Tiredness sign: Fatigue – Better Health Channel
Fatigue – Better Health Channel
Fatigue is a feeling of constant tiredness or weakness and can be physical, mental or a combination of both. It can affect anyone, and most adults will experience fatigue at some point in their life.
Each year, around 1.5 million Australians see their doctor about fatigue. Fatigue is a symptom, not a condition. For many people, fatigue is caused by a combination of lifestyle, social, psychological and general wellbeing issues rather than an underlying medical condition.
Although fatigue is sometimes described as tiredness, it is different to just feeling tired or sleepy. Everyone feels tired at some point, but this is usually resolved with a nap or a few nights of good sleep. Someone who is sleepy may also feel temporarily refreshed after exercising.
If you are getting enough sleep, good nutrition and exercising regularly but still find it hard to perform everyday activities, concentrate or be motivated at your normal levels, you may be experiencing fatigue that needs further investigation.
Symptoms of fatigue
Fatigue can cause a vast range of other physical, mental and emotional symptoms including:
- chronic tiredness or sleepiness
- sore or aching muscles
- muscle weakness
- slowed reflexes and responses
- impaired decision-making and judgement
- moodiness, such as irritability
- impaired hand-to-eye coordination
- appetite loss
- reduced immune system function
- blurry vision
- short-term memory problems
- poor concentration
- reduced ability to pay attention to the situation at hand
- low motivation.
Causes of fatigue
The wide range of causes that can trigger fatigue include:
- Medical causes – unrelenting exhaustion may be a sign of an underlying illness, such as a thyroid disorder, heart disease or diabetes.
- Lifestyle-related causes – alcohol or drugs or lack of regular exercise can lead to feelings of fatigue.
- Workplace-related causes – workplace stress can lead to feelings of fatigue
- Emotional concerns and stress – fatigue is a common symptom of mental health problems, such as depression and grief, and may be accompanied by other signs and symptoms, including irritability and lack of motivation.
Fatigue can also be caused by a number of factors working in combination.
Medical causes of fatigue
There are a number of diseases and disorders which trigger fatigue. If you experience prolonged bouts of fatigue, consult your doctor.
Lifestyle-related causes of fatigue
Common lifestyle factors that can cause fatigue include:
- Lack of sleep – typically adults need about eight hours of sleep each night. Some people try to get by on fewer hours of sleep.
- Too much sleep – adults sleeping more than 11 hours per night can lead to excessive daytime sleepiness.
- Alcohol and drugs – alcohol is a depressant drug that slows the nervous system and disturbs normal sleep patterns. Other drugs, such as cigarettes and caffeine, stimulate the nervous system and can cause insomnia.
- Sleep disturbances – disturbed sleep may occur for a number of reasons, for example, noisy neighbours, young children who wake in the night, a snoring partner, or an uncomfortable sleeping environment such as a stuffy bedroom.
- Lack of regular exercise and sedentary behaviour – physical activity is known to improve fitness, health and wellbeing, reduce stress, and boost energy levels. It also helps you sleep.
- Poor diet – low kilojoule diets, low carbohydrate diets or high energy foods that are nutritionally poor don’t provide the body with enough fuel or nutrients to function at its best. Quick fix foods, such as chocolate bars or caffeinated drinks, only offer a temporary energy boost that quickly wears off and worsens fatigue.
- Individual factors – personal illness or injury, illnesses or injuries in the family, too many commitments (for example, working two jobs) or financial problems can cause fatigue.
Workplace-related causes of fatigue
Common workplace issues that can cause fatigue include:
- Shift work – the human body is designed to sleep during the night. This pattern is set by a small part of the brain known as the circadian clock. A shift worker confuses their circadian clock by working when their body is programmed to be asleep.
- Poor workplace practices – can add to a person’s level of fatigue. These may include long work hours, hard physical labour, irregular working hours (such as rotating shifts), a stressful work environment (such as excessive noise or temperature extremes), boredom, working alone with little or no interaction with others, or fixed concentration on a repetitive task.
- Workplace stress – can be caused by a wide range of factors including job dissatisfaction, heavy workload, conflicts with bosses or colleagues, bullying, constant change, or threats to job security.
- Burnout – can be described as striving too hard in one area of life while neglecting everything else. ‘Workaholics’, for example, put all their energies into their career, which puts their family life, social life and personal interests out of balance.
- Unemployment – financial pressures, feelings of failure or guilt, and the emotional exhaustion of prolonged job hunting can lead to stress, anxiety, depression and fatigue.
Psychological causes of fatigue
Studies suggest that psychological factors are present in at least 50 per cent of fatigue cases. These may include:
- Depression – this illness is characterised by severe and prolonged feelings of sadness, dejection and hopelessness. People who are depressed commonly experience chronic fatigue.
- Anxiety and stress – a person who is chronically anxious or stressed keeps their body in overdrive. The constant flooding of adrenaline exhausts the body, and fatigue sets in.
- Grief – losing a loved one causes a wide range of emotions including shock, guilt, depression, despair and loneliness.
As fatigue can present a vast range of symptoms and be caused by many different factors working in combination, diagnosis can be difficult. Your doctor may diagnose fatigue using a number of tests including:
- Medical history – recent events such as childbirth, medication, surgery or bereavement may contribute to fatigue.
- Physical examination – to check for signs of illness or disease. Your doctor may also ask detailed questions about diet, lifestyle and life events.
- Tests – such as blood tests, urine tests, x-rays and other investigations. The idea is to rule out any physical causes, for example anaemia, infection or hormonal problems.
Fatigue is a symptom –something you can feel and describe – not a condition or disease. To reduce your fatigue you first need to understand what the underlying reasons for your fatigue are.
If fatigue is having a negative effect on your quality of life, or causing you distress, then consider speaking with a health professional. By asking questions, they will help you work out why you are experiencing fatigue, and offer some suggestions on how to find relief.
If necessary, your doctor might suggest certain medical tests if there is a reasonable chance the cause of your fatigue may be an undiagnosed medical issue (for example, anaemia or thyroid dysfunction).
Fortunately, for most people fatigue will get better over time on its own or with some simple and practical lifestyle changes.
Where to get help
Chronic fatigue syndrome: Symptoms, treatment, and causes
Chronic fatigue syndrome is a complex, long-term illness that can affect the whole body, causing pain and extreme fatigue.
Also known as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), it is a serious, chronic illness that can affect a person’s ability to carry out everyday tasks.
The Centers for Disease Control and Prevention (CDC) estimate that between 836,000 and 2.5 million people in the United States have ME/CFS, most of whom do not have a diagnosis.
In the past, some people did not believe that ME/CFS was a real illness. However, experts have started to take it more seriously in recent years, and research is underway to find out why it happens and how to treat it.
Meanwhile, lifestyle strategies and medical treatment may help people manage some of the symptoms.
ME/CFS is a complex condition that can affect a range of bodily systems and functions. As a result, the symptoms can vary widely.
Many of the possible symptoms resemble those of other conditions, making ME/CFS hard to diagnose.
The symptoms of ME/CFS can vary among individuals, but there are three core symptoms:
Reduced ability to do activities that were previously possible
A person with ME/CFS will experience fatigue that interferes with their ability to carry out daily tasks.
- is severe
- does not improve with rest
- is not due to activity
- was not previously present
For a diagnosis of ME/CFS, this fatigue and the resulting decrease in activity levels must last 6 months or longer.
A person with post-exertional malaise (PEM) will experience a “crash” after physical or mental exertion.
During times of PEM, they may have new or worsening symptoms that include:
Following an event that triggers PEM, the person may be unable to leave the house, get out of bed, or do regular chores for several days or even weeks. The symptoms tend to become worse 12–48 hours after the exertion.
The trigger will depend on the individual. For some people, even having a shower or going to the grocery store can trigger PEM.
A range of sleep disorders can occur. The person may feel very sleepy but be unable to sleep or not feel refreshed after sleeping. They may experience:
- intense and vivid dreaming
- restless legs
- nighttime muscle spasms
- sleep apnea
Other key symptoms
As well as the three core symptoms above, one of the following two symptoms must be present for a diagnosis of ME/CFS, according to the CDC.
Problems with thinking and memory
The person may find the following challenging:
- making decisions
- focusing on details
- thinking quickly
- remembering things
People sometimes refer to these symptoms as “brain fog.”
Dizziness when standing up
When the person moves from lying on their back to sitting or standing, they may experience:
- vision changes, such as blurred vision or seeing spots
Other possible symptoms
Pain is a common symptom. A person with ME/CFS will often experience pain or discomfort that does not stem from an injury or other identifiable cause.
Common types of pain include:
- muscle aches and pains
- joint pain without redness or swelling
The person may also experience:
In addition, the American Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Society (AMMES) note that other possible symptoms include:
Experts do not know what causes ME/CFS, but some people who have the condition say that it started after another health issue, such as:
- a flu-like illness
- a stomach bug or other infection
- the Epstein-Barr virus, which causes mononucleosis, commonly known as “mono”
- extreme physical stress, for example, surgery
There is growing evidence of a link between ME/CFS and the way the immune system works, but more research is necessary to establish the mechanism behind this.
According to the Office on Women’s Health, females are two to four times more likely than males to experience ME/CFS. The condition can also affect children, although this is less common.
The symptoms of ME/CFS vary widely and can resemble those of other conditions, which can make it difficult to diagnose.
If a person seeks medical help for ME/CFS, a doctor will likely begin the diagnostic process by:
- asking about the person’s symptoms
- carrying out a physical examination
- recommending tests to try to identify the cause of any symptoms
To receive a diagnosis of ME/CFS, a person must have the three core symptoms of the condition for 6 months or longer. In addition, the doctor must be unable to find another explanation for the symptoms.
It can take time to eliminate other possible causes of ME/CFS symptoms, but there is no specific test that can identify the condition.
In 2018, researchers found that the levels of some molecules appeared to change when people had ME/CFS. One day, this may help make it easier to diagnose ME/CFS, but more studies are necessary before this can happen.
In 2019, another research team announced that they had made further progress in developing a test. The test focused on certain features of blood cells and electrical activity in people with ME/CFS.
In the past, many doctors did not believe that ME/CFS was a real disease, but major health organizations have now begun to recognize it.
Various advocacy groups, including Solve M.E., are working to promote awareness of ME/CFS and empower people with the condition to persist in getting a diagnosis. The AMMES list other advocacy groups on their website, as well as providing useful resources and explaining where people can get support.
There is currently no cure or treatment specific to ME/CFS, but a doctor may work with individuals to help them manage the symptoms. The treatment plan will vary among individuals, as ME/CFS affects people differently.
However, it may involve:
- focusing on whichever symptom poses the greatest challenge
- alleviating pain
- learning new ways to manage activities
One way to manage fatigue after activity is through pacing, or activity management.
The person will work with a doctor to determine the best way to balance rest and activity. The doctor will also help them identify their personal triggers and establish how much exertion they can tolerate.
ME/CFS causes fatigue, and it can also disrupt sleep. A doctor will encourage the person to establish healthful sleeping habits, such as having a regular sleep schedule.
If these strategies do not help, the doctor may prescribe medication.
At first, a doctor may recommend over-the-counter (OTC) drugs for headaches and other types of pain. If these do not work, they may prescribe stronger medication.
A person with ME/CFS may be sensitive to various chemicals. Therefore, they should speak to a doctor before using any new medication.
Nondrug therapies that may help include:
- gentle stretching and toning exercises
- gentle massage
- heat therapy
- water therapy
Anxiety and depression
Anxiety and depression are common among people with ME/CFS. Antidepressant drugs may help some people, but they can sometimes make symptoms worse.
Lifestyle remedies that may help include:
Some laboratory research has suggested that rituximab (Rituxan), a cancer drug that targets the immune system, could be effective for people with ME/CFS.
However, more research is necessary to ensure that the drug is safe to use in the treatment of this condition.
Various strategies can help people manage ME/CFS.
- finding a doctor who understands the condition
- seeking a counselor who can help manage the emotional and practical challenges
- making family and friends aware of the symptoms and challenges
- scheduling rest and activity times to maximize quality of life
- using calendars and journals to help with memory lapses
- learning which relaxation techniques are effective for them
- following a balanced and nutritious diet
- taking nutritional supplements, if tests reveal a deficiency
- finding someone to help with child care and household chores at difficult times, if possible
What about exercise?
Gentle stretching, yoga, and tai chi might be helpful in some cases, and at the right time, but vigorous exercise can make symptoms worse.
The CDC note that exercise plans that benefit many people with chronic diseases are not usually suitable for people with ME/CFS, and they may be dangerous.
People with symptoms or a diagnosis of ME/CFS should not follow any type of activity plan without discussing it with their doctor first.
ME/CFS is a life changing condition that can affect every aspect of a person’s daily life.
It can take time to get a diagnosis, as the symptoms are not specific but overlap with those of other conditions. Whether or not a person has a diagnosis, some lifestyle strategies can help them manage the challenges.
Until scientists find a specific treatment, coping strategies will play a key role in managing ME/CFS.
Causes, symptoms, risk factors, and prevention
Emotional exhaustion can arise when someone experiences a period of excessive stress in their work or personal life.
When people experience emotional exhaustion, it can make them feel emotionally drained, overwhelmed, and fatigued. These feelings tend to build up over a long period, though people may not notice the early warning signs.
This can have significant impacts on a person’s everyday life, relationships, and behavior. In this article, we discuss the symptoms, causes, and risk factors of emotional exhaustion, and we explore the many ways people can treat it or prevent it from happening.
Emotional exhaustion usually arises after a period of stress.
Different things can contribute to emotional exhaustion in people, depending on a person’s tolerance for stress and other factors in their lives at the time.
Examples of things that can triggers emotional exhaustion include:
- going through a significant life change, such as divorce or death of a loved one
- being a caregiver
- experiencing financial stress
- having a baby or raising children
- being homeless
- juggling several things at once, such as work, family, and school
- living with a chronic medical condition
- working long hours
- working in a high-pressure environment
Typically, emotional exhaustion occurs if someone feels overwhelmed by factors in their life. They may believe they have a lack of control over their life or they may not be correctly balancing self-care with life’s demands.
Emotional exhaustion causes both physical and emotional effects that, in turn, can affect a person’s behavior. The symptoms can build up over time and with repeated stress, though people may not recognize the early warnings.
Looking out for and recognizing the symptoms of emotional exhaustion in oneself and others is necessary so that a person can start taking steps toward feeling better.
Here, we discuss some common symptoms of emotional exhaustion:
1. Changing mood
Emotional exhaustion affects a person’s mood and mental health.
People may initially notice that they are feeling more cynical or pessimistic than usual. They may lose their motivation to work, socialize, or perform simple tasks.
Eventually, these feelings can become stronger and cause individuals to feel trapped or disconnected.
Emotional exhaustion can lead to feelings of:
- anger and irritability
- lack of motivation
People who experience anxiety, depression, and thoughts of self-harm should seek help from a doctor or therapist, as soon as possible.
2. Thinking difficulties
Those with emotional exhaustion may experience changes in thinking and memory. Some people refer to these symptoms as “brain fog.” They include:
- difficulty concentrating
- lack of imagination
- loss of memory
Research suggests that burnout, which involves emotional exhaustion, is linked to a decline in three main cognitive areas:
- executive function, such as planning and organizing
Cognitive changes can be especially challenging when a person is trying to juggle stressful situations, including work pressure or emotionally demanding tasks.
3. Sleeping problems
During stressful periods of life, it can be challenging to maintain a regular sleeping pattern.
People with emotional exhaustion also feel physically fatigued and may have difficulty falling asleep or staying asleep at night. Otherwise, they may oversleep in the morning.
Low mood and brain fog can make it difficult to get out of bed in the morning or to make it through the day.
4. Physical changes
Emotional issues can manifest themselves in physical ways, including:
- changes in appetite
- digestive problems
- heart palpitations
- weight loss or gain
5. Effects on work and personal relationships
Physical, emotional, and cognitive changes can affect a person’s relationships, and their ability to function in their home and workplace, such as:
- less ability to connect with others on a personal or emotional level
- increased rates of absence from work
- a lack of enthusiasm in work and personal life
- low self-esteem
- missed deadlines
- poor work performance
- social withdrawal from others
Anyone can experience emotional exhaustion, especially if they live with long-term stress or if they have recently experienced a significant change in their lives.
But some people are more at risk than others, including people who experience the following:
Share on PinterestPeople with demanding jobs, such as nurses, are at risk of emotional exhaustion.
Those in demanding or stressful jobs are more likely to experience emotional exhaustion and burnout than others.
For example, medical professors in the early stages of their career show higher indicators of emotional exhaustion and burnout risk, according to a 2014 study from the Netherlands.
Research suggests that people with high work demands, and those who are preoccupied with thoughts about work during leisure time, are more at risk.
Police officers, nurses, social workers, and teachers may also be more at risk than others.
The risk of emotional exhaustion increases for anyone who:
- works in a job they dislike
- has a poor job fit
- works long hours
- feels a lack of control at work
Individuals who strive for what they see as “perfection” in one or more areas of their lives often experience emotional exhaustion and burnout. Numerous studies have cited perfectionism as being a risk factor for such conditions.
By way of explanation, perfectionists are more likely to put themselves under excessive stress by taking on more than they can comfortably manage.
Loneliness may increase feelings of emotional exhaustion and burnout. People without many close relationships may have fewer people with whom to share their feelings.
Research suggests that fostering social relationships may help people lessen the harmful effects of burnout, potentially, by promoting resilience and a sense of greater well-being.
People who do not prioritize their own well-being may be more prone to emotional exhaustion. This can include those who do not get enough exercise, sleep, or healthful foods.
For example, some research links insufficient sleep with a greater risk of burnout.
Excessive use of alcohol or illicit drugs may also increase risk, especially if people use these instead of more constructive coping techniques.
Individuals may be more likely to experience emotional exhaustion if they:
- use harmful coping strategies, such as drugs or alcohol, to deal with stress
- feel they have too few personal resources, such as status, money, or support
- live or work in a culture that does not value their freedom of expression
Psychologists first began using the term “burnout” in the 1970s to describe the effects of severe stress on “helping” professionals, such as doctors and nurses.
Today, people use “burnout” to describe the results of chronic stress on anyone. Even so, no clear definition of burnout exists.
According to the United States National Library of Medicine, emotional exhaustion is one of the symptoms of burnout. The other two are:
- Alienation from work activities. Those with burnout become increasingly more stressed about their work. They may feel less committed to their organization, and they may distance themselves emotionally from colleagues.
- Reduced performance. Burnout causes cynicism and feelings of negativity about work-related tasks. Coupled with emotional exhaustion, this leads those with burnout to miss deadlines and otherwise perform poorly at work.
To reduce emotional exhaustion and burnout, people typically need to make lifestyle changes. In some cases, they may require medications or therapy. Treatments and tips to aid recovery include:
Where possible, people should try to reduce sources of stress. They may be able to take on fewer tasks, delegate to others, and ask for help. Another tact is to consider moving to a different role or organization if work is a significant source of stress.
Make healthful lifestyle choices
Living a healthful life can improve physical and mental health and foster resilience. To do this:
- Eat a balanced diet, rich in fruits, vegetables, whole grains, and lean sources of protein.
- Limit how much alcohol you drink.
- Avoid tobacco smoking.
- Exercise for 30 minutes a day, most days of the week.
- Establish a sleep routine by going to bed at the same time each night and getting 7 to 9 hours of sleep.
Maintain a good work-life balance
Share on PinterestTaking a break from work to do something creative can help prevent and treat stress.
People should try not to let work or caring for a loved one take over, and ensure they plan regular vacations and rest days.
People should take scheduled breaks throughout the day and make time for things they enjoy at least weekly. This may include:
- collecting items, such as stamps or coins
- seeing a movie
- spending time with pets
- walking in the park
Regular mindfulness practice can reduce anxiety and depression and improve mood.
According to one research study, people who practice mindfulness report significantly less emotional exhaustion and more job satisfaction than those who do not use mindfulness techniques.
Connect with others
Social disconnection is both a symptom of and a risk factor for emotional exhaustion. To avoid emotional exhaustion and other mental health issues, people should try to connect with others whenever possible.
Meeting up with a friend, joining a club or walking group, and reaching out to family and neighbors are all ways of connecting socially.
Change your attitude
Changing a person’s thoughts can alter their moods and behaviors. These small changes can have a big impact on physical and emotional well-being. Examples of ways to change negative thinking include:
- focusing on what is going right in life rather than what is not
- replacing negative thoughts with more positive or realistic ones
- avoiding comparisons with others
- accepting that sometimes negative feelings occur and not fighting them
- staying in the present rather than focusing on the past or trying to anticipate the future
- remembering that these unhelpful feelings will pass
See a therapist or doctor
Therapy can be an effective way to treat emotional exhaustion. A therapist can help people work through stress, anxiety, and depression. They can help individuals challenge negative thoughts and equip them with new coping skills.
Sometimes, a doctor may recommend medication to treat depression or anxiety, such as antidepressants, anti-anxiety medicines, or medications to help sleep.
Many of the treatments for emotional exhaustion can also help prevent it from occurring in the first place. These include:
- reducing stressors at home and work
- engaging in enjoyable activities
- taking time out for oneself
- eating a healthful diet
- exercising regularly
- limiting alcohol and avoiding tobacco
- getting enough sleep
- maintaining a good work-life balance
- connecting with friends, family, and others
- keeping a positive mindset
- practicing mindfulness and meditation
- seeking professional help at the onset of anxiety or other changes in mood
People can experience emotional exhaustion after a period of excessive stress. It can have wide-ranging effects of a person’s physical and mental health, careers, and relationships with others.
Looking out for the symptoms can help people take steps to improve them. Lifestyle changes and stress reduction methods can help.
Common thyroid disorders and their symptoms
The thyroid is a small gland that helps regulate a person’s metabolism by producing hormones.
Problems can occur if the thyroid overproduces hormones, when it is known as hyperthyroidism, or underproduces hormones, which is called hypothyroidism. These issues may also result in the growth of the thyroid, which is called a goiter.
Researchers estimate that about 13 million people have an undiagnosed thyroid condition in the United States.
This article looks at the different types of thyroid disorders, what causes them, what their symptoms are, and how doctors diagnose and treat them.
Hypothyroidism is when a person’s thyroid does not produce enough thyroid hormone. It is a more common thyroid issue than hyperthyroidism.
Not having enough thyroid hormone can slow down a person’s metabolism. Hypothyroidism is especially common in women.
Causes of hypothyroidism include:
- Hashimoto’s thyroiditis
- surgical removal of part or all of the thyroid gland
- radioactive iodine treatment for hyperthyroidism
- radiation therapy for head and neck cancers
- some medications, such as lithium for bipolar disorder and sulfonylureas for diabetes
- damaged or missing thyroid gland, often occurring from birth
- too much or too little iodine intake in the diet
- Turner syndrome, a chromosomal disorder affecting females
- pituitary gland damage
The most common cause of hypothyroidism is Hashimoto’s thyroiditis, which is an autoimmune disorder. It is sometimes called Hashimoto’s thyroiditis or shortened to Hashimoto’s.
The exact cause of Hashimoto’s is unclear, but heredity may play a role, and having a close family member with the condition may increase a person’s risk.
Having another autoimmune disorder, such as rheumatoid arthritis, type 1 diabetes, or lupus, also increases the risk for Hashimoto’s.
Development of the disease can be very slow, occurring over months or even years.
Hypothyroid symptoms can vary, but may include:
A person may also develop a goiter, or enlargement of the thyroid gland. This condition happens because the gland tries to compensate for the lack of thyroid hormone.
After discussing a person’s symptoms and family history, a doctor may recommend a blood test to check for hypothyroidism.
This test looks for a high level of thyroid-stimulating hormone (TSH) in a person’s blood. The body releases TSH to signal the thyroid gland to release thyroid hormone.
When the body senses low levels of thyroid hormone, it releases more TSH, so a high level of TSH typically indicates hypothyroidism.
Alternatively, a doctor may test for a low level of the thyroid hormone, which is known as thyroxine.
There is no cure for hypothyroidism, but a person can manage it with thyroid hormone replacement.
A person typically takes thyroid hormone replacement orally, once a day as a pill, for the rest of their life.
Hyperthyroidism is when a person has too much thyroid hormone in their body, which speeds up their metabolic processes.
Someone with hyperthyroidism may initially have more energy, but their body will break down more quickly, which can cause various issues, especially fatigue.
Hyperthyroidism is most often due to an autoimmune problem called Graves’ disease that causes the whole thyroid gland to make too much thyroid hormone.
It is not clear why people develop Graves’ disease, although researchers believe that genetics plays a role.
Graves’ disease is an autoimmune condition because it occurs when a person’s immune system creates antibodies that signal the thyroid gland to grow and produce significantly more thyroid hormone than the body needs.
Another cause of hyperthyroidism is called multinodular goiter. This condition is the result of one or more hormone-producing nodules in the thyroid gland that enlarge and release excess thyroid hormone.
Two problems that cause a high thyroid hormone level without having an overactive thyroid gland are:
- Thyroiditis, a temporary inflammation of the thyroid gland due to an autoimmune condition or a virus. The same illness can also cause hypothyroidism.
- Taking thyroid hormone replacement for an underactive thyroid.
According to the American Thyroid Association, common symptoms of hyperthyroidism can include:
- an initial increase in energy
- fatigue over timesweating
- rapid pulse
- tremors in the hands
- problems sleeping
- thin skin
- fine and brittle hair
- muscle weakness
- frequent bowel movements
- unintended weight loss
- a light menstrual flow or fewer periods
A person with Graves’ disease may also experience inflammation of the eyes. This pushes the eyes forward, and they appear to bulge out.
However, only 5 percent of people with Graves’ disease have their vision severely or permanently affected.
The overstimulation of the thyroid gland often makes it enlarge, which is called a goiter.
When diagnosing hyperthyroidism, a doctor will look for key symptoms, including an enlarged thyroid, a rapid pulse, tremors in the fingers, and moist, smooth skin.
As with hypothyroidism, they will also use laboratory tests that measure the amount of thyroid hormone and TSH in a person’s blood.
When people have hyperthyroidism, the body senses the high level of thyroid hormone in the blood and stops releasing TSH. As a result, tests show a low level of TSH. Other tests can then be done to determine the cause of the condition.
A doctor may recommend beta-blockers as a short-term treatment for hyperthyroidism. Beta-blockers stop some of the effects of the thyroid hormone and quickly reduce some of the symptoms, such as a rapid pulse and tremors.
According to the American Thyroid Association, a doctor may also suggest a more permanent treatment:
- Antithyroid drugs: These stop the thyroid from making so much thyroid hormone.
- Radioactive iodine tablets: Thyroid cells absorb the iodine. This treatment destroys them, and the gland’s hormone overproduction stops.
- Surgery: This is done by a surgeon who removes part or all of the thyroid.
If a person takes radioactive iodine or undergoes surgery, their thyroid may no longer be able to produce enough hormones, and they may develop hypothyroidism. They would then require thyroid hormone replacement treatment.
Thyroid nodules are lumps on a person’s thyroid. They can appear alone or in groups and are very common.
According to the American Thyroid Association, about 50 percent if people over 60 years of age have a thyroid nodule. However, the vast majority of thyroid nodules are harmless.
It is not clear why people develop thyroid nodules. Thyroid nodules do not typically cause symptoms, although there is a chance they may cause hyperthyroidism by becoming overactive.
A doctor will be able to feel thyroid nodules on a person’s neck, during an examination. If they discover nodules, they may check for hyperthyroidism or hypothyroidism.
There is a small risk of thyroid nodules being cancerous. To check for this, a doctor can do an ultrasound or a fine-needle biopsy.
If there are any signs of cancer or possible risk of cancer in the future, a doctor will recommend removing the nodules. Depending on the type of cells found in a biopsy, and the risk of the nodule being cancer, a doctor may remove part or all of the gland.
There are many different thyroid disorders, but doctors typically categorize them into two groups: those that make the thyroid overactive and those that make it underactive.
Although the symptoms can be nonspecific, diagnosing a thyroid disorder is usually straightforward.
If a person is concerned that they may have a thyroid disorder, they should speak to a doctor about testing.
4 Signs To Look For
What Is Exhaustion?
Feeling tired is a common experience. It can be caused by disrupted sleep habits, a change in routine, or the appearance of stressors in your life. No matter the reason, tiredness can push us to our limits emotionally and mentally. In some cases, extreme tiredness sets in. This is called exhaustion.
How can you tell if you’re tired or exhausted? Learn the signs of exhaustion and ways to prevent it from affecting your life and the lives of those around you.
Exhaustion, also known as fatigue, becomes a problem when it continues day to day, affecting your health and safety.
Exhaustion isn’t a mental disorder. But it can be caused by anxiety, depression, bipolar disorder, neurological and sleep disorders, anemia, electrolyte abnormalities, diabetes, obesity, and/or an infectious disease or cancer.
Common reasons for fatigue could be lifestyle choices you should address. Here are frequent reasons for fatigue:
- Alcohol or drug use
- Too much physical activity with no rest
- Jet lag disorder
- Lack of physical activity
- Shortage of sleep
- Some medications, like cough medicines or antihistamines
- Unhealthy eating habits
Exhaustion isn’t normally a cause for concern. But it is when accompanied by:
- Lack of physical or mental energy
- Inability to stay awake or alert
- Accidentally falling asleep, such as when driving or operating heavy machinery
- Inability to maintain or complete an activity
- Tiring easily
- Difficulty concentrating, memorizing, or maintaining emotional stability
If exhaustion starts affecting your daily life, it’s time to talk to a doctor to determine underlying causes.
Signs of Exhaustion
Exhaustion can impact your daily activities, especially if you’re too tired to take care of average tasks. The good news is that exhaustion is treatable; however, here are some signs that you or someone you may know is experiencing it:
Symptoms of Depression or Anxiety
When you or a loved one is dealing with depression and/or anxiety, it can have a draining effect.
Depression can affect your sleep cycle. It may make you unable to sleep. Or not you may not be able to sleep for long periods. A lack of energy associated with depression may keep you from completing normal activities.
Anxiety can be crippling for people who experience uncontrollable worry all day long. The symptoms include irritability and extreme fatigue.
Lack of Goal Making
Exhaustion can leave you tired and without energy to set goals and stick with them. You might be able to make goals, but you’ll set them aside and be unsure of when you’ll return to them.
Lack of Concentration
Lack of concentration happens when you’re exhausted and can’t focus on a task you had started. You may have a big task to complete, but you can give it only five minutes before you become frustrated and give up.
Exhaustion can lead to inability to nurture relationships. This could mean giving your children time-consuming activities so you don’t have to deal with them. Or perhaps your significant other is requesting attention you don’t have the emotional capability to give.
If exhaustion begins to leave you drained and unable to complete anything, you should talk to your doctor. They may run tests to find underlying health causes.
Determining the cause of your exhaustion will help you identify what you need to do to alleviate its symptoms. Common treatments include:
Getting enough sleep is extremely important. Make sure you’re sleeping enough for your body to feel rested. Keep a normal sleep schedule, and go to bed only if you’re tired.
Make sure your bedroom is prepped for deep sleep — a dark room, comfy furniture, and minimal distractions. You might also try writing about your worries in a journal before bed, so you can let them go while sleeping.
Cut out caffeine to reset your body. It’s found in coffee, tea, soft drinks, energy drinks, and some pain killers and herbal remedies. After a month, take note of how you feel. Caffeine withdrawal can include headaches and irritability at first.
Consistent physical activity can improve symptoms. Beginning to exercise can seem like a big obstacle if you feel exhausted, but moving for just 15 minutes a day can boost your energy levels.
Carrying excess weight exhausts your body. Eating healthier, exercising, and weight loss can improve your symptoms too.
Psychotherapy, or talk therapy, might include counseling to discuss the underlying causes and stressors in your life. These could include stress, anxiety, or low mood.
What Is Fibromyalgia? Causes, Risks, Tender Points, Symptoms, and More
What Is Fibromyalgia?
Fibromyalgia is a non-life-threatening, chronic disorder with widespread pain as its main symptom.
This musculoskeletal condition affects your whole body. When you have fibromyalgia, your brain may process pain signals differently. This could cause you to feel more intense pain. You may also have problems with your bowels, memory, sleep, or mood.
A related, key part of fibromyalgia is the presence of “tender points.” These are areas on your muscles and tendons that are tender when pressed. Typically, tender points are in your neck, back, knee, shoulder, elbow, and hip.
You may also have trigger points with fibromyalgia. These are areas on the muscles around your bones that hurt when pressed. Trigger points may also cause pain or tenderness that you feel in other areas of your body. This is called referred pain. You could have weak muscles, too.
Fibromyalgia symptoms may start after you’ve had a physical injury, surgery, infection, or extreme stress. But you may notice symptoms build up over time for no particular reason.
Symptoms may include:
- Muscle pain throughout the body
- Tenderness at certain points
- Pain that:
- Ranges from mild discomfort to severe enough to limit daily activities
- Commonly occurs in the neck, upper back, shoulders, chest, rib cage, lower back, and thighs
- May feel like a burning, gnawing, throbbing, stabbing, or aching
- Might come on gradually
- Could seem worse when you try to relax and is less noticeable during activity
The basic cause of fibromyalgia is still unknown. More than one thing may be involved. Possible causes include:
- Problems in the way your brain and nerves process pain. Experts don’t know what causes this. Nerve stimulation may cause you to have high levels of brain chemicals called neurotransmitters. These chemicals lead to changes in how your brain perceives pain. You may feel painful reactions to mild causes.
- Not getting enough sleep
- Physical or emotional trauma
- Infection or other illness
Fibromyalgia Risk Factors
Risk factors for fibromyalgia include:
- Sex: Experts estimate that at least 5 million American adults have fibromyalgia. Of these, up to 90% are women.
- Family history: Fibromyalgia also seems to run in families, so a gene may be at least partly responsible for the condition.
- Age: Most people with fibromyalgia begin to notice symptoms between the ages of 20 and 40, but children and older adults may also get the condition.
The doctor will give you a physical exam and ask you about your pain and other symptoms. If you’ve had widespread pain for more than 3 months that has no other clear cause, you may have fibromyalgia.
Other tests may help your doctor diagnose fibromyalgia or rule out other causes of your symptoms:
- Tender point exam, where the doctor presses down on 18 specific areas of your body to see if you feel any pain with light touch
- Complete blood count
- Thyroid function test
- Blood tests that check for signs of inflammation. These include:
- Erythrocyte sedimentation rate
- Cyclic citrullinated peptide test
- Rheumatoid factor test
Medications, exercise, diet, therapy, and self-management can help relieve your fibromyalgia symptoms.
Several drugs can relieve fibromyalgia pain, improve sleep, or treat other fibromyalgia symptoms:
Different types of therapy can help you cope with fibromyalgia or manage your symptoms:
- Physical therapy can help you learn to do exercises, such as workouts in a pool, to improve your stamina, strength, and flexibility.
- Occupational therapy can help you learn new ways to do tasks at work to put less stress on your body.
- Counseling or mental health treatment can help you manage stress and learn to cope with fibromyalgia.
Changes to your lifestyle may ease fibromyalgia symptoms and help you manage your condition:
- Regular exercise like walking, swimming, biking, or stretching can relieve fibromyalgia pain. Stick with your exercise routines and build up your stamina a little at a time.
- Try to get enough sleep at night. Don’t take afternoon naps. Set a regular bedtime and stick to it.
- Find ways to manage your stress. Take time to relax. Deep breathing or relaxation exercises may help. Don’t try to do too much in your daily schedule. It’s OK to say no to some invitations or requests.
- Eat a healthy diet of fresh foods. Keep your caffeine intake low.
Some people with fibromyalgia use alternative or complementary treatments to relieve pain or improve their symptoms. These treatments may include:
- Yoga and tai chi, exercises that include gentle movement and breathing to help you relax
- Acupuncture, where a trained practitioner inserts tiny needles into the skin at specific spots to ease pain
- Massage therapy, which may help ease pain and relieve stress
Psychiatry, Psychology, Counseling, and Therapy: What to Expect
Psychiatry and psychology are overlapping professions. Practitioners in both — psychiatrists and psychologists — are mental health professionals. Their area of expertise is the mind — and the way it affects behavior and well-being. They often work together to prevent, diagnose, and treat mental illness. And both are committed to helping people stay mentally well.
But there are differences between psychiatry and psychology. And people sometimes find those differences confusing, especially when they are looking for help. To make matters even more confusing, psychiatrists and psychologists aren’t the only mental health professionals you can choose from. There are mental health counselors, social workers, nurses and nurse practitioners, and others who deal with issues of mental health. And if you consider the multiple approaches to treatment, ranging from counseling to various forms of psychotherapy, the whole mental health system begins to look like a maze that’s nearly impossible to navigate.
But here’s a guide you can use to help you make your way through that maze.
Where to Start
Issues with mental health, especially if they’re chronic (persistent or recurring often), can be debilitating. Your body can respond physically to depression or anxiety much like it does to physical illness. And sometimes, mental problems can actually be caused by a physical condition. So the first person to see if you think you are having a mental problem is your primary care doctor.
Your doctor will ask about your symptoms, how long you’ve been having them, and whether they’re constant or come and go. Your doctor will check for physical problems that could be causing your symptoms and help you decide what type of mental health professional and what kind of therapy might be best for you.
Types of Mental Health Professionals
Your doctor might refer you to any of the following mental health professionals:
Psychiatrist. A psychiatrist is a medical doctor (M.D. or D.O.) who specializes in preventing, diagnosing, and treating mental illness. A psychiatrist’s training starts with four years of medical school and is followed by a one-year internship and at least three years of specialized training as a psychiatric resident. A psychiatrist is trained to differentiate mental health problems from other underlying medical conditions that could present with psychiatric symptoms. They also monitor the effects of mental illness on other physical conditions (such as problems with the heart or high blood pressure), and the effects of medicines on the body (such as weight, blood sugar, blood pressure, sleep, and kidney or liver functioning).
As a doctor, a psychiatrist is licensed to write prescriptions. Many mental disorders — such as depression, anxiety, ADHD, or bipolar disorder — can be treated effectively with specific drugs. If you are working with a psychiatrist, a lot of the treatment may be focused on medication management. Sometimes medication alone is enough to treat the mental illness. Sometimes a combination of medication and psychotherapy or counseling is needed. If that is the case, the psychiatrist may provide the psychotherapy, or the psychiatrist may refer you to a counselor or other type of mental health professional.
Psychologist. A psychologist has a doctoral degree (PhD, PsyD, or EdD) in psychology, which is the study of the mind and behaviors. Graduate school provides a psychologist an education in evaluating and treating mental and emotional disorders. After completing graduate school, a clinical psychologist completes an internship that lasts two to three years and provides further training in treatment methods, psychological theory, and behavioral therapy.
Licensed psychologists are qualified to do counseling and psychotherapy, perform psychological testing, and provide treatment for mental disorders. They are not, though, medical doctors. That means that, with the exception of a few states, psychologists cannot write prescriptions or perform medical procedures. Often a psychologist will work in association with a psychiatrist or other medical doctor who provides the medical treatment for mental illness while the psychologist provides the psychotherapy.
Licensed Mental Health Counselor. A psychological counselor is a mental health professional who has a master’s degree (MA) in psychology, counseling, or a related field. In order to be licensed, the professional counselor also needs two additional years’ experience working with a qualified mental health professional after graduate school. A mental health counselor is qualified to evaluate and treat mental problems by providing counseling or psychotherapy.
Clinical Social Worker. A clinical social worker has at least a master’s degree in social work and training to be able to evaluate and treat mental illnesses. In addition to psychotherapy, social workers can provide case management and hospital discharge planning as well as work as an advocate for patients and their family.
Psychiatric or Mental Health Nurse. Some nurses have had special training in providing mental health services. Depending on their level of training and certification, they can evaluate patients for mental illness and provide treatment in the form of psychotherapy. In some states, they are also licensed to prescribe and monitor medications, sometimes independently and sometimes under the supervision of a medical doctor. Nurses also provide case-management services and serve as patient advocates.
The Difference Between Counseling and Psychotherapy
Although the terms counseling and therapy are often used interchangeably, there is a difference between psychotherapy and psychological counseling. Counseling focuses on specific issues and is designed to help a person address a particular problem, such as addiction or stress management. The focus may be on problem solving or on learning specific techniques for coping with or avoiding problem areas. Counseling is also usually more short-term than therapy.
Psychotherapy is more long-term than counseling and focuses on a broader range of issues. The underlying principle is that a person’s patterns of thinking and behavior affect the way that person interacts with the world. Depending on the specific type of psychotherapy that is being used, the goal is to help people feel better equipped to manage stresses, understand patterns in their behavior that may interfere with reaching personal goals, have more satisfying relationships, and better regulate their thinking and emotional responses to stressful situations. If someone has a form of mental illness such as depression, bipolar disorder, schizophrenia, or an anxiety disorder, psychotherapy also addresses ways in which the illnesses affects their daily life, focuses on how to best understand the illness and manage its symptoms and follow medical recommendations.
Types of Psychotherapy
There are numerous approaches to psychotherapy, also called talk therapy, from which mental health professionals draw their treatment practices. Different types of psychotherapies are often better-suited to specific types of problems. For example, some psychotherapies are designed mainly to treat disorders like depression or anxiety, while others focus more on helping people overcome problems with relationships or obstacles to greater life satisfaction. Some forms of psychotherapy are one-on-one with a therapist, while others are group-based or family-based. According to the American Psychological Association, those approaches fall into five broad categories.
Psychoanalytic or psychodynamic therapies. The idea behind this kind of therapy is that people’s lives are affected by unconscious issues and conflicts. The goal of the therapist is to help the person bring those issues to a conscious level where they can be understood and dealt with. This may involve analyzing dreams or exploring a person’s personal history.
Behavioral Therapy. This approach to therapy focuses on learning and behavior in an effort to change unhealthy behavioral patterns. Some therapists try to help patients learn new associations by using a system of reward and punishment to bring about certain behavioral changes. Another approach might involve a controlled series of exposures to a phobia trigger to desensitize a person to an unreasonable fear.
Cognitive Therapy. The emphasis in cognitive therapy is on a person’s thoughts. The idea is that dysfunctional thinking is what leads to dysfunctional emotions or behaviors. The goal is to help the person recognize unhealthy thinking patterns and to recognize and change inaccurate beliefs.
Humanistic Therapy. This approach to therapy is based on the idea that people are capable of making rational choices and developing their maximum potential. This approach to therapy is often client centered, with the client being seen as the authority on what is going on inside.
Integrative or Holistic Therapy. This approach relies on integrating multiple approaches to therapy based on the client’s individual needs. For instance, cognitive behavioral therapy is a combination of the two individual therapies and focuses on both thought and behavior.
Getting Started With a Mental Health Professional
Finding the right mental health professional and the right approach to therapy is as important as finding the right medical doctor. Whether you are planning to see a psychologist or a psychiatrist or another type of mental health professional, you should start with a phone call to the professional. Ask about the professional’s approach to dealing with mental issues and how they generally work with clients. Ask about whether or not they accept insurance and how payments are handled. You might describe your reason for wanting to make an appointment and ask if they are experienced in dealing with such issues. If you are comfortable talking with them, the next step is to make an appointment.
At your first office visit, the mental health professional will want to talk with you about why you think you need to come to therapy. They will want to know about what your symptoms are, how long you’ve had them and what, if anything, you’ve done about them in the past. They will probably ask you about your family and your work as well as what you do to relax. This initial conversation is important in developing the appropriate approach to treatment. Before you leave the office, the mental health professional should describe to you the plan for treatment and give you an opportunity to ask any questions you might have.
It will likely take several weeks before you become fully comfortable with your therapy. If you still aren’t feeling comfortable after two or three visits, let the mental health professional know and explain why you feel that way. The two of you need to work together as a team in order to get the most out of your treatment.
90,000 Chronic fatigue syndrome. Symptoms Prevention.
Chronic fatigue syndrome – a constant feeling of fatigue and overwork, loss of energy that does not go away even after a long rest. The main cause of the syndrome is considered to be long-term psychoemotional stress on the human nervous system.
Basically, people aged 25-45 are susceptible to chronic fatigue syndrome, since at this age they are the most efficient and strive for success and career growth, imposing unbearable loads on themselves.According to statistics, about 85-90% of those suffering from this disease are residents of large, densely populated cities, with an accelerated pace of life and an unfavorable environmental situation. The largest number of cases was registered among residents of the United States and Australia.
- Chronic Fatigue Syndrome can spread in the form of an epidemic, affecting several hundred residents of the same city.
- Women suffer from this syndrome several times more often than men, their proportion among the sick is 75-80%.
- Increased responsibility at work (doctors, pilots) can cause chronic fatigue.
- Chronic fatigue syndrome has been officially recognized as an independent disease since 1988.
The causes of chronic fatigue.
The exact causes of chronic fatigue syndrome have not yet been established. However, there are certain risk factors that can trigger the onset of this disease:
- Chronic diseases – prolonged illnesses or frequent relapses disrupt the coordinated work of the immune system and the body as a whole, leading to an overload of the nervous system, depletion of the vital forces of the body and the appearance of a feeling of chronic fatigue;
- Psychological disorders – frequent depression, constant stress, dark thoughts and feelings of anxiety and fear are the main “pests” for the activity of the nervous system, leading to constant fatigue and overwork;
- Wrong lifestyle – chronic lack of sleep, irrational daily routine, prolonged mental or physical stress, lack of sunlight, fresh air or movement can lead to chronic fatigue syndrome;
- Eating disorders – lack or excess of food, poor-quality foods, lack of vitamins, macro- and microelements in food disrupt the body’s metabolism, leading to a lack of energy and the emergence of a persistent feeling of fatigue;
- Environmental factors – an unfavorable environmental situation makes the body work hard, protecting itself from the effects of harmful factors, therefore, people living in polluted noisy cities are more likely to suffer from chronic fatigue syndrome;
- Infections and viruses – there is a theory according to which one of the main causes of chronic fatigue is the ingestion of herpes viruses, cytomegaloviruses, retroviruses, enteroviruses, etc.
Signs and symptoms of chronic fatigue syndrome.
The main difference between chronic fatigue syndrome and simple fatigue is the fact that after a long rest the feeling of fatigue disappears and the body is again ready to work. Chronic fatigue, on the other hand, persists with reduced stress on the body and does not go away even after sound sleep.
The main symptoms of chronic fatigue syndrome are: insomnia, headaches, mental impairment, lack of energy, psychological disorders, impaired physical activity, decreased immunity.
Diagnosis of chronic fatigue syndrome .
When should I see a doctor?
In most cases, the symptoms of this disease appear not one at a time, but immediately in a complex manner. Therefore, you should carefully listen to your body so as not to miss the onset of the disease and avoid possible complications.
If you experience a persistent feeling of fatigue that does not go away after a good rest, bad mood, apathy, weakness and fatigue even after performing light tasks, lack of appetite, poor sleep, you should immediately consult a doctor.Also, chronic fatigue syndrome can be suspected with frequent colds or exacerbations of chronic diseases, since in this case all the body’s forces go to fight the infection, which significantly reduces performance and leads to feelings of constant fatigue and apathy.
Which doctor should I see?
A person with chronic fatigue decides for himself which doctor he should go to. It depends on his understanding of the disease, its main manifestations, as well as the factors that provoked the appearance of this syndrome.
How is CFS diagnosed?
It is very important to distinguish chronic fatigue syndrome from other more serious diseases. Therefore, the doctor should describe in detail all the manifestations of this disease, the possible causes of its occurrence, and also warn about the presence of other diseases or taking medications.
General recommendations for treatment.
- Diet – an adequate intake of proteins, fats and carbohydrates, as well as high-quality foods rich in vitamins, micro- and macroelements, can significantly improve well-being in chronic fatigue syndrome, as well as increase the body’s energy reserves and resistance to harmful environmental factors;
- Psychotherapy – a good psychologist or psychotherapist will help you cope with insomnia, persistent depression, fear and anxiety, teach you how to cope with stressful situations and restore good mood and self-confidence;
- Good sleep – when the nervous system is overstrained, a sufficient amount of sleep and rest is especially important, sleep should be calm, deep, continuous, an adult should be given at least 8 hours of sleep a day;
- Daily routine – to avoid overwork, you need to carefully plan your day, avoid overwork, alternate work and rest, eat at least three times a day, try to spend more time outdoors, and walk for at least 30 minutes a day.
Prevention of chronic fatigue syndrome .
- Proper planning of the daily routine – a well-planned day, alternation of work and rest, daily walks in the fresh air, adequate sleep will help to avoid the occurrence of chronic fatigue syndrome;
- Quitting Bad Habits – Excessive alcohol consumption, smoking, poor quality food or coffee abuse can cause various diseases, including chronic fatigue syndrome;
- Sports – regular sports strengthens the body, improve blood circulation and nutrition of the brain, increase the body’s resistance to stress, restore metabolism;
- Change of environment – trips to nature, frequent walks or forays into the forest, recreation at the resort will help to avoid overstrain and give the nervous system the opportunity to rest and recover;
- Proper nutrition – avoiding fast food, eating a lot of fresh vegetables and fruits, properly preparing food, drinking plenty of fluids throughout the day contribute to the restoration of energy reserves, the good functioning of all organs and systems, as well as strengthening the immune system.
Your health is in your hands!
Take care of yourself and be healthy!
Deputy Head of the Central State Sanitary and Epidemiological Service of the Medical Unit E.A. Lebedeva.
10 causes of chronic fatigue and how to deal with it
10 causes of chronic fatigue and how to deal with it
With the modern rhythm of life and a negative information background, it is very difficult to avoid stress and emotional overwork. It is even worse if fatigue builds up and then begins to come not only at the end of the working day or week, but almost constantly.This means that it is time to finally hear the “help signals” that the body sends.
The causes of chronic fatigue
Chronic fatigue syndrome is a disease of civilized countries. At risk are residents of megacities, especially people whose work is associated with increased responsibility. These include teachers, doctors, firefighters, entrepreneurs, people in high positions. However, chronic fatigue syndrome can also appear in people of other professions – no one is immune from this unpleasant disease.Poor sanitary and ecological conditions, chronic diseases, viral infections and an unbalanced emotional and intellectual load – all this increases the chances of earning chronic fatigue syndrome even at a young age.
The onset of chronic fatigue syndrome is associated with the development of a specific neurosis of the central regulatory centers of the autonomic nervous system. If left untreated, this syndrome can develop into depression, as well as cause infectious and allergic diseases.
Chronic fatigue symptoms
Normally, any severe fatigue goes away after proper sleep and rest. If a person slept and ate well, but continues to feel sluggish and tired, which prevents him from doing his usual things, this is more of a pathological condition. The main symptom of chronic fatigue is unreasonable constant fatigue, which reduces performance by several times. However, this is reflected in the psycho-emotional well-being of a person: it significantly limits everyday life and interferes with communication, since moral resources are no longer enough even for loved ones.In addition, with chronic fatigue, headache, memory impairment, insomnia, nausea and much more occur. Due to the variety of symptoms, the disease is difficult to diagnose.
Chronic weakness and fatigue appear gradually, and a person may not realize for a long time how many opportunities have been lost until he tries to compare his performance in the old days with what is now. Unfortunately, people often attribute the loss of energy to age or life circumstances, thereby ignoring the symptoms and exacerbating the situation.
It is important to pay attention to the following signs of chronic fatigue in time:
- Constant loss of strength and decreased performance.
- Rapid fatigability.
- Mood swings.
- Sleep disorders: drowsiness, insomnia, not invigorating superficial or intermittent sleep.
- Headaches that differ from those before in intensity, nature or duration.
- Problems with memory and thinking: impaired concentration, mood deterioration, difficulty remembering information, irritability.
- Decreased immunity, for example, frequent sore throat, exacerbation of chronic diseases.
- Increased body temperature.
- Increase in different groups of lymph nodes: cervical, axillary or others.
The first of the listed symptoms is key, while the rest complement the picture.In advanced cases, chronic fatigue not only reduces the quality of life, but can also provoke life-threatening situations. For example, sudden deterioration in concentration or drowsiness is a common cause of accidents. That is why it is important to start treatment on time for chronic fatigue syndrome.
Treatment and prevention
Chronic fatigue syndrome can and should be treated, but don’t self-medicate. Only doctors who can prescribe outpatient treatment or send to a wellness center are able to correctly determine the diagnosis.People at risk and those who have noticed anxiety symptoms should pay attention to their lifestyle.
Make sure to rest for a couple of weeks at least twice a year. Give yourself a couple of hours in the evenings, and spend time with family or friends on weekends.
2. Physical activity
Correct and regular physical activity helps to strengthen the body, improve mood and cope with fatigue.Swimming, fitness, yoga, aerobics, running, dancing, cycling, and even regular morning exercises will do.
3. Healthy sleep
Try to get at least 6-8 hours of sleep. At the same time, it is very important to sleep in the dark: melatonin is produced during sleep at night. Deficiencies can cause stress.
4. Wellness procedures and normalization of the psycho-emotional background
To improve the general condition of the body in case of overwork and chronic fatigue syndrome, it is worth taking a course of massage and other health-improving and relaxing procedures.
Chronic fatigue and its consequences
There is such a thing as chronic fatigue syndrome. It would seem that everyone gets tired and you just need to rest, have a full sleep, but in fact it doesn’t get any easier. This is the main symptom of such a disease, constant fatigue and fatigue can last for months and years without any other signs. At the same time, a person feels sluggish, he is pursued by an oppressed state.
People from 25 to 45 years old who are trying to succeed in their careers are most susceptible to this syndrome. They take on too much responsibility and work to the bone, even to the detriment of mental and physical health.
Signs of chronic fatigue
In this condition, the disease can manifest itself unexpectedly, for example, a cold or indigestion. For a gastroenterologist, this can interfere with making the correct diagnosis, if he does not find anything significant, then a good specialist will definitely refer you to a neurologist.
When a person develops chronic fatigue, his immunity decreases and the body is susceptible to attacks by various viruses and bacteria. Against the background of a decrease in protective forces, a person can get sick with a variety of ailments. This is the main danger of chronic fatigue. Most often, problems happen at work:
of the gastrointestinal tract, it is a dull or aching pain, a feeling of heaviness in the stomach, a violation of the stool;
hearts, rhythm is disturbed, pains appear;
liver and kidney.
Hair loss, dull complexion, weight loss, characteristic of chronic fatigue syndrome. Medication can mask the symptoms, but not correct the cause. What other signs may indicate a disease:
feeling of moral and physical devastation;
unwillingness to communicate with others;
avoiding a new job;
impairment of memory, attention, concentration;
poor sleep despite fatigue.
The body will react in this way:
sore throat, joints, muscles;
migraines, pain in the temple area;
fast fatigue after minimal stress;
increased body temperature;
inflammation of the lymph nodes.
This is not a complete list of the consequences of chronic fatigue, in each case the body reacts differently.If there are several of the listed signs, for example, persistent headache, restless sleep, then you need to seek medical help.
Causes of the disease
To defeat chronic fatigue, you need to understand where it comes from. This condition can be called a disease or syndrome if it does not go away for more than 3 months. The causes of the condition include:
tragic events in human life;
exhausting mental stress;
constant change of biorhythms;
poor nutrition with a lack of essential vitamins, minerals and amino acids;
thyroid problems, autoimmune diseases;
alcoholism or drug addiction;
use of certain medications;
depression, obsessive states, fears, phobias;
sedentary lifestyle, lack of sunlight, air;
no change of scenery.
Chronic fatigue does not appear overnight, it accumulates from daily stress, worries, and so on. This syndrome is typical for residents of large cities, with a fast pace of life and an unfavorable environment.
How to deal with fatigue
Getting rid of an illness should begin with a visit to a psychologist and other specialists. There are viral infections that can affect the constant feeling of fatigue, therefore, the bacterial nature of the disease must be ruled out.An electrocardiogram, blood and urine tests, and allergy tests are prescribed.
A patient with suspicion of certain diseases may have to visit a gastroenterologist, endocrinologist, neurologist. After excluding the organic cause, the diagnosis of Chronic Fatigue Syndrome is established.
The psychologist in his work with patients applies individual or group therapies with effective methods for relieving stress, for example, through:
creative art process;
creative therapy based on fine motor skills of the hands, as well as other methods that will be effective in each individual case.
Treatment for a psychogenic cause should be systematic, long-term, and it will include lifestyle changes, getting rid of bad habits, stress. Workaholics will have to reconsider their priorities, learn to get more rest and spend time with loved ones.
The specialist will also prescribe medications that alleviate the condition and symptoms at the initial stage of complex treatment. These are sedatives, sleeping pills, possibly antidepressants.In addition to the course of therapy, massage, hydrotherapy, etc. can be used. Subject to all the recommendations of doctors, the prognosis of treatment is favorable – recovery occurs within 2-3 months. It is important to seek help without using antidepressants uncontrollably or, even worse, alcohol, causing additional harm to the body.
90,000 How to distinguish ordinary fatigue from dangerous chronic fatigue syndrome – explains the doctor
Why is this happening? There are several suggestions
Every cell in the human body has tiny components – organelles called mitochondria.They are sometimes called cell generators because their job is to generate energy. Mitochondria can be poisoned by toxins such as pesticides, chronic bacterial, viral, and fungal infections, or nutritional and hormone deficiencies. Parts of the brain such as the hypothalamus and pituitary gland can be especially sensitive to any such malfunction, and chronic fatigue can become one of the symptoms of decreased function of the hypothalamus and pituitary gland.
Deficiency of thyroid and adrenal hormones, in particular cortisol, is the most common cause of squeezed orange syndrome.Chronic stress leads to depletion of the adrenal glands – this is adrenal insufficiency in which the body is no longer able to produce enough cortisol (stress hormone). Low cortisol levels are a sign of chronic fatigue syndrome. Thyroid hormone levels are reduced by toxins and disturbances in the hypothalamus or pituitary gland.
Infections can cause or contribute to chronic fatigue syndrome and / or fibromyalgia.For example, the Epstein-Barr virus, herpes virus or bacterial infections can become provocative.
In response to chronic infection, the immune system can cause a special type of blood clotting disorder called coagulation. Instead of dissolving blood clots, it forms deposits on the inner wall of blood vessels. These deposits impede the delivery of oxygen and nutrients to all parts of the body, which also contributes to the development of chronic fatigue syndrome.Neurotoxic compounds such as salts of heavy metals (mercury, lead) that enter the brain can also contribute to the development of chronic fatigue syndrome and fibromyalgia.
90,000 symptoms, diagnosis, treatment of chronic fatigue – Department of Neurology of the Central Clinical Hospital of the Russian Academy of Sciences
Chronic Fatigue Syndrome (CFS) is a disease characterized by an endless feeling of fatigue, loss of strength, fatigue, which does not go away even after sound sleep and prolonged rest.Psychoemotional stress on the human nervous system is the main cause of this disease. Residents of megacities aged 25 to 45 are most susceptible to chronic fatigue syndrome, and women suffer more from this ailment. Until recently, it was believed that only adults are susceptible to the disease, but now the diagnosis of chronic fatigue syndrome has begun to haunt children, especially of school age.
Causes of chronic fatigue.
The exact causes of chronic fatigue syndrome have not yet been established. However, there are risk factors that can provoke the onset of this disease:
- Wrong lifestyle (frequent lack of sleep, lack of sunlight and fresh air, the use of nicotine and alcohol, etc.)
- Chronic diseases (lead to depletion of the body)
- Psychological disorders (constant stress, frequent depression, anxiety)
- Unbalanced diet (low-quality food, excess or lack of food, lack of vitamins)
- Unfavorable environment (the ecological situation in cities is much worse than in rural areas)
- Infections and viruses (the body’s constant fight against viruses leads to general fatigue)
Symptoms of the disease.
A distinctive feature of chronic fatigue is constant overwork, which does not disappear after sound sleep and long rest. Such a painful condition can last for more than six months.
Other symptoms of chronic fatigue:
- Fast fatigue
- Decreased immunity
- Vertebral and muscle pain
- Mental impairment
- Constant exhaustion
- Swollen lymph nodes (armpits and neck)
This disease must be treated without fail so that in the future it does not lead to the development of serious neuropsychiatric diseases.
Diagnosis of chronic fatigue.
Chronic fatigue syndrome is often difficult to diagnose due to the fact that most of the symptoms occur in other diseases as well. At the same time, the symptoms of this disease appear in a complex, and not one by one. Only a specialist is able to make an accurate diagnosis after a detailed examination and a detailed compilation of a medical history. Sometimes, in order to exclude other pathologies, the doctor may refer the patient to a blood or urine test. The main diagnostic sign of the disease is the appearance of a persistent feeling of fatigue, which does not disappear after a good rest, and bad mood, loss of appetite, apathy, general weakness are associated factors.Frequent colds, exacerbation of chronic diseases can be added to this condition, which significantly reduces performance and aggravates the feeling of constant fatigue.
Depending on the manifestation of the symptoms that provoked this disease, the patient can visit the following specialists:
You can make an appointment with the specialists you are interested in in Moscow at the clinic of the Central Clinical Hospital of the Russian Academy of Sciences.
Treatment of chronic fatigue.
- Medication (vitamins, immunomodulators, homeopathic, anti-inflammatory drugs, antidepressants, antiviral drugs)
- Physiotherapy (physiotherapy exercises, acupuncture, soothing massage, hydrotherapy, etc.))
- Recommended good sleep, diet, planned daily routine.
- Proper nutrition
- Rational planning of the daily routine
- Sports activities
- Healthy sleep
- Quitting bad habits.
If a situation arises in which a professional consultation of a neurologist becomes necessary, please contact the specialists of the Central Clinical Hospital of the Russian Academy of Sciences.The best doctors in the capital will help you restore your health. Recording is conducted around the clock on the site. You can also make an appointment with a neurologist by phone during the working hours of the central clinical hospital.
Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) – Symptoms, Diagnosis and Treatment
Chronic Fatigue Syndrome / Myalgic Encephalomyelitis (CFS / ME) can be distinguished from medical and psychiatric disorders in the differential diagnosis of fatigue due to the presence of debilitating fatigue over 6 months; a combination of cognitive dysfunction, pain throughout the body and sleep that does not bring vigor and restoration of normal function; and also post-load weakness, when exposure to other stressors leads to an exacerbation of such symptoms, developing immediately after such exposure for several hours or in the evening.
The World Health Organization classifies CFS / ME as a neurological disease.
There are no objective diagnostic tests, verified biomarkers, drugs or methods that provide cure for CFS / ME. The primary goals of treatment are symptom relief and functional improvement. Initial treatment should be individualized and based on the patient’s most pronounced complaints.
Chronic but fluctuating disability requires significant lifestyle changes to carefully plan daily activities, conserve energy resources for the most important tasks, schedule rest periods so that people do not overwork themselves and improve the quality of sleep.
Up to 30.5% of the population suffers from chronic fatigue.  van’t Leven M, Zielhuis GA, van der Meer JW, et al. Fatigue and chronic fatigue syndrome-like complaints in the general population. Eur J Public Health. 2010 Jun; 20 (3): 251-7.
Thus, diagnostic criteria and exclusion criteria must be considered when evaluating patients with long-term persistent fatigue.
Several diagnostic criteria for CFS / ME are used in clinical practice. There are also differences and disagreements regarding the use of the concepts of ME, CFS and ME / CFS (doctors often, but not always, use them interchangeably). According to many patients, the name “chronic fatigue syndrome” is superficial, simplistic and carries a negative assessment. The notion of “myalgic encephalomyelitis” is also problematic, given the limited evidence supporting brain inflammation.
CFS / ME is characterized by the sudden or gradual development of persistent fatigue, disabling the patient’s ability to work, post-workout weakness (PNS) / stress exhaustion, sleep that does not bring recovery, cognitive and autonomic disorders, myalgia, arthralgia, headache, sore throat and tenderness of lymph nodes (without palpable lymphadenopathy), with symptoms lasting at least 6 months.  Komaroff AL. Myalgic encephalomyelitis / chronic fatigue syndrome: a real illness.Ann Intern Med. 2015 Jun 16; 162 (12): 871-2.
Fatigue is not associated with other medical or psychiatric conditions, and symptoms do not improve with sleep or rest.
Definitions of CFS / ME have evolved from a focus on fatigue and impairment, as described in the US Centers for Disease Control and Prevention (CDC) criteria, to Post-Exercise Malaise (PEM) / Exercise Waste in ME / CFS, as defined by the Canadian Criteria consensus, and Systemic Exercise Intolerance Disease (SISD), presented in 2015 by the US National Academy of Medicine (then known as the Institute of Medicine [IOM]). Fukuda K, Straus SE, Hickie I, et al. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994 Dec 15; 121 (12): 953-9.
 Carruthers BM, Jain AK, De Meirleir KL, et al. Myalgic encephalomyelitis / chronic fatigue syndrome: clinical working case definition, diagnostic and treatment protocols. J Chron Fatigue S. 2003 Dec; 11 (1): 7-115.https://www.mefmaction.com/images/stories/Medical/ME-CFS-Consensus-Document.pdf
 Jason LA, Evans M, Porter N, et al. The development of a revised Canadian myalgic encephalomyelitis chronic fatigue syndrome case definition. Am J Biochem Biotechnol. 2010; 6 (2): 120-35.
The definition of SZNFN was formulated on the basis of a large-scale analysis of the literature, and this concept was introduced as an alternative to CFS / ME to emphasize that dysfunction affects the whole body and is exacerbated by physical or cognitive stress, as well as by other stressors. Institute of Medicine of the National Academies. Beyond myalgic encephalomyelitis / chronic fatigue syndrome: redefining an illness. Feb 2015 [internet publication].
 Jason LA, Brown A, Evans M, et al. Contrasting chronic fatigue syndrome versus myalgic encephalomyelitis / chronic fatigue syndrome. Fatigue. 2013 Jun 1; 1 (3): 168-83.
http: // www.ncbi.nlm.nih.gov/pubmed/23914329?tool=bestpractice.com
Diagnosis of SZNFN suggests disability-related fatigue, PNS, and restless sleep, which are stable, moderate to severe, and present at least 50% of the time, as well as cognitive or orthostatic intolerance of a similar severity and frequency.  Institute of Medicine of the National Academies. Beyond myalgic encephalomyelitis / chronic fatigue syndrome: redefining an illness.Feb 2015 [internet publication].
Pain is not considered a unique symptom in CFS / ME and was therefore not included in the CFSN criteria. The use of the term SZNFN is not widespread today, and in this topic we will use the designation CFS / ME. These three definitions (CDC, Canadian Consensus Criteria and National Academy of Medicine / IOM) combine criteria focused on PNS, disability, sleep, pain, and perception. Jason LA, Evans M, Brown A, et al. Chronic fatigue syndrome versus sudden onset myalgic encephalomyelitis. J Prev Interv Community. 2015; 43 (1): 62-77.
 Jason LA, Brown A, Clyne E, et al. Contrasting case definitions for chronic fatigue syndrome, myalgic encephalomyelitis / chronic fatigue syndrome and myalgic encephalomyelitis. Eval Health Prof. 2012 Sep; 35 (3): 280-304.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3658447/
PNS is the most characteristic feature of CFS / ME according to the criteria of the National Academy of Medicine / MI  Institute of Medicine of the National Academies. Beyond myalgic encephalomyelitis / chronic fatigue syndrome: redefining an illness. Feb 2015 [internet publication].
 Jason LA, Brown A, Evans M, et al.Contrasting chronic fatigue syndrome versus myalgic encephalomyelitis / chronic fatigue syndrome. Fatigue. 2013 Jun 1; 1 (3): 168-83.
PNS is a collection of symptoms after mental or physical exertion, the duration of which is 24 hours or more. PNS symptoms include fatigue, headache, myalgia, cognitive deficits, and insomnia.PNS can occur even after performing simple tasks (such as walking or maintaining a conversation) and requires significant lifestyle changes for people with CFS / ME to maintain their physical resources and mental focus to remain functional in normal professional, educational and social settings. [ 10] Jason LA, Evans M, So S, et al. Problems in defining post-exertional malaise. J Prev Interv Community. 2015; 43 (1): 20-31.
http: // www.ncbi.nlm.nih.gov/pubmed/25584525?tool=bestpractice.com
Often, the productive efforts of patients are limited to a few hours a day, the rest of the time they spend resting, slowly and only partially recovering from disorganized thoughts, general body pain, weakness and other signs of chronic fatigue. The definition of fatigue as mental and mental fatigue is too simplistic to denote the scope of injury in CFS / ME and indicates an inconsistency with the word “fatigue”.There is a significant bias in the use of the vocabulary of acute viral diseases such as influenza or polio, as they are historically considered prerequisites for CFS / ME.  Sigurdsson B. Clinical findings six years after outbreak of Akureyri disease. Lancet. 1956 May 26; 270 (6926): 766-7.
The World Health Organization classifies CFS / ME as a neurological disease.  World Health Organization.International classification of diseases 11th revision for mortality and morbidity statistics (ICD-11 MMS). 2018 [internet publication].
If your child complains of fatigue
How to recognize this condition and help to cope with it?
Until recently, it was believed that chronic fatigue is the scourge of only adults who are exposed to stress at work.Today, the diagnosis of chronic fatigue syndrome has begun to overtake children, especially of school age. Alas, their lives are also full of stress, emotional stress, instability in relationships with parents and peers.
When does chronic fatigue appear?
Chronic fatigue syndrome sounds to many not as a diagnosis, but as an “excuse”. But in fact, psychologists and neurologists have long recognized the seriousness of this condition, although it cannot be called a disease in the full sense of the word.Chronic fatigue syndrome can be characterized as a low resistance of the nervous system to psycho-emotional and physical overload.
Most often this condition occurs after a period of overwork, both nervous and physical. In other words, chronic fatigue can occur both after a strong experience of stress, and as a result of a busy rhythm of life, for which the child was not ready. Overwork, one way or another, is faced by every modern schoolchild: lessons, extra classes, TV, computer, telephone, relationships with peers – all this easily exceeds the permissible limits of the load on the child’s psyche.Although sometimes the cause of chronic fatigue may lie in a common cold, which weakened the child’s body and left such a “side effect”.
Signs of chronic fatigue
Chronic fatigue syndrome is manifested not only by apathy and lethargy. He has other signs that noticeably interfere with learning normally and just enjoying life.
- Sleep disturbance. You should be wary if the child suddenly began to fall asleep longer than usual, wake up more often in the middle of the night, or, conversely, constantly want to sleep.
- Loss of appetite. Chronic fatigue often leads to the fact that the child refuses to eat, it suddenly becomes completely unappetizing for him, even when it comes to the once favorite dishes.
- Changeable mood. Moodiness and tearfulness during the day can change dramatically to irritability or apathy.
- Physical discomfort, especially headache and increased sensitivity to weather changes.
- Decreased performance and concentration.
Unfortunately, parents sometimes do not understand what caused such changes in the child’s behavior, and begin to get angry at his “bad character”, exacerbating the situation. Although it is in such cases, it is necessary to seek advice from a neurologist or a child psychologist in order to analyze the symptoms and get the recommendations of a competent specialist.
Fight against chronic fatigue
There are very simple techniques that will work effectively if parents use them regularly.First of all, you need to establish the child’s sleep pattern. Track the time when the baby goes to bed.
In case he falls asleep badly, stay with him so that the childish feeling of anxiety recedes. Even on weekends, do not allow your child to stay up late watching the TV, as this indulgence can shift the entire sleep schedule.
Encourage daily walks in the fresh air. Do not forbid your child to meet with friends on the playground after school because of the need to do homework, because if he is not feeling well, he will still not be able to study well.
Be sure to unload your extra-curriculum schedule. Discuss with your child and choose the ones that he really needs and those that can be donated. If possible, make a convenient schedule so that there is at least one completely free weekday. At the same time, it is advisable to add something new to the routine of everyday affairs – it is this move that helps to cope with chronic fatigue. Watching TV again can be replaced by watching a movie in a cinema, walking in a green area, or in an amusement park.
Reduce the time your child spends at the computer and TV. Constant eye strain, coupled with a continuous flow of information, does not allow a normal rest, although the kid himself is sure that computer games are a way to relax.
Do not force your child to do the same thing for a long time without interruption. After 45 minutes of doing your homework, you need at least a 15-minute break. Correct organization of work and rest, reduction of stress, positive emotions and pleasant impressions will have a positive effect on the children’s nervous system.Chronic fatigue syndrome can be overcome, the main thing is to provide children with help and support on time.
Pediatrician of the OKDC Anna Pogorelova