Fatigue

Fatigue

You Don't Have to Be So Tired

The alarm goes off at 6:00 a.m. You snuggle with your mate for a moment, then give him a kiss, push the dog off the bed and reach for your moccasins.

You get breakfast for the kids, throw a load in the washer, get dressed, drop the cat at the vet, pick up the dry cleaning and get yourself to work. And it's only 9:00 a.m.

Then you work like a dog trying to meet the deadlines and responsibilities of your job.

It's almost a relief when you stuff a little work into your briefcase at 6:00, grab your keys and head for home.

Once there, of course, life's a breeze. You make dinner, supervise homework, get the kids to bed, fold the laundry and then, with pillows propped behind you and a cup of hot tea at your side, you pull out the work you brought home from the office.

Long, Hard Hours

Women have always worked hard. But today, doctors say, women are exhausted. Married or single, with or without kids, working in an office, a laundry or at home, it seems as true as ever that a woman's work is never done.

The result is that fatigue is one of the top ten complaints in doctors' offices across the country.

That's not to say that the deadening fatigue of which women are complaining can't be caused by physical ailments. It can. Fatigue is a side effect of almost every disease and condition known to woman. It can be caused by pregnancy, menopause, an approaching period, overweight, flu, anemia, mononucleosis, cancer, a low-grade urinary tract infection, a vaginal infection, diabetes, hypoglycemia, depression, fibromyalgia, the common cold, smoking, stress or just having your thyroid out of whack.

It can also be caused by drugs. Antihistamines, tranquilizers, muscle relaxants, sedatives, narcotics, birth control pills, heart medications and pain relievers can all cause fatigue.

Then there is chronic fatigue syndrome, which is something completely different. Some doctors believe it's caused by some kind of malfunction in the immune system.

But when a woman shows up in a doctor's office with fatigue as her chief complaint--rather than fever, itching, sneezing or pain--the problem is not usually illness or medication.

"I think that people feel chronically tired for a very simple reason," says fatigue researcher Anthony Komaroff, M.D., professor of medicine at Harvard Medical School. "They're working long, hard hours."

The work week in the United States has been steadily increasing since the mid-1960s, says Dr. Komaroff, particularly for women. It's one of the most important phenomena of our time, he adds. Yet it's a cultural trend that most Americans haven't yet recognized.

Why? They're too busy working.

The Incomplete Revolution

Why are women working so hard? The problem for most women is that they're caught between social revolutions, experts agree. While one social revolution has expanded women's roles to provide increased career opportunities, a second, hoped-for social revolution--that of increased men's roles in the family--hasn't come to fruition.

In the 1993 National Study of the Changing Workforce, researchers at the Work and Families Institute, a New York City-based think tank, surveyed 3,000 working Americans and found that while men were spending more time working in the home than their fathers, women were still working twice as many hours as men at home. The overwhelming majority of women (81 percent) did most of the shopping and cooking, 78 percent did the bulk of the cleaning, 71 percent assumed primary responsibility for child care, and 63 percent took charge of the check-writing and bill-paying.

Most men (91 percent) did the household repairs, and 35 percent of men did most of the check-writing. Eighteen percent did the shopping, 15 percent did most of the cooking, 7 percent did the cleaning, and 5 percent took responsibility for child care.

"Men think they're doing more, but when you compare what they say they're doing with what their wives say they're doing, there's a 50-point spread," says Dana Friedman, Ed.D., co-president of the Families and Work Institute and one of the researchers who conducted the study.

It's not that the guys are fibbing, she adds. It's that guys look at tasks--specifically the tasks related to the kids--and ignore all the planning that goes into executing various family activities.

"With regard to school, for example, women take all the responsibility for the kids," says Dr. Friedman. "She selects the school, she visits the school, she finds the parents to car pool, she sets the car pool schedule. And then, one day, he drives.

"You hear what's happening?" asks Dr. Friedman. "She did the 42 steps to set something up, he drove, and he thinks he's sharing in the child care!"

Fighting Fatigue in the 1990s

Since these circumstances are not about to change overnight, how do you fight fatigue in the 1990s? Here's what experts say.

Prioritize. "Most of us are still assuming the traditional responsibilities that society says a 'real' woman does," says Claire Etaugh, Ph.D., professor of psychology and dean of the College of Liberal Arts and Sciences at Bradley University in Peoria, Illinois.

But just because our moms baked apple pies, had hot chocolate waiting after school and kept the toilet bowl sparkling doesn't mean that we should--especially not in a world where an attorney who works 40 hours a week is considered a part-timer.

"There are too many 'shoulds' in our lives," says Dr. Etaugh. "You have to decide what's most important, set priorities and then--whether it's cleaning, family, friendships or career--let the rest go."

Drop the guilt. If not fulfilling your own image of a perfect wife, mom, worker or housekeeper makes you feel guilty, see a therapist, adds Dr. Etaugh. Otherwise, feeling guilty over not baking your son's favorite cherry pie could leave you feeling just as exhausted as if you'd taken the time to make it.

Learn to manage your time. Most working women--particularly working mothers--are highly efficient at managing their time. They wouldn't survive if they weren't. But it always helps to have someone else look at your workload--both at home and at work--with a critical eye. There's a good chance that somewhere, somehow, there's a more efficient--that is, less fatiguing--way to get things done.

Do two things at once. Become an expert at figuring out how to do more than one thing at a time, says Dr. Etaugh. Hang an extra cleaning brush on the shower caddy and scrub down the walls when you shower. Fold laundry while you listen to a theme your child has written for tomorrow's class.

Use the phone. Bank by phone. Pay by phone. Use direct-mail catalogs and 800 numbers to shop at home. Order gifts by phone--then have them wrapped and sent, says Dr. Etaugh.

Take control of your worklife. "Probably the most tiring situation is to have responsibility without authority in the workplace," says Susan Schenkel, Ph.D., Cambridge psychologist and author of Giving Away Success: Why Women Get Stuck and What to Do about It:"It makes things difficult, unpleasant and exhausting. And it's a big workplace issue for a lot of women," she says.

Moving up the corporate ladder--or even sideways--into a different job is one answer, as is looking for another job or quitting and starting your own business. Either way, says Dr. Schenkel, taking control of what you do and when you do it is a big energy booster.

Talk to your boss. If you're finding more and more work on your desk, Dr. Etaugh says, talk to your supervisor and try to work out a more manageable workload.

Check the parking lot. To avoid taking the kind of job in which a 60-hour week is the norm, cruise through the parking lot of any company you're thinking of working for at about 6:00 a.m. or 6:00 p.m. during the week, suggests Dr. Friedman. Count the number of cars. If there are one or two, no problem. But if the lot is a quarter full, there's a good chance that this is a corporation that pushes its people to the wall.

Exercise. "Fatigue is a big problem for me," says Dr. Schenkel. "That's why I spend a considerable amount of time working out. I do sit-ups and stretches every morning. And I try to spend about 25 minutes a day on the exercise bike. Then every other day I try to do water walking or walking on the sidewalk for anywhere from 40 minutes to an hour."

Besides keeping your energy levels up on a long-term basis, exercise can also energize you on the spot, doctors agree.

In a study at California State University, for example, researchers compared the energy levels of a group of volunteers who took a ten-minute walk and a group who ate candy instead. The researchers found that the walkers increased their energy more than the munchers, and the effects of walking lasted much longer than those of munching--up to two hours.

Wake up to your diet. "Another factor that makes a lot of women tired is that they have poor nutrition," says Dr. Schenkel. "Part of the problem is ignorance, some of it is that women are too busy to pay attention, and some of it is that every woman in America thinks she's at least ten pounds overweight."

Whatever the cause, the solution is to keep an eye on your diet, says Dr. Schenkel. Nutrition experts suggest that a high-energy diet is one that's high in complex carbohydrates like those found in grains, beans, pasta and most baked goods, with less than 25 percent of its calories coming from fatty foods. And if you really must lose weight, keep your energy levels up by keeping your calorie intake above 1,000 a day.

Get help. One thing that's going to be slow to change is the lack of support women get at home from their men. Social changes take time, says Dr. Etaugh. So instead of draining your emotional energies along with your physical ones by trying to speed up the redefinition of men's roles, hire some outside assistance. If you can afford it, hire someone to clean the house, mow the lawn and babysit the kids, and have the pizza delivered.

The Alternative Route

Since so many illnesses can cause an overwhelming sense of fatigue, check with your family doctor whenever you feel exhausted for more than a few weeks.

But if your doctor gives you a clean bill of health even when you're still exhausted, think about consulting a professional who practices alternative medicine, says Dr. Schenkel.

"If you go to your average doctor and say that you're tired and she doesn't find anything interesting on the tests, she will say, 'You need to reduce your stress, and God be with you, Madam,' " she says. But a physician who practices alternative medicine will take the fact that you're tired as important information. Ask your doctor to refer you to someone who practices this kind of medicine.

For instance, Dr. Schenkel says, "in oriental medicine, doctors organize their whole medical system around energy--around the concept of chi. So someone who practices oriental medicine will be curious about where in your body the chi is blocked, and they'll help you try to unblock it," possibly with acupuncture, herbs and exercise.

Who knows? says Dr. Schenkel. Maybe an of hour or two of slow, flowing movements of the Chinese exercise tai chi chuan every week is all you need to reenergize.