Recurring severe fatigue.. how to cope?

July 29, 2007 9:05 AM

Has anyone else experienced recurring bouts of severe fatigue? I'm having trouble keeping to some deadlines on my job because for the past week and a half I've been utterly exhausted..

I have a lot of things to get done (work projects, schoolwork) in the next week and I'm overwhelmed because for at least 8 days now I barely have the energy to leave the house by mid afternoon. Maybe I am making it worse by worrying about it, I also can't seem to sleep until past 2 am. Then I sleep in until after 10 in the morning, because I am so tired.

This is very strange because two weeks ago I had plenty of energy and was doing fine, getting exercise, moving projects along at work. It came on rather suddenly, and now I'm wiped out. I feel terrible and have no motivation and wake up tired. This has happened before and I have been to the doctors but all they've told me thus far is, cut down on stress, and gave me Claritin for allergies. (I am not bipolar.) So I have been getting rest, taking multivitamins, taking Claritin, eating healthy food but the fatigue hasn't passed yet and things I have to do are just stacking up..

I made another appointment to the doctor but wanted to ask - has this happened to others? Can prolonged stress cause it? Maybe a specific allergy or really bad PMS? What are your strategies for coping with it? What to tell supervisor/coworkers about sudden inability to finish tasks when I don't really know the cause but I have no energy for them? Should I just make the decision now to take a full week off and ask the deadlines be extended?

posted by citron to health & fitness (16 comments total)

Sorry to hear about your fatigue problem. I guess reading your description I'm at a loss for even venturing a guess as to the cause(s). Does it feel mental/emotional or physical?

It sounds like you've got an handle on the physical with your diet. Are you exercising regularly? Getting enough sunlight, fresh air? Taking time out for yourself away from work and other pressures? Hows your alcohol consumption (up or down?)

2am is sort of late to go to bed if you've got to be up and functioning by 8am. Maybe take a mild sleep aid around 9 or 10pm to get back in the habit of sleeping all night? (Also, are you physically trying to go to bed at a reasonable hour, and unable to go to sleep, or have you found yourself staying up watching tv or doing some other passive activity?) Cut out coffee/soda/tea after noon (or all together) if you haven't already.

A girlfriend recently told me of her bout years ago with mono which completely left her wiped out for a month... but I suppose you'd know if you were sick like that (fever, etc.)

Sorry I can't make specific suggestions, but you should go over some of the questions above and work backwards toward specific causes. Good luck!
posted by wfrgms at 9:51 AM on July 29, 2007

The number one cause of sudden fatigue is a thyroid problem. No doubt your doctor will look into that first via a series of blood tests. Google hyperthyroidism or hypothyroidism.

Have you been taking anything that might have affected your thyroid, such as diet tablets (ephedrine or herbal similars)?

Or it could be stress, or caffeine.
posted by deeper red at 10:15 AM on July 29, 2007

Yes prolonged stress can cause fatigue. And its a vicious cycle, because of the stress and fatigue, you don't think as fast, so you get behind in your work, making you more stressed. So does worrying about your symptoms ;)

What do you do at the weekends? Do you take time to just slob out and relax? If you're working on the weekend then you're not getting any time to recharge. Sometimes all it takes is a day or 2 of relaxation and pampering can get you fully recharged and ready to get back to work.

What do you do in the evenings when you get back from work? Do you take some time for yourself?

Taking time off could just cause you more stress, thinking about the pile of work waiting for you when you get back.

Try to put your work into an order of priority then work on 1 project at a time. Try to focus on 1 task at a time and forget all about the other projects
posted by missmagenta at 10:20 AM on July 29, 2007

Lots of diseases can present with fatigue. Have you gotten a second opinion?
posted by NucleophilicAttack at 10:32 AM on July 29, 2007

This happens to me sometimes and is fairly common with some of my co-workers. I have never really solved the problem, but here are some suggestions:

-You mentioned you take Claritin and have allergies. How do you breathe at night? Do you snore? An easy check is to set up a camera on yourself while you sleep or try to sleep. The ungodly expensive check would be to have your doctor order a sleep study. I was diagnosed with sleep apnea a few years ago. I would stop breathing over 200 times a night. Each time my heart rate would jump up for several minutes. I thought it took hours to fall asleep, but I really fell asleep in minutes, but never got to the level where I lost awareness. Eventually you get to the point where you're so tired you "sleep" but you get very little rest, especially your heart. In the morning you are very tired. You're body is trying to rest your heart without sleeping. This is a very under diagnosed problem, although there is more awareness. My sleep doctor was a neurologist who opened a sleep clinic because he lived with sleep apnea for years without being diagnosed. You may have a mild case that comes and goes. breathe Right strips help a bit, but they have devices called CPAP machines that keep a minimum air pressure in your nasal passageways. Another possibility is a sinus infection.

-Also with the allergies, you could have an environmental allergy. Did you start using any scented products about two weeks ago? Different laundry detergent, candles, air fresheners, pesticides, spend more time with a smoker? Or food allergy - different type of alcohol?

-Heat Stress. This may be the most probable since it has probably been a lot hotter where you live in the last few weeks. If your spending more time out in the heat, it will take away a lot of your energy. Try drinking a lot more water and a banana or two if you will be out in the heat, and keep the water coming after you come in.

-Sleeping pills. I really hated the idea of taking sleeping pills, but my doctor suggested trying them and I gave it a shot. My doctor recommended Lunesta. It is supposed to be non addictive and you are supposed to be able to take it for a long time. I found over time it helped me sleep about 6-8 hours a night, but I was pretty much unable to drive for about 10 hours after taking it. Also, it may take a few hours to fall asleep, but you might not remember anything that happened during that time. Over the counter sleep aids might work, but I recommend discussing this with your doctor before taking anything.

-Blood Pressure. How is your blood pressure. If it is low or high it could cause your sleep and tiredness. Get a blood pressure monitor and chart your BP during the day. It may be in normal range when you visit your doctor, but go to an extreme at other times.

-Stress. This is the easiest thing for a doctor to assume and is usually part of the problem. As you alluded to, stress might not be the problem, but worrying about it makes it worse.

-Hormones and metabolism. deeper red mentioned the thyroid. You mentioned PMS which may indicate you think it may be hormonal.

As for taking the week off and getting you deadlines pushed back, this may not help you. Your problem with work is probably not that you are "tired," but that you can not think straight. This is not likely to change if you rest for a week without fixing the underlying problem.

If any of this seems plausible let us know and we may be able to point you in the right direction. Your regular doctor may not be able to help too much and you may want to ask about a referral to a sleep clinic.
posted by Yorrick at 10:32 AM on July 29, 2007 [1 favorite]

Right before my period, I get exhausted, as if knocked out by a sleeping pill. It only lasts a day or two, however. And I tend to get a spike of energy during my period that helps me make up for it. Is it possible you're pregnant? Pregnancy also completely wiped me out, much more severely than PMS, for the first two months. I quit my job because I was afraid the exhaustion was going to be that bad the whole time.

Do you have the kind of job where you can accomplish tasks at home? When I'm off productivitywise, a bout of insomnia actually helps. I get something off my plate and I'm not lying in bed going, "Just let me sleep so I can do work!" Stress and dread can create this sort of cycle and I find getting ahead of things gives me the mental permission to relax.

The healthy thing, of course, is to cut out caffeine, alcohol, get on a normal schedule.

What's worked for me when I'm off my sleep schedule, which is far from the healthy thing, is to push through the tired with caffeine. Slog through my to do list like crazy, one task at a time, staying focused with headphones and a detailed to do list, rewarding myself in small ways (like, if I finish this, I can have a muffin, these 5 things, I can go home and sleep). Then, when things are done, the stress of work is popped in a certain way. I kill off social engagements and anything that's not absolutely necessary and sleep when I can, not when I tell myself I should. So sleeping at 6pm might not get me into a great cycle right away, but I get caught up. And then on weekends, I sleep until my body tells me stop. Which means sometimes I miss a Saturday completely. But usually by Monday I'm in a better rhythm.
posted by Gucky at 10:41 AM on July 29, 2007

This just happened to me and a bunch of coworkers so I think there might be a virus going around. I had about two weeks of utter exhaustion but now I feel better. fwiw, the night I went to bed at 9pm or so and got 10+ hours of sleep I felt nearly human the next day so that's worth a try.
posted by fshgrl at 11:23 AM on July 29, 2007

The number one cause of sudden fatigue is a thyroid problem.

No, it's absolutely not. Not even close. It would be sublime if it were, so that the dozen or so cases of fatigue we see in a month were explainable.

Please go in and see your doctor. If there is no discernable reason, labs ought to be run, including a CBC, TSH, Vitamin D, B12, MMA, CMP for starters. Acute titers of Epstein Barr virus are another thing to check. But most of the time it's a passing issue with no apparent reason.

Good luck.
posted by docpops at 11:41 AM on July 29, 2007

From my (non-medical) experience I would see your description as symptoms of being overloaded; a sign from the body to relax, pause, reduce workload and generally chill out.

I see health as a far greater priority than work, so I would cut out any and all work that isn't essential. If I could take some time off and ask for extensions, I probably would.

It seems unlikely to me that having a break can be worse than forcing yourself to work when you don't feel up to it, and getting stressed out. Sometimes a couple of good nights sleep and a walk in the woods can do wonders.
posted by MetaMonkey at 1:13 PM on July 29, 2007

Yeah, I was going to ask, have you googled "burnout?"
posted by salvia at 4:15 PM on July 29, 2007

Thank you all for the thoughtful replies! I know I need to go back to the doctor and have been several times and wondered if there was anything I hadn't even thought to ask about. It also helps with my stress level at least to know others have had similar experiences, so I appreciate it a lot..

Sleep apnea/sleep trouble I will ask about, I thought that was only likely to happen if one was overweight? sometimes I have felt somehow low on oxygen no matter how I tried to breathe deeply, and where I live (DC area) there tend to be lots of allergens, my current place is a house that gets quite dusty too, though I am moving soon. Maybe that'll make a difference. But I have been living where I am now for a year and the fatigue isn't always a problem, just occasionally.

A little more -

* Yes, I have read plenty on burnout. I am looking into switching jobs at my organization (not finding any good opportunities right now), and I am taking a certification course with tuition covered by my benefits so unwilling to quit the place entirely before the end of the year.

* Does it feel mental/emotional or physical?
Physical, mostly. Mentally plenty of stuff about my job gets to me but it's only sometimes I have a span of days where I run out of gas completely around dinnertime, go home and rest, sleep for nine hours and come into the office after lunch, and am still wiped out by dinnertime again. I eat fine, it's not a blood sugar thing.

* No thyroid problems or anything abnormal in bloodwork I had done last time this was a problem (early this year). They told me take tylenol PM for insomnia when needed and cut back on stress. Not pregnant, not taking any supplements or diet pills.

* I have always had low blood pressure, at the lowest end of the normal range, basically.

* I've been eating a nearly all vegetarian diet in the past month and wonder if that contributed, I tried to get plenty of protein via peanut butter, tofu, tempeh, legumes. Probably slacked off on taking my vitamins, though.

* My next question for AskMeFi should probably be, "what the heck do I do with free time to relax?" I am not that good at figuring out how to do that. I would love to go for a walk in the woods and if I were back in my home town I would do that every weekend but, frankly, in metro DC as a single female walking in the woods is not a wise idea I think. But maybe I will go out to Great Falls, it's not far, or get around to buying a bike and find a nice bike trail.. :)
posted by citron at 4:54 PM on July 29, 2007

I've known more than one person who's adopted "sleeping all day" as a symptom of depression. I had one good friend in college who ended up taking this to a point that it was almost comical--if he had a a big term paper coming up, you'd ask his roommate "Where's 'Jim'?", and he'd say, "Where else? There's a paper due tomorrow. He's sleeping."

Not to make fun of it, but you should seriously consider the option that you're wrestling with some form of depression or deep dissatisfaction with your life, and that some part of your psyche is trying to avoid it through sleep. It's no small thing, but if that's the cause, it's not going to go away until you find a way of dealing with the core cause.

Of course, it might be totally something totally different. No matter what--good luck.
posted by LairBob at 5:08 PM on July 29, 2007

Well, I did Google "burnout" again for a refresher, and -

The following scenarios can lead to workplace burnout:
[...]
* Setting unrealistic goals for yourself or having them imposed upon you.
* Being expected to be too many things to too many people.

This describes my job to a T. Or at least the way my job was, up until quite recently, when management took some steps to change the way things are done. I am feeling resentful about my job as well, because I was indeed asked to do to many things and not given the resources to get them done, and then the yearly evaluation my boss wrote criticized me for showing stress and burnout. I think I need to have a talk with him.
posted by citron at 5:19 PM on July 29, 2007

I know some folks here aren't fans of acupuncture, but I've had success with it for morning tiredness. I was always OK during the day, but I was a zombie for a while after getting up. A couple of acupuncture visits didn't turn me into a morning person person by any means, but I can now function in the mornings a lot better than I was able to before. (I no longer stare into the cabinet where the coffee is, wondering what I'm doing there).

I still recommend the "regular" medical checks, too. You want to be able to rule out something serious.

It also sounds like stress is likely to be a big factor here. I'd be sure to talk about that to MD and/or acupuncturist.
posted by altcountryman at 8:51 PM on July 29, 2007

For years I had the same symptoms you described (2 weeks normal, then two weeks completely wiped out). I began charting my period on this website called My Monthly Cycles and after several months realized the only thing different between my "good" weeks versus my "bad" weeks were that my bad weeks were always the two weeks before my period. OH, is this what PMS is?!

After months of reading tons of pms literature (seriously) and guinea pigging myself on pms remedies (vitex, calcium, vitamin d, magnesium, b-complex vitamins; all of which I had high hopes for but were not able to 'cure' me of my PMS induced depression/fatigue/wanting to eat every single piece of candy) I came across this article in About.com about taking Evening Primrose Oil for PMDD. I followed the advice in the article by taking two EPO capsules twice a day at meals, and amazingly for the first time I've had a symptom-free PMS week.

Some people might claim it is a placebo effect but it worked for me above and beyond what I expected. YMMV of course.
posted by zippity at 10:41 PM on July 29, 2007

Is it Lyme Disease? I had it and it felt like someone stuck a hose in me and sucked my energy out. I don't know where you live but in many parts of the country doctors just aren't looking for it. You have to do a couple of blood tests a few weeks apart to tell. And you can get it, start to feel better, then it comes back pretty hard. If you spend time outdoors in an area with deer, this might be it.
posted by lpsguy at 6:17 AM on July 30, 2007