September 25, 2024 • 42 mins
Ever wondered why you still feel tired after a full night's sleep? Join us on "Why Am I Like This?" as we uncover the hidden factors behind fatigue and share effective strategies for managing it. We'll explore the nuances of sleep quality, from the impact of substances like alcohol and marijuana to the importance of REM sleep and proper sleep hygiene. You’ll also gain insights into how mental health can influence your physical energy, and why maintaining a structured bedtime routine can make all the difference.
In this episode, we delve into the significance of sleep for children and how bedtime routines can foster a sense of security and self-soothing behaviors. Laura Wood and Michelle Bieber discuss the bonding hormones released during nighttime rituals and the challenges posed by childhood trauma. They also emphasize the need to rule out medical conditions like thyroid issues and sleep apnea when addressing persistent fatigue, ensuring that you have a comprehensive approach to improving sleep quality and overall well-being.
Finally, we'll tackle the often-overlooked aspects of dietary sensitivities and chronic stress on your energy levels. Learn practical methods for identifying food sensitivities and the critical role of gut health. Discover how chronic stress can lead to adrenal fatigue and effective strategies for managing it, from behavioral activation to engaging in hobbies and social connections. With valuable tips on recognizing and combating fatigue, this episode promises to equip you with the tools to boost your energy and enrich your life.
Laura's Free Course on Emotional Development and Regulation:
https://benavieri.com/neuroception-sign-up/
This show is sponsored by:
Core Self
Benavieri Counseling & Coaching
www.benavieri.com
Active Healing Psychiatric Services
www.activehealingpsych.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Laura (00:03):
Hello and welcome to.
Why Am I Like this?
The podcast for those whodidn't get enough hugs as a
child?
I'm Laura Wood and I'm a traumatherapist.
Michaela (00:13):
Hi and I'm MishMayla.
I am a psychiatric nursepractitioner.
Laura (00:18):
So, M, why are we doing this podcast?
Michaela (00:21):
I'm so glad you asked.
We want to help you understandyourself a little bit better,
like how the things you learnedabout yourself and the world and
childhood are still affectingyou today.
We want to figure out why arewe like this, those random
things about ourselves that wemight wonder like why am I so
jumpy, why am I so anxious?
Why do I take everythingpersonally?
(00:42):
Why are my thoughts so negative?
Why do I feel like I have tofix everything all the time?
Laura (00:48):
Yes, so we are trying to dig into fatigue today, so
we're going to try to answer thefollowing question why am I so
tired all the time?
How do I get more energy andwhat else can we do to learn
about the root cause of ourfatigue why are we so tired?
This?
Michaela (01:09):
is such an interesting question and I feel like, well,
what is fatigue right?
Like, is it that we just feelsleepy, right?
So I think that there'sdifferent things and different
pieces of this.
Right, there's like the I feelsleepy part and there's also the
(01:33):
I don't have like the physicalenergy part of fatigue, right,
um, but I think I think thatthere's multiple causes for
fatigue.
Um, the first thing that wenormally like think about is
like, are you sleeping Right?
Tell me about your sleep atnight, and trying to understand,
(01:54):
like, what is the quality ofsleep that you are getting?
So, are you having troublefalling asleep?
Are you having trouble stayingasleep?
Are you getting up like 800times in the night to go to the
bathroom, or because you have akid waking you up?
So you know, sleep quality isreally important.
Another thing that we talk aboutis having good sleep hygiene,
(02:17):
because you know we don't alwaysthink about, like you know, tv
or things like that, having youactually like you think like, oh
, it's just, I'm not going to beable to fall asleep, but why am
I waking up in the middle ofthe night?
Well, maybe the TV, and thatyou know that adrenaline is
still contributing to you wakingup in the middle of the night?
(02:38):
Did you drink alcohol beforebed?
Sometimes alcohol will kind ofwear off in the middle of the
night, make us wake up and notget very good sleep.
Interestingly, the other thingthat I talk a lot about with
people is weed.
So people are very commonlyusing marijuana to try to get to
sleep.
That's a thing that people dovery often, right, and it works
(03:01):
Right.
It actually helps them.
You know, we talked about likethey're stoning the hamster,
right, so the hamster is runningon the wheel, running on the
wheel and they can't get theirbrain to stop.
So they stone the hamster,right, so we're shutting down
our brain and we're lettingourselves calm down so we can
get sleep.
But what people don't know aboutit is is that it's actually
(03:21):
impairing your ability to getinto REM sleep.
So I don't know a lot of mypatients that I talk to.
I'm like they tell me they useweed to go to sleep and I'm like
do you dream at night?
And the answer typically like90% of the time I would say is
no, and that's because they'renot getting into that REM sleep
(03:42):
and thus they're not gettingthat the full sleep cycle and
then they wake up feeling tired.
Even though they could get tosleep, they're still tired
throughout the day because theydidn't get quality sleep.
So that's number one thing thatI kind of talk about and look
at.
Laura (03:56):
Yeah, that's so interesting.
So you're saying that if youdon't get the full sleep cycle,
then that can be a reason whyyou wake up tired.
So what is so important aboutREM sleep?
Michaela (04:08):
Well, I'm not like a Freudian person, but I think
that there's a lot of ideasabout what happens in REM and
how our dreams are a big pieceof us being able to process
things.
Laura (04:22):
Yeah, when we're dreaming, we're processing
information right, we'relearning.
We're moving information fromour short-term memory to our
long-term storage.
We are like clearing out.
It's kind of like clearing yourcash and cookies on your
computer.
Yeah, I'm terrible at that.
Yeah, so you got to remember todo that, otherwise all this
(04:43):
stuff just gets built up andthat's why, like if you don't
sleep for like a significantperiod of time, like you'll just
start to glitch, like you'lljust start to not work properly
anymore, like your brain doesn'twork properly, like.
So when I think about fatigue,sleep is a good one.
I think sleep hygiene is oftenoverlooked.
(05:04):
We don't think about like howmuch, what is our bedtime
routine?
Like going into the eveningwith a plan to relax and wind
down and actually make the bestof your nighttime routine could
be really helpful.
But I also think aboutdepression.
Fatigue to me is just linked todepression, and I don't know if
(05:30):
that's the same like, if youfeel that same way.
But the DSM, the DiagnosticStatistical Manual of Mental
Disorders, is what we use tolike diagnose and categorize
different disorders, so like ifyou have anxiety disorder or
depression or you know one ofthese things.
(05:51):
Fatigue is a symptom of a lotof different disorders, but it
can be mental, it can be aboutnot being able to shut your mind
down, not being able to recoverfrom the shutdown.
So, like with depression andfatigue, and depression is
(06:15):
shutting down your body andshutting down your mind to
probably avoid things that aredifficult.
So, even if we're notconsciously avoiding them, we're
avoiding difficult experiencesthat lead to our depression or
that are triggers for ourdepression.
So, for example, going to work,getting out of bed, you know,
(06:39):
taking a shower, getting readyin the morning, if we're feeling
depressed, all of that stuff isreally difficult to do.
We're avoiding all of thatstuff because it just doesn't
seem like it's going to besatisfying or give us joy in any
way.
We talked about that when wetalked about procrastination too
.
Michaela (06:56):
Right, don't you think that being sleepy is actually
an avoidance technique fortrying to not have to deal with
the things?
Right, that's what you'resaying, yeah.
Laura (07:09):
I do believe that that's true.
Being sleepy and shut down is away of just avoiding distress.
I'd rather be sleepy than sad.
I'd rather be sleepy than upsetor dysregulated in some way,
and so it is a sign ofdysregulation when we're super
fatigued all the time.
It could be a sense that couldbe derived from trauma as well.
(07:31):
Yeah, trauma can cause this.
Michaela (07:34):
The other thing that I was thinking about too, that
something that you said made mybrain go there, was you're
talking about sleep hygiene andI'm thinking, isn't that
something that we probablydeveloped to like as a kid, like
our ability to be able to learnto shut down our brain, and how
we learned how to fall asleepin childhood, like if we didn't
(07:58):
ever learn that skill?
You know, maybe we were able tojust watch TV until we fell
asleep and that seemed to work,and so, you know, we just that's
what our parents let us do, butyou know, then we didn't really
ever learn how to clear ourbrains, to allow ourselves to
self-soothe, to be able to go tosleep.
Laura (08:22):
Yes, I think absolutely.
We learned this in childhood.
We learn the process, but Ithink we also learn the
importance of it too.
So we're not only we'relearning how to fall asleep and
if that's through using the TVor using unhealthy ways to go to
sleep we're learning that inchildhood but we're also
learning.
Is it important for us to takecare of our sleep?
(08:44):
Is it important for us to focuson our sleep and get enough
sleep and recognize the impactof our sleep?
When we're kids, one of the mostdifficult times in our day is
bedtime, because we don't wantto have to miss out.
We don't want to miss out.
(09:05):
We don't want to have to beseparated from our caregivers.
We want to stay connected withthem.
We don't want to, you know, bealone.
So we want our caregiver to bepart of that bedtime routine.
And sometimes, if it's not partof our bedtime routine and
we're just left to our owndevices, as a little kid we
(09:26):
might not ever have learned howto self-soothe.
We've never had thatopportunity to learn how to lay
down and feel safe and rest.
You know, nighttime can also bereally triggering for those
who've experienced childhoodtrauma and who were abused at
night.
You know, nighttime canrepresent a time that is not
(09:47):
safe for people and that can bea really big issue when it comes
to getting good sleep.
Michaela (09:54):
Yeah, that's a very good point.
I have conversations withparents all the time and they're
like, oh my kid, they just wantto keep coming back out and
asking for water.
And can I get another story, orcan I have some snack?
And one of the things that wetalk about is like, well, could
this be a cry for attention?
(10:16):
Right, is this actually them,you know, struggling for falling
asleep, or is it just thatthey're looking for you and
needing connection?
Laura (10:28):
Most of the time it is that connection.
And so there's a handful oftimes in a child's life that are
really difficult and thatrequire a lot of connection,
because that's when they get themost the secretion of the most
bonding hormones, which isbedtime.
I get the most the secretion ofthe most bonding hormones,
which is bedtime.
So nighttime feeding behaviors,so like when we're feeding our
(10:51):
children and when they're eatingthey're getting nourished by us
, so they're feeling really.
They're feeling reallyconnected.
And we also feel reallyconnected when we're being
groomed by our caregiver, solike hair brushing, teeth
brushing, showering, bathing,all of that stuff.
Those are the three mostdifficult times of any kid's day
is feeding, grooming andnighttime.
(11:14):
That's when we needed moresupport as kids.
Michaela (11:18):
Well, and I always thought, or I was thinking, that
like part of the fact that theydon't want to brush their teeth
and do all that stuff isbecause they know what's coming
next.
They're like if I get in thebath, then I have to go to bed,
and I don't want to go to bedbecause that means I'm alone.
Laura (11:33):
Yeah, that's possible too.
It's like leading up to thosekinds of things and, you know,
we learn these things as kids,whether or not we're going to be
cared for or whether we'regoing to be left on our own, and
so we might have some likeresidual stuff about going to
bed and ending our day.
You know, I think about peoplewho say have you ever heard
(11:56):
people say like, oh, you'llsleep when you're dead?
Like I don't want to miss out,like I want to stay up, I want
to maximize my day, I want to,you know, be awake and do fun
things, and I don't want to stayup.
I want to maximize my day, Iwant to be awake and do fun
things and I don't want to missout on the hours.
So that's something I think welearn in childhood.
I think that's a habit, that isa rollover, for sure.
Michaela (12:19):
Yeah, I could see that definitely being a case.
Well, and you know, as you weretalking about the depression
and how that can play a role inus feeling fatigued, I was
thinking like, when it comes tomedication management of, you
know, depression, medicationmanagement of, you know,
(12:45):
depression, the focus and thesleepiness or fatigue are
probably the harder things totreat.
They linger for a longer time,they can be more challenging,
but it's very important that wemake sure that we rule out
medical causes before we justassume that it's all mental
health right.
So we're doing a lot ofchecking for thyroid issues
(13:09):
Anemia is another oneTestosterone hormone issues,
sleep apnea, right, or evennarcolepsy.
I know people think that it'ssilly when I talk about
narcolepsy because they're like,well, I'm not just like passing
out while like doing things, Idon't have narcolepsy, but
(13:30):
actually there is a narcolepsywithout cataplexy, and so you
know, that's where you cataplexyis, where you just, you know,
fall asleep, and so I think thatlike it is worthwhile to get
checked out, especially ifyou're one of those people that
if I sit down and relax for toolong in the afternoon, I'm
asleep and I dream right away.
(13:52):
Right, if I just go right intodreaming and I'm into REM really
quickly.
That could be an indicator thatthere could be something there.
Right, like that, earlyentrance into dreaming is not
normal, right, we're going.
We usually take, you know, alittle while to get into that
phase, even with a nap, and soif you're kind of having that
presentation, it's worth gettingchecked out from a sleep
(14:15):
medicine doctor who can diagnosenarcolepsy.
Laura (14:21):
That's really interesting.
I had no idea.
Michaela (14:24):
There's also idiopathic hypersomnia, which is
a thing.
There's really not a cause, butthey're just very tired all the
time.
And then there's chronicfatigue syndrome, which I
believe can be a symptom ofcomplex trauma as well as,
potentially, you know some ofthe viral infections that you
(14:46):
know.
Epstein-barr virus reactivationis a thing, a mono, and there's
other, you know different.
You know Lyme disease andthings like that.
Now, I'm not a specialist inthose areas, but I do try to
identify those things so that wecan refer out to those
specialists, so they can get thehelp they need so that they
don't feel so tired all the time.
Laura (15:08):
That's really interesting that you can have a
virus affect your fatigue, notjust when you are sick.
So I think about when I have acold, like of course I have
fatigue right, but once my coldis done I would think that I
would be back, you know, up andat them.
Michaela (15:29):
It's usually not that kind of cold virus that would be
causing that chronic fatigue.
I mean there you think aboutCOVID, though people are having
long COVID and they're having alot of problems with brain fog
because of long COVID.
Laura (15:43):
Yeah, yeah, all of these things make us so tired.
How do we get more energy?
How do we flip the script andsay, okay, I've got this fatigue
.
How do I combat it?
What do I do?
Michaela (16:01):
okay, I've got this fatigue.
How do I combat it?
What do I do?
Yeah, that's a good question.
So unfortunately, the answerisn't very simple, right?
So we have to identify what theunderlying cause is, and that's
what the reason for the labwork and the workup and all
those things Cause.
If it's thyroid, that's easy totreat, right, um.
If it's testosterone, that'snot too hard to treat.
If it's sleep apnea, you get aCPAP.
Um, so, medically, we treat themedical problems, um.
(16:27):
And if it's a nutrition relatedthing, you know, I think of like
, um, if I don't have enoughnutrition, then I'm just
thinking that I'm going to needto get more nutrition and be
very conscious of that.
You know, I talk a lot withclients about their circadian
rhythm of your gut and your guthas its own circadian rhythm and
so, you know, you hear peoplesay I'm just not a breakfast
(16:49):
person, I just don't eatbreakfast.
Well, yeah, of course, becauseyou, you've never really eaten
breakfast and your gut hasn'tgotten into the routine of doing
that.
But unfortunately, if you don'thave the calories, some, some
people do intermittent fastingand they, you know, there's
evidence that they, or there'sideas that they feel good with
(17:12):
it and they have more energy, um, but that's not always the case
with everybody.
And so if you're not gettingthat breakfast in your, your
crashing by the afternoon.
You're feeling grouchy, you'refeeling tired.
If you ate too many highcarbohydrate or sugary things
like a donut for breakfast,right, there's lots of sugar,
lots of carbs, and you're goingto get this really big insulin
surge and then you're going toget a crash.
(17:33):
And so things that you can do isI'm not saying you can't ever
have a donut for breakfast, butmaybe eat some almonds or some
nuts with it, get some proteinin with it.
Maybe that's not your go toevery day.
I'm not recommending thatthat's what you should eat, but
if you want, if you're going,you know we're not going to say
don't ever eat that stuff, right, but pair it with some protein,
(17:54):
and that's going to help withyou feeling more full, you're
getting a little bit morebalance in and you're slowing
down the digestion, right, andso you're not having that really
big spike of your blood sugarand insulin and then that crash
later, and that's going to helpyou.
And then you know some peopleyou know, as they're getting,
(18:16):
they're changing these thingsthey might need to eat every
protein every three hours,sometimes not a huge meal, but
they might need to get somethingin them so that their body can
start getting used to havingmore nutrition and then
preventing that crash that'shappening and then, as their
body gets more used to it, thenthey don't have to quite eat
that that frequently.
(18:37):
They can go back to three mealsa day and making sure they're
getting that balance in theirdiet.
Laura (18:44):
Yeah, I feel like I've heard to eat five to six times a
day.
Is that to keep my blood sugarsteady and stable, so that I'm
not having those crashes, and soI'm not having that tiredness
throughout the day?
Michaela (18:59):
If you're eating the right things, then yes, that
could be helpful.
You're saying it's?
six donuts a day is not going tobe the solution to my problem,
probably not, but you know, Ithink that it can be, you know,
very helpful, especially asyou're getting into that, trying
to heal your gut, you know,trying to develop that circadian
(19:23):
rhythm, and it will help withdecreasing that, that crashing
um, or even overeating, I think.
Like you know, there's I'veheard it said a number of
different times that, likehypoglycemia is when people make
the worst decisions right.
That's when, like we, we reallymess up when we're blood sugar
is low because our brain doesn'thave what it needs right
(19:46):
Glucose to function properly,and so it doesn't have that, and
so we're not going to be at ourbest when we're we're having
those crashing.
Laura (19:55):
So my nutrition, I think , is probably a big cause and
possible solution, or at leastlike a supplement, supplemental
solution.
If I'm eating well, if I'meating enough protein, I always
recommend eating protein, likechecking in on your protein
intake with you know parents whocome in and say their kids are,
(20:17):
you know, lethargic andstruggling intake with you know
parents who come in and saytheir kids are, you know,
lethargic and struggling.
Michaela (20:23):
I'm always wondering hmm, are they?
Laura (20:24):
getting enough protein and also water, drinking more
water.
I think we don't add enough.
We don't.
I don't know that everybodyvalues water at the level that
we should.
Michaela (20:39):
Yeah, I believe that's true, Although we really like
carrying around our Stanleys.
Laura (20:44):
I know I love my Stanley , but I need to drink two of
them every day in order to getenough water.
Is that right?
Michaela (20:52):
So you should drink probably about half your body
weight in water.
So if I fill up my Stanley cupand I have it filled with ice
before I put water in there, I'mnot getting whatever 40 ounces
of water.
I'm getting probably 20.
So you need to be, you have tobe careful.
(21:14):
How much ice am I using?
If you're drinking it juststraight water, two is probably
plenty, but two is probably notenough if there's a bunch of ice
in there.
So people think that they'redoing a really good job.
They're like.
I drank two of these today, butit wasn't really full too if
there was a bunch of ice inthere, unfortunately, Good point
.
Laura (21:33):
I don't like ice, I like room temperature water, so if I
drink two Stanleys, that'sprobably about right for me.
You're golden, perfect, okay.
So that's, I'm checking thatbox.
I like the idea of doing almostlike a food journal for a
period of time, right, because Idon't think that we really
(21:55):
think that hard about what we'reeating and how that's actually
affecting us.
Michaela (21:59):
Oh, 100% no, well, and I think that I like this idea.
I'm glad that you brought it up, because I think that we
underestimate our foodsensitivities, right, so we have
allergies and we're not.
You get these major reactions,but food sensitivities may not
be so obvious, and so that's oneof the other reasons why we can
(22:20):
have inflammation in our body,and that inflammation is causing
our brain to be foggy as well.
Right, and so we can reduce thethings that we're sensitive to,
that we're consuming hard toget rid of.
You know, if you're sensitiveto dairy, it's in everything.
Right, it's added into stuffthat you wouldn't even think.
(22:42):
But, but for for sure, if youcan eliminate, but if not, if
you can just dramatically reduce, you're going to feel a lot
better, and that that brain fogis going to get better as well.
How can?
Laura (22:55):
we find out?
Are there tests that we can doto determine our food
sensitivities or like our bestnutrition plan?
Is that something possible todetermine with like labs?
Michaela (23:07):
or something like that .
There is a food sensitivitytest.
So you have your IgE mediatedresponse.
That's your allergies, right?
That's what's going to comeback on an allergy test.
There are IgG testing for foodsensitivities.
Now I say this with a caveat andI tell this to my clients.
(23:27):
I think that they can be veryhelpful, especially if you don't
want to like, figure it out onyour own right.
It's a good place to start.
So just a simple food log.
You do not have to go get thistesting done.
You can do a simple food logand mark what you're when you're
having symptoms and see if youcan correlate it.
(23:48):
Maybe you're like, OK, that'snot enough.
I'm not sure my, my symptomsare there all the time.
Ok, let's try getting rid ofthe most common things dairy
wheat, like the for the gluten.
You know, those are, those aresome good eggs, right, Like
those are some of the reallycommon things.
So we're going to talk aboutwhat, what things we want to try
(24:09):
to avoid.
Okay, we're going to start witheggs.
All right, cool, we're going toget rid of eggs and we're going
to see how we do.
We're going to do that for afew weeks and then we're going
to try to reintroduce eggs onetime and see what happens.
And then, if you get symptoms,you're like, oh OK, this could
be a thing, Right, so that's away.
But you can do this IgGmediated testing and then just
(24:30):
now, you kind of have an idea.
Now the caveat with this isthat when we have dysbiosis of
the gut, when we have our gutlining, you know, when we don't
have a healthy gut right, wehave something maybe that we're
calling leaky gut now right, orthat mucosal lining gets thin.
Things are crossing throughthat barrier that normally
(24:52):
wouldn't.
And so just because you have asensitivity to something right
now doesn't mean that you willalways be sensitive to it, right
.
If you can heal that lining ofthe gut by avoiding the things
that you should avoid and youknow, take eating, you know
upping your nutrition andgetting good bacterial balance
back in your gut, if you can, ifyou can achieve that, you may
(25:14):
not be sensitive to that anymore.
Laura (25:17):
That's so interesting.
I didn't know that you couldchange your sensitivity.
Michaela (25:24):
Even stress is something that can actually.
You know, all of a sudden I'mhaving this big stressful thing,
and now I can't eat this foodright, like it bothers my
stomach, and now I feel sickevery time I eat it, and so
stress is tied to this as well,and so then, once you can get
the stress calmed back down,then our body is fine again and
(25:47):
we can tolerate that food again.
Laura (25:48):
Hmm, okay, stress also can cause quite a bit of fatigue
.
Yeah, because our brains arewired and tired, right?
You told me that phrase.
When we're stressed, we areconstantly using so much energy
on all of the wrong things.
Our bodies can't keep up withour nutrition, our bodies can't
(26:09):
keep up with our digestion thatour bodies can't keep up with
the normal everyday things thatwe're supposed to be doing, and
so it's just expending all thisenergy trying to.
It's's not working efficiently,right.
And when we're in fight orflight, we're doing the same
thing.
So stress increases our chancesof being in fight or flight mode
, right?
Well, the more stress we have,the more likely we are to be
(26:32):
spending more time in fight orflight mode, and fight or flight
mode is exhausting.
Yes, it is a high energy usagemode.
It is not one that is efficientat all.
It's not advantageous for us tomaintain this fight or flight
mode, and then often what willhappen is, when we're in fight
(26:54):
or flight, fight or flight,fight or flight then our body
switches into shutdown, andthat's when we get that shutdown
sleepy.
I'm over it.
I'm going to bed.
I just want to lay down I don'thave any energy to do anything
and we feel like we want to getup and go do something, but we
just don't have the energy forit.
Michaela (27:14):
Yeah, people who are in fight or flight for years can
end up in something calledadrenal fatigue.
Right, they're producing allthis cortisol, cortisol,
cortisol.
And you know, our bodies cometo a point where sometimes they
can't keep up anymore and thenour cortisol actually drops
(27:35):
really low and isn't respondinglike it should to the situations
.
Right, and that's exhausting,right we?
If we don't have cortisol tohelp give us what we need, we're
not getting that adrenalinetype of stuff, then we're tired,
then it feels like too much torespond to things.
Laura (27:52):
Yeah, everything feels like too much.
When we feel really overwhelmed, it's an indicator that your
fatigue is maybe taking over.
If you're starting to feel thisway, if you're noticing that
you're feeling overwhelmed a lot, if you're noticing you're
feeling like things are just toomuch like regular, menial,
everyday tasks are just sodifficult or seem kind of out of
(28:16):
reach or seem like they wouldbe really really energy
consuming more so than theyreally would be right, like
something like going for a walk.
I'm not talking about doinglike a serious exercise routine,
but just to go for a walkaround the neighborhood or do
something active generally everyday.
(28:37):
If you're feeling so fatiguedthat you're not doing that, like
you might be, that might besomething to consider.
That you want to reevaluateyour nutrition, your sleep, all
of those things.
Michaela (28:49):
Absolutely yeah, and um, when, when I think some of
the things that I'm thinkingabout too is like, um, when
we're highly stressed, like ourbrain doesn't work as well,
right, we can't remember thingsas well.
You know, there's cortisol inour brain, like there's cortisol
(29:12):
receptors on the hippocampus ofthe brain, and so kind of going
back to that, like we, that istoxic to that brain and makes us
kind of not remember things aswell, which is contributing to
more stress.
Laura (29:27):
And the brain fog, and when we feel foggy and just not
quite right, we're not doing ourbest, we're not able to perform
at our best, we're not able tomanage our day quite as well.
We're not able to stay asorganized.
We're not able to manage ourday quite as well.
We're not able to stay asorganized.
We're not able to maintainfocus.
All of those things contributeto our stress and it's sort of a
(29:48):
vicious cycle.
It sounds like.
Michaela (29:52):
Also, when people have adrenal fatigue, I tell them
not to exercise strenuously,right, because it actually can
make them feel so much worsebecause they don't have the
cortisol to respond to thatheavy exercise and so it can be
even more depleting for them.
But I do think that, you know, Ithink about the upward spiral
(30:16):
or the downward spiral ofdepression.
So maybe we've talked about thishere before, but you know, I
think that, like when we feeldepressed, we don't want to do
things and then we don't dothings, so then we feel more
depressed and don't want to domore things and it just kind of
digs this hole down, down, down,and we end up feeling so much
(30:38):
worse.
And so sometimes, even when wedon't want to do it, even when
it sounds like not that much fun, even if we know that it's not
going to be as fun as it used tobe, I think that doing stuff,
whatever it is your hobby, awalk, you know, spending time
with friends, whatever that isthat you are trying to avoid I
(31:01):
think you need to go do it.
I think that it's going to behard and it's going to be not
great, but it's not going to beas bad as what you assume that
it's going to be, and so that isone way to get your energy back
right.
Like you think about, um, youknow, doing things that give us
energy, that help fill us up andgive us positive feelings, and
(31:26):
it's not like, oh, that was themost fun thing ever, but it's
going to get us going in theright direction, and so the more
we do things, the more fun theyare and the less we feel sad
and alone.
Laura (31:38):
Yeah, behavioral activation doing a food log,
getting on a routine, going fora walk each day, engaging in
some kind of hobby, engaging inconnection with others Once per
day each of those things doesn'ttake that much time, right?
You could do all of thosethings in a 30-minute period and
(32:00):
I'm saying just do them eachsometime throughout the day.
That behavioral activation canactually give you more energy
and give you a bigger sense ofsatisfaction.
It can alleviate depression andactivity.
So, even not strenuous, butjust walking, whatever activity,
exercise is a very, veryeffective treatment for
(32:23):
depression.
In conjunction with all theseother things that we're talking
about here, if you areexperiencing depression and you
have medication for it and youhave fatigue still, some of this
stuff could be what it takes totake you over the edge of
feeling a little bit better.
Mm-hmm.
Michaela (32:41):
Yep, I think morning sun is underappreciated as well.
So we're talking aboutcircadian rhythm of our gut and
getting that back.
We also want to get circadianrhythm of our brain back on
track right.
So, like getting out andfeeling the sun on our skin and
the light coming into our eyeshelps start that circadian
(33:02):
rhythm of decreasing that nap,that melatonin in our brain
Right.
But we get up and we're in adark room and like our brain
still is just seeing darkness,that melatonin is still going to
be high, right, it's not goingto be getting that, that light
that tells us to go down.
That helps with decreasingfatigue.
Laura (33:23):
That's a really good point.
I see those wake-up alarmclocks that kind of simulate the
sunrise, and I think that's thescience behind it If you can
wake up in the morning with thesun I'm not saying wake up with
the sunrise necessarily, butwaking up and experiencing the
(33:45):
sunshine that is available atthe time that you wake up is a
really good way to give yourselfan energy boost.
Also, there are foods that youcan eat that do provide energy.
I mean, we talked a little bitabout protein, but I think I
read somewhere once that anapple has more energy, like
(34:06):
producing material, than than acup of coffee.
I didn't know that, but I don'tknow if it's that caffeinated.
I don't know if apples arecaffeinated, that's not what I'm
saying, but like they create asmuch energy as like the
caffeine in a cup of coffee.
Yeah, an apple and some almondsAn apple and some almonds, some
(34:26):
energy producing apples andenergy producing protein, and
keep you full longer, andthere's so many good things
about that.
That's a really good way tostart your day.
Michaela (34:38):
Back to the sun thing.
So not everybody has time tolike pop outside, sit and sip
their coffee in the sunlight,right.
We're busy human beings withjobs and kids and all that stuff
, but we are all doing somethingin the morning that we can get
these light therapy lamps and wecan sell them on Amazon.
(35:01):
They don't have they're notsuper expensive some of them and
so you can get this light andyou don't want to look directly
at it, but you can like set iton your desk in the morning when
you first start working, or youcan set it up in your bathroom
to kind of shine on you whileyou're getting ready in the
(35:22):
morning, and that can be analternative to the sunlight,
right, getting that same thinggoing in the morning.
Laura (35:31):
Yes, I love that.
I actually have one of thoseand I love it.
I think it works really well.
It really does help me it hasgood data behind it.
I've never used one, but yeah,I'm like a houseplant with
feelings.
I need light and I need waterand that's pretty much it and
I'm good to go.
(35:51):
Some lab tests we mentioned afood log.
We've talked through a coupleof different ways.
What other types of screeningscan help us determine the root
cause of our fatigue?
Michaela (36:10):
I'm sure I'm missing something here, but, like, I
feel like we covered a lot ofthe big, big things.
I think the biggest thing isjust meeting with a provider who
is well-versed in, like, andlooking for all the things.
Right, I know we've all been tothe provider where they're like
(36:31):
, you know you have heartpalpitations, you must be
anxious or you know you must bedepressed.
This is just depression, right,like, and they're not looking
at the person as a whole, right?
So you're going to seek outsomebody who is going to dig
deep and look at you as a wholeperson?
Um, because you are, you'redynamic.
(36:55):
There's not just one thing.
It could be multiple thingscontributing to it, um, the.
The other thing that just popsinto my head is obesity, right?
Um, there are, so there's somany, um, you know, options out
there for people to help themand support them with, uh,
(37:15):
managing their weight, right,and, um, the reason I mentioned
this is because it createsinflammation in the body, and
inflammation is a driving forceof depression.
So, not only do you feeldepressed, you don't like how
you look, or you feeluncomfortable in your skin, but
(37:35):
it's also creating and wreakinghavoc in your body from, like,
an inflammatory standpoint andthat's a major contributing
factor of depression.
They've tied having elevatedCRP levels, which is an
inflammatory marker in our body,to increased risk of depression
.
Laura (37:52):
Interesting yeah.
That's a really good point.
Michaela (37:56):
So I mean, even like lithium levels, like lithium is
supposed to be in our soil, andI think that there's probably a
varying range and it can bedepleted in some areas.
And they've really studied andlooked around at lithium levels
in the soil and the drinkingwater, right, and the risk of
(38:16):
depression and suicidal suicideattempts?
I think, or maybe, just yeah, Ithink it's suicide attempts
maybe.
And the lower the amount oflithium in our our drinking
water and in our food, thehigher rates of depression.
Wow, our bodies are reallyconnected.
(38:39):
We are a whole person with it'svery multifactorial, and so you
need someone who's going to beable to you can find someone
that's able to help you kind offigure out what's going on for
you, then that's going to be thebest bet.
Laura (39:11):
And what about hormone testing?
Michaela (39:14):
Yeah, you can do hormone testing and see what's
going on there.
I think you know, I know I'mI'm approaching my forties and I
know that there are a lot ofwomen that I see kind of getting
into that perimenopausal timeperiod and all of a sudden
they're like man, I'm just soanxious all the time and I can't
(39:36):
, I can't find anything and I'mdistracted and I'm not sleeping
at night, right, and a lot oftimes they'll go and get put on
an SSRI, right Antidepressantfor for their insomnia, anxiety,
maybe depression that they'rehaving.
But ultimately it could be thatthe insomnia could be tied to
low progesterone, right.
(39:57):
That starts going down anywherebetween you know, around 10
years, even before you startgoing through menopause, and so
there very well could be a tiebetween that hormone imbalance
and the insomnia and fatiguethat they're feeling during that
time of their life,specifically, probably in
additional times of life, thathormones are imbalanced.
(40:22):
So yeah, that's a good point,okay.
Laura (40:26):
So we can get some labs.
We can see a holistic providerwho knows about more than just
one thing and is looking atourself as a whole person, and
we can kind of monitor our food.
We can take a look at our sleephygiene and our bedtime routine
and track whether or not we'redreaming.
(40:47):
Those are really helpful.
Michaela (40:50):
You can also go seek therapy right Like for
depression, anxiety underlyingtrauma.
There are really goodtherapists out there that can
help with that Someone who'strained in cognitive behavioral
therapy for insomnia rightSpecific treatment that helps
with people developing bettersleep habits and decreasing the
(41:15):
anxiety around sleep, because Ido feel like that's probably one
of the biggest driving forcesfor continued insomnia.
Everybody has a bad night ofsleep, but sometimes people get
so anxious about not sleepingand not feeling good the next
day that it can drive thatanxiety up at nighttime and make
(41:36):
it more of a habitual thing.
Laura (41:37):
So that's another thing that you can do habitual thing,
so that's another thing that youcan do.
That's a good point.
Therapy is always somethingthat I recommend.
Obviously, as a therapist, Ifind it to be very helpful, and
when we talked about some traumaand we talked about depression
and we talked about anxiety andall of these different things,
you know, therapy can be reallyhelpful for that, and so finding
(41:59):
a good therapist who is wellversed in all of those things is
really really helpful for that,and so finding a good therapist
who is well-versed in all ofthose things is really really
helpful as well.
Absolutely Okay.
Well, thank you so much forthis conversation today.
This is incredibly informative.
Yeah, this was fun, and thankyou for listening to.
Why Am I Like this?
If you like our show, pleaseleave us a rating and review on
(42:19):
your favorite podcast platform,Follow the show and share it
with your friends.
This episode was written andproduced by me, Laura Wood and
Michelle Bieber.
Our theme song is Making EndsMeet by Thick as Thieves, and a
special thanks to BeneveryCounseling and Coaching and
Active Healing PsychiatricServices for sponsoring this
show.
Hello and welcome to.
Why Am I Like this?
The podcast for those whodidn't get enough hugs as a
child?
I'm Laura Wood and I'm a traumatherapist.
Michaela (00:13):
Hi and I'm MishMayla.
I am a psychiatric nursepractitioner.
Laura (00:18):
So, M, why are we doing this podcast?
Michaela (00:21):
I'm so glad you asked.
We want to help you understandyourself a little bit better,
like how the things you learnedabout yourself and the world and
childhood are still affectingyou today.
We want to figure out why arewe like this, those random
things about ourselves that wemight wonder like why am I so
jumpy, why am I so anxious?
Why do I take everythingpersonally?
(00:42):
Why are my thoughts so negative?
Why do I feel like I have tofix everything all the time?
Laura (00:48):
Yes, so we are trying to dig into fatigue today, so
we're going to try to answer thefollowing question why am I so
tired all the time?
How do I get more energy andwhat else can we do to learn
about the root cause of ourfatigue why are we so tired?
This?
Michaela (01:09):
is such an interesting question and I feel like, well,
what is fatigue right?
Like, is it that we just feelsleepy, right?
So I think that there'sdifferent things and different
pieces of this.
Right, there's like the I feelsleepy part and there's also the
(01:33):
I don't have like the physicalenergy part of fatigue, right,
um, but I think I think thatthere's multiple causes for
fatigue.
Um, the first thing that wenormally like think about is
like, are you sleeping Right?
Tell me about your sleep atnight, and trying to understand,
(01:54):
like, what is the quality ofsleep that you are getting?
So, are you having troublefalling asleep?
Are you having trouble stayingasleep?
Are you getting up like 800times in the night to go to the
bathroom, or because you have akid waking you up?
So you know, sleep quality isreally important.
Another thing that we talk aboutis having good sleep hygiene,
(02:17):
because you know we don't alwaysthink about, like you know, tv
or things like that, having youactually like you think like, oh
, it's just, I'm not going to beable to fall asleep, but why am
I waking up in the middle ofthe night?
Well, maybe the TV, and thatyou know that adrenaline is
still contributing to you wakingup in the middle of the night?
(02:38):
Did you drink alcohol beforebed?
Sometimes alcohol will kind ofwear off in the middle of the
night, make us wake up and notget very good sleep.
Interestingly, the other thingthat I talk a lot about with
people is weed.
So people are very commonlyusing marijuana to try to get to
sleep.
That's a thing that people dovery often, right, and it works
(03:01):
Right.
It actually helps them.
You know, we talked about likethey're stoning the hamster,
right, so the hamster is runningon the wheel, running on the
wheel and they can't get theirbrain to stop.
So they stone the hamster,right, so we're shutting down
our brain and we're lettingourselves calm down so we can
get sleep.
But what people don't know aboutit is is that it's actually
(03:21):
impairing your ability to getinto REM sleep.
So I don't know a lot of mypatients that I talk to.
I'm like they tell me they useweed to go to sleep and I'm like
do you dream at night?
And the answer typically like90% of the time I would say is
no, and that's because they'renot getting into that REM sleep
(03:42):
and thus they're not gettingthat the full sleep cycle and
then they wake up feeling tired.
Even though they could get tosleep, they're still tired
throughout the day because theydidn't get quality sleep.
So that's number one thing thatI kind of talk about and look
at.
Laura (03:56):
Yeah, that's so interesting.
So you're saying that if youdon't get the full sleep cycle,
then that can be a reason whyyou wake up tired.
So what is so important aboutREM sleep?
Michaela (04:08):
Well, I'm not like a Freudian person, but I think
that there's a lot of ideasabout what happens in REM and
how our dreams are a big pieceof us being able to process
things.
Laura (04:22):
Yeah, when we're dreaming, we're processing
information right, we'relearning.
We're moving information fromour short-term memory to our
long-term storage.
We are like clearing out.
It's kind of like clearing yourcash and cookies on your
computer.
Yeah, I'm terrible at that.
Yeah, so you got to remember todo that, otherwise all this
(04:43):
stuff just gets built up andthat's why, like if you don't
sleep for like a significantperiod of time, like you'll just
start to glitch, like you'lljust start to not work properly
anymore, like your brain doesn'twork properly, like.
So when I think about fatigue,sleep is a good one.
I think sleep hygiene is oftenoverlooked.
(05:04):
We don't think about like howmuch, what is our bedtime
routine?
Like going into the eveningwith a plan to relax and wind
down and actually make the bestof your nighttime routine could
be really helpful.
But I also think aboutdepression.
Fatigue to me is just linked todepression, and I don't know if
(05:30):
that's the same like, if youfeel that same way.
But the DSM, the DiagnosticStatistical Manual of Mental
Disorders, is what we use tolike diagnose and categorize
different disorders, so like ifyou have anxiety disorder or
depression or you know one ofthese things.
(05:51):
Fatigue is a symptom of a lotof different disorders, but it
can be mental, it can be aboutnot being able to shut your mind
down, not being able to recoverfrom the shutdown.
So, like with depression andfatigue, and depression is
(06:15):
shutting down your body andshutting down your mind to
probably avoid things that aredifficult.
So, even if we're notconsciously avoiding them, we're
avoiding difficult experiencesthat lead to our depression or
that are triggers for ourdepression.
So, for example, going to work,getting out of bed, you know,
(06:39):
taking a shower, getting readyin the morning, if we're feeling
depressed, all of that stuff isreally difficult to do.
We're avoiding all of thatstuff because it just doesn't
seem like it's going to besatisfying or give us joy in any
way.
We talked about that when wetalked about procrastination too
.
Michaela (06:56):
Right, don't you think that being sleepy is actually
an avoidance technique fortrying to not have to deal with
the things?
Right, that's what you'resaying, yeah.
Laura (07:09):
I do believe that that's true.
Being sleepy and shut down is away of just avoiding distress.
I'd rather be sleepy than sad.
I'd rather be sleepy than upsetor dysregulated in some way,
and so it is a sign ofdysregulation when we're super
fatigued all the time.
It could be a sense that couldbe derived from trauma as well.
(07:31):
Yeah, trauma can cause this.
Michaela (07:34):
The other thing that I was thinking about too, that
something that you said made mybrain go there, was you're
talking about sleep hygiene andI'm thinking, isn't that
something that we probablydeveloped to like as a kid, like
our ability to be able to learnto shut down our brain, and how
we learned how to fall asleepin childhood, like if we didn't
(07:58):
ever learn that skill?
You know, maybe we were able tojust watch TV until we fell
asleep and that seemed to work,and so, you know, we just that's
what our parents let us do, butyou know, then we didn't really
ever learn how to clear ourbrains, to allow ourselves to
self-soothe, to be able to go tosleep.
Laura (08:22):
Yes, I think absolutely.
We learned this in childhood.
We learn the process, but Ithink we also learn the
importance of it too.
So we're not only we'relearning how to fall asleep and
if that's through using the TVor using unhealthy ways to go to
sleep we're learning that inchildhood but we're also
learning.
Is it important for us to takecare of our sleep?
(08:44):
Is it important for us to focuson our sleep and get enough
sleep and recognize the impactof our sleep?
When we're kids, one of the mostdifficult times in our day is
bedtime, because we don't wantto have to miss out.
We don't want to miss out.
(09:05):
We don't want to have to beseparated from our caregivers.
We want to stay connected withthem.
We don't want to, you know, bealone.
So we want our caregiver to bepart of that bedtime routine.
And sometimes, if it's not partof our bedtime routine and
we're just left to our owndevices, as a little kid we
(09:26):
might not ever have learned howto self-soothe.
We've never had thatopportunity to learn how to lay
down and feel safe and rest.
You know, nighttime can also bereally triggering for those
who've experienced childhoodtrauma and who were abused at
night.
You know, nighttime canrepresent a time that is not
(09:47):
safe for people and that can bea really big issue when it comes
to getting good sleep.
Michaela (09:54):
Yeah, that's a very good point.
I have conversations withparents all the time and they're
like, oh my kid, they just wantto keep coming back out and
asking for water.
And can I get another story, orcan I have some snack?
And one of the things that wetalk about is like, well, could
this be a cry for attention?
(10:16):
Right, is this actually them,you know, struggling for falling
asleep, or is it just thatthey're looking for you and
needing connection?
Laura (10:28):
Most of the time it is that connection.
And so there's a handful oftimes in a child's life that are
really difficult and thatrequire a lot of connection,
because that's when they get themost the secretion of the most
bonding hormones, which isbedtime.
I get the most the secretion ofthe most bonding hormones,
which is bedtime.
So nighttime feeding behaviors,so like when we're feeding our
(10:51):
children and when they're eatingthey're getting nourished by us
, so they're feeling really.
They're feeling reallyconnected.
And we also feel reallyconnected when we're being
groomed by our caregiver, solike hair brushing, teeth
brushing, showering, bathing,all of that stuff.
Those are the three mostdifficult times of any kid's day
is feeding, grooming andnighttime.
(11:14):
That's when we needed moresupport as kids.
Michaela (11:18):
Well, and I always thought, or I was thinking, that
like part of the fact that theydon't want to brush their teeth
and do all that stuff isbecause they know what's coming
next.
They're like if I get in thebath, then I have to go to bed,
and I don't want to go to bedbecause that means I'm alone.
Laura (11:33):
Yeah, that's possible too.
It's like leading up to thosekinds of things and, you know,
we learn these things as kids,whether or not we're going to be
cared for or whether we'regoing to be left on our own, and
so we might have some likeresidual stuff about going to
bed and ending our day.
You know, I think about peoplewho say have you ever heard
(11:56):
people say like, oh, you'llsleep when you're dead?
Like I don't want to miss out,like I want to stay up, I want
to maximize my day, I want to,you know, be awake and do fun
things, and I don't want to stayup.
I want to maximize my day, Iwant to be awake and do fun
things and I don't want to missout on the hours.
So that's something I think welearn in childhood.
I think that's a habit, that isa rollover, for sure.
Michaela (12:19):
Yeah, I could see that definitely being a case.
Well, and you know, as you weretalking about the depression
and how that can play a role inus feeling fatigued, I was
thinking like, when it comes tomedication management of, you
know, depression, medicationmanagement of, you know,
(12:45):
depression, the focus and thesleepiness or fatigue are
probably the harder things totreat.
They linger for a longer time,they can be more challenging,
but it's very important that wemake sure that we rule out
medical causes before we justassume that it's all mental
health right.
So we're doing a lot ofchecking for thyroid issues
(13:09):
Anemia is another oneTestosterone hormone issues,
sleep apnea, right, or evennarcolepsy.
I know people think that it'ssilly when I talk about
narcolepsy because they're like,well, I'm not just like passing
out while like doing things, Idon't have narcolepsy, but
(13:30):
actually there is a narcolepsywithout cataplexy, and so you
know, that's where you cataplexyis, where you just, you know,
fall asleep, and so I think thatlike it is worthwhile to get
checked out, especially ifyou're one of those people that
if I sit down and relax for toolong in the afternoon, I'm
asleep and I dream right away.
(13:52):
Right, if I just go right intodreaming and I'm into REM really
quickly.
That could be an indicator thatthere could be something there.
Right, like that, earlyentrance into dreaming is not
normal, right, we're going.
We usually take, you know, alittle while to get into that
phase, even with a nap, and soif you're kind of having that
presentation, it's worth gettingchecked out from a sleep
(14:15):
medicine doctor who can diagnosenarcolepsy.
Laura (14:21):
That's really interesting.
I had no idea.
Michaela (14:24):
There's also idiopathic hypersomnia, which is
a thing.
There's really not a cause, butthey're just very tired all the
time.
And then there's chronicfatigue syndrome, which I
believe can be a symptom ofcomplex trauma as well as,
potentially, you know some ofthe viral infections that you
(14:46):
know.
Epstein-barr virus reactivationis a thing, a mono, and there's
other, you know different.
You know Lyme disease andthings like that.
Now, I'm not a specialist inthose areas, but I do try to
identify those things so that wecan refer out to those
specialists, so they can get thehelp they need so that they
don't feel so tired all the time.
Laura (15:08):
That's really interesting that you can have a
virus affect your fatigue, notjust when you are sick.
So I think about when I have acold, like of course I have
fatigue right, but once my coldis done I would think that I
would be back, you know, up andat them.
Michaela (15:29):
It's usually not that kind of cold virus that would be
causing that chronic fatigue.
I mean there you think aboutCOVID, though people are having
long COVID and they're having alot of problems with brain fog
because of long COVID.
Laura (15:43):
Yeah, yeah, all of these things make us so tired.
How do we get more energy?
How do we flip the script andsay, okay, I've got this fatigue
.
How do I combat it?
What do I do?
Michaela (16:01):
okay, I've got this fatigue.
How do I combat it?
What do I do?
Yeah, that's a good question.
So unfortunately, the answerisn't very simple, right?
So we have to identify what theunderlying cause is, and that's
what the reason for the labwork and the workup and all
those things Cause.
If it's thyroid, that's easy totreat, right, um.
If it's testosterone, that'snot too hard to treat.
If it's sleep apnea, you get aCPAP.
Um, so, medically, we treat themedical problems, um.
(16:27):
And if it's a nutrition relatedthing, you know, I think of like
, um, if I don't have enoughnutrition, then I'm just
thinking that I'm going to needto get more nutrition and be
very conscious of that.
You know, I talk a lot withclients about their circadian
rhythm of your gut and your guthas its own circadian rhythm and
so, you know, you hear peoplesay I'm just not a breakfast
(16:49):
person, I just don't eatbreakfast.
Well, yeah, of course, becauseyou, you've never really eaten
breakfast and your gut hasn'tgotten into the routine of doing
that.
But unfortunately, if you don'thave the calories, some, some
people do intermittent fastingand they, you know, there's
evidence that they, or there'sideas that they feel good with
(17:12):
it and they have more energy, um, but that's not always the case
with everybody.
And so if you're not gettingthat breakfast in your, your
crashing by the afternoon.
You're feeling grouchy, you'refeeling tired.
If you ate too many highcarbohydrate or sugary things
like a donut for breakfast,right, there's lots of sugar,
lots of carbs, and you're goingto get this really big insulin
surge and then you're going toget a crash.
(17:33):
And so things that you can do isI'm not saying you can't ever
have a donut for breakfast, butmaybe eat some almonds or some
nuts with it, get some proteinin with it.
Maybe that's not your go toevery day.
I'm not recommending thatthat's what you should eat, but
if you want, if you're going,you know we're not going to say
don't ever eat that stuff, right, but pair it with some protein,
(17:54):
and that's going to help withyou feeling more full, you're
getting a little bit morebalance in and you're slowing
down the digestion, right, andso you're not having that really
big spike of your blood sugarand insulin and then that crash
later, and that's going to helpyou.
And then you know some peopleyou know, as they're getting,
(18:16):
they're changing these thingsthey might need to eat every
protein every three hours,sometimes not a huge meal, but
they might need to get somethingin them so that their body can
start getting used to havingmore nutrition and then
preventing that crash that'shappening and then, as their
body gets more used to it, thenthey don't have to quite eat
that that frequently.
(18:37):
They can go back to three mealsa day and making sure they're
getting that balance in theirdiet.
Laura (18:44):
Yeah, I feel like I've heard to eat five to six times a
day.
Is that to keep my blood sugarsteady and stable, so that I'm
not having those crashes, and soI'm not having that tiredness
throughout the day?
Michaela (18:59):
If you're eating the right things, then yes, that
could be helpful.
You're saying it's?
six donuts a day is not going tobe the solution to my problem,
probably not, but you know, Ithink that it can be, you know,
very helpful, especially asyou're getting into that, trying
to heal your gut, you know,trying to develop that circadian
(19:23):
rhythm, and it will help withdecreasing that, that crashing
um, or even overeating, I think.
Like you know, there's I'veheard it said a number of
different times that, likehypoglycemia is when people make
the worst decisions right.
That's when, like we, we reallymess up when we're blood sugar
is low because our brain doesn'thave what it needs right
(19:46):
Glucose to function properly,and so it doesn't have that, and
so we're not going to be at ourbest when we're we're having
those crashing.
Laura (19:55):
So my nutrition, I think , is probably a big cause and
possible solution, or at leastlike a supplement, supplemental
solution.
If I'm eating well, if I'meating enough protein, I always
recommend eating protein, likechecking in on your protein
intake with you know parents whocome in and say their kids are,
(20:17):
you know, lethargic andstruggling intake with you know
parents who come in and saytheir kids are, you know,
lethargic and struggling.
Michaela (20:23):
I'm always wondering hmm, are they?
Laura (20:24):
getting enough protein and also water, drinking more
water.
I think we don't add enough.
We don't.
I don't know that everybodyvalues water at the level that
we should.
Michaela (20:39):
Yeah, I believe that's true, Although we really like
carrying around our Stanleys.
Laura (20:44):
I know I love my Stanley , but I need to drink two of
them every day in order to getenough water.
Is that right?
Michaela (20:52):
So you should drink probably about half your body
weight in water.
So if I fill up my Stanley cupand I have it filled with ice
before I put water in there, I'mnot getting whatever 40 ounces
of water.
I'm getting probably 20.
So you need to be, you have tobe careful.
(21:14):
How much ice am I using?
If you're drinking it juststraight water, two is probably
plenty, but two is probably notenough if there's a bunch of ice
in there.
So people think that they'redoing a really good job.
They're like.
I drank two of these today, butit wasn't really full too if
there was a bunch of ice inthere, unfortunately, Good point
.
Laura (21:33):
I don't like ice, I like room temperature water, so if I
drink two Stanleys, that'sprobably about right for me.
You're golden, perfect, okay.
So that's, I'm checking thatbox.
I like the idea of doing almostlike a food journal for a
period of time, right, because Idon't think that we really
(21:55):
think that hard about what we'reeating and how that's actually
affecting us.
Michaela (21:59):
Oh, 100% no, well, and I think that I like this idea.
I'm glad that you brought it up, because I think that we
underestimate our foodsensitivities, right, so we have
allergies and we're not.
You get these major reactions,but food sensitivities may not
be so obvious, and so that's oneof the other reasons why we can
(22:20):
have inflammation in our body,and that inflammation is causing
our brain to be foggy as well.
Right, and so we can reduce thethings that we're sensitive to,
that we're consuming hard toget rid of.
You know, if you're sensitiveto dairy, it's in everything.
Right, it's added into stuffthat you wouldn't even think.
(22:42):
But, but for for sure, if youcan eliminate, but if not, if
you can just dramatically reduce, you're going to feel a lot
better, and that that brain fogis going to get better as well.
How can?
Laura (22:55):
we find out?
Are there tests that we can doto determine our food
sensitivities or like our bestnutrition plan?
Is that something possible todetermine with like labs?
Michaela (23:07):
or something like that .
There is a food sensitivitytest.
So you have your IgE mediatedresponse.
That's your allergies, right?
That's what's going to comeback on an allergy test.
There are IgG testing for foodsensitivities.
Now I say this with a caveat andI tell this to my clients.
(23:27):
I think that they can be veryhelpful, especially if you don't
want to like, figure it out onyour own right.
It's a good place to start.
So just a simple food log.
You do not have to go get thistesting done.
You can do a simple food logand mark what you're when you're
having symptoms and see if youcan correlate it.
(23:48):
Maybe you're like, OK, that'snot enough.
I'm not sure my, my symptomsare there all the time.
Ok, let's try getting rid ofthe most common things dairy
wheat, like the for the gluten.
You know, those are, those aresome good eggs, right, Like
those are some of the reallycommon things.
So we're going to talk aboutwhat, what things we want to try
(24:09):
to avoid.
Okay, we're going to start witheggs.
All right, cool, we're going toget rid of eggs and we're going
to see how we do.
We're going to do that for afew weeks and then we're going
to try to reintroduce eggs onetime and see what happens.
And then, if you get symptoms,you're like, oh OK, this could
be a thing, Right, so that's away.
But you can do this IgGmediated testing and then just
(24:30):
now, you kind of have an idea.
Now the caveat with this isthat when we have dysbiosis of
the gut, when we have our gutlining, you know, when we don't
have a healthy gut right, wehave something maybe that we're
calling leaky gut now right, orthat mucosal lining gets thin.
Things are crossing throughthat barrier that normally
(24:52):
wouldn't.
And so just because you have asensitivity to something right
now doesn't mean that you willalways be sensitive to it, right
.
If you can heal that lining ofthe gut by avoiding the things
that you should avoid and youknow, take eating, you know
upping your nutrition andgetting good bacterial balance
back in your gut, if you can, ifyou can achieve that, you may
(25:14):
not be sensitive to that anymore.
Laura (25:17):
That's so interesting.
I didn't know that you couldchange your sensitivity.
Michaela (25:24):
Even stress is something that can actually.
You know, all of a sudden I'mhaving this big stressful thing,
and now I can't eat this foodright, like it bothers my
stomach, and now I feel sickevery time I eat it, and so
stress is tied to this as well,and so then, once you can get
the stress calmed back down,then our body is fine again and
(25:47):
we can tolerate that food again.
Laura (25:48):
Hmm, okay, stress also can cause quite a bit of fatigue
.
Yeah, because our brains arewired and tired, right?
You told me that phrase.
When we're stressed, we areconstantly using so much energy
on all of the wrong things.
Our bodies can't keep up withour nutrition, our bodies can't
(26:09):
keep up with our digestion thatour bodies can't keep up with
the normal everyday things thatwe're supposed to be doing, and
so it's just expending all thisenergy trying to.
It's's not working efficiently,right.
And when we're in fight orflight, we're doing the same
thing.
So stress increases our chancesof being in fight or flight mode
, right?
Well, the more stress we have,the more likely we are to be
(26:32):
spending more time in fight orflight mode, and fight or flight
mode is exhausting.
Yes, it is a high energy usagemode.
It is not one that is efficientat all.
It's not advantageous for us tomaintain this fight or flight
mode, and then often what willhappen is, when we're in fight
(26:54):
or flight, fight or flight,fight or flight then our body
switches into shutdown, andthat's when we get that shutdown
sleepy.
I'm over it.
I'm going to bed.
I just want to lay down I don'thave any energy to do anything
and we feel like we want to getup and go do something, but we
just don't have the energy forit.
Michaela (27:14):
Yeah, people who are in fight or flight for years can
end up in something calledadrenal fatigue.
Right, they're producing allthis cortisol, cortisol,
cortisol.
And you know, our bodies cometo a point where sometimes they
can't keep up anymore and thenour cortisol actually drops
(27:35):
really low and isn't respondinglike it should to the situations
.
Right, and that's exhausting,right we?
If we don't have cortisol tohelp give us what we need, we're
not getting that adrenalinetype of stuff, then we're tired,
then it feels like too much torespond to things.
Laura (27:52):
Yeah, everything feels like too much.
When we feel really overwhelmed, it's an indicator that your
fatigue is maybe taking over.
If you're starting to feel thisway, if you're noticing that
you're feeling overwhelmed a lot, if you're noticing you're
feeling like things are just toomuch like regular, menial,
everyday tasks are just sodifficult or seem kind of out of
(28:16):
reach or seem like they wouldbe really really energy
consuming more so than theyreally would be right, like
something like going for a walk.
I'm not talking about doinglike a serious exercise routine,
but just to go for a walkaround the neighborhood or do
something active generally everyday.
(28:37):
If you're feeling so fatiguedthat you're not doing that, like
you might be, that might besomething to consider.
That you want to reevaluateyour nutrition, your sleep, all
of those things.
Michaela (28:49):
Absolutely yeah, and um, when, when I think some of
the things that I'm thinkingabout too is like, um, when
we're highly stressed, like ourbrain doesn't work as well,
right, we can't remember thingsas well.
You know, there's cortisol inour brain, like there's cortisol
(29:12):
receptors on the hippocampus ofthe brain, and so kind of going
back to that, like we, that istoxic to that brain and makes us
kind of not remember things aswell, which is contributing to
more stress.
Laura (29:27):
And the brain fog, and when we feel foggy and just not
quite right, we're not doing ourbest, we're not able to perform
at our best, we're not able tomanage our day quite as well.
We're not able to stay asorganized.
We're not able to manage ourday quite as well.
We're not able to stay asorganized.
We're not able to maintainfocus.
All of those things contributeto our stress and it's sort of a
(29:48):
vicious cycle.
It sounds like.
Michaela (29:52):
Also, when people have adrenal fatigue, I tell them
not to exercise strenuously,right, because it actually can
make them feel so much worsebecause they don't have the
cortisol to respond to thatheavy exercise and so it can be
even more depleting for them.
But I do think that, you know, Ithink about the upward spiral
(30:16):
or the downward spiral ofdepression.
So maybe we've talked about thishere before, but you know, I
think that, like when we feeldepressed, we don't want to do
things and then we don't dothings, so then we feel more
depressed and don't want to domore things and it just kind of
digs this hole down, down, down,and we end up feeling so much
(30:38):
worse.
And so sometimes, even when wedon't want to do it, even when
it sounds like not that much fun, even if we know that it's not
going to be as fun as it used tobe, I think that doing stuff,
whatever it is your hobby, awalk, you know, spending time
with friends, whatever that isthat you are trying to avoid I
(31:01):
think you need to go do it.
I think that it's going to behard and it's going to be not
great, but it's not going to beas bad as what you assume that
it's going to be, and so that isone way to get your energy back
right.
Like you think about, um, youknow, doing things that give us
energy, that help fill us up andgive us positive feelings, and
(31:26):
it's not like, oh, that was themost fun thing ever, but it's
going to get us going in theright direction, and so the more
we do things, the more fun theyare and the less we feel sad
and alone.
Laura (31:38):
Yeah, behavioral activation doing a food log,
getting on a routine, going fora walk each day, engaging in
some kind of hobby, engaging inconnection with others Once per
day each of those things doesn'ttake that much time, right?
You could do all of thosethings in a 30-minute period and
(32:00):
I'm saying just do them eachsometime throughout the day.
That behavioral activation canactually give you more energy
and give you a bigger sense ofsatisfaction.
It can alleviate depression andactivity.
So, even not strenuous, butjust walking, whatever activity,
exercise is a very, veryeffective treatment for
(32:23):
depression.
In conjunction with all theseother things that we're talking
about here, if you areexperiencing depression and you
have medication for it and youhave fatigue still, some of this
stuff could be what it takes totake you over the edge of
feeling a little bit better.
Mm-hmm.
Michaela (32:41):
Yep, I think morning sun is underappreciated as well.
So we're talking aboutcircadian rhythm of our gut and
getting that back.
We also want to get circadianrhythm of our brain back on
track right.
So, like getting out andfeeling the sun on our skin and
the light coming into our eyeshelps start that circadian
(33:02):
rhythm of decreasing that nap,that melatonin in our brain
Right.
But we get up and we're in adark room and like our brain
still is just seeing darkness,that melatonin is still going to
be high, right, it's not goingto be getting that, that light
that tells us to go down.
That helps with decreasingfatigue.
Laura (33:23):
That's a really good point.
I see those wake-up alarmclocks that kind of simulate the
sunrise, and I think that's thescience behind it If you can
wake up in the morning with thesun I'm not saying wake up with
the sunrise necessarily, butwaking up and experiencing the
(33:45):
sunshine that is available atthe time that you wake up is a
really good way to give yourselfan energy boost.
Also, there are foods that youcan eat that do provide energy.
I mean, we talked a little bitabout protein, but I think I
read somewhere once that anapple has more energy, like
(34:06):
producing material, than than acup of coffee.
I didn't know that, but I don'tknow if it's that caffeinated.
I don't know if apples arecaffeinated, that's not what I'm
saying, but like they create asmuch energy as like the
caffeine in a cup of coffee.
Yeah, an apple and some almondsAn apple and some almonds, some
(34:26):
energy producing apples andenergy producing protein, and
keep you full longer, andthere's so many good things
about that.
That's a really good way tostart your day.
Michaela (34:38):
Back to the sun thing.
So not everybody has time tolike pop outside, sit and sip
their coffee in the sunlight,right.
We're busy human beings withjobs and kids and all that stuff
, but we are all doing somethingin the morning that we can get
these light therapy lamps and wecan sell them on Amazon.
(35:01):
They don't have they're notsuper expensive some of them and
so you can get this light andyou don't want to look directly
at it, but you can like set iton your desk in the morning when
you first start working, or youcan set it up in your bathroom
to kind of shine on you whileyou're getting ready in the
(35:22):
morning, and that can be analternative to the sunlight,
right, getting that same thinggoing in the morning.
Laura (35:31):
Yes, I love that.
I actually have one of thoseand I love it.
I think it works really well.
It really does help me it hasgood data behind it.
I've never used one, but yeah,I'm like a houseplant with
feelings.
I need light and I need waterand that's pretty much it and
I'm good to go.
(35:51):
Some lab tests we mentioned afood log.
We've talked through a coupleof different ways.
What other types of screeningscan help us determine the root
cause of our fatigue?
Michaela (36:10):
I'm sure I'm missing something here, but, like, I
feel like we covered a lot ofthe big, big things.
I think the biggest thing isjust meeting with a provider who
is well-versed in, like, andlooking for all the things.
Right, I know we've all been tothe provider where they're like
(36:31):
, you know you have heartpalpitations, you must be
anxious or you know you must bedepressed.
This is just depression, right,like, and they're not looking
at the person as a whole, right?
So you're going to seek outsomebody who is going to dig
deep and look at you as a wholeperson?
Um, because you are, you'redynamic.
(36:55):
There's not just one thing.
It could be multiple thingscontributing to it, um, the.
The other thing that just popsinto my head is obesity, right?
Um, there are, so there's somany, um, you know, options out
there for people to help themand support them with, uh,
(37:15):
managing their weight, right,and, um, the reason I mentioned
this is because it createsinflammation in the body, and
inflammation is a driving forceof depression.
So, not only do you feeldepressed, you don't like how
you look, or you feeluncomfortable in your skin, but
(37:35):
it's also creating and wreakinghavoc in your body from, like,
an inflammatory standpoint andthat's a major contributing
factor of depression.
They've tied having elevatedCRP levels, which is an
inflammatory marker in our body,to increased risk of depression
.
Laura (37:52):
Interesting yeah.
That's a really good point.
Michaela (37:56):
So I mean, even like lithium levels, like lithium is
supposed to be in our soil, andI think that there's probably a
varying range and it can bedepleted in some areas.
And they've really studied andlooked around at lithium levels
in the soil and the drinkingwater, right, and the risk of
(38:16):
depression and suicidal suicideattempts?
I think, or maybe, just yeah, Ithink it's suicide attempts
maybe.
And the lower the amount oflithium in our our drinking
water and in our food, thehigher rates of depression.
Wow, our bodies are reallyconnected.
(38:39):
We are a whole person with it'svery multifactorial, and so you
need someone who's going to beable to you can find someone
that's able to help you kind offigure out what's going on for
you, then that's going to be thebest bet.
Laura (39:11):
And what about hormone testing?
Michaela (39:14):
Yeah, you can do hormone testing and see what's
going on there.
I think you know, I know I'mI'm approaching my forties and I
know that there are a lot ofwomen that I see kind of getting
into that perimenopausal timeperiod and all of a sudden
they're like man, I'm just soanxious all the time and I can't
(39:36):
, I can't find anything and I'mdistracted and I'm not sleeping
at night, right, and a lot oftimes they'll go and get put on
an SSRI, right Antidepressantfor for their insomnia, anxiety,
maybe depression that they'rehaving.
But ultimately it could be thatthe insomnia could be tied to
low progesterone, right.
(39:57):
That starts going down anywherebetween you know, around 10
years, even before you startgoing through menopause, and so
there very well could be a tiebetween that hormone imbalance
and the insomnia and fatiguethat they're feeling during that
time of their life,specifically, probably in
additional times of life, thathormones are imbalanced.
(40:22):
So yeah, that's a good point,okay.
Laura (40:26):
So we can get some labs.
We can see a holistic providerwho knows about more than just
one thing and is looking atourself as a whole person, and
we can kind of monitor our food.
We can take a look at our sleephygiene and our bedtime routine
and track whether or not we'redreaming.
(40:47):
Those are really helpful.
Michaela (40:50):
You can also go seek therapy right Like for
depression, anxiety underlyingtrauma.
There are really goodtherapists out there that can
help with that Someone who'strained in cognitive behavioral
therapy for insomnia rightSpecific treatment that helps
with people developing bettersleep habits and decreasing the
(41:15):
anxiety around sleep, because Ido feel like that's probably one
of the biggest driving forcesfor continued insomnia.
Everybody has a bad night ofsleep, but sometimes people get
so anxious about not sleepingand not feeling good the next
day that it can drive thatanxiety up at nighttime and make
(41:36):
it more of a habitual thing.
Laura (41:37):
So that's another thing that you can do habitual thing,
so that's another thing that youcan do.
That's a good point.
Therapy is always somethingthat I recommend.
Obviously, as a therapist, Ifind it to be very helpful, and
when we talked about some traumaand we talked about depression
and we talked about anxiety andall of these different things,
you know, therapy can be reallyhelpful for that, and so finding
(41:59):
a good therapist who is wellversed in all of those things is
really really helpful for that,and so finding a good therapist
who is well-versed in all ofthose things is really really
helpful as well.
Absolutely Okay.
Well, thank you so much forthis conversation today.
This is incredibly informative.
Yeah, this was fun, and thankyou for listening to.
Why Am I Like this?
If you like our show, pleaseleave us a rating and review on
(42:19):
your favorite podcast platform,Follow the show and share it
with your friends.
This episode was written andproduced by me, Laura Wood and
Michelle Bieber.
Our theme song is Making EndsMeet by Thick as Thieves, and a
special thanks to BeneveryCounseling and Coaching and
Active Healing PsychiatricServices for sponsoring this
show.
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