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Fatigue a common symptom seen in ME/CFS and Long COVID. 

Fatigue is not the same as ‘tiredness’. We are all familiar with the normal feeling of sleepiness, or tiredness after exercise, a long period of concentrating or ‘burning the candle at both ends’, but fatigue is different and does not feel normal. 

Fatigue is an overwhelming sense of tiredness, lack of energy and a feeling of exhaustion. 

Fatigue can affect your ability to think clearly, balance on your feet, or organise your thoughts. It can also affect your physical energy levels and can make you much more emotionally unsteady when it is bad. 

Fatigue can be worsened or triggered by: 

  • stress and anxiety 
  • emotional upset 
  • multitasking 
  • driving 
  • lost sleep 
  • an irregular eating pattern 
  • and many other things that are often specific to the person and are not limited to physical exertion. 

You may experience what we call a ‘boom-bust’ effect where some days you feel "okay" and others you are exhausted. Some people describe fatigue as feeling like ‘moving through treacle’ or ‘hitting a wall’. 

If you are suffering from fatigue, it is important that you manage your energy levels throughout the day and try to improve your sleep patterns at night. This is best done using the 3Ps: Prioritising, Planning and Pacing. 

This link: gives information on how to apply the 3Ps and a downloadable version of the advice is available. Advice is available in English and Welsh at the bottom of the linked page. 

The Primary Fatigue Service Occupational Therapists and Physiotherapists can also help you with this if you are struggling. 

They can encourage and support you to use pacing techniques, diarising and scoring activities. They will guide you in planning your life to avoid overdoing it some days and triggering fatigue requiring large quantities of rest on others. 

Each video is approximately 10 minutes long.

Watch as many times as you need and also show to your family so they have a better understanding of your condition.

Watch in this order:

1. Finding a Stable Baseline

2. How To Manage Your Energy

3. Moving Forward

More about fatigue

  • World Physio website, Detailed information on fatigue in Long COVID and how to manage it. Our specialists have checked this information and it can be applied safely if you are living with ME/CFS, Long COVID or Post Viral Fatigue. 

The F-word

The word fatigue is defined in the Collins English Dictionary as:
A feeling of extreme physical or mental tiredness
Fatigues are clothes that soldiers wear when they are fighting or when they are doing routine jobs.
Fatigue in metal or wood is a weakness in it that is caused by repeated stress. Fatigue can cause the metal or wood to break.

As you can see from the dictionary definition, the word “fatigue” has many meanings. Regarding our health and well-being, we only have this one word to describe a range of experiences of feeling “extreme physical and mental tiredness”. At one end of the scale it can be used to describe feeling particularly tired following a poor night’s sleep, additional everyday life demands or excessive physical activity, by an otherwise fit and healthy individual. Fatigue can be experienced as a result of a known disease process, such as is experienced by people living with cancer or a heart or lung condition. We think of this as “Secondary Fatigue” as the symptom comes as a result of something else. Although we use the same word, we consider the fatigue experienced by people living with ME/CFS, Long COVID or Post Viral Fatigue to be central, debilitating, and encompassing PEM/PESE and the array of symptoms that go with it. For this reason we use “Primary Fatigue” to make a distinction.



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