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The Exhaustion Cure

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Body+Soul, March 2009

Are you feeling stressed, fatigued, and burned out? Discover the top 10 ways to put a stopper in your personal energy drains
Consider this simple question: How are you?
We answer it 10 times a day, often rejoining with a clipped “Fine” or “Busy!” accompanied by a glazed smile. But when your best friend or spouse asks, perhaps you tell the deeper truth: You’re stressed out and tired. Really tired.
“Busy,” “stressed,” and “tired” are intimately connected. They describe the ethos of our times — and its inevitable aftermath. We balance work, family, friends, and our various self-improvement programs. We take in a steady stream of information from the people, screens, phones, and sounds that surround us. We don’t sleep enough. We multitask like crazy, striving to get more done in less time.

For a while, maybe even years, it’s easy to feel like you can handle this frantic pace — or even thrive at it. But ultimately, it works against you. “Stress is pervasive in our society, and it’s only getting worse,” says integrative-medicine expert Woodson Merrell, M.D., author of “The Source: Unleash Your Natural Energy, Power Up Your Health, and Feel 10 Years Younger.” “And people do not necessarily have the coping skills to deal with it, even when they think they do.” We often don’t realize how much of our days are spent dealing with stressful situations, and on a physiological level, the effects of stress add up. “You don’t start every day with a clean slate,” he says. “You start the day with all the stress you’ve accumulated in your life, and you add to that.”

No wonder we’re so tired. In fact, many experts contend that chronic stress and our inability to cope with it are the biggest factors in fatigue. “I hear it all the time. People tell me, ‘I have no energy, I can’t sleep, I’m exhausted,'” says Andrew Weil, M.D., director of the Arizona Center for Integrative Medicine at the University of Arizona and author of “Healthy Aging.” 
This “tired-wired” state has become a cultural condition, he adds. And for those that struggle with it, fatigue can also become a significant crisis. “Your personal energy level should meet the demands of the day. Your sense of well-being should be good most of the time,” says Weil. “When it’s not, you have a real quality-of-life shortage.”
As is always the case, however, in crisis lies opportunity. Fatigue, it turns out, can be a terrific teacher, giving you a chance to slow down and examine your life, learn more about yourself, and consider what’s really important. 
For starters, you want to cover your bases by eating a healthy diet, getting regular exercise, maintaining good sleep habits, and following other steps toward sound overall energy hygiene. But many of our most potent energy drains fly under the radar. By taking careful stock of your daily habits, work life, and relationships, you can begin to see patterns that cause your vitality to slip away unnoticed; make some simple changes, and you’ll plug these leaks and start feeling better.
Here, Merrell, Weil, and other experts highlight 10 surprising causes of fatigue and offer thought-provoking solutions to help you energize your mind, body, and spirit — and your life.
1. Exhaustion Cause: Good NewsWe know that our energy gets drained by negative events: death of a spouse, divorce, imprisonment, getting fired, serious illness or injury, losing your home or savings. But positive events can drain us, too, says Alice Domar, Ph.D., executive director of the Domar Center for Mind/Body Health in Waltham, Massachusetts. “Getting married, having a baby, buying a new house, getting promoted at work — these are all positive steps, but they often come with a lot of worry, which can be exhausting.”
To further complicate the picture, it’s hard to find support when things are going great. “Tell people you’re exhausted because you’re caring for your dying mother, and you’ll get all the support in the world,” Domar says. “Tell them you’re exhausted because you got a fantastic new job, and they’ll be like, ‘Give me a break!’ “
Exhaustion Cure: Make A Positive Prep PlanThe best way to end-run positive exhaustion? Prepare for it. “When you start getting tired,” says Domar, “ask yourself two questions: ‘What’s being asked of me that I don’t feel that I can deliver?’ and ‘Am I accurately perceiving what’s needed?'” Then make a list of what really needs to be done, and when. “We often feel like everything needs to happen at once, and that’s not true,” says Domar. Breaking things down into manageable chunks lets you catch your breath so you can plan and delegate accordingly.
2. Exhaustion Cause: Shallow BreathingBreathing is our most elemental and immediate need. But there’s a big difference between breathing to survive and breathing to thrive. “Most people I meet take shallow, rapid breaths, using only about a third of their lung capacity,” says Weil. You need oxygen to metabolize your food so your body can produce energy. “Not breathing fully and efficiently has a huge effect on your vitality.”
Most of us don’t often stop to consider the way we breathe. “We don’t pay attention to it because we’re never taught to,” explains Weil.
Exhaustion Cure: Extend Your ExhalationsIf you make a conscious effort to deepen your breathing, says Weil, “you’ll sleep better, gain more control over your moods, experience less fatigue, and have better energy overall.” Rather than start by taking a big, deep inhalation, increase your breathing efficiency with a focus on breathing out. “We have more voluntary control over the exhalation,” he explains. By learning to use the intercostal muscles (between the ribs) to expel more air from the lungs, “inhalation will automatically increase.”
For best results, Weil recommends spending a little time every day on breathwork. “Keep it very simple. For several minutes, simply squeeze at the end of every exhalation. You don’t have to sit in any special posture. You can do this anywhere, but lying in bed is a good place to start. Over time, your breath will become more regular, quieter, and deeper.” And your energy level will grow stronger.
3. Exhaustion Cause: Disconnection from NatureIt’s hard to feel tired or anxious while hiking in the wilderness or staring out at a blue expanse of ocean. “Nature has built-in mechanisms for relieving stress,” says Doreen Sweeting, M.D., founder of Psychosomatic Wellness Intuitive Life Coaching. “There’s aromatherapy in the scent of the pine trees and grass, chromatherapy in the colors of the rocks and sky and flowers, sound therapy in the birdsong and wind rustling the leaves.”
Our society, unfortunately, is increasingly cut off from this wellspring of energy. “We live in artificial light. We walk on concrete. We exercise on machines,” Sweeting says. “We go from home to work to the store and back home.”
Exhaustion Cure: Take A Morning WalkWhether you live in a suburb or a bustling city, take a walk first thing in the morning — if possible, in an area filled with trees. “You’ll feel the energy of nature replenishing you,” says Sweeting. “The tree huggers are on to something.” As often as possible, venture deeper into the woods by planning day hikes or overnight camping trips.
Make an extra effort to notice the changing seasons. “You’ll start to realize the rhythms of nature apply to you, too,” Sweeting concludes. “When you harmonize yourself with nature, you’ll develop a stronger sense of well-being. The body responds quickly to being honored in this way. And it can all start with getting out to the park.”
4. Exhaustion Cause: Toxins Everywhere“Clean air, clean water, and clean food are the physical building blocks of good energy,” says Merrell. But those fundamentals are increasingly hard to come by. According to the Centers for Disease Control, as many as 148 industrial chemicals course through our bloodstream at any given moment. Are they toxic? Probably. 
“[Scientists] tend to look at the data and determine whether each chemical is within an acceptable level,” says Merrell. “But what happens when you get 148 potentially toxic chemicals that may be interacting in your body? Little bits of this and that add up, and we just don’t know what’s really safe.” Processing these ever-present chemicals can strain your body’s energy resources, possibly contributing to fatigue.

Exhaustion Cure: Clean HouseLimit your exposure wherever you can, says Merrell. Invest in a good water filter and air purifier, buy nontoxic cleaners, and choose home products (paints, carpets, furniture) less likely to emit harmful fumes and chemicals. Finally, choose organic food whenever possible. Merrell suggests consulting theEnvironmental Working Group to assess which fruits and vegetables are most and least likely to contain pesticide residues.
5. Exhaustion Cause: Lack of Meaning and JoyTo feel fully alive and energetic, says Merrell, we need a sense of meaning and connection. But it’s all too easy to get caught up in the day-to-day grind — work 9 to 5, buy groceries, make dinner, pay bills, watch TV — and let the things that make us feel truly happy slide off our priority list. Without enough meaning and joy to buoy you, fatigue and stress can easily drag you down.

Exhaustion Cure: Keep A JournalStart by recording your sources of disconnection and stress. At the end of each day, write down all the things that created stress in your life, how you reacted to them, and the result of your actions. “After a while, you’ll start to notice patterns,” says Merrell. Then record all the things that bring you joy and pleasure.
Now plot your own route to a more meaningful life. Do less of the things that bring you unhappiness and anxiety, and more of those that make you feel good. You might find, for instance, that a nightly chat with your spouse keeps you grounded, whereas watching TV drains you. You could discover that making time for that dance class is worthwhile even when you’re tired, because you always leave energized. Or that you feel renewed after attending religious services or sitting down to meditate. Follow the trail of the positive, and you’re guaranteed to feel a charge. And if you don’t already, consider practicing random acts of kindness. “Giving to others without expecting anything in return is the highest form of connectivity,” says Merrell.

6. Exhaustion Cause: Thinking Like a PessimistA negative outlook presents a huge energy drain, but we can overcome it. “You first have to recognize what pessimistic thinking looks like,” says Joan Borysenko, Ph.D., author of “Your Soul’s Compass.” The best time to do that? When you experience a setback — say, your car broke down or you didn’t get a job you’d been hoping for. Take note of whether you experience a trio of qualities that psychologist Martin Seligman, Ph.D., termed the “three Ps”: personal, pervasive, and permanent. “Personal means, ‘It’s all my fault,’ ” Borysenko says. “Pervasive means, ‘I mess up everything I do.’ And permanent means, ‘It’s the story of my life.’ ” If you find yourself reacting this way, consider an attitude reform.

Exhaustion Cure: Learned OptimismOptimism can be learned, Borysenko insists, “even though we might have ingrained patterns and brain circuitry that support negative thinking.” On the flip side of the three Ps are the three Cs: challenge, commitment, and control. “Optimists see changing circumstances as a challenge to meet,” she says. “They approach it with commitment. And they feel they can influence the situation, so they have control.”
That last ingredient, control, requires a measure of discretion. “You can’t control everything,” she says. “Optimists focus on making life less stressful by controlling only what they can, and in a skillful manner.” Understand the difference in these two ways of thinking and you’ll start the process of moving from pessimist to optimist.
7. Exhaustion Cause: Leaky BoundariesTo draw more energy into your life, you have to first ask an important question: Where do I begin and end? “When I see patients complaining of exhaustion, nine out of 10 have trouble setting personal boundaries,” says psychologist Bo Forbes. One of the biggest emotional drains for women, she says, is the need to be available for everyone — our friends, children, spouses, and bosses — all the time.

The most empathic among us often pick up negative emotions from other people, too. “Even if we’re in a great mood,” she says, “we can encounter someone who’s anxious or angry or tired, and we end up taking on that person’s emotions.” The net result is a plundering of our energy resources. “If we don’t have sufficient boundaries, we’re like a house with all the windows and doors open,” says Forbes. “Energy is leaking out everywhere.”

Exhaustion Cure: Just Say NoLearning to set boundaries is a personal-growth odyssey, and it requires a close and careful inventory of what’s really important to you. But the best way to get started on the path is to start saying no. “If someone drains your energy, say no to spending time with them,” says Forbes. “Say no to checking your emails after 5:30 in the evening, or to that extra committee meeting.” As you scale back, start adding into your life the things that renew you. 

8. Exhaustion Cause: Not Enough RestSure, insufficient sleep presents an enormous energy drain. But so does insufficient rest, a state that’s entirely different from sleep, says Judith Lasater, Ph.D., author of “Relax and Renew: Restful Yoga for Stressful Times.” “Rest requires that you be still and quiet,” she says.
Americans don’t get enough for two reasons. First, time and labor are both valued and demanded in this country; second, we have too many options. “We have theaters, shopping malls, and restaurants to choose from, pottery classes to take, home improvements to make,” she says. “At any given time, we could be balancing our checkbook, hitting the gym, weeding the garden, or working on our scrapbooks.” Combine the national work ethic with all those options, she says, and you have a nation of very busy people. And we wonder why we’re tired.

Exhaustion Cure: Play DeadEvery day, set aside 20 minutes for Savasana (corpse pose), the most restful of the yoga positions.
1. Set a kitchen timer for 20 minutes so you don’t have to watch the clock.

2. Lie down on your back on a soft yet firm surface, such as a rug (but not a bed). Place a rolled pillow or blanket under your knees if that feels good, and cover your eyes with a soft cloth. Cover yourself with a light blanket.

3. Let your arms and legs roll slightly out from the body as you relax and begin to take a series of long, slow breaths, setting an intention to disengage from the external world. If your mind starts spinning away, simply return your attention to the breath.

4. When the timer chimes, bend your knees, roll to the side, and sit up. After a moment or two of stillness, reengage with your day.

9. Exhaustion Cause: Information OverloadEver spend an hour watching the news and feel hungover afterward? Felt knocked down and slapped around after checking your BlackBerry for the 40th time? If so, you’re suffering from a common energy-zapping malady: information overload. “Our media culture offers up sensory experiences that don’t nourish us, even when they seem pleasurable,” explains Thomas Yarema, M.D., national director of clinical services at Kerala Ayurveda USA.
In Yarema’s view, based on India’s ancient health system, Ayurveda, the underlying cause is a disruption of the energy that animates our lives, known as vata. But you don’t need to understand Ayurveda to know that too much information can leave you upset and depleted.

Exhaustion Cure: Get GroundedAs you make strides to reduce your media exposure, Yarema also suggests creating a stronger center of gravity so that you’re not so easily buffeted on the winds of information. To that end, follow a simple grounding ritual every morning: At sunrise, drink 2 to 4 ounces of warm water with a pinch of salt and a squeeze of lemon. Then warm some sesame oil and, sitting on a towel, massage the oil into your skin, head to toe. Follow this with five minutes of deep breathing, directing the breath to tension in your body. Finally, do some yoga or take a walk. With this nurturing, vata-soothing routine, you’ll be able to strengthen your center in the face of sensory overload.
10. Exhaustion Cause: Resentments and RegretsIf you’ve dallied in the spiritual life at all, you know that living in the present moment allows you to feel awake, alive, aware, and energized. Unfortunately, says Borysenko, too many of us live in the past. 
While running a mind-body clinic at Harvard Medical School for people with cancer, AIDS, and stress-related disorders, Borysenko noticed that some people underwent stunning transformations and others didn’t get much at all out of the program. “The difference was the willingness to let go of [negative experiences] in the past,” she says. “People who weren’t ready to release regrets or resentments simply couldn’t come into the present to make use of the program.”
Many of us have our own “grievance story,” says Borysenko, and replaying it over and over wedges it ever deeper into the limbic brain, which controls basic emotions and instinctual drives. Eventually, the story takes on a life of its own, zapping our energy in the process.

Exhaustion Cure: ForgivenessForgiving someone — or yourself — comes with realizing that the feelings you’re holding on to have “made your life unmanageable, stealing your energy, your sleep, and your happiness,” Borysenko says. “Forgiveness isn’t about pardoning the offender; it’s about transforming the forgiver.
Borysenko recommends creating a ritual to help reset the limbic brain. “This involves two kinds of memory: verbal memory, which we’re all aware of, and iconic memory, which stores images away in the amygdala. When you perform a forgiveness ritual, you create new images that can get into that part of the brain.”
Write your intention to forgive on paper and burn it, then bury the ashes. Or tie a string to yourself and a photo of the person you want to forgive, then cut the string to set yourself free. To forgive yourself, try this ritual drawn from the Judaic tradition: “Deposit your sins into a piece of bread, and throw it in moving water,” says Borysenko. Although traditionally done during Rosh Hashanah, you can try it anytime you need to see your regrets float away.
Don’t Forget the BasicsTake care of the energy essentials to maximize your personal vitality
Get Enough (But Not Too Much) Sleep
Studies indicate that seven or eight hours a night work best for most people. To get them, establish a wind-down routine: Keep everything but sleep (like paying bills or watching TV) out of your bedroom; avoid caffeine, alcohol, spicy food, and strenuous exercise within four hours of bedtime; and dim the lights an hour before you hit the sheets. Remember, though, that you can get too much of a good thing. Sleeping more than nine hours is associated with waning energy levels and increasing illness.
Eat Right
The body thrives on a diet of whole foods, with lots of anti-inflammatory fruits and vegetables. “Start by trying to make one meal a day perfect,” says Ronald Stram, M.D., founder of the Center for Integrative Health and Healing in Delmar, New York. “Get some lean protein, a monounsaturated fat or omega-3 fatty acid, a whole grain, and a serving or two of fruits and vegetables.” Beyond that, limit your intake of processed foods, sugar and white flour, and artificial flavorings and sweeteners.
Stay Hydrated
If you’re underhydrated, fluid doesn’t move through the body as actively as it should,” Stram explains, and the body has to work harder to keep its processes going. That depletes your energy. If a headache accompanies your fatigue, you probably need more fluid. Stram recommends 1 ounce of water for every 2 pounds of body weight; if you’re an avid exerciser, add another 16 ounces to your daily intake.
Get Plenty Of Exercise
Upping your exercise quotient is perhaps the surest bet for more energy. “On a cellular level, it’s mitochondria that produce energy,” says Woodson Merrell, M.D. “You can increase the size, efficiency, and number of mitochondria by exercising. It plugs you into the energy grid.” Cardiovascular exercise also tones the body so it needs less energy to operate, says Stram.
Limit Caffeine
A cup of coffee may be the quickest route to energy, but it comes at a cost. “It doesn’t give you energy, it just bunches your energy up early in the day, says Andrew Weil, M.D. “Then you run out.” Consider switching to green tea.
Check With Your Doctor
A number of health conditions can underlie fatigue, so visit your health-care provider if you’re tired all the time.

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