Chronic fatigue can be due to a variety of factors. The best way to explain this might be to look at it as a form of “hibernation”. Many animals and plants go into hibernation when the environment and nutrient availability becomes adverse. In winter, many wild animals go into deep sleep, their basal metabolism (BMR) slows and they are unaware of the world around them. Chronic fatigue is not a dissimilar state. The seat of fatigue is the brain. Drawing an analogy from exercise, a second wind sometimes comes along and this is not because the muscles have miraculously replenished their stores, but the brain has reset its “threshold”. In times of intense fear or motivation, we can do things that we thought impossible. These show the almost miraculous power of the brain to readjust the “normal”.

Need for sleep Chronic fatigue is associated with increased need for sleep. Often unrefreshing sleep is a feature of fatigue and it feels as though the body can just not get enough sleep.

Sleep quality Sleep quality is poor with frequent wakening and shallow sleep. Once awake, it is difficult to get back to sleep

Weight gain Our metabolism slows down as the brain often is in control of our metabolism. the brain makes a decision on the need for energy expenditure

When do animals come out of hibernation? When the brain perceives that the environment has changed. so it is with chronic fatigue. You cannot wish away fatigue. We have to work with the brain to convince it that the environment has changed.

 

How do we get through this?

  1. Routines – Routines are important to modulate brain behavior. If you go to be at 9 PM on one day and 12 midnight on another day, the brain will clamp down making fatigue worse. In the brains perception, fatigue state = sleep state…
  2. Sleep hygiene 
    1. Caffeine – Stimulants that keep us awake tends to cause paradoxical fatigue and sleep disruption. It is ok to have a cup of coffee prior to your stress period.
    2. Lighting – Lighting in your room can be important for a group of people who are sensitive to lights. Instead of cold blue/ White lighting use the warm yellow lighting
    3. Screen time – Screens work in two ways, What we see on the screen can stress us (eg news/current events)
  3. Shorter stress periods. It is a mistake to avoid stress altogether during times of stress. However our body’s ability to deal with stress is reduced. The ideal way to return to work is 4 hour work days (not 3 days a week). Work out which time is best for you to work. Circadian rhythms vary and some people are best in the mornings and others in the afternoon.
  4. Improving sleep quality. Techniques or medications that improve sleep quality and deepen sleep will help with recovery. It is important to use medications judiciously and if at all use medications that do not alter the ratio of REM to N-REM sleep.
  5. Meditation/ mindfulness. Use 15 minutes of the day in the morning and evening to be aware of our surroundings . Close your eyes for 5 of those minutes listening only to ambient sounds and sensations ( The breeze or warmth on your skin). the smells around you.
  6. Aromatherapy ( using different smells)
  7. Avoid self fulfilling prophesies – We consider that we have free will to make choices. However, here we are wrong. Our brain makes fine judgements on our chances of success and failure and gently guides us towards the better bet…  for example You make a decision regarding 30 minutes of exercise and start off..You walk a little bit more, and a bit more and a bit more You then pay for it the next 3 days. Trust your intuition. Don’t change your mind half way through a planned activity
  8. Failure – there is no such thing as failure.. there are only stepping stones. Dont dwell on things that have not worked out well. Let it go..
  9. Negative emotions – Guilt, fear, anxiety are all feels that served our ancestors well . In a world filled with threats, hyper-anxious and fearful individuals probably had better survival chances. However in this day and age where the biggest threat might be perceived as your boss, we can experience negative emotions without much true substance behind it.
  10. Negative perceptions.. You may feel that because you look well physically, you are expected to perform well. This  is a perception