Exhaustion can be a threat to your health

Debilitating fatigue isn't just for celebrities, and it's dangerous

Chicago TribuneDecember 21, 2010 

  • Four ways to fight exhaustion

    ■ Exercise. Once you have enough energy to stand, get moving. Exercise can especially help if the exhaustion is related to depression.

    ■ Take meditation mini breaks. If you're wired all day, you'll have trouble calming down at night and getting to sleep. The short breaks "will help you decompress, calm your mind and relax," said Judith Orloff, an assistant clinical professor of psychiatry at the University of California at Los Angeles and the author of Positive Energy. "Take a few deep breaths to relax the body," she said. "Focus on a positive image such as a sunset, a flower, a child's face. Stay focused on the positive image, breathe and relax. This will keep you in a centered place."

    ■ Stay in the present. Worrying is exhausting. "Do not project into the future or catastrophize," Orloff said. "Take doable-action steps to solve problems."

    ■ Nip it in the bud. Before things get too bad, prescribe yourself some rest.

  • Famously exhausted celebs

    Here are some stars who have claimed exhaustion:

    Wyclef Jean: The hip-hop star and would-be Haitian presidential candidate was hospitalized last month to treat exhaustion.

    Lindsay Lohan: The troubled star's "exhaustion" generally translates to "trip to rehab." She's on her fifth stint and is undergoing treatment at the Betty Ford Center.

    Amy Winehouse: In 2007, the Rehab singer canceled a number of shows in Europe as a result of what her publicists called "exhaustion" and ill health. Winehouse told the German magazine Stern that she was hospitalized during this time after overdosing on a mix of substances, including heroin, ecstasy, cocaine, ketamine and alcohol.

    Susan Boyle: The Britain's Got Talent runner-up jetted to worldwide fame before entering the Priory rehab center in London after the show's 2009 finale, suffering from exhaustion.

    Ashlee Simpson: During a 2005 performance in Japan, the singer left the stage midsong and briefly returned to apologize for losing her voice. She was hospitalized later that night for dehydration, bronchitis and what she reportedly called "complete exhaustion."

    Vincent D'Onofrio: After being hospitalized for exhaustion in 2004, D'Onofrio, who at the time starred in Law & Order: Criminal Intent, began sharing his leading-man duties.Ruben Studdard: After his second album, I Need an Angel, in 2004, Studdard checked himself into an Alabama hospital for "exhaustion," canceling a number of appearances.

    Dave Chappelle: The comedian was reportedly hospitalized for exhaustion in 2007. His representatives said he needed to drink more water.

    Colin Farrell: Like Lohan, the Irish heartthrob was "exhausted" before heading off to rehab in 2005.

    Eminem: The rapper canceled a tour because of exhaustion and other medical issues in 2005. He reportedly was treated for sleeping-pill addiction.

For many of us, exhaustion is a fact of life. For the rich and famous, though, it seems that acute weariness can be so debilitating that it requires hospitalization.

Although eyes often roll when celebrities vanish to be treated for "exhaustion," experts say it can be a valid medical condition, even for those who don't have a publicist. Prolonged periods of physical stress and sleep deprivation can cause problems that shouldn't be ignored, they say, although Americans might not want to admit it.

"Exhaustion is real on many levels, but it's not part of our medical lexicon," said Dr. John Stracks, a mind-body specialist at Northwestern Memorial Hospital's Center for Integrative Medicine who treats chronic pain.

Americans have more sleep loss and longer work schedules than residents of most other industrialized countries, and both factors can lead to physical and emotional collapse, said Dr. Eve Van Cauter, a sleep researcher and professor of medicine at the University of Chicago.

Experts say chronic stress can trigger a cascade of negative health effects — in particular, gastrointestinal distress.

"Your mood and your gut function are intimately tied together," said Dr. Gerard Mullin, a gastroenterologist and associate professor of medicine at Johns Hopkins School of Medicine.

When you're stressed, for example, the body's "flight or fight" response causes a surge in adrenaline, which can result in valves in the upper digestive tract staying open. When this happens, food and digestive enzymes can travel the wrong way, resulting in reflux, heartburn and other stomach problems, Mullin said.

Sleep loss and fatigue also lead to problems with people's circadian rhythm, which can promote inflammation throughout the body and cause gastrointestinal issues, Van Cauter said.

In some cases, fatigue is a sign of an underlying disease, including cancer, low thyroid, anemia or other metabolic abnormalities, such as adrenal insufficiency. Exhaustion is commonly seen with depression and is a possible side effect of many prescription drugs, including beta blockers, muscle relaxants and mood stabilizers.

But University of Chicago Medical Center internist Dr. Alex Lickerman said fatigue caused by dehydration, infection, drug or alcohol abuse, or lack of sleep — from either insomnia or just burning the candle at both ends — is treatable in the outpatient realm. Lickerman has yet to admit anyone to the hospital for being tired.

"It's a symptom," he said.

Of course, dozens of celebrities — from hip-hop star Wyclef Jean to actress Lindsay Lohan — have been carted off to the hospital amid reports of exhaustion. The term is a common euphemism for "drug or alcohol addiction" or a mental illness such as depression, but performers also can suffer physical effects from their frenetic lifestyle and the harsh glare of the spotlight.

"It is a legitimate diagnosis when exhaustion causes someone to collapse and be unable to function," said Los Angeles-based psychiatrist Judith Orloff, who frequently treats exhausted celebs. "Exhaustion can also lead to low serotonin, which causes depression, anxiety and insomnia. But it's not accurate if the real diagnosis is drug or alcohol intoxication or overdose."

Exhaustion by any name is hardly a new phenomenon. In the 1800s, women were said to suffer from hystero-neurasthenia, or "nervous exhaustion." Triggers included excessive amounts of exercise, cohabitation, brain work and worries over motherhood, according to an 1887 article in the Journal of the American Medical Association. Women also were at risk if they worried too much about "impending or actual misfortune."

In the 1950s, about the time that women were having "nervous breakdowns," scientists published research showing that it was, indeed, possible for business executives to suffer from exhaustion. Today the term burnout, which is characterized by emotional exhaustion, is recognized in Europe and is a common concern among those who work in the medical or humanitarian aid fields.

Still, even though the World Health Organization recognizes several forms of medical exhaustion due to heat, pregnancy, excessive exertion, combat, malaise and other conditions, the U.S. government has not given it a diagnostic code.

Some data suggest that "vital exhaustion," or a state of excessive fatigue, irritability and hopelessness, can be a risk factor for heart attacks and death. Dutch researchers found that people with high vital exhaustion scores were three times as likely to suffer subsequent heart attacks, perhaps because it increases blood clotting.

In the United States, a problem is that the main treatment for exhaustion — sleep — is often seen as laziness, a bother or a barrier to productivity. In 1960, the average American received a luxurious amount of shut-eye: 8½ hours a night. Today, most people get by on an average of less than seven hours, and a substantial proportion sleep less than six hours, according to National Sleep Foundation data

Stracks says he thinks investing in rest for the chronically tuckered out could have a large payoff down the road. "Would a two-week break really cost that much more than another MRI or ER visit?" he asked.

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