If you're in need of an energy boost (of the noncaffeine-, nonsugar-, nonephedra-based variety), take a look at what revived our three volunteers.
Subject: Gail Wilson
Fatigue Factors: Overbooked on all fronts—caring for teenage children, involved in community service, and working full-time at a pressure-filled job.
Gail runs errands for her elderly parents, takes martial arts classes twice a week, and has two teenage sons whose activities alternately require cheerleading or chauffeuring. An observant Muslim, Gail is involved in activities at her mosque that include gathering gifts for children in homeless shelters and developing more community services. She's also a senior-level attorney for the Environmental Protection Agency. "EPA enforcement work means rumbling with people," Gail says, "and that takes up huge amounts of time and mental energy." Right now her bicycle is unridden, and the house, she says, looks like hell. What would she do with extra energy? Gail would up her physical activity and think about someday starting her own business. "There are more things I'd like to accomplish in my life," she says, "but I'm running all the time just to keep up."
Gail, who lives in Philadelphia, chooses to work with New York–based life coach Nancy Boyd. Life coaching is a by-product of the self-help movement and the consulting world, says Boyd, a founding member of the International Association of Coaches. Unlike psychotherapists, coaches don't focus on the past. They help you investigate your current situation and suggest how to overcome obstacles.
Talking via telephone, Boyd starts off by asking Gail to complete two assessment exercises. First she tells Gail to draw two pie charts, one representing how she actually spends her time and the other how she'd like to. Gail then identifies the biggest gaps between the two charts and the changes she could make to move toward the ideal schedule. In the second exercise, Gail is asked to list 10 to 15 irritants that she tolerates in her daily life. This is tough for most people to do, Boyd explains, because we tend to see the burdens we shoulder, large and small—from a creaky door to a coworker who leans on you to solve her problems—as inevitable.
Gail struggles to come up with her first five irritants, which coaches call tolerations, but the more she thinks about it, the more easily they come to her. She and Boyd review the list, which includes mostly domestic tasks and office workload. Together they choose one—housekeeping—to actually tackle, and start brainstorming ways for Gail to delegate some responsibilities. Once Gail has moved a few things off her plate, she'll have time to address a few nagging concerns (like the pile of mending she's walked past for months).
End Result: Gail says the process of evaluating her situation was valuable. "It's easy to feel overwhelmed," she says. "To have somebody asking questions helps clear away clutter and barriers." She hasn't yet figured out how to wedge in more exercise time, but she has found a neighbor who, for a small fee, will help out around the house, sweeping her sidewalk and washing her car. The pleasure of eliminating some irritants is small but significant, producing, Gail says, "little bursts of energy." Having off-loaded those tasks, Gail stopped ignoring the to-be-mended heap; she finally sewed on buttons and repaired fallen hems.
Going forward, Gail plans to redraw her pie charts periodically, hoping to cut down the huge slice that is work and build up the slices that are personal time. And if she could start her own business, that would put her in charge of her own schedule. Boyd says that many women are so accustomed to addressing the needs of others, they cease to take care of their own. "They don't see that if they're giving it all away, they won't have enough left for themselves," Boyd says. Gail has definitely gotten the hang of the second exercise and now looks at her life with more of a sense that she is in charge: "Every day I think about another two or three things I could eliminate."
Try It Yourself: Coaches charge $200 to $1,000 a month, with most falling in the $300 range for two to three sessions, often by phone, each lasting 30 to 45 minutes. You can find referrals through two major certifying organizations: the International Coach Federation and the International Association of Coaches. Nancy Boyd can be reached at DayToppers.com.
How acupuncture works to cure fatigue
Fatigue Factors: Keeping up with housework, yard work, two young children, and let's not forget the new puppy.
Penka is a mother on the move, often spotted on neighborhood sidewalks with 4-year-old daughter Lilliana in a stroller, baby Isabella in a backpack, and new puppy Solomon on a leash. If Penka is not playing with the kids, she is cleaning or cooking or gardening or crossing items off her to-do list in rapid fire (with the exception of item number one, getting enough sleep). Her husband teaches during the day, and so evenings combine kid time with couple time. If she had more energy, she says, "I would just do everything better. I'd have more memory. I'd have more patience with my kids and be more creative with them when we do projects. I'd have more peace of mind."
For years Penka has been curious about acupuncture, a more than 3,000-year-old Chinese practice in which thin metal needles are inserted under the skin to unblock and stimulate energy flow in the body. "Bring it on," she says gamely upon meeting Ian Cyrus, an Eastern-medicine practitioner who serves as the staff acupuncturist for Philadelphia's Thomas Jefferson University Hospital Center for Integrative Medicine. Cyrus explains that acupuncture is only one of eight Asian healing arts he offers, including herbal formulas and bodywork.
"Calling me an acupuncturist is like calling a mechanic a wrench-ist," says Cyrus, who explains that Eastern medicine helps put the body back into balance, and that acupuncture is particularly useful for people with chronic conditions—ranging from fibromyalgia to depression, infertility, and allergies—but not acute illness. "I wouldn't want to go to somebody like me if I had a ruptured appendix," he says.
Cyrus examines Penka's tongue color (unusually purple, he determines, possibly indicating compromised liver function) and texture (normal). Then he checks the rhythm of her pulse and takes her temperature. He questions her about circulation ("Do your feet and hands get cold?"), illnesses in her family, and what she eats. Penka takes no vitamins or supplements, and her diet leans heavily toward bread and cheese. "That's a big staple in Bulgaria, where I'm from," she explains. She's rarely able to sleep through the night because she is breastfeeding her 18-month-old, and she hasn't yet resumed her menstrual cycle. These last two facts draw Cyrus's attention as potential contributors to fatigue.
"She's probably running on E," he says. "Tired and wired."
"Exactly," Penka responds. Cyrus chooses to address what he sees as possible compromised liver function. Penka definitely needs to take vitamins, he says, especially while breastfeeding; he suggests a multivitamin with iron and a few other supplements, including milk thistle, some of which will require taking several pills several times a day. Then Penka lies on the treatment table so Cyrus can place the needles into her ears, wrists, feet, and ankles. She feels buzzing in her right foot and slight discomfort at her extremities but nothing more. Needles can stay in up to 60 minutes, but Cyrus usually leaves them in for 10 to 15. That's sufficient time, he thinks, for the needles to stimulate the nervous system and help open up energy and circulation pathways. According to Eastern medicine, proper flow of both is necessary to keep the body and spirit in balance, and one symptom of being out of balance—or blocked—is fatigue.
End Result: Penka says there's no way she can keep up the supplements regimen of 20 pills a day, so she'll drop all but the multivitamin with iron (for breastfeeding) and B12 with folic acid (which helps in the maturation of red blood cells). Penka did feel her energy levels shift after each treatment. "They relaxed me, so I could relax more," she says. Penka had been trying to cope through hypervigilance—doing everything she thought of as soon as she thought of it. But the taste of relaxation changed her priorities, and now she'll opt for recharging over relentlessly accomplishing: "Anything I can put off, I put off. One more phone call, loading the dishwasher, doing whatever—I put it off just so I can be with the kids or read a book."
"Most of us are so used to being on edge and stressed," Cyrus says, "we don't know what it's like to achieve a baseline of deep relaxation. After a few treatments, patients' systems learn to develop a different frame of reference. They know the difference between what they've grown accustomed to and what they should feel like."
Try It Yourself: Eastern-medicine treatments generally range from $100 to $200 for an initial visit. Follow-up appointments cost between $50 and $100, and a typical treatment cycle will include eight to 10 visits. Supplements are additional. Cyrus advises that the practitioner you choose be certified by either the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) or by the state in which he or she practices.
How nutrition works to cure fatigue
Fatigue Factors: Trying to raise children, volunteer at her church, and run her own business—all while traveling for work at least two days a week.
Margie has two children (a baby and a 3-year-old), is involved in church committees, and owns a 10-person landscape design firm with clients all over the country and in India and Mexico. "It's ironic that I work on all these ecologically oriented resorts focused on reinvigoration," she says, "and I'm dragging around." She says she can pack her daughter's lunch every morning but has trouble organizing her own diet: "I'm trying to eat well, but I need a plan." Travel days are the worst, and she's likely to find herself eating highway-rest-stop fried clams for breakfast. Business meetings include catered lunches that look deceptively healthy but leave her feeling sleepy. "Those wraps are evil," she says. "They're just camouflaged mayonnaise." Weekends at home feature salads and grilled meats or fish, except when she and her daughter make pancakes or her husband cooks comfort foods from his native England. What would Margie do with more energy? "I would do nothing more. I would just be less tired doing everything I'm doing."
Margie meets with Molly Kellogg, who has trained as both a dietitian and a clinical social worker because of the overlap she sees between nutritional and psychological issues. Our culture tends to see food as either good or bad, Kellogg says, so if we make so-called bad choices, we feel we've failed. We blame ourselves for diet slipups, too many trips back to the buffet, and that second bowl of Häagen-Dazs Dulce de Leche. Eating, Kellogg says, becomes laden with guilt.
In their first session, Kellogg asks Margie what she eats and when, and how she feels before and after. Margie has been fairly strict in her avoidance of carbohydrates, although she admits that's only because she's heard carbs are bad. She avoids bread and pasta and rice, except when she succumbs to a craving. Then she not only feels guilty but has to deal with a big rush followed by a tremendous low. Does Margie take vitamins? "I own them," she says, as if she might earn partial credit with that answer.
At the end of the meeting, Kellogg recommends that Margie stop thinking all carbohydrates are bad. "That sets up a seesaw dynamic of avoidance and craving," Kellogg says. "I'm afraid that's been one of the spillovers of the Atkins diet in our culture. Extremes—deprivation or saturation—are not great. Generally your energy level is more consistent if you have protein along with carbohydrates, and if you spread carbohydrates evenly throughout the day."
Kellogg suggests Margie plan ahead so that she'll have protein and carbs at the ready. She recommends that Margie pack serving-size snacks for her road trips and stock her office refrigerator with yogurts (she can top those with granola) and cottage cheese (mixed with fruit) so that she's not left with pretzels or doughnuts or other staff leftovers as the only snack option. Margie likes the specificity of Kellogg's suggestions, and she loves the idea that she now has permission to eat more carbohydrates.
End Result: "It's a miracle," declares Margie after two weeks. "Everybody at the office says I'm not dragging around anymore." Margie has also stopped having sugar cravings, which Kellogg suspects were signaling a need for carbohydrates. "I was always running around grabbing something," says Margie. "Now I'm planning, putting stuff together in the morning. The diet changes have helped balance me out."
Try It Yourself: An initial hour-long nutritional consultation costs $60 to $120; follow-up visits are shorter and less expensive. The American Dietetic Association has a referral service of registered dietitians: Go to EatRight.org, or call 800-877-1600.
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