Fatigue has been the one MS symptom that has been a constant for me from the point of diagnosis. It’s not that unusual, since fatigue is one of the most common symptoms of MS which means I know that I’m not alone in experiencing it.
What can make it harder to cope with though is that people experience fatigue in different ways. So just like there’s no “one size fits all” method of managing your MS in general, the same can go for fatigue.
When I try to describe fatigue to my friends I say it’s like “walking through quicksand with boots filled with water whilst experiencing the world’s worst hangover.” Fatigue hits me in two ways – physically and mentally. Physically my entire body slows down, to the point where every movement feels like a monumental effort. Mentally, I’m overtaken by a thick fog and just putting a single sentence together becomes a full-on workout for my brain.
People who don’t experience this often misunderstand the severity, so people – even well-meaning ones – sometimes have frustrating responses. I’ve made a list of the things people say about fatigue that I really wish they wouldn’t.
5 things not to say to someone with MS fatigue
1. “We all get tired”
Fatigue isn’t like regular tiredness. It can be completely arbitrary and disproportionate to your activity levels. Plus, it feels different; I can quite easily tell the difference between regular tiredness and MS fatigue.
2. “Why don’t you just take a nap?”
Sleep doesn’t always help. In fact, a lot of the time a nap is no more than a sticking plaster. Even if it might make me feel better for a few hours, very quickly I’ll be back to square one. It’s like never being able to fully recharge the battery on your phone.
3. “Are you sure it’s not just a bit of laziness?”
Seriously?! I would love to be able to do everything that I want to do, when I wanted to do it. When I think about having a “lazy day” it often involves watching a movie, eating ice-cream, reading a book or chatting on the phone with a friend. When fatigue hits, even doing those things uses too much energy.
4. “I know so-and-so with MS and they never get tired like you.”
Everyone with MS is different and can experience different sets of symptoms. While fatigue is common, not everyone experiences it. People also have different coping mechanisms depending on how fatigue affects them. So it might not always be obvious if someone is experiencing it, if they’ve been able to manage it effectively.
5. “It’s not like fatigue is a serious symptom”
The way an individual views each of their MS symptoms is personal. Someone I know with MS once told me that for them, losing their ability to walk properly and having to use a wheelchair was by far the lesser of the two evils when compared with his debilitating fatigue. For someone else, the opposite might be true. So, if you’ve never experienced it, don’t make a judgement on it.
Things I wish people would say when I experience fatigue
If you do know someone who is experiencing fatigue and you’re wondering what you could say or do for them to offer solidarity and support, I have listed three of the most important things that I would find useful:
1. “Tell me what works best for you and we can work around that”
I dread getting invitations and having to turn them down because the place is too far, the timing isn’t right, or I feel like I can’t cancel at the last minute if I’m having a bad fatigue day. Being able to do things closer to home and at times when I know my energy levels are likely to be at their best can make things easier when planning social occasions. And being understanding if I have to cancel at the last minute also goes a long way. I wouldn’t cancel unless I really had to and I’ll already be feeling rubbish because I know I’m going to miss out.
2. “What can I do to make things easier for you?”
Offering a lift, picking up some shopping and suggesting an alternative if we’ve had to cancel plans are all things that can make things easier. I was at a wedding this summer and it was going to be an all day/late night event. The couple whose wedding it was offered me use of their hotel room during the day to be able to rest if I needed to, because I’d told them I might not be able to stay the whole time. Knowing that there was an option to rest if I needed to, meant that I could relax and enjoy the day much more. But please, don’t assume you know what will help – just ask me!
3. “I thought this might cheer you up a bit”
When fatigue hits I feel rubbish. I feel frustrated. And my mood completely dips. Something as small as receiving a nice text message from someone, making exciting plans for a future date, or doing something that will make me laugh or smile just helps to lift my mood. It won’t cure the fatigue but at least my mood might improve!
Hacks to help you manage your MS fatigue
There are no real hacks to cure fatigue, there are just ways to try and manage it. I’ve had MS for ten years now and fatigue was one of my first symptoms – I’d been experiencing it for quite a while even before my diagnosis. I can’t actually remember what it’s like to feel 100% full of energy anymore! But over the years I’ve learnt what works for me and what can help to optimise my “battery levels.”
1. Post-it note queen
I make lists. Lots of them. I prioritise. I schedule. I keep an appointments diary for EVERYTHING. I colour code. I cross-off and tick. Writing things down not only helps me to remember things when my brain gets foggy, it helps me to see very clearly what the most important things are, and which things are going to need the most physical and/or mental energy. I can then do those things when I know my energy levels will be at an optimum and do the “easier” or “lesser” tasks when my battery is running lower. This also helps me to pace myself – if I know I have a particularly busy day scheduled, I’ll make sure that the following day is more relaxed.
2. Routine, routine, routine
I find that waking up at around the same time (even on weekends), eating my meals at around the same time, and having a regular bedtime routine can really help my body to know what’s happening and when. This can also help with other symptoms that can exacerbate fatigue, such as bladder issues. So not drinking too much before I go to bed means I’m less likely to have disturbed sleep due to getting up to use the bathroom in the middle of the night.
3. Exercise for energy
It sounds counter-intuitive but regular exercise actually makes me feel better. Muscles which aren’t used regularly become weaker, which means that more energy is needed to carry out general tasks. This makes fatigue worse. Exercising regularly will keep my body in as good a shape as possible. I’ll adjust what type of exercise I do depending on my energy levels. I love dancing, and that’s something I’m able to adapt if I’m having a “bad energy” day. Otherwise, a gentle walk or stretching and muscle strengthening exercises are just as good. Exercise also helps me to sleep better and feel good about myself.
4. Ask for help
This has been really hard for me. I’ve always been very independent and I like to do things myself. However, I’ve learned that accepting help often means that I can get more done or enjoy things more because I’m conserving precious energy. I have a few people who are close to me who I know I can really rely on for support. They understand me and my fatigue and I know I can call upon them if necessary.
5. Don’t beat yourself up about it
In time, I’ve learned to accept things more, deal with the frustration of living with fatigue (even though it’s still annoying!) and develop alternative interests that fit around the ups and downs of my energy levels. I now enjoy being at home just as much as being out. I’ve learned to enjoy my own company, so when I do have to stay at home I’m not as sad about it.
Most of all, I’ve learned to be kinder to myself. If I can’t get something done, I just let it go.
NPS-IE-NP-00165 December 2020