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I’m exhausted, is something wrong with me?

6 Nov, 2013

A recent conference held at the University of Kent, funded by a Wellcome Trust medical humanities small grant explored the different medical, psychiatric, and social narratives on the origins and cures for exhaustion. Chris Hassan reports back from the frontiers of fatigue. 


Image courtesy of Pixelflake on Flickr.

Technically speaking, exhaustion is not seen as a medical condition in itself. Nowadays, exhaustion is a symptom rather than a sign of a disease. It can’t be observed by other people in the way that a rash can be, for example. It can only be reported by someone to describe how they feel. Because we can feel exhausted for many different reasons, exhaustion is described as a non-specific symptom, as it can have many possible causes.

Indeed, exhaustion is something we all feel from time to time. Whether we have been working too hard or have just run a marathon, it’s entirely normal to feel tired. That said, there are many illnesses that can make us feel exhausted. These could be temporary, such as a bout of the common cold, or they could be more serious and of a longer duration. Mental stress and depression can make us feel fatigued, as can therapies for the treatment of conditions such as cancer.

Although we might safely imagine the feeling of exhaustion to have been a constant feature of the human condition, how the medical profession has interpreted exhaustion has changed throughout history. In the nineteenth century, for example, a previously unknown pandemic of extreme fatigue seemed to beset the western world.

V0011402 A doctor giving his prognosis and therapeutic suggestions toWith the arrival of the telegraph, railways, and modern capitalism, members of the professional and business classes came to be struck down with feelings of overwhelming tiredness. Neurasthenia, as this alarming condition was soon termed, was presumed to be a disease of the nerves. Afflicted individuals were believed to have exhausted their limited supply of nervous capital running the factories and expanding bureaucracies of the age. It was a condition held in high esteem, indicating the exemplary work ethic of its sufferers. But as the century drew on, competing psychiatric and psychoanalytical explanations came to the fore. Neurasthenia came to be regarded as a far less worthy affliction, worryingly associated with the perceived mental fragilities of women and the working class, before disappearing from mainstream medical diagnosis.

Today, conditions such as Chronic Fatigue Syndrome (CFS), otherwise known as ME, inhabit a similarly grey area between medicine and psychiatry. Though there is no doubt that CFS can be hugely debilitating for its sufferers, there is a great deal of uncertainty around what causes the condition. Various viral origins have been suggested, as have weaknesses within the immune system and genetic susceptibility. However, as yet, none of these explanations have met with scientific consensus. Rather, it is thought that a complex relationship between the body, mind, and environment underlies chronic feelings of fatigue.

With no definite physiological cause, the most practical method of treating the condition sits with a combination of cognitive behavioural therapy (CBT), graded exercise therapy, and activity management.

Fortunately, CFS is rare. But, like neurasthenia, the way we have sought to understand it is bound by contemporary models of science and medicine. Whatever the cause of exhaustion, whether it is an entirely normal feeling, or a symptom of a bodily or psychological illness, it would seem that exhaustion rests somewhere between being a personal ailment and cultural condition even today.

Chris Hassan works in the Medical Humanities grants team at the Wellcome Trust.

Image credit (top image) courtesy of Pixelflake on Flickr.

4 Comments leave one →
  1. 6 Nov, 2013 12:03 pm

    I am an artist and artistic director looking for a research collaborator to study the activity/inactivity of the human body using puppetry. Theatre-Rites are an Arts Council funded organisation which has been creatng work for the last 17 years. Please let me know if you are interested.Thanks. Sue

    • 7 Nov, 2013 3:09 pm

      Sue – have you thought about contacting our grants team? – they know a lot of people in both science and arts and might be able to suggest someone? Also, did you see Sparkle and Dark’s Killing Roger?

  2. 7 Nov, 2013 3:04 am

    It’s a virus, would be the general answer now – Ross River(Qld), Chronic Fatigue Syndrome, Clinical Depression – so many still unknowns – but still debilitating. ‘To be or not to be, that is the question’ or why me?

  3. 7 Nov, 2013 10:36 pm

    I can just see puppets doing it. What a fantastic idea! If you need a script writer I do science/arts collaborations. :)

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