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A study in Clinical Rheumatology found that half of patients with rheumatic disease are severely fatigued. What’s worse, the fatigue can be just as disabling as the pain associated with those illnesses, not to mention a bear to manage.  

So that afternoon slump that most people experience? It might be a little rougher for you to shake. Not only are you dealing with normal circadian rhythms that send energy dipping between one and three pm, but you may also be contending with aggravating factors such as chronic fatigue, inflammation, poor sleep, and certain medications. 

And reaching for a cup of joe, a Red Bull, or some other caffeine-laden energy drink? Bad idea. While it might give you a quick jolt, you’ll pay for it come bedtime with disrupted sleep — just the kind of vicious cycle you’re trying to avoid.  

Instead, take a cue from people like Shelley Ramsey DeJongh, LPC, CSAC, of Chippewa, WI: “Living with multiple chronic health challenges, I know firsthand the struggle to keep my energy level balanced throughout the day. As a psychotherapist, it is important to me to feel energized and balanced in all sessions, so I have worked hard at finding solutions to the afternoon decline.”   

For financial planner Andy Pendergrass, of Minden, LA, “having RA means you can’t take the little things for granted,” he says. “There are little triggers to inflammation that can cause you to feel worn down with mental and physical fatigue. Fortunately, I have found some ways to help combat the sluggish gray cloud that threatens to descend on me some afternoons.” 

Fight Back Against Afternoon Fatigue

Read more from Shelley and Andy, as well as other patients and experts, on strategies to fight afternoon fatigue.

Scentsationalize your surroundings

“I sometimes find I need to change something about my environment to snap me out of a slump, but I can’t always leave my office when I feel that way,” says Andy. “So, I’ve discovered that dropping some essential oils in a diffuser can help. I use citrus (lemon, grapefruit, or orange) and peppermint oils when I need a lift.” 

Shake it up

“I do 20 to 30 jumping jacks between clients,” says Shelley, who schedules seven sessions a day. “My body struggles to do it, but the boost it gives me is great.”  

Jumping jacks are too taxing on your body? Take a walk. The activity stimulates the release of endorphins and helps the body use blood sugar, both of which pep you up. If possible, take the walk outside, which is study-proven to lift your mood as well as your energy.  

Think about the ebb and flow of your energy

“If you find yourself regularly affected by the afternoon slump, save this time for tasks that take less of your energy, whether physical or mental,” suggests Shannon Garcia, LCSW, a psychotherapist in private practice at States of Wellness Counseling located in Illinois and Wisconsin. 

Pop a stick of gum

Chewing gum raises your alertness, improves your focus, and even improves your mood, according to research in Nutritional Neuroscience. And as a bonus, some studies find that chewing gum can help reduce stress too 

Crank up the tunes

Pick something upbeat, advises Shannon. “And if you can, play it at a higher volume, which can be more energizing.” Studies show a tempo of at least 140 beats per minute is ideal for keeping your brain energized. Try Taylor Swift’s “Shake It Off,” Beyonce’s “Move Your Body,” or Survivor’s “Eye of the Tiger.” 

Take 10 — at regular intervals

“My best advice to fight afternoon fatigue is to take short, more frequent breaks throughout the day,” says Stefanie Remson, MSN, APRN, FNP-BC, aka The Rheumatoid Arthritis Coach. “Even if you don’t think you need them, five to 10 minutes can really recharge you. Your day is a marathon, not a race. Pace yourself.” 

Load up on LOLs

Cue up a funny cat video or anything you know will make you laugh for a pick-me-up that will kick your productivity into overdrive. Researchers found humor to be especially helpful for those facing a long, repetitive task. 

Fuel up wisely

For Shelley, that means starting the day with a meal that’s low in sugar and high in protein for a sustained burst of energy: “My go-to is toasted gluten-free bread with sliced avocado and a fried egg.”  

When Andy feels that PM crash coming on, he reaches for fruit, yogurt, or a granola bar. It’s not always an easy decision: “I have to walk by a table of snacks made up of chips, cookies, etc., any time I walk out of my office. I can’t always stop myself from snagging something out of that basket on the way into my office. But I feel much better if I go with the Kind bar than the Oreos or Pringles.”  

See the light

Ideally, that means getting some sunlight outside, which slows the body’s production of the sleep-inducing hormone melatonin and raises levels of the happiness hormone serotonin. Can’t get outside? Turning on a bright light or light therapy lamp may help.  

S-t-r-e-t-c-h it out

There’s a reason you might instinctively stretch before you even get out of bed: It’s a gentle way to get blood flowing, increase muscle activity, stimulate the release of endorphins. In short, stretching helps wake up your body.  

Andy often takes 10 or 15 minutes to stretch in the afternoon. “Your muscles, bones, and joints communicate with your mind all day, every day,” says Andy. “That communication needs to change frequency throughout the day. Just stretching will even help your brain kick in some endorphins that will help you feel and think better in the afternoons.” Try these “20+ Gentle Stretches for Arthritis.” 

Just breathe

“Breath work is great too,” says Shelley. “Doing diaphragmatic breathing hourly will boost circulation and increase blood and oxygen flow to the brain and the rest of the body’s cells.” That helps the body work at peak levels.  

To begin, find a place to sit quietly and comfortably. Close your eyes and focus only on your breathing. Inhale to a count of four, allowing your belly to expand. Exhale to a count of six, drawing in your belly.  

If you like, pick a word to say to yourself as you inhale, like “vitality,” “happy,” “energy,” “focus,” “balance,” “power” or anything you choose. Repeat the inhalation-exhalation cycle at least three to five times. For more breathing exercises, listen to the Wellness Evolution podcast.  

Seek professional help

If you find that your energy is limited and you’re struggling to get through your day, it’s important to talk to your doctor. Together, you can determine if your afternoon fatigue is a sign that your disease is progressing or needs to be treated more aggressively. You can also tease out if any comorbidities are causing or exacerbating your fatigue.

Be a More Proactive Patient with ArthritisPower

Join CreakyJoints’ patient-centered research registry to track your symptoms, disease activity, and medications — and share with your doctor. Sign up.

Cheng D. “Examining the Energizing Effects of Humor: The Influence of Humor on Persistence Behavior.” Journal of Business and Psychology. December 2015. doi:

Hurless N. Music genre preference and tempo alter alpha and beta waves in human non-musicians. Impulse: The Premier Undergraduate Neuroscience Journal. 2013.

Nasish N. Why Sunlight Is Actually Good for You. Forbes. February 28, 2018.

Northwestern Medicine. Quick Dose: Why Do I Feel Tired Mid-Afternoon? August 2022.

Overman C, et al. “The Prevalence of Severe Fatigue in Rheumatic Diseases: An International Study.” Clinical Rheumatology. February 2016. doi:

Smith A. “Chewing Gum and Stress Reduction.” Journal of Clinical and Translational Research. April 24, 2016.

Thompson Coon JK, et al. “Does Participating in Physical Activity in Outdoor Natural Environments Have a Greater Effect on Physical and Mental Wellbeing than Physical Activity Indoors? A Systematic Review.” Environmental Science & Technology. March 2011. doi:

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