That Tired Feeling May Be a Warning
( Originally Published 1956 )
LARRY WARNER went into business for himself on his fortieth birthday. At his birthday party he exulted: "Life really does begin at forty!"
One year later he came to see me, wondering if his life was ending instead of beginning.
"This first year as an independent businessman has been such a struggle," he told me, "that I can't bear to face the second. I've had to spend so much time in office management and selling that I've had no time or freedom to create my packaging designs, which is what I'm better equipped for."
"Doesn't your wife help you?" I asked. "She should know the business of office management. Wasn't she your secretary before you were married?"
"Sure," he said. "But not any more. The boss's wife work? Ridiculous! She's too busy with her social life. I tell you I'm all washed up. I can't sleep, I'm too exhausted to go any place with Margaret, and she's always having to apologize for my absences. That makes her angry, and we fight, which results in more insomnia and nervousness. I'm headed for a crack-up, and my family would be better off without me. I've taken out some more insurance--"
"Larry," I interrupted, "you sound like a man who's going on a sit-down strike against the realities of life."
"It's more than just a strike," he answered wearily. "I'm figuring out a graceful exit."
"Don't talk nonsense," I said. "Of course you feel defeated —trying to live a twenty-four-hour day in your sixteen waking hours. No man can do the impossible, Larry. He shouldn't expect it of himself, nor should his wife expect it of him."
Larry was, figuratively, trying to juggle five raw eggs with one hand. He had reached what psychologists call the melancholia field of fatigue. Worry about his business started his downfall, and as difficulties at home increased—his wife's nagging and his own feeling of unworthiness—he had become unable to digest his food well or to fall asleep at night.
"I used to be pretty healthy," Larry said. "And I hate to reel off a long list of complaints--"
"Go ahead," I said. "I want to hear them so I'll know how to help you."
"Well," he said, "besides the sleeplessness I have muscular spasms, I've acquired headaches, and constipation alternating with diarrhea. What's the use of living, feeling the way I do, both mentally and physically?"
"Fatigue," I said, "has so many different symptoms that it isn't always recognized for what it is. Most of us fail to realize that the sensation of fatigue is in fact a sensation of pain, produced by the action of certain toxic products upon the nerve centers."
These toxins may be produced in the muscles when you exercise too strenuously, as a by-product of the oxidation of food substances that supply energy to support the physical activity. Muscular fatigue from physical effort is first experienced as a sensation of moderate discomfort. This gradually develops into true pain, which eventually becomes so excruciating that the continuation of the activity is impossible. Fatigue is really a protective mechanism. Pain causes cessation of muscular activity before the muscles are completely exhausted.
"It's pain, all right," said Larry. "But I didn't know it was fatigue that caused it."
"After you reach the age of forty," I said, "extreme fatigue is harder on you. It affects the nervous system and produces irritability, nervousness, restlessness, and insomnia. It lowers your resistance to disease. Acute fatigue is the inevitable result of severe physical or emotional strain."
"I've been under both," declared Larry, "since I went in business for myself."
"With chronic fatigue," I explained, "you can feel extremely tired without having exerted yourself. Yet that tiredness can disappear abruptly if something interesting occurs. Haven't you ever gone against your will to some social function and had fatigue develop quickly?"
"Haven't I!" said Larry. "Just the thought of going to certain social affairs exhausts me."
"That's because chronic fatigue can and does become a conditioned response. Once a given situation has produced tiredness, it's apt to do so again. After a day of active sports a person may not feel tired at all; he may be eager for more activity. And you probably don't get so tired when you work all day at your packaging designs."
"Of course I don't," Larry agreed. "I'm happy when I'm creating."
"That's your answer," I said. "It's work you like. Enthusiasm has a great psychological effect on fatigue. When you're tired it's hard to be enthusiastic about anything. But when you're enthusiastic you're seldom tired."
"I never thought of it before," he said, "but that's right. When I'm doing work I like I can go without rest for a long time. It's when the management side of the business worries me, or when I'm fighting with my wife, that I get up in the morning more tired than when I went to bed."
Overexertion and fatigue produce that slow poison chronic fatigue. Larry, in company with some 42,766,000 other Americans over forty, was too old to invite such a poison into his system. Your energy capacity is lessened with age. At sixty you have only 5o per cent of the energy you had as a child of ten.
Chronic fatigue lowers vitality day after day, week after week. What rest Larry managed to get gave him only temporary relief. Poisoned by chronic fatigue, he no longer found life worth living.
What was the reason for it? Larry didn't have any of the diseases which produce chronic fatigue—tuberculosis, sinusitis, heart disease, or diabetes. He was neither an alcoholic nor a drug addict, and he used tobacco only in moderation. Before the onset of his fatigue he hadn't suffered from eye-strain, chronic constipation, painful feet, poor posture, disturbance of his glands, or nervous instability.
The most likely causes of his fatigue were: (1) worry, or nervous tension, because of his business problems, coupled with (2) the emotional strain of his home life, and (3) a diet inadequate in the essential proteins, vitamins, and minerals needed to keep his body in a healthful condition.
Chronic fatigue is the commonest symptom of a nervous breakdown. It's the fatigue that rises in the brain because of poor nerves. It means that the brain is tired and functioning badly. You may be unable to read without discomfort. You forget a paragraph as soon as you've read it, and may find yourself reading the same sentence over and over again. Your brain tires and becomes tense. The distress you feel in your eyes cannot be helped by glasses: It's caused by the poor condition of your nerves. This type of fatigue represents a danger signal that should never be disregarded.
The origin of the trouble lies in the cells of the central nervous system, which bind together the close, delicate inter-relationship of mind and body. Both your body and your mind should be treated, for both are sick. First, to replenish the energy of the nerve cells, you must receive sufficient nutriments and whatever medication is necessary. Then, if required, you should have skillful psychiatric treatment to correct your disordered personality.
The word used to describe nerve difficulties is psychosomatic (psycho-, "the mind"; soma, "the body"). They must be treated accordingly. Mind and body are so intimately associated that the state of one inevitably affects the condition of the other. Steady nerves and a tranquil mind are the results of a sound body and a healthy psychology.
There are two reasons why you must feed the nerve cells to combat chronic fatigue: (I) The nerve cells, or neurons, are permanent cells of the body. Once they are depleted, rejuvenation is difficult. (2) The nerve cells comprise the body's communication system. The cortex of the brain is a closely packed network of microscopic nerve cells. Each of these nerve cells has fibers' and threads of protoplasm which reach out and make delicate contact with the fibers of other nerve cells.
All the signals are carried by a network system of nerve cells, or neurons. The neurons relay the impulses to the brain and from the brain to parts of the body. So swiftly are these impulses received and dispatched that you react immediately to your sensory perceptions—those of sight, sound, smell, touch, and taste. You are only as strong as your nervous system. You owe it to yourself to maintain your nerves at their highest level of efficiency!
A new hypothesis about the brain is that the neurons that perform the highest level of integration are to be found in a region which is buried deep inside the brain. From the standpoint of evolution this core of tissue, which controls the autonomic nervous system, is among the most ancient. It is called the old brain. A hundred million years ago it was already highly developed in the dinosaurs.
The integration of your brain is remarkable—the achievement of unity out of diversity. The ant's nervous equipment contains about two hundred and fifty nerve cells; the human brain has millions of such cells. This nerve mass plays an important role in arousing and satisfying our hunger and other primitive needs, as well as in regulating such vital functions as breathing and heartbeat rate.
Your central nervous system is an intricate, lightning-rapid communication system which makes your body and brain function practically simultaneously. It is through your central nervous system that you are able to work, observe, learn, and experience all the emotions of human existence—to be aware that you're alive, to feel joy, sorrow, and love.
The neurons of your central nervous system are your life capital. Their important characteristics include adaptability and conductivity. Their impulses flash along the nerves, from cell to cell, very much as an electric current passes along a wire. While the nerves are physical, the impulses that pass through them are mental. This body-brain communication began before you were born; it will continue up to the moment of your death.
Although you grow in stature and in knowledge, you create no more nerve cells than were present in your body at birth. These same nerve cells work for you throughout the years, constantly expending the energy which represents your permanent investment in your body. If you make them expend more energy than they can replenish with the nutrition and rest that you give them, they grow weaker. Their fatigue is revealed through their sensitivity and irritability, and you become chronically fatigued.
Mistreat your nerve cells and you destroy the dynamos that supply you with the ability to imagine, to create, to develop a personality—the ability to be a human being. Once these cells are destroyed by the strain of hectic living, the body cannot replace them.
Experiments show that sleep is chiefly to rest the brain. This organ needs sleep more than do other parts of the body. During our sleep the heavy flow of sensory impulses to the brain is reduced to a relative trickle, and the mind has a chance to rest and relax.
During the working day the brain is bombarded with an infinite number of sensory impulses, from which it has to filter out meaningful stimuli, assign priorities among the stimuli competing for attention, and finally make a decision as to possible things to do. If unduly fatigued, the brain ignores all the stimuli.
Scientists at Camp Elliot, in California, conducted experiments on the psychology and purpose of sleep, using human subjects. Two hundred volunteers stayed awake for four or five days. While there was no evidence of muscular fatigue or strain on the hearts of the soldiers, their brains were definitely affected. They had hallucinations or imagined they were victims of secret plots. Some even became violent. These men were young and healthy. Fortunately a night's sleep was usually enough to bring them back to normal.
The following things wear down your nerve energy: emotional upheavals, competition, the struggle to get ahead against obstacles, responsibilities that weigh heavily over long periods of time, inadequate sleep, and the bolting down of unbalanced meals. Fatigue is nature's way of warning you to keep your daily withdrawals of energy from bankrupting you.
Dr. Edgar D. Adrian discovered, in 1912, that nerves always fire on an all-or-nothing basis. Since then, brain specialists have made great progress in showing how a healthy brain depends on a healthy body. A nerve must be in condition to fire, regardless of the size of the stimulus. The nerve's method of signaling that the stimulus has increased in size is to fire more rapidly.
Nerve impulses in a healthy nervous system are transmitted across a synapse—a junction or small gap where the end fibers of one nerve cell meet those of another. In fatigue, one of the chemicals that paralyzes the neuron and keeps it from firing is secreted.
The majority of cases of nervous breakdown and mental illness are directly traceable to a combination of physical and mental causes: infections with sufficient recovery, shock, malnutrition, long-sustained nervous strain, emotional shock, or prolonged worry. Nature has provided for some of these circumstances by giving most of us a nerve-cell energy margin. However, if we continue to call upon this reserve without replenishing it with sufficient food and rest, we experience the symptoms of fatigue. This is nature's way of warning us that the chemistry of the nerve cells is changing.
"You may have known somebody," I said to Larry, "who had always been efficient, good-natured, optimistic, and hard-working, but suddenly became discouraged, miserable, apathetic, depressed, and unable to work."
"I know such a person quite well," said Larry. "That description fits me."
"Those are the symptoms of a nervous breakdown," I said. "There are three types of fatigue: physical, mental, and nervous. We may experience one or more of these. For all types we have a bank account of energy which we build up by deposits to our credit whenever we eat well or rest. As we work or worry, we make withdrawals from our energy account. Overdrawing our account results in exhaustion."
"That's putting it in practical terms that anybody can understand," said Larry. "I wouldn't think of overdrawing my bank account. But I hate to think of what's been happening to this important energy account of mine!"
"Your normal pulse rate," I said, "is about seventy-two beats per minute. If you become too fatigued the heart recovery rate is slowed down. After three minutes of recovery the rate may be one hundred and fifty beats per minute, indicating fatigue with the possibility of exhaustion."
If we measure the physical expenditure of certain tasks, as has Dr. Lucien A. Brouha, of DuPont's Haskell Laboratory for Toxicology and Industrial Medicine, we find that a stenographer filing papers in a four-drawer cabinet works twice as hard as a housewife ironing a shirt.
"It's the nervous system that gets tired first," I went on, "and the people suffering from emotional fatigue need more help than those affected by any other type. It takes them longer to recover. They must have good nutrition and rest, or they become tired of living—the tiredness that drives them to self-destruction."
Many successful businessmen recognize the danger of emotional fatigue. Conrad N. Hilton, president of Hilton Hotels Corporation, refuses to take his business worries with him to his evening events. John S. Knight, head of the Knight newspaper group, gets in a nap before he tackles a situation in which he is apt to show tension. Harlow H. Curtice, president of General Motors Corporation, says, "I don't get nervous."
"If emotional fatigue," said Larry, "can make me so despondent that I'm tired of living, then I want to know how to live with my nerves."
"First," I answered, "learn to counteract the toll taken by a trying experience, a tiring day, or a sleepless night by replenishing your nerves through plenty of rest and nourishment. Fatigue is a protective action against stress. Obey its first warning to protect yourself from chronic fatigue. You must hoard your lifetime supply of energy, or you'll over-draw your most precious savings account—your energy ac-count!"
Because expended energy drains off your oxygen supply you must replace the drain on your oxygen and blood sugar before it depletes your vital organs. Mental work uses up the most oxygen, and brainfag can express itself in physical tiredness. If the brain does not receive a constant supply of oxygen it goes into a coma.
Your body requires different amounts of oxygen for each activity. When you sleep it uses barely one cupful per minute. When you work, the oxygen consumption zooms to six and one-half gallons a minute. Chain smoking robs your body of its needed oxygen.
Under normal circumstances the body manufactures only one gallon of oxygen per minute through the circulation of blood through the lungs. The rest of the oxygen you need comes from the reserve in your red blood corpuscles. And how can you manufacture more red blood corpuscles? By getting enough rest to erase that "tired feeling" and by eating plenty of foods containing protein, vitamins, and minerals.
The complete protein foods—lean meat, chicken, fish, eggs, cheese, milk, and milk products—are our best natural source of vitamins and minerals, and provide us with the generous quantities of energy that we need.
When you are sick you need more protein than if you were healthy, to restore your depleted body cells. If you are tired you need more protein than if you were rested, to restore the depleted oxygen.
"This past year," said Larry, "has made an old man out of me. I'd like to revive some of my ambitions, enthusiasms—and youth. Is it too late?"
"Indeed it isn't," I answered, "if you'll start giving your starved nerves the food nutrients they need. The B vitamins are so necessary to the health of our nerves that insanity results from severe deficiencies. Meat gives you a good supply of these vitamins, but for a serious nervous condition I recommend a B complex vitamin supplement. Also a food concentrate called lecithin, which I advise every man to take, has a remarkably beneficial effect on the nerves."
"Protein, B vitamins, and lecithin," said Larry. "Anything more?"
"There's a lot more," I said. "Cut out your. high-starch foods and martinis. They destroy the important B vitamin thiamine. You need minerals to restore your nervous system to first-class working order. Calcium and magnesium are the mineral relaxers for your jangled nerves. Your nerves use calcium to transport their impulses. One of the major causes of nervousness in persons of all ages is a calcium deficiency, and this deficiency increases as you grow older."
"Calcium," said Larry, "is a busy little fellow, isn't he?"
"He has to be," I said, "when so much depends on him. You'll find both calcium and magnesium in cottage cheese and other milk products. I think you know that I recommend, for adults, buttermilk or skim milk—either fresh or reconstituted from the powdered variety—instead of whole milk. And vitamin D helps your body to absorb calcium. You'll get that in the sunshine that goes with your outdoor recreation."
"What outdoor recreation?" asked Larry.
"The kind that you're going to start taking," I said, "if you're serious about regaining that grip on youth."
"I'm dead serious," said Larry. "O.K. Then it's sunshine, fresh air, and the great big outdoors for me."
In various experiments on industrial health a lack of vita-min A was found to contribute to a nervousness and fatigue which sleep failed to alleviate. The companies involved furnished a vitamin A concentrate to the workers, and within a very short time all symptoms of nervousness and fatigue disappeared. Because nervous disease involves so many deficiencies, I suggest a complete vitamin and mineral supplement.
"And, Larry," I said suddenly, "throw away those sleeping pills!"
"But I can't sleep," he protested. "I have to take something, or I'd never get any rest."
"We'll take up the problem of sleep in a little while," I said. "But if you turn to drugs to relieve your fatigue you're really inviting a nervous breakdown. There are two types: those which depress your sensations and temporarily lessen the feeling of fatigue and those which stimulate the higher nervous centers to carry on in spite of fatigue. The primary depressants are alcohol and narcotics such as morphine, cocaine, and their derivatives. Morphine and cocaine are dangerous, habit-forming drugs; they should never be used except under the direction of a physician."
"I used to be able to relax with a few cocktails before dinner," said Larry. "But it got so, after the first glow wore off, I was more tired and depressed than ever. So now what do I do? I get a morning hangover from sleeping pills! Even coffee makes me jittery."
"There are no known ill effects resulting from the caffeine in tea and coffee," I said, "except for the nervousness and insomnia it causes some. Caffeine has been used for a long time as a stimulant to offset fatigue. But the so-called pep pills —Benzedrine Sulfate tablets—are far more powerful stimulants than caffeine. These tablets make some persons so nervous and jittery that they're unable to sleep or do concentrated work for several days. I know of several cases of serious toxic results from their use."
There was a long silence as Larry sat thinking something through. Then he got up, took a bottle of tablets from his pocket, and threw it in the wastebasket.
"My wife told me I was going to end up a drug addict," he said, "if I didn't stop taking these things." He reached in another pocket and tossed away a pill box.
"I didn't know what you were taking, Larry," I said. "That was just a shot in the dark. From the state you were in I knew you must be depending on something."
"Sure," said Larry. "Sleeping pills to get me through the night, pep pills to keep me going all day. I was ready to do something desperate. But now, with your help, I'm going to win this battle of nerves!"