the most common symptoms during cancer therapy is fatigue. It is a
side effect of chemotherapy and radiation but it may persist long
after treatment is complete. Fatigue is not unique to cancer. It occurs
for people with heart disease, kidney problems, hepatitis or with
arthritis as well. Fatigue is also a common symptom in people who
are otherwise healthy and have no diagnosed illness.
People describe fatigue in different ways. Some experience it
as a feeling of low energy, as being too much effort to move, or
feeling drained. Sometimes people describe it as being lazy
and lacking in motivation. It is different from being sleepy though
sometimes people say they are tired.
There are myriad medical conditions that are associated with fatigue.
When some of these are treated, like anemia or hypothyroidism, energy
level returns. Other conditions are not as easy to relieve, such
as a low cardiac output from a serious heart attack or chronic disabling
Though many of the other side effects of cancer treatment are
preventable or treatable, fatigue has been one of the hardest to
help. Anemia can be prevented with erythropoetin, which stimulates
the bone marrow or corrected with blood transfusions. Medicines
can help the heart or kidneys. When patients complain that they
are tired, however, most of the time they are told to be patient
and that eventually they will have their energy back.
Waiting passively for energy to return may not be acceptable to
you. You may wish to take a more active role in restoring your energy
level. This chapter offers ways of approaching the problem of low
energy that can help now.
It is relatively easy to understand how diseases of certain
organs will cause fatigue. If you are anemic and dont have
enough blood to carry oxygen, or if your heart doesnt pump
enough blood to supply your bodys needs, you wont have
enough energy. If your kidneys or liver dont function well
and metabolic wastes build up, it is not surprising that you would
feel tired. If you are low on thyroid or adrenal hormones which
are necessary for maintaining the bodys metabolism, you would
likewise feel low energy.
Sometimes fatigue is present but is difficult to explain in terms
of the conventional medical model. In Chinese medicine fatigue results
from a lack or imbalance of Chi, or vital energy. In
order to maintain your energy level, Chi must flow harmoniously
throughout the body. Certain organs have a dominant role in maintaining
that flow, notably the liver and the kidney. Diseases are characterized
by an excess or deficiency of various kinds of energy, particularly
Yin and Yang. (In Chinese medicine, however, the organs are better
understood as a group of functions rather than as specific anatomic
objects. You can get a better understanding of this medical system
and its principles from the book The Web That Has No Weaver, by
Whether you describe the phenomenon in terms of a Western or Chinese
model, the final pathway of fatigue is in the perception of having
low energy. There are many factors that can affect that perception.
Optimism or a sense of control tends to increase the sense of energy.
Interestingly, research on fatigue in women who were treated for
breast cancer showed that fatigue did not depend on the kind of
treatment they received but upon their emotional reaction to it.
Depression or a negative mood correlated more with fatigue than
chemotherapy or radiation!
Though there may be specific reasons for low energy, it is useful
to look at fatigue as the result of entire cancer process disrupting
your energy "economy." The metaphor of energy bank
accounts suggests ways you can gain some control over your
Imagine that energy is like money in a series of bank accounts.
You spend energy doing various things and lower your balance by
withdrawals from your account. You can bring in energy from different
sources and deposit it, raising your balance. You can borrow energy
or transfer it from one energy bank account to another. If your
balance is low, you may have to go on a budget or you wont
have enough energy to spend on the things you need. If you continue
to spend energy and dont replace it, you create a deficit.
If that continues, you may become bankrupt. Fatigue can be considered
You have several energy bank accounts. There are accounts for
nutritional, physical, emotional, mental, social, recreational and
spiritual energy. Nutritional energy
Nutritional energy is brought in with deposits of nutritious food.
This is the most obvious source of energy. The wrong food, however,
acts like a bounced check or counterfeit money. It is
not credited to your account and may even cost you energy. An example
of this would be very greasy or spicy food that causes heartburn
Certain foods are more valuable than others. Refined sugar is
like kindling: it flames for a moment and is quickly burned. Complex
carbohydrates, vitamin-rich vegetables and protein last longer and
provide more necessary nutrients.
Different circumstances and individual metabolisms require adjustments
in food intake. Often it is easier to bring in food energy with
frequent small snacks rather than large meals. If you are unintentionally
losing weight, you might have to change your diet to include richer
foods, at least until the recession is over. Similarly,
if you have unavoidable loses (i.e., diarrhea or changes in your
digestive tract), you may have to take in more food, though the
kinds of food will depend upon your exact condition.
Food energy deposited in this account is used for physical activities.
These include healing from surgery and rebuilding your body after
Physical energy You spend energy from your physical energy bank account with all
the things you do. Sometimes, however, that energy is wasted doing
unnecessary things. If your energy is limited and you are on a tight
budget, you may need to avoid or delegate certain activities that
are not vital to your needs.
after surgery or repairing the body during chemotherapy or radiotherapy
also takes energy. Though nutritional energy is the primary source,
most of the energy passes through your physical energy account.
Because healing may seem passive, it is easy to underestimate the
amount of energy it requires. You should make allowances for healing
and repair when preparing your energy budget.
whether it is walking, biking, stretching, or tennis, deposits physical
energy. Physical movement keeps the bank account active. Being physically
inactive both deprives you of new deposits and makes it harder for
you to draw from your account.
such as yoga, tai chi chuan, or Qi Gong help keep Chi (vital energy)
moving and distribute it throughout the body. In both Chinese medicine
and Ayurveda, the breath is a source of both oxygen and energy.
The exercises recommended in those systems emphasize coordinating
your breathing with the movements.
exercise capacity will vary. Even if you cannot run for five miles
you can walk for five minutes several times a day. Regular, moderate
exercise maintains a healthy bank account best. Over-exercising
actually may cost you more energy in the long run, particularly
if you are too tired afterwards.
Emotional energy Emotional energy bank accounts are frequently low or overdrawn
during cancer treatment. Withdrawals are often both frequent and
large. Conscious worry, fear, depression, and anxiety all use up
energy. There can even be a form of embezzlement if
these feelings are subconscious and unacknowledged.
In addition to emotional energy that is inevitably used in adjusting
to your status as a patient, there may be other withdrawals that
either waste energy or at least are not necessary. Worrying about
other peoples needs or opinions doesn't help you. Let them
take care of themselves or at least ask directly if they need your
help. They probably can manage well on their own. They may even
be worried about you. Reassuring each other can stop the drain on
both your accounts.
Emotional energy is deposited when you receive support or caring
from others around you. A kind word, a hug, a letter, or even just
a smile can change a negative balance to a positive one. Humor and
laughter add emotional energy, too.
Because your overall energy economy is so dependent on your emotional
state it is important to monitor this account. Some people are unaware
of their emotions and may not recognize their account is low. Others
may be reluctant to receive emotional deposits and either
ignore or hide their needs. The fatigue that results from an empty
emotional account significantly diminishes your overall quality
A negative balance in your emotional account is often experienced
as depression, though not everyone has a depressed mood. Sometimes
it is just a lack of interest in doing things, or feeling of lethargy.
The section Brain-fry which follows discusses this
issue more fully. Mental energy A positive balance in your mental or intellectual energy account
can give you a sense of mental alertness and enthusiasm. Mental
and emotional energy accounts overlap somewhat in creating a sense
of optimism. You need both to sustain a positive interest in life.
You use mental energy in problem solving. If you have ever tried
to do your own income tax return you know how much energy mental
work consumes! Making decisions about your treatment, readjusting
your schedule to accommodate doctors visits, and juggling
your other responsibilities all consume vast amounts of mental energy.
When your mental energy account is low, it is harder to concentrate
and make decisions. Even simple things may seem difficult. You may
have to read something several times to understand it. Your memory
can deteriorate and you may forget words, names and events.
The lack of mental energy is most obvious when there is a disparity
between the amount of energy you need and the amount you have. Often
you have some energy in your account, but the problem youre
trying to solve is too big. Dividing the problem into its constituent
parts corrects this disparity and allows you enough time to replenish
your account before the next expenditure.
Bringing in mental energy requires focus and stimulating practice.
You need to think about and do one thing at a time. If you try to
stuff too much in at once, nothing will pass through. It is like
having a narrow slot on a piggy bank. Mental energy tends to replenish
itself if given a chance. Just slowing down helps this process a
There are certain activities that tend to be mentally stimulating.
Reading about topics that interest you, talking with certain people,
watching movies, or going shopping can all bring in energy. Often
hobbies or playing games are a source of energy. Making decisions
about what shrub to plant, what color to paint, or what card to
play creates energy even though the same process, when applied to
your disease, is exhausting. Social energy Social interaction is a potential source of both energy expenditures
and deposits. Certain situations and people can energize you, leaving
you refreshed and excited. Conversely, other situations and people
can leave you completely empty, drained of whatever energy you previously
Though difficult to measure scientifically, it is easy to feel
another persons vibes. Certain individuals seem
to radiate energy as a flower does its fragrance. Being with such
people is a ready source of social energy. Close friends and family
may also be important sources of social energy. A phone call or
going for a walk with them may provide a significant boost when
you are low.
Groups of people can also provide an energy-rich environment.
Some people are stimulated by game arcades, sports events like baseball
or soccer matches, or by shopping malls. Concerts and parties offer
more than just the musicthere is the shared energy of people
Social energy is lost when you are with people who themselves
are down or are drawing energy from you. Usually this is not intentional.
Perhaps you have had the experience of being with someone who is
so depressed or negative that you began to feel the same way. Similarly,
there are certain environments where there is a palpable sense of
gloom even when there is nothing wrong.
The secret to keeping a positive social energy account is to limit
the withdrawals and maximize the deposits. You cannot avoid all
negative people, since some of them may have irreplaceable
roles in your life. You can restructure the interaction, however,
to limit the drain on your account.
When your energy is low you can limit the amount of time you spend
or the topics you discuss with certain people. Some healthcare workers
can be pessimistic. You may not be able to make them optimists but
you can request they not give you gratuitous information that is
not immediately useful.
Similarly, you can improve a social experience by bringing your
own support system with you. You can listen to a humor tape or music,
or talk with a friend while youre having chemotherapy or in
the waiting room. Recreational energy The energy to re-create yourself comes from various
sources. Positive energy comes from having fun, enjoying yourself,
and even from remembering enjoyable experiences. Laughter is such
a good medicine because it contributes both to your emotional state
and helps renew your entire being. It is easy to get lost in the
seriousness of treating a life threatening disease and forget that
the purpose of the treatment is to restore you to a life worth living.
Many cultures emphasize the serious nature of life. There is often
not enough emphasis on playfulness and frivolity. One of the best
ways to keep a positive balance in this bank account is to have
fun each day. You can make a deposit in your recreational energy
account by writing the name of fun activities on cards. These might
include things like watching a movie or going shopping, or silly
things like popping a sheet of bubble wrap thats used for
packing material or drawing mustaches on pictures in magazines.
Use your imagination and past experience of what has been fun for
you. Whenever you notice your account is low, give yourself a deposit
slip and do that activity, just for the fun of it.
Being artistically creative also brings in energy. Playing music,
sketching, taking photographs, or arranging flowers can allow you
to connect with a source of creative energy and happiness. Expressing
your feelings with poetry or painting also adds to your energy balance.
Certain environments are particularly nurturing.. Some people
may feel enlivened by a walk along a forest path; others may find
that watching ocean waves at the beach is best. The essence of the
environment is its ability to nurture you. You can have the same
experience of re-creation by taking a leisurely tub-bath if you
arrange the room so that it feels special to you.
Questions to Ask Yourself
Have I had my fun yet today?
Spiritual energy The spiritual energy bank account is more important to some people
than others. It is not necessarily religious, though religion is
an important source of spiritual energy for many people. Spiritual
energy can also arise from a transcendental source of power such
as Nature or the Universe. Regardless of its source, spiritual energy
can function as an emergency fund that is available even when other
accounts are empty.
You can make deposits of spiritual energy in a variety of ways.
Going to church, temple, mosque, or any place of worship can provide
a source of energy. Any gathering of like-minded worshipers can
be energizing. Spiritual books and tapes likewise provide a boost.
Certain source books for each of the worlds religions are
important, such as Bibles, the Torah and commentaries, various Sutras,
the Koran, etc. Spiritual stories and folk wisdom provide another
source of energy.
Certain teachers, pastors, mullah's and other clergy have the
ability to help you tap into the wealth of spiritual energy they
access. Listening to them is enriching. You may also have friends
who possess a spiritual wisdom they are willing to share.
Certain environments and experiences create spiritual energy.
Some people can fill themselves by watching a sunset at the beach,
examining the perfection of flowers in a garden, or any experience
of great beauty. You can also receive spiritual energy by sharing
the joy of others, whether it is the happiness of your friend as
she receives good news or the total peacefulness of a child asleep.
Spiritual energy is used in dealing with the transcendental questions
provoked by life-threatening illness. The uncertainty and fragility
of life can become unavoidable when you are fatigued by treatment
and wonder if it is worth it. Questions like why me?
or what is the meaning of this illness? or what
will happen if I die? all require spiritual energy to find
There is an ongoing effort to make sense out of your disease and
its place in your life. This effort uses energy, whether it is done
consciously or subconsciously. If your energy is depleted you may
feel that life is meaningless or that you lack purpose. This dis-spiritedness
can be dangerous, since spiritual energy contributes to the will
to live. Just as keeping a positive balance in your emotional account
maintains a positive mood, a positive balance in your spiritual
account maintains positive efforts to stay alive. Energy economy This model of energy bank accounts is valuable because it points
out the things you can do to maintain your energy. It calls attention
to the areas where you may be wasting energy and can cut your loses.
More importantly, it highlights the things you can do to bring in
Energy in one account can be used in other accounts, just as you
would transfer funds from one account to another. If you are physically
tired, a transfer of emotional or social energy can revive you.
The exception to this is transferring nutritional energy to the
emotional account. If you are emotionally empty, filling yourself
with food doesnt solve the deficit, except very briefly.
The following tables are designed to help your prepare an energy
budget. They serve as a partial list of potential energy credits
and debits. When you are on a tight budget every little bit helps.
The lists are not exhaustive but meant to stimulate your own creativity.
Write down your ideas for energy resources.
balanced diet including fresh fruits and vegetables; flavorful
meals attractively served
Sugary foods like donuts or candy; fatty or greasy foods;
foods you know will upset your digestion like milk if you
are lactose intolerant or rich foods if you have gall bladder
brisk walk with the dog; bicycling to the store or to work;
yoga or Tai Chi Chuan classes; a walking club with neighbors
in the morning or co-workers at lunch
back to work right after a chemotherapy appointment at 4:30
PM; volunteering to supervise a 3rd grade field trip the day
after you complete radiotherapy; cleaning the garage yourself
so your teenager can play video-games
up a college roommate or high school buddy to catch
up on things; receiving a call or letter from a friend;
writing cards to old friends; telling someone how grateful
you are for their help; having someone tell you how much they
to someone complain who isnt interested in solutions;
having someone try to cheer you up by telling you their problems;
spending unnecessary time with depressed people
your favorite poems; writing a poem; doing puzzlescrossword,
anagrams, brainteasers, jigsaw, etc.; reading a book on a subject
youd like to learn about; taking a class on Italian art
history, Japanese woodworking, or Russian literature
about things you cant change; trying to solve someone
elses problems; finishing a book that bores you just because
you started it
to a performance of a school orchestra or theater group and
watching the other parents pride at their children; shopping
at a farmers market early in the morning; listening to
first and second grade children playing at recess; playing cards,
chess or backgammon with friends; volunteering with a group
on a community project; spending time with optimists
time with pessimists; going to a really dull party and not leaving
early when you have a chance
Taking photographs and making a photo-essay or collage; collecting
sea shells or making sand sculptures at the beach; walking on
a forest path and studying the patterns light makes as it filters
through the trees; hanging out at a café-bookstore in
the afternoon sipping tea, coffee or hot chocolate
TV channel surfing; sitting through something you dont
want to attend; routinely doing what someone else wants when
you dont enjoy it
down 10 (or 100) important things you have learned in your life;
walking slowly through a garden, smelling each flower individually;
reading inspirational books and stories; writing a story about
yourself that will help inspire someone else
to yourself or other people tell you how bad you are and that
you are not loved by God
to Ask Yourself
is the balance in my energy bank account?
am I spending energy wastefull?
there ways I can invest my energy more wisely?
term brain-fry conjures a picture of being overwhelmed,
over-stressed and burned out. It evokes an image of trying to do
too much, being under pressure for too long, and having no chance
to cool off. Brain-fry is not a medical term but it does describe
the medical condition of unrelieved stress that stretches your coping
model of stress as brain-fry is a simplification of very complex
neurochemical events. There is a large body of literature on stress,
and its effects on the body, the immune system and the nervous system.
There is active research to discover the mechanisms of how stress
affects the mind and how neurotransmittersthe chemicals that
transfer a signal from one brain cell to anotherchange in
disease and in health. Much of this research is very technical and
difficult to understand even if you are a physician. The model,
while based upon this research, is designed to make the events occurring
in the brain more understandable. Though the image of brain-fry
is not a scientific description of neurochemistry it is easily understood
and immediately suggests ways of turning down the fire or insulating
yourself from the heat.
kinds of stresses are more likely to cause brain-fry than others.
Foremost of these are constant uncertainty, feeling out of control,
and facing the possibility of illness or even death. These are particularly
likely to cause brain-fry when coupled with the physical effects
of an illness and its treatment. These of course, are the exact
conditions you face when youre being treated for cancer.
occurs not only with big things but also with a series of little
things. It is like the camel whose back is broken by the addition
of one more straw. It wasnt really the last straw that broke
his back; it was all the others before it. You may be coping with
everything else but come unglued at something simple, like being
stuck in traffic or having the lab call to tell you they lost your
blood sample and want you to come back for another one.
one is immune from brain-fry, though some people are more vulnerable
to it than others. Given enough unrelieved stress over a long enough
time, everyone will experience some kind of brain-fry symptoms.
If you have had depression or anxiety symptoms in the past you may
be more likely to feel the strain. You may be more vulnerable to
stress or more sensitive to recognizing the symptoms. As a result
of these experiences, however, you may also have developed successful
coping mechanisms to deal with it.
do you know if you have brain-fry?
brain-fry is easy. If you are affected, when you hear the word there
is an immediate recognition, an aha response. There
is an intuitive sense that this word is a good description of what
you feel like.
you are not certain, check the symptoms listed below. If it is easy
to remember times you have experienced at least five symptoms, its
likely you have at least had brain-fry temporarily. If you have
these symptoms commonly, you probably are suffering from it now.
of brain-fry include:
- Lack of energy, fatigue, a sense that everything is an effort
- Difficulty concentrating, focusing attention
- Difficulty making decisions, even simple ones
- Poor memory, forgetting appointments, where you left your keys,
what you wanted when you went upstairs, etc.
- Lack of creativity and resourcefulness; feeling stuck in old and
- Variable moods: easily angered, feeling on the verge of tears,
- Variable activity: unable to sit still, feeling the need to move
around all the time or conversely, feeling immobilized, not wanting
to move for hours at a time, wanting to go back to bed
- Unaccountable fear or anxiety, feeling jumpy, waiting for
the second shoe to drop
- Panic attacks, palpitations, unexplained sweating, feeling dizzy
or unsteady all the time
- Worrying excessively and not accepting reassurance
- Feeling shut down, numb, unable to feel or to show emotion even
- Problems with sleep: either sleeping too much or difficulty falling
or staying asleep
- Problems with appetite: losing your appetite, eating too much,
- Hypersensitivity to normal body sensations, intolerance of previous
symptoms (e.g., joint aches, headaches, etc.) that were accepted
before, having your whole body hurt
- Feeling depressed, even to the point of considering suicide or
that youd be better off dead
- Feeling unable to enjoy anything, losing any interest or pleasure
in things you have enjoyed before
Questions to Ask Yourself
Do I have brain-fry?
the brain simplified version
are several basic principles that explain how the brain works.
Different parts of the brain are responsible for different things.
The frontal lobes control most intellectual processes like concentration,
memory, and decision making. The limbic system is in charge of emotions.
There are other parts that are involved with appetite, sleep, alertness
or arousal, physical sensations and physical movements. There is
no single part of the brain that is in charge of your energy
level. The experience of having energy or being fatigued is
the result of the interaction between several areas.
Brain cells communicate with each other via neurotransmitters, chemicals
like serotonin, norepinepherine, dopamine, etc. These chemicals
are released by one brain cell, travel across a short space between
brain cells called the synapse, and then influence the next cell.
A sufficient amount of neurotransmitter is needed to produce a complete
signal. Sometimes the neurotransmitters will stimulate the cell,
sometimes suppress it. The different chemicals act in different
ways depending upon the specific part of the brain and the state
of the cell. An exhausted cell may not respond the same
way a normal one does.
Even though neurotransmitters are conserved and recycled between
cells, they can be used up and the cells become deficient. This
occurs with repetitive stress, as the cells capacity to regenerate
the chemicals is insufficient for the demand. When neurotransmitters
are low, the activity of the brain cells change. The proteins
and enzymes that control the way the brain cell functions become
defective and the message transmitted between cells is garbled.
For example, if one brain cell was trying to give another the signal
for Mississippi, it might come out as Miss.
There are different symptoms of low neurotransmitters, depending
upon what part of the brain is affected. If the portion of the brain
that controls intellectual activity is low, you might experience
difficulty concentrating or making decisions. If the limbic system
is affected, you might feel more anxious, depressed, irritable,
or moody. You might become so depressed that you become hopeless,
and unable to find anything pleasurable. If sleep centers are out
of balance you may have difficulty falling asleep, staying asleep,
or even difficulty staying awake. If several areas affected, your
overall energy level may drop.
If you replenish the neurotransmitters, the brain regains its equilibrium
and corrects the imbalances. The sleep cycle is restored to normal
and you awaken more refreshed. Your ability to think clearly and
make decisions returns. Anxiety and depression improve. Your sense
of energy and optimism come back. In terms of the brain-fry metaphor,
the heat is turned down and your brain is no longer cooked.
is not the same as depression
of the symptoms of brain-fry are similar to those of depression.
Our culture has unfairly stigmatized depression as a moral or mental
weakness, something you should just snap out of. New
understandings of the neurochemistry of the mind have debunked this
myth. Currently, depression is recognized as a disorder of neurotransmitters.
On a genetic basis, some people do not synthesize and maintain normal
levels of brain chemicals as well as others. Under unusualor
even common--levels of stress the amounts of serotonin, norepinephrine
or dopamine fall, preventing normal brain function. This produces
originally treating patients with a depressed mood, found that other
symptoms often accompanied it. It wasnt until the development
of new medicines that affected specific neurotransmitters, however,
that it became clear that these other symptoms were common, and
occurred without necessarily a depressed mood. The new medicines,
SSRI (Selective Serotonin Reuptake Inhibitor) antidepressants, were
found to help these symptoms, too.
is becoming clear that the neurochemical mechanism of depression
is similar to the mechanism of chronic stress or brain-fry. There
are, of course, some differences. The hallmarks of depression are
a depressed mood and the inability to experience pleasure. These
probably reflect a predominant effect of neurotransmitter depletion
on the centers in which emotions are experienced. Other parts of
the brain are affected also, producing the other symptoms of sleep
disturbance, appetite changes, difficulty concentrating, etc.
and the immune system
or stress affects other areas of the body, particularly the endocrine
and immune systems. The hypothalamus, pituitary and adrenal glands
typically suffer the effects of stress most. Levels of adrenal hormones
drop, or dont respond to challenges normally.
is an overlap between the mind and body, which is explored in the
field of psychoneuroimmunology. This field of study examines the
relationship of the mind, the nervous system and the immune system
under various kinds of stress. Different studies have documented
the effect of stress on hormone levels and immune function. Common
examples of this include irregular menses in young women under the
stress of final exams in college and the increased frequency of
viral illnesses following unusual stress in both men and women.
overlap between the brain and the immune system is even more intriguing.
There are the same receptors for neurotransmitters on lymphocytes
as on brain cells. Furthermore, most of the cells of the brain are
glial cells, derivatives of the immune system. Though the exact
relationship between the nervous and immune system is not fully
understood, it is clear that there is a relationship and that both
might be affected by the same events.
research linking stress, the immune system, and cancer shows mixed
results. Some studies link changes to cancer outcomes, others do
not. Whether correcting brain-fry will improve your immune system
and help cancer treatment is still an open question. At minimum,
however, your quality of life can improve, and with it, your will
basic problem of brain-fry is being mentally overheatedtrying
to do too much, too fast, without time to recover. The solutions
to this problem can be thought of as either turning down the heat
(cooling off or getting out of the fire) or insulating yourself
(becoming more heat-resistant).
simplest way to turn down the heat is to decrease the number of
stresses in your life and slow down. President Harry Trumans
advice is correct: If you cant stand the heat, get out
of the kitchen.
there are problems that dont need attention now, it may be
wise to defer them. If you can delegate some responsibilities to
someone else, let them do the worrying. Sometimes, however, there
are no practical ways to turn down the fire and you will have to
look at ways to cool yourself down in the midst of the flames.
even before Shakespeare knew that sleep knits up the ravelld
sleave of care. (Macbeth Act II, sc, 2, ln 33). Restful sleep
allows the body and brain to repair itself. During REM or dream
sleep the brain cells have a chance to replenish neurotransmitters.
Since one of the symptoms of brain-fry is sleep disturbance, getting
a good nights rest can be challenging.
clinics have discovered several important techniques that can help
restore normal sleep. Treat yourself as if you were helping a child
fall asleep. Establish a ritual with a warm bath, quiet music, or
reading a comforting story. Avoid alcohol and caffeine-containing
beverages in the evening. Reserve your bed only for sleeping, dont
make it an office. If you find that you are awake thinking about
things or trying to solve problems, get up and go to another room,
so you dont associate your bed with anything but sleep. Go
to bed reasonably early, at least before midnight, to accommodate
your normal sleep biorhythms.
can help you as much as sleep in restoring your energy level. This
need not be marathon-running levels of exercise, though that does
increase neurotransmitters including endorphins; a brisk walk or
a moderate bike ride is sufficient. It is probably better not to
do vigorous exercise right before bedtime because it can be too
stimulating. Gentle stretching before bed, however, is relaxing
and conducive to sleep.
is a very effective way to cool off your mind. There are many forms
of meditation and all of them can work. Specific relaxation techniques
like tapes or progressive muscle relaxation are commonly used. Dynamic
meditations like Yoga or Qi Gong or techniques that focus on the
breath or a mantra are popular, too. The best image of how meditation
works would be comparing it to cooling down an overheated car. Resting
and reading a book is like stopping the car and putting it in park
with the engine running. Meditation is more like turning off the
engine or getting a tune-up.
are several ways to become more heat-resistant. Meditation,
including mindfulness practice, can help you discriminate between
threats and worries so you can release the worry portion while you
concentrate on avoiding threats. Psychological counseling can also
be very effective. Prayer and spiritual practices that allow you
to feel protected and safe are particularly useful as insulation.
some people, or under certain circumstances, medication is the most
appropriate solution to brain-fry. Because of the cultural mythology
about depression, drugs labeled anti-depressants are
sometimes viewed with suspicion. Some people think that if they
are taking such a drug they will be considered weak, that they should
be able to overcome their symptoms without medication. Other people
are reluctant to take medicine for fear of side effects or losing
control. Others minimize the problem and dont feel they are
sick enough to warrant treatment.
deciding whether to treat brain-fry with medication it is important
to consider the dangers of not treating it. Left untreated, fatigue
and other symptoms not only diminish your subjective quality of
life they interfere with your daily activities and social function.
Your immune system may be affected, which conceivably could impair
your response to your cancer.
is common for years even after treatment stops. It is almost as
if fatigue is a conditioned response to the cancer, produced by
the treatment, but persisting because of the association with the
condition. During treatment for breast cancer with either radiation
or chemotherapy, 99% of women experience fatigue; 60% of them rating
it as moderate or severe. One third of women continue to be fatigued
even a year or more after treatment is complete. The persistence
of fatigue is associated with depression (or more accurately, brain-fry)
more than with anything else. If fatigue and the symptoms of brain-fry
are treated early, you may never develop the conditioned response.
of looking at these medicines as antidepressants, think of them
as ways you can turn down the heat or insulate yourself
from the fire. Even if you are suffering from brain-fry, you may
not be depressed. You may simply be overheated. Using
medicines like Prozac, Zoloft, Effexor, Wellbutrin or Celexa for
brain-fry may not be approved by the FDA, but if you are burned
out, they may be useful. They allow normal levels of neurotransmitters
to build up even if the stress doesnt diminish. They can restore
your energy level and sense of optimism, enabling you to cope better.
You might discover more creative ways of solving problems. It is
like being given an insulated mitt to hold the handle of the frying
pan: you can get a better grip on your life.
decision about using medicines to treat brain-fry is a personal
one. Not everyone either needs drugs or wants them. The fear of
using medicine, however, is unfounded. The fear itself can be a
manifestation of the very disease that needs treatmentthe
sense of being out of control and unable to tolerate even one more
exhaustion and fatigue of brain-fry merit treatment. If you can
reduce your stresses, do so. If you cant change the external
events, change the way you perceive them. If these efforts dont
help, seriously consider changing your brain chemistry. Not only
will the quality of your life get better; you might live longer,
Questions to Ask Yourself
What do I need to do to turn down the heat? Would medication