Dealing With Fatigue and Chronic Illness
Bone-deep exhaustion
An overwhelming sense of energy depletion
An inability to make it through the day without napping
Constant tiredness that can’t be fixed by simply sleeping more
Fatigue is one of those things that’s beyond difficult to explain to people that haven’t experienced it. I’ll use the phrases above and still be met with looks of confusion or responses like “just sleep in more!”
But they don’t get it. They don’t get what it’s like to feel like your body is being sucked into the couch, unable to get up. Or to feel like your legs are dragging through peanut butter just trying to walk around doing daily tasks. Or to have your eyelids droop despite sleeping and sleeping and sleeping even more.
Almost 75% of people with IBD experience fatigue when their condition is flaring, according to a study published in 2011. And 30% of the people in thisstudy who were in remission still experienced fatigued. So although fatigue isn’t a universal symptom for individuals with IBD, it’s pretty dang common.
So what is fatigue caused by when you have IBD? It can be caused by a whole array of things - anemia due to blood loss in the stool, the body’s response to inflammation, side effects from medication, depression or anxiety from living with IBD, malabsorption issues, etc. I think although it’s important to get checked for certain aspects of causation (like anemia), but it’s also important not to stress over the “cause.” Many times fatigue just happens and it isn’t worth stressing your body out more trying to get to the bottom of it or find what “you did” to cause it (newsflash - most of the time the fatigue is completely out of our control).
And it’s funny because fatigue has a way of turning “justs” - just walking around, just doing daily chores, just grabbing groceries, just sitting at your desk, just reading or working or cleaning or hanging out with friends - into what feel like near impossible tasks.
And it’s frustrating to have a body that fights against you. it’s frustrating to be a normally active, energetic person, trapped in a fatigued body. it’s frustrating to feel like you’re moving in slow motion while the world zips by around you. I get that. I get YOU. I get how frustrated the fatigue makes you feel.
But fatigue is part of the territory, fatigue will always come and go, so when it decides to take over my body I give it grace and speak kindly to it, and when it decides to give me relief I celebrate.
And those little pockets of celebration, where I don’t have to fight to keep my eyes open and can go about my day without exhaustion, are what I hold onto.
But what CAN you do when fatigue strikes to feel some relief or comfort?
Give yourself grace and remind yourself that you aren’t lazy: before trying to do anything else to help reduce or lift some of your fatigue, I think it’s important to take a deep breathe and make sure your mind is in a good place. Some mantras while you’re fatigued to help you mentally get through it: I am not lazy; I am worthy of giving myself all the rest I need; It is okay to take things slow; My body is not failing me; I will get through this because I am strong and capable; It is okay if this fatigue doesn’t lift right away. Being gentle with yourself, rather than turning right away to frustration with yourself and your body, is huge. It’s so much easier to ride out the waves of fatigue when we’re speaking kind words to ourselves.
Ask your doctor to check your iron levels: Did you know that 1 in 3 people with IBD have anemia? And that’s just talking anemia, not even slightly lower levels of iron that don’t quite qualify as anemia (but could still be causing fatigue). Checking to see where your levels are at will help your doctor come up with a care plan - whether that’s taking iron supplements, getting iron infusions or incorporating more iron-rich foods into your diet. B12 and serum folate may also be lowered (you can read more in this study), so it’s worth checking as well.
Participate in light, mindful movement: When I say “mindful movement” I mean really tuning into your body and seeing what would feel good for it while you’re fatigued. For me personally, I find going on walks, doing yoga, or other light workouts while I’m fatigued can sometimes boost my energy. Whether it’s the boost in endorphins and serotonin or simply the reminder that my body is strong and capable, it feels good to me when I’m fatigued to move just a little bit. But, as always, find what works for YOU. If you are too fatigued to go on walks or do other forms of movement, that is SO okay! There are times where my fatigue reaches a heightened level and movement is out of the question, but when I’m able to move while I’m fatigued it’s so helpful.
Get out in the fresh air: Going off of my last post - walking out in the fresh air is a game changer for me when I’m fatigued (especially if it’s a cold, crisp day). Breathing in the fresh air makes me feel so much more alive and helps my fatigue lift a little bit. If I’m too fatigued to go on a walk, I will just sit on my patio in the fresh air and it still does the trick.
Get at least 8 hours of sleep a night: Although we all know sleep doesn’t “fix” fatigue it sure as heck can help! Making sure you’re getting enough sleep each night (and taking naps as needed) can help your level of functionality while fatigued increase. It can seem almost impossible some days to get 8 hours of sleep because life and adulting is difficult, but it just takes prioritization! Some days I leave laundry unfolded or some emails unread because I know it’s more important for me to go to bed at a certain time. Try putting your “bedtime” in your calendar to keep you on track. I like setting a little calendar reminder for 45 minutes before I want to be sleeping to make sure I have ample time to wind down and do my nightly routine.
Reduce your stress levels: We all know stress is not good for the body, but it’s especially not good for a body with IBD. Adding more stress to your body can exacerbate symptoms (such as fatigue). Obviously, it’s difficult to go through life with zero stress, but we can always work on being as stress-free as we can be. This could mean small changes like - incorporating meditation every morning, cutting back on caffeine, going on more walks or delegating tasks at work. But this could also mean bigger changes like - changing your career to have a less stressful job, asking for more flexible hours at work, hiring a nanny to help take the load off at home (no shame if you need this assistance!), etc. Really think deeply and write down a list of small and big ways that would help your life be less stressful and start working on them.
Cut back on caffeine: Going off of the previous point - caffeine causes stress in the body. It’s a natural reaction to reach for caffeine when our body is tired or fatigued, but you will inevitably get that caffeine crash which can make the fatigue feel even more unbearable. I always find that caffeine may help initially, but I always feel worse an hour-or-so later.
Eat nutrient dense foods or take supplements to help: Working with your doctor or naturopath to check in on all of your vitamin and mineral levels can be extremely helpful to see where your body is lacking and know what supplements to take or what foods to prioritize. Making sure you’re eating foods rich in nutrients can help your energy levels and making sure you’re eating enough food in general will also help. If you aren’t sure how to get in more calories, especially if your body can’t handle huge portions, working with a nutritionist who specializes in IBD can be hugely helpful. For me, having 5-6 small meals throughout the day, rather than 3 big meals, has been a huge help.
Don’t feel like you need to “prove” anything (aka give your body the rest it needs!!): When we get fatigued and have been fatigued for days on end, it can feel like we need to “prove” that we can still work hard and do all of the things. But YO. Stop that! You have nothing to prove. Give your body the rest it needs - sleep more, take naps, take it easy. Your body will only become more fatigued by pushing too hard to “prove” yourself to society, your boss or your family.
Get in touch with your body: Tune in and notice patterns of what triggers your fatigue. You may find that there isn’t any true pattern, since IBD is so unpredictable, but you may find certain activities or habits seem to be connected to your fatigue. Maybe you find getting up just half an hour earlier some days causes you to be more fatigued. Or maybe you find days you do exercise versus days you don’t exercise makes you feel more fatigued. Maybe it’s the opposite for you. Maybe you find coffee makes you fatigued, but green tea doesn’t. Maybe you find having two social outings in a row really hits you hard. Whatever it is - tune in and see what your body is trying to tell you.
So if you've been struggling with fatigue, know that you’re not alone, you’re not failing, you’re not lazy. your body will give you a reason to celebrate again I promise.
What has your experience with fatigue been like? Xx