Living with fatigue: expert tips

Fatigue is very common in people with conditions like heart failure and cardiomyopathy. Certain heart medications can also make you feel tired.

When it comes to defining fatigue, one challenge is that it means different things to different people. “For some people, fatigue is a constant presence, while for others, it comes and goes,” says Professor Julia Newton, a consultant geriatrician with over 20 years’ experience researching and treating people living with fatigue. "It can also be linked to symptoms like brain fog and muscle aches.

“Essentially fatigue is the overwhelming feeling of lacking energy. People often describe it as a battery running out. They might start the day with a full battery, but it runs down too quickly.”

Professor Newton adds: “Another common sign of fatigue is when people wake up feeling just as exhausted as they did yesterday, even after sleeping reasonably well.”

Facing emotional challenges

Professor Newton explains that people with fatigue face several challenges. “Because fatigue levels cannot be tested and you cannot actually see how tired someone feels, other people may doubt the experience of people living with fatigue. As a result, people often battle on in silence rather than admitting they do not feel 100 per cent.”

Because you cannot see how tired someone feels, others may doubt people living with fatigue

Many people are also forced to give up or scale back on activities they find fulfilling such as work, hobbies and spending time with loved ones. "Many of us feel defined by our roles at work or in the family. Not being able to fulfil those roles can lead to feelings of low self-worth,” Professor Newton says.

It is not unusual for people with fatigue to experience challenging emotions. Professor Newton explains: “People use words like ‘guilt’, ‘frustration’ and ‘anger’. They feel like fatigue is somehow their fault, that they are a burden, that they are not doing enough.

“But dwelling on difficult emotions can become a problem. Anger, for example, uses up precious energy – energy you could put towards something you want to do.”

Learning to pace yourself

Living with fatigue may not be easy, but it is certainly possible to adapt on both a practical and psychological level.

“We all have a ‘pie of energy’ that we use to do things every day,” says Professor Newton. “With fatigue, your pie is smaller. It might be possible to enlarge that pie over time, but in the meantime it is important to manage it so you can get through each day.”

To achieve this, it all comes down to a strategy called pacing, says Professor Newton. “If you use up today’s energy and start borrowing from tomorrow, you are going to crash. Pacing helps you avoid cycles of ‘boom and bust’. It means breaking tasks down into small, manageable steps that you can tackle one at a time.

“For example, could you spread out the spring cleaning over a series of days or weeks? You might need to accept there are certain things you cannot do in the same way as before. But it’s better to achieve something small every day than take on too much and be out of action for the rest of the week.”

Rediscovering rest

Professor Newton also highlights the importance of resting at regular intervals, but points out not all rest is equal.

“In modern society, we’ve forgotten what rest is. You might think sitting down to check your emails counts, but it does not. However, things like mindfulness and yoga can help you get some energy back.”

You can also look for ways to save energy during tasks. “Ask yourself, ‘is there a less tiring way to do this?’”, says Professor Newton. “I once saw a teacher who believed she always had to stand in front of her class. Initially she found the idea of sitting uncomfortable before realising it would make life easier.”

“You do not have to make sweeping changes; simple ones can make a difference. If you work a four-day week, for example, would it be better to take Wednesday off rather than Friday? A mid-week pause could give you more relief than a long weekend.”

3 simple tips for managing fatigue

• Learn to read your body. For example, you could fill out a fatigue diary to get familiar with your limits and help you plan each day with pacing in mind.
• Stick to a routine. Include not only ‘must-do’ activities but also enjoyable ones, such as socialising or learning a hobby. But remember to pace fun activities too.
• Stay positive. Living with fatigue can feel demotivating, but try to focus on what you can do rather than what you cannot do.

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