Ideas on how to pace
What it means to young people
Pacing is a technique used by many people with M.E. Pacing is about learning what activities your body will tolerate or cope with, without causing a relapse or a set back. It's about taking a positive attitude to your recovery but discovering and recognising your limitations.
Make sure your expectations are realistic. If you set out to run a marathon in four hours and limp home in six, you will feel defeated, despite the enormous achievement of completing the course. M.E. is not a race, although sometimes you may feel that there is a marathon task ahead of you. Many people find that they begin to improve once they accept their illness, understand how it works, and follow a realistic and achievable approach to getting better.
When thinking about activities, it’s important to remember that this includes activities that use your brain, such as reading and speaking, as well as those that are physical, such as brushing your teeth or getting dressed. Some people find mental tasks like talking and listening much more tiring than physical activities. Most activities use a combination of brain and muscle power.
There has been very little research into pacing in children or adults with M.E. Surveys from adult members of Action for M.E. and feedback from young people show that the vast majority have found pacing helpful. It can bring structure to the day and give back a sense of control.
The effectiveness of pacing is to be compared with cognitive behavioural therapy and graded exercise in a major Medical Research Council trial. You can find out more in News.
Some ideas on how to pace your activities:
1. Find a level or a ‘baseline’ of mental and physical activity that you are comfortable with. You may be surprised about how much you are currently doing and may have to bring your activity levels down quite a lot!
To help you work this out you could try keeping a simple diary for a few weeks to see how different activities affect you. You should be able to see a pattern. For example, if you spend an hour talking to a friend on the phone and later in the day you feel exhausted, it may be because of the telephone call. Over a period of weeks it may become more obvious that phone calls are a major energy drainer for you! Quite often the full effect of an activity won’t be felt for one to three days or more afterwards. A diary can be really helpful in spotting these sorts of patterns.
2. Don’t just do things the way you have always done them. For example, if you get up in the morning and eat your breakfast, maybe have a rest before you get dressed. Don’t stick rigidly to old routines unless they are manageable.
3. Set yourself sensible time limits when planning your day. Try and stick to them. You may have to stop an activity half way through and go back to it later in the day or week.
4. Once you have found a comfortable level and your condition has stabilised, start to build on this baseline of activity gradually making very small increases, especially at the beginning.
5. Don’t be surprised to feel muscle aches when building up your activities. This is normal if you haven’t used those muscles for a while. Watch out, however, for aches or pains that might indicate you are pushing yourself too hard. All this takes trial and error to get right! You have to become an expert at reading your body.
6. Try and prioritise activities that you enjoy and are good at, so that you feel motivated about what you are doing.
7. It can really help to switch from mental to physical activities throughout the day.
8. Make sure you make time for rest and relaxation. Resting means just that - doing nothing! Reading and watching TV may be relaxing, but your brain will still be active. Sit somewhere comfortable, or lie down. Some people find it helps them to listen to gentle music. Tapes or CDs designed to help you relax can be good.
9. Remember not to be tempted to compare your current level of activity with what you were like before you got ill - this is guaranteed to make you feel really fed up. Many people find that they begin to improve once they stop fighting the illness and let it run its course.
Some examples of what ‘pacing’ means to young people:
'I try and plan my day and organise it into periods of work, rest and enjoyment. I find this hard to do and this has got more difficult since I started University as I have a different timetable everyday and lots of distractions! To help with this I try and create a store of energy from quieter days so that I can dip into this store on busier days.'
'I have learnt to budget the day’s - or week’s - energy so that I get the right balance of rest and activity. If I have a busier day I make sure that the following day is very quiet. I now find it easier to say no and change my plans at the last minute and my friends are used to this as well!'
'I try and only use 70% of my energy and I always leave a little bit over for the unexpected. I have learnt to switch my activities – a bit of brain work, then rest, then a bit of physical activity like a 10 minute walk and then rest again. I find the alternating between using my brain and then my body really works for me.'
'I’m now a lot better than I was and really look forward to going out with my friends once a week – sometimes to see a film or maybe the pub. I plan for this – save up some energy in anticipation and then the following day I make sure I do very little as I know that although I will feel better psychologically for being ‘normal’ and seeing my friends, physically I’m likely to be really exhausted'.
'I have learnt to prioritise the things that I need to do – those that are really important and those that are less so and then I spread them over the whole week and try and keep to this timetable. It may sound very restrictive but it works for me'.
Information produced July 2003
Updated June 2004
