Pathwaytofree

(Cross posted)

Hi all,

I'm not a newcomer to recovery, and work an AA program. I got a lot out of my step work. The problem is, though, that I have been extremely fatigued for so very long.

My husband thinks it's depression/anxiety but I don't really feel that depressed or anxious. Then again, sometimes I think I have been depressed and anxious for so very long (like forever) that maybe it's just my norm and I don't see it as depression/anxiety.

My fatigue is just really awful. I hate it. I have zero energy to do anything. I feel like I'm walking through muck and everything is at a snail's pace. I can't concentrate, remember things, process stuff, etc. Sometimes coffee perks me up but I don't like to have to rely on caffeine.

I can't seem to structure my day. I seem to jump from one thing to the next. I try to read but I can't focus. Things like washing the dishes or hanging laundry take so much energy. I tend to waste time on the computer but even when I read something I want to read, I can't focus. There's just too much out there on the internet. I pin stuff to read later but I never do. I can't seem to just lose myself in one thing. It's not ADDish though either. It's hard to explain.

I sleep fine, I don't have insomnia. But I do sleep a lot. I never feel refreshed after a full night of sleep. I have trouble getting out of bed. I don't wake up with energy. I don't wake up during the night, though, either. I don't generally have trouble falling asleep, either.

My memory is crap and I don't know why. Sometimes I feel brain damaged but I'm not.

I'm extremely unorganized, and I used to be very organized. I have little notes all over the place, notes all over my calendar, clothes all over the place. I just can't seem to muster the brain power to straighten up and get organized. I can't focus.

I seriously don't know what I do with my time.

Sometimes I think it's that my brain is just absolutely exhausted. Like it needs a rest. That all this really hard effort I made with my recovery and step work exhausted all of my reserves and energy. Like I need to recharge.

Or maybe I am still clinically depressed/anxious and am lying to myself because I don't want to face it or go on meds again that either make me feel flat, gain weight, or cause more fatigue.

The self-honesty and self-awareness that recovery took sure took a lot of me. It took me a long time to get through the step work. And I had a ton of anxiety through the step work and with my self-honesty/awareness. It's hard to explain here. I know it's not the norm. I wouldn't trade being on this side of the step work for anything, but it completely left me mentally and emotionally drained. So my gut is that that's what's caused this extreme fatigue. But trying to build a real life is just completely foreign right now. I used to do it, but it feels like it was a different life.

Does this make sense to anyone? I'm hoping someone from an outside perspective can tell me what I'm not seeing.

This certainly isn't how I want to live my life. I feel like I am just surviving but not actually living, if that makes sense.

I just want this crushing fatigue to go away. And I want the anxiety to stay away, that is draining and I certainly don't need that.

I've gone to the doctor and all my blood work is fine. But I wonder if I have Chronic fatigue syndrome or something like that.

I've also recently switched therapists because I felt I wasn't getting anywhere with my current one. I am hoping seeing someone with a different technique might help me. It's very frustrating, as I have to muster up energy to go to therapy, but I have felt for quite a while that I wasn't getting anything out of it and I don't know why that is happening. Maybe I'm not focusing well in there, either, I don't know.

Gottalife

Just a few thoughts.

You seem to be talking as if your step work is finished, done. Yet the program suggests it is a life times work to continue to grow spiritually. Two of the eleventh step promises. "We become much more efficient. We do not tire so easily, for we are not burning up energy foolishly as we did when we were trying to arrange life to suit ourselves"

Exhaustion is not meant to be an outcome of the steps, at least that wasn't my experience. Adopting a new way of life was empowering and energizing. From an earlier post it sounded like it is quite a while since you took the steps. You didn't remember how your sponsor took you through them. Could it be that you have let up on the daily practice. " we are headed for trouble if we do" ( rest on our laurels.)

It would be a rare alcoholic indeed who didn't suffer some brain damage. I certainly did a lot of damage and had much the same symptom s as you talk about, in early recovery, probably the first two years. Then it came right for many years, but seems to be returning at the moment. Memory is the main problem. I even took an altzheimers test recently.

Sometimes there is an unresolved issue tapping our energy reserves. A secret kept, an amends not made, something like that, and it could be from our sober time, not just our drinking time.

Lack of physical exercise could also play a part.

Then of course there could be a medical problem, but given what you are talking about is common among alcoholics, in my experience, and your doctor has not found anything to be concerned about, the solution could be more spiritual than medical.

Andante

All of the symptoms you describe -- fatigue, "brain fog", memory issues, difficulty focusing, mild depression, unexplained anxiety -- sound to me like what's sometimes referred to as "PAWS".

Post-Acute Withdrawal Syndrome (PAWS) is a catchphrase that refers to any group of otherwise unexplained withdrawal-like symptoms that recur or persist after the period for acute withdrawal is well past, or from around 3 months to 2 years sober. Not everyone experiences it, but for those that do, the symptoms can be aggravating and debilitating.

If you've seen a doctor and ruled out any causes not related to your past drinking, it's probably just your brain and nervous system healing from the abuse it was subjected to in your drinking days. Some brains get back to normal more quickly than others.

You're already doing a lot to help your plight by being engaged in an active recovery program, but sometimes even the best program can't magically heal an injured brain -- only time can do that.

Sometimes it helps to separate the symptoms out and deal with them individually; e.g., treat the anxiety as a separate problem from the fatigue. For me, though, they were all interconnected, and beyond the obvious tactics such as healthy diet, exercise, and techniques like mindfulness and meditation (already addressed by your AA program, I should imagine), I found that time was the only answer.

There are a few good PAWS threads on SR if you care to do a search, and there's also an article that often comes up:

http://digital-dharma.net/post-acute...r-immediately/

Hope you feel better soon!

Dee74

Hi pathwaytofree
I think there are many things that can cause fatigue like anemia to sleep apnea and a million things in between including depression and anxiety - I know myself I wasn't aware for many years I was depressed.

Maybe a check up and a chat could help?
D

Seren

I typed this out on your other thread and was too tired to type it again

tangledknot

If you've felt this way for 6 months or longer, have tried other things to boost your energy (diet changes, drinking more water, sticking to a regular sleep schedule, etc) with no relief, I highly suggest getting a sleep study done by a certified sleep specialist.

I struggled with my energy levels my entire life. After being diagnosed with depression and then ADD, told I was a hypochondriac and that my problem was psychological, I demanded a sleep study from my GP. My intuition told me they were wrong.

It turns out that I have Narcolepsy. Getting that diagnosis revolutionized my life. Now the physical problems I was experiencing make sense and I have access to treatment which has helped so much.

Pathwaytofree

Thanks for everyone's replies. I'm avoiding this right now but I will get back to it hopefully later. Lots of food for thought....

zjw

you didnt mention how long you have been sober. or maybe i missed it. for what its worth i was in a fog for a while after ig ot sober it hink it started to lift maybe 6 months in or so. my anxiety was awful too.

My point is much of what your describing sounds par for the course and in time eases. But if you have more sober time then this or even if you dont somethings to consider.

first and foremost see your doctor etc..

But for me i was in a big quest to resolve the issue myself. i was so tired of it. what works for me now is to avoid caffine and all stimulants. try to get a good nights rest. eat healthy and excercise. if i'm VERY strict about all this i fair well. if i deviate even slightly i got to crap. its hard i have to keep a strict program so i feel well. I wish it wasnt so i but it is for me.

and at the end of the day despite all my efforts. I still get tired at times I still get anxious at times and depressed and so on. But all of it is way less then it would be if i didnt do what i do. Or its explainable. i'm tired because i slept bad ok thats easy enough to resolve. Or Im' anxious because such and such happened or i bit off more then i could chew again ok ok.

So i'm constally mindful of whats going on so that i can try and keep things in order.

but of course trying to keep everything in order all the time also has its issues. for example at times i'm a prisoner of my routine. Oh no i cant watch a suspenseful movie before bed i'll never sleep. Oh no i cant go out to dinner with you on friday night staying out like that will wind me up to much and i wont be able to sleep and i'll feel awful the next day sorry cant go etc.. that part can be frustrating at times.

it is what it is.

Pathwaytofree

Hi Mike,

That's a really good point and ironically one I bring up myself at meetings to help others. Yup I can help the world but not myself...

I think sometimes I may be in my mind and thoughts again without realizing it. And then I burn up energy and it's too late.

It's not something I'd share at a meeting, unless I could explain it really well, because I don't want to scare a newcomer who misunderstands. For me, my anxiety was *off the charts* while working my steps. It was my own fault. Instead of doing my step work and continuing to live life during each day, I became absolutely obsessed with it. Also the fear that I'd have to make amends to someone in particular completely overtook my mind with terror. Turns out I didn't owe this person an amends, just a living amends. All that wasted energy over nothing. Also, I started and stopped my 4th step for years, so the anxiety of having that in the back of my mind overwhelmed me.
YES!!! I experienced that, too. Until I started to rest on my laurels.

Sorry I wasn't clear in what I wrote. It hasn't been that long, just 5 years. But I don't clearly remember how she took me through steps 1, 2, and 3. However, I clearly remember all the other steps.

Yes. Yes I have. It's the biggest most frustrating most self-hating ironic thing ever. I believe in this program with every cell of my being. It worked. And it continued to work when I continued to do it. It's like exercising. The longer you're away from the gym, the harder is it to get yourself make into shape. It's like I'm physically, mentally, and spiritually fatigued now and I can't snap out of it, which fills me with self-hate.

Ironically, I can share beautiful, raw, honest experience of what it was like for me when I didn't rest on my laurels. It's so freaking annoying. Why isn't there Step 12 1/2--what to do when you rest on your laurels and get spiritually lazy...

This is really frustrating for me, because although I am a real alcoholic, I had a pretty uneventful drinking career. I binged every now and then. Around perimenopause and job stress, I started to drink wine at home and I saw it slowly increasing, as I rationalized it. That was pretty much it. But who knows, maybe I do actually have brain damage from it even though I didn't drink that much before it turned into an obsession and craving.

Then again, part of me thinks I had a sensitive brain to begin with, if that makes sense. You know how some people have sensitive stomachs? I think I have a sensitive brain. So yeah maybe it's the alcohol, plus a lifetime of depression and anxiety, trauma during my formative years, and decades of antidepressants, that has changed my brain. It pisses me off to write it. I have fears all the time that I'm going to get dementia and Alzheimer's and end up alone in a nursing home. I, too, have read up about early onset Alzheimer's because sometimes I swear I feel like I have it. I just hate to think of alcohol as causing brain damage. Maybe I need to 10th step "alcohol". I don't think that was on my 4th step... It took me a long time to admit my alcoholism and I don't think I admitted yet that I'm angry at it.

Yes, that is such a good point and I'm glad you brought it up. Although my main amends went really well, I haven't let go of the self-anger and shame. I can't even seem to discuss it in therapy.

There's also one amends that eats away at me too sometimes, but I can't find the person because I don't remember their last name. It's not a big amends, but it's that it hurt this person's feelings greatly and very rightfully so. It bothers me that I can't make it right. Interestingly enough, I bumped into them about 12 years ago while visiting relatives (before AA). So I think I know where they live but I can't remember their last name. Maybe this is something I need to talk to someone in my network about.

I agree. I used to exercise. So how does one fight through the horrendously debilitating fatigue to exercise?

It does help to hear that this is common among alcoholics. No one's told me that before and I've never heard it shared. I have one AA friend who also was addicted to drugs and he thinks that's why he always needs naps. But he never appears fatigued although he goes to sleep early.

My doctor's up on my blood work, he's good about that. When I was in the hospital for a medical thing, there was one particular lab that got to critical levels, and he's been watching it carefully. It's been normal.

I feel a little better getting this all out. Maybe I'll see if there's an old thread on alcoholic fatigue.

I'm not sure I fit the criteria for PAWS since I stopped drinking 5 years ago. But it's weird because I had some neurological stuff going on a few years ago and I think it coincided with my sobriety. So maybe I had PAWS before and didn't realize it. This is all kinda hard to face that's all. I didn't think my physical alcoholism was that bad, because the quantities I drank and how often I drank took years to reach the level it did, and that level wasn't as low as many others suffering--although my mental and spiritual alcoholism was (I know Mike you get what I mean). I thought I caught it early because I knew what it looked like due to other experience. Maybe I wasn't being honest with myself.

I truly feel like God lets you see your truth when He feels you're ready to face it. Too much truth at once could lead me back to a drink. I guess that's why I was told to only write Step 4 for 30 minutes each day. A little truth at a time. But there's always more to be revealed and to face.

I'm going to be proactive instead of falling into self-pity and do a second search on how to heal the alcoholic brain. Maybe this will solve my fatigue.

Thanks, Mike.

Pathwaytofree

Hi Andante,
Thank you so much for your post. It does sound exactly like PAWS. But I'm a little more than 2 years sober. :-(

I tell myself since my liver enzymes never got high, that I caught my alcoholism early and I am fine. :-( Just another lie I tell myself I guess.

I do feel like my brain and nervous system are still out of whack. Actually, now that I think of it.... three years after my sobriety my nervous system went absolutely haywire when I tried to wean off antidepressants. It's not something common at all.

I had a couple of "little slips" with alcohol over those three years, but I didn't reset my sobriety date because it was kinda controlled drinking (well, if you call it that....my husband putting his hand on my glass gently but firmly and saying maybe I had enough.... yeah I guess it was a relapse but I didn't see it that way) and because my original sobriety date was such an amazing day of spiritual surrender that I like to keep that date official. I can't believe I hadn't thought of all of this before. Damn it I feel like such a complete hypocrite.

I'm sorry for the long sentences but I'm processing this all as I'm typing....

I am so much in denial aren't I. You're right. Just because someone's spiritually well doesn't mean their brain doesn't need more time to heal.

I never thought of that.

Unfortunately before I got into AA, a low dose SSRI, healthy diet, exercise, yoga, etc didn't help the anxiety and depression go away.
Yes I do find when I can discipline myself to do step 11 meditation I feel a lot better. Again it's like the gym thing.... when I'm this fatigued, I have so much trouble doing anything minor that stuff like exercising, eating right, and meditating I just cannot do. Everything I do feels like I need the strength of walking thru a mud pit to do.

Thank you.
Time to face this.

Thanks for your help.
And thanks to SR for helping me open up from my keyboard. I don't think I could've talked about this F2F.

Pathwaytofree

Hi Dee!

Thanks for your reply. :-)

My doctor's been regularly checking my labs.

What helped you see that you were depressed?
Sometimes I wonder if this is just so familiar to me that I don't see it as depression.
Thanks, yes, I did see him very recently, had new blood work taken, and he again brought up increasing my antidepressants. I'm reluctant to because they made me even more fatigued. I always had so many side effects from all the different ones I tried.

Pathwaytofree

Thanks, Seren. That was very kind of you to post it here, too. :-) I replied on my other thread.

Pathwaytofree

My mind just said to me, "How could it have been PAWS, you didn't drink every day and your liver enzymes were always normal?"

Jeez do we like to lie to ourselves.

I should've also mentioned that yes even though I didn't drink every day (only some weekends) and toward the end Thursday nights were beginning to look like good wine nights, I did drink while on SSRIs. But I'm sure many of us did. I wonder what kind of affect that had on our brains.

Pathwaytofree

Hi tangledknot!

Yes I've tried all those things. Hmm I'm not sure what my doctor would think if I asked him for a sleep study prescription.

Wow. How in the world did your intuition know that you needed a sleep study. Sorry for my ignorance, but I was assuming that most people who go for sleep studies are obese and so have problems with sleep apnea? I'm not obese and I don't snore or wake up during the night. I actually sleep without waking up in the middle of the night and yet never wake up refreshed.

Again I am sorry for my ignorance on the subject, but don't people with Narcolepsy fall asleep while standing or driving or something like that? True I can fall asleep anywhere, anytime, and have been this way forever. I often can sleep a lot and take a lot of naps. I can fall asleep at the drop of a hat. But I don't know if that's narcolepsy? I'm eager to hear more. How did you know you had it?

Pathwaytofree

Hi zjw!

I've been sober 5 years, with about 2 or 3 slips in between.

Yeah I guess I need to consider other things since it's not due to early sobriety.

That's great advice. I limit caffeine but don't avoid it entirely because I need it to function. But it's in moderation. I think I sleep too much, yet I feel it when I don't get a good night's sleep, I eat pretty healthy but I just don't have the energy to exercise because of the crashing fatigue. But when I can push myself, it does help. How do you push yourself on the days when your fatigue is debilitating?

That's good you see what is helping and how to fix it.

Maybe I need to be more mindful of what is going on in my mind and see if that's tiring me out.

I don't blame you for having a routine like that. It's better than the alternative.

Gottalife

Pain seems to be the touchstone of all spiritual growth. My guess is you are in a growth phase, and this will al clear up in time and you will see huge progress.

Page 83 talks about amends, and that we should not worry if we cannot make an amends for some reason provided we can honestly say to ourselves that we would right them if we could.

I have been in a few grotty patches myself over the years. In every case the solution has been to work with other alcoholics, in a modest way. Home group, sponsor a couple, that sort of thing.

I had a spell of therapy one time, and another time was a year or more of bleating to my doctor. Neither had a solution. It only got better when I got active in my AA life. I was one of those that had an awakening, but on more than one occasion, I went back to sleep again.

Hang in there PTF, it will pass.