Dealing with Fatigue on a Daily Basis

With fibromyalgia, you may be subject to experiencing a variety of health problems or symptoms. They can vary widely, and not everyone exhibits the same symptoms. Yet, there are several shared characteristics common to individuals with fibromyalgia, and the most common for sufferers is fatigue. Fatigue is reported in 60% to 80% of all instances of fibromyalgia.[1] In fact, statistics from 2008 indicate that approximately 5 million Americans, mostly women, suffer from fatigue associated with fibromyalgia.[2]

Fatigue is Physical and Mental Exhaustion

Fatigue is defined as both physical and mental exhaustion. It is not simply being tired or feeling temporarily exhausted. It is much more than that. Fatigue is marked by a mental weariness and the inability to perform even the simplest tasks on the worst days. Fatigue may range from mild to severe, and it may be short term or chronic.

Causal Factors Relating to Fibromyalgia

There are many potential causal factors relating to the onset of fatigue when you have fibromyalgia. They include any or all of the following:

  • Emotional distress or stress
  • An additional physical illness
  • Poor sleeping habits or lack of sleep
  • Poor eating or nutritional habits
  • Depression

In fibromyalgia, however, one other factor may increase your sense of fatigue and have an impact on the other aspects of the syndrome. This factor is pain and, particularly chronic pain. In fact, fatigue in any situation rarely occurs without being triggered by something else. In fibromyalgia, it is usually linked to other related problems like pain, lack of adequate sleep or feelings of stress.

How to Treat It

There are several ways to treat fatigue. You can address the situation – specifically the overall syndrome, through pharmacological means which include both prescribed and over-the-counter (OTC) medications. Medications can include low doses of several drugs including amitriptyline or cyclobenzobrine, or duloxetine among others. Stimulant drugs, such as modafinil (Provigil) and Dexedrine ER are prescribed specifically for combating fibromyalgia fatigue. Alternatively, you can turn to other forms of treatment. These include alternative, complementary and holistic approaches. Among the most common types are:

  • Diet – Some women with fibromyalgia are food sensitive. As a result, you may need to adjust your diet and cut down on certain foods that seem to increase your fatigue. One good example is food containing high amounts of processed sugar. Instead, you can focus on eating fresh foods that are lightly prepared and highly digestible.[3]
  • Supplements – Sometimes dietary supplements, including vitamins and other substances such as zinc, magnesium, calcium, chromium picolinate and folic acid, can reduce fatigue.
  • Exercise – The best type of exercise for combating fatigue is that which will increase your level of aerobic fitness. It may include hydrotherapy aerobic exercises which are easy on the body’s muscles and joints but work the cardiovascular system. Exercise is considered one of the best ways to energize your body and can supplement other steps taken to reduce fatigue.
  • Sleep – Research has indicated that sleeplessness, fatigue and pain are the fibromyalgia equivalent of the “Three Amigos.” In other words, they regularly occur together. If you want to avoid or reduce pain and fatigue, make sure you get a solid and natural night’s sleep.[4]
  • Chemical supplements – Supplements that may reduce fatigue include chondroitin sulfate, fish oil and GLA.
  • Yoga and/or meditation – You can join a yoga class, read a book, watch a video or enjoy other calming activities to reduce your fatigue level.
  • Therapy – For some, formal medical therapy is the best alternative for dealing with and learning how to eliminate the cause of fatigue. Cognitive behavioral therapy or insight-oriented therapy can prove to be effective.
  • Natural or herbal supplements – Some people find relief from fatigue by taking supplements like magnesium, Coenzyme Q10, vitamin B12, vitamin C and many others.
  • Alternative or Complementary Medicine – Ayurvedic Medicine or similar practices including Chinese Traditional Medicine (CTM)  are alternative medicine techniques designed to address the specific health needs of individuals.

What you decide to implement depends on your level of fatigue and other symptoms you are experiencing. However, it’s always important to first consult with medical professionals, including doctors, herbalists and specialists from various fields, before taking supplements of any kind. This is especially true if you are taking prescription medications.

Assessing Your Lifestyle

If you wish to reduce your medications for fatigue or forego them completely, you should address other aspects of your lifestyle that may be leading to fatigue. The best approach is to review your daily activities and determine what changes you can make that would be effective in helping you cope better with stress or would reduce the fatigue you are experiencing.

  1. Stop and take a look at your schedule.
  2. Compose a “to do” list.
  3. Prioritize what is essential to get completed each day versus what you would like to accomplish but is not critical. You may want to make 2 lists, and then combine what you must accomplish that day or week with what would be nice to do if time permits.
  4. When making a decision to do something that unexpectedly leads to stress or physical fatigue, you should be ready to change your priorities if you find you have overextended yourself.
  5. Learn to pace yourself.  You can’t be all things to all people. If you learn to manage your time to accomplish what is important then you will be able to complete everything you need to complete.
  6. Don’t hesitate to ask for help from friends and family when needed. They will be more than willing to help you and provide some relief when you are too fatigued to manage those prioritized items that must be completed.
  7. Learn to solve your problems before they actually happen. In other words, consider the real cause of your fatigue. Is it stress? Is it frustration with not being able to do everything on your list? Consider the root causes and look at both possible solutions and alternatives.

To make this approach successful, you are going to need to create order in your life because chaos is stressful. It is recommended that you modify your lifestyle and that you talk to your family and friends who have a vested interest in your health and explain what you are trying to accomplish. Moreover, you need to clearly communicate when you are experiencing extreme fatigue. That way they can help you out without being obtrusive, and you can avoid the guilt feelings that women in particular feel when they can’t fulfill their daily duties related to caring for family or work.

Fatigue is a Real Symptom

Fatigue is a very real symptom of fibromyalgia. It affects nearly all of those who have the syndrome. If it is chronic fatigue, you need to consider the many treatment and coping options available. While medications may provide you with temporary relief from fatigue, you need to address the root causes in various ways.

Dealing with the fatigue associated with fibromyalgia usually requires using a variety of methods that include medications, dietary changes, supplements, exercise and/or other alternative or complementary methods of treatment. A comprehensive approach will work best. That requires also making changes to your lifestyle to insure you can meet your daily needs with as little fatigue as possible. By prioritizing what you need to do each day, it will be easier to insure your energy is expended on what needs to be accomplished while keeping stress levels low.

References 

[1] Arthritis Foundation (2006). Good Living With Fibromyalgia. Atlanta, GA: Arthritis Foundation.

[2] Lawrence, RC; Felson, DT; Helmick, CG; Arnold, LM; Choi, H; Deyo, RA; Gabriel, S; Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Kremers HM, and Wolfe, F (2008). “National Arthritis Data Workgroup: Estimates of the Prevalence of Arthritis and other Rheumatic Conditions in the United States. Part II.” Arthritis Rheum, 58 (1):26-35.

[3] Bassman, L (2007). The Feel Good Guide To Fibromyalgia And Chronic Fatigue Syndrome. Oakland, CA: New Harbinger Books.

[4] Theadom, A; and Cropley, M (2010). “‘This constant being woken up is the worst thing’ – Experiences of Sleep in Fibromyalgia Syndrome.” Disability and Rehabilitation, 32(23): 1939-1947.