Fatigue has been described as an “overwhelming sense of tiredness.” Up to 80 percent of people with MS experience the disabling effects of fatigue. This overwhelming tiredness could occur any time in the course of MS, and it has not been shown to be related to measures of disability like the EDSS (Extended Disability Status Scale). Many people with MS find that fatigue increases as the day goes on, and worsens with a rise in body temperature, which might be caused by hot and humid weather.
Fatigue can be difficult for family members and friends to understand, because it is invisible to others. If fatigue is poorly understood, a person with MS who is experiencing fatigue might be characterized as “lazy.” Educating family, friends, and partners about MS fatigue is very important.
Although we do not know at this time what causes fatigue in MS, a number of influences on fatigue have been identified. Among others, these include depression, poor sleep, and sedating medications.
If you feel that you might be experiencing depression, discussing this with your physician is important. Treating depression can also help with fatigue. Sleep problems are very common in people with MS. They may lose sleep due to bladder problems, limb movements, poor sleep habits, or depression. Sleep difficulties are thought to likely be another cause of depression.
Medications taken to solve other problems can contribute to fatigue. If you look at your pill bottles, some say, “May cause drowsiness” or “Do not operate heavy machinery while taking this medication.” These warnings indicate that the medicine is sedating, i.e., it can make you tired. Medications that are used to treat bladder dysfunction, spacticity, and pain can cause fatigue in MS patients. If this is the case and you are experiencing fatigue, a good place to begin is to review all of your medications with your physician.
People with MS who experience fatigue often feel as though their “batteries have run low” after doing some of their daily activities. A brief rest often serves to recharge the batteries, so it’s possible to finish the task. Planning one’s activities can help, such as trying not to go up and down the stairs more often than necessary, and other types of energy conservation can help.
It is not advisable for a person with MS to rest more than necessary. In fact, while a person with MS may feel very tired after exercise, exercise is one of the best ways to build endurance and reduce fatigue. Scheduling and planning ahead can be very helpful with saving energy. Listing activities in their order of importance enables a person to see clearly what needs to done first and what can wait until another day – should all energy be used up before reaching the end of the list. Those with limited energy can learn to accept that not everything will necessarily be completed when and how one prefers them to be done. In most cases, an unfinished job or activity will still be there the next day. By waiting, more energy and enjoyment will be found in accomplishing the task at a later time. Scheduling sufficient periods for rest and alternating them with periods of physical exertion can be helpful, to avoid becoming too tired too quickly. Should you take on a project that is too much to handle at one time, divide it into smaller parts and schedule things accordingly. If this is not possible, you may want to have someone lend a hand to accomplish the task and avoid overexertion.
Some people with MS find that caffeine, found in coffee, tea, or caffeinated soda, in moderation, can be helpful in managing fatigue. Unfortunately, caffeine is an irritant to the bladder, and can exacerbate urgency and frequency. Individuals should speak with their doctor about their intake of these beverages, to be sure they are not exceeding levels of caffeine that are appropriate for them.
Also, antidepressants can be effective in reducing fatigue.