The Exhaustion Epidemic

Unfortunately, thanks to the cultural stereotype of the super-harried, super-drained superwoman, direct questions about energy and fatigue levels may not be asked during physicals, and patients, accustomed to incessant lethargy, forget to broach the topic altogether.
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These days, there's a silent epidemic afflicting women in the U.S. It's silent because most of the women who are suffering don't seem outwardly unwell, and because many affected women don't talk about what they're going through. Nevertheless, the epidemic of exhaustion is real, and it's bringing too many women down.

Consider this: In 2010, women across the U.S. named fatigue among their top five health concerns in WebMD's annual Year in Health survey. A 2013 survey by the Pew Research Center found that there is literally no job more exhausting than being a mother. In the American Psychological Association's 2012 Stress in America survey, 45 percent of women reported feeling fatigue due to stress. And in a 2011 study, researchers at Stony Brook University in New York found that women consistently report higher levels of fatigue than men do.

Think about your own social and professional spheres: Do you know a woman who doesn't complain about being wiped out or tired? I don't. In my Manhattan medical practice and in my personal life, I see more women than not who are struggling with their own personal energy crises. And yet, most accept it without a second thought, viewing fatigue as the price they must pay for leading such full lives. Exhaustion is explained away as an inevitable consequence of balancing work and family responsibilities, not getting enough sleep, having too much to do in too little time, and coping with the other demands of modern life. Pushing through painful fatigue is even seen as a badge of honor, proof that women can "do it all," and earn extra admiration if they can appear to do it all effortlessly. But it shouldn't be that way.

While feeling tired is a natural response at the end of a long day or after exertion (a 6-mile run should make you feel exhausted), feeling constantly drained isn't normal -- or acceptable. It's a cry for help from your body or mind, just as pain or fever can be. You wouldn't ignore those symptoms, would you? Eventually a constant state of fatigue will damage your physical and mental health, and take a toll on the quality of your life and relationships.

This is personal for me: For nearly 20 years straight, I suffered from debilitating fatigue, from morning to night. From the moment I awakened, I'd start thinking about how and when I could take a nap. More often than not, it was a true struggle to get through the day. Despite my unrelenting exhaustion, like most women I know, I simply forged ahead and kept moving. I put one foot in front of the other, fulfilling my daily tasks, as I became a wife, mother, doctor, and TV medical correspondent. But I was running on empty, drained and depleted, and not fully enjoying the life that I had built.

Ironically, during my most severe periods of exhaustion, I was surrounded by, and had open access to, some of the most brilliant doctors I've ever known. Yet still, getting to the root causes of my fatigue was challenging. It was brushed off with, "Oh, you're in medical school, you're supposed to be tired," or "You're a resident, there's nothing wrong with you." But I knew there was.

Eventually, I was diagnosed with a few medical conditions, the most serious of which was fibromyalgia. The diagnoses were an important acknowledgment that the fatigue wasn't all in my head but unfortunately they didn't add up to a solution right away. Over time, I tried numerous interventions, from traditional and herbal medications, to nutritional supplements, acupuncture and yoga -- I even gave an oxygen chamber a whirl. Through a process of trial and error, I have found a combination of approaches that work for me, and my still busy, full life. And because of that, I now enjoy it more than ever.

My feeling is: No one should accept fatigue as her fate. You are entitled to live the life you want, and feel healthy and vibrant while doing it. Fatigue should be investigated until you get to the bottom of it and treated until you have reclaimed your energy. Some of the most common (and commonly overlooked) illnesses in which fatigue is a primary symptom occur more frequently in women. These include autoimmune conditions (like lupus and rheumatoid arthritis), thyroid disorders, anemia, irritable bowel syndrome, and depression. And they all can and should be diagnosed and treated. Even if there isn't a medical cause for your fatigue, hundreds of simple lifestyle-related habits -- including non-restful sleep, nutrient-deficient eating, breathing shallowly, having poor posture, or worrying -- could be secretly robbing your energy and damaging your body over time.

Unfortunately, thanks to the cultural stereotype of the super-harried, super-drained superwoman, direct questions about energy and fatigue levels may not be asked during physicals, and patients, accustomed to incessant lethargy, forget to broach the topic altogether. That should change. But until it does, it's up to each and every woman to view exhaustion as unacceptable, and then arm herself with the information she needs to walk into a doctor's office, describe her symptoms in as much detail as possible, request appropriate testing, and fight fatigue until she wins.

This is why I wrote my new book The Exhaustion Breakthrough: Unmask the Hidden Reasons You're Tired and Beat Fatigue for Good (Rodale): to empower women through the journey of reclaiming their vitality. In the book, I guide readers through hundreds of common but commonly overlooked energy drains -- and how to find lasting solutions. I've done it, and you can too. We all deserve to feel energetic and full of life. It's up to you to make it happen.

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