What is Fatigue?
 
Fatigue is a feeling of constant tiredness or weakness and can be physical, mental, or a combination of both. Many people experience some form of fatigue in their lifetime; however, it is more common in individuals with a disability. Fatigue is different from just feeling tired as it causes a general lack of motivation and energy. The Cleveland Clinic states, “People who have fatigue are so drained that their exhaustion interrupts their daily life.” Some examples of disruptions include waking up in the morning, going to work/school, spending time with family, being social, exercising, and even eating.

Classifications of Fatigue

Different types of fatigue can be felt, primary and secondary. Primary fatigue is caused by damage to the brain and spinal cord; it is believed that trauma in these parts of the body makes passing messages from the brain to nerves take extra energy. Secondary fatigue is identified as living with a disability or chronic fatigue, this includes sleep abnormalities, depression, inactivity, and deconditioning (functioning in an opposite way of typical behaviors). In some cases, fatigue lasting more than six months is considered chronic. Chronic fatigue can feel like a total body “crash” with symptoms that can worsen over time. This form of fatigue is not always caused by a medical condition making it frustrating for individuals experiencing it.
 
Who is Affected?  

In the United States, 45% of the population reports feelings of fatigue. Fatigue itself can be draining for some depending on the severity of symptoms, it can prevent individuals from doing work or participating in activities, have a negative impact on mood or clarity, and cause general weakness.

Primary fatigue is common in individuals with multiple sclerosis (MS), muscular dystrophy (MD), and spinal cord injuries (SCI). In MS, fatigue is generally caused by damage to the central nervous system that slows down responses and messages from the brain to the body. In MD, damage to the muscles or nervous system or a combination of both can result in fatigue. Those with SCI can experience total or partial damage to their spinal cord decreasing mobility and sometimes causing muscle changes.  

The symptoms of fatigue are experienced in individuals with disabilities the same way as those without but can be further debilitating for individuals with decreased mobility or strength.  
 
How to Fight Fatigue:  
 
There are many ways outside of medication-to help reduce the effects of fatigue such as diet, exercise, consistent sleep, and mindfulness.  
 
Nutrition
The way we fuel our bodies has a big effect on the way we feel. Feeling fatigued could be caused by low vitamin D levels, as well as deficiencies in iron, magnesium, potassium, vitamin B12, or folic acid. The best way to combat a lack of energy is to eat a diet full of energy-giving food. When shopping for groceries or preparing a meal, it is important to:

1. Avoid processed foods
2. Eat more fruit and vegetables, 
3. Decrease caffeine (okay in moderation)
4. Increase protein in meals
5. Drink water.

Why? Processed foods are full of preservatives and additives like salt that can slow the body down. Fruits and vegetables are packed with nutrients that keep your body functioning and support overall health. Lean proteins such as chicken, turkey, and fish contain protein that helps strengthen and repair bones and muscles, they also are packed with heart-healthy fats. Drinking enough water is extremely important for your body as it prevents dehydration which can cause unclear thinking and decreased mood. Here is an example of a fatigue-fighting grocery list:

• Fish (salmon, tuna)
• Poultry (chicken, turkey)
• Healthy fats (avocados, olive oil)
• Eggs
• Green leafy vegetables (lettuce, spinach)
• Vegetables (tomatoes, peppers, cucumber, cabbage, carrots, sweet potatoes, squash, zucchini)
• Fruits (bananas, apples, oranges, berries, grapefruit, pineapple, cantaloupe, watermelon, honeydew)
• Nuts and seeds (almonds, cashews, sunflower seeds)
• Mushrooms 

At times, extreme exhaustion or a general lack of motivation can make eating or preparing a meal feel like a chore. A general tip is to have your biggest meal when you have the most energy-this may typically be around breakfast and lunch. It can also help to have healthy snacks (like trail mix, cheese sticks, yogurt, fruits, and vegetables) to eat throughout the day to maintain energy. Protein shakes or energy bars are also great options for snacks. These are especially helpful on days when eating a big meal feels like an impossible task.

A great way to still make sure you are eating enough throughout the day without causing further symptoms of fatigue is to either meal prep or find healthy frozen meal choices.

Having a few easy-to-prepare recipes can be a great way to have ready-to-go meals stored in the fridge with only one day of prep. Here are some websites that offer 30-minute or less meal prep ideas:

• A Beginners guide to starting meal prepping:
• Breakfast Meal Prep
• 30 minutes or less Lunch/Dinner Prep

If you would instead opt for a frozen meal, some great choices are Amy’s products, Healthy Choices, and Lean Cuisine which can all be found at your local grocery store. These meals eliminate the need for prep while still making sure you are nourishing your body in a way that will support your health.
 
Exercise
Exercise is known to increase energy and improve overall mood, and while exercise may look different for different people, the effects remain. Any type of movement with your body, chair exercises, small weights, resistance band training, and stretching, can help fight the symptoms of fatigue.  
 
Sleep
Sleep has a huge impact on overall health. Taking naps throughout the day can help manage fatigue, 1-2 short naps (10-30mins) generally help maintain energy without impacting normal sleep patterns. When taking a nap or going to sleep at night it is important to create a supportive environment by reducing distractions like TV, music, and lights. It can also help to set an alarm or timer so that you are managing your naps even if you can’t fall asleep, limiting distractions and resting can help you relax and feel more energized later in the day. Planning your day can also help to reduce fatigue symptoms as it prioritizes tasks and can space out activities to allow your body to rest. Mindfulness can be coupled with sleep as its primary goal is to relax your mind and reduce distractions such as stress.  
 
Tips

Along with these main strategies, here are some other tips for managing stress:

• Talking to a healthcare provider can help identify if there are any habits or medications that are increasing fatigue
• See if any changes can be made to your living space to make moving around easier 
• Find foods and activities you enjoy to create healthy fatigue-fighting habits