• Fatigue is common in a variety of chronic conditions, including multiple sclerosis (MS).
• People with MS can practice self-management strategies to help conquer fatigue, including creating a fatigue journal, addressing sleep issues, and dealing with underlying symptoms like depression.

An estimated 80 percent of people living with multiple sclerosis experience fatigue, which can interfere with work, school, and tasks of daily life. However, there are several lifestyle strategies for tackling this symptom. Experts from across the MS care spectrum shared advice on this topic during the International Progressive MS Alliance’s Nov. 9 webinar, Fatigue in Progressive MS.

“Usually, fatigue is described as this overwhelming feeling of tiredness or exhaustion — it’s not specific to MS, and may occur in other chronic conditions as well,” said Dr. Jaume Sastre-Garriga, a neurologist at The Multiple Sclerosis Centre of Catalonia, in Barcelona, Spain, during the event. “It can be one of the most common and also disabling symptoms in multiple sclerosis.”

Dr. Sastre-Garriga noted that people with MS may face a stigma due to the fatigue that they experience. In fact, others might consider them to be lazy when they are truly feeling fatigue due to their MS. “Being fatigued by MS is not being lazy. Fatigue is a symptom that needs to be tackled in the best way we can,” he said.

Fatigue Management Strategies

The event panelists shared several tips on how people with MS can manage fatigue. “Usually one of the first strategies I look at for people with MS is creating a fatigue journal,” said Dr. Michelle Murphy, a psychotherapist based in Ireland who specializes in the long-term cognitive and emotional impacts of individuals and families living with neurological conditions.

With a fatigue journal, a person maps out their days over a period of time. “I usually suggest two weeks,” she said. Journal entries can include a log of hours slept, daily activities, and the amount of fatigue experienced after each activity.

“By the end of a few weeks, you should be able to identify patterns, behaviors, or potential fatigue triggers,” she said. At that point, a person can make adjustments to plan out their days. They may avoid scheduling several fatigue-heavy activities together or scheduling more taxing tasks during the times of day when they experience the least amount of fatigue. This is also referred to as “energy management” or “energy dosing.”

In addition, people with MS should ensure they receive a full assessment of their fatigue from a health care professional, said Dr. Stefan Gold, professor of neuropsychiatry at the Charité University of Medicine in Berlin, Germany, during the panel discussion. “Fatigue correlates with cognition, depression, and sleep problems, and these all require different potential strategies, and some of them are easily treatable,” he said.

Learn more about how to fight fatigue with MS.