What Does Multiple Sclerosis-Related Fatigue Feel Like?

Fatigue is one of the most common symptoms of MS. About 80% of people with MS deal with it.

MS fatigue is more than just a feeling of being tired. It can slow down your body and your brain in unique ways and make it harder to get through a typical day.

Once you know how it shows up for you, it'll be easier to talk to your doctor about it. Then you can learn the best ways to manage it.

More Than Just Tired

Typically when you feel worn out, you can trace your tired feeling to a physical activity or lack of sleep. But MS fatigue can happen any time and without much logical reason.

“Most people describe it as an overwhelming feeling of tiredness that’s disproportionate to whatever activity they were doing, or manifesting all of a sudden or at unexpected times, like in the morning.” says Alessandro Serra, MD, PhD, a neurologist at University Hospitals Cleveland Medical Center.

It’s not uncommon to feel fatigued after a full night’s sleep, for example, or after small tasks like getting the mail or brushing your teeth.

MS fatigue also tends to:

  • Happen daily
  • Get worse as the day goes on
  • Keep you from doing normal activities
  • Get worse when you’re hot

You may also feel weighed down, like your body is heavier than usual. This muscle weakness tends to happen after you’ve used some energy. You might start dragging your feet when you walk, for example, because it feels too hard to pick them up.

“Often people say that their legs feel heavy and they’re hard to lift,” says Gloria Hou, MD, medical co-director of the UW Medicine Multiple Sclerosis Center in Seattle. “That’s a very typical description for neurologic weakness.”

Mental Exhaustion

Another thing that sets MS fatigue apart is how it affects your focus and concentration.

“People with MS may say they just simply can't think when they’re fatigued,” Hou says. For example, you might read the same words over and over again but not be able to process the information because you’re so tired.

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Doctors aren’t exactly sure why MS causes fatigue, but they think it may have something to do with the lesions on your brain getting in the way of normal mental function.

“The interruption of regular brain pathways might make it harder for your brain to work,” Serra says. When you have to use multiple areas of your brain to do a task that used to only take one, he says, your brain may get tired quicker. 

How to Know It’s MS Fatigue

Even though fatigue happens in most people with MS, it’s possible other things could be dragging you down.

Non-MS fatigue, also called secondary fatigue, can happen when you have another condition such as:

  • Mood disorders like depression
  • Bladder problems
  • Sleep disorders
  • Vitamin D deficiency
  • Anemia
  • Infections
  • Thyroid issues

“If you’re up at night because you feel like you have to empty your bladder often, or your sleep is disrupted because of loud snoring and frequent awakenings because of sleep apnea, or muscle cramps … then it’s not surprising your day is hindered by fatigue,” Serra says.

You may also feel fatigued as a side effect of a medication you’re on, or from drug or alcohol use.

Most of these are issues your doctor can help you manage and treat.

How Your Doctor Can Help

You need to let your doctor know all about your fatigue symptoms. This can help them see the patterns in your day-to-day life.

“Don’t just say ‘I'm fatigued,’” Hou says. “Explain what that actually means, like ‘I'm fatigued and therefore I can't finish showering,' or 'I avoid showering because it’s too tiring.’ Tell us if you can’t finish vacuuming, or have to take a nap at two o'clock every day.”

Once they’ve gathered this info, they can help you come up with a plan. They might suggest that you:

  • Treat underlying conditions. “One of the first questions I ask is, ‘How is your sleep?’ to determine if there’s a sleep issue that can be addressed,” Serra says.
  • Pace yourself. Learn strategies to conserve your energy during the day so you have some when you need it.
  • Check your mental health. “You can be very, very tired if you’re feeling severely depressed, and depression can be increased in MS as well,” Hou says.
  • Eat well. “I have [people] who say that their diet really matters and that if they eat more fruits and vegetables, they feel like they have more energy,” Hou says.
  • Ease stress. Try not to load up your schedule. Build in rest during your day.
  • Ask for help. Ask family and friends if they can ease some of your responsibilities by picking up some of your tasks.
  • Stay cool. Heat makes MS symptoms worse. Avoid hot places and learn cool-down techniques.
  • Exercise. It may sound odd, but Serra says that “logging in some exercise every day, in whatever form and intensity is possible and tolerated, pays off in the long run.” If you’re feeling up for it, take advantage of the energy and move your body.

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Above all, reach out. Talk to your doctor, your loved ones, and others with MS for connection and help with your fatigue.

“As with everything MS, having a good support system is of great importance,” Serra says. “Recognizing that fatigue is a common and disabling symptom in MS, and that you are not alone in experiencing it, is a good first step.“

WebMD Feature Reviewed by Neha Pathak, MD on September 16, 2020

Sources

SOURCES:

Alessandro Serra, MD, PhD, neurologist, University Hospitals Cleveland.

Gloria Hou, MD, medical co-director, UW Medicine Multiple Sclerosis Center.

National Multiple Sclerosis Society: “Fatigue.”

Cleveland Clinic: “Multiple Sclerosis: Fatigue: Management and Treatment.”

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