Self-management of fatigue: Reducing the impact of fatigue

My previous blog explored the physical steps you can take to manage fatigue, but there are also important emotional and environmental consequences of fatigue. For me, this means accepting that there are some things I cannot do on a given day, which may make me disappointed. Harder still is accepting that there are some things I may never be able to do – this can turn into a long session of reexamining my future plans and dreams.
On a more immediate level, I often just get sad and angry that I don’t feel well. I even occasionally dip down into an ugly resentment that other people feel so much better and take their health for granted. I typically allow myself to wallow in these feelings for a while, until I end up getting so tired of myself that I talk to a friend, go for a walk or do something else to get me out of this dark place. Other people may find it helpful to talk to a therapist or engage in some other activity that helps them feel better.
There are also things we can do to manage our environments and optimize the world around us. One of the most important things you can do is build and maintain social networks. Not only can other people help you feel better by providing emotional support, friends can help out in a pinch when the fatigue is too much.
Another component of environmental management involves accessing information, transportation, public spaces and civic opportunities. ­ There are many resources for people with MS. Take advantage of them. Look online for different fatigue-fighting strategies and tips from other people living with MS. Contact the National MS Society to see what kinds of programs they may offer in your area, such as support groups or yoga classes. Apply for a disabled parking placard to help on those really bad days where a parking lot looks like a five-mile stretch of desert. 
Some people will be more successful than others at really doing all that they can to combat fatigue. Dr. Finlayson refers to the people who have the following characteristics as “activated patients.” These people:
  • Act in ways consistent with self-management
  • Have a good understanding about MS and fatigue
  • Actively share decision making with members of their health care teams
  • Manage and monitor their symptoms
  • Make adaptations and changes to reduce impact of fatigue on all aspects of life
  • Engage in healthy life behaviors
  • Are confident in their ability to identify and access resources 
All of these things are done with the goal of reducing the impact of fatigue on everyday life. Despite best efforts, some days we will be more successful in our fight against fatigue, while other days may feel impossible. The most important thing is to keep looking for ways to feel just a little bit better all of the time, while not blaming ourselves during those times when fatigue gets the upper hand.
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Julie Stachowiak, PhD

Julie is the author of the Multiple Sclerosis Manifesto, the winner of the 2009 ForeWord Book of the Year Award in the Health Category. She is an epidemiologist who is also a person living with MS, Julie has an in-depth understanding about current research and scientific developments around MS. She also has first-hand knowledge of the frustrations and anxiety surrounding the disease, as she had MS for at least 15 years before receiving a diagnosis in 2003 and has had several relapses since her diagnosis.

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  • Myra Ann Loftis   Oct 28, 2013 11:36 AM
    where can I find your book? I have MS along with COPD and the days really are long....thanks.
  • Lori   Oct 28, 2013 12:43 PM
    I too find myself resenting others, I confess, when I read that you can take a walk to get out of it, I resented You! I would give anything to be able to walk again and take walks again. As I look out my window and see other walking their dogs, I envy them.
  • Jean   Oct 28, 2013 12:57 PM
    I don't think I have true "MS fatigue" but I do find a just yawn, a lot! I also happen to have a B--12 deficiency and receive B-12 injections monthly, I used to just get extra "yawny" when my monthly shot was due, though this month it's been a few days since I've had my shot and I'm just yawning all the time. But, I'm guessing this is not what you consider to be MS fatigue, am I right? P.S My background is first MS attack at age 18 then nothing until at 50. I am now 53 and started copaxone about 4 months ago.
  • Michelle McArthur   Oct 28, 2013 2:35 PM
    Reading this story sounds so much like something I would say about myself. :( I am now depressing to me around, a bit of a "B" as my Husband would say, angry because I can no longer so many of the things I once enjoyed...taking my Daughter apple picking, trick or treating, cooking, holding down a job! Yoga, etc. I feel so jipped and resentful of so many things :(
  • Beth   Oct 28, 2013 2:42 PM
    Last week I was given an unexpected heart ache from a grandchild. I was crushed and quickly ended up in bed or resting on the couch. I could continue in a downward spire-role but I don't want to. As soon as I released what was happening I went to the only One who can heal my body and spirit. I praise God for giving me another job to do.
    "There are also things we can do to manage our environments and optimize the world around us. One of the most important things you can do is build and maintain social networks. Not only can other people help you feel better by providing emotional support, friends can help out in a pinch when the fatigue is too much." GOOD ADVICE! My choice of "social networks" are Church and volunteering.
  • eleni   Oct 28, 2013 4:37 PM
    Hi there!
    So,so true!
    It s a good idea ,to be an activated patient,as you and others are!

    But ,for the thought:
    "Harder still is accepting that there are some things I may never be able to do " i suposse its a fact for all the people with or without ms.My personal everyday goal would be not to take problems as if it is all from ms.There are multiple problems to healthy people too that, need to be solved.

    We need to find the solution!For us ,a bit harder but ...possible.
    thank you so much!
  • Jenny Mc   Oct 28, 2013 5:16 PM
    Thanks so much. Last week, I started attending a 6-week Occupational Therapy Class, and I have chosen to focus on Managing Fatigue. For me this is foundational to every other goal I am trying to accomplish in my life ... re-launch my career, exercise more, have more patience with my children, reduce clutter in my house, volunteer more, etc.

    I made the simple goal to get 8 hours of sleep a day (at least 7 during the night). So far so good. I am averaging about 7.5 hours. I even find that by getting in bed on time, I wake up with the energy to exercise 30 minutes before my kids get out the bed. The snow-ball affect of this has been an improvement in my mood and my outlook.

    Thanks for your timely article. It let's me know I'm moving in the right direction.
  • deannay  Oct 29, 2013 10:40 AM
    I'm right in the throws of it. Also I moved to a new community so I only know a couple of people and not all that well. I do have an amazing husband though. I find the fatigue part the worst of all things and just this morning began a medication to help combat it. armodafinil. I can't tell you yet what the affect will be. I no longer work due to my MS but still want to feel vitally involved with my family and do my share of household chores, taking care of business etc. I feel just horrible when my husband has to take care of everything after working all day.I am secondary progressive and this seems a constant struggle. I have figured out that I can do 2 errands a day, 1 if I plan to do some house work as well. When I slip into a depressed state, I have to stop and count myself lucky for the things I am able to do. Number 1, I can still love, encourage, appreciate. After that it's a day by day process and I never book more than one commitment/appt. a day. Some days are better than others. I think acceptance is such an important aspect to being less miserable about it all.
  • sandersbabs  Nov 18, 2013 8:22 AM
    This website has been a God sent. I am learning so much and gaining so much knowledge. I too am very tired all time and not being able to do the things I did before makes me sad.

    I was the type of person that was on 10 all the time. Cleaning the house 10, cooking 10, coming home from work and cleaning and cooking 10. Now if I forget and try to do 10 my body will shut down. I am learning what I can do and what I can't do. It is so hard because I want to do it all....and I can't.

    The hardest part for me is the holidays. I can't stand and cook for hours like I did in the past. I can't peel a bag of Sounds like a little thing, but when you can only peel one and have to rest for about 15 minutes because your hand is cramping...that is a big thing. I need lots of help and/or prepared food.

    I think I am adjusting well to this life change...
  • SIRAN ABESHYAN   Aug 20, 2015 3:27 PM
    Thank you so much for sharing all the information in regards to MS.
    I ma not quite sure about my diagnosis yet. I had spinal injury several years ago. I have herniated and bulging disc in my cervical and lumbar spine.
    I have been having numbness and tingling in my entire body including. What is more scary for me is that I have numbness in my head and my tongue for the last few months. I also have tingling and twitching under my skin in different parts of my body. I am not sure if I have MS or ALS.

    I am still being diagnosed. First I was told this symptoms could be related to my back, but by doing my own research if it was from my back then I should not be feeling numbness on my face or my tongue. I also feel tired all the time. I am 53 years old female and use to live a healthy life until this.

    I would appreciate if you could share your thoughts or advise if you had any symptoms related to your head and tongue.

    Thank you again and god bless.