I miss you so much!

Two months ago my friend Jim died. Every day since, he has been on my mind at some point in my day. We didn’t know each other long, less than a year, but the time we shared was really meaningful. He liked that we could talk about anything and everything. I knew, as we became fast friends, that we might not have long, so I made a point of not missing out on opportunities to spend time together. Jim died just before celebrating his 94th birthday, following a short illness. 

Our time together changed both of us for the better. My friendship with him, reminded me that I’m capable of being “all in” even if I know that it might be short-lived; that the pain of the loss does not out-weight the meaningfulness of the shared experience. 

That was a valuable reminder. Over my many years working with very sick patients I’ve experienced a lot of losses. But even before that, I was someone who favoured having a few close friends and who experienced losses deeply. Prone to introspection, I often wondered how it was that some people seemed to manage multiple short-term connections and then more easily bounce back from their loss after they exited each other’s lives. The answer is a complex one and I’m still figuring out all its parts but here’s a bit of what I know about getting through losses. 

Mourning

We need to mourn our losses. Mourning is when we take the grief we feel inside and find ways to express it outside ourselves. 

I’m getting ahead of myself. Maybe I should tell you about grief first.

Grief

Grief is our internal experience of loss. The word is used to define our experience facing all kinds of loss. Today, I’m talking about the loss of a loved one, from dying.

There is no right or only way to mourn. However, I would venture to say that, in my experience, those who find a way to share their experience with others, tend to fare better.

Complicated grief

Some people have to deal with losing a lot of people during their lifetime. If there are too many losses, within too short a time span and the person hasn’t had the opportunity to “properly” mourn one loss then the impact can be further complicated. Sometimes a new loss can trigger the resurfacing of previous unresolved losses and make dealing with the new loss more difficult. 

Unresolved losses can lead a person to adapt by emotionally withdrawing and avoid making new meaningful connections with others for fear that they might have to experience another loss. This seems very protective and is partly unconscious. It is also not the best coping strategy for the long run.

We can’t selectively cut out some of our emotions and feelings. Invariably, if we try, we end up cutting everything out and numbing ourselves. The consequence of this is that we end up depriving ourselves of the good stuff too.

If, as time passes, you feel like your grief is getting heavier instead of lighter, you might be experiencing complicated grief. 

Here for you

You don’t have to struggle alone. If you’re concerned about the way you are coping, reach out! I can help you through this. If you are worried about someone else, reach out! I can help you learn more about this and help you help them.

During the “social distancing” period some of my services are available by phone and via secure video conferencing and my rates are on a sliding scale. Contact me for details.

Nathalie Héloïse Graveline, NP

Tired looking dog on leash

I’m so tired!

What is fatigue?

Fatigue is such a common complaint. It is one of those symptoms which is too often not getting proper attention.

Everyone has, from time to time, felt overtired. Feeling temporarily fatigued after working too hard for too long is easy to understand and typically resolved with getting proper rest. Most people know what to do about that kind of fatigue.

I want to discuss a different kind of fatigue — that unrelenting exhaustion, that “I’m so tired I could cry” kind of tiredness. I’m talking about the kind of fatigue which isn’t resolved by rest alone. That weariness which has developed over time and seems to sap your energy, your motivation, your concentration. The kind which has got you disconnecting for the world around you and has got you thinking that you are “not fit for human consumption.”

Fatigue has so many causes. 

Lifestyle factors

There are many lifestyle factors contributing to fatigue, such as the adverse effects of alcohol, drugs and certain over the counter medications such as allergy medications or cold remedies. Too much physical exertion or, conversely, a lack of exercise are also common causes. The better understood cause of fatigue is, of course, is lack of sleep or a lack of recuperative sleep. Or then again maybe a lack of quality sleep is not that well understood. With our frenetic schedules today we have created a problem by neglecting the need for good sleep hygiene.

Health conditions

A great many health conditions also present with fatigue as one of their symptoms. I won’t list them all. I will draw your attention to the fact that sometimes we attribute fatigue to one cause and we might have missed the culprit, or more likely the combination of culprits. 

Another thing to consider when assessing fatigue is that ironically, some of the medications used to treat certain medical conditions cause some fatigue. The intensity of this undesired effect varies widely from person to person. That’s why it is worthwhile to find out if a smaller dose or a change of medication is indicated for you. Going though life feeling fatigued all the time is not ok. 

Being a Nurse Practitioner with a practice focussed on mental health and addiction problems, I cannot talk about fatigue without including the fact that many mental health problems present with fatigue. If you’ve experienced grief before, you’ll remember that bone deep fatigue. People who suffer with depression also experience fatigue. So do those with PTSD and anxiety disorders.  Many of my patients recovering from opioid addiction started out with and continue to struggle with chronic pain. Chronic pain is almost always accompanied by fatigue.

Why am I writing about this? I know what it’s like. Fatigue is a difficult thing to tackle but I’m a puzzle solver. One of my former, long time patients called me her “health detective.” I hate knowing that many people are out there slugging their way through life feeling tired all the time. It doesn’t necessarily have to be that way. If you are tired of being tired and you’d like some help figuring out your fatigue puzzle, reach out. I’m here for you.