Fatigue can deeply affect your ability to work, engage socially and enjoy daily life. Our expert guide offers practical, occupational therapy–based strategies to help you self-manage fatigue and regain control.
Fatigue is defined as 'a subjective lack of physical and/or mental energy that is perceived by the individual or caregiver to interfere with usual and desired activities' - National Clinical Guideline Centre, UK, 2014.
Symptoms of fatigue can include:
It can also result in:
Fatigue may not be relieved by sleep, so some people wake up exhausted even if they've slept relatively well.
It can be a symptom of a wide range of physical, cognitive, emotional, and communication difficulties, including (but not limited to) chronic health conditions such as:
See our page on Achieving occupational balance for more information.
There are also useful resources in the RCVS Mental Health Initiative (MMI), including:
Explore these resources in our Applied Mental Health Science series.
Fatigue impacts a person’s ability to engage in all the activities and occupations they have in their daily life - even those which are perceived to be simple, such as making a hot drink, going for a short walk, or meeting friends for coffee.
Fatigue can also be a barrier to participation in more complex occupations, including work, education, housework and leisure activities.
These activities and occupations often have both physical and cognitive demands. When someone experiences fatigue, they may struggle with both simple and more complex occupations, including:
Efficiency and performance are also reduced. This, in turn, negatively impacts a person's ability to do their job productively, safely and effectively.
Fatigue is also associated with low levels of health-related quality of life and an increased risk of depression. Therefore, managing fatigue and making reasonable adjustments are essential to reducing the risks and the consequences associated with it.
A systematic review and meta-analysis of 34 international studies demonstrated that self-management strategies can be effective in reducing fatigue and helping individuals regain control, leading to an improved quality of life (Kim et al., 2022).
As fatigue is usually a symptom of a broader health issue, it is assumed that you have already sought professional expertise for the underlying cause of your fatigue.
Before you begin self-management strategies, an accurate assessment of your fatigue is advised as a basis for planning the right strategies for you. This starts with an evaluation, followed by an analysis to inform goal setting.
Below are some self-help strategies and reasonable adjustments that may be helpful in managing fatigue.
Fatigue is complex and each person experiences it differently. Therefore, a personalised approach is advised, based on each person's lived experience. This requires a detailed understanding of that lived experience.
Our perception is not always reality. Gaining a more accurate awareness of what you do each day is an important first step in fatigue management. An awareness of how fatigue affects you - and the situations and activities that increase it - can support you in managing it.
A record of your activity could validate your experience and enable you to take the next steps in managing your fatigue. Alternatively, a record of your activity might be surprising, and suggest your fatigue is different to what you thought or that you are achieving more than you thought.
You can choose either a paper diary or an electronic diary to keep track. Here are some tips:
Note how the fatigue is for you: what you feel and what you do. It is recommended that you record your activity at regular intervals - real time reporting is generally more accurate than recalling events later. The more accurate your data is, the more reliable it is as a basis for making changes.
Recording your activity for two weeks should give you a good basis for the next steps.
Note: focusing on your fatigue in this way can be a negative experience, causing some people to feel despondent initially. Setting a clear time limit can help. It's the first step to regaining control and setting meaningful goals to improve your fatigue.
This also provides a rationale for sharing it with someone who can support and encourage you to keep going. They may also support you in the next stage: analysing your records and setting goals.
Using your results, determine what is surprising and what isn’t.
Consider:
Sometimes, the context of the activity is key to understanding fatigue triggers, such as if you are with others, or alone, and where the fatigue is experienced.
Consider whether you want to share your results with another person to seek their views and perspective. Choose someone who knows you quite well and you are comfortable discussing this with. Or this could be the point that you seek help from professional, starting with your GP.
Do you have fatigue management goals you would like to set for yourself? Make them realistic and meaningful, or use the SMART approach:
This approach can increase the likelihood of success. Some of the fatigue self-management strategies below are also well worth considering.
Evidence-based self-management strategies shown to improve fatigue for some people (depending on the underlying cause) include:
Improve your understanding of fatigue - enhancing your understanding of fatigue is the first recommended step to begin to manage it. Your GP may be able to recommend the best sources for information.
Energy conservation - gaining a balance of activity with rest is vital in energy conservation. Remember that physical and cognitive activities use energy, so consider balancing both with rest each day.
Developing an appreciation of rest - including its duration, amount and timing, and understanding what works best for you and can be incorporated into your lifestyle.
Analysing how you undertake activities - this is important as it shows you where you may be able to conserve energy.
For example:
Avoiding distractions as much as possible by creating a protected, quiet space can also be effective because it improves concentration, which can be impacted by fatigue, and boosts productivity.
Pacing, also referred to as 'activity pacing', is a self-management skill used to balance time spent on activities with rest. It supports a person's ability to carry out their meaningful occupations.
Over time, pacing can help build up tolerance for activities by gradually increasing how long you can do them.
To pace your activities effectively:
As with energy conservation, it is important to pre-plan your activities for a day or week, including frequent breaks, before fatigue symptoms appear. Pacing is not an instinctive response when you start to feel fatigue - so be proactive.
Even on a 'good day', you should still pace your activities. Consider whether some activities can be undertaken in manageable pieces of time, rather than completing them in one go. This supports good habit formation and should help prevent sudden fatigue from overexertion.
Activity pacing can also lead to a better understanding of when you can push yourself a little further - and when not to. It might also enable you to prioritise the activities that are most important and meaningful to you, rather than trying to do them all and then having negative consequences the next day.
Keeping a diary of your plans and your experiences afterwards could help with this. It is worth reflecting on how you feel after doing all your activities, as some can be energising. You might also have a better time in the day to do the more demanding activities.
Important: it you have a chronic health condition, you are advised to seek medical advice before beginning a schedule to increase your exercise levels.
Choose exercise(s) that you like and are most likely to continue. You can also choose the frequency, duration and intensity, striking a balance between between achievable and ambitious.
A good starting point might be:
Example 1:
Example 2:
Continuous review of your exercise progress and fatigue level is important. You can alter the exercises based on how you feel, but do this gradually.
If your fatigue symptoms get worse after increasing the intensity or duration of exercise, it is recommended that you continue at the level of exercise until the symptoms stabilise.
Over time, you could work towards meeting the NHS recommendation for adults:
High levels of stress and anxiety release cortisol throughout the body, which can lead to feelings of exhaustion. Therefore, managing stress and anxiety can be helpful for people experiencing fatigue.
Relaxation techniques, such as yoga and mindfulness, may be beneficial. Achieving a good occupational balance also helps ensure that time is allocated for rest and leisure activities.
See Achieving occupational balance for more information, as well as the RCVS Mental Health Initiative (MMI) guide: Understanding and managing stress in the veterinary Workplace.
Sleep quality is essential for overall wellbeing. Improving sleep is a huge area in itself, and again, is very individual.
Positive results have been reported with good sleep habits, which include:
For more advice on improving your sleep, visit How to fall asleep faster and sleep better on the NHS Every Mind Matters website.
A healthy diet is important for everyone’s overall health. Most people know the "good" foods and what a healthy, balanced diet looks like, but it’s helpful to remind ourselves now and again.
Top diet tips:
Foods rich in fibre and protein help maintain energy levels. Avoiding ultra-processed foods is vital, even though these can sometimes seem like an easy option when you’re tired and not up to shopping or preparing regular meals.
Consider simple, nutritious meals that don’t take long to prepare when you’re feeling fatigued. Alternatively, meal kit delivery services based on healthy recipes can reduce preparation time even further.
The benefits of peer support in self-management interventions are well documented. Having a trusted family member, friend or colleague to share your goals and progress with can be both motivational and encouraging.
It’s important that your employer and/or manager is aware of your fatigue. Fatigue can impact the organisation, and when your employer is informed, they can better support you with reasonable adjustments.
Topics to discuss may include:
As further motivation, there is evidence that as people improve their ability to manage work demands and self-manage fatigue, their self-efficacy increases - which in turn improves mood (McCormack et al., 2018).
If you would like professional support with managing fatigue, an occupational therapist can:
Bryant, W (2024) Rest-do days: How to live with fatigue and get things done. London, Hammersmith Health Books
Kim, S. Xu, Y., Dore K. Gewurtz R. Larivière N and Letts, L (2022) Fatigue self-management led by occupational therapists and/or physiotherapists for chronic conditions: A systematic review and meta analysis Chronic Illness 18(3) 441-457
McCormack, R.C. et al. (2018) ‘Impact of a fatigue management in work programme on meeting work demands of individuals with rheumatic diseases: A pilot study’, Musculoskeletal care, 16(3), pp. 398–404.
Explore helpful guides and information to support your wellbeing:
The pages in this section were written by occupational therapy expert Professor Nicola Spalding - view Nicola's biography.
