Tired, Fatigued or Exhausted?

by John Leverington, LPC, LMFT, LMSW

Chronic fatigue is real, but the vast majority of people do not recognize it and do not take the steps needed to deal with it before it becomes even more difficult to recover.

After working in private practice and at a Christian Counseling Center in the United States for 16 years our family moved overseas in 1994 where my wife and I began a full time Christian Counseling Ministry that has continued to this day. One of the issues that frequently came up in counseling people serving in faith-based organizations was fatigue. Not just tired or having a bad day by months of chronic fatigue. Based on my prior experience the number of people experiencing these often-debilitating symptoms was out of proportion to the general public. While much could be speculated about the reasons, this hand-out is for you or someone you know who may be experiencing chronic fatigue to learn the classic signs of chronic fatigue and not take them as “normal.”


What is Chronic Fatigue?

People with chronic fatigue suffer an unexplained and extreme feeling of tiredness that can last for many months, and often years. The amount of energy a person has influences how easily a person can adapt to stressors. Individuals who are tired still have a fair bit of energy, so although they may feel forgetful, and impatient, and experience gradual weakness in muscles following work, this is often alleviated by rest. Difficulty concentrating, anxiety, a gradual decrease in stamina, difficulty sleeping, and the limiting of social activities once viewed as important, on the other hand, characterize fatigue.

Until recently, there was a widespread misconception—even among doctors—that chronic fatigue was psychological, or worse, imagined. In 2015 a US government panel of experts defined chronic fatigue as a serious and debilitating condition and estimated that at least 84% of people haven’t yet been diagnosed. The panel wrote that, “Patients often struggle with their illness for years.”


Are you experiencing debilitating fatigue?

It is profound fatigue that leads to a sharp reduction in your ability to function on a day-to-day basis—and lasts for six months or more. The tiredness isn’t brought on by excessive activity (moving to a new country or learning a new language), but by activities you could once do easily.

The tiredness is unrelenting, and does not go away with rest. If you have eight or more hours of sleep, but when you get up, you feel like you haven’t slept at all, this could be an indication of extreme fatigue that can lead to exhaustion. Not being able to sleep or waking up several times during the night that leaves you feeling more tired than when you went to bed is a common report.
You may have other difficulties with paying attention, problem solving, and planning which make it difficult to do ministry or interact in social situations. And the issues get worse when you’re stressed, or you’ve over-exerted yourself. This can lead to feelings of isolation and hopelessness.

For many people, the simple act of standing upright—in the shower, for example, or while doing dishes—can lead to feelings of dizziness and lightheadedness, and possibly fainting. When lying down, the symptoms get better, but don’t necessarily disappear.
Pain is one of the most common features of chronic fatigue—but it can come in many forms, from headaches to joint and muscle pain. It can also differ in intensity from one person to the next, one person described it as, “… feels like permanently having the flu, a hangover, and jet lag while being continually electrocuted.”


Don’t wait to get help
The important thing is to prevent the progression from tiredness to fatigue and from fatigue to exhaustion. If you recognize the signs of chronic fatigue in yourself—especially the severe exhaustion, unexplained pain, and unrefreshing sleep—talk to a counselor or go see your doctor. The quicker you get help; the sooner you can get the treatment you need to live well overseas.