Why Hard Work Doesn’t Pay Off in Chronic Illness: How to Stop Pushing Through Your Fatigue and Give Yourself Permission to Rest

Why Hard Work Doesn't Pay Off in Chronic Illness How to Stop Pushing Through Your Fatigue and Give Yourself Permission to Rest

I’ve never been a big fan of napping. I was that overexcited kid, running around, yelling “No! I am not tired!” Moving on to the next thing I want to do has always seemed more interesting to me than stopping and sleeping. You can imagine how well that impulse has (not) translated into living with fibromyalgia. The metaphor I like to use is putting a racing car engine in a beat-up old car – my mind always wants to go faster than my body can keep up with. But it’s not just curiosity that pulls me forward. I also put a lot of pressure myself to push through, to keep working until it’s all done.

I’ve learned that always pushing forwards is toxic for my body. I’ve also learned that the impulse to soldier on isn’t a personal failing. Believing that “hard work pays off” is a social value, something we are all taught growing up.  We attribute positive character traits to people who spend long hours at work, without ever making time for themselves. We describe them as being committed, determined, effective, ambitious, responsible, and upstanding, rather than just calling them workaholics. The flipside – laziness – is a cardinal sin in our productivity-obsessed culture. But encouraging this imbalance between activity and relaxation serves to support unhealthy attitudes and behaviour around work.

I’m far from the first person to point this out. In recent years there’s been a movement to prioritize emotional wellbeing. You hear a lot about self-care, emotional balance, burnout, stress management, mindfulness, and disconnecting from social media, among other things. Psychologist Guy Winch, in his TED talk How to Practice Emotional First Aid, explains our favouritism towards physical well-being over emotional well-being. He points out that, while we learn from a young age to put a Band-Aid on physical injury, we don’t learn how to treat our psychological injuries, like sadness, loneliness, or anxiety. Psychological pain has a significant impact on the body’s state of health, and increases the risk of chronic disease. The mind and the body are interconnected, and what affects one has an impact on the other.

I think chronic illness magnifies the mind-body connection. Living in a state of constant physical fatigue has significant cognitive and psychological consequences. Brain fog, frustration, anxiety, a sense of helplessness, and many other responses are common among people living with illnesses involving chronic fatigue. Dr. Peter Rowe, director of the Chronic Fatigue Clinic at Johns Hopkins Children’s Center in Baltimore, says that “The emotional impact of a diagnosis of chronic fatigue syndrome is different for each person, but it relates to the loss of the ability to do the things you were good at before” (quoted in Everyday Health).

Put another way, fatigue causes people living with conditions like fibromyalgia, to experience multiple and complicated losses. These losses occur in areas that affect our sense of self-identity, like career, friendships, hobbies, parenting, and daily functioning. Kate Jackson (2014) calls them ‘infinite losses’ because they are not time-limited – instead they are unending, which makes them harder to resolve.

So, you might be asking, what does this have to do with taking a nap? For people who don’t live with chronic illness, resting might be a straightforward solution to fatigue. A physical solution to a physical problem. Even for healthy people, however, I doubt that’s always true. Call it stress, emotional overload, or burnout, the impulse to push through when you actually should stop and recover can result in significant psychological and physical problems. Our general preoccupation with work and productivity encourages unhelpful mindsets like perfectionism, shame, anxiety, guilt, and low self-esteem. In turn, these feelings and beliefs can cause us to double down and work even harder in order to measure up (Psychology Today). It’s very difficult to stop and listen to what your mind or body need when you’ve learned to routinely override those signals.

I’ve read countless tweets and blogs from people living with chronic illness who are frustrated with themselves for overdoing it on a good day and causing a flare-up. I’ve wondered why it seems so hard for me to pace myself, to proactively rest, to achieve balance between activity and relaxation. Over time I’ve realized these problems occur because resting is not just a habit. When the fatigue settles in it can often feel like a gate slamming shut.

Fatigue, along with pain, are the primary restrictions that have been placed on my abilities. The resulting frustration or sense of helplessness is a manifestation of the sadness and anger over the ‘infinite losses’ caused by chronic illness. Coping with these feelings is difficult. In this context, it’s a lot easier to say “just go and lie down” than it is to actually do it.

Behind the decision to stop and nap is a whole set of thoughts, feelings and beliefs about how you relate to work and productivity. If I’m writing an article and I feel brain fog and fatigue setting in, my first reaction is to feel frustrated with my body and tell myself to “tough it out.” Even when I take the reasonable step of stopping and lying down for awhile, there is a part of me that feels a creeping sense of guilt or self-blame. In a world where people with disabilities are applauded for “overcoming their limitations,” as if disability is a failure to move past, it’s hard not to worry if taking breaks is some kind of character flaw. I believe that it’s this mindset, this negative self-talk, that sabotages our attempts at pacing.

Becoming aware of our thoughts and feelings is a powerful way to take better care of ourselves – many people find that regularly practicing mindfulness meditation, journaling, or cognitive behavioural therapy techniques very helpful for developing greater self-awareness. Maybe I’m making a mountain out of a mole hill, but I think it’s important that we talk openly about the social and emotional impacts of valuing work and productivity over balance and acceptance. We need to prioritize healing the psychological as well as the physical. Because, ultimately, resting is an act of self-awareness, self-compassion, and self-acceptance, not just a solution for being tired.

Why Hard Work Doesn't Pay Off: Listening to Your Fatigue Instead of Fighting Through It


Jackson, Kate. (2014). ‘Grieving Chronic Illness and Injury: Infinite Losses. Social Work. http://www.socialworktoday.com/archive/070714p18.shtml

Kromberg, Jen. (2015). ‘4 Difficulties of Being a Perfectionist.’ Psychology Today. https://www.psychologytoday.com/ca/blog/inside-out/201311/4-difficulties-being-perfectionist

Orenstein, Beth.(2010). ‘The Emotional Side of Chronic Fatigue.’ Everyday Health. https://www.everydayhealth.com/authors/beth-orenstein/

Winch, Guy. (2014). https://www.ted.com/talks/guy_winch_the_case_for_emotional_hygiene



13 thoughts on “Why Hard Work Doesn’t Pay Off in Chronic Illness: How to Stop Pushing Through Your Fatigue and Give Yourself Permission to Rest

  1. C D Beatty says:

    Dear Ms Zulak,
    After a lifetime of chronic pain via fibromyalgia, I always find your writing refreshing, uplifting and to the point. Keep up the good work.

  2. walkamyelinmyshoes says:

    You bring up so many excellent points! I love the racing car engine analogy, that’s exactly what I feel like. And the comment about ‘overcoming limitations’ is spot on, there does need to be a societal shift to value more than just work, especially with the increase of chronic disease. I had a revelation this weekend that the anxiety I had thought was brought on by my MS is something I have had my whole life, I think I was in denial. Your comment about the long-term effect of stress on the body makes me wonder if it was another contributing factor to my disease. Fantastic post, thank you!!

  3. Liz Terry says:

    I think there is a difference between things we feel we “should” or “have” to do and things we want to do.
    I long ago gave up working because of fibromyalgia, and (thank goodness) I don’t have responsibilities like child care. Where I struggle is with things I really want to do, but which I know will make me feel worse.
    At the moment, I am visiting my sister. She lives in Sussex, I live in Gloucestershire. To get here meant a long train journey with two changes. I got baggage assistance, but just the travelling is exhausting, and I have to do the exact same journey going back in a few days. I never get as much rest as normal when I’m here, not because my sister doesn’t understand (she’s a fibro sufferer too) but because I am sleeping in a different bed, it’s much noisier here and a whole host of other reasons. I’ve had to block out three days after I get home to “recover” (although I know it will take me longer than that). So I shouldn’t do it, right?
    However, the emotional support I can give and get from my sister is invaluable. I get to visit my sweet 93-year-old granny, who may not be with us much longer. I get to have coffee with my mother. All these things do me so much good emotionally.
    So, is the physical cost worth it? I would say so. It’s all about that in the end.

    • Katarina Zulak says:

      Thanks for your comment, and I think you make a really good point. There are definitely times when the emotional benefit outweighs the physical cost. I’ve experienced that when going to celebrate the wedding of a friend, or seeing family during the holidays. For me, the struggle has been less around the big moments and more about the daily habits – an unhelpful drive to push through all the time without considering the impact on my quality of life. There’s a lot of trade offs for me when you have limited energy, but I hope i’m learning to spend my time more wisely.

  4. Deborah says:

    Superbly written article. The need to “prioritize healing the psychological over the physical” — just wow! After four years of chronic pain I finally grieved the loss of my former self and accepted the new normal. No longer would I be that wife and momma that kept the family machine running smoothly. Naps were something I could *never* do! That was the ultimate laziness in my book. Oh how things can change! Now it’s literally mandatory. I still fight it but I’m slowly realizing that it’s essential for my wellbeing. Thanks for highlighting this important point.

    • Katarina Zulak says:

      Thank you so much for your kind words. I find it really validating to connect over shared experiences – that’s the great part about blogging! I’m really glad to hear that you are working towards acceptance, I know all too well how hard that can be. Like you say, a nap is not just a nap, you have to start to see yourself in a different light to integrate those changes into your life. xx

  5. Kerry Howard says:

    your blog really was needed by me it is hard for me to accept the fatigue deal with acceptance of not being able to accomplish what I think needs to be done and prioritize what is importance like total resting

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