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By: Jane Milardo, LMFT

dreamstime l 19191786coffeeBecoming a widow/er is one of the most stressful times most of us will ever face. Besides the pervasive sadness of losing a spouse and the adjustments it requires, there is a funeral home to deal with, an attorney involved with the Will, Power of Attorney, and Advanced Directive, being the executor of the estate, receiving and notifying your spouse’s creditors that (s)he is deceased, thank you notes to the many people who sent cards and flowers, the late spouse’ possessions and what to do with them, and so on. With so much to be done at once, no wonder many widow/ers feel overwhelmed by the enormity of all these tasks.

It’s easy at a time like this to neglect your own health. You’re running from place to place on the fly, eating whatever you can when you can, or barely eating at all. You’re lying awake at night missing your spouse, crying, ruminating about all the things you have to do, and losing sleep. Having so many responsibilities to attend to at a time when you’re feeling emotionally vulnerable can wear you down, physically and emotionally. You find yourself so fatigued that everything seems like an effort.

There’s Something Wrong

If you find yourself dragging through the day without the energy to address all the work at hand, or barely able to get out of bed in the morning, there is something wrong. If you’re so worried all the time that you can’t eat or sleep, and find yourself unable to attend to the most basic daily household tasks or personal hygiene, there is something wrong. If you’re unmotivated to do anything, or you find yourself not even caring, the problem needs to be addressed. The most common causes of fatigue have to do with lifestyle, and are correctable. They include:

Nutrition: If you’ve been living on caffeine to keep going, or you’ve been overindulging in sugary treats, you’re going to experience “crashes” of exhaustion. Too much sugar causes an imbalance in your metabolism. When the pancreas works overtime to process all that sugar, insulin spikes are followed by more craving for sugar. It’s a cycle that perpetuates itself, but you can get out of it. You’ll feel more energetic if you forego the desserts and snack foods, and concentrate on getting more green leafy vegetables, fruits, protein, and healthy nuts and grains. Stick with fresh foods as much as possible, avoiding processed foods. When you eat better, you feel better and have more energy.

Sleep: Avoid caffeine later in the day, so as not to interfere with your sleep. Practice “Sleep Hygiene”, that includes a regular routine of getting to bed at a consistent time and waking up at the same time each day, shutting off the TV and the computer an hour or so prior to going to bed, winding down your activities and eating lightly in the evening. Chamomile tea or melatonin sometimes help.

Exercise: Even moderate exercise helps tire you out, and you’ll sleep better. You’re don’t need to be the athletic type - walking is great exercise. Ride a bike, run, dance or do whatever type of exercise you enjoy. All exercise helps to decrease tension and improve mood by increasing endorphins, our body’s natural anti-depressants. If you enjoy it, you’ll do it. If you’re not active, you might get too much rest during the day and upset your normal sleep cycle at night, which becomes an ongoing cycle and can cause fatigue.

How a doctor can help

If you’ve done these things for at least a month and you still have no improvement in your fatigue, it’s time to see your doctor to find out if there is a medical cause. Are you taking medications that may cause you to feel lethargic, such as antihistamines, cough and cold medication, or pain medications? Tell your doctor about your pattern of drug or alcohol use, and what prescriptions and over the counter medications you’re taking. Medical conditions must be ruled out before psychiatric conditions are considered. Common medical causes of fatigue include anemia, sleep disorders, thyroid problems, obesity, and diabetes. But don’t diagnose yourself. Leave that to your doctor. If you continue to have fatigue that doesn’t improve, despite no obvious medical cause, or that doesn’t respond to medical treatment, you could have Chronic Fatigue Syndrome or a sleep disorder. If your doctor suspects a sleep disorder, s/he may send you for a sleep test. Some examples of sleep disorders include primary insomnia, sleep apnea, and narcolepsy. If your doctor determines that the cause is not medical, s/he may refer you to a therapist.

How a therapist can help

sea ocean waterAs a therapist, I always address symptoms by doing a full evaluation, which gives me an initial impression of what the problem might be. I evaluate whether the symptoms are normal reactions to common problems, or whether they may indicate something more serious. Grief, in and of itself, is a normal experience, since most of us go through it at some time in our lives. But if it has gone on too long (usually 2 years or more) and is not getting better, it may have developed into Major Depression, which is a treatable condition. Some of the symptoms of Major Depression include low energy and motivation, lack of sleep or excessive sleep, repeated awakening, or awakening too early with inability to fall back to sleep, poor appetite or overeating, lack of attention to hygiene, feelings of guilt, not caring about anything, thoughts about death, or even, in extreme cases, suicidal thoughts. So obviously if you have Major Depression, it is likely to be the cause of your fatigue, and should be treated. Talk therapy can be helpful, and sometimes, but not always, medication is indicated.

Anxiety can also be a cause of fatigue, since worrying can keep you up at night, and disturb your normal sleep cycle. Sometimes you just can’t shut your brain off, thinking of all the things you have to do, or worrying about all the things that have, or could go wrong. Again, as with major depression, anxiety can be a normal response to stressful circumstances, or it can be a psychiatric problem. If your whole life, day and night, is consumed with worry and “worst that can happen” scenarios, nightmares, uncontrollable panic, or fear of even leaving your home, your anxiety should be treated. Continued, unrelenting stress, state of worry, or frequent panic over a period of time can certainly cause fatigue. Again, talk therapy can help, and medication might be indicated if the anxiety is severe and unabated. Talking about your stress, rather than bottling it up inside, can give you great relief, and consequently, help you relax and sleep better, relieving your fatigue.

Work with a team of professionals

Since some medical problems sometimes present symptoms that mimic emotional problems, it’s important to know what’s really going on and causing the fatigue before you can come up with a plan to address it, hopefully with your doctor or counselor. I believe in first identifying the problem(s) and then developing a plan for treatment. You can’t effectively deal with a problem if you don’t know what it is. So if you are very fatigued, first see your doctor to make sure there isn’t a medical problem. If you are in good health, and the problem persists, don’t hesitate to contact a grief counselor, pastoral counselor, or a therapist. There is no need to suffer in silence. Help is available, so don’t hesitate to ask for it.

• www.webmd.com/women/guide/why-so-tired-10-causes-fatigue
• www.womentowomen.com/fatigue-insomnia/why-am-i-so-tired-all-the-time/

For more information contact me at This email address is being protected from spambots. You need JavaScript enabled to view it..

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