sleep, for feelings of liveliness and energy. For calm.
It was an odyssey. I saw a medical doctor who tried to diagnose me with depression. I saw a naturopath who gave me diet advice, vitamin injections and adrenal hormones. Finally I saw a medical doctor with a naturopathic focus, who correctly diagnosed me with subclinically low thyroid, and put me on thyroid hormone. It worked, and I began the slow haul back to health. It took a year for my brain to come back, and another year before I was able to exercise without suffering the famous fatigue hangover afterwards. Two years later I did a hill to coast hike in Marin and felt fine the next day--that was the day I knew I was cured.
Chronic fatigue and trauma
Chronic fatigue is caused by many factors. Markers in my blood showed that I had had mono, at some point. I also found food intolerances. But the main thing was that I had been through a lot of stress, and I had early trauma--a great combination that's proven to create a risk of illness. I am convinced that people who are carrying unresolved trauma burn through their stress-response system, and end up crashing into chronic fatigue. I had done years of therapy--but it wasn't somatic, trauma-focused therapy with a clinician who knew the physiology of trauma.
Now I have become the therapist I ought to have been seeing, and I treat people with chronic fatigue. Addressing your trauma, and your stress response, is the beginning of it. But you also need to treat your body in a whole new way. You're on a journey that will ultimately bring you a life filled with a lot more joy and happiness. But it will take a while. In the meantime, here are some suggestions.
What to do if you have chronic fatigue
Remember, this condition is about stress, and physical factors, so you are going to need to address multiple areas for the best chance at success.
1. Consult a medical doctor. (I would say you need a medical doctor, not just a naturopath, just in case you have something organically wrong.)
The doctor will test you for major infections, cancers, immune diseases and so on--it's good to eliminate these so you can either get treatment or stop worrying that you have something awful. (Worrying is a given in people with a lot of stress and trauma, so eliminating a source of anxiety is a good move.)
If you choose a naturopathically-oriented medical doc they will also test for heavy metals, food allergies, low thyroid, adrenal hormones and other things that may be making you tired.
One element often found in chronic fatigue is adrenal hormone imbalances--often due to prolonged stress. Stress causes the body to release cortisol. But prolonged stress and prolonged high cortisol is damaging to the body. One paradoxical effect can be very low cortisol, or cortisol peaks at the wrong time of day. (We're supposed to have peak cortisol in the morning, to help us get up and get moving. Then it tails off during the day, preparing us for rest and sleep.) If your levels aren't right, then that could be contributing to your fatigue.
Another common problem is thyroid hormone levels. If you're a woman in mid-life, your could be in peri-menopause, and there could be other hormonal elements involved. All hormones interact, so if your doctor prescribes them, it could take a while to get the right balance.
2. Clean up your diet. People with chronic fatigue can't afford to eat badly or follow fad diets--if you have chronic fatigue then you have special nutritional needs, and what's 'healthy' for your raw, vegan or breathairian friends may not be healthy for you. Consult a nutritionist, or ask advice from your doc. I was told to kiss goodbye to sugar, booze, caffeine and a lot of starch, and to bid a big welcome to balanced meals with adequate protein and a lot of green vegetables. Ask expert advice on what you should eat, and follow it.
3. Hydrate properly--again ask your nutritionist/doc for advice. I find that when I don't drink enough water, I get tired.
4. Rest. If your system is exhausted, it needs rest. Pushing against that doesn't help, at least until you get this thing stabilised. Then you can slowly and carefully get fit again. People with chronic fatigue were usually high achievers until they hit a wall of fatigue, so it can be hard for us to let go of being the fastest, the smartest, and fittest. But you need to learn a new way of being, that doesn't involve intensity. Respect your (new) limits and don't push yourself too hard.
5. Find gentle, safe ways to move your body. Exercise that doesn't raise your heart-rate, or peak your cortisol, can help you relax--check with your doc about this. Ask the doc about restorative yoga classes, progressive muscle relaxation, and gentle exercise like T'Ai Chi (though I remember being too tired to keep up with 81 year old Chinese T-Ai Chi teacher!)
6. Don't watch stressful TV or movies, or hang out with stressful people. You need to stop doing things that add stress to your system. Shows that raise your heart-rate are a no-no. Now is the time to watch feel-good shows that make you smile. Listen to your favourite radio shows. Rewatch old series that you loved as a kid. Hang out with people who are easy to get along with.
7. Learn to ask for help, and accept it. Now's the time to learn to receive, which can be hard for high-achieving, A-type people, even when they're exhausted. But people love to help. So let them do it! Take in love and care, and let them make the dinner and do the dishes, even if they don't do it quite right. Your job is to smile and say, "thank you".
8. Do one thing a day and let the unimportant stuff slide. When you have chronic fatigue, things get overwhelming really fast. I advise people to do one thing a day, because if you try to do everything on your list, the chances are you'll be so daunted by the prospect that you'll end up not doing anything. If you do one thing a day, you'll get a lot more done. Prioritise the important things, and let the rest slide. Adjust your expectations of yourself: the grass can get long and the house can get dusty; it will be OK.
9. Find a therapist with whom you can start to address your trauma and what it taught you about you and the world. Look for someone who knows about trauma, and who can help you resolve traumatic memories, and reset your stress response, which is probably stuck on overdrive. Chronic fatigue is hard to live with, and a therapist can help support you with the depressing effect of not being able to do what you used to take for granted. Later, your therapist can also help you set realistic goals for recovery, as you rediscover your life. Contact me for a free telephone consultation, about how I can help you manage your chronic fatigue.
10. Keep the faith. People do recover from chronic fatigue, and you can be one of them.
People used to say, "Maybe you just need to rest", but I knew there was something wrong. I got so tired I would have to sit down right where I was, because there was no choice. I've sat down in Safeway, on the floor of the produce aisle, like a wilted vegetable. I've sat on the curb of sidewalks and on the tarmac in parking lots. When a friend said, "One day I watched a towel drop off the towel rail and I cried because I had no idea how I would pick it up again", I knew she got it. Chronic fatigue makes you that tired. I estimate that at the peak of it, I was sleeping up to 18 hours a day.
But it's not just the fatigue. Your brain stops working too. During a bad week, at the doctor's, when they asked me to fill my own name and address out on a form, I wept because it was so difficult.
It takes time to get better, but it can be done!
All in all, it took me five years to come out of chronic fatigue. Now, a further five years on, I'm grateful for everything: for hiking, dancing, swimming and being able to lift things. For a brain that works (even if it doesn't feel quite as sharp as it once did). For restful sleep, for feelings of liveliness and energy. For calm.
It was an odyssey. I saw a medical doctor who tried to diagnose me with depression. I saw a naturopath who gave me diet advice, vitamin injections and adrenal hormones. Finally I saw a medical doctor with a naturopathic focus, who correctly diagnosed me with subclinically low thyroid, and put me on thyroid hormone. It worked, and I began the slow haul back to health. It took a year for my brain to come back, and another year before I was able to exercise without suffering the famous fatigue hangover afterwards. Two years later I did a hill to coast hike in Marin and felt fine the next day--that was the day I knew I was cured.
Chronic fatigue and trauma
Chronic fatigue is caused by many factors. Markers in my blood showed that I had had mono, at some point. I also found food intolerances. But the main thing was that I had been through a lot of stress, and I had early trauma--a great combination that's proven to create a risk of illness. I am convinced that people who are carrying unresolved trauma burn through their stress-response system, and end up crashing into chronic fatigue. I had done years of therapy--but it wasn't somatic, trauma-focused therapy with a clinician who knew the physiology of trauma.
Now I have become the therapist I ought to have been seeing, and I treat people with chronic fatigue. Addressing your trauma, and your stress response, is the beginning of it. But you also need to treat your body in a whole new way. You're on a journey that will ultimately bring you a life filled with a lot more joy and happiness. But it will take a while. In the meantime, here are some suggestions.
What to do if you have chronic fatigue
Remember, this condition is about stress, and physical factors, so you are going to need to address multiple areas for the best chance at success.
1. Consult a medical doctor. (I would say you need a medical doctor, not just a naturopath, just in case you have something organically wrong.)
The doctor will test you for major infections, cancers, immune diseases and so on--it's good to eliminate these so you can either get treatment or stop worrying that you have something awful. (Worrying is a given in people with a lot of stress and trauma, so eliminating a source of anxiety is a good move.)
If you choose a naturopathically-oriented medical doc they will also test for heavy metals, food allergies, low thyroid, adrenal hormones and other things that may be making you tired.
One element often found in chronic fatigue is adrenal hormone imbalances--often due to prolonged stress. Stress causes the body to release cortisol. But prolonged stress and prolonged high cortisol is damaging to the body. One paradoxical effect can be very low cortisol, or cortisol peaks at the wrong time of day. (We're supposed to have peak cortisol in the morning, to help us get up and get moving. Then it tails off during the day, preparing us for rest and sleep.) If your levels aren't right, then that could be contributing to your fatigue.
Another common problem is thyroid hormone levels. If you're a woman in mid-life, your could be in peri-menopause, and there could be other hormonal elements involved. All hormones interact, so if your doctor prescribes them, it could take a while to get the right balance.
2. Clean up your diet. People with chronic fatigue can't afford to eat badly or follow fad diets--if you have chronic fatigue then you have special nutritional needs, and what's 'healthy' for your raw, vegan or breathairian friends may not be healthy for you. Consult a nutritionist, or ask advice from your doc. I was told to kiss goodbye to sugar, booze, caffeine and a lot of starch, and to bid a big welcome to balanced meals with adequate protein and a lot of green vegetables. Ask expert advice on what you should eat, and follow it.
3. Hydrate properly--again ask your nutritionist/doc for advice. I find that when I don't drink enough water, I get tired.
4. Rest. If your system is exhausted, it needs rest. Pushing against that doesn't help, at least until you get this thing stabilised. Then you can slowly and carefully get fit again. People with chronic fatigue were usually high achievers until they hit a wall of fatigue, so it can be hard for us to let go of being the fastest, the smartest, and fittest. But you need to learn a new way of being, that doesn't involve intensity. Respect your (new) limits and don't push yourself too hard.
5. Find gentle, safe ways to move your body. Exercise that doesn't raise your heart-rate, or peak your cortisol, can help you relax--check with your doc about this. Ask the doc about restorative yoga classes, progressive muscle relaxation, and gentle exercise like T'Ai Chi (though I remember being too tired to keep up with 81 year old Chinese T-Ai Chi teacher!)
6. Don't watch stressful TV or movies, or hang out with stressful people. You need to stop doing things that add stress to your system. Shows that raise your heart-rate are a no-no. Now is the time to watch feel-good shows that make you smile. Listen to your favourite radio shows. Rewatch old series that you loved as a kid. Hang out with people who are easy to get along with.
7. Learn to ask for help, and accept it. Now's the time to learn to receive, which can be hard for high-achieving, A-type people, even when they're exhausted. But people love to help. So let them do it! Take in love and care, and let them make the dinner and do the dishes, even if they don't do it quite right. Your job is to smile and say, "thank you".
8. Do one thing a day and let the unimportant stuff slide. When you have chronic fatigue, things get overwhelming really fast. I advise people to do one thing a day, because if you try to do everything on your list, the chances are you'll be so daunted by the prospect that you'll end up not doing anything. If you do one thing a day, you'll get a lot more done. Prioritise the important things, and let the rest slide. Adjust your expectations of yourself: the grass can get long and the house can get dusty; it will be OK.
9. Find a therapist with whom you can start to address your trauma and what it taught you about you and the world. Look for someone who knows about trauma, and who can help you resolve traumatic memories, and reset your stress response, which is probably stuck on overdrive. Chronic fatigue is hard to live with, and a therapist can help support you with the depressing effect of not being able to do what you used to take for granted. Later, your therapist can also help you set realistic goals for recovery, as you rediscover your life. Contact me for a free telephone consultation, about how I can help you manage your chronic fatigue.
10. Keep the faith. People do recover from chronic fatigue, and you can be one of them.
Contact me for a free telephone consultation, about how I can help you manage your chronic fatigue.
Rachael Vaughan MA, MFT # 50730: Psychotherapy and EMDR in San Francisco and the North Bay, for individuals and couples, in English and French