Exhaustion or being burnt out are today common topics and frequently discussed topics and describes what happens to persons when living in a stressful environment for a long period of time. Especially when we are dealing with hair loss for women. Telogen effluvium is a state often encountered when stress is involved. But first the basics.

There is a great difference of being tired from working a lot and being worked out and ending up in the medical state of chronic fatigue, CFS. But it is also important to be aware that all tiredness is not caused by chronic fatigue. There can also be non-psychological causes of tiredness.

Definition - A state of chronic fatigue, exhaustion and tiredness during the day that lasts more than six months and that cannot be explained by a physical pathogenic cause. Experts prefer calling this disorder exhaustion/fatigue syndrome.
Symptoms of CFS - It is important to note that exhaustion, tiredness during the day and a lack of energy and productivity are very unspecific symptoms and are very common among patients. Typical accessory symptoms of a fatigue syndrome (i.e., chronic fatigue syndrome) are: emotional fatigue, lack of empathy towards other people’s needs, fatigue, lack of energy and memory lapses - concerning especially short time memory. Also loss of hair is seen in many of the persons due to the internal stress that is one major problem.

More than half of the patients suffering from this disease suffer also from depression. The difference between those who are exhausted and those who also suffer from depression is that the exhausted ones seldom show symptoms such as self-accusation, thoughts about suicide and decreased appetite. People who are exhausted feel frustrated about their situation.

Fatigue/exhaustion depression or “burnout” is caused by protracted stress, both in private and work life, without any possibility of recovering. This leads to a series of physical and mental symptoms. It may start with pains in the back of the neck, shoulders, back, stomach and chest/heart. It continues with other psychological symptoms such as anxiety and low mood, which can become exhaustion and depression, where even thoughts about suicide can occur.

When CFS has been determined one relevant thing is to understand the mechanisms on a lower level especially in the brain. Stress effects the brain when exposed for a longer time. The stronger and more severe stress the more happens and the reaction times goes down. The brain starts sending signals to the adrenal gland. The adrenal glands are hormone producing glands then starts to secrete stress hormones ? adrenalin, noradrenalin and cortisol. All three secreted so vi can get activated and speed up work. These changes in hormone levels are the problems given rise to the hair loss and often ending up as telogen effluvium.

Hair loss due to lack of hormone production of the thyroid gland or adrenal gland can be very problematic. The hair can come off very quickly for seemingly no reason at all ? at least no reason that the patients can think of. The correlation between chronic fatigue syndrome, CFS, and loosing the hair is hard for the patients to see in their situation. Normally after being treated with the drugs or cognitive therapy things will often turn better (cognitive therapy - the patient learns to think effectively e.g. in the case of hair loss disorders “I am normal and it is the looking good and have a lot of hair on the scalp” instead of: “I am really going completely bald and everyone are staring at me because I am the only human being loosing my hair”. The medical reason for hair loss or the thinning of hair is unknown. Many more females are affected than men. There are many theories but one that we have thought of after several years of treating patients with thyroid or adrenal gland problems is one of stress. The stress experienced when hair is falling off will lead to stress related hair loss ? telogen effluvium ? in which the hair can be lost even quicker than in the case of gland deficiency. Telogen effluvium is hair thinning over the scalp that occurs because of changes in the growth cycle of hair. A large number of hairs enter the resting phase at the same time, causing shedding and subsequent thinning. The process of getting the hair back could more than a year from the time control is taken over stress.

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