Emerging from Chronic Fatigue After COVID-19
Many people experience the feeling of fatigue or exhaustion, which can be a typical response to a busy week filled with work and activities. Common fatigue can often be recovered within a few hours or days with adequate rest. However, for those who experience chronic fatigue as a result of viral illness, there is often no such luxury of recovery. The difference here is the debilitating and persistent long-term feeling of exhaustion where no amount of rest comes to the rescue. This may present as weeks, months or even years of endless symptoms interfering with your daily activities and ability to live happily or purposefully.
A subset of those who have recovered from COVID-19 have reported that persistent fatigue and other symptoms can last for up to months after the acute phase of the illness. Often referred to as “long COVID”, the mechanisms that underlie post-viral fatigue are still not fully understood. But a recent study suggests that the nervous system has a remarkable ability to adapt and reorganize, known as neuroplasticity.
Following an illness, a person may experience negative effects on their everyday activities, which can result in a decrease in participation and satisfaction in once-enjoyed hobbies. Over time, the process of less participation can create new habits of behavior which may be why the symptoms of chronic fatigue post COVID-19 are persistent and difficult to change. For instance, someone who was previously very active may have developed a habit of staying in bed all day after experiencing chronic fatigue post COVID-19. Over time, this behavior has become ingrained, making it difficult for the individual to change and regain their previous level of activity. The lack of participation has led to a new habit that is contributing to the persistence of chronic fatigue symptoms.
A study in the journal Trends of Neuroscience titled “Experience-Dependent Structural Plasticity in the Cortex” refers to this mechanism as experience-dependent plasticity, or the brain’s ability to change and adapt in response to both experiences and behaviors. In this article, we will be discussing the most important findings related to recovering from chronic fatigue post COVID-19, including how an inspiring neuroplasticity-based treatment program can potentially help you rid yourself of symptoms and regain a sense of purpose in your life.
Symptoms of Chronic Fatigue After COVID-19
Chronic fatigue after COVID-19 can cause a range of concerning symptoms, including:
- A profound and persistent feeling of exhaustion not relieved by rest or sleep
- Memory impairment, confusion, and difficulty concentrating
- Persistent sleep disturbances such as excessive sleepiness
- Pain in the form of headaches, muscle, chest and joint pain
- Anxiety, depression and mood changes
While it may seem like there is a small task in front of you, the impact on daily activities and quality of life can be significant when dealing with chronic fatigue. With new research suggesting that symptoms may be related to self-perpetuating inflammatory conditions, such as chronic fatigue syndrome, it’s important to note that experience-dependent plasticity can play a significant role in the persistence of such symptoms.
For example, fatigue can affect performing and engaging in professional or personal activities, leading to physical and mental exhaustion and difficulty staying alert for focused when required. Completing tasks, meeting friends or organizing the week efficiently can be time-consuming, leading to further stress, frustration and relationships breaking down. Here at re-origin, we care about you regaining your functional independence through an evidence based approach to retraining the limbic system. Test your symptoms of chronic fatigue with our Chronic Fatigue Quiz , helping you make more informed decisions!
Causes and Risk Factors of Chronic Fatigue After COVID-19
A variety of factors can cause chronic fatigue after COVID-19. A recent study found that COVID-19 can have direct viral damage to the central nervous and immune systems, and can negatively affect, mental health symptoms and sleep quality. Damage to the nervous system can lead to persistent fatigue, while inflammation can begin to present itself from an overactive immune system response. See more detail here to learn about these causes and its effect on the limbic system. Symptoms can also be exacerbated by the accumulative physiological and psychological stresses that built up as a consequence of COVID-19. Additionally, sleep quality can make it more difficult to stick to normal sleep/wake times creating a lot of physiological stress.
Daily fluctuations of stress can potentially increase pressure on psychological symptoms such as anxiety and depression, making it difficult to challenge looping patterns or habits, further hightening chronic fatigue.
Interestingly not everyone who is in recovery from COVID-19 will experience chronic fatigue. However, some higher risk factors include:
- Age-related changes in the nervous system create an immune response.
- Heart disease, diabetes and chronic respiratory disease may lead to chronic fatigue.
- Severe cases of COVID-19 can create a higher risk.
- Those who experience high levels of stress.
- Lack of physical activity.
Teaching you how to overcome chronic fatigue is part of our role at re-origin, arming you with the tools to help you retrain your limbic system.
How Post-COVID Fatigue is Treated
The specific process for how chronic fatigue can come about after COVID-19 still needs to be studied because of its lack of a distinct immune signature. The presence of various factors, both physical and psychological, requires a personalized approach in treating chronic fatigue post-COVID-19. This means that the treatment must be tailored to the individual, taking into account all the factors that may be contributing to their fatigue. This can make the treatment process frustrating, and so, being empowered through alternative treatments can make a real change to the symptoms of chronic fatigue. Including:
The nature of chronic fatigue can make it more difficult to participate in daily activities. Brain retraining techniques can help individuals reframe negative thoughts and beliefs about one’s abilities and energy levels. Tailored exercise programs, such as yoga exercises, can focus on building energy and improving overall function. All of these techniques can be personalized to meet the specific needs and goals of the individual with chronic fatigue, making them potentially more effective in improving sleep quality.
It is common for pain sensations to increase shortly after infection due to cytokine activity. However, these symptoms can be reversed through neuroplasticity training. Pain management is essential for effective participation in daily activities. Enhancing energy through a variety of activity-focused therapies, such as graded exercise and brain retraining, can have a major positive effect on general well-being. While medication can be helpful, it is important to note that a combination of medication and other treatments may be necessary to improve quality of life while working through chronic fatigue.
The Power of Relaxation
Stress can play a major role in the exacerbation of symptoms of chronic fatigue while also worsening experiences of anxiety and depression. A study from 2011 found that focusing your attention to be intentionally with relaxation time can be a helpful treatment. Building a relationship with deep breathing, progressive muscle relaxation, and yoga are just some of the therapeutic modalities available.
Diet and Nutrition
Managing inflammation to support the immune response and improving energy levels may require the right combination of nutrients, vitamins and minerals. A 2012 study in the Journal of the Science of Food and Agriculture found that deficiencies in b vitamins, iron and magnesium can contribute to fatigue. Whole foods, fruits and vegetables can support the energy needed to improve overall participation in daily living.
How We Approach Chronic Fatigue After COVID-19
At re-origin, we believe that classical conditioning can cause the brain and body to learn to overprotect itself through the immune reflex, which may contribute to the persistence of symptoms with chronic fatigue. Experience-dependent plasticity can also reinforce the repetition of symptoms through activities. Our program here at re-origin focuses on rewiring neural networks within the brain by providing activities designed by neuroscientists to stimulate neuroplasticity. Through our activities, you too can return to the happy, fulfilling life you deserve.
- Townsend, L., Dyer, A. H., Jones, K., Dunne, J., Mooney, A., Gaffney, F., O’Connor, L., Leavy, D., O’Brien, K., Dowds, J., Sugrue, J. A., Hopkins, D., Martin-Loeches, I., Ni Cheallaigh, C., Nadarajan, P., McLaughlin, A. M., Bourke, N. M., Bergin, C., O’Farrelly, C., . . . Conlon, N. (2020). Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection. PLOS ONE, 15(11), e0240784. https://doi.org/10.1371/journal.pone.0240784
- Nahum, M., Lee, H., & Merzenich, M. M. (2013). Principles of neuroplasticity-based rehabilitation. Progress in brain research, 207, 141–171. https://doi.org/10.1016/B978-0-444-63327-9.00009-6
- Jason, L. A., Porter, N., Herrington, J., Sorenson, M., & Kubow, S. (2009). Kindling and Oxidative Stress as Contributors to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Journal of behavioral and neuroscience research, 7(2), 1–17. Available from: https://pubmed.ncbi.nlm.nih.gov/21253446/
- Fu, M., & Zuo, Y. (2011). Experience-dependent structural plasticity in the cortex. Trends in neurosciences, 34(4), 177–187. https://doi.org/10.1016/j.tins.2011.02.001
- Willi, S., Lüthold, R., Hunt, A., Hänggi, N. V., Sejdiu, D., Scaff, C., Bender, N., Staub, K., & Schlagenhauf, P. (2021). COVID-19 sequelae in adults aged less than 50 years: A systematic review. Travel Medicine and Infectious Disease, 40, 101995. https://doi.org/10.1016/j.tmaid.2021.101995
- Iadecola, C., Anrather, J., & Kamel, H. (2020c). Effects of COVID-19 on the Nervous System. Cell, 183(1), 16-27.e1. https://doi.org/10.1016/j.cell.2020.08.028
- Moghimi, N., Di Napoli, M., Biller, J., Siegler, J. E., Shekhar, R., McCullough, L. D., Harkins, M. S., Hong, E., Alaouieh, D. A., Mansueto, G., & Divani, A. A. (2021). The Neurological Manifestations of Post-Acute Sequelae of SARS-CoV-2 Infection. Current Neurology and Neuroscience Reports, 21(9). https://doi.org/10.1007/s11910-021-01130-1
- Alonso-Lana, S., Marquié, M., Ruiz, A., & Boada, M. (2020). Cognitive and Neuropsychiatric Manifestations of COVID-19 and Effects on Elderly Individuals With Dementia. Frontiers in Aging Neuroscience, 12. https://doi.org/10.3389/fnagi.2020.588872
- Jahanshahlu, L., & Rezaei, N. (2020). Central Nervous System Involvement in COVID-19. Archives of Medical Research, 51(7), 721–722. https://doi.org/10.1016/j.arcmed.2020.05.016
- Zhu, F. C., Guan, X. H., Li, Y. H., Huang, J. Y., Jiang, T., Hou, L. H., Li, J. X., Yang, B. F., Wang, L., Wang, W. J., Wu, S. P., Wang, Z., Wu, X. H., Xu, J. J., Zhang, Z., Jia, S. Y., Wang, B. S., Hu, Y., Liu, J. J., . . . Chen, W. (2020). Immunogenicity and safety of a recombinant adenovirus type-5-vectored COVID-19 vaccine in healthy adults aged 18 years or older: a randomised, double-blind, placebo-controlled, phase 2 trial. The Lancet, 396(10249), 479–488. https://doi.org/10.1016/s0140-6736(20)31605-6
- Daugherty, S. E., Guo, Y., Heath, K., Dasmariñas, M. C., Jubilo, K. G., Samranvedhya, J., Lipsitch, M., & Cohen, K. (2021). Risk of clinical sequelae after the acute phase of SARS-CoV-2 infection: retrospective cohort study. BMJ, n1098. https://doi.org/10.1136/bmj.n1098
- Blomberg, B., Mohn, K. G. I., Brokstad, K. A., Zhou, F., Linchausen, D. W., Hansen, B. A., Lartey, S., Onyango, T. B., Kuwelker, K., Sævik, M., Bartsch, H., Tøndel, C., Kittang, B. R., Madsen, A., Bredholt, G., Vahokoski, J., Fjelltveit, E. B., Bansal, A., Trieu, M. C., . . . Langeland, N. (2021). Long COVID in a prospective cohort of home-isolated patients. Nature Medicine, 27(9), 1607–1613. https://doi.org/10.1038/s41591-021-01433-3
- Simani, L., Ramezani, M., Darazam, I. A., Sagharichi, M., Aalipour, M. A., Ghorbani, F., & Pakdaman, H. (2021). Prevalence and correlates of chronic fatigue syndrome and post-traumatic stress disorder after the outbreak of the COVID-19. Journal of NeuroVirology, 27(1), 154–159. https://doi.org/10.1007/s13365-021-00949-1
- Ryan, J. T., De Jesus Perez, V. A., & Ryan, J. J. (2021). Health Disparities in Pulmonary Arterial Hypertension and the Impact of the COVID-19 Pandemic. Advances in Pulmonary Hypertension, 20(1), 6–15. https://doi.org/10.21693/1933-088x-20.1.6
- Schmidt, S., Grossman, P., Schwarzer, B., Jena, S., Naumann, J., & Walach, H. (2011). Treating fibromyalgia with mindfulness-based stress reduction: Results from a 3-armed randomized controlled trial☆. Pain, 152(2), 361–369. https://doi.org/10.1016/j.pain.2010.10.043
- Foster, M., Chu, A., Petocz, P., & Samman, S. (2013). Effect of vegetarian diets on zinc status: a systematic review and meta-analysis of studies in humans. Journal of the Science of Food and Agriculture, 93(10), 2362–2371. https://doi.org/10.1002/jsfa.6179