The Exhaustion Breakthrough

Unmask the Hidden Reasons You're Tired and Beat Fatigue for Good

It's become the norm to complain that we're always tired. In Dr. Holly Phi llips' Exhaustion Solution, Dr. Holly aims to end this accepted state of exhaustion and send a message to readers that they do not have to be drained of energy just because they have a demanding job, a family, or an active social life—or all three. She also explains the insidious nature of fatigue, educating readers on the havoc that persistent tiredness wreaks on the body and mind, from weight gain and cognitive impairment to even a higher risk of heart attack and stroke.

Dr. Holly's passion for the subject stems from the quest to cure her own constant weariness—which she struggled with for more than 20 years—as well as the countless complaints of chronic tiredness she hears from patients each day in her internal medicine practice. While a few readers might find a link between their fatigue and a medical condition such as chronic fatigue syndrome or fibromyalgia, Dr. Holly knows that many more will discover that diet, exercise, and sleep habits are contributing to their lack of energy.

This guide will help readers understand their exhaustion, rule out any underlying illnesses, correct any allergies or hormonal issues that may be contributing to extreme tiredness, and incorporate lifestyle factors and alternative therapies that will improve overall energy. Clear, comprehensive, and practical, Dr. Holly Phillips' Exhaustion Solution shines a bright light on an issue many people have simply accepted—but that they don't have to any longer.
CHAPTER ONE

How Tired Are You, Really?

If you've picked up this book, you already recognize that you're fairly exhausted. But you may not realize just how tired you really are or recognize the exact ways in which you're exhausted. After all, fatigue can take many forms. One woman feels chronically wiped out with a pervasive tiredness that isn't relieved by getting enough sleep, while another starts the day with plenty of vim and vigor but runs out of energy quickly. Meanwhile, a third woman might have a vague but enduring sense of malaise or listlessness, while another feels physically weak, apathetic, and emotionally vulnerable on a regular basis. The point is, there are many different faces of exhaustion, literally and figuratively speaking.

To address your personal energy crisis and repair the elements that are depleting your vitality, it's important to be sensitive to the specific messages your body is sending. You need to listen closely to what your exhaustion is telling you. Otherwise, how can you possibly expect to reverse your state of depletion and restore your vigor to healthier levels? It's not enough to recognize that your energy balance is out of whack; you need to figure out why it's off kilter. Could it be because you're sick with an underlying medical condition? Could your thought patterns, your stress level, or your general state of mind be dragging and slowing you down? Could lifestyle habits such as your food choices or eating patterns, sleep practices, or exercise routines (or lack thereof) be creating an energy leak that's draining you physically and/or mentally? Or have you created a work or social schedule for yourself that's so demanding that it causes you to run out of fuel without ample opportunities for replenishing your energy reserves?

The first step toward breaking the exhaustion cycle is to identify and understand what is zapping your energy and contributing to your profound sense of fatigue. Then, and only then, can you begin to take steps to revitalize and reclaim your vigor and well-being. So let's start that identification process!

GETTING TO THE BOTTOM OF FATIGUE

First, let's establish a sense of how profound your fatigue is and how it affects you. Read each of the following questions and pick the response that best describes you.

1. Would you say that you become fatigued easily?

Rarely Sometimes Often

2. Is your motivation or desire to do things lower when you feel fatigued?

Rarely Sometimes Often

3. Do you have trouble starting new things?

Rarely Sometimes Often

4. Does your fatigue limit you or cause problems in your life?

Rarely Sometimes Often

5. Does your fatigue interfere with your ability to carry out and fulfill certain responsibilities in your life?

Rarely Sometimes Often

6. Does fatigue affect your work, social, or family life?

Rarely Sometimes Often

7. Has your fatigue affected how you socialize with friends or family or engage in leisure activities?

Rarely Sometimes Often

8. Does your fatigue affect your thinking skills, concentration, communication abilities, or other aspects of mental functioning?

Rarely Sometimes Often

9. Does your fatigue interfere with your ability to function physically?

Rarely Sometimes Often

10. Does exercising give you an enduring sensation of tiredness?

Rarely Sometimes Often

11. Does your fatigue affect your eating or sleeping habits or other aspects of your behavior?

Rarely Sometimes Often

12. Has your fatigue affected how you take care of yourself (with bathing, dressing, and the like)?

Rarely Sometimes Often

13. Has your fatigue affected your sex life?

Rarely Sometimes Often

14. Does fatigue rate among your three most incapacitating symptoms?

Rarely Sometimes Often

15. Do you feel distressed or bothered by your fatigue?

Rarely Sometimes Often

If you answered "often" three or more times, you are in need of an antidote for your exhaustion and could use an infusion of fresh, vibrant energy. Fatigue is taking a serious toll on your life, affecting the way you feel and function, your behavior and attitude. And if it hasn't already, it probably will affect your physical or emotional health in the not-too- distant future.

The same is true if you answered "sometimes" five or more times. This is your wake-up call to take your exhaustion seriously.

If you chose "rarely" for many of your responses, you're not entirely out of the energy-drain zone. There's always room for improvement, and this book will show you how to fix your exhaustion triggers and boost your energy in a sustainable fashion. If, however, you chose "rarely" for every single answer--granted, it's a remote possibility, assuming your responses were honest and accurate--then you might want to pass this book along to a tired friend who could truly benefit from reading it.

Now let's try to pinpoint the patterns and rhythms of your fatigue as well as the lifestyle factors that may be contributing to it. Read the following questions and choose the responses that best describe your exhaustion.

1. At what time(s) of the day is your fatigue most pronounced?

a. Late morning

b. Midday

c. Late afternoon

d. Evening

2. Which of the following statements best describes your sleep-wake patterns?

a. I often wake up feeling unrefreshed and soon start thinking about if or when I can nap.

b. I have trouble getting to sleep and/or I wake up with the roosters and have trouble going back to sleep.

c. I tend to skimp on sleep to get more done during the day and evening hours.

d. I feel as though I get enough sleep and start the day feeling reasonably rested.

3. Which of the following best describes your eating patterns?

a. I tend to eat erratically, and my pattern can change from day to day.

b. I usually skip breakfast but eat lunch and dinner.

c. I eat three square meals a day with lunch or dinner being the biggest meal of the day.

d. I often have multiple small meals throughout the day.

4. How would you describe your food preferences?

a. I'm a junk-food junkie--if it's fried, salty, or sweet, I'll probably love it.

b. I'm a serious carb lover--breads, pastas, and grains are the mainstay of my diet.

c. I'm a meat-and-potatoes kind of gal--I like hearty meals that fill me up.

d. I eat a primarily plant-based diet with moderate portions of lean protein.

5. How stressed out do you feel on a daily basis?

a. I am flirting with stress overload; I feel tense and anxious all the time.

b. I spend much of the day feeling anxious about the challenges and responsibilities I have to deal with.

c. I generally feel calm until something upsetting happens--then my stress level soars.

d. I experience ups and downs in the stress department but feel like I have it under control.

6. How well do you manage your stress?

a. I don't. If anything, it manages me; I often feel like I'm at the mercy of the stresses and strains in my life.

b. So-so. Sometimes I remain calm under pressure, but sometimes I cave into it and feel like a wreck.

c. I try to hold on to my can-do spirit and try to control what I can and let go of what I can't--but sometimes stress gets the upper hand.

d. I carve out at least 10 minutes a day to decompress with meditation, deep breathing exercises, or other relaxation strategies--whether I'm feeling stressed or not.

7. Which of the following best describes your exercise habits?

a. Erratic at best--often I do little more than move my fork to my mouth.

b. I spend much of the day sitting at my desk, but I try to go for a daily walk.

c. I'm an addict--I kill myself at the gym with daily extreme-intensity workouts.

d. I do moderate-intensity exercise on a regular basis and feel as though it boosts my energy.

8. How do you typically use your spare time?

a. I try to catch up on all the things I never seem to get done on my to-do lists.

b. I spend a lot of my so-called downtime trying to recover from exhaustion.

c. I often worry about work, my finances, my family, or other issues--and find it hard to relax.

d. I spend time with loved ones and engage in hobbies or other activities I enjoy in order to recharge my batteries.

9. Which of the following is your usual beverage of choice?

a. I'm a java junkie and often drink coffee or strong tea all day long.

b. I drink a lot of soda--it's refreshing and sweet, which boosts my mood.

c. I often count the hours until it's cocktail time and don't focus on fluids until then.

d. I try to drink water or watered-down juices throughout the day.

10. In a perfect world, which of the following best describes the way you'd like to be able to move through life?

a. I just want to regain the feeling that I can make it through each day without crashing and burning.

b. I want to stop worrying about running out of gas and falling further and further behind on things.

c. I want to feel more in control of my life, my moods, and my energy.

d. I want to feel like a force--strong, capable, unstoppable, really.

Before I tell you how to interpret your responses to these questions, it's worth giving yourself a reality check (or reminder). In the media, the myth of the superwoman or supermom is alive and kicking--but it's a fantasy. It's not real or attainable. It's true that you may know a few women who seem to have mastered the juggling act--they look polished or professional; every aspect of their lives (their homes, their children, their careers, their fitness regimens) seems to be in stellar shape; and they often seem ready, willing, and eager to add more to their already full plate of responsibilities. But think about this: How much do you really know about the inner workings of their lives?

They may have an entourage of help (nannies, housekeepers, personal assistants, chefs, trainers, and so on) at their disposal or the financial resources to continuously make their lives easier. They may have an extensive network of family members and friends who can step in at a moment's notice to help. Or they may work very hard to make it seem this way. Appearances can be deceiving, as we all know, and despite the happy face these perfectly put-together women show to the world, they may be privately grappling with depression, exhaustion, or deeply rooted insecurities. They may feel just as overwhelmed, stressed, or depleted as the rest of us do. So cut yourself some slack before playing the comparison game.

Here's another reality check: Some fatigue is natural and inevitable, especially for women. A modicum of fatigue could be a sign that you're living your life with full engagement and commitment--and you probably wouldn't want it to be any other way. So if you chose mostly d's on this questionnaire, you're actually doing pretty well. If you chose mostly b's or c's, you're in good company among the tired sisterhood who run out of fuel in the afternoon and tend to collapse into bed at the end of the day, feeling worn out, stressed out, and in danger of burning out. If you chose mostly a's, you may already be in that state of utter exhaustion, barely able to drag yourself through the day.

The point here isn't to judge yourself but to get a baseline sense of the level of exhaustion you're dealing with--and what it's trying to tell you. Then you can begin to take steps to recharge your body and mind and reclaim your vitality. The key steps are to track your levels of fatigue in a diary and do a 7-day fatigue-beating challenge (both detailed in Chapter 14). If your eating habits seem to be responsible for at least some of your lethargy, you can upgrade your dietary choices by consuming more fruits, vegetables, whole grains, lean protein, and healthy fats. If sedentary behavior is draining your energy, you'll want to move more and sit less. If insufficient or fragmented sleep is making you tired, it's time to make getting good quality shut-eye a priority by improving your sleep hygiene and consulting a sleep specialist if need be. If excessive stress is pushing you into the exhaustion zone, it's time to get a grip on your stress and find ways to relieve it or manage it better. In the pages that follow, you'll learn more about how these various aspects of your lifestyle can contribute to fatigue and discover how sneaky medical conditions (from anemia to autoimmune diseases, from fibromyalgia to type 2 diabetes) can drain your energy, too.

Armed with this knowledge, you'll be able to develop a customized energy- boosting plan that's likely to work for you, as you'll see in detail in Chapter 14. It doesn't matter how long you've been tired or how severe or mild your fatigue is. What is important is that you identify your current energy drains, repair them, and put an end to exhaustion. It is possible. I did it, and you can, too!
Holly Phillips, MD, is a board-certified general internist with a private practice in Manhattan. She has gained nationwide recognition as the medical contributor to CB S News, and she is featured regularly on CBS This Morning, CBS Evening News, and 48 Hours. She has also appeared on The Dr. Oz Show, The Doctors, and other programs, and her medical advice has been featured in Vogue, Cosmopolitan, O The Oprah Magazine, Town and Country, and elsewhere. She lives in New York, NY. View titles by Holly Phillips

About

It's become the norm to complain that we're always tired. In Dr. Holly Phi llips' Exhaustion Solution, Dr. Holly aims to end this accepted state of exhaustion and send a message to readers that they do not have to be drained of energy just because they have a demanding job, a family, or an active social life—or all three. She also explains the insidious nature of fatigue, educating readers on the havoc that persistent tiredness wreaks on the body and mind, from weight gain and cognitive impairment to even a higher risk of heart attack and stroke.

Dr. Holly's passion for the subject stems from the quest to cure her own constant weariness—which she struggled with for more than 20 years—as well as the countless complaints of chronic tiredness she hears from patients each day in her internal medicine practice. While a few readers might find a link between their fatigue and a medical condition such as chronic fatigue syndrome or fibromyalgia, Dr. Holly knows that many more will discover that diet, exercise, and sleep habits are contributing to their lack of energy.

This guide will help readers understand their exhaustion, rule out any underlying illnesses, correct any allergies or hormonal issues that may be contributing to extreme tiredness, and incorporate lifestyle factors and alternative therapies that will improve overall energy. Clear, comprehensive, and practical, Dr. Holly Phillips' Exhaustion Solution shines a bright light on an issue many people have simply accepted—but that they don't have to any longer.

Excerpt

CHAPTER ONE

How Tired Are You, Really?

If you've picked up this book, you already recognize that you're fairly exhausted. But you may not realize just how tired you really are or recognize the exact ways in which you're exhausted. After all, fatigue can take many forms. One woman feels chronically wiped out with a pervasive tiredness that isn't relieved by getting enough sleep, while another starts the day with plenty of vim and vigor but runs out of energy quickly. Meanwhile, a third woman might have a vague but enduring sense of malaise or listlessness, while another feels physically weak, apathetic, and emotionally vulnerable on a regular basis. The point is, there are many different faces of exhaustion, literally and figuratively speaking.

To address your personal energy crisis and repair the elements that are depleting your vitality, it's important to be sensitive to the specific messages your body is sending. You need to listen closely to what your exhaustion is telling you. Otherwise, how can you possibly expect to reverse your state of depletion and restore your vigor to healthier levels? It's not enough to recognize that your energy balance is out of whack; you need to figure out why it's off kilter. Could it be because you're sick with an underlying medical condition? Could your thought patterns, your stress level, or your general state of mind be dragging and slowing you down? Could lifestyle habits such as your food choices or eating patterns, sleep practices, or exercise routines (or lack thereof) be creating an energy leak that's draining you physically and/or mentally? Or have you created a work or social schedule for yourself that's so demanding that it causes you to run out of fuel without ample opportunities for replenishing your energy reserves?

The first step toward breaking the exhaustion cycle is to identify and understand what is zapping your energy and contributing to your profound sense of fatigue. Then, and only then, can you begin to take steps to revitalize and reclaim your vigor and well-being. So let's start that identification process!

GETTING TO THE BOTTOM OF FATIGUE

First, let's establish a sense of how profound your fatigue is and how it affects you. Read each of the following questions and pick the response that best describes you.

1. Would you say that you become fatigued easily?

Rarely Sometimes Often

2. Is your motivation or desire to do things lower when you feel fatigued?

Rarely Sometimes Often

3. Do you have trouble starting new things?

Rarely Sometimes Often

4. Does your fatigue limit you or cause problems in your life?

Rarely Sometimes Often

5. Does your fatigue interfere with your ability to carry out and fulfill certain responsibilities in your life?

Rarely Sometimes Often

6. Does fatigue affect your work, social, or family life?

Rarely Sometimes Often

7. Has your fatigue affected how you socialize with friends or family or engage in leisure activities?

Rarely Sometimes Often

8. Does your fatigue affect your thinking skills, concentration, communication abilities, or other aspects of mental functioning?

Rarely Sometimes Often

9. Does your fatigue interfere with your ability to function physically?

Rarely Sometimes Often

10. Does exercising give you an enduring sensation of tiredness?

Rarely Sometimes Often

11. Does your fatigue affect your eating or sleeping habits or other aspects of your behavior?

Rarely Sometimes Often

12. Has your fatigue affected how you take care of yourself (with bathing, dressing, and the like)?

Rarely Sometimes Often

13. Has your fatigue affected your sex life?

Rarely Sometimes Often

14. Does fatigue rate among your three most incapacitating symptoms?

Rarely Sometimes Often

15. Do you feel distressed or bothered by your fatigue?

Rarely Sometimes Often

If you answered "often" three or more times, you are in need of an antidote for your exhaustion and could use an infusion of fresh, vibrant energy. Fatigue is taking a serious toll on your life, affecting the way you feel and function, your behavior and attitude. And if it hasn't already, it probably will affect your physical or emotional health in the not-too- distant future.

The same is true if you answered "sometimes" five or more times. This is your wake-up call to take your exhaustion seriously.

If you chose "rarely" for many of your responses, you're not entirely out of the energy-drain zone. There's always room for improvement, and this book will show you how to fix your exhaustion triggers and boost your energy in a sustainable fashion. If, however, you chose "rarely" for every single answer--granted, it's a remote possibility, assuming your responses were honest and accurate--then you might want to pass this book along to a tired friend who could truly benefit from reading it.

Now let's try to pinpoint the patterns and rhythms of your fatigue as well as the lifestyle factors that may be contributing to it. Read the following questions and choose the responses that best describe your exhaustion.

1. At what time(s) of the day is your fatigue most pronounced?

a. Late morning

b. Midday

c. Late afternoon

d. Evening

2. Which of the following statements best describes your sleep-wake patterns?

a. I often wake up feeling unrefreshed and soon start thinking about if or when I can nap.

b. I have trouble getting to sleep and/or I wake up with the roosters and have trouble going back to sleep.

c. I tend to skimp on sleep to get more done during the day and evening hours.

d. I feel as though I get enough sleep and start the day feeling reasonably rested.

3. Which of the following best describes your eating patterns?

a. I tend to eat erratically, and my pattern can change from day to day.

b. I usually skip breakfast but eat lunch and dinner.

c. I eat three square meals a day with lunch or dinner being the biggest meal of the day.

d. I often have multiple small meals throughout the day.

4. How would you describe your food preferences?

a. I'm a junk-food junkie--if it's fried, salty, or sweet, I'll probably love it.

b. I'm a serious carb lover--breads, pastas, and grains are the mainstay of my diet.

c. I'm a meat-and-potatoes kind of gal--I like hearty meals that fill me up.

d. I eat a primarily plant-based diet with moderate portions of lean protein.

5. How stressed out do you feel on a daily basis?

a. I am flirting with stress overload; I feel tense and anxious all the time.

b. I spend much of the day feeling anxious about the challenges and responsibilities I have to deal with.

c. I generally feel calm until something upsetting happens--then my stress level soars.

d. I experience ups and downs in the stress department but feel like I have it under control.

6. How well do you manage your stress?

a. I don't. If anything, it manages me; I often feel like I'm at the mercy of the stresses and strains in my life.

b. So-so. Sometimes I remain calm under pressure, but sometimes I cave into it and feel like a wreck.

c. I try to hold on to my can-do spirit and try to control what I can and let go of what I can't--but sometimes stress gets the upper hand.

d. I carve out at least 10 minutes a day to decompress with meditation, deep breathing exercises, or other relaxation strategies--whether I'm feeling stressed or not.

7. Which of the following best describes your exercise habits?

a. Erratic at best--often I do little more than move my fork to my mouth.

b. I spend much of the day sitting at my desk, but I try to go for a daily walk.

c. I'm an addict--I kill myself at the gym with daily extreme-intensity workouts.

d. I do moderate-intensity exercise on a regular basis and feel as though it boosts my energy.

8. How do you typically use your spare time?

a. I try to catch up on all the things I never seem to get done on my to-do lists.

b. I spend a lot of my so-called downtime trying to recover from exhaustion.

c. I often worry about work, my finances, my family, or other issues--and find it hard to relax.

d. I spend time with loved ones and engage in hobbies or other activities I enjoy in order to recharge my batteries.

9. Which of the following is your usual beverage of choice?

a. I'm a java junkie and often drink coffee or strong tea all day long.

b. I drink a lot of soda--it's refreshing and sweet, which boosts my mood.

c. I often count the hours until it's cocktail time and don't focus on fluids until then.

d. I try to drink water or watered-down juices throughout the day.

10. In a perfect world, which of the following best describes the way you'd like to be able to move through life?

a. I just want to regain the feeling that I can make it through each day without crashing and burning.

b. I want to stop worrying about running out of gas and falling further and further behind on things.

c. I want to feel more in control of my life, my moods, and my energy.

d. I want to feel like a force--strong, capable, unstoppable, really.

Before I tell you how to interpret your responses to these questions, it's worth giving yourself a reality check (or reminder). In the media, the myth of the superwoman or supermom is alive and kicking--but it's a fantasy. It's not real or attainable. It's true that you may know a few women who seem to have mastered the juggling act--they look polished or professional; every aspect of their lives (their homes, their children, their careers, their fitness regimens) seems to be in stellar shape; and they often seem ready, willing, and eager to add more to their already full plate of responsibilities. But think about this: How much do you really know about the inner workings of their lives?

They may have an entourage of help (nannies, housekeepers, personal assistants, chefs, trainers, and so on) at their disposal or the financial resources to continuously make their lives easier. They may have an extensive network of family members and friends who can step in at a moment's notice to help. Or they may work very hard to make it seem this way. Appearances can be deceiving, as we all know, and despite the happy face these perfectly put-together women show to the world, they may be privately grappling with depression, exhaustion, or deeply rooted insecurities. They may feel just as overwhelmed, stressed, or depleted as the rest of us do. So cut yourself some slack before playing the comparison game.

Here's another reality check: Some fatigue is natural and inevitable, especially for women. A modicum of fatigue could be a sign that you're living your life with full engagement and commitment--and you probably wouldn't want it to be any other way. So if you chose mostly d's on this questionnaire, you're actually doing pretty well. If you chose mostly b's or c's, you're in good company among the tired sisterhood who run out of fuel in the afternoon and tend to collapse into bed at the end of the day, feeling worn out, stressed out, and in danger of burning out. If you chose mostly a's, you may already be in that state of utter exhaustion, barely able to drag yourself through the day.

The point here isn't to judge yourself but to get a baseline sense of the level of exhaustion you're dealing with--and what it's trying to tell you. Then you can begin to take steps to recharge your body and mind and reclaim your vitality. The key steps are to track your levels of fatigue in a diary and do a 7-day fatigue-beating challenge (both detailed in Chapter 14). If your eating habits seem to be responsible for at least some of your lethargy, you can upgrade your dietary choices by consuming more fruits, vegetables, whole grains, lean protein, and healthy fats. If sedentary behavior is draining your energy, you'll want to move more and sit less. If insufficient or fragmented sleep is making you tired, it's time to make getting good quality shut-eye a priority by improving your sleep hygiene and consulting a sleep specialist if need be. If excessive stress is pushing you into the exhaustion zone, it's time to get a grip on your stress and find ways to relieve it or manage it better. In the pages that follow, you'll learn more about how these various aspects of your lifestyle can contribute to fatigue and discover how sneaky medical conditions (from anemia to autoimmune diseases, from fibromyalgia to type 2 diabetes) can drain your energy, too.

Armed with this knowledge, you'll be able to develop a customized energy- boosting plan that's likely to work for you, as you'll see in detail in Chapter 14. It doesn't matter how long you've been tired or how severe or mild your fatigue is. What is important is that you identify your current energy drains, repair them, and put an end to exhaustion. It is possible. I did it, and you can, too!

Author

Holly Phillips, MD, is a board-certified general internist with a private practice in Manhattan. She has gained nationwide recognition as the medical contributor to CB S News, and she is featured regularly on CBS This Morning, CBS Evening News, and 48 Hours. She has also appeared on The Dr. Oz Show, The Doctors, and other programs, and her medical advice has been featured in Vogue, Cosmopolitan, O The Oprah Magazine, Town and Country, and elsewhere. She lives in New York, NY. View titles by Holly Phillips