thoughts on fatigue

There’s another post that I’ve been trying to write for, oh, a couple of months now, and it’s not an emotionally difficult topic or anything, so I was struggling to write, struggling to understand why I couldn’t, and frustrated with the (total lack of) result. Blogging was starting to feel like work, and I wondered what the hell my problem was. I think I might have figured it out…

I organize my life around the fatigue that has dogged me for over five years now. I’ve always had fairly low energy, but it now interferes with all aspects of my life. It feels, I think, like how you might feel if you had a had a shit sleep or had to get up hours before your usual wake time, except that I feel like this every day.

I usually sleep for about 9 to 10 hours a night, sometimes even more. If I’m feeling (relatively) alert when I wake up, I can get out of bed within 20 minutes. (I say “relatively” to mean alert according to my personal scale.) If not, I might feel groggy for up to an hour (this is “sleep inertia”) or very occasionally for the rest of the day. I like to catch up on social media for a while because it engages my brain and helps me to wake up.

I eat shortly after I get up: breakfast before 11:00 feels almost “early”. I start my day doing things that I like (reading, looking at coffee table books, drinking a mocha while looking out the window, etc.) and/or things I don’t mind (laundry, folding and putting away clothes). My energy level at this time of day tends to be (relatively) good.

Right around the time I feel like I can face doing some work, my energy and motivation drops. In order to do any work, I need my brain to be functioning well and if it isn’t, there’s not much point in pushing myself because I can’t accomplish much, and I lack the motivation to force myself to do it anyway.

The fact that I work with family members and that I can work from home gives me a tremendous amount of flexibility (including the ability to take a nap if needed), which is great. (If I had a regular job, I’d struggle miserably.) On the other hand, these same family members are also workaholics, and it’s really difficult for me not to compare myself to them and get frustrated with myself and my low output. Also, since my family tends not to talk about difficult things at all, just because I haven’t heard any complaints about my low productivity doesn’t necessarily mean that everything is fine.

Months ago, I used to have one- to two-hour naps almost daily. I always benefit from a nap: I wake up feeling better, and it doesn’t seem to keep me up at night. If I can’t shake the morning groggy feeling, I usually end up having a nap. I’ve been napping less lately though, maybe once or twice a month.

Most days I feel guilty because I didn’t work more. Getting started on work feels difficult at best and excruciating at worst, depending on the day. With the right work and highest energy, checking my email or writing a list can be all I need to get rolling. An average day (if there is such a thing for me) might involve me sitting at the computer doing nothing and allowing myself to get bored enough to start. If my motivation and energy are low and the work to be done requires problem solving, I might not be able to force myself to do anything. Sometimes the amount of work I get done in a day is embarrassingly little. Or none at all. I hate that.

In this culture, busyness is a virtue. If I run into an acquaintance, they almost always say something like, “Keeping busy?” and everyone knows that the correct answer is “yes”. Not being busy is an anomaly, and choosing to relax is a radical act. I used to grit my teeth to give the correct and yet wrong answer, but now I say I make an effort not to fill my schedule. Though I suppose I could in all honesty say that I’m busy, as long as I know that this means I’m doing as much as I can, and not that I’m doing as much as the next person, measured in hours and sweat.

I rarely feel really alert. Maybe that’s why it’s hard to distinguish between “My energy is too low for my willpower to function” and “I don’t really like this job and I suck at making myself do it”. It frequently feels like laziness.

After supper I usually feel pretty good, though I can’t face working in the evening, and besides, that’s when I do my important fun stuff, like my bi-weekly two-hour Skype appointment with Gawan.

Then there’s the exercise issue. During the school year I’ve been teaching two dance classes a week, and over the summer I’ve taught one and been a student in another. It’s important to me to stay active, but I don’t recover quickly and I may still feel wrecked the day after a particularly vigorous class. I also have a daily exercise routine of an hour or so (maybe 1h20 if I do every single exercise) to manage my various aches and pains. My health is top priority.

Although I aim to go to bed around 11:30, I sometimes don’t turn out the light until 12:20. I don’t tend to feel sleepy until fairly late unless it’s a dance class night, in which case blood flow, reflexive analysis of the class, and earworms conspire against me. I take a sleep aid to help me with falling and staying asleep, so those issues don’t currently vex me.

Up until my trip to Europe this past spring, my leisure time was spent mostly on the blog. After I got home (and recovered), my writing and photography slowed down, and then pretty much stopped. I thought the issue was that I just didn’t feel like blogging for a while — I had picked up a couple of old hobbies that I’d dropped some time ago, and it seemed that I was just choosing to spend my time differently — but now I’m not so sure.

Over the last couple of months, I had gotten seriously bummed about the fatigue; it’s deeply frustrating when my body can’t keep up with my mind, but my mind has slowed down too, and I mostly don’t feel like doing anything. Also, because I can’t predict when I’ll have a good day versus a bad day, I avoid making plans in order to avoid the sense of failure and frustration when I don’t have the energy or motivation to do what I intended to do. If I have a good day — that is, a day during which I feel almost normal and I do an ordinary number of ordinary things — there’s a fair chance that I’ll be exhausted the next day. I had started to resign myself to the fact that I may be suffering from chronic fatigue syndrome, a diagnosis that my doctor has been hesitant to make since there’s no test and no treatment and thus potentially no benefit to me to be labelled in this way.

However, since I started looking at the details more analytically in the process of working on this post (which has, unsurprisingly, taken much too long to write), I realised that the nature of the fatigue has changed. It was bad last year but then I did actually see some improvement. I discovered that the timing of when the fatigue started being especially problematic again roughly corresponds to adjustments to the dosage of my anti-depressants.

Part of the difficulty I had in pinpointing the problem up to now is that I experience a lack of motivation as one of my more significant symptoms of depression. Now I suspect the lack of motivation is being caused (at least in part) by the lack of energy. In other words, lack of motivation may be cause by the anti-depressant dosage being too low or too high. This is… not helpful.

So now I’m cautiously optimistic that my recent lack of interest in blogging is due, not to an authentic desire to stop, but rather to a sense that I just didn’t have the energy or brainpower to put into it. And if lack of energy and brainpower can undermine my interest in a hobby that I know I have enjoyed, then it’s possible that my disinterest in work is also primarily an issue of energy and not that I hate my job. I have a doctor’s appointment this coming week and will see about adjusting my meds.

With any luck, I’ll be blogging more regularly again in the not too distant future.