Managing Fatigue with Mental Illness

One of the most common symptoms of mental illness, though might be one of the least talked about with your mental health provider, is fatigue. Exhaustion, drowsiness, weariness, lethargy, sluggishness

Right off the bat, I’m going to warn you that this guide is long and intensive. That alone could feel overwhelming to you.

Making all these changes or trying all these ideas in one day is impossible.

I highly suggest reading through slowly and simply absorbing the information before taking any actionable steps.

Once you feel less overwhelmed by the information and new knowledge, then find one tiny place you can start to make a change.

After that one change, simply build from there. Slowly.

But knowledge is power, so let’s begin there!

What is fatigue?

Many people think fatigue is just feeling tired. But really, fatigue is much worse.

Fatigue is the feeling of being extremely overtired, burnout, and the constant need for sleep. This constant need for sleep begins to interfere with activities of daily living.

You can experience both physical fatigue and mental fatigue.

Where does fatigue come from in mental illness?

Fatigue can come from a number of sources. A few of them are listed here:

• symptom of your disorder or illness

• medications

• work stress

• home life

• demanding lifestyle or job duties

• stressful relationships

• financial stressors

• poor sleep hygiene

How can I manage fatigue with mental illness?

Managing fatigue with a mental illness can sometimes be a little harder than managing fatigue without a mental illness. Although we all experience fatigue at one point or another, for those with mental illness, fatigue can be a lingering symptom or side effect that doesn’t go away even if we are doing the right things. With mental illness, sometimes eliminating fatigue is impossible, and in those situations we have to instead learn how to MANAGE the fatigue as best as we are able.

The basics.

There are some basic things that we can all do to help manage and combat the feeling of fatigue. These items are the things anyone can focus on to ensure energy stores are being replenished.

• Drink enough water daily. Staying hydrated is essential to combating fatigue. (The daily average for men is 15.5 cups and for women is 11.5 according to the U.S. National Academies of Sciences, Engineering, and Medicine.)

• Eat a healthier diet and don’t skip meals. Eat breakfast!

• Caution with consuming caffeine. Too much caffeine can do things like disrupt your sleep cycles or cause caffeine crashes once the effects have worn off.

• Get enough sleep! If you have trouble sleeping, now is the time to begin talking to your doctor about your irregular sleeping patterns and habits. Get help if you need it. Not having restful sleep is one of the biggest contributors to fatigue. There are medication options and non-medication options that can help you have a more restful nights sleep. Along with this, make sure you are waking up at the same time every day! A regular wake-up time will strengthen your sleep routine and will help create a more consistent time of going to sleep.

• Learn how to relax with options like meditation or yoga. Ensuring you get some relaxation time (that is actually relaxing) is essential to feeling less fatigue. It helps replenish your cup so you can keep going with your day. Relaxing is not easy, especially if you’re someone prone to anxiety. But practice makes perfect! Relaxing used to be impossible for me, but after a lot of practice, I have learned how to have a more relaxing time with myself. Pro tip: If you struggle with meditation, try listening to some form of relaxing music like rain showers, trance music, or singing bowls with headphones in when trying to meditate. It wasn’t until I mastered meditation with music and found a place of calm that I could finally introduce and master meditation in silence on my own. I went from having panic attacks while trying to meditate to using it multiple times a day to help ground me in the present.

• Exercise or get some form of movement daily. Exercise has been proven to boost energy levels. There is no shame in starting slow and taking it easy at first to get yourself going. Even 10 minutes of yoga a day is better than nothing. Pair that with a walk around the block or neighborhood and it’s even better. It may not seem like much but you’ll eventually find yourself finally being able to accomplish more as you build up stamina and strength. As a side note, there can be such thing as TOO much exercise when it comes to managing your fatigue, so be mindful of how much you are doing and what you are capable of. Starting slow will allow you to get a better idea of what is manageable and how much you can increase overall. Also, exercise is tiring so plan your exercise at a time of day where you can give yourself a break afterwards as well.

• Do things that relax you and fill your cup. This can be anything from painting, drawing, playing video games, horse-back riding, or reading. Doing things that you enjoy and that make you feel good will help make sure you have a healthy balance of restorative activities and stressful or physically demanding activities. Be mindful that restorative activities can also cause fatigue, and we may need to take a break while doing them, but they are still essential to us having well-rounded lives.

House work

House work and fatigue just don’t go together well. There’s no way around that fact.

But there are things you can do to help reduce your fatigue with cleaning and other house chores.

Getting help. Although this might seem like an impossible option financially, there is almost always a few extra things you can cut out of your normal financial budget to get at least one of these services to help lighten the load:

• Use a house cleaner or maid once or twice a month to help keep up with cleaning or even just the deeper cleaning.

• Use a meal delivery service to help eliminate having to go to do the store for groceries.

• Use an app like Instacart to help pick out and deliver your groceries so you don’t need to go to the store.

• If you qualify, look into getting a caregiver that can help with extra chores or daily tasks around the home.

• Consider having an occupational therapist come to your home one-time to help you find areas in your home life that you can change to accommodate your fatigue.

Keeping things simple. Don’t make cleaning or other tasks harder than they have to be.

• DECLUTTER. This seems to be popping up in every blog post but I cannot emphasize enough how much decluttering has changed my life and my ability to keep my home life organized and clean. Looking at and maintaining a mess is EXHAUSTING. Decluttering will help reduce the amount of things you have to manage, therefore making it easier to manage. Making sure all your items have a home helps keep clutter away. Keep 1 or 2 of everything, throw the rest away. Keeping only the essentials will have such a giant impact on your ability to keep your home looking and feeling its best.

• Prep meals in bulk once a week so you’re not having to cook every day. Make sure these meals are easy for you to warm back up or put together to eliminate any resistance that may come from making the meals.

• Keep one or two frozen or canned meals options stashed away so if you are having trouble managing fatigue one day, you still have access to a meal. Keep meals simple.

• Use minimal cleaning products. Using minimal cleaning products, like mainly white vinegar, can help eliminate decision fatigue when it comes to cleaning. It also reduces the amount of stuff you have to manage for cleaning.

• Keep cleaning products in every room so they are always on hand when something happens. This will help with times where you have a spill and don’t have the energy to go to another room to get cleaning products. I keep a spray bottle with white vinegar and a bundle of paper towels in each room in my home to help make cleaning up a less demanding task.

• Spread tasks out through the week instead of doing it all in one day.

Some other helpful tips:

• If you wear shoes in the home, try adding in anti-fatigue insoles to your shoes. Or if there is specifically one place or area in your home you stand the most, try putting anti-fatigue matting there.

• Set reminders on your phone or calendar to keep you on track and to aid in not losing track of time.

Work

Managing a full-time or part-time job around fatigue can be quite tricky. I’m not going to lie, some days it takes all my effort and mental power to get through my work day. By the time I’m done working, my physical and mental energy is at zero. This often times bleeds over into my weekends, making it difficult to get anything but the bare minimum accomplished.

A few things you can do to increase alertness: adjust your lighting, temperature, and physical surroundings.

This means not working from your bed, even if you can, keeping the temperature cooler if possible, and making sure the area you are working in is brighter, preferably with some light from the outside.

Other things you can do to manage your fatigue come in the form of accommodations at work.

Some accommodations that can help with managing fatigue:

• Extra 15 or even 30 minute breaks

• Later start/end times (work during the hours you feel most awake)

• Anti-fatigue matting (if you are required to stand for long periods of time)

• Job restructuring (switching any marginal jobs that may require more energy with another job that is less draining - note: employers are not required to provide this for essential job tasks)

• Written instructions (for days when your fatigue is causing memory loss or mental confusion)

• Uninterrupted work time (if you work in an environment where you can be interrupted often, this could be useful for helping remain focused and on task)

• Use a modified work schedule to attend medical appointments during the workday

• Work from home, if possible.

Another common tool that can be used to help manage fatigue around work is FMLA. FMLA allows you to take unpaid, protected leave from your job due to a medical condition. It covers 12 weeks of work. This allows you to take time away from work without being worried about losing your job. Personally, I use what is called intermittent leave which allows you to use at random periods during the year, pre-approved. My FMLA agreement covers me taking 2 2-day periods off from work each month without notice. Although FMLA is unpaid, I use my PTO time to still get paid for those hours.

Routines

I cannot rave enough about routines.

When I first began trying to get my life back together, I was exhausted. The first thing my doctor and I did was begin to build routines that I could rely on to help keep me on track. We did this very slowly. We started with a morning routine, then a night time routine, then even made a cleaning routine to do for 10-15 minutes every evening.

Not only do routines help you stay on track, they also take less mental energy. After some time of doing your routines, your conscious mind no longer needs to put in the effort to keep you on track, and you begin to use your unconscious mind to automatically power through these tasks. Doing tasks on autopilot is proven to be far less exhausting than those we have to think about completing.

Planning

This one piggy backs on routines a little bit.

You know your body best. This means you likely know when fatigue hits you the worst.

Try to keep a planner or notebook to help plan your day around these specific times of the day.

If you experience fatigue all day, then trying to do your biggest tasks at the beginning of the day and leaving the smaller ones towards the end of the day may be your best bet OR scheduling your routine so that your day is planned out evenly when it comes to stressful or exhausting tasks. Maybe do something difficult first in the morning, then a smaller ticket item after. Rest during your lunch and give yourself a break. Then do another bigger task after your break, followed by smaller ones for the rest of the day or evening.

When it comes to planning, one of the most important things is to be honest about what you can reasonably do or get done. Although trying to do much might seem in your best interests, it often times means you’re taking extra energy from your cup, meaning the next day you might need to make up for all the extra energy used and it may take a lot more TLC to get back to normal functioning.

Keep a fatigue diary

Tracking your fatigue throughout the day each day will help you pick up on patterns and times that your body is more fatigued. This will allow you to understand the best times for you to do things throughout your day. You can do more exhausting tasks when you’re most likely to have the most minimal fatigue and the easier tasks when you’re likely to have the most.

Tracking your fatigue and self-care can also help you determine which things you can do to give yourself more of what is most effective. This means, tracking your self-care items and watching which things cause positive changes in your fatigue patterns. This should help you understand what you need the most when you’re struggling.

Along with your self-care, tracking your different medical treatments side by side with your fatigue levels can help you see which medical treatments may be hurting and which ones make the most difference for your daily life.

Have a self-care plan.

Different days may require different things from you, but having a self-care plan in advance can help ensure you are giving yourself the breaks and restorative activities you need to be at your best.

Include items from the daily basics into your plan to make sure you are meeting all of your self-care needs.

Additionally, one of the things that has made the biggest difference for me when it comes to having a self care plan is refusing to prioritize anything else above my plan. This was very hard for me to do at first, it’s very easy to get caught up in the roles we play at work or home and feel we don’t have a choice, but we always have a choice.

Choosing to focus on self-care is essential for being the best worker and homemaker you can possibly be. You cannot be at your best without self-care. We are never our best selves when we are in need of self-care, so it’s better to get the self-care that we need when we need it, rather than waiting until we break down, which will be harder and longer to bounce back from.

Be honest and open with your doctors or other medical professionals.

Be open and honest with doctors and other medical professionals in your life so they can help you in the best ways they know how.

This means being honest about how fatigue is affecting your life overall - mentally, physically, emotionally, relationships included. It may be difficult for others to understand just how distressing or impactful fatigue is for you specifically. It is our jobs to give them the full picture of what we are dealing with.

Be honest about what you can and can’t do. Tell them exactly what is hard for you each day. Be open to showing them your fatigue journal.

Being honest can be a terrifying experience when you’re unsure what will come from you opening up, but we have to be honest with our doctors, our therapists, and others to get the help we need and deserve if we are struggling to keep up.

If you are unable to keep up with your daily living habits, your doctor may be able to recommend or refer you to an organization that can help. But they can only do this if you are being honest about just how impacted you are by your fatigue.

In conclusion…

When going through this list, you may feel overwhelmed about all the options. You may feel addressing the fatigue itself is just too exhausting because you’re already struggling to just keep it together, so how could you possibly manage all of this?

Managing fatigue can be an extremely difficult thing to do. The symptom itself makes doing the bare minimum feel impossible.

As I stated in the beginning, the best way to read and digest this guide is to start small by simply knowing and absorbing the information.

Once you feel more open to making change and seeing what relief these ideas can provide you, start with one small simple thing.

Once you’ve seen a difference and started to build a habit with that one thing, then try another.

Do so slowly and reasonably. Give yourself time to build each habit or item up.

As time goes on, you will begin to notice more and more of a positive change in your life when it comes to managing your fatigue.

If you have any additional tips or tricks for managing fatigue, please leave your thoughts in the comments below!