Two techniques can help you manage your energy when you have ME/CFS. They are:
- Staying within your energy envelope.
- Pacing yourself.
These techniques can give you better control over your symptoms so that you can be as active as possible. They may also lead to fewer times when you feel so ill that you can't do anything at all. This worsening of symptoms is called post-exertional malaise. People who have ME/CFS often call it a "crash."
Staying in your energy envelope
You can think of the amount of energy you have to spend in a day as your "energy envelope." You stay within your energy envelope when you use about the same amount of energy as you have in a day—not more and not less.
With pacing, you plan your activities so that you can rest when you need to. No matter what kind of activity you are doing—physical, mental, social—you stop to rest. Have a plan for how long you will do the activity before you take a break (for example, every 15 minutes). Even if you are still feeling well, it is important to still stop and rest. It may help to set an alarm so that you don't lose track of time.
Putting it all together
Using these two techniques can be hard to do. When you are having a good day, it's tempting to overdo it. But if you do too much in a day or force yourself to keep going when your body needs rest, you could then crash and need several days to recover.
But with practice, it will get easier. Soon you'll get better at knowing how much you can do in a day and when you need to rest, so you can do more of what you want to do.
How can you stay in your energy envelope?
The amount of energy you have to spend each day is called your energy envelope. These steps can help you manage your day so that you stay in your energy envelope, not spending too much or too little energy.
- Each morning, estimate how much energy you feel you have for the day.
Give it a number from 0 to 100.
- A 0 (zero) would be no energy at all. People who rate their energy as a 0 might not be able to get out of bed.
- A 100 would be lots of energy. People who rate their energy as a 100 might feel like a time when they were the most well and active before they had ME/CFS.
- For each activity you want to do, think about how much energy it will take.
Give it a number between 1 and 100. Do this for physical activities like walking, driving, or doing dishes; mental activities like reading a book or handling email; and social activities like talking with friends or sharing a meal.
- At the end of the day, add up the numbers for the total energy you used on activities that day.
- Compare this total activities number to your daily energy number.
If the energy you used about equals your energy number for the day, then you stayed within your energy envelope.
How can you pace yourself?
- Check in with your body and think about how much energy you have that day.
Your energy levels can change from day to day.
- Choose one activity you want to do.
You may be tempted to think about all the things you want or need to do. But focus on just one activity.
- Ask yourself how much energy that activity will take.
It may seem hard to estimate this at first. But try using an activity log or a fitness tracker to track your daily activity. Over time, you can use these tools to decide how much energy your activities take.
- Ask yourself how long you think you can do your activity.
If you can do your activity for a longer time (for example, 30 minutes), decide when you will take a break to rest (for example, every 15 minutes).
- Set a timer or alarm to go off when your time is up.
This will help you keep track of time so you don't overdo it. It can also let you know when it's time to take a break.
- Stop the activity when the time that you've set is up.
You may feel like you can do more. Or you may want to do more. But staying within your energy limits for that day is important. It can help you get some tasks done without making your symptoms worse.
Current as of: October 6, 2021
Author: Healthwise Staff
E. Gregory Thompson MD - Internal Medicine
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine