Dealing with Multiple Sclerosis Fatigue
Multiple sclerosis is a poorly understood autoimmune disease with a variety of symptoms, not all of which are felt by every person. Perhaps the most common symptom of MS is fatigue, and even that does not affect everyone equally.
Tiredness and lassitude
Fatigue can manifest itself either mentally or physically, and can be a slow drain throughout the day, a lack of ability to recharge at night, or bursts of enervation which leave you suddenly unable to perform the task you were wanting to do.
It can often feel like a sort of low-grade flu, or can feel like you have not slept for a week. When the fatigue is only an annoyance, typically it is called tiredness. However, when the tiredness becomes overwhelming, then the term to use is lassitude.
Fatigue covers the entire range and will be the typical term used in this article.
Though there is as of yet no cure for MS, there are steps you can take to mitigate the fatigue. Perhaps together we can re-energize your life and give you back some more control over your day!
Identifying MS-associated fatigue
Everyone feels tired at some point. Generally that tiredness comes from exertion, lack of rest, or even an improper diet. Multiple sclerosis can cause its own fatigue, however. There are a few ways to identify fatigue that comes from MS.
The biggest factor is whether or not you can identify why you are tired. If you consistently have a good night’s rest and are not engaged in strenuous physical activity, but are still tired every day, that is MS fatigue. It can also come suddenly, or can be aggravated by hot and humid conditions.
Sometimes there are other symptoms that happen at the same time. If your fatigue is more than just tiredness and also comes with a general feeling of malaise, it may be MS related. Other symptoms might include headaches, dizziness, difficulty concentrating, depression, limbs which feel heavy, and a worsening of other symptoms you already know come from multiple sclerosis.
What causes MS-related fatigue?
The short answer is that nobody knows for sure what cause MS related fatigue. The largest possible culprits are the compromised immune system as well as the central nervous system damage caused by MS. Your endocrine system may also be disrupted by the disease, along with your brain function.
Sometimes the symptoms of MS are what cause MS related fatigue. The extra effort it can take to get through the day can be draining enough to cause daily tiredness, and MS can disrupt your sleep.
How your doctor can help
If you feel like MS fatigue is negatively affecting your life, you should discuss it with your doctor. Sometimes combating the other symptoms, such as the headaches and dizziness, can give you just enough energy to power through the fatigue.
There are a few medications which can be administered in cases of extreme MS fatigue. Two of them are Amantadine and Modafinil. Though they can be necessary if you have strong lassitude, it may be wise to seek other methods of treating your fatigue as well.
Also, sometimes your fatigue is not caused by multiple sclerosis. Fatigue with similar symptoms can be caused by other illnesses, such as anemia or a thyroid disease. It is also possible that it stems from the medication you are taking to fight MS, in which case changing your prescriptions may be all that’s necessary to defeat the fatigue.
How you can help
There are two basic methods of fighting MS related fatigue, and those are to bolster your energy stores, and to prevent them from being drained.
Exercise can help immensely. Both aerobic and anaerobic exercise improve your body’s ability to store and utilize energy. Strengthening your cardiovascular system helps your heart pump energy-giving blood all over your body. Strengthening your muscles increases their glycogen stores to improve the energy stored, and teaches them to move in a more efficient way.
The benefits of exercise do not stop themselves at fatigue, and are known to help MS patients in other ways as well.
Cognitive behavioral therapy will require the assistance of a therapist, and was originally developed to treat depression, but has been shown to be beneficial to combat MS related fatigue. To a certain extent that fatigue is in the mind, and CBT helps you move past the mental exhaustion.
Diet can also help, to a lesser extent. Consuming nutrient dense foods will help your body energize itself better, and skipping foods with high caloric but low nutrient content can stabilize your blood glucose levels, helping maintain your energy.
Sometimes, the way to combat MS fatigue is to minimize your energy expenditure. We do not recommend flying around on a floating chair while robots tend to your every need, but the occasional assistive device may help save your energy for when you need to use it most.
An occupational therapist may be able to assist you in making your workday flow more efficient. Similarly, a rehabilitation therapist may be able to do the same thing, just with your own muscle movements.
Heat is one of the external factors which contributes to MS fatigue, so staying cool can help a lot. Even a small fan can cool you enough to restore some energy, and there are advanced cooling therapy techniques which can help when the situation becomes too hot.
Even though MS fatigue can strike despite a good night’s rest, consistently getting good sleep will help in the long run. Try to avoid caffeinated and alcoholic drinks before bed. The reason for avoiding caffeine is a no-brainer, but some people use alcohol to help them fall asleep. This actually does not help because while alcohol can help you fall asleep, it disrupts your sleep pattern as you sleep, preventing you from getting as much rest as possible.
Avoiding blue light can help you fall asleep as well, since blue light inhibits melatonin production. Melatonin is a hormone that is responsible for telling your body that it is time to sleep. Most people are exposed to blue light via computer and phone screens.
Some techniques to lower the amount of blue light received includes: Limit technology use before bed, use apps which change the screen’s hue to minimize the production of blue light, or wear amber colored (or ultraviolet blocking) glasses while looking at the screen.
If your computer is running a recent operating system, there is a built in Night Mode option that can turn reduce the amount of blue light automatically.
Rest and relaxation is another technique to minimize your energy expenditure, so you can power through fatigue when necessary. Do not be afraid to take a few minutes every now and then to get off your feet and rest. Power naps can be helpful, about 20-30 minutes long. Even NASA knows that pilots should take power naps!
Sometimes fatigue comes and goes on schedules. Take note of when you tend to feel tired and when you tend to feel energized. This will not always mesh up with how most people want to spend their day, but if you are consistently full of energy in the morning instead of in the evening, maybe that is the best time to perform your chores.
Also try not to schedule too much for one day. Consecutive decision making can be mentally draining, allowing lurking MS fatigue to come to the surface.
Decide which tasks are the most important, plan to perform those when you know you have the energy, and place less importance on other tasks. Seek help with the lesser chores, or learn to be at peace with being too tired to perform some things.
After all, fretting over a problem often makes it worse, and focusing on your fatigue rather than accepting it can make you feel even more tired. If you accept not being able to perform everything, then you will be less stressed when your fatigue prevents you from doing something you planned. And less stress may help with MS fatigue.
Final thoughts
Though about ninety percent of MS patients will feel fatigue from their disease, it does not have to ruin your life. There are ways you can combat this fatigue, with or without the help of other people. Some are small, some are large, but even a little bit of extra energy can mean the difference between a good and a bad day.
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910465/
https://www.healthline.com/health/multiple-sclerosis/beating-fatigue
https://www.ncbi.nlm.nih.gov/pubmed/20030543
http://www.jetlog.com/fileadmin/downloads/NASA_TM_94_108839.pdf
