Increasing your activity levels

Once you have established a more consistent pattern of activity and rest, you will be in a position to start to increase – gradually – the amount of activity you do each day. This will probably be about two weeks after you start your activity program. By this time, we would hope that you will feel that you are managing your planned activities and planned rests fairly consistently.

Look at your activity program and ask yourself, foreach different activity: ‘How successful was I at completing it?’

Using Table 7.1 overleaf to guide you, set new levels for each of your activities.

TABLE 7.1 INCREASING ACTIVITY LEVELS

Success in achieving activity 0% = no success 100% = complete success

Possible reasons for achievement/ non-achievement

How to change your activity level/program

0–25%

Activity level set much too high; an acute illness Other factors; e.g. moving house, holidays, other commitments getting in the way

Reduce the level of those activities that you did not achieve on a regular basis* Keep activity levels the same, or reduce only slightly

25–50%

Activity level may have been set slightly too high

Reduce your activity level slightly if nearer 25% achievement level; otherwise keep activity level the same

50–75%

Activity level set about right

Keep your activity level the same if nearer the 50% achievement level; otherwise slightly increase the activity level**

75–100%

Activity level set about right

Increase** your activity level, unless you have reached your target, in which case keep the activity level the same

* For example, if you planned to cook a meal once a day and did not manage to do so at all, maybe plan to cook a meal just twice a week. Or if you planned to get up at 9 a.m. every day and managed to do so only once, maybe reset getting-up time at 9.15 a.m.

** The amount of time by which you increase your activity will depend on what the activity is and the time that you are already spending on it. For guidance, please refer to Chapter 5 on setting targets.

How often should I make changes to my activity program?

How often you change your activity program will depend on how successful you are in achieving your plans. However, we would recommend that you set aside 15–30 minutes each week to review your activity program. This will give you the opportunity to assess your progress and help you to decide whether you can make any changes toyour activity program for the next week. We recommend that you make at least one revision a month.

When should I introduce new activities?

You may consider introducing new activities:

When the overall success of the previous week’s/fortnight’s activity program reaches about 75 per cent. It is important that you feel that you are managing your program reasonably well before adding in new activities. Otherwise you may end up feeling a little out of control.

When you have achieved a target. When you have achieve done of your targets, you may find that you have the time to introduce another activity. So, for example, if you have achieved a target of going out socially once a week, you may feel like adding a new social activity each week or perhaps doing something different, such as a regular exercise class or evening class.

If, for reasons beyond your control, you are unable to continue to work towards a particular target. Sometimes you will find that you plan targets that are not manageable for a variety of reasons. So, for example, if one of your targets was to go swimming each week and the pool was closed for cleaning, you might substitute another exercise for swimming. If you have planned a target to send emails for 15 minutes three times a week and your computer breaks down, plan to write to friends instead.

When your rests have decreased and you have the time for more activities. Once you reduce your resting time you will be able to include another activity or toincrease one that you are already doing. So, for example, if one of your rests used to last for one hour and is now half an hour, you can use that time to include another activity.

It is not necessary for your fatigue to have decreased for you to increase or start a new activity.

How do I decrease my rests?

Once your program has been established for a few weeks you are likely to have recovered from any temporary increase in fatigue and feel that you are able to reduce yourrests. Gradually cut down the amount of time you spend resting at first. So, for example, if you rest for an hour three times a day, you may start by reducing each rest by ten minutes. Or, if you rest for half an hour six times a day, you may want to reduce three of the rests by five minutes and leave the others at half an hour.

If you have a lot of rest periods in the day, say, more than five, you may want to reduce the number of rests once you have reduced the amount of time resting.

If you find yourself feeling much better you should continue to include some short rests in the day; otherwise you may get into the cycle of pushing yourself too hard for too long and having to take long ‘recovery’ rests. We would recommend that you have at least a mid-morning and amid-afternoon break, as well as one at lunchtime.

SECTION 2: PLANNING ACTIVITY AND REST FOR PEOPLE WHO GENERALLY DO TOO MUCH

We have already discussed the factors that frequently contribute to the maintenance of chronic fatigue syndrome. We hope that by now you will have a better understanding ofsome of the things that are responsible for keeping your own CFS going, such as keeping on the go all day without a breakand/or sleeping erratically.

People who generally do too much are often able to ‘keep going’ at work, maintain their home, or study for long periods, but in the evenings and at weekends spend most of their time resting or sleeping in an attempt to feel better. This pattern can be very frustrating, causing you to miss out on pleasurable activities such as seeing friends or family, taking days out, doing some exercise, or pursuing your hobbies.

The key to improving your health is to make your life as balanced as possible. It is therefore important that you identify areas that you could change. For example, do you find that you tend to keep going at work without taking breaks? Do you find that you do not sit down at home until you have taken your children to school, tidied the house, and done the shopping? Do you find that you do not leave work until you have completed everything there is to do, even if it is late? Do you study for hours without taking a break and then have to sleep for a couple of days because you feel so fatigued? If the answer to some of the above questions is yes, then maybe you could consider some of the following ideas.

Could you leave work a little earlier?

Could you have a proper lunch break, instead of eating a sandwich at your desk?

Could you postpone the cleaning, washing, preparing meals, and so on, and sit down for half an hour?

Could you plan one or two pleasurable activities each week?

Could you put aside one hour for yourself each day?

Could you break up your studies with a brisk walk?

It is important to plan in advance what you are going to do each day by creating an activity program once a week. This will help you to balance your time between things that you have to do, for example work, studying, or managing your home, with pleasurable activities such as seeing friends and having time on your own to relax.