Part of living with CFS is wrestling with the appeal of stimulants — prescribed and not.
It’s 1:00 a.m. on a work night. There are 2 hours to close, 3 hours until clean up’s done. If you choose to brave the kebab shop queues on your way home, the total work-to-bed pipeline will be no less than 4 hours.
The next day, you wake up plastered to your pillows. You watch the clock turn from 2:00 p.m. to 3:00 p.m., jumping to 7:00 p.m., before inexplicably reading 9:30.
You try to get up, but your joints creak, and your brain drops into your belly. When you attempt to form a sentence, it comes out curly and incomprehensible.
You lie back down, shirking phone calls and gathering an army of unread text messages.
All of your friends and enemies are out drinking, dancing, and harnessing their youth. If you manage to get out of bed, you can join them. The hard part is just getting up.
As someone whose FOMO is more clinical than their chronic fatigue, I couldn’t go on spending my days like Grandpa Joe in “Charlie and the Chocolate Factory.” Missed night out after missed night out, my resentment for my tiredness grew.
Then, I found my golden ticket.
Cocaine wasn’t entirely off my radar. But it wasn’t something I ever committed to until I decided it could be a performance-enhancing tool.
I was stuck in Scotland, where prescribed Adderall is more or less unheard of. Coke seemed like a reasonable route to energy and endurance — a way to cope.
And so I began.
On days I felt exhausted, I would arrange several lines around a matcha latte and resurrect myself with a stimulant seance.
I thought I had my chronic fatigue in remission. All of a sudden, I could keep up with all the other 20-somethings.
I got myself out of the bath and to the bar (for more than 2 hours!). I broke up with the couch, ghosted DoorDash, and finally washed my pajama pants.
Work and play –– for the first time ever, I had it all.
I became a delusional crusader of health and wellness. Doing yoga, going for long walks, and sipping my oat milk-turmeric blends, I felt like I had elevated to a higher plane and had no problem preaching it to my friends.
I turned my nose up at the smokers heading outside for their smoke breaks, while I was escaping every hour on the hour for a coke break.
“No, I can’t have coffee. It’s not good for my condition,” I would say.
“You’re literally on cocaine,” they would counter.
Chronic fatigue syndrome (CFS) is an elusive and difficult to diagnose disorder characterized by unrelenting tiredness. People with CFS experience extreme fatigue following mental and physical activities.
Brain fog, memory issues, joint pain, and sore throat are also common symptoms.
CFS can co-occur with mental health disorders, autoimmune diseases, and sleep disorders. Because of this, treatment for one of the above may offer relief.
But, for some, there’s no long-term recovery. Instead, they’re left to do the impossible: strike the perfect subjective balance between activity and rest.
Some doctors prescribe stimulants, like Adderall, Vyvanse, and Ritalin — all commonly used to manage symptoms of attention deficit hyperactivity disorder (ADHD) — to people with CFS who don’t respond to other treatments or who experience symptoms of both CFS and ADHD.
But how well do these actually work? Does the research around them back up my personal use of a stimulant (albeit, a non-legal one) to manage CFS?
Sounds like an easy fix, right? Not necessarily.
Before considering stimulants for chronic fatigue, think about the nature of your symptoms.
If you experience insomnia or sleeplessness, for example, stimulants might only serve to make
Even for people with CFS who don’t experience sleep disorders, ADHD meds (or, if you’re like me, cocaine) may feel like the answer in the early hours. But they’ll catch up with you.
After several weeks of consistently using cocaine, I crashed — hard.
It doesn’t matter if you buy your energy boost in a trendy café or skulk for it in a dark alley –– all stimulants work by, well, stimulating your central nervous system. This results in an increase of certain neurotransmitters in the brain.
But as the stimulant wears off and neurotransmitters return to their previous levels, you might be left with even worse fatigue (not to mention irritability).
A number of people in the CFS community also report experiencing high blood pressure, dizziness, digestive issues, and insomnia after using stimulants. Some attribute these symptoms to adrenal fatigue, a condition most medical experts don’t recognize.
Regardless of the underlying process that causes them, these symptoms won’t do you any favors if you’re dealing with CFS.
With such inability to sleep, you can easily find yourself putting a bandage over your health issues, suspended in an endless cycle of Ambien and Adderall.
If your doctor has prescribed you Ritalin or Adderall, use it as intended, and try to avoid the temptation of believing more is always better.
The advice “take rest” can be, um, annoying.
In this work-first world, some people wear overexertion and burnout like a badge.
What’s more, not all of us can afford to find a new job with fewer demands and stay afloat –– especially when fronting bills to see endocrinologists and other specialty doctors.
It’s no secret that we live in a stimulant-dependent society. We’re expected to do the most, even when we’re feeling the worst.
“Take rest” can be an impossible ask on top of an already impossible condition.
So, are there any other ways to augment energy levels without risking addiction or adrenal insufficiency?
Some people swear by natural nootropics or medicinal mushrooms, like cordyceps and lion’s mane, for beating brain fog and other symptoms. But research around these approaches is limited, and healthcare professionals aren’t always open to discussing them.
I’ve had sleep issues since I was 12 years old, before I even had my first drink (unless you count the 0.2 ounces of vodka and orange Gatorade I’d mix myself after school before watching “The Real World”).
Growing up, I never had any stimulants prescribed to me, I kept away from cups of Kona coffee, and I was even light on the sugar. But insomnia still manifested.
Eventually, it became something I would use to justify my exhaustion, my rage, my propensity to addiction. The worst part is: It still haunts me, even when I do everything right.
Unfortunately, even if you lighten your workload and perform self-massage every night, managing chronic fatigue is a life-long process for many people.
There’s no flowery or pretty takeaway from all of this.
You may have to accept that your days of being able to go from the gym, to work, to the grocery store, to a friend’s place, across state lines, then back home for a nightcap are over.
Or your doctor might prescribe you a stimulant that rebirths you and doesn’t make you curious about any of the stronger stuff.
Everyone is different.
I still get tempted to give myself an illegal boost around significant events, like weddings, holidays, and bachelorette parties. (Who wants to be on a party boat with Grandpa Joe?) Occasionally, I give in –– and I forgive myself.
Lastly, remember: Tired people can party, too –– we just pay a higher cost.
Kiki Dy is a copywriter, essayist, and yoga instructor. When she is not working, she is probably shortening her life span in some fun-filled manner. You can contact her via Twitter, which she intends to use professionally despite her username.