Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Managing Your Energy
Two techniques can help you manage your energy when you have myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). They are:
- Staying within your energy envelope.
- Pacing yourself.
These techniques can give you better control over your symptoms. They may also lead to fewer times when you feel exhausted and have so little energy that you can't do anything at all. This worsening of symptoms is often called a "crash."
These two techniques can work together to help you get more done in the long term. Some people find that over time, they can increase the amount of energy that they have in a day.
What is your energy envelope?
You can think of the amount of energy you have to spend in a day as your "energy envelope." You stay within your energy envelope when you use about the same amount of energy as you have in a day—not more and not less.
What is pacing yourself?
With pacing, you plan your activities so that you can rest when you need to. No matter what kind of activity you are doing—physical, mental, social—you stop to rest as soon as you feel the first sign of fatigue or other symptoms.
How can you stay in your energy envelope?
- Each morning, estimate how much energy you feel you have for the day. Give it a number from 0 to 100.
- A 0 (zero) would be no energy at all. People who rate their energy as a 0 might not be able to get out of bed.
- A 100 would be lots of energy. People who rate their energy as a 100 might feel like a time when they were the most well and active before they had ME/CFS.
- For each activity you want to do, think about how much energy it will take. Give it a number between 1 and 100. Do this for physical activities like walking, driving, or doing dishes; mental activities like reading a book or handling email; and social activities like talking with friends or sharing a meal.
- At the end of the day, add up the numbers for the total energy you used on activities that day.
- Compare this total activities number to your daily energy number. If the energy you used about equals your energy number for the day, then you stayed within your energy envelope.
How can you pace yourself?
As you do an activity, pay attention to your ME/CFS symptoms. As soon as you feel the first sign of fatigue, pain, or other symptoms, stop the activity. Lie down, close your eyes, and rest for 10 to 15 minutes. Then you can get up and start your activity again. It's important to stop and rest even when you're having a good day and think you should do more.
To do this, you will need to think about what you'll do if you start to feel bad while you are doing your activity. Make sure you have a safe and easy place to lie down, especially if you're not at home. For example, if you have driven somewhere, this could include lying down in the back seat of the car.
How can you practice these techniques?
Pacing yourself and staying within your energy envelope take practice. You may find that keeping a diary helps. You could start out by simply estimating how much energy certain activities take. For example, ask yourself how much energy does it take to drive to the store or do the dishes? How much does it take to spend 10 minutes reading a book, writing emails, paying bills, or talking to a friend?
You can also use your diary to write down how much energy you thought you would have in a day. Then list your activities. Write down how much energy you thought each one would take, and how much each one actually took.
You may want to break your activities down into chunks. For example, you may want to weed your garden. You could divide your area into small sections. Then you can estimate how much energy you would use for each section. Plan to do only the amount of weeding you can do without going outside your energy envelope. In this weeding example, you would also lie down and rest when you start to feel symptoms, even if you haven't finished a section.
Using these two techniques can be hard to do. When you are having a good day, it's tempting to overdo it. You might think that you should try to get everything done to make up for days when you had less energy. You might think you should push yourself even when you start to feel tired. But if you do too much in a day or force yourself to keep going when your body needs rest, you could then crash and need several days to recover.
But with practice, it will get easier. Soon you'll get better at knowing how much you can do in a day and when you need to rest, so you can do more of what you want to do.
Current as ofJune 3, 2018
Author: Healthwise Staff
Medical Review: E. Gregory Thompson, MD - Internal Medicine
Kathleen Romito, MD - Family Medicine
Adam Husney, MD - Family Medicine