So your friend had a long day at work and is tired

And you have fatigue

And they say ‘Yeah everyone gets tired sometimes’

So what is the difference?

I’m tired, I’ll go to bed early today

I’m fatigued and carried a lead blanket of it all day. Dragging my butt through the day. And needing to rest more than Do.

I’m tired, I’m going to take a nap

So will I, but it won’t help the fatigue. Naps do not kill fatigue.

I worked all day so I am now tired

I barely could do a thing because of the fatigue. I did 1 thing and I am exhausted.

Chronic illness: Tired or fatigued

Oh, we are tired. Getting through the day with chronic illness can make one very tired and in need of a recovery nap. But tired isn’t fatigue. Fatigue pulls you down like gravity itself is more powerful. Like you are swimming through molasses through the day. Effort is just exhausting.


Now physical and mental fatigue are different entities. But I can tell you, both can pair up. Some say with chronic illness it is our sleeping issues or lack of sleep, that can lead to the levels of fatigue we feel the next day. I wonder about that though. Mostly because lately, I can sleep like the day having had to exist with dizziness and vertigo all day… I am so tired I crash and burn. It has, in fact, cured my pervasive insomnia. But I still have a heavy fatigue regardless of that quality sleep and not over or under sleeping. But I also know some research that does suggest our fatigue is worse with less sleep or poor quality sleep due to illness.

And fatigue can come with a lot of chronic illnesses. I get it from migraines. Definitely from fibromyalgia, as it is definitely a feature in that. From the vertigo.

Physical fatigue

Feels like you are dragging your body through the day. Getting up the stairs is Effort. Exercise causes extreme weakness. And muscle weakness itself is a common feature of fatigue.

Mental fatigue

Our brains feel sluggish and slow. Our concentration and focus lag. We feel sleepy. May micronap. Like thinking through mud. I call it ‘pudding brain’.

Being sleepy though, or tired, can be from lack of sleep as well. Fatigue is intenser and often associated with a medical condition. But we should also be very aware it can be caused by or made much worse by medications. And when fatigue is immense it is always a good idea to go over our medications with a doctor. Lyrica was one med that made my fatigue so intense I was a groggy zombie. I had to actually split the dose to two times a day, so I could actually even get up in the morning. And even when I did, I wasn’t on the recommended dose of that med for fibromyalgia. The fatigue it caused was so intense we never increased the dosage. And I was taken off of it by the pain clinic due to the fatigue. They wanted me to be capable of exercising and extreme fatigue gets in the way of that… a lot.

We know we have to pace. And activities can cause fatigue. Sometimes when the fatigue is bad, anything we do makes it so much worse. Like this fatigue with vertigo is relentless. It really tires the body out when it is constantly trying to adjust its sense of where you are in the world. It is a level of fatigue I have not felt since being on Lyrica. Every single thing you do requires rest time. But, here is a mean trick, lack of activity can also cause fatigue. We become sluggish and lethargic due to not enough activity. So pacing isn’t just tricky for pain, it is tricky for the fatigue levels. Do things, yes, but not too much. And on bad days, we can do little. On good days, we should do more, but not too much more. Or we crash and burn. So moderation. Which means a different thing to different levels of fatigue in individuals and in on different days. We aim for a basic level of activity that is in the Goldilocks zone.

And it is not relieved by napping. Unfortunately. And too much napping can mess up sleep, and we can say that will make the fatigue worse if our sleep is worse. Mental and physical fatigue. Sleep management is very important with chronic illness and especially with fibromyalgia which is associated with a lot of sleep issues. When I wasn’t being treated for my insomnia I barely slept and what I got was poor. I was sleep deprived every day. I used to get hypnic jerks and regular sleep paralysis… the trigger of both being common and frequent was pervasive sleep deprivation. I also always had a morning migraine with severely disorientating aura symptoms. And all that stopped when I was put on a sleeping med. Which isn’t necessarily a permanent solution. Pain management can also help with sleep because painsomnia is very common.

Symptoms (Source: Medical news today)

  • aching or sore muscles
  • apathy and lack of motivation
  • daytime drowsiness
  • difficulty in concentrating or learning new tasks
  • gastrointestinal problems such as bloating, abdominal pain, constipation, and diarrhea
  • headache
  • irritability and moodiness
  • slowed response time
  • vision problems, such as blurriness

Treatment, of course, involves treating the condition that is the cause. But that can be a complex issue.

When you have an extreme fatigue issue remember to ask your doctor about:

  • Medications
  • Sleep quality (also things like ruling out sleep apnea)
  • Pain management in order to have better quality sleep
  • To rule out other things (infection, anemia, CFS/ME)
  • And remember pacing applies to fatigue as well
  • Do not feel guilty for napping or resting before activity or to recover from activity. Both can help when needed. Resting before can give us the energy for activity. But the activity itself takes a toll and may require recovery.

I do now meditation can help with my mental clarity and mental fatigue. Not sure about CBT or yoga (See studies below). But the point is some things can help with fatigue management. Even exercise can, with physical and mental, fatigue. And that could be as low impact as taking a daily walk. Starting slow and working up to more moderately long walks.

In one study, participants reported that fatigue, anxiety and depression fell, while quality of life improved in those with multiple sclerosis (MS) who underwent 2 months of mindfulness meditation training.

study on the benefits of yoga, found some improvement of symptoms of fatigue and sleep quality in cancer survivors. The 4-week program included postures, meditation, breathing, and some other techniques.

A 2017 study reviewed the benefits of cognitive behavioral therapy (CBT), mindfulness, and yogaon treating sleep disturbances in breast cancer patients. Researchers reported those who participated in CBT appeared to have the most improvement in sleep, with decreased fatigue, depression, and anxiety, along with improved quality of life. Medical News Today

Being tired is a normal phenomenon if we slept poorly or worked hard. We get tired. Fatigue is more consistent and heavier. It is a symptom of a medical condition and is difficult to manage.

See other related posts:

Fibromyalgia and fatigue

Rhodiola rosea: My fatigue brain

Monday Manual: Fatigue

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