Are you dealing with chronic fatigue syndrome?
Or, is your fatigue really a symptom of depression?
The depressed and fatigued brain
Let’s imagine you have chronic fatigue syndrome. You’ve done your research and learned that a ketogenic diet is the best diet for increasing your energy. You’re two weeks into your fatigue-busting nutrition plan when a group of your friends invites you out for dinner. You think to yourself “stay strong” and “you can do this“. But when the waiter comes to take your order, you cave. You order what the group orders – chicken wings, fries, and a beer.
On your way home from dinner, the following thoughts run through your mind:
Way to go. You really blew your diet tonight.
Why is my willpower always so weak?
Well, my diet is ruined now, there’s no sense in continuing it.
I guess I’m just going to be fatigued forever.
Once home, you break out the ice-cream. And all the gluten. Just like that, you’ve abandoned your wellness goals.
Does this sound familiar?
Why does your brain interfere with health/wellness goals that will be of benefit to your whole body? Why does your brain want to stop you from overcoming fatigue?
A depressed brain is a pessimistic brain – and if you have chronic fatigue syndrome, you’re more than twice as likely to experience depression. Not only that, a pessimistic brain is a fatigued brain. To overcome chronic fatigue, you need to train your brain to be optimistic. If you have chronic fatigue syndrome, you’re more than twice as likely to experience depression.
An optimistic brain is an energized brain. In this post, I’ll show you how to decrease your depression, and simultaneously increase your energy with some simple (evidence-based) techniques devised by psychologists.
Are you chronically fatigued?
In an attempt to offer you at least some relief, your doctor has likely offered you an antidepressant prescription. Unfortunately, there’s little scientific evidence to support their use for chronic fatigue syndrome. (1, 2, 3)
That’s not to say antidepressants are useless in treating chronic fatigue. There is anecdotal evidence and small research trials that have shown there to be moderate improvements in fatigue scores and pain levels. But antidepressants don’t address the root cause of your fatigue. And all too often, in an effort to offer you some diagnosis, your doctor will diagnose you with depression. When what you’re actually dealing with is chronic fatigue.
Chronic fatigue vs depression: what’s the difference?
Below, I offer you a side-by-side comparison of depression and chronic fatigue. These two conditions are similar; there’s no denying that fact. But there are distinct differences between the two. (4)
Chronic fatigue syndrome
- Fatigue worsens after exercise
- Fatigue is associated with not functioning well
- Unrefreshing sleep
- Increased body pain(s)
- Intolerance to standing upright
- Tender lymph nodes
- Normal appetite
- Increased levels of inflammatory cytokines
- Fatigue improves after exercise
- Fatigue is associated with apathy and an inability to experience pleasure
- Insomnia or excessive sleep
- Little to no body pain
- Able to stand upright without issue
- Lymph nodes are not tender
- Suppressed or excessive appetite
- Cytokine levels may or may not be elevated
Read more about the diagnostic criteria behind chronic fatigue syndrome.
Primary care physicians are more knowledgeable about depression than chronic fatigue syndrome. As a result, more doctors are diagnosing depression than chronic fatigue syndrome. In 2017, nearly 20% of women in the United States were taking an anti-depressant. (4) That’s an increase of more than 65% since 1999. (5)
Those with chronic fatigue syndrome are more than twice as likely to experience depression and/or anxiety – which means as many as 40-50% of CFS sufferers. (6, 7) I believe that depression is a symptom of chronic fatigue syndrome. Emerging new theories on depression suggest depression has little to do with low levels of serotonin. Instead, depression is a symptom of a chronic inflammatory state. (8, 9) It has been shown that chronic fatigue syndrome is also an inflammatory condition. If depression really is caused by inflammation, it should be no surprise to see it strongly correlated to chronic fatigue.
How to improve both depression and chronic fatigue
Operating under the assumption that both depression and chronic fatigue are strongly correlated to high levels of inflammation, a generalized treatment principle should look to lower inflammation. The perfect place to start is your diet. The standard Canadian/American diet is incredibly high in processed, inflammatory foods.
You can start your journey towards lowered levels of inflammation with avoiding specific foods. Or, if you’ve already got a healthy diet mastered, try implementing the best diet for chronic fatigue syndrome.
How can you make healthy choices when you’re too tired to go through the food prep required to eat healthily?
How can you exercise when you don’t have the energy to get out of bed?
Sometimes, your brain gets in the way of making positive diet/lifestyle changes. Below, I’ll show you how to implement positive changes. Even when your brain says no.
The pessimistic brain
If you haven’t already, check out my article about how optimists have better health than pessimists. When your brain is getting in the way of you overcoming fatigue, remember your ABCs:
Let’s return to the example I used at the beginning of this post of ‘cheating’ on the ketogenic diet. The adversity comes when you go out for a meal with friends. A meal you know is not going to be keto-friendly. Heck, it’s not even fatigue friendly.
After choosing to partake in the chicken wings, beer, and french fries, your internal voice becomes quite negative. You use self-talk that is permanent (this always happens), pervasive (this happens in every area of my life), and personal (I can never follow through on diets). Instead of this being a one-time mistake, your diet unravels. You eat all the cakes, cookies, and cinnamon buns. It’s the pessimistic brain that has such a strong correlation with depression.
If your brain was trained to be more optimistic, your diet would likely have not unraveled. You’d acknowledge that this was a one time mistake. That you’ve been super strict for the past two weeks. And that one meal isn’t going to ruin anything.
You’d get back on the keto diet and keep working your way to overcoming fatigue. But that’s not what happens for most of you. One mistake often spells the end. This occurs because of pessimistic self-talk. And pessimistic self-talk is a hallmark sign of depression.
So, how can you take steps to change your self-talk so that you stick to your keto diet and any other endeavors that will help you to overcome fatigue?
How to make your brain fatigue-proof
An optimistic brain is an energized brain. A pessimistic brain is a fatigued brain. To see what type of thinking your brain defaults to, I want you to practice your ABCs five times in the next week.
Every time you encounter adversity, write down a brief description of your encounter in a journal. Underneath it, write a brief description of your belief(s) in response to this adversity. Your beliefs can include thoughts that ran through your head or outward displays of emotion(s). Underneath beliefs, I would like you to write out the consequences that occurred as a result of your beliefs to the adverse situation.
After you’ve got five of your ABCs complete, I want you to now look for the link/connection between your beliefs and their corresponding consequences that followed. You’ll quickly notice a repeating pattern. Pessimistic/negative beliefs result in fatigue, dejection, and unwanted feelings. Optimistic beliefs energize you and fill you with positive emotion.
It goes without saying (though I’ll say it anyway) that should you change your beliefs to be optimistic, you’re more likely to increase your energy and overcome fatigue.
But how do you change your beliefs? They are what you believe, after all.
There are two strategies you can employ to successfully manage your negative beliefs:
In order for you to best distract yourself, a physical stimulus is required. This stimulus breaks up the thought loops you can get trapped in. A simple technique is to place a rubber band around your wrist. When you become aware of a pessimistic thought loop starting, snap that elastic band on your wrist.
After distracting your self with a physical stimulus, focus your attention on something in your environment. Maybe you pull out a weather app on your phone. Or, grab a book from out of your purse.
Some will find it helpful to write down the troubling thought. Once written down, make a deal with yourself to revisit your concern at a specific time of the day when you can devote resources to solving the problem.
Distraction can help get you out of a jam. But it doesn’t help to solve the underlying problem (your negative thoughts). What’s far more effective in the long run is to dispute your own thoughts (especially the negative ones!).
Are your beliefs grounded in reality? Or, are they just an emotional reaction?
Your beliefs are not necessarily facts. Often, they’re based on emotion. Not on evidence. You can dispute your feelings with facts. Look to the evidence. Your pessimistic feelings need to be disputed!
Returning again to the example of breaking your ketogenic diet, you could easily calculate the number of excess carbohydrates and calories contained within the meal. Such a calculation would likely reveal that yes, you’d be out of ketosis due to the high carbohydrate load. But with a small fast the next day you could easily move right back into ketosis. And the excess calories contained in one meal are not enough to throw off your entire week. So really, that one meal out wasn’t a big deal.
What happens if your beliefs are true and factual?
Sometimes your negative emotions and beliefs are based on the facts. They cannot be easily disputed. In these situations, it’s best to look at the implications. Ask yourself “even if my belief is correct, what are its implications?”.
Does breaking your anti-fatigue diet make you a failure? Of course not. The implications are that you are out of ketosis for roughly eighteen hours. That’s it. You can re-enter ketosis by sticking to your nutrition plan.
Will breaking your diet mean you’ll never overcome fatigue? The implications may be that it will delay you. But should you stick with proper nutrition over the long term, you will overcome fatigue.
A simple plan to help your brain overcome both depression & fatigue
Do you remember the ABCs from the beginning of this post? Adversity, beliefs, and consequences are your ABCs. I now want you to add two more letters to the mnemonic. These are your ABCDEs.
The next time adversity comes your way, apply the ABCDEs. Just like you did before, start by naming the adversity, your beliefs surrounding it, and the consequences your beliefs bring about. Then, I want you to fiercely dispute these beliefs. Pretend you’re a top lawyer arguing for your client’s wrongful accusal. Don’t back down!
After disputing your beliefs, make note of the energization that occurs afterward. When you successfully dispute your own beliefs, you should experience a warm glow of energy. When you’re just starting this exercise, I recommend writing everything down. This way, you can reflect on your adversities and how you disputed your behavior. With practice, you’ll become a stellar negotiator!
The next time you find yourself feeling down, depressed, fatigued, or anxious pay close attention to the thoughts you’re telling yourself. Then, I want you to challenge these beliefs. Put up a strong argument against yourself. Use facts to bolster your argument. Look to the implications of your belief(s) – they’re likely not permanent nor pervasive like you think they are.
Why does your brain default to negativity?
As I wrote in a previous post, pessimism or, negativity is a learned behavior. Those of you dealing with a chronic illness like fatigue or depression will have to be extra diligent to not succumb to its clutches.
But why is it so easy for your brain to be negative? And so effortful for it to be positive?
I suspect this has a lot to do with our species survival. The extreme optimist would try to take down a mammoth by herself. Of course, this would likely result in her untimely demise.
It’s not a stretch to say that nature selected the realistic/pessimistic traits. These traits likely kept your ancestors alive longer than extremely optimistic traits. But in today’s world, this proclivity towards pessimism is no longer a genetic advantage.
In the hunter-gatherer days, one did not have time to think about the development of the self. One’s energy was spent on ensuring food and shelter could be obtained. These were never guaranteed like they are today.
In the twenty-first century, you have your basic needs met. Food, clothing, and shelter are no longer of great concern. And with those needs met, you move up Maslow’s hierarchy towards self-actualization.
Our society does not offer strategies for you to transcend the self. To do this, you need to find meaning outside of yourself. Meaning can come from family, religion, or even your career. But it has to be something bigger than yourself. Should your life lack meaning, your brain will tend towards negativity, depression, and fatigue.
When you’re dealing with chronic fatigue, the mind tends to focus solely on your lack of energy. It cannot begin to fathom working on something bigger than the self. The self is too tired for that.
To successfully overcome chronic fatigue syndrome you need to take a multi-modal approach. This means that you must simultaneously focus on your physical body (nutrition, exercise, sleep, stress reduction) and your mental well-being (positive self-talk, cognitive behavioral therapy, neurofeedback).
Start your anti-fatigue journey with the ABCDEs combined with a fatigue reset diet. This will help you to break the cycle of negative self-talk while simultaneously empowering your mitochondria to create more energy. The approach will simultaneously address fatigue caused by your body and your mind.
Now, I want to hear from you!
How does your brain and pattern of thought interfere with your energy levels?!
Also published on Medium.