Fatigue is one of the most common symptoms in multiple sclerosis. It is estimated that more than eighty percent of people with MS deal with some form of fatigue. Fatigue is also one of the leading causes for people with MS to leave the workforce. Not loss of mobility, but fatigue. Not debilitating nerve pain, but fatigue. If someone with MS tells you they are tired, do not underestimate what they are saying to you.

Like other symptoms of MS, fatigue is going to differ from person to person and will also vary based on the reason for the fatigue. Someone who awakens frequently during the night due to bladder issues or muscle spasms may feel the effects of sleep deprivation and experience fatigue the next day. Also, a majority of people with MS have depression which can cause fatigue. On top of that, many MS medications list tiredness, depression, and fatigue as side effects.

Another reason for fatigue may be directly due to immune system attacks on the central nervous system. These attacks leave areas of damage that are difficult for messages to travel through. Our body expends a lot of energy attempting to get these messages across. For instance, every time I raise my right foot to take a step, my body is not only exerting physical energy to move my muscles, but also energy to try and force signals across the damaged nerves located between my brain and leg. This is an exhausting process especially when you consider I raise my right foot from the floor more than five thousand times a day.

For some people with MS, daily tasks are more than enough to induce fatigue. Simple chores such as brushing our teeth, combing our hair, and cooking can be exhausting. On many occasions I have found myself needing to sit and rest after a shower and getting dressed.

While all of those types of fatigue can have an effect on a person’s life, there is also MS lassitude. It is unique from the other types of fatigue and generally more severe and more likely to interfere with a person’s ability to function throughout the day. Lassitude occurs on a daily basis and can start in the early morning when a person first wakes up. A restful night of sleep tends to have no effect in reducing lassitude. Lassitude will also worsen as the day goes on. It is not directly related to sleep deprivation, depression, or a person’s physical impairments.

Since shortly after the onset of my MS, I have had a general fatigue. I am tired, more often than not, but I am usually able to trudge on. For me, fatigue means divvying my energy out based on how important something is to me I need to get done. I have to get up in the morning, shower, walk/feed/water the dog, and go to work. I have to walk the half of a mile into work from the parking garage and the half of a mile back. I have to come home, walk/feed/water the dog, make dinner, and get breakfast and lunch ready for the next day. Those are essential daily activities for me and I’m usually out of energy before I am halfway through the day. Yet, it is extremely important to me that I still attempt exercise. Some days I manage a full workout, some days I try and realize in less than five minutes that it is not going to happen, and some days I can barely lift my leg to walk through my front door and know to not even try.

I have never been a couch potato in my life and am fighting hard not to become one now. I try my best to stay busy and take small breaks when I can. More importantly, staying physically busy also serves to keep my mind busy. I still get overcome with anxiety at times and that brings me to a halt, especially on the weekends. I stop moving and I start thinking. Once I start thinking, I can’t get moving again. For now, I simply do the best I can.

I know what total exhaustion feels like. Before MS my hobby was mountain biking. I have done several endurance races where I have pedaled my bike for six to twelve hours. Sometimes in the sweltering heat, sometimes in a cold drizzling rain. Both zap your body of energy equally. You wake up the next morning and no matter how much sleep you got; you still needed a little more. Your body is sluggish, but functioning. By the next day, the reset button had been hit and you started to feel better. Maybe even a little better than you did before the race.

I have never in my life been as exhausted as I was when I was in the throes of an MS flare. I would get eight hours of sleep and it would not be enough. I would get nine hours, still not enough. I would wake up just as tired as when I had gone to bed. There was no reset button. It was a steady twenty-four/seven exhaustion.

At work, I would walk around in zombie mode. My brain was just as tired as everything else. The world was in a fog. If I sat down at a computer to work, I would begin to nod off within a few minutes. I would seek out a workstation I could stand at to keep from falling asleep. Even then, I would feel my eyes grow heavy and my head nodding forward. I would head straight home from work to take nap. A nap that would do absolutely nothing for me, but I had no choice but to take. My body demanded the rest. I would skip dinner because I would be too tired to cook. I had lost all momentum with no recovery in sight.

I also yawned nonstop. I would yawn in people’s ears while talking on the phone. If they were in front of me, I would yawn in their face. My major pet peeve is people yawning when I am talking to them and here I was doing it to everyone who dared to try to have a conversation with me. I could not control it. I was just that tired.

When my fatigue was at its worst, I had difficulty cooking for myself. I have read stories from other people with MS who have had their food cooked and handed to them but have been too tired to even hold their heads up to eat.

I am unfortunate in that I have MS and fatigue is now a real issue in my life. I am, so far, fortunate that most days I can still make it to work and feed myself. I still walk my dog and go for short hikes. Some days I even muster up the energy to pedal a bike. Life is harder, but it goes on. And so do I.

In my next few posts I hope to share ways to combat fatigue. Some things that I already do myself and maybe some new techniques I can trial and see what works.