Fatigue: Why Are You So Worn-Out?

Fatigue: Why Are You So Worn-Out?

It’s all you can do to put one foot in front of the other – even maintain upright posture. Heck, you barely have the energy to think. You’re worried and looking for resources, ’cause you have no idea as to what’s going-on. What say we learn about fatigue?  

More specifically, fatigue is a perception of weakness or feeling worn-out, drained, or depleted.

I’m betting there are a lot of worn-out and concerned mood and anxiety disorder sufferers out there. Fatigue has always been a potential issue for us, but with the stress of this pandemic thing? Yikes!

Doc’s Opinion: Dr. Axel F. Sigurdsson

I had the good fortune of bumping into a blog called Doc’s Opinion, featuring the work of Axel F. Sigurdsson, MD, PhD, FACC. Dr. Sigurdsson is a cardiologist in Iceland and has published scads of scientific work in journals and textbooks around the globe.

His article, 19 Important Causes of Fatigue – Tiredness and Chronic Fatigue Explained, especially grabbed my attention. In fact, it was so good that I knew I had to bring it to you. I believe you’ll find the content really informative and helpful.

Now, Dr. Sigurdsson put a ton of thought and information into his piece. But that means I can only present highlights. So you’re going to want to read his entire article – link at the end.

Let’s roll…

Tiredness & Chronic Fatigue

Dr. Sigurdsson opens his piece by pointing-out that though fatigue and tiredness are common medical complaints (more prevalent in women) that can seriously disrupt one’s life, a specific medical disorder is seldom revealed.

And he follows that up by observing that mood and anxiety disorders – primarily depression, panic disorder, and somatization disorder – are commonly associated with fatigue. In fact, psychiatric illness is present in 60-80% of chronic fatigue patients.

The good doctor reports that fatigue caused by an underlying medical condition, which occurs in only 10% of cases, will usually go away when the condition is treated. But chronic fatigue, fatigue that’s present for more than six months, is obviously persistent.

Before we move-on, it’s really important to understand the difference between daytime sleepiness and fatigue. According to the doc, sleepiness is the inability to remain fully awake or alert during the day. Fatigue is a subjective lack of physical or mental energy interfering with daily activities. More specifically, fatigue is a perception of weakness or feeling worn-out, drained, or depleted.

Causes of Chronic Fatigue

do i have chronic fatigue syndromeAfter laying a firm informational foundation, Dr. Sigurdsson lists his 19 important causes of chronic fatigue.

Before we get into them, will you promise that you won’t believe you have each and every disorder listed? Come on, you know what I’m talking about. Just go easy, okay?

Again, I only have space to highlight, so you’re going to want to read Sigurdsson’s article for a full education. And I’m telling you, it’s worth it.

Here we go…

  1. Chronic Fatigue Syndrome (CFS): CFS is characterized by chronic fatigue, orthostatic intolerance, and cognitive issues with no apparent medical cause. It’s also been named systemic exertion intolerance disease (SEID) because of its hallmark massive energy crash after relatively minor exertion. Though cause is unknown, CFS is believed to be an infectious disease with immunologic manifestations.
  2. Idiopathic Chronic Fatigue: Chronic fatigue with no underlying medical condition or psychiatric illness. Criteria for CFS aren’t met.
  3. Fibromyalgia: A chronic pain syndrome characterized by widespread nonarticular (muscles, not joints) pain, stiffness, and fatigue. Cognitive complaints (“fibrofog”) are present in 90% of cases. Fatigue is most often noted when arising from sleep.
  4. Anemia: A medical condition in which the red blood cell count is below normal. Fatigue and loss of energy are significant symptoms. The most common type is iron-deficiency anemia.
  5. Hypothyroidism: A medical condition in which the thyroid gland doesn’t produce enough of the thyroid hormones T3 and T4.
  6. Diabetes Mellitus: Many with diabetes describe themselves as feeling tired, lethargic, or fatigued at times. The fatigue may be caused by an imbalance in blood sugar levels. However, the chronic fatigue that may be experienced, known as diabetes fatigue, isn’t related to blood sugar levels.
  7. Other Endocrine Disorders: In addition to hypothyroidism and diabetes, other endocrine and metabolic disorders may be at play with fatigue. Examples: hypogonadism, hyperparathyroidism with associated hypercalcemia, adrenal insufficiency (adrenal fatigue), apathetic hyperthyroidism, growth hormone deficiency, glucocorticoid resistance.
  8. Chronic Infections: Examples: endocarditis, tuberculosis, mononucleosis, hepatitis, parasitic disease, HIV infection, cytomegalovirus.
  9. Autoimmune Disorders: At times, in response to an unknown trigger, the immune system may begin producing antibodies that attack our own tissues. This can lead to a chronic inflammatory response, which is characteristic for most autoimmune disorders. Examples: rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, multiple sclerosis, Hashimoto’s thyroiditis.
  10. Cancer: Known as cancer-related fatigue or cancer fatigue.
  11. Sleep Disorders: Daytime sleepiness is a key symptom of obstructive sleep apnea. But, remember, sleepiness and fatigue aren’t synonymous. Still, people with sleepiness due to obstructive sleep apnea may use descriptive terms like “fatigue.”
  12. Central Nervous System Disease: Fatigue can be a prominent symptom of stroke, multiple sclerosis, Parkinson’s disease, and others.
  13. Neuromuscular Disease: In some cases, muscle weakness and other signs of neuromuscular disease are evaluated in the face of fatigue.
  14. Gastrointestinal Disorders: Fatigue can present in peptic ulcer disease, gastroenteritis, irritable bowel disease, and others. Typically, though, symptoms like pain, nausea, vomiting, constipation, and diarrhea accompany.
  15. Cardiovascular Disorders: Fatigue can be a sign of underlying heart disease. It’s important to look for symptoms such as chest pain and shortness of breath.
  16. Chronic Obstructive Pulmonary Disease (COPD): COPD refers to a group of conditions that cause airflow blockage leading to shortness of breath, mucus production, and wheezing. It includes emphysema, chronic bronchitis, and in some cases asthma. Fatigue is a common complaint.
  17. Anxiety and Depression: Up to 75% of patients with chronic fatigue also have mood or anxiety disorders. Some have suggested that chronic fatigue is an atypical form of anxiety or depressive states. So it may be that chronic fatigue is yet another version of anxiety or depression.
  18. Somatization Disorder: A person with somatization disorder is preoccupied with numerous “somatic” (physical) symptoms, which can’t be explained by an underlying medical disorder. Fatigue is a common complaint, along with pain. And it’s important to understand that the patient isn’t faking.
  19. Pharmaceutical Drugs:  Fatigue is believed to be a common side effect of many pharmaceutical drugs. These may be over-the-counter and prescription. Name ’em: antihypertensives, statins, antihistamines, antidepressants, antipsychotics, benzodiazepines, opioids. Fatigue can be a factor.

I might add, Dr. Sigurdsson recommends general measures focusing on sleep, healthy diet, regular exercise, and stress reduction in the treatment of fatigue.

Off We Go

Fatigue – feeling entirely worn-out – is the real deal. And as if we didn’t know from personal experience, Dr. Sigurdsson emphasizes what a huge issue it is for mood and anxiety disorder sufferers.

I’m hoping this summary provides enough information to whet your appetite for more knowledge if a thing or two hit home. And that, of course, includes intervention strategies.

Be sure to read Dr. Sigurdsson’s article. Much more info I couldn’t include here: 19 Important Causes of Fatigue – Tiredness and Chronic Fatigue Explained.

Hey, if you enjoy poetry you’ll love my eBook: Feelings & Rhymes Through Treacherous Times.

And if you’re looking for some good reading while you’re stuck at home, hundreds of Chipur articles are here to help.

11 Ways to Manage Your Biological Clock During Stressful Times

11 Ways to Manage Your Biological Clock During Stressful Times

Things have been just a tad stressful lately, wouldn’t you say? Seems a certain pandemic has wreaked havoc on our lives, and so many things just aren’t the same. That includes our personal rhythms and routines. And here are 11 ways we can minimize damage…

Get up at the same time every day. A regular wake time is the most important input for stabilizing your body clock.

COVID-19 is cold, mean, and nasty. I mean, heck, if its physical threat isn’t enough, there’s its impact upon how we live our lives – to side-step and survive it.

In that regard, our context is going to be a manifestation of social distancing and shelter-in-place practices. I think you’ll find the info relevant and helpful…

Our Body Clock

Browsing around the web I found a great “please circulate freely” handout I’d like to summarize. Written with the pandemic in mind, it very nicely details self-management strategies for increasing the regularity of daily routines. A big thank you goes out to the International Society for Bipolar Disorders.

As I’m sure you know, one of the most important brain systems that contributes to our well-being is our body (biological) clock. That precious timekeeper is huge because it synchronizes our body and behavior with the 24-hour cycle of light and dark.

Let’s always keep in mind that predictable daily schedules and regular routines help to keep our body clock running smoothly. And when that’s happening we feel better. Fact is, disrupted body clocks are associated with all sorts of unpleasant circumstances – depression, anxiety, diabetes, obesity, and cancer, to name a few.

I don’t think it would be a news flash if I observed that if we’re dealing with a mood or anxiety disorder, it’s likely we have a sensitive body clock. That means it’s more prone to losing track of time when our environment is disturbed. Could even lead to spikes in mood and anxiety episodes.

Do I need to say more? Mood and anxiety disorder sufferers really need to pay attention to routines, keeping our body clocks happy, during highly stressful times.

11 Ways to Manage Your Body Clock During Stressful Times

how much longer do i have to stay homeThe gang at the International Society for Bipolar Disorders came up with some easy tips for improving the regularity of our daily routines. And they emphasize – even when nothing about our lives feels at all regular.

This is really good stuff, people. But it’s only as good as its practice. Give these some serious thought.

Here we go…

  1. Set up a routine. They help stabilize body clocks.
  2. Get up at the same time every day. A regular wake time is the most important input for stabilizing your body clock.
  3. Make sure you spend time outdoors every day, especially in the early morning. Your body clock needs to “see” light in the morning to know “when” it is.
  4. If you can’t go outside try to spend at least two hours next to a window, looking into the daylight, and focusing on being calm.
  5. Set times for a few regular activities each day such as home tutoring, telephone calls with a friend, or cooking. Do these activities at the same time each day.
  6. Exercise every day, ideally at the same time.
  7. Eat meals at the same time every day. If you’re not hungry, at least eat a small snack at the prescribed time.
  8. Social interactions are important, even during social distancing. Seek out “back and forth” social interactions where you share thoughts and feelings with another person in real-time. Videoconferencing, telephone, or even real-time text-messaging is preferred to scrolling through messages. Schedule these interactions at the same time every day.
  9. Avoid naps during daylight hours, especially later in the day. If you must nap, restrict them to 30 minutes. Napping makes it hard to fall asleep at night.
  10. Avoid bright light (especially blue light) in the evening. This includes computer screens and smartphones. Blue spectrum light suppresses melatonin, the hormone that helps us sleep.
  11. Stick to a consistent sleep and wake time that fits your natural rhythms. If you are a night owl, it’s okay to stay up a little bit later and get up a little bit later than others in the household. Just make sure you go to sleep and get up at the same time every day.

That’s All Folks

No doubt, we’re in the midst of trying times and stress levels are running high. If you’re a mood or anxiety disorder sufferer I’m thinking you know you’ll be somehow vulnerable. And struggling with rhythm and routine is right there at the top of the challenge list.

Let’s use our personal insight – anticipation skills – wisely. In this case, how ’bout we put the tips into action?

Hey, be sure to snoop around the International Society for Bipolar Disorders site.

If you’re longing for community, hop on over to the private Chipur Facebook group and join us.

Are you looking for some worthy reading while you’re hanging at home? Hundreds of Chipur articles are waiting for you.

11 Things to Do When Life Gets Flaming Hot (E/M First Aid)

11 Things to Do When Life Gets Flaming Hot (E/M First Aid)

We both know it isn’t a matter of if, but when. Life can get flaming hot, especially for someone already trying to manage a mood or anxiety disorder. So what are we to do amid the flames? Here are eleven heat-tested emotional/mental first aid techniques…

Find yourself a safe and quiet place, and slow down long enough to get an accurate fix on exactly what’s happening. There’s no way you can expect to survive…

Life has been a little tough for our family over the past six weeks. I’m thankful it doesn’t involve physical health issues. Still, one of my children has had a rough go. And you know the drill – what hits one of us hits us all.

I was talking to a friend yesterday who’s aware of the situation. At one point during my outpouring I whined about not even knowing what I was going to write about this week. She looked at me like “Duh!” Actually, the thought had already occurred to me.

Needless to say, I’m not going to get into the details of my kid’s situation. But I’d love to get into how to survive the immediate fallout of flaming circumstances.

Emotional/Mental First Aid

How many first aid courses have we taken? Heck, I have a current American Heart Association card in my wallet. So I’m Johnny on the Spot should someone, including me, find themselves in a bad way – physically.

But what if someone’s in a bad way emotionally and/or mentally? Unjustly, that seems to be a different story. I have to say, though, that these days such circumstances are being more directly addressed with terms and curricula like Psychological First Aid.

For our purposes I’m going with emotional/mental first aid (E/M First Aid).

11 Things to Do When Life Gets Flaming Hot

how to cope with stressSo within the context of E/M First Aid and gut-wrenching circumstances like my offspring’s (and mine as I try to help), I’m bringing you the following techniques to turn to when life flames-up.

Certainly there are more, but these eleven have worked well for me over the years. And you don’t have to put them into practice exactly as I’ve written them. These are for you so season to taste, if you will. Most important of all, be proactive – don’t just take the hits…

  1. Understand that extinguishing the flames isn’t the goal. Sure, if there’s mitigating action you can easily take, roll with it. But save as much of your energy as possible for emotional and mental survival. That’s the bottom-line here.
  2. Find yourself a safe and quiet place, and slow down long enough to get an accurate fix on exactly what’s happening. There’s no way you can expect to survive in the immediate if you don’t know for sure what’s going-on. While you’re at it, take into account how you traditionally receive, interpret, and respond to troubling stimuli. Could that generate inaccuracies?
  3. Expanding upon #2, if you endure a mood or anxiety disorder I’ll bet the farm that cognitive distortions are a big part of your life. There are several that may come into play, but catastrophizing – the “What if’s?” with disaster being the expect – can unnecessarily fuel the flames.
  4. Recall a time when you found yourself amid flames. Maybe the circumstances are the same, perhaps different. Doesn’t matter. What did you do that worked? What didn’t? And if you fell to pieces, encourage yourself for this go-round by saying, “What better time to change? I’ll pull it off this time!”
  5. Don’t go it alone, unless you truly have no choice. Isolation will get you nowhere fast. Spouse, partner, family member, friend, mental health professional, spiritual leader – solicit help. You definitely deserve the company and support.
  6. Never, ever discount the positive influence of exercise, proper food and drink intake, quiet time, hobbies, meditation, yoga, rest, sleep – and more. Perfection in practice isn’t the goal. Considering and practicing the activities that work best for you is.
  7. I can think of all sorts of quick severe stress relievers: alcohol, cannabis, recreational drugs, tobacco, benzos, opioids, and then some. Don’t abuse – rely – upon any of them. You can do this without that kind of help.
  8. Keep a progress diary, updating it at the interval of your choice. What a great way to stay focused and disciplined. And it’s the perfect way to track progress. Keep it, by the way. It’ll be great inspirational and reference material for the next time.
  9. Reach-out to someone in need. Yep, I said that. Amid your own flames, help someone survive theirs. Don’t worry, there’s enough of you to go around.
  10. If you don’t have a spiritual figurehead and practice, what better time to find one? If you’re all set, what better time to nurture the relationship?
  11. Who knows how long the flames will last? Fact is, they’ll eventually be extinguished or they’ll snuff-out on their own. Always remember, you’re not dealing with a forever set of circumstances. And never detach from hope. It may be all you have at times.

Be Prepared

So what do you think? Will they work for you? And, hey, if you come up with more share with us in the comment section.

Yep, we both know it’s a matter of when, not if. The flames are going to hit and it’s going to be all about emotional and mental survival. Be prepared. Why not keep this article, as well as other material, around for when the moment strikes?

See, the thing is, when the chips are down, it’s important to be able to say to yourself, “I got this.”

Chipur is a reservoir full of hundreds of mood and anxiety disorder centered articles. Really now, hit the titles.

Yikes! 12 Signs You’re Overstimulated

Yikes! 12 Signs You’re Overstimulated

You know the drill. You have scores of things going on and you’re huffing and puffing to keep pace. And on top of it all, your mood and anxiety symptoms are spiking. All signs you’re overstimulated. Yikes!

Sure, it’s not a problem for many; however, just as many of us are wired differently and don’t do well with commotion.

Was talking with a friend a couple of weeks ago. 

We knew we shared certain mood and anxiety leanings, but out of nowhere came something else…

We’re easily overstimulated. And if we don’t manage it, life can become way harder than it has to be.

How ’bout you? Overstimulated?

What Is Overstimulation?

If you do a web search for overstimulation, you’ll likely see a lot of results related to babies and children.

That makes sense, doesn’t it?

Sure, every so often noise, goings on, sensations, and too many faces add up to more than the little guy or gal can handle. And, boom, on come all sorts of misery (for all parties involved).

The same with grown ups

And so it is with many grown ups…

Way too many visuals, sounds, smells, touches, flavors, vibes, thoughts, feelings, and opinions. And before we know it the beaker’s full – even overflowing.

Overstimulation – sensory overload – has arrived.

And if someone with a mood or anxiety disorder is in the midst of the tumult, the trouble threshold can present much faster and the fallout can be more brutal.

Are you a highly sensitive person?

Here’s an interesting tidbit. It’s believed that 15-20% of us are considered to be a “highly sensitive person” (HSP). The glitzy term is sensory processing sensitivity (SPS).

In short, a HSP is much more responsive to their environment. And that’s because their nervous system and mind allow more stimulation to enter without any sort of automatic or unconscious filter.

Also, a HSP cognitively processes their received stimulation in greater detail than others.

If you struggle with overstimulation, who knows, maybe you’re a HSP. I believe I am. I’ll give you a nice resource at the end.

12 signs you’re overstimulated

I'm tired of being depressed

“This is just silly. I mean, my mind is on full speed to nowhere. I’m done.”

We know that peacefully living with a mood or anxiety disorder only happens with well-considered and targeted management.

And so it is with overstimulation.

But how are you supposed to manage something if you don’t know what it looks like?

Well, I did some digging and found what I believe are 12 biggies to keep an eye out for. Go with your gut as well.

  1. Attention, concentration, and direction are compromised. You’re a spinning top.
  2. Distortions dominate your thinking and perception of reality.
  3. Your thoughts – mind – are on full speed to nowhere.
  4. It’s easy to get ticked off at anything, anyone, anytime.
  5. Your sleep can be barely there or dominate the day.
  6. You’re tired – emotionally, mentally, physically cashed.
  7. You feel overwhelmed, and tears may come out of nowhere.
  8. Your already troubling mood and anxiety symptoms are spiking.
  9. You physically hurt and ache.
  10. What little self-esteem you had hit the highway.
  11. More and more you prefer your own company.
  12. Hopelessness rules.

That’s how overstimulation looks. Now, no one’s saying you have to run the table. But if you’re experiencing your share of the 12, it’s time to self-assess and do something about it.


It’s so easy to fall into the trap of taking on way too much. And, of course, piling on is all sorts of environmental stimuli.

Sure, it’s not a problem for many; however, just as many of us are wired differently and don’t do well with commotion. Can we once and for all recognize and accept that?

Overstimulation is a force to be reckoned with. Connect those dots and take care of business.


If you’d like to learn more about the highly sensitive person, check out Dr. Elaine Aron’s website. Tons to offer.

And as long as you’re doing some reading, kick back and leisurely peruse the Chipur titles. Plenty of info and inspiration.

6 COPING with an ILLNESS Tips If You Struggle with a Mood or Anxiety Disorder

6 COPING with an ILLNESS Tips If You Struggle with a Mood or Anxiety Disorder

Looks like our friend isn’t feeling so hot. Being sick is bad enough, right? But throw it on top of a mood or anxiety disorder and life can become downright intolerable. I think he could use some coping tips. You too?

Look, I understand it’s important to learn about what ails us, but deeply immersing ourselves in the role of a graduate from the Google School of Medicine could cause problems.

Okay, extremely long story, short. A week ago this past Thursday night I was one hurtin’ cowboy. And though I sure didn’t want to, I mustered the brains and energy to hit urgent care the following morning.

‘Course, that didn’t cut it and I was referred to an ER. Go figure, after some testing and assorted misery I was told I needed to be admitted. You know, the old IV fluids and meds routine. Thing of it was, I was down for the count, so the admission made sense to me (but OMG, I didn’t want to go in).

But in I went, got bagged-up with those fluids and meds, and was discharged two days later with arms that looked like pin-cushions.

Am I Really “Sick?”

For the week following leaving the hospital, though the primary symptoms were gone, I didn’t feel too well. Fact is, I’m just now starting to get back in the race. Curious, family members, friends, and medical folk have told me it’s to be expected. But somehow that’s hard for me to buy.

No kidding, here I sit writing this piece only halfway believing an infection and its manifestations are powerful enough to leave me feeling this way. Maybe that’s denial. And maybe those of us who have a mood or anxiety disorder just don’t cope well when we’re physically ill.

Is that how it is for you?

I mean, to accept having a legitimate illness can mean so many terrible things to someone emotionally or mentally, well, bound. But the good news is, most of those terrible things are driven by catastrophic thinking. They don’t stand to reason.

By the way, here are but a few: “If I rest I may never get up and around again.” “I may really have something serious or even life-threatening.” “If I can’t go to work I’ll lose my job and life will be over.”

Dang, we are just too good at that.

6 COPING with an ILLNESS Tips

I can't stand being sickOkay, it’s unlikely you’ll get nailed with what I have; however, the flu is knocking people down all over the place. If you wrestle with a mood or anxiety disorder and find yourself physically ill, I believe these tips will help.

Now, some would find them “duh” material. But keep in mind, we’re wired, and think, differently.

Here goes…

  1. Don’t fall into the denial trap. News flash! Human beings become ill, even though some of us unreasonably prefer to believe we’re indestructible. Acceptance is just as huge here as it is with our emotional and mental circumstances.
  2. Rest, which is often so hard for many of us to facilitate, is absolutely necessary – period. No, we don’t have to put on our PJs and climb into bed. But we do need to go very easy on expending energy. And, yes, it may have to be for a couple of days – plus.
  3. Be careful with the internet. Look, I understand it’s important to learn about what ails us, but deeply immersing ourselves in the role of a graduate from the Google School of Medicine could cause problems. And this especially applies before seeing a doc and knowing for sure what’s up.
  4. Don’t be sick alone. I mean, it can easily throw us into an isolation episode, and that’s a losing proposition. Sure you may live alone and you may be contagious. But the phone, texting, FaceTime, and Skype are still in existence. Use them.
  5. If you’ve been prescribed meds, go ahead and do your due diligence (you will anyway). But unless something really goofy emerges, take ’em as written.
  6. You may feel as though you’re walking through the valley of the shadow of death, and you’ll never ever feel better again – you’re cooked. But the odds overwhelming favor you’ll get past your misery. That is if you take care of yourself as directed.

How ’bout it? Do these fly? Sure, there are many more, and if you have some, please share in a comment.

We’re Done Here

Hey, no one likes being sick. However, I believe those of us who endure a mood or anxiety disorder are more apt to take it on the chin. You know as well as I that it only makes sense.

That said, we have to accept our leanings and approach the dilemma creatively.

Wishing you nothing but good health, but if you’re sick, you’re sick. It’s real, legit, and calls for acceptance and immediate attention. So take care of yourself, okay?

Now, then, I’m gonna’ rest…

For thousands of mood and anxiety disorder tips – and insight – go ahead and take a gander at hundreds of Chipur titles.