Chronic Fatigue

Fatigue

Woman surrounded by cups of coffee with her head on her deskFatigue is a state of feeling extremely tired, exhausted, and weak. It differs from normal sleepiness, because it is typically more chronic and often linked to an underlying medical or mental health issue. Fatigue can be experienced physically or mentally or as a combination of both. When an individual is fatigued, they may not be able to function at their optimal level.

Understanding Fatigue

While everybody feels tired from time to time, fatigue can become problematic when it is persistent. Individuals who experience chronic fatigue may have difficulty engaging in strenuous physical tasks or have muscle weakness and less physical strength than they are accustomed to. Additionally, chronic fatigue can lead a person to have difficulty completing simple daily tasks, as well as trouble with concentration. In extreme cases, fatigue can be dangerous, because a decreased level of alertness could impair an individual’s ability to drive a car or operate heavy machinery.

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Chronic fatigue syndrome is a medical condition characterized by intense and persistent exhaustion accompanied by loss of memory or impaired concentration, sore throat, enlarged lymph nodes, muscle pain, headache, non-restful sleep, and joint pain. For individuals who have chronic fatigue syndrome, the fatigue does not improve with adequate rest. 

Causes of Chronic Fatigue

There are many different physical causes of fatigue. Sometimes, fatigue is the result of an underlying medical condition such as kidney disease, diabetes, hypothyroidism or hormonal imbalance, anemia, heart disease, problems with the immune system, or pneumonia. It can also be due to an infection such as a viral infection, influenza or mononucleosis, or vitamin deficiency. In some cases, medications and treatments can cause fatigue. For example, people who undergo chemotherapy treatment for cancer may experience chronic fatigue for years after the treatment has ended. Medications such as statins, antihistamines, and sedatives are also known to cause fatigue.

Fatigue and Mental Health

Sometimes, fatigue may be caused by a mental health condition. Substance abuse, grief, depression, and anxiety can cause fatigue. Depression and fatigue often co-occur, and fatigue is actually a common symptom of depression. Additionally, situations that cause psychological stress such as moving, divorce, and becoming a new parent can cause fatigue.   

However, the relationship between mental health conditions and fatigue is not always clear. In some cases, fatigue may subside when the mental health symptoms are treated, but in other cases, chronic fatigue may be a separate issue that persists even when the mental health issue has been adequately addressed. Because chronic fatigue syndrome and depression share common traits, doctors may misdiagnose chronic fatigue syndrome as depression. 

Just as mental health issues cause fatigue, so may chronic fatigue contribute to mental health symptoms. People who have chronic fatigue may have difficulty participating in activities that make them feel happy and fulfilled, which could lead to depression. In this way, fatigue and depression can become a cycle that may be difficult to disrupt. 

Treating Chronic Fatigue

The treatment for fatigue depends on its cause. If fatigue is due to a medical condition, medications used to treat that medical issue may alleviate the fatigue. If the fatigue is caused by depression or another mental health issue, treatments such as antidepressant medication or therapy may be prescribed. While there is no cure for chronic fatigue syndrome, it is often treated with a combination of antidepressants, physical therapy or exercise, and counseling.  

Self-Care for Fatigue

Lifestyle changes and self-care can also help to reduce fatigue. Yoga has been found to reduce fatigue and improve sleep quality in people who have overcome cancer. Getting adequate, restful sleep is important for individuals with chronic fatigue, as is maintaining a well-balanced diet. Crash diets can negatively affect sleep, causing fatigue. Making time for exercise is another way to combat fatigue. Although being fatigued can make it difficult to find the energy for exercise, physical activity can improve sleep and increase energy. It is recommended that people who have fatigue gradually increase their physical activity level.

Case Examples of Fatigue

  • Co-occurring fatigue and depression: Benjamin, 46, has been feeling constantly tired for months. His fatigue is getting to the point where he cannot focus on his work and is too tired to participate in social events he used to enjoy. He has tried getting more sleep at night, but no matter how much sleep he gets, his energy during the day does not seem to improve. Looking for answers, Benjamin set up an appointment with his medical doctor, but none of the tests done on him indicate a direct medical cause. Upon hearing about Benjamin's loss interest in activities he used to enjoy and difficulty focusing at work, his doctor referrs him to a therapist. After speaking with his therapist, Benjamin is diagnosed with depression. He learns that much of his fatigue seems to be due to his depression. By taking daily nature walks, meditating, and talking with his therapist, Benjamin learns how to effectively cope with and minimize his depression, and his energy slowly begins to return.

References:

  1. Boehm, K., Ostermann, T., Milazzo, S., & Büssing, A. (2012, September 6). Effects of yoga interventions on fatigue: A meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2012(2012). doi:10.1155/2012/124703
  2. Chronic fatigue syndrome. (2017, October 5). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/basics/definition/con-20022009
  3. Nall, R. (2017, July 5). Fatigue and depression: Are they connected? Retrieved from http://www.healthline.com/health/depression/fatigue#Overview1
  4. Nordqvist, C. (2017, August 15). Fatigue: Why am I so tired and what can I do about it? Retrieved from http://www.medicalnewstoday.com/articles/248002.php
  5. Williamson, R. J., Purcell, S. Sterne, A., Wessely, S., Hotopf, M., Farmer, A., & Sham, P. C. (2005). The relationship of fatigue to mental and physical health in a community sample. Social Psychiatry & Psychiatric Epidemiology, 40(2), p. 126-132. doi: 10.1007/s00127-005-0858-5

 

Last updated: 12-05-2017

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