Physical Fatigue Not a Symptom
Is fatigue about feelings or abilities? Is it about feeling emotionally exhausted or about the performance of nerve driven muscles? Taber's Medical Dictionary provides two definitions of fatigue:[1]
1. An overwhelming sustained feeling of exhaustion and diminished capacity for physical and mental work.
2. The condition of an organ or tissue in which its response to stimulation is reduced or lost as a result of overactivity.
The majority of studies conclude that muscle fatigue is not a normal withdrawal symptom.[2] In fact, exercise-induced fatigue has been found to be a symptom of smoking.[3]
The body is shedding the effects of years of dependence upon an insecticide which, for smokers, was transported within a carbon monoxide cloud that robbed blood cells of their ability to transport oxygen. For us, exhaustion after trying to run or climbing stairs was normal.
While early recovery may leave us feeling emotionally drained, physically we should soon be feeling much better with more energy than we've felt in years.
Cessation muscle weakness is not normal. If it occurs and persists get seen and find out why.
Cessation Fatigue
A series of recent papers have focused upon what they term "cessation fatigue." They define cessation fatigue as tiredness of trying to quit, a loss of motivation to continue, a loss of hope, as the exhaustion of self-control resources that increases the likelihood of relapse.[4,5]
In that, they assert that gradual loss of motivation is a "reaction to withdrawal but not a withdrawal symptom,"[4] does it even belong in this chapter?
How did researchers diagnose cessation fatigue? By multiple times daily during the first two weeks having new ex-smokers rate, on a 1 to 10 scale, their response to the statement "I am tired of quitting smoking."
Some hours of withdrawal obviously more challenging than others, and recovery clearly lasting longer than any recovering addict wants, who wouldn't wish it over and done?
A longer eight-week 2018 cessation fatigue study found and framed the obvious in negative terms, that emotional exhaustion can predict relapse, that it's greatest during the first two weeks, before peaking and plateauing at about 6 weeks.[6]
Unfortunately, the study provides little additional useful information, as it failed to share actual raw data as to how many experienced tiredness at each study assessment point, and their tiredness ratings.
What's most needed is the study of those who reported feeling exhausted yet found ways to succeed. How did they keep their resolve strong long enough to transport them to Easy Street?
I submit that even if super tired of quitting, that it's impossible to fail so long as all nicotine remains on the outside. Imagine a sickness that answers exhaustion by inhaling a super addictive chemical and the army of toxins arriving with it.
What we know to be true is that the common thread between every ex-user who has ever failed is that they used.
Baby steps, just here and now, these next few minutes, reach for and breathe life into the reasons that motivated you to begin this amazing journey home. Reach for your dreams.
Just here and now, that next challenge if any, yes you can!
References:
2. Hughes, JR, Effects of abstinence from tobacco: Valid symptoms and time course, Nicotine & Tobacco Research, March 2007, Volume 9(3), Pages 3215-327.
3. Hughes JR, et al, Physical activity, smoking, and exercise-induced fatigue, Journal of Behavioral Medicine, June 1984, Volume 7(2), Pages 217-230.
4. Piper ME, Withdrawal: Expanding a Key Addiction Construct, Nicotine and Tobacco Research, 2015, Volume 17(12), Pages 1405‐141.
5. Liu X et al, Understanding the Role of Cessation Fatigue in the Smoking Cessation Process, Drug and Alcohol Dependence. Dec. 1. 2013. Volume 133(2), Pages 548-555.
6. Heckman BW, et al, Does cessation fatigue predict smoking-cessation milestones? A longitudinal study of current and former smokers. Journal of Consulting and Clinical Psychology, Nov. 2018, Volume 86(11), Pages 903–914.
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