Understanding Fatigue

Fatigue is one of the most common symptoms of chronic illness and may form part of almost any long-term health condition. Sadly, it is also one of the most misunderstood, as it is easily confused with simple tiredness. 

Tiredness is something we all experience. We might have a particularly busy day (or week) at work, take a long-haul flight that gets in at 3am, or organise a birthday party for twenty hyperactive children.

 

We can feel ourselves pushing beyond the limits of what we would normally do. Our body may ache, or our limbs may feel heavy. We may have difficulty concentrating, and lose our train of thought when speaking or writing. But you can put this aside (perhaps with the help of some coffee!) and get through what needs to be done.

 

Afterwards, we feel drained. But if we are able to sit down and relax for a few hours, or get a solid night's sleep, we feel refreshed. After a day or two, we feel pretty much back to normal. 

Image by Jamie Street

Fatigue is rather different from tiredness. It involves many of the same feelings - aching, heavy limbs, difficulty concentrating (sometimes called "brain fog") and so on. But this isn't something that you can just push through to get what you need to do. Fatigue is an overwhelming sense that your body and mind have done far more than they should, and cannot do any more. There is no way to soldier on through this - it demands immediate rest.

 

But unlike tiredness, rest may not help with fatigue. You can sit down for a minute, or nap for an hour, or sleep for 14 hours, and you may still feel almost exactly the same afterwards. The feeling of exhaustion can be unrelenting. 

Unlike other symptoms, like pain or nausea, there is no symptomatic treatment to relieve the effects of fatigue. It often gets better or worse as the underlying health condition does, but the only way to manage it is to restrict how much you do. Each person who is coping with fatigue has to find the right level of activity for them - how much they can achieve each day without burning themselves out.

Lazy Morning

What Is It Like To Live With Fatigue?

Living with fatigue is (ironically) exhausting. At its worst, it can turn the simplest of tasks - showering in the morning, cooking a meal, driving to the shops - into an insurmountable obstacle. Often, what it means is that we have to budget our energy.

 

In the same way that you have a limited about of time in the day, those of us with fatigue have a limited amount of energy. The Spoon Theory is often used to explain this. Each spoon represents one "unit" of energy that we can use.

 

Some activities, like going to work or exercising at the gym, are more tiring and take more spoons. Others, like having a shower or cleaning out the cats' litter trays, are less tiring. Crucially, however, even these smaller activities take some energy - it might only be one spoon, but that's one less than you have to spend over the day. 

A graphic to explain budgeting energy using the spoon theory

There is no good way for us to make more spoons. If we do more in a day than we should, then we can feel the effects for days or even weeks afterwards

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