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Living with Debilitating Fatigue

Extreme fatigue strips life down to the bare basics of human need and God’s grace.
By David Powlison


WHAT YOU NEED TO KNOW

After my heart surgery, I told my wife, "I feel like someone who took his car in for repairs. The car I got back turned out to be a junker." My wounds healed, but my body didn't work.

For five years I suffered from shattering and debilitating fatigue. Fatigue destroyed much of my life. I had no resilience. I was able to do only the bare minimum in every area of my life. I had to let go of many things that were valuable, gratifying, and joyous. My social life became smaller and smaller, and was finally narrowed down to family and a few friends. My ministry—counseling, teaching, and writing—was severely curtailed.

Although I lost much of my social life and ministry, God's social life with me and His ministry to me became incalculably precious and sweet. Because of my deep need for God, my relationship with Him became more intimate. Psalm 46 says that God is a very present help in trouble. The essential dynamic of my moments and days became, "Lord, this is trouble. Help." And He helped.

You've probably experienced similar losses in your struggle with fatigue. God will also help you. Extreme fatigue strips life down to the bare basics of human need and God's grace. As you learn to call upon God, you will find Him. He will meet you, sustain you, comfort you, and give you hope.

Paul says that God "comforts us in all our affliction, so that we may be able to comfort those who are in any affliction, with the comfort with which we ourselves are comforted by God" (2 Corinthians 1:4). God has comforted me in my affliction. This article is one way God has allowed me to offer that comfort to you. I want to share with you the things that God has taught me in the middle of one of the hardest times in my life.

Perhaps you are too weary to even read this whole article right now. Take a few days. Read one section at a time. As you read ask God to give you his perspective on your battle with fatigue. Ask Him to meet you.

What causes debilitating fatigue?

Some people are diagnosed with Chronic Fatigue Syndrome, but that's just one cause of fatigue. There are many other reasons you might be struggling with fatigue—some physical, some emotional, some spiritual. What are some of them?

  • Physical: disease (allergies, arthritis, chronic fatigue syndrome, cancer, hypoglycemia, fibromyalgia, multiple sclerosis, thyroid dysfunction, and many more), medication side effects, old age, parenting young children (nursing and hormonal changes for women, and for both women and men loss of sleep), and sleep problems
  • Emotional: depression, grief, multi-tasking, overwork, stress
  • Spiritual: fear, guilt, worry

This list of reasons is long, but it's not comprehensive. The reason for your fatigue might not be here. You may never find out exactly why you're so tired. Many people don't. And even if you find the cause of your fatigue, that's not a guarantee you'll find a cure.

Most likely, whatever the cause, you will have to learn to live well within fatigue's limitations. You will have to learn how to think, feel, choose, believe, and not sin while you feel like a "dimly burning wick." You need to know God and live fruitfully despite your constant weariness. Is this possible? Yes it is. I know that God used my fatigue, difficult as it was, for good in my life. He plans to do the same in yours.

How our world sees fatigue

Start by swimming against our world's perspective on fatigue. The fact is, our world despises fatigue. It hates weakness, dependency, aging, inability, and weariness.

Our culture's ideal is to be strong, independent, youthful, vigorous, capable, radiant, healthy, and energetic. That is a half truth. To enjoy health and strength is a wonderful gift from God. To lose them is hard. But our culture takes those good gifts and says, "You gotta have them!" And if you don't have them, you are defective. You are less than a human being. The world takes the gifts of God without God. It lives for the gifts, not for the Giver.

In addition, our world treats fatigue only as a medical problem. We love to give problems a name and try to fix them with a pill or program. Sometimes a medical diagnosis and treatment can help you. But weakness and fatigue are normal within a fallen world. Our world ignores that reality and abnormalizes the normal by creating or seeking a medical label for something that is also a profound aspect of the human condition.

How God views fatigue

God views your fatigue differently. He uses fatigue to teach you important truths.

God is in control. You live in God's world. He made it and is in charge of everything that happens. Your long-lasting fatigue is not a bad accident. It's under God's control and will be used by Him to deepen your relationship with Him and to grow you to be more like Him. Jesus learned obedience on the hard road of suffering (Hebrews 5:7-8). He will deal gently and sympathetically with you as He makes you like Himself (Hebrews 4:15; 5:2).

You are fundamentally weak and dependent. When Paul says that, "The Spirit also helps us in our weakness" (Romans 8:26), he's talking about what it means to be a creature. We are mere dust. We are clay. We are mortal. And that means we are fundamentally fragile and dependent. Long lasting, debilitating fatigue is one of the many ways we experience weakness and dependence. Your weakness, tiredness, and fatigue are highlighting what has always been true—you are completely dependent on God for every breath.

Your fatigue is a door to knowing God

God will use your fatigue as the door into a deeper knowledge of His love. Read the Psalms, and you will see that those who know God well are afflicted, weak, oppressed, broken, humble, and needy. Psalm 31:5 ("Into your hand I commit my spirit") was on Jesus' lips as He hung on the cross, powerless and in great pain. He became this for us.

Hebrews 4:15 (ESV) says, "For we do not have a high priest who is unable to sympathize with our weaknesses but one who in every respect has been tempted as we are, yet without sin." Jesus lived in weakness. He knows what it's like to depend on the mercies of God for every breath. Jesus' experience of weakness is the door to one of the most marvelous promises of God in the next verse, "Let us then with confidence draw near to the throne of grace that we may receive mercy and find grace to help in time of need" (Hebrews 4:16).

What is fatigue? It's a very specific time of need. You are struggling. Life is hard. You are living through a dark time. You're living in a body that's a junker. You have a need. Your Lord sympathizes with your need. He promises you grace and mercy—immediate help in the context of your need.

Fatigue is a door to seeing your heart's true condition

Like any trouble, fatigue exposes what's really going on in your heart and mind. In your trouble you can turn to God for help, or you can turn away from God. Fatigue is a particular kind of trouble that brings its own particular temptations. Here are some ways that you might be tempted to turn from God as you live with fatigue:

  1. Anxiety. You have lost your health. It's tempting to fret, obsess, and worry about your health, your future, and your identity.
  2. Compulsively seek a cure. Another typical temptation is to obsess about your health in such a way that it takes over your whole life. Hear me rightly—I am not making light of the goodness of medical care. Certainly you should look for help from your doctors. But when you aren't healthy, it's easy to make getting healthy the center of your life.
  3. Escapism. Because you don't feel like doing anything, it's tempting to just vegetate—to turn to food, to television, or to other escapes. Because you feel lousy, it's tempting to turn to something that will help you forget how you feel.
  4. Use it for secondary gains. Fatigue gives you a very convenient excuse to not do things. So it's tempting to use it as an excuse to not do the things you are still able to do.
  5. Grumble. Fatigue will sorely tempt you to grumble. The Israelites did not grumble when they were in the land of milk and honey. They grumbled when it was hard, when it was hot. They grumbled when they were fatigued and hungry.
  6. Give up. To lose so many capabilities, and to have so many things you would like to do, but can't, is depressing. It's a loss. The temptation to give up in your situation is huge.
  7. Denial. Maybe you don't give up; instead, you deny you have a problem. You keep going forward, pushing yourself, and trying to do it all. You don't want to admit you have any limitations. You're afraid that if you ever stopped or slowed down you would lose your identity.
  8. Self-pity. It's tempting to feel sorry for yourself and imagine that your life is harder than anyone else's.

Can you find your temptations on this list? Perhaps you could add a few more. Think about what underlies your temptations. What is going on in your heart as you struggle with anxiety, discouragement, and escapism?

Perhaps you have found your identity in what you do. Now "doing" is taken away from you. You don't know who you are or what your place is in this world. So you're tempted to despair, to obsess about how to recover your abilities, or to try to escape the new reality of your life.

Or perhaps you notice that behind your escapism and irritation is a demand for certain things that you want from life: "I want this, and I fear its opposite." The Bible calls these demands, "lusts of the flesh" (Galatians 5:16; Ephesians 2:3; 1 John 2:16).

Lusts of the flesh are not just sexual. They're anything you want more than the living God. These are your God substitutes. For instance, "I want my social life. I fear being isolated. I need entertainment. I want to feel good." Of course there's nothing wrong with enjoying friends and family, but when your fatigue takes it away your response will show you if you were making it the center of your life. Your fear and obsession are pointing to what you worship instead of God.

There is only one thing to do when you feel trapped by your response to fatigue. You turn. You turn away from your false identity and false desires towards the living God. Turn to Him in repentance and ask for mercy.

Turn to God every day and every moment. Turn to Jesus who sympathizes with your weakness. He has experienced your temptations, and He promises to help you in your time of need. This is what the life of faith is all about—noticing your sins and relying on Jesus for forgiveness and help. His death and resurrection guarantee that you will be forgiven and helped. They guarantee that one day your tears will be wiped away and you will be with God, strong and healthy forever (Revelation 21:3-4).

Your fatigue reveals God's power

As you turn to God, He will help you by changing the way you think about your life. Instead of despising your weakness, you will see that your weakness reveals God's power.

Pour out your heart to God just like Paul did in 2 Corinthians 12. He had a weakness that he called a "thorn in the flesh," He begged God to take his weakness away, "Three times I pleaded with the Lord about this that it should leave me" (v.8).

Paul received from God this response: "My grace is sufficient for you, for power is made perfect in weakness" (v.9). God's power is perfectly revealed in our weakness. God will use your weakness to show you that what makes your life good is not you, but the power and mercy of Another.

Paul responded to God by saying, "I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me" (v. 9). So the very thing that the world despises becomes the occasion for the power of Christ to be displayed in Paul's life. Then Paul said, "For the sake of Christ sake I am content with weaknesses, insults, hardships, persecutions, and calamities" (v.10).

He was not content because these things are fun to experience. He was content in them for Christ's sake; "For when I am weak, then I am strong" (v.10). That dynamic of weakness makes Christ matter in your life. When Christ matters in your life, He shines through your life. People see the evidence of something wonderful—the hand of Another at work in you.

God's character shines through your weakness

When others look at you, they will see the evidence of God's divine power at work in you. You are doing things, thinking things, processing things, accepting things in a way that "normal" human beings with typical fears, obsessions, and compulsions don't do.

You can see this in Paul. He does life in a radically different way. He sees that his suffering—his thorn in the flesh—serves a good purpose. God is using it to keep him humble, to protect him from exalting himself. When you turn to God in your weakness, things start to happen that you would have once thought were impossible—things like learning contentment. You will speak of your weakness as the place God most richly reveals Himself to you.

Fatigue forces you to wrestle with how your life still counts even when what you do, how much you do, and how often you can do it is greatly reduced. God is more interested in who you are in Christ than in what you do for Him. God wants you to grow to be like Him. He wants your character to resemble His character. Your fatigue is the context He is using to make His character shine through your life.

God wants to use your fatigue to teach you His patience, endurance, perseverance, and longsuffering (Romans 12:12; 1 Corinthians 13:4; Ephesians 4:2). As you turn from the temptations that come with fatigue and accept your limitations, God will be teaching you the patient endurance of Christ.

WHAT YOU NEED TO DO

How does learning these truths about your weakness and God's power change the way you live? How do you actually live within the limitations of fatigue? The first part of this article talked about facing your weakness with faith. And faith always expresses itself in love. But how can you love those around you when you have no energy? Here are three things you can do, even within the limitations of your fatigue.

Depend on Jesus one day at a time. Yes, this can be misused and turned into a truism. But it happens to be true! Jesus says, "Therefore do not be anxious for tomorrow, for tomorrow will be anxious for itself. Sufficient for the day is its own trouble." (Matthew 6:34). Jesus wants you to depend on Him one day at a time. Learn not to worry about tomorrow. You could be cured tomorrow. You could be cured only when you see the Lord face to face. But whatever your future, you are called to live by faith today.

To do this you must meditate on who Jesus is. Psalm 23 has brought Jesus to life for me in my struggle with fatigue. The Psalm is full of promises—provision, restoration of soul, protection, no fear of evil, goodness and mercy all of your days. Go through this psalm and make it yours. You will be filled with confidence in your shepherd, the Lord Jesus. God doesn't always do it the way we want, yet He does restore us. When you are confident that no matter what you are facing, you have a shepherd who is with you, restoring you, and bringing good things into your life, then you truly have something worth living and dying for.

Think small. One of the keys to living with fatigue is to scale down the size of your life. Think about everything in your life in terms of two nesting circles—one large and one small. Put in the big circle all the things you would like to happen—world peace, your children turning out perfectly, your health restored. Then put in the smaller circle only those things you are actually responsible for. What are you called to do in this world? When you have debilitating fatigue, that inner circle gets very small. There's much less you can do and much less you are called to do.

We live in a go-go-go culture that values achievement and productivity. It doesn't value restorative or recuperative times unless it's a getaway vacation that recharges your batteries so you can get back to the rat race.

But what if you can't get back to the rat race? What will be the quality of your days if you are constantly fatigued? There is a holy rhythm of rest and work. That rhythm may be very different at one stage of your life than another. But at every stage you are called to live for God. He wants to teach you how to live for him through small obediences. Little things can show your love for God and others.

Instead of spending your time thinking about what you can't do, ask yourself, "What can I do?" Perhaps it's something as small as brushing your teeth, emptying the trash, picking up a sock on the floor, greeting your family warmly, or praying for someone. There are things you are not too tired to do—maybe not a lot, but there are a few. God is calling you to the obedience of faith that leads to the obedience of love. These "small obediences" show up in small acts of kindness and care that will make your life sparkle.

Pursue medical help without obsessing. Look for help from medicine, but don't make that the center of your life. There is no formula for this. It will be different for different people. You need to develop wisdom in this area of your life so that you know when you are putting too many of your eggs in a medical cure basket. The people who love you and care for you often will want to talk a lot about medical issues. You need to learn how to graciously change the subject to the more important things God is teaching you. You need to seek appropriate medical help while still living your life within the circumstances God has given you.

A personal note

In the spring of 2006, God ministered to me by curing my fatigue. My doctors realized that my cardiac medicines and an inability to get a restful night sleep were the source of my fatigue. We changed a few simple things and much of my energy and resilience was restored.

The answer to my fatigue turned out to be so simple. Why did no one ever carefully inquire during those five long years? Why did it take so long to find out why I couldn't function? I can't answer those questions, but I do know that my experience with fatigue drew me deeper into intimacy with God and prepared me to love others by offering the comfort that I have received. If this article has helped you, it's because it was forged in the furnace of my own life and the mercies of God for me. Not one second of the dreariness and difficulty of the last five years has been wasted, except for what I wasted when I lost sight of God.

Although you are living with severe limitations right now, your life is not a waste. God heard my cry for help and met me. He will do the same for you. He will pour his wisdom and kindness into your heart as you cry out to Him. Then whether your physical deliverance is in this life or at the resurrection of the dead, you will see that you have the one indestructible thing in this world—the Lord is your shepherd and His goodness and mercy will follow you all the days of your life.

FREQUENTLY-ASKED QUESTIONS

How can I help my family and friends deal with my fatigue?

  1. Recognize that your fatigue also creates suffering for those around you. During my five-year struggle with fatigue, I got all the attention. But my wife suffered as much as I did. She had to function like a single person in much of her social life. She had to deal with a husband whose energies were very unpredictable. Some days I was almost normal, and on others I could barely move.

    As you notice that your fatigue causes others to suffer, you can love them by doing something as small as asking, "How are you doing?" Remember, their experience and what God is doing in them is just as important as what He is doing in you. And, even though you are weak, he is calling you to love those who are suffering along with you.

  2. Graciously listen to all the advice that you get, but don't feel you have to follow all of it. If I took every bit of advice that I received over the years, I would be on eighty-three contradictory diets and spending hundreds of dollars every week on vitamin supplements! The advice others give you is well-meaning—nobody wants to hurt you. They want to help you. But we live in a "fix it" culture and often your friends and relatives will try to fix you. There might even be people who criticize you because you didn't go on that diet, or see that doctor, or do the same thing that helped their third cousin once removed. Others might view your fatigue as purely a spiritual issue, and they will tell you that if you had more faith or more trust in God you would be healed. That is painful. Sometimes, you will have to forgive those who love and care about you.

  3. Share with them how God is helping you to live in His world within the limitations of your fatigue and how God is using your fatigue to make you like Him. There are many ways you can bear witness to the ongoing work of God in your life in areas other than physical healing. For example, God has helped me write articles on the Psalms over the last few years. Without going through the difficulties of fatigue, I would not have had anything to say to those who were also going through hard things. Without suffering with fatigue I wouldn't be able to understand the parts of the Bible that are about hard things. I am delighted that God has strengthened me, but the growth in faith and love that God has worked in me is the weightier blessing. You will bless the people around you if you help them see this. Hearing what God is doing in your life will free them from their anxiety about you and help them to live in God's world.

How can I help my spouse deal with fatigue

  1. Love her and normalize her struggle. It helped me when those around me treated me like a person and not a diagnosis. Your spouse is probably discouraged and disheartened. She is struggling with a whole new set of temptations that come with chronic weakness. It's easy for her to be obsessed with her health, her energy level, and her lack of energy. Try to connect with her and her world. Ask her, "How are you doing?" and then draw her to the truths I covered in this article.

  2. Your spouse may be too tired to pray, but you can pray for her and with her in a way that enters her world and genuinely bears her burdens.

  3. Sympathize with your spouse's weakness. Think about Jesus—He is able to sympathize with our weaknesses. Your wife will know if you are treating her with sympathy or with impatience. She will know if you are trusting God for her or are filled with anxiety. True sympathy notices the person in the midst of trouble. It creates delightful, warm, human conversations. There's nothing like the warmth of a genuine, human relationship to give joy, hope, and the spark of life to someone who has to walk a long, hard road. God often uses a human relationship of love as a vehicle for a more profound relationship with him.

  4. Know when to motivate your spouse. All of us sometimes need a push. You know from experience that there are times when it is good to be pushed (by parents, a teacher, a coach, a boss). This takes a very deft touch when you are living with someone who is fatigued. You sometimes need to have a thick skin, and you always need a tender heart. Your spouse may need you to say, "You can do this." Or, "Here are a couple of ideas for your day." The first response you get (and I speak sadly from firsthand experience) might be grouchy. "I don't like you running my life." "I don't want ideas." But she might also listen to you five minutes later or a day later. This is not a license to nag. Someone struggling with fatigue doesn't need someone else to start running their life. They need to learn how to live fruitfully. We all need a gentle push from time to time. Learn when to give your spouse a little push, and when to sympathize and pray.


[1] The Center for Disease Control and Prevention (Department of Health and Human Services) definition of Chronic Fatigue Syndrome:

  1. Have severe chronic fatigue of six months or longer duration with other known medical conditions excluded by clinical diagnosis; and
  2. Concurrently have four or more of the following symptoms: substantial impairment in short-term memory or concentration; sore throat; tender lymph nodes; muscle pain; multi-joint pain without swelling or redness; headaches of a new type, pattern or severity; unrefreshing sleep; and post-exertional malaise lasting more than 24 hours.

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© Copyright 2010 by the Christian Counseling and Educational Foundation.  All rights reserved.  Used by permission.

For more information on chronic fatigue, read David Powlison's minibook, I'm Exhausted: What to Do When You're Always Tired, from New Growth Press.

More information about the Christian Counseling and Educational Foundation is available at its website. To look at all available CCEF resources, visit New Growth Press.David Powlison, M.Div., Ph.D., is a faculty member and counselor at the Christian Counseling & Educational Foundation (CCEF) with over thirty years of experience. He has written several books, including The Biblical Counseling Movement: History and Context; Seeing with New Eyes; and Speaking Truth in Love; and numerous minibooks, including Breaking the Addictive Cycle; Facing Death with Hope; Grieving a Suicide; Healing after Abortion; I’m Exhausted: What to Do When You’re Always Tired; I Just Want to Die: Replacing Suicidal Thoughts with Hope; Life Beyond Your Parents’ Mistakes; Recovering from Child Abuse; Renewing Marital Intimacy; Sexual Addiction: Freedom from Compulsive Behavior; and Sexual Assault: Healing Steps for Victims.



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