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Fatigue

 

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What is fatigue?

Fatigue is a feeling of being tired all the time that can stop you from doing everyday tasks and activities. There are four areas of life that fatigue can have an effect on:

  • How you feel physically – for example, having no energy and finding it hard to remember things
  • How you deal with day to day tasks – for example you may feel pressure to complete tasks at work so you may not take any breaks to try and get everything done
  • Thoughts and feelings relating to you being ill – for example, having anxiety about getting ill again
  • Thoughts and Beliefs about how you are managing your fatigue and your recovery – for example “I must push myself harder otherwise I am going to lose my job”

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What causes fatigue after COVID?

It is normal to have fatigue after having any virus including COVID because recovering from an illness can use a lot of your energy. This normally gets better after four weeks; however some people might have fatigue for longer. For individuals with long Covid, the severity of fatigue can be different for each person.

There are many reasons why you could feel tired after COVID such as:

  • Your body is still getting better even when you no longer have the virus
  • You might have other illnesses or health conditions that means it takes you longer to get better
  • If you have been very ill with COVID, your body can take a long time to get better
  • COVID may have triggered other effects which cause long COVID which are not yet understood but are being researched.

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What makes fatigue after COVID last a long time?

We are still learning about the normal rate of recovery from long COVID. There are lots of things that can contribute to making fatigue worse and last a long time such as:

  • Looking after other people or children
  • Feeling stressed, anxious or depressed
  • Having a poor diet
  • Not having a daily routine
  • Not sleeping well
  • Not being physically active

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How can I manage my fatigue?

Coming to terms with the fatigue you are experiencing will help you manage your recovery. The recovery journey from fatigue will be different for everyone, and although it can take a long time, it is possible. Some individuals need time to learn how to manage their fatigue. Please see more information below about how you can manage your fatigue.

It can be easy to overdo things at times when you feel you have the most energy or feel pressure to get things done. This leads to a cycle of ‘boom and bust’ where you become completely exhausted during or after activities, are unable to do any more, and need lots of time to recover. Carrying out your day to day activities in a boom and bust cycle is likely to make your recovery take longer, as you have an exaggerated cycle of very good days and very bad days.

Pacing is the name for a technique some people find useful in managing their fatigue. Find out more about pacing on the managing daily activities page.

Be kind to yourself – fatigue can have a big effect on your life but sometimes other people do not understand how much it can affect you. It is important to be kind to yourself and rest before you start to feel tired or once you become tired.

Listen to your body – remember how you feel when you do too much. Write this down and keep it somewhere safe. Thinking about the symptoms you experience can help you to spot them early and slow down.

Talk to other people– tell people around you that you have fatigue and how it makes you feel to help them understand and support you.

Try to keep a routine:

  • Plan your day
  • Remember not to do too much in one day because that can make you feel worse the next day
  • Prioritise and plan when you are going to do high energy activities during the week, such as going food shopping and make sure you give yourself time in between activities to rest
  • Ask other people to help with tasks
  • Look for easier ways to do things – such as online shopping for food or cooking a few healthy meals in one day so you don’t have to cook on other days or ask someone to help you

Find out more about:

Develop a relapse plan – sometimes your symptoms can become worse or return after you start to feel better. You can develop a relapse plan early while you are feeling well to help you with this. This will help you remember what to do and how to think so that you can recover quickly if a relapse occurs. During a relapse all activities can be exhausting, but by having a plan ready, it is one less thing to worry about.

Sleeping well – take a look at the ‘sleeping well’ section of this website for tips on how to get a good night’s sleep.

Try to do things you enjoy – doing things you enjoy will feel less like a chore. This will make you feel more in control of your recovery and help you get back to normal much quicker.

Try out things that help you relax:

  • Gentle yoga or tai chi
  • Arts and crafts such as painting or knitting
  • Listening to calming music

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Keep a diary or list of your activities

Keeping an activity diary about things that make your fatigue worse, including how you feel immediately afterwards and over the next few days, can help you understand your limits and how you are recovering. These activities could be mental or physical.

Activities could be:

  • Exercise
  • Meeting friends
  • Going to work
  • Drawing
  • Reading

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Top Tip

Rest is just as important as activity for your recovery.

 

Do some physical activity

After an illness, you may be more fatigued during and after physical activity. You can improve your fitness by doing gentle exercise such as walking.

As you start to feel fitter you might want to try other exercise such as:

  • Swimming
  • Dancing
  • Going to the gym

Take your time and slowly build up the amount of exercise you do when you feel ready. You might like to keep a log of your exercise so you can reflect on how you feel when exercising, immediately afterwards and over the next few days. This will help you to better understand how you are recovering and any activities you find difficult. Please see section below on post exertional symptom exacerbation.

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Top Tip

When you feel you have done too much:

Rest – plan a rest after the activity.

Wait – see if and how the activity has affected your symptoms.

Observe – think about how you feel during and straight after the activity.

Consider how you feel a couple of hours after the activity and over the following two/three days.

 

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Eat healthily

A healthy diet can help your fatigue and energy levels. You can find out more on our eating well page.

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When should I talk to my doctor?

Go to see your GP if:

  • Your fatigue is getting worse
  • You have other symptoms or feel unwell in other ways

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Post exertional symptom exacerbation

My fatigue worsens after physical activity/exercise

It is common to feel more tired than normal during or after having an illness. This can last several weeks, and even months, in some cases. People recovering from an illness often report feeling a little better each day, but it can take time to fully recover.

With long COVID, you may feel more tired than usual, even when doing activities you previously didn’t find difficult to do. This can affect your quality of life and your ability to do everyday tasks. You are more likely to feel tired at the end of the day or at the end of a busy week.

Some people experience other symptoms that become worse after physical activity/exercise. These symptoms include brain fog, muscle aches or headaches, alongside feeling very tired.

Healthcare professionals may call these symptoms ‘post exertional symptoms’. These are not, in themselves, dangerous but they can affect your quality of life.

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What causes these post exertional symptoms?

The exact cause is not yet fully known. The triggers and symptoms can vary from person to person but are usually linked to physical activity/exercise. Physical activity/exercise can leave you feeling exhausted – mentally, emotionally and physically.

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What can I do to help my recovery?

During your recovery, it is important to do the right level of activity for you to avoid your symptoms getting worse, whilst staying healthy. When in recovery, you will need to listen to your body. You should think about how you feel after each new activity, noting down any symptoms you have. Recovery can be slow and you may have some setbacks but getting the right balance is important.

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Here are some ways to help you recover:

Managing daily activities

  • Slowly build up your activity according to how you feel and what symptoms you may have
  • Try to find the right balance between activity and rest – pace yourself, plan activities by spreading them out across the week, and only do the most important things
  • Change between different types of activity either mental or physical activities – this can help rather than doing the same type of activity until you are exhausted
  • If you start to notice your symptoms getting better and you are having more good days than bad days, slowly increase your activity levels
  • Think of people who can help you if needed and ask them for help
  • Focus on certain tasks rather than feeling you have to do everything
  • Spend more of your energy on things and activities you enjoy to improve your quality of life
  • Try to break up large tasks into smaller tasks

Rest

  • Rest is an important part of your recovery
  • Try to get enough sleep at night, and plan rest breaks to save energy through the day
  • Avoiding all activity and spending long periods of time lying down may cause other problems due to loss of muscle strength and fitness and may make you more likely to feel tired when you try to do something

Find out more about:

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When should I talk to my doctor or nurse?

  • If your fatigue is getting worse rather than better, talk to your healthcare professional so they can rule out anything else that might be affecting your health and causing these symptoms
  • If your fatigue has become so bad that you are often spending all day in bed, ask your healthcare professional for specialist support

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