Own Your Energy: Six Evidence-Based Strategies for Managing Fatigue with Neurological and Autoimmune Conditions
Updated: 4 days ago
Fatigue is one of the most common, and most misunderstood, symptoms of neurological and autoimmune conditions. Whether you're living with MS, Lupus, Parkinson's, or another condition, you've probably heard some version of "just rest more" or "pace yourself." And while those aren't wrong, they're not the whole picture either.
Here's what most people don't know. Both overexertion and underactivity can worsen neurological fatigue. And fatigue with chronic conditions isn't the same as being tired after a long day. It's a different animal entirely, often unpredictable and disconnected from how much you slept or rested.
The good news? Fatigue responds to evidence-based strategies. Not dramatic overhauls, just small, intentional shifts that fit your real life. Here are six that work.
One note before we dive in. These are tools that have worked for others. As you read through them, think about your own day and which one resonates most with where you are right now. You don't need to implement all six. Start with one.
First: Understanding the Energy Envelope
Before we get to the strategies, it helps to understand the framework they all build on.
Think of your daily energy like a budget. You have a certain amount available each day and it varies. Activities cost energy. Some cost more than others. The goal isn't to do as little as possible, that actually shrinks your envelope over time. The goal is to stay within your available energy while gradually and intentionally expanding it.
This is the Energy Envelope. A research-backed framework from MS fatigue research (Packer et al.) that applies across neurological and autoimmune conditions. All six strategies below work within this framework.
Strategy 1 : Energy Pacing
Pacing is the foundation of energy management and it's more nuanced than simply "doing less."
The core idea is break activities into smaller chunks and plan rest before you need it, not after you crash. Instead of pushing through until you hit a wall, build intentional pauses into your day proactively.
A simple starting framework is the 25/5. 25 minutes of activity followed by 5 minutes of intentional rest. This applies to everything: work tasks, household chores, social activities, even cognitively demanding activities like reading or attending appointments.
Try this week: Look at your typical day. Where do you usually push through? Where could a planned pause prevent an afternoon crash? Pick one activity and try the 25/5 approach.
Strategy 2 : The Priority Matrix
When energy is limited, everything can feel equally urgent. The Priority Matrix helps you make smarter decisions about where your energy actually goes.
Think of your tasks and activities in two dimensions: how important they are, and how much energy they cost. Your goal is to align your highest-energy time of day with your highest-priority, most energy-intensive tasks, and to genuinely let go of the things that drain energy without adding much value.
This is easier said than done, especially for people who are used to pushing through and getting things done. But protecting your energy for what actually matters is a genuine act of self-advocacy, not giving up.
Try this week: Write down your top five activities or tasks for the week. Rate each one on importance and energy cost. Is there anything you could move, delegate, or honestly drop?
Strategy 3 : Energy Tracking
One of the most powerful things you can do for fatigue management is also one of the simplest: start paying attention to your energy patterns.
Rate your energy 1-10, three times a day — morning, afternoon, evening — and note what you were doing, what you ate, and your sleep quality the night before. Do this for one week.
What you'll likely find is that your energy is more predictable than it feels. Patterns emerge. Maybe you're consistently better late morning. Maybe you notice a crash every time you skip breakfast. Maybe certain social situations leave you more depleted than you expected. That's not random, that's data. And data is where intentional change begins.
Try this week: Start tracking. Not to judge yourself, just to notice. Three check-ins a day, 30 seconds each.
Strategy 4 : Strategic Rest
Rest isn't just doing nothing. And scrolling your phone isn't rest. For your brain, it's actually quite stimulating.
There are four types of rest worth knowing about: physical, mental, sensory, and social. Different activities deplete different reserves. The type of rest you need depends on what depleted you.
• Physical rest: stillness, gentle stretching, lying down
• Mental rest: quiet, low stimulation, stepping away from cognitive tasks
• Sensory rest: dim light, reduced noise, calm environment
• Social rest: time alone, or time with people who feel easy and restorative
A 10-minute body scan or quiet sit restores differently than 10 minutes of social media. One depletes, one restores.
Try this week: Notice what you usually do when you "rest." Is it genuinely restorative? Try one intentional rest break, matching the type to what you've been doing.
Strategy 5 : Nutrition and Hydration Basics
The relationship between blood sugar stability and neurological fatigue is often underestimated. When blood sugar spikes and crashes, from skipping meals, going too long without eating, or eating in ways that cause instability, it compounds the fatigue that's already coming from your condition.
The basics that make the biggest difference:
• Pair protein with complex carbohydrates at meals and snacks
• Don't go too long without eating, the gap between meals matters
• Hydration matters more than most people realize, even mild dehydration worsens cognitive function and fatigue
• Eat something with protein within an hour of waking
This isn't about following a specific diet. It's about blood sugar stability as a foundation for more consistent energy throughout the day.
Try this week: Eat something with protein within an hour of waking for three days. Notice what happens to your mid-morning energy.
Strategy 6 : The Movement Paradox
This one surprises most people. Research shows that appropriate exercise actually reduces neurological fatigue over time.
The key word is appropriate. Not intense (though that may work for some). Not pushing through. Appropriate means calibrated to where your energy actually is today and building gradually from there.
When you stop moving because you're fatigued, your envelope can actually shrink, making fatigue worse over time. Gentle, consistent movement builds energy reserves rather than depleting them.
What counts:
• A 5-10 minute walk
• Gentle yoga or stretching
• Chair exercises
• Swimming or water movement
Consistency over intensity every time. Showing up for 10 minutes regularly does more than pushing hard once a week and crashing for three days.
Try this week: If you've been avoiding movement, start with 5 minutes of something gentle. Notice your energy afterward, not during, but a few hours later.
Putting It Together: Your Action Steps This Week
Six strategies is a lot to take in. Here's how to start without overwhelming yourself:
• Track your energy for 3 days morning, afternoon, evening
• Identify one pattern that stands out
• Choose one strategy that resonates with that pattern
• Notice what happens, no judgment, just curiosity
That's it. One pattern, one strategy, one week. This is how sustainable change actually happens. Not through dramatic overhauls, but through small, intentional shifts that compound over time.
About Joel Riciputi
Joel is an integrative health coach at Rooted Rise Health, working with people navigating MS, Lupus, Parkinson's, and other neurological and autoimmune conditions, along with their care partners. He lives with MS himself and brings both lived experience and evidence-based coaching to his work. Joel is a UC San Diego Certified Health and Wellness Coach.
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