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Beyond Fatigue: Fibromyalgia is Exhausting!

  • Nov 26, 2023
  • 8 min read

Updated: Dec 20, 2023

Episode 23: The Connection Between Fibromyalgia and Exhaustion and what to do about it!



Beyond Fatigue:

The stress in my personal and work life seems out of my control and has landed in my body. The fibro-flares are intense, so much so that I have forgotten to follow my own advice. Let me explain. I have started this post at least 5 times in the last 9 weeks. I was going to spew some research and spout remedies and fix-alls (which, if you are reader of my blog, I would never do). Furthermore, In my last post I wrote about the beginning of the school year and all of the bugs and viruses that a teacher encounters on a day to day basis. As this is simply a truth about teaching, I tried to follow my own advice with rest, sleep, and nutrition. But then, life happened, teaching happened, and I neglected to take into account the taxing absurdity of human behavior, my own included and I have suffered.


I seem to be in a constant state of frustration, a cycle really. I can't seem to get ahead of the pain or fatigue. I seem to be under a constant barrage of stressors that trigger yet another fibromyalgia flare-up. Here's the teacher breakdown: initially, there's challenging student behavior, then there are the parents' unrealistic beliefs about their child's skills and effort. In addition, there is constant pressure from administrators to do more with fewer resources, the responsibilities and anticipations of daily life at home, and the physical toll this takes on my body, resulting in pain and exhaustion. The pain and exhaustion make it difficult to do all of the above, and when I attempt to rest and tend to my well-being, the workload and stress accumulate, initiating the cycle once more.


Let's deal with some basic facts about fatigue and fibromyalgia:

Though 76% of people living with fibromyalgia experience significant fatigue, this symptom has not garnered the same attention as other more obvious symptoms like pain. Fibromyalgia pain increases fatigue and in many cases, exhaustion. The Mayo Clinic explains that even though many fibromyalgia patients report getting the recommended amounts of sleep, if not more, they are often awoken by pain. Thus, sleep is not restful and this increases daily fatigue. The fatigue from fibromyalgia is not only a physical experience, but it is also emotionally, cognitively taxing, and stressful. It is exhausting. With or without a diagnosis of fibromyalgia, it is widely known that stress can increase fatigue and in some cases insomnia. But with fibromyalgia, increased stress can snowball into a plethora of symptoms including: chronic pain, depression, and especially fatigue to name a few. This frustrating, bone deep exhaustion makes everything more difficult!



I tend to use fatigue and exhaustion interchangeably, but what is the difference between the two? There is no specific medical consensus on this but the NHS of the UK delineates the difference this way: tiredness and fatigue tend to be temporary, exhaustion is extreme fatigue resulting in mental, emotional, and physical symptoms.

Fatigue:

  • Fatigue is a state of physical or mental tiredness or weariness.

  • It is often a general feeling of being drained or lacking energy.

  • Fatigue can result from various factors, such as a lack of sleep, physical exertion, stress, or mental exertion.

  • It is typically a temporary condition and can be relieved with rest, relaxation, or a good night's sleep.

​Exhaustion:

  • Exhaustion is a more severe and extreme state of fatigue.

  • It goes beyond just feeling tired and often involves a complete depletion of physical, mental, or emotional resources.

  • Exhaustion is usually a result of prolonged or intense physical or mental exertion, stress, or a combination of factors.

  • It can have a more significant impact on a person's ability to function and may require an extended period of rest and recovery to overcome.

Fibromyalgia or Chronic Fatigue Syndrome

At this point, I would say I am "exhausted". This condition does not seem temporary as it has gone on for months now. But I do not have chronic fatigue syndrome. I have fibromyalgia. This, of course, begs the question: what is the difference between Chronic Fatigue Syndrome and Fibromyalgia? According to Benjamin H Natelson, MD, only the difference appears to be the exclusion factor:


"One major difference between the two diagnoses is that the existence of any medical cause of severe fatigue excludes patients from receiving the diagnosis of [chronic fatigue syndrome] CFS; in contrast, there are no medical exclusions in making the diagnosis of [fibromyalgia] FM. Instead, patients with no other cause for body-wide pain are diagnosed as having primary FM while those with coexisting rheumatological diagnoses receive the diagnosis of secondary FM. This difference in diagnosis is responsible for a ten-fold difference in prevalence with CFS occurring approximately 0.3% (1) of the population and FM in about 4% (2)".


I am fatigued because I have fibromyalgia. Fibromyalgia is my exclusionary medical cause. Therefore, I do not have chronic fatigue syndrome. I have fibromyalgia because there is no other medical cause for the pain I am experiencing. But, then there is stress. Stress is my medical cause for the fibro-flares I have. But stress is only a trigger for fibromyalgia, not a CAUSE. I could go in endless rounds with this. The fact is, I am tired; we are tired. And circling back to my original story, though I have acquired a wealth of knowledge and understanding about how to live in a body deeply affected by fibromyalgia, the teacher stress I am under is not conducive to feeling pain-free and full of health. I feel sick and exhausted.


What Now? Find Peace.

The obvious solution would be to quit teaching. But that is not conducive to my budget. Nor is it practical. All jobs have stress, maybe not the overwhelming stress a teacher feels, but certainly stress enough to cause a triggering event. The solution is to find peace. But, how do I find peace in a job like teaching? Here are some of the 7000 Million useless solutions: practice self-care, eat a balanced diet, get enough sleep, reduce your workload, delegate responsibilities, do yoga, exercise more, take deep breaths, love yourself more (?), engage in activities you love, plan better, plan more, plan enough time for you, practice better work-life balance. In the past 3 years (since the advent of COVID), I have heard all of these suggestions 1000 times and although this is all true, all of this puts the onus on us: on the teachers. Do the schools bear any of the responsibility? Sure they do. Sarah Gonser of Edutopia says, "Educators’ health and well-being should be prioritized in school culture [and] school leaders can help create the conditions for that". I agree with this 100%, but I am not holding my breath. Since I can't quit my job and school culture is not going to change any time soon, here is the new approach I have adopted:




  1. Monitor my stress levels. Well before I start to feel "undone", "off balance", or "fragile" I need to check in with myself and assess my level of anxiety, stress, or sense of overwhelm. I need to stop what I am doing so that my stress levels remain manageable and breathe to engage the parasympathetic nervous system and calm my body and mind down until I am ready to re-engage with the world.

  2. Remind myself that sometimes "done" is good enough. As a perfectionist (yes, a trauma response) this is one of the most difficult reminders I can give myself. It kills me not to achieve excellence. But perfectionism is not healthy: "Perfectionists tend to believe that anything short of perfection is horrible, and that even minor imperfections will lead to catastrophe". This is me. I am terrified of making mistakes. But I am in a profession where things are changing so rapidly, expectations of teachers feel unmanageable that in an effort to complete tasks to the best of my ability, I am bound to make some mistakes. Sometimes, done really is good enough.

  3. Recognize when I am Catastrophizing. Or as my therapist guides me to do, "Reality Check That!". Basically, I work to stop my catastrophic thoughts in their tracks with positive affirmations. A perfect example is from last week was when my Principal contacted me to tell me she wanted to talk about the rubric I used for grading a summative assignment in which some students did not do well. I had to talk to myself and say out loud that, I was not going to be chastised or reprimanded, that I was NOT going to lose my job, and that it was just a clarifying conversation about grading. I repeated: "This is a clarifying question about a tested rubric that I am fully capable of answering in a satisfactory manner". I repeated this until I felt my heart rate come down, my breathing become deeper and slower and I felt "safe" enough to go to bed and sleep soundly. I have to do this a lot.

  4. Focus on the positive. Though my job is challenging and at times soul sucking, focusing on the positive aspects of my work can lighten the load, at least temporarily. Evolution makes us susceptible to focusing on the negative in order to help us survive to see another day. But that survival focus is limiting and depressing. By using what Bono and Glomb call the "three good things intervention", whereby I take account of at least 3 good things that have happened during the workday, I can improve my mood and lift my spirits. This intervention has proven to lower stress levels and pain complaints and turn off negative work-related thoughts even at home.

  5. REST! As a person living with fibromyalgia, it is imperative that I rest when I need it. This means taking the needed days off to recover when I have had a particularly stressful time at work and I am experiencing a FLARE. If managing my stress level has proven difficult and I still wake up in a fibro-flare, I have to be OK putting myself first. Period.



RECAP:

I am on a quest for equilibrium and tranquility. Navigating the challenges of persistent fatigue and grappling with fibromyalgia has proven to be quite the uphill battle for me. The strain of teaching and life stressors, creates a continuous loop of exhaustion and physical pain. Quitting my teaching job isn't a practical solution. Instead, I'm trying a fresh approach that includes actively monitoring my stress, accepting that sometimes 'good enough' works, and confronting catastrophic thoughts head-on. I am making efforts to practice recognizing three good things each day, and the absolute necessity of rest, especially considering the challenges of fibromyalgia. I advocate for schools to prioritize the well-being of teachers, emphasizing the importance of creating environments that not only foster academic success but also support the overall well-being of those dedicated to teaching. It is a shared responsibility that highlights the vital role of supportive surroundings in the teaching profession. In the midst of my ongoing challenges, my journey stands as proof of resilience, providing insights into finding peace amid the ongoing challenges of fibromyalgia and its accompaning exhaustion.


Karen Palmen, EdD

If you enjoyed this post, share it with your friends and colleagues, and consider becoming a subscriber. If you have any tips or suggestions about how to better cope with chronic pain, leave a comment. I would love to hear from you!


Karen Palmen, EdD is a veteran educator in Saint Paul, Mn. She teaches Dance and English at Saint Paul Central High School. She has an active TikTok page that features humorous, political, mental health, and educational content (kickin it with karen2). And a a dormant YOUTUBE channel with the same name, featuring fermented foods and other cooking oddities.

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The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this blog.

Sources:

Ajmera, Rachael. “Stress Symptoms: Physical Effects of Stress and How to Treat.” Healthline,


Bono, Joyce E, and Theresa M Glomb. “The Powerful Effect of Noticing Good Things at

Work.” Stress Management, Harvard Business Review, 28 Dec. 2015, hbr.org/2015/09/the-powerful-effect-of-noticing-good-things-at-work.


Cleveland Clinic Medical Professional. “Fibromyalgia: Symptoms, Diagnosis & Treatment.”

Cleveland Clinic, Cleveland Clinic, 1 Dec. 2022, my.clevelandclinic.org/health/diseases/4832-fibromyalgia.


Gonser, Sarah. “Schools, Not Teachers, Must Reduce Stress and Burnout-Here’s How.”

Edutopia, George Lucas Educational Foundation, 11 Feb. 2021, www.edutopia.org/article/schools-not-teachers-must-reduce-stress-and-burnout-heres-how/.


Mayo Clinic Staff. “Fibromyalgia.” Mayo Clinic, Mayo Foundation for Medical Education and


Nall, Rachel. “What Is Catastrophizing? 6 Ways to Stop Catastrophic Thinking.” Medical

News Today, MediLexicon International, 20 Feb. 2023, www.medicalnewstoday.com/articles/320844#related-conditions.


Natelson, Benjamin H. “Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and

Fibromyalgia: Definitions, Similarities, and Differences.” Clinical Therapeutics, U.S. National Library of Medicine, Apr. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6589349/.


Palmen, Karen L. “Flu and Viruses and Covid 19 Oh My!” My Fibro Life, WIX, 14 Oct. 2023,


Pearce, Julia. “Eight Signs of Exhaustion That You Shouldn’t Ignore.” Canopi, Canopi, 29


Vincent, Ann, et al. “Beyond Pain in Fibromyalgia: Insights into the Symptom of Fatigue.”


“What Is Perfectionism and How Do I Overcome It?” Anxiety Canada, Anxiety Canada, 7








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