Why are famous people always so "exhausted"?

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July 18 2007 6:47 PM

Is Celebrity "Exhaustion" for Real?

The medicine behind the fatigue.

Dave Chappelle. Click image to expand.
Comedian Dave Chappelle was recently hospitalized for exhaustion

Comedian Dave Chappelle was hospitalized over the weekend for what his spokeswoman called "exhaustion." He's just the latest instance of a long celebrity tradition: Eminem canceled a tour due to "exhaustion" and other medical issues, Lindsay Lohan was carted off for "heat exhaustion," and Mariah Carey took a post-Glitter break after being hospitalized for "extreme exhaustion." Is exhaustion actually a medical diagnosis?

Yes, albeit a bendy one. The diagnostic manual published by the World Health Organization, known as the ICD, lists conditions of medical exhaustion due to heat, pregnancy, exposure, excessive exertion, and combat, as well as plain old "malaise and fatigue." (Browse the manual here.) Each affliction has its own code for use when filling out insurance forms, although companies are likely to be skeptical of nonemergency ailments like exhaustion. The fact that exhaustion has no single cause—you could be exhausted from too much work, improper nutrition, or intoxication—leads some doctors to avoid using it in diagnoses.

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There are plenty of legitimate reasons to hospitalize someone for exhaustion. For one thing, exhaustion can be a symptom of an underlying condition. Metabolic ailments like adrenal insufficiency, which develops after periods of extended physical or emotional stress, or hypothyroidism, a chronic slowing of the thyroid glands, can leave you feeling wiped. Same goes for anemia, a red blood cell deficiency, if left untreated. Those hospitalized for exhaustion might receive blood tests for these conditions. (Insurance companies might even require it.)

Sometimes debilitating exhaustion can't be traced to physiological causes. "Chronic fatigue syndrome" is a diagnosis generally applied to people who suffer from an otherwise unexplained malaise that lasts for six months or more. (Recent research has changed perceptions that it's just "yuppie flu.") Exhaustion may have psychological roots as well, and is a common symptom of depression. It's also a possible side effect of many prescription drugs, including beta blockers, muscle relaxants, and mood stabilizers.

Treatment for exhaustion varies depending on the cause. If it's the result of stress, a good night's sleep and some fluids are often enough to calm the nerves. (Exercise is good, too, once you're ready to stand.) More deep-seated exhaustion may require hormonal supplements or antidepressants.

The euphemistic language of celebrity publicists has historical precedent. In the late 1860s, upper-crust women, including American writer Charlotte Perkins Gilman, came down with cases of "neurasthenia," a vague sense of fatigue and anxiety. "Nervous exhaustion" and "nervous breakdown" were interchangeable—and practically indefinable—in the mid-20th century. In 1950s Britain, "myalgic encephalomyelitis" became synonymous with inexplicable fatigue.

Got a question about today's news? Ask the Explainer.

Explainer thanks Barron Lerner of Columbia University, Roger G. Mazlen of Mount Sinai Medical School, and Eric L. Weiss of Stanford University.

Christopher Beam is a writer living in Beijing.

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