Posted by Paul Samael on Tuesday, July 21, 2020 Under: Random thoughts
This is the third and last in a series of posts about my experience of both post-viral and chronic fatigue, prompted by media reports that quite a few people who’ve had Covid-19 seem to be having similar problems. Click HERE for Part 1 and HERE for Part 2. In this one, I’m going to focus on treatment – and in particular, whether there is anything other than rest/relaxation, pacing and/or the passage of time which might help.
The main treatment recommended by the NHS is pacing, which is basically: get as much good quality rest as you can, work out what levels of activity you can tolerate and then look to build these up very gradually over time (in most cases, quite a long time). However, if you’re anything like me, your reaction to pacing will be along the lines of: IS THAT IT? Is there really NOTHING else I can do to get better? So it’s only natural to start looking around for other things that might help.
As explained in my last post, I think that historically, the NHS hasn’t exactly covered itself in glory on this front - so I was pleased to see this video from Dr Phil Hammond, which advocates more of a “holistic” approach, including looking at things like meditation/mindfulness and diet. These were both things that I personally found helpful in recovering from chronic fatigue. But it’s important to make clear that (i) I can’t prove that they helped; and (ii) although I think they helped me, that may have been for reasons which are quite specific to me as an individual (and if that’s the case, then they may not help you).
I was a bit sceptical about meditation/mindfulness at first, but I’ve found it sufficiently helpful that I still do it on a daily basis. I find that if I’ve forgotten to do it or don’t have time, I often feel more stressed and the day sometimes feels like it’s running away with itself. Anyway, there are various forms of it that you can try – some work by focussing on the breathing, others (like Transcendental Meditation) by focussing on a mantra which you silently repeat to yourself. The basic idea is that, by focussing on the breath or mantra, you let go of other thoughts and achieve a state of calm.
Why is this at all helpful? Well, one of the problems with post-viral of chronic fatigue is that although you need good quality rest and relaxation, it’s surprisingly difficult to achieve. You wake up feeling tired and that probably triggers a couple of thoughts. One of these is: bloody hell, I have spent weeks resting up and not doing very much and yet I still feel exhausted – what is wrong with me? The other is: I really really MUST get some better quality rest today, so that tomorrow (hopefully) I can start feeling a bit better. And straightaway you are starting to stress about it all – which is hardly conducive to getting the good quality rest and relaxation that you need. For me, I think this is where the meditation/mindfulness helped, because it helped to take my mind away from those worries and (eventually) to relax properly, particularly during the day.
But I did not find it easy to begin with and it took time to get the hang of it. I would find myself checking my watch after just a couple of minutes of repeating my mantra and thinking “God, this is boring – when can I stop? Oh, I’ve still got 17 minutes left.” It takes a while to accept that it is perfectly OK to have other thoughts while you are meditating (including “God, this is boring”) – in fact, I would say that even now, I rarely get to a state where my mind is clear of thoughts, even though that is often said to be the ultimate aim (and if I do, it probably doesn’t last long). The key realisation for me was accepting that the thoughts will come (and that you shouldn’t feel bad about that) - but that you also shouldn’t be trying hard to pursue them to any definite conclusion, you just let them meander (so it becomes a bit like daydreaming). I also found this book on mindfulness helpful, including the CD of mindfulness exercises.
I did a couple of things on the diet front. I spoke to a nutritionist, who recommended giving up caffeine (to help with sleep) and eating a wider variety of foods – for example, I did not have much in the way of nuts or seeds in my diet, whereas now I eat them most days, especially as snacks (I suspect the NHS would be broadly fine with this – see Dr Hammond’s video).
I also switched to a version of the “stone age diet” – and it’s only fair to point out that this is something of which the NHS would probably be less approving. What is the stone age diet? Well, fortunately for me, it does not involve only eating what you can kill with flint-tipped stick weapons (if it did, I would undoubtedly have starved to death by now); at its most basic, it essentially involves avoiding wheat and dairy, since these were not things that stone age man would have eaten (having no agriculture and no domesticated animals, other than maybe dogs).
The theory, as I understand it, is that humans did not evolve to digest lots of wheat and dairy, which entered our diets relatively late on in human history – and in some (but not all) modern humans, eating those foods can cause stomach problems. The gut is also quite closely connected to the immune system (e.g. see this article) – and post-viral/chronic fatigue may be related to problems with the immune system (no one knows for sure - but it seems a fair bet to me).
Anyway, I had a prior history of digestive problems. If I got particularly tired or stressed, I would often wake up the next day feeling as if I had quite a nasty hang-over (splitting headache and nausea that would last most of the day). This occurred even if I hadn’t drunk any alcohol. One explanation advanced by a consultant that I saw privately (i.e. not on the NHS) about my chronic fatigue was that my stomach was not digesting wheat-based carbohydrates properly; they were fermenting and turning to ethanol, hence the hang-over symptoms (all courtesy of my lovely internal home brew). I found this quite persuasive as an explanation of my digestive problems. And she was the one who recommended the stone age diet as something that might help with the chronic fatigue too.
I wouldn’t say that the diet alone “cured” my chronic fatigue though - it was one of a number of things I did in order to try to get better, but it has certainly cleared up my digestive problems (and I've now gone several years with no major recurrence of the fatigue). Also, as mentioned above, it may be that the diet was more helpful to me as an individual with a prior history of digestive problems than it would be to someone without that background. So don’t assume it will definitely work for you.
Diet is not the only thing you can look at – supplements may also be worth considering and you’ll note that on Dr Hammond’s video he recommends Vitamin D. Beyond that, the NHS is generally sceptical about other supplements – and it is true that you can spend a small fortune on them. But I was prepared to spend some money if there seemed to be a reasonable chance that they might help with recovery (and no clear evidence of possible harm), so in addition, I took:
- B vitamin supplements (as these are thought to help with fatigue)
- Probiotic supplements (to help with digestion – see above)
- Co-Enzyme Q10 – click here for some research on that (but note that the papers cited only establish that there may be a correlation with chronic fatigue – they do not appear to prove that taking Co-Enzyme Q10 will definitely help).
I also recommend having a look at this site: https://www.drmyhill.co.uk/wiki/Main_Page Again, it’s only fair to warn you that Dr Myhill is a somewhat controversial figure – but whatever you make of her work, at least she is attempting to come up with explanations of how post-viral or chronic fatigue functions and how it might be possible to break the vicious circle of fatigue that many sufferers find themselves in (and if there were more people like her doing this, then we might be further on with treatment than we currently are).
Your head may need looking after too
Lastly, you may find that post-viral or chronic fatigue makes you a bit depressed. I did end up taking a low dose of an antidepressant to help lift my mood. I was a bit reluctant to do so at first because I was worried about becoming dependent on it – but I managed to wean myself off it after about 18 months or so without much difficulty. I also had Cognitive Behavioural Therapy to help with various issues which tended to make the fatigue worse, such as my tendency to be a bit of a perfectionist. I think that was helpful too – if nothing else, it’s useful to have someone to talk to about the frustrations of the condition and offer a bit of emotional support.
All this head stuff might seem a bit strange given the emphasis I placed in Part 1 on how chronic or post-viral fatigue are (in my view at least) definitely not “all in your head”. But it seems to me entirely natural that the longer these conditions go on, the more likely it is that they will make you feel down – so make sure you look after your head as well as the rest of you.
In : Random thoughts
Tags: covid-19 coronavirus "chronic fatigue" cfs "post-viral fatigue" nhs
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