I was recently asked by a patient, “Is it OK to push through when living with fatigue?”
It’s such a good question, and one that many of the people we work with at Flourish with Fatigue find tricky to navigate.
When people talk about “pushing through,” what I often hear is that they’re noticing signs that their symptoms are increasing and trying to decide whether to keep going.
This can be particularly difficult when you’re enjoying what you’re doing, such as catching up with a friend or going for a walk, or when you’re doing something that feels necessary, such as picking up the kids from school or meeting a work deadline.So, what do you do when you notice that you’re pushing through, but you also have something you want or need to do?
There isn't always a straightforward answer. Sometimes, continuing with an activity may feel manageable, while at other times, pushing through can contribute to a flare-up of symptoms. Rather than having a simple rule about when to push through or stop, it can help to notice what's happening in your body, understand what's pulling you towards continuing, and explore whether there might be another way.
Step 1: Noticing signs of pushing through
Your body is designed to respond to life's demands by adjusting its responses and mobilising the energy needed to help you do the things you need and want to do. Ideally, once a demand has passed, your body gradually returns towards balance, allowing it to rest and replenish its resources.
When living with chronic fatigue, however, everyday activities can sometimes contribute to heightened responses and symptoms such as fatigue, pain and brain fog. Your body may take longer to settle after an activity, affecting your ability to rest and replenish your resources. For some people, this can contribute to a flare-up of symptoms.
Learning to notice changes in your body can help you recognise when you might be pushing beyond what feels manageable. You may notice increasing muscle tension, headaches, a sense of overwhelm, irritability or changes in concentration. Sometimes, the signs are less obvious and may only become apparent later, such as a worsening of symptoms or a need for more time to recover.
Recognising these signals isn't always straightforward. When you're absorbed in a task, focused on meeting expectations or accustomed to pushing through, it can be difficult to notice what your body is communicating. Experiences of trauma, neurodivergence and living with persistent symptoms can also influence how bodily sensations are noticed and interpreted.
Tuning into these experiences can feel uncomfortable, particularly if they bring up worry, frustration or concerns about what you might need to change. The aim is to develop a gentle curiosity about your body's signals over time rather than monitoring every sensation or becoming preoccupied with symptoms. Even beginning to notice patterns, including how you feel during an activity and in the hours or days afterwards, can help you make more informed decisions about your energy and recovery.
Our Traffic Lights framework can be a helpful place to start. By gradually building awareness of your own signals, you may begin to recognise when you’re pushing through and have an opportunity to pause, check in with yourself and consider what might support your energy and recovery.
Step 2: Noticing your “hooks” and meeting them with curiosity and compassion
Alongside noticing your body signals, it can be helpful to explore what's driving you to push through.
In Acceptance and Commitment Therapy (ACT), we describe these as hooks - the thoughts, feelings, beliefs, expectations and stories that can pull us towards a particular behaviour , in this case, pushing through.
There might be a thought like: “If I don't finish this report, my colleagues will have to pick up the pieces, and I'll feel like I've let everyone down.”
Or a belief like: “No pain. No gain.”
When we're hooked by these thoughts, we might stay late at work, skip breaks or neglect our own needs to finish a task, even when our symptoms are increasing.
These hooks often arise for understandable reasons. Perhaps you work in an environment where there is little flexibility or understanding of chronic fatigue. Perhaps being reliable and capable has always been an important part of how you see yourself, or you've experienced judgement when you've needed to rest or ask for help. Over time, these experiences can shape our beliefs and influence how we respond when we're struggling.
Acknowledging these hooks with curiosity, compassion and acceptance can help us move forward rather than automatically pushing through.
- Curiosity: “I'm noticing that I feel I have to finish this report. I wonder if that's because being responsible and doing a good job are important to me.”
- Compassion and acceptance: “I'm worried about disappointing my team, and it's difficult to accept that I can't always help in the way I'd like to. It makes sense that I want to keep contributing. I can care about doing a good job while also recognising that my needs matter.”
This takes practice, particularly when thoughts and feelings are uncomfortable. Therapy can help you explore where these patterns come from and learn to respond to them differently.
Step 3: Find a more flexible way forward, guided by what matters
Self-compassion, curiosity and acceptance can help us begin to unhook from the thoughts and feelings that may be leading us to push through. From there, we can explore other ways of responding.
In ACT, connecting with our values can help guide our choices. Rather than automatically pushing through or stopping altogether, we can consider what's important to us and how we might act in line with that value while also responding to our body's needs.
For example, perhaps completing a work report before a deadline is important to you because you value being responsible and contributing to your team. You might notice that your fatigue is increasing, but feel pulled to keep going until the report is finished.You may also be aware of the real pressures involved, such as concerns about letting colleagues down or the consequences of missing a deadline.
Rather than automatically pushing through, you could pause and ask yourself: What's important to me here, and is there another way I could act on this value while also taking care of myself?
Approaches may include:
- Taking a break before continuing.
- Breaking the remaining work into smaller, more manageable steps.
- Reducing other demands for the rest of the day.
- Asking for support or an extension where possible.
- Deciding what needs to be completed today and what can wait.
While adjustments may not be easy to implement nor completely alleviate the demand, even small strategies can help you work towards meeting the deadline more flexibly, and in a way that aligns with your values while also responding to your body's signals. Rather than automatically pushing through, you can make more deliberate choices about how to move forward, taking both what matters to you and what your body needs into account.
At Flourish with Fatigue, we support people to recognise when they're pushing through, understand the patterns that keep them doing so, and explore alternative ways of responding to their body's needs so that pushing through doesn’t feel like the only option