Are you exhausted? How do you deal?
October 20, 2022 5:30 PM   Subscribe

Are you dealing with exhaustion? If so, how do you manage your work day?

I apologize if this is chat-filter or some such. Starting in 2021 I have had periods of exhaustion and brain fog. I haven't had Covid so far as I know, but who knows. But since 2021 I have experienced periods of total exhaustion. Basic blood work shows me to be normal. I tried to cut out gluten in the theory it was a gluten allergy but that hasn't panned out. Still exhausted even without eating anything with gluten. Plus as a kid I was tested for food allergies and nothing showed up. I need to work but my brain feel fried and I have no idea how to recover long term.
posted by Saucywench to Health & Fitness (18 answers total) 23 users marked this as a favorite
Do you think the work is part of the problem? Are there any other life circumstances that feel like a drain?

I think this kind of thing can build on itself, because the more exhausted you are, the higher percentage of your total energy is taken by work. The work doesn't get any easier, but you have less and less for everything else.

This means you stop having the energy to do things that help take care of yourself, and at a certain point work is demanding more than you have, and the strain of that perpetuates more exhaustion.

I don't think it's possible to climb out of this cycle without having less demands on you for some period of time. This doesn't mean not working forever, it might mean choosing to not care and do the minimum amount, it might be changing jobs, but a lot of people find that a period of a few months of genuine rest is necessary to recover from cycles like this.
posted by lookoutbelow at 5:40 PM on October 20, 2022 [1 favorite]

Not chat filter, this is a good question.

(not a doctor, not your doctor...)

I would do some tests, with simple and safe trials:
* vitamins - it's easy to supplement with multivitamins for a week or two. Largely no harm, but if you were deficient, the effects could be great
* sleep - are you getting enough? good quality? If not, try some sleep meds for a few days (note: many sleep meds make people feel like shit, so this can be confusing)
* talk about this with others - what exact kind of exhaustion? "I can't eat" vs "I can't keep going to that fuckwit psychologist that the state makes me see so I can see my kids" may be quite different...
* caffeine - it's the most popular drug in the world. Does it work? If not, that may actually be diagnostic...
posted by soylent00FF00 at 5:46 PM on October 20, 2022

How to Keep House While Drowning is about housework and personal care tasks, but might have some insights that either help you to preserve your energy and get better rest outside of business hours, or might have counterparts in your workday (e.g., addressing negative, shaming self-talk about getting work done).

You still have an unresolved medical question, and it would be perfectly reasonable to ask your primary care or any other medical provider you've seen recently what type of specialist they'd recommend trying next. Or, to just start going to the specialists that make sense to you (neurology, for the brain fog? rheumatology, because sometimes mysterious symptoms and normal bloodwork can mean autoimmune conditions?). I recognize this isn't going to be accessible to everyone, depending on your health insurance and medical care situation, but if you have the means to continue pursuing medical answers, that would be a totally valid choice despite the seemingly "normal" bloodwork. One thing about normal bloodwork: depending on your PCP, they might see bloodwork that's technically in the normal range for adults and call it good, where a specialist would see the same results and notice that your levels would be typical for a 70-y.o., but indicate something amiss in a younger adult.
posted by theotherdurassister at 6:08 PM on October 20, 2022 [7 favorites]

I have been experiencing this off and on too. For me the issues seem to be related to low iron, poor sleep (I have a young child), thyroid function.

Getting my iron back up has helped. Small amounts of exercise throughout the day helps. As does getting out into nature when I can. Working on the sleep. Some nights are better than others.

Possible things to look into:
* Vitamin/mineral deficiencies?
* Thyroid function?
* Sleep disorders?
* Physical activity? If you are exhausted, then motivation to exercise may be lacking but some gentle exercise may be helpful.
* Depression?
posted by kinddieserzeit at 6:10 PM on October 20, 2022 [1 favorite]

On the advice of my therapist I just watched this guy (TED alert) this morning, and his idea of "languishing" makes a lot of sense to me and maybe fits your feeling.
posted by rhizome at 6:13 PM on October 20, 2022 [1 favorite]

Is your blood pressure low? I've noticed a lot of people lately being told by their doctors to increase their sodium intake because of this issue, even without an autonomic disorder diagnosis. I have POTS and I was told to drink at least 64oz of water a day, wear compression stockings, and eat 5mg extra sodium a day. A lot of my friends and therapy clients with low blood pressure have been given the same advice, and it's significantly increased their energy and focus.

I was on the wrong salt pills for a long time (mix-up between the "medical food" and "athlete" lines of the same brand) and once I started consuming the right amount of salt + drinking enough water I saw a significant increase in my energy and decreased brain fog and headaches. Just drinking water alone didn't do it and often made it worse.

On top of this, I implement regular breaks throughout my day and make sure those breaks are used to calm down my nervous system. Not scrolling the internet or playing games; I do some deep breathing and stretches and listen to visualizations or sleep stories while under a weighted blanket. Things that really calm me down. Definitely helps me feel less burned out at the end of the day. One before lunch and one before dinner at minimum, but if I have meetings or work that stresses me out I'll take more of these breaks. 15 to 30 minutes.
posted by brook horse at 7:31 PM on October 20, 2022 [5 favorites]

How do I manage it? In the best case scenario I have a great manager who understands I get my work done and I take a long lunch that allows me to have a 1.5 hour nap. Luckily I take an hour lunch anyway and work from home so I can take a ~30 minute nap just about any day. If I’m REALLY on top of taking care of myself, lunch is already prepped and just needs two minutes in the microwave and I can take a quick walk around the block and a nap for the powerful combo of sunlight and rest.
posted by raccoon409 at 7:43 PM on October 20, 2022 [1 favorite]

are you in a position, given everything going on in your life, to create routines for yourself? If so, maybe try to create a routine where you go to bed at a certain time every night, and for a set number of minutes before that bedtime, you just wind yourself down, in whatever way works for you. Quiet meditation, reading, yoga, or just sitting on the couch staring at the wall for 20 minutes - any of these can be used to help calm your brain a bit and prepare you for bed and sleep.

I would definitely check with your/a doctor about things like blood pressure and vitamin deficiencies, too (and diet/nutrition habits), but at its most reductive, the best way to feel more rested is to get more rest. So try to orient your life towards that goal, as a first step.

I need to work but my brain feel fried

You don't have to share anything here, but a critical step in this process is to figure out what is actually contributing to the frying of your brain. Work? Personal interactions? Life in general? Getting a handle on your stressors (even if you don't know they're stressors right now) will be key in helping you navigate this going forward.

Good luck, and I hope you find some rest and peace of mind.
posted by pdb at 8:17 PM on October 20, 2022 [1 favorite]

Adderall helped me. I don’t know if I have ADD or if the stimulants just help me get stuff done, though, like a steadier, less jittery infusion of coffee.
posted by supercres at 8:22 PM on October 20, 2022 [1 favorite]

(If I have ADD it manifests in the way you’re describing, not just being glib. When I don’t take a pill I get brain foggy and badly need a nap every day at about 1 pm.)
posted by supercres at 8:25 PM on October 20, 2022

I think it's important to know if you're dealing with the more general kind of exhaustion that modern life can precipitate, which people are talking about in this thread, or the kind of exhaustion that comes from Long Covid, ME/CFS or post-viral syndrome in general. The key determinant is post-exertional malaise: do you feel significant worsening of symptoms 1-2 days after exertion? If you do something reasonably vigorous for you, do you feel significantly worse the next two or two days later? If you can query your past experiences or watch for this, I think you'll be in a better position to move forward with a better understanding of what is going on.

Normal blood tests are unfortunately not really helpful. Plenty of people are quite sick and have "normal blood tests".
posted by ssg at 8:29 PM on October 20, 2022 [5 favorites]

I went through this in my twenties. It was especially bad after lunch. I'd just conk out, put my head on my desk, and sleep for an hour. Luckily my job had the flexibility to allow me to do that. When I was around 30 I was diagnosed with MS. I have had a very mild case, but exhaustion has been an ongoing thing. Modafinil saved my life and has allowed me to function. It doesn't feel like speed, it just erases the exhaustion and brain fog, like windex on a dirty window.
posted by Winnie the Proust at 8:51 PM on October 20, 2022 [2 favorites]

This might just be a UK/NHS thing, but I've found that the bottom ends of reference ranges where I live are absolute garbage.

Iron deficiency symptoms kick in for me severely when my ferritin gets below 20 ug/L, even though the bottom of the reference range here is 10 ug/L, even if my haemoglobin is on the low end of 'normal' (also according to NHS reference ranges).

Similarly, I feel much better when my B12 is over 500 ng/L, even though the bottom of the reference range here is 200 ng/L.

Supplementing in those areas has helped me immensely with fatigue, even though my levels were 'normal' and didn't warrant further treatment according to the GP who ran the tests.
posted by terretu at 1:59 AM on October 21, 2022 [5 favorites]

Range wise, it's the same for vitamin D, which you should aim to have at the upper bound of the range. This may require ridiculous doses if you have the same genetic thing I do - all my family is deficient even in summer despite spending almost all day outside.

For getting by: plan naps and just lying down for half an hour or an hour, especially if you work outside the house it's important to lie down as soon as you get in. Helps me get a second wind so much. Also protein-rich food and easily digestible stuff, don't waste energy on digestion.
posted by I claim sanctuary at 3:03 AM on October 21, 2022

This is a long shot, but allergy-related sinus problems can give me brain fog. If you don't know whether or not you have sinus issues, the first diagnostic test the doctor tried was just to tap my cheekbone lightly: it felt tender, and apparently it's not supposed to.

I use a fluticasone nasal spray to get things under control when it flares up to a problematic extent, which is only an occasional thing. By the time I get to the end of the bottle, I'm feeling more like myself. (So my answer to "how do you deal?" is "by using the OTC medication I know helps", which I realise is a bit of a cop-out, sorry.)
posted by ManyLeggedCreature at 5:59 AM on October 21, 2022

I’ve been like this for a year and a half, was never sick but turns out I did have covid. I’m operating under the assumption of long covid.
posted by Iteki at 6:46 AM on October 21, 2022

I've been like this since about 2015, when I went through an extremely traumatic series of experiences. My doctor eventually convinced me to try Vyvanse, which has been a total game changer.

So I had to get formally diagnosed when I moved states in order to still get the prescription and I found out that I am almost certainly ADHD, inattentive type. In my case, my brain is hyperactive (albeit in sometimes unproductive directions), not my body.

Then I learned (recently) that hyperactive brains produce excess glutamate, a toxin that leads to brain fog and physical tiredness. Even in neurotypical people, long periods of intense focus and concentration produce excess glutamate in the brain. This is flushed out during sleep, but if you're having sleep issues also... no toxin flush for you!

So. There is that aspect. I hope you find something that works for you!
posted by ananci at 7:28 AM on October 21, 2022 [7 favorites]

Sleep apnea could also be a culprit. You might be sleeping "enough" but actually waking yourself up a bunch of times during the night, which severely disrupts your quality sleep (and it's normal not to remember those episodes). If you ever have a bed partner, you can ask whether they've noticed you snoring or they've ever heard you stop breathing during the night. You can also ask your primary care doc for a referral to a sleep clinic. Or fill out this questionnaire to see if you're in a likely high-risk group for apnea.
posted by xoiok at 12:54 AM on October 23, 2022 [1 favorite]

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