Ever since the pandemic - emails, questions, and discussions about fatigue has come up quite a lot amongst my clients. The ramifications of Covid can appear in many forms and fatigue is one of the long-lasting effects it can have in some people. For many, it lasts just a few weeks whilst in others, it feels like a long battle of never feeling like oneself again.
Below is a guide about fatigue, lifestyle, and exercise, regardless of the main cause of the symptoms. Please seek medical advice if you experience long lasting fatigue. Fatigue is a symptom of another underlying medical, lifestyle or stress reasons, and not a stand alone illness (except for diagnosed ME/CFS) Always seek medical advice before partaking in any physical activity and with an instructor who is trained and certified in working with patients living with chronic illness.
The Invisible Vampire
Living with Arthritis, if I was ever given the chance of eradicating just one symptom during a flare – Fatigue would win every time. Not the pain. It is my biggest enemy and it is one of the main reasons why I left my career as a graphic designer and returned to the fitness industry. To improve my life after my Arthritis diagnosis. With exercise being my main job now, I have had to find a balance between doing my job and allow for rest, pacing, setting priorities, conscious eating habits and practice mindfulness to destress. In my luck, I only experience fatigue during an Arthritis flare, therefore it is always a goal to minimise a flare in the first place. Knowing the underlying cause and having a treatment plan is the base to minimise the symptoms.
I compare fatigue to the movie scene in The Neverending Story, when Atreyu and his horse Artax get into the Swamp of Sadness and Artax gets swallowed up by the swamp. A scene that still haunts me in my 40s. (If you haven’t watched it, don’t, it has traumatised a generation!)
The Swamp of Sadness overwhelms its victim with hopelessness and sadness, so they lose the will to fight to live, slowly swallowing its victim into the heavy, thick, and draining clay-like muddy swamp. That is fatigue in a nutshell. One part of you is stuck in the swamp losing, whilst the other is pulling the reins, trying to live a functional life.
Fatigue is unrelenting and profound exhaustion. Its life draining, and like an invisible vampire - will suck the life out of you slowly, making you question your own existence.
Legs and arms become heavy as led, a feeling of flatness and depleted muscles. As if there is a lack of oxygen and therefore life in the body. The mind becomes fuzzy and disorganised. Concentration and motivation are low. It can have such devastating impact on a person mental and emotional state of being and therefore paramount to address it , to live a happier and healthier life.
What Fatigue Is Not
It is not tiredness and can’t be improved by sleep. It is not laziness or lack of ambition. It is not a character trait and does not represent or define you as a person.
1. Something to learn and adapt to live with – Lifestyle adjustments.
2. A symptom that we can lower the frequency and intensity of.
There is a wide range of causes that can set off fatigue, such as medical conditions, sedentary lifestyle choices, stress and/or anxiety disorders. Unless you have been diagnosed with ME/CFS, which is a multi-system disease that causes dysfunction of the neurological, immune, endocrine and energy metabolism systems - If you experience long bouts of fatigue, it is important to seek medical attention to find the underlying cause.
Don’t overdo it. When dealing with fatigue it’s about doing things in smaller chunks and pacing. When we do too much it will deplete the energy stores further.
Prioritise your daily tasks
Break up household chores into smaller chunks.
Delegate and share chores with other household members. Yes, even kids. Come up with a plan and schedule to get everyone involved.
Have regular sleep routine – sleep/wake
Take time out to relax and do things you enjoy each day.
Reduce or remove caffeine from your diet to help you sleep.
Be mindful of your eating habits, little and often is best to avoid the urge of reaching for refine sugar snacks. Sugar might boost your energy quickly, but the energy will soon fall even lower than before.
Practice mindfulness, de-stressing techniques to avoid emotional stress.
WHY ON EARTH SHALL I EXERCISE? – Prolonged lack of exercise can worsen fatigue.
Writing a piece about fatigue and exercise feels like I'm telling you to put ketchup on your ice-cream. It just doesn't go together, right? It sounds evil and I'm asking for far too much. But it is about understanding your threshold and working right below it and progress slowly.
It is well researched and proven that exercise increases the energy supply in the body. Exercise also boosts oxygen circulation which supports the mitochondria’s energy production: chemical energy!
Exercise increases happy hormones (Serotonin, Dopamine) , decreases stress hormones (cortisol) and improves sleep and concentration. All the stuff we need, even more so when suffering with fatigue. Please see Mental Health & Exercise blog post for more information.
Most recent study LIFT by Versus Arthritis found for the first time that non-drug treatments such as physical therapy and talking therapies can significantly improve fatigue.
Although exercise might feel exhausting temporarily – lack of it for prolonged amount of time can worsen fatigue.
Don’t overexert – Too high intensity/time can worsen fatigue.
Start with short bouts of exercise of 5 -15 minutes, and gradually increase. (For CFS maximum 30 minutes at one time)
The most effective form of physical activity for fatigue is aerobic exercises – walking, cycling, or swimming.
Strength and mobility training is great for building up endurance and strength to aid the aerobic activity, but it is not considered as the main form of treatment.
Plan a time in the day you know you can cope with physical activity. Most people prefer late morning to allow the body to wake up slowly and get moving. Others enjoy an evening workout to sleep better. Middle of the day tends to be the worse time. Do what works for you.
Rest after physical activity and do something that will relax your body and mind.
Note that the body will become what we ask it to be. Even through illness, although it is harder. If I start to do a 10-minute walking program every day, the body will adapt to cope with that walk. With time – I can increase my 10 minutes’ walk to 15 minutes and so on. However, with fatigue it is imperative to set a sustainable baseline of physical activity and gradually increase this level over time. Timeframe will differ from person to person.