Being chronically ill means that that individual is also in chronic survival mode.
The body's survival mode is not intended to be experienced in the long term. It is supposed to be a short term event to simply provide an individual with the means necessary to get through a crisis; an acute crisis.
So what happens when that mode is extended beyond the short term?
Fatigue.
We all know the feeling of an adrenaline packed sensation that happens in a crisis. That car almost running us off the road. The near accidents. That random strange noise in the house you've never heard before and think it's a burglar. That cracking sound in the forest at 2am out camping.
Once the crisis is dealt with, all of a sudden you tune into your own body. You realize that you were (perhaps) holding your breath, your heart is pounding quickly, you maybe even notice that your fists are clenched. Once the crisis is averted, your body starts to relax, breathing normalizes, heart rate slows down.... And then you *may* feel really tired.
Any health issue that causes long term pain means a long term survival mode. Your body is fighting 24 hours a day. It's as though your white cells are always on high alert - everything in your body is an intruder - so they attack everything in sight. It's like when you think there is a burglar and you swing a bat or a golf club in any direction of any noise. You have no proof that the intruder exists, you have no clue if there is an actual threat, but you are in survival mode, so anything out of the ordinary seems threatening and you are ready to attack at any moment.
Your body attacks anything that is out of the ordinary. It starts to see cells and organs like intruders so it attacks everything - always in fight-or-flight mode, and always fighting.
With your body so focused on fighting itself - 24 hours a day - in survival mode, no wonder there's severe fatigue! You are literally fighting ALL THE TIME. No rest. No breaks. Constant mini battles going on everywhere in your body.
It's exhausting! And it also takes up a pretty big chunk of your focus. So while you are trying to pay attention to something in the world that is important, the mini battles going on everywhere in your body are stealing that focus away from the world around you.
This can result in memory loss, a clear inability to focus - ha! 'Clear confusion'! Oxymoron! Yes!.. Being absentminded, missing details... People with chronic illness can seem distracted or apathetic. I promise, in my case, it's not that I am purposely not listening or uninterested, my body is simply taking up all of my energy and brain power.
This issue is one of the reasons why I am always nervous to meet new people now. Not only is it difficult to explain my situation in a concise and condensed explanation if asked, but if I am feeling particularly ill, I am absolutely not as social as I'd like to be. I literally have to focus on maintaining a smile on my face, trying to keep proper posture, and really focus on not being distracted. I know there have been many times where I have not made a great impression simply because I sat back and said virtually nothing.
Trust me when I say that I am truly a chatterbox... And the better I feel, the more social I become... I love meeting new people and sharing stories and experiences and going out and doing fun things - but if I am having a bad day, I will be very quiet, I will not (or cannot) fully participate, and I will usually have to leave early. This is all because the constant pain and inflammation take up too much space in my head.
Long term survival mode.