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Sick and Tired and don't want to lose my job. Help.
October 17, 2011 8:36 AM   Subscribe

I’m sick, or overworked, or both, and need to come up with a plan to deal with it and not lose my job. My doctor hasn’t been able to find what’s wrong or help me get better. I love my work but it’s stressful, and getting worse as I get worse. I may need extended time off but not sure how to do it, or if that is even the best solution.

I’ve been struggling for a while now with an undiagnosed problem where I’m tired all the time. There are several other symptoms, but the big, problematic complaint is that I’m always sleepy, I’m fatigued after a short amount of physical activity, I have problems with insomnia (but not always hand-in-hand). It’s been going on for a few years, and getting progressively worse, though there are various ups and downs. I’ve worked with my doctor to try and find the cause, and been to a few specialists, but so far no one really knows. Part of it is my fault, I haven’t always followed up with my doctor as well as I should, a) being too tired to follow up b) being frustrated by the lack of progress.

Tired as I may be, I could generally do my job. It might take a lot out of me and I might be useless after work, but since my job is sitting and using my mental facilities, I have been able to do it. However, the last several months I’ve felt like my ability to think clearly and concentrate has gone down the tubes, and it’s really affecting my ability to get my work done. I either make really obvious mistakes, or it takes me significantly longer to figure things out. I just feel like there is a fog over my thoughts. And because of this, I’ve been taking work home, trying to get more time to do what I need to do. Of course, this creates a vicious cycle where I’m more stressed and more foggy and then in a bit of a panic.

It really hit me last week how bad it had gotten, when I sat at my desk trying to focus and figure something out, and I sat there, basically unable to do anything for the last 3 hours of the day. I just couldn’t focus and couldn’t think clearly. I kept redoing things and getting nowhere.

So far, no one has really noticed, or at least said anything about my performance, or lack there of, but I’m not sure how much longer I can hide this. My boss knows I’m going to the doctor for some vague medical reason (I needed to tell him so he knew why I was leaving work to go to the doctor so frequently). I really like my job, but I don’t know how much more I can keep it up before it starts to negatively impact me.

On top of that, my job has a busy season that is very stressful. Fun, in its own way, because everyone really comes together to work hard, but it’s difficult. And this year there was a lot of additional stress, we had a big project launch that required everyone to be working a lot more than normal, and didn’t get a break from that project to the busy season. On top of that, I recently got a promotion I’ve been wanting, which is wonderful, but now I’m afraid I’m letting people down. I don’t know how much stress is playing into everything that is going on with me, but I’m sure it can’t be helping.

I’ve considering looking for a new job, but fundamentally, I like my employer and I love the job I’m doing, when I can do it well. I’m also not sure jumping into a new job is going to help with whatever *IS* wrong with me. And I’ve started to think that maybe I just don’t want to work anymore, anywhere, which is a really unusual thought for me, I love what I do professionally.

I’ve taken two vacations this past summer, hoping the time away from the office would help me clear my head and feel better. They didn’t. I don’t want to say I felt worse, but there was no rejuvenation or refreshed feeling.

Even though I’m currently working closely with my doctor to figure out what’s wrong, I’m afraid I’ll keep declining at work and lose my job. I’ve been starting to think that maybe I need to take a month or two off to clear my head of anything related to being stressed out and to focus on figuring out what’s wrong with me. But how does one take FMLA if they don’t have a diagnosis? I’ve considered talking to my boss to see if I can just take a leave of absence, and I think he’s the type of person to be understanding about it, however I know how easily minds can change once you’re not around every day, hence my interest in FMLA. And what if after 2 months, I still don't know what's wrong and I still feel terrible?

Two things I should mention because they seem relevant:
One, I don’t think its depression, I see that mentioned in a lot of threads with people feeling tired. But in general, I’m pretty happy and have as rich of a life outside of work as my energy levels allow, I just peter out quickly.

And two, most of the problems I’ve noticed with my ability to focus started before the big stressors at work started. It’s gotten worse, perhaps exacerbated by it, but it wasn’t the start of it.

I don’t know what the next steps are, and I’m turning to the hive mind for advice. Time off seems to be the most logical thing I can think of right now, but I’m not sure I’m in a state to see clearly or make good decisions about this.

Anonymous because my online identity is tied closely to work. If you need to get in touch, email me at throwmeaway2011@gmail.com
posted by anonymous to Work & Money (23 answers total) 15 users marked this as a favorite
 
Have you had your thyroid tested? Have you been tested for Lyme disease? Are there any other symptoms besides fatigue? Does caffeine help you focus?
posted by bq at 8:59 AM on October 17, 2011 [1 favorite]


Dude, you sound burnt out, plain and simple.

I used to feel the same as you, tired all the time, energy petering out quickly, poor concentration. Are you irritable? Have you gained weight recently? You don't mention it in your question, but how many hours a day are you truly putting in at work? Not everyone can put in herculean hours in at work every day and wake up fresh as a daisy every morning.

My doctor once told me that it takes as long to recover from stress as you spent being stressed. A couple of short vacations might not have restored your energy, depending on how long you've been under stress.

In terms of what to do, start small. For me, a simple thing like starting work at 9am instead of at 8am made a huge difference. I was still just as likely to work late, but I wasn't putting in crazy hours each day by virtue of the extra hour in the mornings. Try small changes to see what works.

As you move up the ranks, you'll start to notice people jealously guarding their free time. This is something all managers have to learn sooner or later. If you take on the work, people will gladly give it to you. And then bugger off to enjoy their free time. Don't let that happen.

Good luck!
posted by LN at 9:24 AM on October 17, 2011 [1 favorite]


You might also consider getting tested for sleep apnea.
posted by elmay at 9:25 AM on October 17, 2011 [1 favorite]


In response to your assertion about your loss of focus prior to the big stressors at work: it has been my observation in the past that people in the modern era are really, really poor at assessing when they're under stress. So much of our lives are spent rushing around and trying to do more that we don't recognize the low-level stress in our lives any longer. Just the big, major-league stresses.

Just bear in mind that you may have been under stress longer than you imagine.
posted by LN at 9:28 AM on October 17, 2011 [3 favorites]


i think that you can get FMLA without a diagnosis. your doctor has to fill out paperwork and they can say on there that you need some time to rest and undergo further testing until they can figure out what is going on.

i've seen the papers in HR before - i think it's just a simple one page form with some blanks. you might also be able to just get an adjusted schedule - maybe work from home half-time for a month or two. i've worked with people who've had health or family issues that did this sort of thing.
posted by sio42 at 9:33 AM on October 17, 2011


I was also thinking sleep apnea. There is a type of apnea called central apnea where you basically stop breathing periodically through out the night.
posted by dyno04 at 9:56 AM on October 17, 2011


You sound like a friend of mine, who has struggled with an odd mix of maladies (some diagnosed, some not) for the last several years. She took FMLA a few years ago and it really helped her during a terrible low point. The paperwork, as sio42 said, is pretty simple.
posted by fairfax at 10:22 AM on October 17, 2011


Have you had your thyroid tested? Sleep issues + fatigue + brain fog is exactly how mine tends to pop up when it's getting wonky. If you haven't had this tested, you should. You may also have a Vitamin D issue. (IANAD, and I imagine yours has already thought of this.)

In my personal experience, I have issues like this when I am stressed about work, in part because the stress means I neglect my personal health -- I don't sleep well, I drink too much, my nutrition isn't great, and I don't exercise the way I should, and my health suffers, because I am not as able to take the strain as well as I used to be able when I was younger.

It is hard to know how to manage work stress when you really like your job, though, because you don't want to GET another job. For me, I just have to be mindful of it -- and take off whole weekends instead of sort of half-assedly kind of working during them, which I have a tendency to do, and you might as well.
posted by Countess Sandwich at 10:32 AM on October 17, 2011


Seconding the person who said this sounds like burn-out.

You're working too hard, or too long, or you're stressing/thinking about work too much. Yes, a vacation would be good, but what would be better would be to re-think the way you think about work. Take steps to really manage your time. Really get hold of that, because it will give you control, and control reduces stress. And you are stressed. You were stressed before you think the stress started. Where you think the stress started was merely where you noticed it. This is not where it started.

Get strict. Lay down some lines in the sand. You do not do any of that unpaid overtime nonsense for a while. You get hard-ass on anyone who tries to impose on you or take you away from your priorities. You explain to your boss that you need to make some changes in your work pattern in order to become more productive and effective, and those changes involve less overtime, ability to work flexi (if you don't already have it) and, if possible, ability to work from home now and then. Stuff like that. Get yourself more time away from work and try to impose more structure on your work time. Do not sit there for three hours thinking "Shit, I can't concentrate", tell your boss you're leaving early and you'll put the time in later in the week. And so on. However it works, or can work, at your place.

Work to live. Do not live to work. Not when it makes you feel like this. You do not sound ill, to me. You just sound stressed.
posted by Decani at 10:40 AM on October 17, 2011 [2 favorites]


New doctor?

You may love and trust your doctor, but sometimes a new set of eyes and/or a specialist may be helpful.

Take care.
posted by BlueHorse at 11:18 AM on October 17, 2011


Have you considering consulting a naturopath? I don't know how you feel about alternative medicine, but my naturopath was able to help me with a very similar situation a few years ago where my family doctor and the various specialists she referred me to weren't able to help me.
posted by Amy NM at 11:28 AM on October 17, 2011


If you're tired all the time and feel just as badly on the weekends as you do the weekdays, and vacation didn't help at all, I don't think we can blame it on being burned out on your job. I also tend to think that looking for a NEW job is only going to stress you out more, and if you're not feeling overly capable at the one you have right now, how are you going to have the energy to job hunt and then master a new job? Not to mention the joys of dealing with the health insurance if you change insurers or something.

I think you need to tell your doctor, "Look, I was unable to think or function at work for the last 3 hours and I am deeply worried about my ability to continue here. Is there any way you could write me a prescription" (or whatever it's called) "for medical leave if I stop being able to function, even if we have no diagnosis?"
posted by jenfullmoon at 1:33 PM on October 17, 2011 [1 favorite]


Echoing some things already said, and throwing in some new ones: could be thyroid, sleep apnea, or allergies. It could be one, or even all, of these.

You could be vitamin/mineral deficient. (Especially if you happen to be vegetarian/vegan, but even if you're not - modern food has most of the good stuff processed out of it. Even "fresh" produce has been sitting around so long before you buy it that there's not much nutrition left in it.) Try taking a really good multi-vitamin. Not the drugstore one-per-day stuff, but something from a health food store. I like Bluebonnet Super Earth Multinutrient (check out the "Supplement Facts" tab) best, or the Alive brand as a second choice. With either of these, I get the iron-free and also take (vegetarian, non-binding) iron from MegaFood, and additional B vitamins, calcium citrate, potassium, and vitamin D. Yeah, it's a handful of stuff, but it has made a huge difference in how I feel. Additionally, several people who have started taking the Bluebonnet multi-vitamins on my recommendation have told me how much better they felt after a few weeks.

Note: Calcium and vitamin D should be taken at the opposite end of the day from the other stuff, because it there's some sort of absorption issue when calcium is taken with other stuff - think it's the potassium, but I don't remember for sure.
posted by MexicanYenta at 1:35 PM on October 17, 2011


I feel your fog, and your fatigue. You're describing exactly how I felt at work 16 years ago, just before I took a "3 week leave" that turned into permanent disability. One day, my boss did notice how wonky I was, and she had someone drive me home. I rested, and de-stressed, ate like a saint, exercised gently in the fresh air, and tried to go back part-time, but my sick body could not be cajoled back to anything near normal functioning. For years they called it "chronic fatigue syndrome," then finally my symptoms became clearer and they identified a nasty little bundle of autoimmune diseases.

Your fatigue might be the fatigue of stress and burn-out, but it sounds more like the fatigue of illness. You're not describing a situation that sounds desperately stressful, and you certainly don't sound depressed. Unaccountable, disproportionate, unrelenting fatigue is a hallmark of many illnesses. It's especially frustrating when it's the first symptom to show up; diagnosis can be nearly impossible until you get sicker with whatever it is that's stealing your energy.

Pursuing a medical leave seems like a good idea, to give yourself time to focus on pursuing a good diagnosis. If you run into any doctors who don't take you seriously, or who want to tell you it's all in your head or you just need to get some exercise, don't waste your time on them. When fatigue becomes this debilitating, it needs to be taken seriously. Hope you're feeling better soon.
posted by Corvid at 1:52 PM on October 17, 2011 [2 favorites]


Wow, been there, done that. I too suffer from fatigue. I've been diagnosed over the years with Chronic Fatigue Syndrome, allergies, Chronic Mono (that's a fun one), a sleep disorder and depression (not depressed but everything else). Because I look so healthy, I have no support from anyone. I hide my symptoms as best I can because no one believes me anyway.

I am highly allergic to everything. If I avoid allergy triggers (nearly impossible) and avoid stress (really impossible) then I can have good days. I try to find a balance. Stress makes my symptoms worse. Moderate exercise helps me sleep and reduces stress.

The trick is to do just enough exercise to relieve stress and tire yourself out enough to sleep well that night, without doing so much that you make the fatigue worse.

I don't know if you are physically active or not. If you are not, then commit to walking at least 15 minutes, every day, for a week, in the sunlight if possible. Then switch it up to 30 minutes every other day. If you have access to yoga classes, commit to them.

Avoid eating anything that cannot be grown in someone's back yard.

Your body has been feeling like this for a long time, it's going to take awhile before you feel better. Stress does make any illness worse. Exercise can alleviate a lot of stress. It can help you to sleep better at night.

I would try diet and exercise before quitting your job, but if you are already doing that stuff then you may need to find something less stressful.

Good luck! It does get better, then it gets worse, then better again.
posted by myselfasme at 3:43 PM on October 17, 2011 [1 favorite]


Another me, too, here. I've had Chronic Fatigue, which is a description more than a diagnosis, for at least 15 years, and now have a tentative diagnosis of Rheumatoid Arthritis. Does CF cause depression, or does depression cause CF? Don't know, don't care, but anti-depressants help with my energy levels. Go back to the doctor and explain that your work is suffering due to the fatigue, and that you are concerned about keeping your job. There was a CFS story in the BBC recently that may be of interest. If your job offers sick leave and/or disability coverage, consider some serious time off.
posted by Mom at 5:31 PM on October 17, 2011


From the OP:
Thanks for all the thoughts, everyone. The FMLA question cleared up,
anyone know if an extended leave such as this would fall under
something like short term disability? My company offers it, but the
documentation I have is vague about what’s covered. I guess it doesn’t
matter if it’s covered, if I need the time off, I need it off, but it
would be nice to have some idea that I’m protected.

And, anyone who’s taken FMLA or other sickness related leave, any idea
of there will be a stigma attached when I return? I am close friends
with a few of the people I work with, and everyone there is generally
concerned for each other, so I can’t imagine that this won’t get out.

To answer some of the questions, my symptoms are as follows: fatigue,
daytime sleepiness, insomnia, random aches in my legs (infrequent),
headaches and migraines, weight gain, constipation and bloating,
heartburn, cold sensitivity, high blood pressure, high cholesterol, no
libido, frequent yeast infections, dry hair, thinning hair, lack of
focus, brain “fog”, memory problems. (and I have no idea if they are
related or not). Caffeine does help me focus.

I have been tested for thyroid repeatedly in the past few years - but
most of the tests had shown the TSH wasn’t high. It was slightly
elevated the last time it was checked (just over 3), so little that my
doctor wasn’t much concerned but she’s testing for antibodies and t4
levels to be on the safe side (results pending). And the symptoms have
been going on since my TSH was as low as 2. Also being tested for
celiac’s because of some gastrointestinal issues. Had low vit. D this
summer, and low potassium. Vitamin D is fine now, waiting on potassium
results. Noticed a bit of an improvement to my mood with the vitamin
D, but not much in terms of energy.

Weekends aren’t much better than at work, I tend to be too tired to do
much. A small shopping trip tires me out. Some days more than others.
I don’t exercise, I’m too tired to, but when I was trying to last
winter I’d end up with horrible insomnia the night I exercised, even
if I went to the gym early in the evening. Morning exercise is
positively out of the question - I can BARELY get up in the morning,
it is an honest-to-god fight with myself.

I’ve previously had a sleep study, about 5 years ago, which found mild
sleep apnea and restless leg syndrome. RLS was because of low iron,
and resolved with iron pills and eating meat again. I didn’t tolerate
the CPAP well and would rip it off at night without realizing what I
was doing. The doctor at the time thought the apnea was so mild it
wasn’t a major concern. I just got a referral to another sleep doctor,
and will probably be doing another sleep study.

I’ve not been tested for lime disease. I will bring that up to my
doctor. The last time I had a tick bite was probably over a decade
ago, and never had the red ring. Is it still possible I have lime?
I’ve only been bitten by a deer tick once (that I know of), though as
a child I was a bit of a tick magnet for the bigger kind.

myselfasme, your comment scares me. I have allergies, as in I’m
allergic to everything under the sun. Every doctor I’ve ever suggested
their might be a connection to the way I feel and my allergies says
nope, not possible, unless I’m congested and having trouble sleeping
because of that. But they didn’t think that was the case. I’ve also
recently been diagnosed with adult onset asthma after an asthma attack
that occurred early September.

I had surgery September 2010 to open up my nasal passages and sinuses,
and from a comfort level, I feel much better; I can breath in a way I
never could before, and foods taste better, and I don’t wake up every
morning with a sinus headache. A lot of the congestion I thought was
from allergies was from physical blockage, and both my ENT and my
primary physician thought the surgery might also help with my energy
levels, but they seem to still be declining. The ENT thought a) I’d
get more oxygen b) I’d sleep better because I wouldn’t have the
chronic congestion at night and c) It could also affect sleep apnea
because with the way my nose was configured, it was very likely
creating suction in such a way that it stopped my breathing (he
explained it better than I am now)

To all those that said burnout, I wouldn’t doubt that’s coming into
play, but if anything, its a consequence of trying to keep up and
trying to stay ahead of the fatigue. Or maybe its a little more than
that, but I think I’d be able to deal with what my job had to throw my
way if I could just get a little energy.

I don’t have the aches and pains that seem to be associated with CFS
or Fibromyalgia. I do get the occasional aches in my legs, but I can
only describe them as “tired” aches, and they only happen some of the
time.
posted by jessamyn at 12:03 AM on October 18, 2011


I have allergies, as in I’m
allergic to everything under the sun. Every doctor I’ve ever suggested
their might be a connection to the way I feel and my allergies says
nope, not possible, unless I’m congested and having trouble sleeping because of that. But they didn’t think that was the case.


With all due respect, your doctors are so very, very wrong. I'm also allergic to everything under the sun. When I get tired of it and go ahead and eat dairy and/or wheat anyway, for instance, I'm exhausted and unable to function the next day - I have pretty much all the symptoms you describe. If I scrupulously avoid everything I'm allergic to, I feel nearly normal. It absolutely stuns me that any doctor would tell you that your allergies couldn't be causing this.
posted by MexicanYenta at 4:35 AM on October 18, 2011


Hit post too soon. I was going to add, while it might not be a specific allergic reaction, it could be that when your allergies are flaring, it stresses your body to the point that you need extra supplements, as I suggested in my first comment. To automatically say that there is no connection at all strikes me as just not willing to go to the trouble of investigating further.
posted by MexicanYenta at 4:41 AM on October 18, 2011


A lot of the symptoms you describe sound very familiar to me. I've also had repeated thyroid/blood tests in the past couple of years.

Two things:
- have you been tested for diabetes? I imagine so given that it's one of the simple explanations for being tired, but worth trying.
- I had my prolactin levels tested because I had blurred vision as well as headaches/tiredness. This might be worth looking at - it's linked with low libido as well so worth ruling this out as well.
posted by mippy at 8:10 AM on October 18, 2011


I’ve not been tested for lime disease. I will bring that up to my
doctor. The last time I had a tick bite was probably over a decade
ago, and never had the red ring. Is it still possible I have lime?
I’ve only been bitten by a deer tick once (that I know of), though as
a child I was a bit of a tick magnet for the bigger kind.

Yes, it is still possible. Lyme disease does not always present with a red ring. I don't know about the time span.
posted by bq at 1:02 PM on October 18, 2011


Agreeing with MexicanYenta. Doctors--even allergy doctors--might not help you figure out the allergy part very well. My daughter no longer tests positive for dairy allergy but there's NO question she reacts when she has it (sneezing, itching, coughing, stomach upset, dark circles under her eyes, tired). Her doctor says go ahead and have it as much as you want and even SHE knows what will happen after a giant frozen yogurt.

You may have to try out some elimination testing on yourself. My friend with lifelong allergies and asthma says she feels better on a dairy free/gluten free diet. Dramatically. I know it's a bit trendy (at least here) to be gluten free, but don't let that stop you. Good luck!
posted by hellochula at 5:17 PM on October 18, 2011 [1 favorite]


These are classic CLASSIC CLASSIC thyroid symptoms, including the random leg pain, the sensitivity to cold, the fatigue, and the problems with your hair. Literally, every single one of those symptoms you listed presents with thyroid issues. (IANAD, but I HAVE had thyroid problems for over 10 years, although they are well controlled with medicine.) Studies seem to indicate that the range of "normal" thyroid is smaller than some doctors think, and people can be VERY sensitive to small changes in it (which I also am). Slightly elevated can be enough to cause problems, and it's good that she's testing the rest of your antibodies and T4 levels, because that can be telling.

Again, IANAD, but it might be worthwhile to get a second opinion on your thyroid.
posted by Countess Sandwich at 12:07 AM on October 19, 2011


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