How You Can Still Be Productive When Living with Pain, Fatigue and Brain Fog

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It’s not the most logical combination: chronic illness and productivity. After all, chronic illness often drains you of your energy, pain can stop you from doing physical labour, while symptoms like nausea and dizziness make it hard to focus and perform mental tasks.

In a culture where hustle is praised, productivity has become synonymous to efficiently putting out as much work as possible, filling every moment with useful tasks. But in my view, true productivity revolves more around being effective than being efficient.

You can be working 10 hours a day, but are you doing the things that matter? Or is most of your time spent on answering emails, having meetings and tackling a long lust of to do’s instead of doing deep work as computer science professor Cal Newport calls it?

Of course, for some people, those tasks are the main part of their job. And not all of us have autonomy over how we spend our work hours. But still, in some cases, we could be making just as much impact – or perhaps even more – by working smarter instead of harder.

When you’re living with a chronic illness like ME/CFS, kidney disease, multiple sclerosis or traumatic brain injury, it becomes all too clear that productivity is not the same as putting in many hours. Because when you push yourself hard to reach a deadline on Wednesday, you might crash afterwards and not be able to work or study again for the rest of the week. Or maybe you can only be active for a small amount of hours each week, but you still get important tasks done, because during that time you’re as focused and energized as possible.

So what exactly does being productive with chronic illness look like? That will change from person to person, but in general, productivity with chronic illness means you’re still getting meaningful tasks done despite your limitations and fluctuating health. Those meaningful tasks can be related to work, study or volunteering, but keeping your household running and caring for your family also counts. Although many examples below will focus on mental tasks, you can adapt these tips to what productivity means to you.

Productivity with chronic illness means you’re still getting meaningful tasks done despite your limitations and fluctuating health.

Let’s assume you already have the basics of productivity covered, like setting priorities, limiting distractions and using the Pomodoro technique to help you focus. How can you apply these principles when you’re dealing with pain, fatigue and other symptoms every day?

Here are some health-oriented tips on how you can still be productive when you’re chronically ill. 

1. Practice Pacing

According to Psychology Today, “an individuals’ productivity hinges on their mental (and physical, red.) energy and a sense of internal and external motivation”. That’s exactly what makes it so hard to be productive with chronic illness: dealing with constantly changing energy levels, mental focus and overall health situation.

One way to tackle that problem is by mastering the basics of pacing. Pacing is the practice of alternating activity with rest, to prevent you from overexerting yourself. That also means taking breaks before you get too tired. The goal of pacing is to still get meaningful things done on bad days, and not push yourself too far on days when you feel relatively good, followed by post-exertional malaise afterwards.

Let’s take a closer look how you can manage your energy wisely.

Know your peak hours.

Which days of the week and what time(s) of day are you most likely to feel relatively good? Maybe your health fluctuates too much to easily tell or you don’t yet have a consistent sleep-wake schedule, but if you track your health for at least one week, you’ll probably notice patterns of periods when your symptoms are mild or get worse.

Now you don’t want to waste your precious energy on replying emails or paying bills when you could be making progress on writing a great article or marketing plan. To boost your productivity effortlessly, plan high-focus tasks or physically challenging jobs for times when you’re most likely to feel energetic and focused. At the same time, you could make a list of low-energy tasks for bad days, so you can still do some reorganizing or social media promotion and not feel frustrated for not making any progress.

An interesting fact: According to The Power of When, the majority of people have their most productive period for high-focus work like analyzing, making strategic decisions and learning new skills between 10am and 2.30pm. In the late afternoon, your mood and creativity peak, making this a great time for brainstorming and social tasks like phone calls, emails and meetings. Working with the rhythm of your chronotype could help you to get more done with less energy.

“The key to unlocking your full potential is to get back in sync with your natural rhythm.” – Michael Breus, The Power of When.

Alternate different types of tasks.

When you’ve got a lot to do but limited energy, one way to pace yourself is to switch between physically, mentally and emotionally-demanding activities. For example, after grocery shopping, you pay the bills or make a phone call so your body can rest from the walking and heavy lifting. But it works both ways: when you need a break from work or studying, it’s best to stretch your legs and make yourself a cup of tea instead of scrolling social media if you want to restore your brain power.

Schedule buffer time.

Life rarely ever goes as planned, and dealing with unexpected events like a malfunctioning computer or family emergencies can take up all your energy when you’re chronically ill. What’s more, you may feel like you’re falling behind with your to-do list, and you can’t easily catch up because of your limitations.

Buffer time is the extra time planned for the unexpected, from traffic jams during commutes to gathering your thoughts and things between appointments. That way, you won’t have to hurry, get stressed or feel overwhelmed – all of which drains you. You can add more buffer time into your days by adding whitespace to your calendar to prepare or catch up, splitting you to-do lists into ‘must-do tasks’ and ‘would-like-to’ ones, and having a back-up plan for bad days.

Learn to recognize the warning signs .

It’s a common dilemma for many chronically ill people: when do you push through the pain to get things done and when do you decide to stop and rest?

Only you can decide that. You’re the only one who can feel your bodily sensations. It is wise to watch out for warning signs of your body and mind though. When you’re living with pain, fatigue and brain fog every day, it can be hard to recognize when you’re running on empty and heading for the danger zone. Your warning signs will look different than mine, but things like intensified pain, feeling close to fainting and getting really anxious are probably cues that you need to stop and take a break.

Remember, productivity with chronic illness is a long-term game, and you’ll probably get less done when you push yourself too far and end up exhausted with a flare-up of symptoms.

2. Optimize Your Working Conditions

Depending on your health situation and job requirements, you might need certain modifications to your work environment to function well. Here are some steps you can take to optimize your working conditions:

Discuss work conditions with your boss.

Laws and legislations differ from country to country, and sometimes even from state to state. But many disability acts in Western countries require employers to make reasonable accommodations for their workers, like accessibility in and around the building and adjustable chairs and desks.

But the number one requests from chronically ill employees has nothing to do with ergonomics, but with flexibility. Flexible work hours, a self-paced workload, frequent breaks and/or working from home one or more days a week all make it much easier to be productive with chronic illness.

Discuss with your boss what you need to work optimally given your situation and what’s realistic for your employer, so you can hopefully find some common ground and avoid running into flare-ups or tense relationships at work. For more tips, check out Chronic Illness and a Career: Can You Have Both?

Optimize your work space.

When it comes to productivity in the office or at home, there are a few things you can do to optimize your work space.

First of all, if possible, do not work in bed to keep your bedroom for sleep and intimacy only, to prevent sleeping problems. Secondly, clear your work area from clutter. Clutter acts like a visual reminder of what needs to be done, and therefore reduces your mental focus and mood. What’s more, staying somewhat organized helps to save you precious energy in the long run, when you no longer have to search for those papers or tools.

You should, however, make room for plants, succulents or terrariums on your desk. Having plants in the workplace doesn’t just look nice, but studies show it also helps to improve your productivity and concentration. What’s more, looking at greenery has been proven to ease mental fatigue. Sounds like an easy win, right?

Good lighting is one of the key determinants of workplace wellness. Catching natural daylight, by sitting by the (open) window, is best for fine-tuning your biological clock and increasing alertness. Even on a grey day, sunlight still has a more suitable intensity than any indoor lighting. But if moving your work area to a naturally lit space isn’t an option, neuroscientist Andrew Huberman advises you to use bright lights – overhead or in front of you – in the morning to stimulate your alertness. During the late afternoon, you want to bring the lights slightly down. Also be mindful of your screen brightness, especially later in the day. If you’re working at night, limit the amount of bright light to avoid messing up your sleep and metabolism.

Speaking of vision: According to the fascinating Huberman Lab podcast, there’s a direct link between your brain stem – that regulates alertness – and your eyes. When you gaze down, looking at your phone, keyboard or book, the neurons that control your eye movement will activate areas of your brain associated with calmness and even sleepiness. But the opposite is also true: by placing your computer screen at or slightly above eyesight, these neurons will signal to your brain it needs to increase your alertness. Using a monitor stand riser could help you to effortlessly boost your mental focus (and improve your posture too).

For more ideas on how to design your environment for success, check out these 27 subtle ways to optimize your home for healing.

Limit distractions.

Did you know that on average it takes us 23 minutes (!) to return to a state of focus after being interrupted by coworkers, notification pings or the doorbell that rings? That’s a big waste of your mental energy, especially if you’re already struggling with brain fog or fatigue.

So limit distractions during your most productive hours. Depending on the work you do, you could only check your email during set times of the day, turn off social media notifications, put your phone away during analytical tasks and only do one thing at a time. As much as we all believe we’re good at multitasking, our brains don’t handle multiple sources of input at once.

Also, find out how much background noise works best for you. Random sounds like a siren and ongoing humming from the air conditioning can be highly distracting, and even hurt your cognitive performance. You might want to use noise-cancelling headphones if you’re prone to sensory overload. But research shows that ambient background  noise – the kind you hear when working in a coffee shops – is actually beneficial to creative work and productivity. What’s more, classical music helps you memorize new information. People react very differently to which level of noise feel comfortable, so experiment what supports your productivity with chronic illness.

3. Boost Your Energy Throughout the Day

Let me be clear: There’s no health hack in the world that will take away the deep fatigue that accompanies so many chronic illnesses. When your body does not function well and you cannot cure the underlying cause at this time, you’ll probably have to deal with exhaustion, brain fog and post-exertional malaise more often than you care for.

But there are a few science-backed ways to subtly support your energy levels throughout the day – and we all know what a difference a little more energy can make in your mood, performance and wellbeing. Here are some simple things you can do:

• Expose yourself to natural daylight early in the morning. Light is the most powerful cue to fine-tune your internal body clock. When your eyes catch that morning light, it signals to your brain that it’s time to start the day, triggering a cascade of physiological reactions that raise your alertness. So open your curtains first thing in the morning, drink your coffee on the balcony or go for an invigorating stroll around the block if you possible.
• Move your body gently to boost your blood and lymph circulation. That way, blood rich in oxygen and nutrients will easily reach every corner of your body, while waste products are carried away. You don’t have to do intense workouts to get your blood flowing and feel more energetic, a short walk or some stretching will work just fine. Ideally, you should get up from your chair every hour during the day to support your circulation.
• End your morning shower with 30 to 60 seconds of cold water. Or, if that idea really does not appeal to you, splash some cold water on your face. Exposing yourself regularly to cold temperatures is known to speed up your metabolism, reduce inflammation and give you a burst of energy. Disclaimer: Cold therapy might not be right for you when you suffer from heart problems and during pregnancy, so please check with your doctor or other medical professional first before trying this practice. 
• Time your caffeine intake wisely. If you drink your coffee first thing in the morning, you might want to reconsider. You see, caffein is known to raise cortisol levels. But when you wake up, your cortisol levels are already naturally high to prep your body and mind for activity. So sipping your espresso early in the day can create unnecessary stress in your body, leaving you feeling jittery at first and tired a few hours later. It’s better to have your coffee mid-morning, between 9am and 11am. Also, have your last cup of jo no later than mid-afternoon to avoid sleeping problems. You could also swap your cappuccino for a matcha latte or green tea for a milder buzz.

• Stay hydrated. Over 60% of your body consists of water, so you need to drink around 8 glasses of water each day to function well. Even mild dehydration can increase fatigue, reduce alertness and lower your mood. Especially on warm days or when performing physically challenging tasks, make sure you have a glass of (flavored) water before every meal and snack.
• Embrace hara hachi bu. We’ve all had it: the after-lunch dip. Big portions of food, no matter how healthy, will draw blood from your brain to work on digestion. That’s why the Japanese rule of hara hachi bu comes in handy: eat until you’re 80% full.
• Keep your blood sugar levels stable throughout the day. When the afternoon slump rolls around, it’s tempting to reach for the cookie jar. Sugary snacks will definitely give you a short energy boost, but that spike in blood sugar level is followed by a crash. And a blood sugar crash can make you feel tired, irritated and anxious, shaky and struggling to concentrate. Instead of grabbing a chocolate bar, have a low-glycemic snack like a handful of unsalted nuts, unsweetened yoghurt or veggies with hummus to keep your blood sugar levels stable throughout the day.
• Practice breathing exercises for a quick pick-me-up. The 4-7-8 breathing technique will relax your body and mind, while alternate nostril breathing balances your nervous system, providing you with a calm energy and mental clarity.
• Consider using adaptogens. Studies show that some adaptogens have a protective effect against stress and can enhance your attention and endurance, even when tired. Goji berries, for example, help to boost your energy and performance, whereas Rhodiola rosea could alleviate fatigue. Other adaptogens known to improve energy and focus are ginseng, maca, cordyceps and ashwagandha. Disclaimer: Please check with a medical professional and/or your pharmacist on how to safely use adaptogens and to prevent potential harmful drug interactions.
• Drink beet juice to improve your stamina. According to a study by the University of Exeter, the nitrate in beet juice reduces the uptake of oxygen, which in turn makes exercising less tiring and therefore boosts your stamina. Although the research focuses on athletic performance, the authors say it could have interesting implications for people with cardiovascular, respiratory or metabolic diseases.

You can find more actionable advice on how to manage your energy for high performance in The Power of Full Engagement by Jim Loehr and Tony Schwartz, and discover the best way to work with your body clock in The Power of When,.

4. Schedule Rest Like You Schedule Work

Your calendar is probably filled with work deadlines and doctors appointments, but do you also purposely plan moments of rest? And not just weekends off or a quiet evening by yourself, but also time to recharge throughout the day?

Even healthy people cannot be productive and mentally sharp all day long. Research shows you can only focus for 90 minutes at a time. That’s why traditionally we have short breaks mid-morning and mid-afternoon. But it’s easy to mindlessly eat a sandwich behind your computer or quickly have a snack on the go when taking inventory or looking after little kids. And even if you do step away from your workspace, you might still be mentally going over upcoming tasks instead of restoring your physical, mental and emotional energy.

What if you would use those small pockets of free time to relax your body and calm your mind? Instead of checking your email by the coffee machine, you could incorporate mindful micro-breaks into your day, from a quick body scan and walking meditation to doing a simple breathing exercise that balances your nervous system. You could also take a power nap if your work allows it. However, only nap if it does not disturb your sleep at night, and preferably for just 20 minutes before 3PM.

After work, it helps to create relaxing routines to wind down at night. And I’m not talking about binge-watching your favorite show, but doing something that activates your body’s relaxation response, like taking a warm bath, doing restorative yoga or drinking chamomile tea. At least one hour before bedtime, put your screens away and focus on relaxing your muscles, slow down your heart rate and breathing and calm your racing mind to get a restful night’s sleep.

I’m well aware that none of these tips will ensure that you will wake up feeling rested and ready to tackle the day. No matter how healthy your lifestyle is, there’ll likely still be days when you have to deal with fatigue, pain, brain fog and all kinds of symptoms.
However, I do believe that creating supportive circumstances can help you to boost your productivity with chronic illness and get meaningful things done. It won’t be easy, but living a good life despite chronic illness is worth it.

What helps you to support your productivity with chronic illness? 

If you enjoyed reading this article, you might also like Why Pacing Beats Push-and-Crash Cycles (And How You Can Best Manage Your Energy) and 10 Subtle Ways to Boost Your Energy, Spoonie Style.