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Fatigue, Pain, Depression

These so often exist together. But they are really three separate problems closely intertwined. 


What does the doctor do when you complain of fatigue? He checks to see if you are anemic and if your thyroid is working. When that is normal, well then, that’s pretty much the end of it. Yes, you can go to an endocrinologist and get things triple checked, or you can go to a rheumatologist and get labeled chronic fatigue. Or you can just assume that it’s a normal part of getting older and live with it. But perhaps you should delve deeper...

What is the opposite of fatigue?  It’s energy.  And no, the secret to more energy is NOT just upping your thyroid dose – or playing with your adrenals.  Thyroid is often used like body coffee, the more the better. Certainly T3 can jazz you up and give you palpitations. But it often dumps you right back down again. Cortisol can pump up your adrenals. But then what made them sick to begin with?  I think it’s better to get to the bottom of your low energy.  So, why ARE you fatigued?

My first question here is how do you sleep?  To have energy, your body needs to renew itself overnight. Good sleep comes FIRST!  So, how old are your mattress and pillows?  How stuffy is your bedroom? No wonder you wake up with a crook in your neck and your nose stopped up! No wonder you are fatigued.  If you can’t sleep, why?  Do you have a fall asleep or a stay asleep problem? Both quantity and quality of sleep count.  Different solutions are for different problems here.  Sometimes, it’s your pet, your snoring, your hormones, your computer screen, or your restless legs which are the culprits. Again, sleep comes first. Then tackle residual lack of energy.

Sleep well? Then let’s look at the many other causes of fatigue.

Some are drug related, some psychological, many stress related, some nutritional and others toxin based.

Chronic fatigue IMHO is a label. It has no specific cause or cure. Just a range of treatment modalities that can help. Other diseases can be cured, why can’t chronic fatigue?

I suspect we really haven’t gotten to the root of things here. But it is worth a thorough search. Often there is more than one aggravating cause.

To quote Dr Sid Baker: If you have 2 tacks in your butt, taking one out does not lead to a 50% improvement. You need to address the complete picture..

What generates our energy anyway? To get right down to it, our mitochondria do. What are they? They are millions of tiny little powerhouses inhabiting our very cells and merrily or reluctantly generating organic energy in the form of ATP. So, how healthy are your mitochondria, have you poisoned them with toxins, do you supply them with enough building blocks? Just how do you actually nourish your mitochondria and your own body’s energy production?.

Fatigue, lack of energy, is a highly individual complex topic. It is much too large for this simple post.  Energy forms dance with each other and interconvert. Your fatigue may ultimately respond to changes in biochemical, electromechanical, magnetic, solar, or psychic energy. They all reverberate within and without us, dancing with our mitochondria, our nervous system, ourselves, and our bodies. Energy is everywhere, we just need to know how to harvest it.












                                                                     Enough, I'm tired.


No pain, no gain is NOT a philosophy which I endorse.  I believe in minimizing all the pain that I can, paying attention to the pain which spells trouble and marshalling all resources possible for those chronic pains which supposedly “can’t be helped”.

When I operate on people, I initially inject the incision site with a form of Novocain, because it blocks the pain at the nerve ending.  The patient will appreciate this later when she wakes up.  I also believe in guided imagery to prompt quick recovery and painless healing. The power of suggestion is awesome.  IV “Advil”, IV Tylenol are mainstays of my intraoperative and postoperative armamentarium.  I believe in stopping the pain before it starts, then heading it off all the way through the healing process.  Narcotics, yes but only if needed, mainly because of their side effects.

Much psychic pain is unwittingly self inflicted and is very toxic. These people unknowingly recycle their pain and spread it around. It’s so unfortunate. Here’s an example:  “How are you Mrs. Jones?”  “Well, I’m so glad you asked, doctor. This year started out with my slipping over the rug and twisting my ankle (details up the whazoo), then my gallbladder, (details), my kidneys…. And to make matters worse, you know I lost my husband 8 years ago.”  Physicians just tune out, and then look sympathetic as they interrupt.  Family members suffer in silence.  No, she couldn’t help slipping, but reliving it constantly certainly doesn’t help her. Too much of her energy is tied up in the recital of her woes. Each recital is initiated as a cry for help, but is lost in depression, emotion then exhaustion. It is hard to intervene here. It is hard to break the cycle.

She needs to see clearly how she is hurting herself. That’s the first step towards healing. Then she needs to ask HERSELF how to become unstuck and move forward. Meanwhile, she is missing the beginnings of spring, the sunsets, and so much more of the joys of any life.

 For those stuck in the cycle, I recommend Dr Fred Luskin’s book “Forgive For Good.” It is truly wonderful. His nine steps work so well for forgiving wrongs AND healing psychic pains that unfortunately keep on giving. Look it up, read it.

For those in chronic bodily pain struggling to improve their quality of life, I would love to make sure that you leave no stone unturned.  There are many treatments to improve your quality of life. Not just more NSAIDS, narcotics, and gabapentin. And I’m sure you have tried heat, ice, the chiropractor and massage.  Some “out of the box” alternatives include off label lidocaine patches, creams containing menthol, capsaicin or natural anti-inflammatories, acupuncture, and a range of herbal remedies. I encourage you to mix and match.  Other treatments utilize energy sources such as ultrasound, laser or electromechanical energy. One exotic treatment uses a “TEMS” machine placed in your ear. Its contact points are based on the Chinese Medicine homunculus.

Do it! Why not?  Embrace self help not self helplessness. Human resourcefulness and resilience are amazing. Your body wants to heal.  Please come share your successes.  I will pass them forward.  Maybe YOU can find that tack in your butt which is causing your pain.  Then I can remove it.



In my darker moments, I feel depression is just another word for Sanity.  After all, we didn’t ask to be born.  We have to grow old no matter what we do.  And then we die.  And this recession certainly isn’t making the interim a piece of cake. In other words, I understand.


So what should we do about it?  Well, certainly there are people who benefit from an occasional anxiolytic, or who need some help with Zoloft and/or psychotherapy. Others benefit from a class of herbs called adaptogens mixed with nervine tonics. I often start with personalized mixtures of these.  Some people with more chronic problems benefit from understanding bits of their genetic code. Just who can’t make enough serotonin to begin with? Whose epinephrine breaks down too slowly leaving them anxious? And whose serotonin transporter genes make serotonin less effective? These people benefit from a little neurotransmitter biohacking.

All in all, I am amazed with the resiliency of the human spirit in the face of adversity.

Many people just need a gentle prod and a little help.  Once they put one foot on the right path again, they blossom.  Here, again I like the Metta Meditation.  I thank Dr Victoria Maizes for reminding me of it.



(Now think of someone you love and repeat it with them in mind.)

“ May you feel safe.  May you be at peace, May your heart remain open. May you awaken to the light of your own true nature. May you be healed, May you be a source of healing for all beings.”


(Now think of someone with whom you are having difficulty and repeat it with them in mind.)

 “ May you feel safe.  May you be at peace, May your heart remain open. May you awaken to the light of your own true nature. May you be healed, May you be a source of healing for all beings.”

“May I feel safe.

    May I be at peace,

May my heart remain open

    May I awaken to the light of my own true nature.

 May I be healed,

    May I be a source of healing for all beings.”

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