Pacing is essential to manage our symptoms and build reserves, but it’s not always clear how to do it. Here is the method I use, which you can adapt to your own needs.

I track my energy usage with a points system, where I have a fixed number of energy points to spend each day.

This follows Spoon Theory, an analogy where you imagine having a set number of spoons on the table in front of you. You remove a spoon when you do an activity, and once they are all gone, you can’t do anything else that day.

To get going, we need to figure out approximately how much energy each activity uses, and also create a baseline number of points that we can use per day (which I’ll write about separately). We can then use this to track the number of points we use daily, which lets us see our energy usage over time and see how it affects our overall energy levels.

Scoring activities

It’s tricky to judge how much energy each activity uses. It varies at different energy levels and evolves over time. As such, we only need a ballpark figure, not an exact measurement.

My rule of thumb is that roughly 30 minutes of gentle mental or social activity counts as 1 point. Physical activity takes a lot more energy for me, so I count a 5 min walk or equivalent physical activity as 1 point.

Some examples of 1 point activities:

• 30 min gentle reading
• 30 min gentle TV
• 30 min gentle meal with others
• Having a shower or bath
• Going up a flight of stairs

I’m emphasising gentle activity because I count emotional or stressful things as taking an extra 1 point in addition to the point that the activity normally takes. So reading a book about fatigue for 30 mins would be 2 points (1 point for the reading, 1 point because I find reading about fatigue emotional).

Anything that makes you tense or stressed - whether that’s TV, work, chores, kids - takes extra energy. The state you do an activity in - stressed or relaxed - can be as important as the activity itself, so we need to acknowledge this in our scoring system.

If I do something for less time, say 10-20 mins, I count that as half a point. Anything less, I don’t count, because I don’t want to deal with quarter points or other awkward measurements, which would turn into a source of stress themselves. We can allow ourselves some slack here as long as we are still being honest about how much energy we’ve used.

Giving an activity a point score doesn’t mean you can do it repeatedly. I can do a short walk once a day at most, and I also need to be careful to pace out social or emotional activities with day or multi-day gaps in between.

Similarly, it doesn’t mean you can spend multiple points in a row. Having a rest between activities is important, even if it’s only a few minutes, to come back to a calm state.

At the moment I find I can do up to an hour of continual activity once or twice a day, with rest between, but above that it starts to trigger Post Exertion Malaise, whereas the same activities spread out over more time can be fine. You will find you own limits through trial end error.

There will sometimes be things that take energy that we can’t control. Illness, pain or life events can quickly drain energy and we need to allow for that. Some things also just overwhelm and can’t really be given a score as such, and that’s ok.

There are also some things that we want to encourage ourselves to do, for our overall health. For example, I find being outside tiring, as it’s generally noisier and more active. But I wanted to get into the garden as much as possible, however, briefly, so I made sitting outside a zero point activity on my scale.

I also allocate 1 point each day to cover my general pottering around and gentle stretches. By allocating this in advance, I don’t worry about the energy usage and it encourages me to do my stretches when I’m able, because I’ve already ‘spent’ the points.

When establishing a points system, I’d recommend just starting simply and evolving it over time. Ease of use is key to making it a habit, and as long as you’re able to compare your energy use across different days, however roughly, that’s fine.