Funks, slumps, and yawns: how undiagnosed anemia affected my productivity

My first year as an assistant professor was hard. This did not come as a surprise to me, because I did not fall off the proverbial turnip truck last week. I knew what I was getting into when I signed up for this job. During graduate school, I attained completely unsustainable-but-glorious levels of productivity, and by the end, I was exhausted. I submitted grant applications during my postdoc that had me burning the candle from both ends, and when I was finished, I knew what it was to feel tired in my very bones. Those feast-and-famine cycles of productivity can wreak havoc in the long-term. I had my 3rd-year PhD slump, and my post-PhD postdoc slump. I’ve recognized that slumps come, and they can be a natural part of the creative process, and I try not to be too hard on myself when I’m in one.

But last spring, I was tired all the time. By late spring, I was spacing out, losing focus, dropping balls. I was late — really late — on a couple of projects. I was falling asleep at 2pm at my desk. I blamed it on not going to the gym, not being hydrated enough, or not eating whatever magical combination of foods was what I needed to feel well and be healthy. I blamed it on depression and anxiety, and thought that maybe what I needed was to go back to a therapist and work through whatever it was that was that was keeping me from getting work done.

I thought it was in my head. It’s so easy to internalize feeling like total crap all the time, as a consequence of working hard. It’s easy to forget what feeling good actually feels like when it’s been a long time.

And then I had a period for 72 days straight. I went to a doctor, and was diagnosed with severe anemia, brought on by the menorrhagia I’ve been struggling with since going off hormonal birth control a few years ago. I’ve written previously about birth control, health issues, and my tenure-track uterus and the problems it’s caused me. It turns out that the body just isn’t designed to bleed as hard or as much I as do, and that has consequences.

I went on iron (plus C!) and a B-complex, and started feeling more human within a couple of weeks. I’ve been slowly getting back into physical activity, after months away from the gym. I soon realized that the anemia was the reason my legs had felt like they were full of lead and my lungs were on fire. I was able to work past 2 pm (and actually get things done!). I started making breakthroughs on my projects once I stopped having afternoon brain fogs or found myself spacing out at my desk for ten minutes without realizing it.

I did end up telling some colleagues that I’d had a health problem that was contributing to my being late on projects. They were all very sympathetic and supportive, though I still feel awful. For this to have happened in my first year was both good and bad; good, because people are very forgiving, and no matter what you do I think the first year is going to feel rough. Bad, because I’m behind on things that should have been done a long time ago, to set me up for success in years 2 and 3.

What amazes me, though, is how much I thought it was me — not me as in my body, but me as in my mind. I really beat myself up over feeling badly, thinking I was brooding, or depressed (which doesn’t make it okay, either, by the way). I’d give myself half pep-talks, half lectures, trying to shake off the chronic exhaustion, only to feel like I was letting myself down, over and over. It became a total snowball of self-directed negativity, when all I really needed was some iron.

My health issues aren’t over (we still need to figure out why my tenure-track uterus is misbehaving), but at least I know why I feel badly and what I can do, in the short-term, to mitigate that. Some people don’t even get that — they might struggle with chronic pain or fatigue or mental illness without ever learning the what or the why. But when we’re in a position where we normalize feeling drained, tired, unhappy, anxious, or stressed as the cost of doing business, that’s not okay. My body was telling me something was wrong for months; rather than listen, I berated myself for feeling badly.

I love Meghan Duffy’s post arguing that you don’t need to work 80 hours a week to be a successful academic, and I think that there’s a mental and physical component to that, too. The mind and the body aren’t separate entities; the health of one affects the well-being of the other. There will be weeks where things are rough, absolutely. I don’t expect every day to be cupcakes and butterflies. But we need to tune into our mental and physical health as much as our productivity, and give ourselves permission to figure out what’s wrong, seek treatment, rest, and heal.

In the meantime, I’ve got a lot of catching up to do, and I’m reframing my thinking about working smart, versus working hard.

10 thoughts on “Funks, slumps, and yawns: how undiagnosed anemia affected my productivity

  1. Glad you found a reason for your problem, and more importantly, a partial solution. It is harder when no-one can find anything wrong, but you know something is amiss. But even then, it is important to believe your body and do what you can to find more info and/or alleviate the pain or problems (even if it means pacing yourself, as has been discussed in previous posts on this blog).

  2. This post hits very close to home for me as well. During my last field season, I had a light period for about 120 days. Doing searches on WebMD (which should be renamed to “you have”) didn’t help because my profile didn’t fit, i.e., I’m physically fit, never have been on birth control, and have no sexually transmitted diseases. Because I study stress physiology and reproductive endocrinology, I thought it was a combination of stress and hormonal imbalance so I ignored my problem for the first 2 months. After 4 gynecologists and a procedure called “water echo,” the doctors finally found out I had a uterine polyp; which, according to research online, usually occurs in women around menopause. However, after speaking to many doctors and research on PubMed, I found out that polyps often occur in younger women but remain undocumented because many women do not realize they have a polyp. From this experience, I learned not to assume I was “ok” and attribute everything to stress. If my body is telling me something, I should probably listen. Lastly, I learned that it helps to do my own research on PubMed for medical issues (researchers still don’t know what causes polyps) and be assertive with the doctors about treatment.

  3. Anemia can be a difficult disease to live with and to manage, but it can be done! Before I myself was diagnosed with an chronic anemic disorder, I had no idea that so many types existed.

  4. Glad you got a diagnosis – I’m struggling right now with exhaustion during my 2nd pregnancy (my 1st one I had the normal bad stretches in 1st/3rd trimester.. this time even the 2nd trimester sucks). In contrast to your experience, I have been demanding tests sure that something was wrong (anemia, thyroid, diabetes, etc). All look normal. Add in chronic back pain that makes sitting in a chair all day hard, and it’s not been fun. But, I’m just stuck accepting that I’m going to be unproductive both pre- and post- baby. Which is hard to do (I’m about 1 year away from tenure review).

    However, at the end of the day, your health matters more than another paper or another grant (and I keep telling myself this to help me get through my annoyance at watching male colleagues who work all the time while I physically can’t). Wishing you the best in finding the root cause – I find it frustrating how little we know about women’s reproductive health (it’s actually an area of research I work tangential too and it’s just shocking what symptom MD’s will tell a woman they just have to put up with – I can’t see any man accepting bleeding for 72 days.)

    • Just to empathise with anonymous, my second pregnancy was like that too and not like either my first or third. And nothing anyone could find that was wrong. The Gyno put it down to having a toddler to look after, who still needed to be picked up etc, as well as doing all the other things i was used to doing. He seemed to think other women felt similarly. For me, it all ended well; but I did reduce my work to part-time after that because I, too, decided my heatlh and family were more important at that time than anything else, and luckily I could still keep my hand in with science a little bit. Hope it ends very well indeed for you too. And anyone else reading this.

  5. Hear, hear. Anemia sucks. I had it in my first (?) year of grad school and it also went undiagnosed for months. Months in which I berated myself for being sluggish and stupid and a wuss and also visited many times (I much prefer the Mayo Clinic site now). Started taking iron and it was like magic, except it was actually science. Thanks Biochemistry! Of course, I’m going through something similar right now and don’t know yet if it’s the anemia that’s back or something else. I needed this post to help me dig myself out of a “you suck” hole. Thank you.

  6. I have an atypical anemia presentation acquired after donating blood for several years. My hemoglobin and hematocrit levels were normal, but my ferritin was ridiculously low, indicating that I had zero iron stored. I had all the classic anemia symptoms, but doctors didn’t think I could possibly be anemic, because those hem numbers were fine. I couldn’t tolerate oral iron therapy, and after I finally got a clinician to take me seriously, I ended up with iron infusions at a hematologists office. It was amazing how quickly it helped. So sometimes, you might need a full iron panel, not just a CBC, to figure out what’s going on.

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