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How to cope with chronic illness and crash days

How to cope with chronic illness ‘crash days’

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An increasing number of people in the UK are su­ffering with chronic fatigue illnesses that result in ‘crashes’. Here’s what you can do when the unavoidable happens.

Think of a house that’s been burgled. The thief might be gone but the security alarm is still blaring and can’t be turned off­.” When Jo Foster, registered nutritional therapist specialising in chronic fatigue, shared these words with me, something clicked.

For the past three years, I’ve been seeking ways to take ownership of my long Covid. I’ve come a long way since 2020 — while I’m not exercising like I once did, I’m no longer spending days stuck in bed.

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The ME Association estimates that there are more than 1.25 million people in the UK living with a diagnosis of myalgic encephalomyelitis (ME), chronic fatigue syndrome (CFS) or long Covid (LC).

What to look out for

Indicators are varied, from malaise and insomnia to flu-like symptoms. One of the hallmarks of ME/CFS/LC is a ‘crash’, which commonly feels like a worsening of fatigue and brain fog. The official term for a crash is post-exertional malaise, and this usually occurs following an increase in mental or physical activity.

“If we can work out what set the alarm off­ and check it’s not still present in the body, we can break the cycle,” Jo says.

The burglar alarm analogy is a way to understand cell danger response, one of the leading theories around what causes symptoms. While there are ways to prevent the likelihood of a crash from happening, at times they’re unavoidable.

“Sometimes they come out of the blue,” says fatigue coach Pamela Rose. “Accept that it’s happening and dial back as many activities as possible. Rest up so that your system can use its resources to work on getting you to a steadier place.” Pamela recommends for those on a fatigue journey to introduce breathwork and meditation practices. Reframing is helpful, too, as crashes can lead to feelings of hopelessness.

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“People tend to feel guilty when a crash day has occurred because they did more than they knew they should. I would encourage them to take the learnings and use them to refi ne their plan going forward,” Pamela adds.

Fatigue bites

A major part of the ME/CFS/LC management process is diet. “Everyone’s needs are di­fferent but as a general rule the first place I start is increasing protein — this is essential for healing,” says Jo. But what about during a crash? “I’d suggest having some minimal prep foods such as fresh soups, tinned fish and precooked meats,” Jo says.

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“Get in the habit of batch cooking so your freezer is stocked when you can’t cook.” Crashes can be unpredictable. The nature of the beast is tough to pin down — but one thing is certain. If rest is king, self-compassion is queen.

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