Are you ALWAYS tired?
You may suffer from chronic fatigue.

This guide includes practical tips to help you regain your energy
...and have a more healthy lifestyle.

Chronic Fatigue Syndrome or simply Chronic Fatigue is a condition that can rob you of your will to live life to the fullest. It is characterized by extreme and often unexplained fatigue that just won’t go away with rest.

Most people who have this condition often find themselves looking to stimulants such as caffeine and energy drinks to cope with their fatigue, but at the cost of dependency.

Do you think you have chronic fatigue? If so, read on.

an image of a fatigued man, putting his head on his hands

Why do we always feel tired?

You wake up, eat breakfast, take a cold shower, stumble your way to work, and when you finally sit down you have this uneasy feeling of Ifeeltireditis. We look for our immediate treatment: Coffee, a whole cup or two. Maybe three if the coffee’s free.

Coffee perks us up for a good while: We feel focused and ready to take on any overdue reports or presentations we pretty much slept through over the weekend.

Then we crash. Hard.

We feel like our desk and comfortable chair suddenly are working together to swallow us whole, except instead of dangling over a giant fictional character’s mouth, we just either recline and sit back or just melt on top of our desk, shoving the innocent keyboard or laptop out of the way. The solution? Coffee. Again. And it’s not even lunchtime yet.

If the above story feels a bit too relatable, then you may have something called Chronic Fatigue.

What is Chronic Fatigue?

Chronic fatigue is described by researchers as an illness characterized by disabling fatigue of at least 6 months (1).

Chronic fatigue disease is considered one of the most complicated disorders to diagnose as it doesn’t have any clear causes, and many doctors can’t explain it by any underlying medical condition. The fatigue also worsens with any attempt at a mental or physical activity, but it doesn’t improve even with a good night’s sleep.

Simply put: You wake up feeling tired for no real reason and it lasts the whole day and for months on end.

It sounds a lot like Monday sickness, but it’s a real condition with a lot of science to back it up. In fact, it’s so complicated other researchers refer to it as not one, but two names: Systemic Exertion Intolerance Disease or Myalgic Encephalomyelitis.

Yeah, we’ll stick with chronic fatigue.

Causes

The big problem with chronic fatigue is how scientists have yet to pinpoint what causes it in the first place. Some studies suggest causes to include viral infections, psychological stress, and even inflammatory bowel disease (2, 3).

Some people are also genetically predisposed to developing chronic fatigue. The CDC suggests chronic fatigue may not be the primary condition, but the end stage of multiple different conditions (4).

While viral infection has been the most possible cause, no single type of infection has been seen as the main culprit behind this physically and mentally debilitating disease.

Some of these viruses include:

  • Epstein-Barr virus
  • Human herpesvirus 6
  • Ross River virus
  • Rubella

More than viruses, bacterial infections have been thought to cause chronic fatigue. Bacteria such as Coxiella burnetii and mycoplasma pneumoniae have been studied in relation to chronic fatigue (5, 6).

People with chronic fatigue can sometimes have weak immune systems, but doctors are still on the fence whether this is enough to cause the disease or just how severely weakened should the immune system get before someone gets chronic fatigue.

Because no one true cause has been identified, and because more than a handful of other diseases produce similar symptoms, chronic fatigue can be difficult to diagnose. There are no real tests for chronic fatigue too, so your doctor will just have to cut away at conditions they can diagnose until they find the right diagnosis.
 

image of a woman, tired, on the bed

Risk Factors

Chronic fatigue is mostly seen in people in their 40s and 50s. Since this is the stage where the body weakens gradually - due to reduced hormone secretions and a slower metabolism - this age bracket makes you a lot more susceptible to the disease.

Women are said to be 2-4 times more likely to be diagnosed with chronic fatigue than men, but some say it’s because men aren’t as open to going to the doctor to complain about “being tired,” so the frequency could be skewed in a sense (7).

Other than age and gender, genetics, allergies, stress levels, and environmental factors may put you at a higher risk of developing chronic fatigue.

Symptoms

The obvious symptom would be lethargy or fatigue, but not just any kind of fatigue. We’re talking about the feeling of being so tired it interferes with how we live our life, especially the way we function. However, this type of fatigue has to have been occurring for at least six months and doesn’t go away after getting a good night’s rest.

Apart from long-term fatigue, other symptoms of chronic fatigue may include:

  • Post-exertional malaise, where your fatigue and its accompanying symptoms get worse after any physical or mental activity which can persist for more than 24 hours.
  • Memory loss and lack of focus
  • Waking up tired every day
  • Sleep disturbances such as insomnia
  • Muscle pain
  • Migraines or headaches
  • Joint pains
  • A sore throat and swollen lymph nodes in your armpits and neck

These symptoms may come and go, and the severity of your fatigue could also come in extreme cycles - one day you’re tired as usual and the next you’re more or less tired. These make chronic fatigue more difficult to treat and diagnose.
 

image of a woman, tired, on her desk

What happens if I have Chronic Fatigue?

The person who suffers most from your chronic fatigue syndrome, obviously, is you. What you may not immediately realize, though, is that if left unchecked and untreated, its ill effects will seep into everything else you do.

For starters, you will find yourself unable to concentrate at work and deliver your best. And this isn’t just something you could brush off as an “off day” or something when your boss asks you to explain. The problem will persist until you either treat it successfully or (inevitably) lose your job as a result of poor performance.

In fact, the very act of getting out of bed to go to work, or school, or pretty much anywhere you need to be will be made twice as difficult by your chronic fatigue. You also won’t have the energy to do even the things that you enjoy and matter to you. You won’t be able to spend as much time with your friends and family as you’d like. Your physical well-being, mental wellness, emotional health, and social life will all take simultaneous nosedives.

Another awful thing about chronic fatigue syndrome is that if you leave it untreated long enough, you likely won’t get to go back to how you used to be before you got it. Research has shown that individuals who considered themselves cured of their chronic fatigue after a certain period of time were actually unable to return to a normal level of functionality; in other words, even though they were free from the illness, they still performed worse than the people who never had it in the first place (8).

Lifestyle Changes

Given all of that, what can you do to treat your chronic fatigue?

Realistically, you won’t be able to completely cure it on your own. However, making sure that you don’t make it worse is just as important — and that can be handled by making a few simple yet significant lifestyle changes.

Diet

For starters, you can be smarter about your diet.

A good way to begin is by limiting your caffeine intake. Everyone loves coffee, sure, but too much is too much — and in the case of coffee, drinking excessive amounts of it can really throw your sleep cycle out of whack. Another effect of too much caffeine in your system is that it can make your headaches worse.

Have you ever heard of caffeine withdrawal? It’s when you’ve gotten so used to caffeine that when you stop taking it in, your brain’s blood vessels end up giving you a nasty migraine. Don’t let it get to that point — limit your coffee intake, and steer clear of it when you’re close to bedtime.

Sugar is another issue. While it does give you a temporary energy boost, the crash that follows just isn’t worth it. In fact, it can even make you feel worse. Refined sugar is the biggest offender here; if you’re tempted to snack on something sweet, reach for something protein-rich and naturally (mildly) sweet instead, such as natural peanut butter or unsweetened yogurt.

Alcohol isn’t bad per se, but the key to it is moderation. It’s also not a good idea to rely on alcohol to fall asleep, as during the second half of the night, your body will process the alcohol you drank, likely disrupting your rest. Chronic fatigue patients have been known to reduce or flat-out stop drinking alcohol because they actually feel better after doing so (9).

Last but not the least: If you’re a smoker, you might want to drop those packs from your daily routine, pronto. In fact, healthcare professionals have been advised to tell smokers about the ill effects of their habit on their chronic fatigue and pain — and that ceasing to smoke should be part of their treatment (10).

Exercise

Exercise can help you sleep better — as long as you don’t overdo it, that is.

Do ten minutes of walking, light jogging, or cycling, and you’ll notice an improvement in the quality of your sleep. However, don’t do any heavy workouts before bed. Instead, try something more relaxing, like tai chi or yoga. These activities not only help you get more rest, but can also ease the pain resulting from chronic fatigue. A study showed that women who engaged in a three-month yoga program reported lower levels of stress and fatigue, and were generally in better health than before they started (11).

image of a man checking his phone in bed

Developing Good Sleep Habits

Hygiene isn’t a word one would normally associate with sleep, but within the context of chronic fatigue, it’s important to understand how good sleep hygiene can help you get better.

A well-rested person can perform better, both physically and mentally, regardless of age. Here are a few good tips that can help you develop better sleeping habits.

  • Don’t over-nap. While napping can help you recover lost strength over the course of your day, it is simply not an adequate substitute for lost nighttime sleep. Limit your naps to 30 minutes max, or avoid it altogether if you find yourself having difficulty getting a full night’s sleep.
  • Establish a sleep routine. Try to go to bed and wake up at the same time every day to ease your body into the cycle.
  • Try not to eat any midnight snacks. You should especially avoid heavy or flavorful foods, as well as greasy or spicy foods. You wouldn’t want any potential stomach troubles or even heartburn to wake you up in the middle of the night.
  • Control the level of natural light in your room. Also, dim the lights when you’re about to go to bed.

A word of caution: Consult your physician

Save for the things that don’t require taking in any additional substances or medication (such as establishing a sleeping routine or cutting back on your coffee intake), always make sure to consult with your doctor before you decide to do any drastic diet or lifestyle changes!

You may not realize it, but sudden, drastic changes can make other existing problems in your body worse. Remember that it’s always best to act on sound medical advice instead of self-medicating.


References:

(1) Afari N, Buchwald D. Chronic fatigue syndrome: a review. Am J Psychiatry. 2003;160(2):221-36.

(2) Bansal AS, Bradley AS, Bishop KN, Kiani-alikhan S, Ford B. Chronic fatigue syndrome, the immune system and viral infection. Brain Behav Immun. 2012;26(1):24-31.

(3) Jelsness-Jørgensen LP, Bernklev T, Henriksen M, Torp R, Moum B. Chronic fatigue is associated with increased disease-related worries and concerns in inflammatory bowel disease. World J Gastroenterol. 2012;18(5):445-52.

(4) Possible Causes | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC. (2018). Retrieved from https://www.cdc.gov/me-cfs/about/possible-causes.html

(5) Wildman MJ, Smith EG, Groves J, Beattie JM, Caul EO, Ayres JG. Chronic fatigue following infection by Coxiella burnetii (Q fever): ten-year follow-up of the 1989 UK outbreak cohort. QJM. 2002;95(8):527-38.

(6) Nijs J, Nicolson GL, De becker P, Coomans D, De meirleir K. High prevalence of Mycoplasma infections among European chronic fatigue syndrome patients. Examination of four Mycoplasma species in blood of chronic fatigue syndrome patients. FEMS Immunol Med Microbiol. 2002;34(3):209-14.

(7) Rowe PC, Underhill RA, Friedman KJ, et al. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer. Front Pediatr. 2017;5:121. Published 2017 Jun 19. doi:10.3389/fped.2017.00121

(8) Brown MM, Bell DS, Jason LA, Christos C, Bell DE. Understanding long-term outcomes of chronic fatigue syndrome. J Clin Psychol. 2012;68(9):1028-35.

(9) Woolley J, Allen R, Wessely S. Alcohol use in chronic fatigue syndrome. J Psychosom Res. 2004;56(2):203–6. doi: 10.1016/S0022-3999(03)00077-1.

(10) Jay SJ. Tobacco use and chronic fatigue syndrome, fibromyalgia, and temporomandibular disorder. Arch Intern Med. 2000;160:2398–2401.

(11) Michalsen A, Grossman P, Acil A, Langhorst J, Lüdtke R, Esch T, et al. Rapid stress reduction and anxiolysis among distressed women as a consequence of a three-month intensive yoga program. Medical Science Monitor. 2005;11(12):555–61.

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