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Lyme Disease Pacing

Lyme_Disease_Pacing Rest is a key factor in successfully managing and living with chronic Lyme disease. However, many people with LD tend to push themselves to their limit every day. Often this results in a push/crash cycle - doing way too much one day, then taking several days to recover.

The best way to avoid the push/crash cycle is to learn pacing. The following article by Bruce Campbell, PhD, Executive Director of CFIDS & Fibromyalgia Self-Help, describes how to effectively pace yourself using the "Energy Envelope." Although this concept was initially developed for people with fibromyalgia and ME/CFS, it is equally applicable for people with chronic Lyme disease and many other chronic illnesses.

Find Your Limits - How to Put the Push-Crash Cycle Behind You

Having a chronic illness can often feel like living on a roller coaster. You swing between intense symptoms and rest, in a frustrating cycle of push and crash.

When your symptoms are low, you push to get as much done as you can. But doing more than the body can tolerate, you intensify your symptoms and crash. You then rest to reduce symptoms, but then, if you feel frustrated and try to make up for lost time, you may plunge into another round of over-activity leading to another crash.

There is an alternative to this cycle of push and crash: living within limits. Your activity level and the way you live your life affect your symptoms. If you honor your limits, you can gain some control over your symptoms and bring predictability to your life...

The Energy Envelope

One way to explore the idea of limits is through the concept of the Energy Envelope. You can think of your situation in terms of three factors:
  1. Available energy: The energy you have. It is limited, and is replenished by rest and food.

  2. Expended energy: The energy you lose through physical, mental & emotional exertion.

  3. Symptoms: fatigue, brain fog, pain, and so on.
If you expend more energy than you have available, you will intensify your symptoms. This is called living outside the Energy Envelope. This approach commonly leads to the push and crash cycle described above.

An alternative is living inside the Energy Envelope.
  • If you keep your expended energy within the limits of your available energy, you can gain some control over your symptoms.

  • If you accept your limits (keeping your activity level within the limit of your available energy), you can reduce symptoms and the severity of relapses, and over time may be able to expand your limits.
This is an upward spiral.

The Fifty Percent Solution & the Bowl of Marbles

Let me suggest a couple of ideas you might use if you wanted to apply the concept of the Energy Envelope.

The first is called the fifty percent solution. Each day estimate how much you think you can accomplish. Then divide this in two and make it your goal to do this lesser amount. The unexpended energy is a gift of healing you are giving to your body.

The second idea is to imagine your available energy as a bowl of marbles. You have a limited number of marbles to use each day. The number may vary from day to day. Physical activity uses some, but mental and emotional activity do as well. With every activity, you take one or more marbles out of the bowl, remembering that stress is a big marble-user and so lessening stress will preserve your supply of marbles for other uses.

The overall idea in both the fifty percent solution and the bowl of marbles is that our limits force us to set priorities in order to control symptoms and bring stability to our lives. Both techniques are ways you can reframe your situation to give yourself permission to do less in order to improve quality of life.

Defining Your Limits

Another way to use the idea of the Energy Envelope is to develop a detailed description of your limits.

This can give you a thorough understanding of what you individually have to do to minimize symptoms and improve your quality of life. If you want to do this, I suggest you look at five different aspects of your life:
  1. Your illness
  2. Activity
  3. Rest
  4. Emotions
  5. Stress
(For more, see the discussion on how to complete the Energy Envelope Log in the "Energy Envelope" chapter of our course textbook.)

The severity of your illness suggests your safe level of activity. To get an initial idea of a safe activity level, you can rate yourself in comparison to other patients on the CFS/Fibromyalgia Rating Scale [also applicable for Lyme disease].

Most of the students in our course have rated themselves between 25 and 45, but we have had people across almost the full range of the scale.

^ Top

Your Energy Envelope is a list of your limits. Having an understanding of your envelope can help you to set priorities.

After completing the exercise of defining your envelope, you might decide that poor sleep was the crucial issue for you at this time. Or you might find that a stressful relationship needs attention. In any case, the idea is to understand your limits in detail, so you can control symptoms and decide where to focus your efforts for improvement.

For further information on finding and managing your Energy Envelope and pacing, see:

Finding Your Energy Envelope A two-part article on controlling symptoms by finding and honoring the body's limits.

Pacing: What It Is and How to Do It A series of eight articles with practical strategies for finding and adapting to limits, plus pacing success stories.

Last Updated: 4/30/15
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