The rest cure: How to beat fatigue in three easy steps

Rest to recharge your batteries and battle fatigue

IN THE late 1800s an American neurologist called Silas Weir Mitchell devised a “rest cure” for Victorian “hysterics” including the novelist Virginia Woolf.

 

These poor women were subjected to six to eight weeks of total bed rest, constant force-feeding with fatty, milk-based foods, a ban on reading, writing or speaking and absolute isolation from friends and family.

Clearly this sort of thing is not going to work today.

However it is worth taking fatigue seriously.

Think for a moment about the mild illnesses you’ve had such as throat infections, food poisoning or a bad cold.

The chances are that you felt listless for quite a while afterwards.

Even being mildly ill can bring on fatigue.

 

Napping can be an important part of resting, but don't feel you have to sleep

It is hardly surprising that after a major health crisis, fatigue can be a serious issue lasting weeks, months or even longer.

Fatigue is the burglar in your house, it is sneaky and very hard to catch and tackle.

Yet all the time it is stealing from you, your get-up-and-go, your capacity to act and make decisions.

Fatigue may not be life threatening but it is a huge barrier to feeling better, both emotionally and physically.

Fatigue is not a sign of weakness and inadequacy.

It is nothing to do with getting older and it may not be anything to do with sleep.

Instead, fatigue is a deep, pervasive and profound tiredness that affects many basic daily tasks and is not always relieved by sleep.

It is a medically recognised after-effect of health problems. Fatigue is common and lasts longer than any other post-surgical symptom.

Up to 90 per cent of women experience fatigue after a hysterectomy.

Over half those who have had a heart attack or heart surgery are fatigued several months later.

Fatigue lasts longer than any post-surgical symptom  

Fatigue is the most common side effect of cancer treatment.

In other words, if you are feeling fatigued after a health crisis, you are normal.

WHY DOES IT HAPPEN?

Fatigue springs from a complex web of interacting factors.

When something happens to the body, the healing response kicks in automatically.

This brings a strong biological need to retreat and “lick your wounds” until you are strong enough to face the world again.

Many medications have side effects that include fatigue.

The after effects of anaesthesia can also last a surprisingly long time.

After a period of lying in bed you lose muscle strength.

You might find it hard to sleep, feel more breathless when you move, have less appetite or be coping with ongoing pain.

It is also very common to feel down after a serious health problem.

Low mood goes hand in hand with low energy.

You may also feel more anxious than usual and anxiety can drain your energy.

THE FATIGUE ROLLERCOASTER

Fatigue rarely feels the same, day in, day out.

A healthy person’s energy levels fluctuate during the average day or week and it works the same way when you’ve had a health problem.

The difference is that the energy swings may feel more extreme now.

When you do have some energy the temptation is to try to get everything done.

You get up, send emails, walk the dog, go to the supermarket, unload the shopping, clean the cupboards, go to the Post Office, come home and cook and collapse.

For the next two days you are unable to do a thing.

 

This is the fatigue rollercoaster.

When going through this, it is easy to think that your life is going to be ruled from now on by your unpredictable energy levels.

You start to feel out of control and you can’t plan or get things done which is distressing and frustrating.

HOW TO MANAGE IT

The great news is that fatigue can be tackled effectively and here are three basic steps for doing so:

1 TALK TO YOUR MEDICAL TEAM 

Put aside any fears that you are “whingeing”, everyone wants to recover.

Fatigue interferes with your recovery no matter what it is you are recovering from.

 

Speak assertively to your medical team.

Be honest, tell them how the fatigue is affecting you, get their advice on strategies and ask about medication tweaks.

The following factors can contribute to fatigue:

- If your red blood cells are not transporting oxygen around your body efficiently, physical actions need more effort and fatigue sets in.

- Fatigue is a major side effect of many drugs. Sometimes the interaction between medications is to blame. Your doctor may be able to tweak your medication if this is the case.

- Your diet may be missing some essential energy-boosting nutrients. Some people find dietary advice from a registered dietitian makes a huge difference to fatigue management.

- Fatigue is a common feature of depression. If you are feeling low, fatigue can be a huge issue. Sometimes a doctor may decide a short course of antidepressants will lift your mood enough to put other strategies into practice.

2 MAKE RESTING A HABIT

Most of us rest when we feel worn out but with fatigue you have to learn to rest before you become weary.

Rest can be surprisingly hard to do unless you are exhausted and have no choice but to collapse.

The very idea can actually be a bit scary for some people.

It can feel like a reminder of being bed-bound.

Or it might seem like a sign of weakness or failure to recover.

You might worry that resting is somehow lazy or self-indulgent.

If you find yourself resisting the idea of rest it might be worth asking yourself why.

Rest time doesn’t actually mean taking a nap, although it is easy to confuse the two.

In fact, naps might be best avoided as they can interrupt night time sleep.

To avoid napping at rest times it helps not to be in bed.

In fact during a rest you don’t have to be totally immobile.

You can read, stretch, have a cup of tea, do a crossword or chat on the phone as these are all restful things to do.

The key to rest is to do less physically strenuous things as to balance out your activity.

3 ADOPT THE THREE Ps 

There are key strategies for managing resting and activity.

They are to:

- Prioritise: what you want to get done (you can’t do it all).

- Plan: how you will achieve this.

- Pace yourself: be realistic about how much you can do and when.

Extracted from How To Feel Better by Dr Frances Goodhart and Lucy Atkins published by Piatkus (£9.99).

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