Types of MS Fatigue
This occurs as a direct result of MS. The body slows down reaction times due to damage to the central nervous system, causing fatigue. This can take the form of “lassitude” which is an overwhelming sense of tiredness unrelated to the amount of activity, as in my attempt to sweep the floor, or how much sleep you've had.
Unlike regular fatigue that a healthy person may experience after a late night or a stressful week at work, lassitude is not alleviated by resting or getting more sleep. It can be mental or physical in nature, or both at the same time.
Many people with MS experience lassitude on a daily basis. Lassitude can:
- Come on suddenly and leave just as swiftly
- Last all day, every day for as long as it occurs
- Occur in the morning after a good night's sleep
- Become worse throughout the day
- Be exacerbated by heat and humidity
- Disrupt daily tasks and activities
A bout of lassitude can last an hour, a week, or even months, and often occurs as part of an MS relapse. Unfortunately, there is no way of predicting when it will strike or how long it will last.
Our bodies also “short-circuit” in small muscle groups due to damage following repetitive movements. As I write this my fingers are slipping on the keys as the muscle groups in my hands become fatigued. I often have to rest during writing for this reason but this aids the whole process so isn’t such a bad thing. It can get annoying at work when I have a report writing deadline though!
This isn’t caused by the disease process but by other related factors, such as:
- Sleep disturbance
- Walking difficulties
- Local environment
For me, managing secondary factors goes a long way to reducing how fatigue impacts me.
Cognitive Fatigue and MS
The course I went on taught me about cognitive fatigue, too. Some participants described being unable to read a book as they were unable to remember the characters and follow the plot due to cognitive fatigue. I am lucky that my symptoms are largely physical, but often when it gets to the end of my working day, I struggle to take in what I’m reading and find holding a conversation more difficult.
This is why I work part-time and have chosen to work four days from 9.00 a.m. to 2.30 p.m. – I can just about manage this before my brain starts to heat up and steam starts coming out of my ears! On a serious note though, cognitive fatigue, also known as brain fog, can lead to feelings of being unable to cope, so we owe it to ourselves to learn about it and manage it to avoid a spiral of depression.
As we know, MS affects everyone differently so no two people will experience fatigue in the same way, but we need to ensure we have the best energy levels available and use it in the most efficient way.
- Recent studies have shown aspirin to be helpful in many MS patients who frequently suffer from lassitude, but discuss this option with your doctor first.
- Physical therapy and exercise can help reduce fatigue, but be careful not to overdo it.
- If you find your lassitude is worsened by heat, try wearing a cooling vest and staying in air-conditioned areas.
- Conserve your energy you when you do have it; don't over-exert yourself on unnecessary activities. Take note of the times you seem to have more energy and plan your activities around those times.
- Be sure to allow yourself time to rest or nap during down time, especially after activities.
- Be sure to deal with stress and get enough sleep.
If at-home methods don't help improve your lassitude symptoms, talk with your physician about alternative solutions that may work for you. Discuss the medications you are on and their side effects – you may be able to switch to something that doesn't worsen your fatigue.
It's also helpful to use the energy you do have efficiently, by:
- Pacing activity
For me, it’s all about lifestyle changes like eating well and resting a lot to avoid over exhaustion, but I’ve also had to learn to delegate and prioritize, which can be hard. I don’t make plans to go out after a busy day at work, for example, as I know it’ll be too much and I’ll suffer the following day.
I also delegate jobs to my husband (who’s amazing) and don’t allow myself to get upset about it. I take help when it’s offered, too. My mum often offers to pick up my daughter from nursery after I’ve been at work all day, so I don’t have to go out again which means I have enough energy to get dinner ready.
Fatigue and MS aren't my fault, and it’s helpful to remember that even though I can’t do everything anymore, I can still do some things – so as long as I do them well, it’s ok by me!