Living with fatigue

It can be part of having a health problem, but there are strategies that can help you cope. Rachael Healy shares tips from an expert and someone who lives with it.

For Sarah Miles, 43, heart failure means she experiences fatigue every day. “It totally wipes out my energy levels,” she explains. “It’s not just tiredness – my whole body feels completely fatigued, my mind goes blank, and I can’t speak sometimes.”

Like Sarah, many people experience fatigue related to a health condition. “About 40 per cent of the people that we see in our clinic have fatigue associated with a chronic disease,” says Professor Julia Newton, Director of Newcastle University’s Centre for Fatigue Research. “For example, it’s the commonest reason why people fail to rehabilitate after a stroke.”

Professor Newton and her team help patients find ways to live well with fatigue, while experience and help from medical professionals have helped Sarah develop strategies to cope.

1. Get checked for the causes illustration of doctor checking heart rate

Fatigue caused by your health condition may be made worse by other, treatable, causes. “We firstly look for reversible reasons why people might be fatigued,” Professor Newton says. “Are they anaemic? Do they have a vitamin D deficiency? If there is pain, we actively manage it as a symptom. Sleep is a problem for many people, so if we can identify things like sleep apnoea [where you stop breathing intermittently] or help people sleep in a regular pattern, that has potential benefits.”

Sarah was found to have pernicious anaemia (an autoimmune disorder where your body can’t absorb vitamin B12) and is now receiving treatment. “I have B12 injections every three months,” she says. “They give me a boost for a few weeks.”

Some medications for heart and circulatory conditions can cause fatigue as a side effect – ask your GP or cardiologist.

2. Pace yourself

No one has unlimited energy. “We talk about a pie of energy – people with fatigue have a smaller pie,” says Professor Newton. “We aim to help people manage that pie in a way that allows them to do things that they want to do. Setting realistic goals, learning how to rest and repair, and realising that they may have to adjust what they’re able to do can help.”

Illustration of a snail on an uphill climb“Pacing yourself is vitally important,” says Sarah. “If I have a day when I feel a little bit better then try and cram everything in, I know that I will suffer the consequences. If I’ve got a big thing to do, I’ll rest more leading up to it. “I try and arrange everything for my best time of day, between 10am and noon. Listen to your body.”

3. Ask for help

Sarah now asks for lifts when she’s too tired to drive and her son helps with household tasks. “I struggled with this immensely because I’ve always been fiercely independent,” she says. “But I understand that I have to – otherwise you end up in a complete mess.”

4. Be kind to yourself

Turning down invitations or asking for assistance can make you feel guilty – but it’s OK to put your needs first. “I don’t feel guilty any more,” says Sarah. “I’ve had long discussions with friends and family, so they understand. Allow yourself time. It’s OK to fall asleep. It’s OK to be tired. It’s part of the illness and you can’t help it.”

5. Look after your brain

Illustration of a workman looking after a brainIt’s important to tend to your mental health too. “There’s a secondary consequence of being fatigued, which is anxiety and depression,” says Professor Newton. “If your mood is affected, which is not unexpected when something devastating happens, then antidepressants can be of benefit.”

Getting support from a psychologist or counsellor can also help you come to terms with the fact that your life has changed and learn to accept that.

“I’ve been through a massive grieving process of what my life was and what it should’ve been,” says Sarah. “I’ve learned to accept what I’ve got and I’ll make the best of it.”

She also sought psychological help through her GP: “I have seen counsellors – my GP is incredibly supportive.”

6. Eat regularly

Sarah saw a dietitian as part of her fatigue treatment. “They’ve said that I should try to eat small things throughout the day to boost my energy,” she says. “Things like a breakfast bar or malt loaf – something that’s got lots of energy.”

7. Find new hobbies

Sarah used to work full time and do crafts, but now she enjoys reading psychological thrillers, watching TV and does voluntary work. “I spend most of my time doing stuff for the BHF and my local GP surgery now,” she says. “I feel of some value again and that’s what drives me forward.”

Read Newcastle University’s full guide to managing fatigue.

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