Understanding Chronic Fatigue

Chronic Fatigue and the Brain’s Alarm System

Just like pain and anxiety, fatigue is a danger signal. Fatigue serves as a warning that the body needs rest and recovery.

But sometimes, the brain generates fatigue even when the body does not actually need to rest — a faulty alarm signal, similar to other neuroplastic symptoms.

When most people say, “I’m tired,” they usually mean they need sleep. Their body rests, recovers, and they wake up refreshed.

Chronic fatigue is different. It can be body-deep and life-altering, affecting work, relationships, identity, and a sense of what’s possible. You can’t simply nap it away.

For some, fatigue builds slowly over years of stress, pain, or health challenges. For others, it begins after an illness and never fully resolves — including post-viral fatigue or long COVID.

However it starts, the message often feels the same: something is very wrong — accompanied by fear, anxiety, and uncertainty about recovery.

The hopeful news is that pain recovery approaches like Pain Reprocessing Therapy (PRT) can help quiet faulty danger signals in the brain and reduce — or even eliminate — fatigue.

“Rest is not idleness, and to lie sometimes on the grass under trees… is by no means a waste of time.”
— John Lubbock

Research: Harnessing Neuroplasticity for Chronic Fatigue Recovery

Recent research on ME/CFS and long COVID suggests these conditions are rooted in reversible dysregulation of the nervous, immune, gut, and hormonal systems — not permanent damage.

This perspective comes from psychoneuroimmunology research linking stress, inflammation, and gut changes to symptoms, along with studies showing improvement when people are given clear, science-based explanations and a sense of self-agency.

Symptoms like fatigue, pain, and brain fog can be neuroplastic — real experiences maintained by a hypersensitive brain–body alarm system stuck in “danger mode.”

To help reverse this pattern, three core steps are often emphasized:

Making sense of symptoms in a way that says “dysregulated, not broken.”
Shifting responses from fear to curiosity and safety (as taught in PRT).
Gradually reintroducing activities so the brain can learn, “this is uncomfortable, but it’s safe.”

These principles are explored further in structured programs like our PRT Healing Workshops.

References:
Bakken, A. K., Mengshoel, A. M., Synnes, O., & Strand, E. B. (2023). International Journal of Qualitative Studies on Health and Well-being, 18(1), 2223420.
Barrett, L. F. (2017). How Emotions Are Made: The Secret Life of the Brain. Pan Macmillan.
Clark, A. (2024). The Experience Machine. Random House.

Chronic Fatigue: Harmful and Helpful

If you’re experiencing chronic fatigue, it’s completely understandable to want relief and a return to life as you once knew it.

All signals from the body are protective in some way. Instead of focusing only on how fatigue has disrupted your life, it can be helpful to explore what it might be protecting you from.

Has fatigue encouraged rest, boundary-setting, or a reduction in overwhelming demands? Has it offered space to reassess expectations — your own or others’?

Imagine what life might look like if symptoms vanished. Joy may arise — along with other complex emotions. That mix can offer valuable insight.

Many people find it helpful to work with PRT-trained clinicians as part of this exploration.

Journal Prompt: Exploring My Chronic Fatigue

Reflect on your experiences with fatigue — or any symptoms you live with.

What has fatigue taught you about your limits and needs?
How has it encouraged self-care or boundary-setting?
What emotions arise when you imagine life without these symptoms?
Can you identify triggers — and what they might be protecting you from?
What small changes can you make to honor your body’s signals?

Take your time. Let thoughts flow freely.

Coping Skill Spotlight: Let It Be

Observe symptoms as if they are clouds passing through the sky. Letting go can be difficult — but it often helps the nervous system settle.

Tune into sensations without fear or judgment.
Notice fatigue in the body — behind the eyes, in the arms, or legs.
Allow sensations to be present without trying to change them.
If fatigue feels heavy, imagine sinking gently into the bed or couch.

Although simple, this practice is powerful.

If You’d Like to Hear These Ideas Applied in Real Time

Our latest PRT Podcast episode explores chronic fatigue through a live session with therapist John Gasienica and guest Raelan Agle.

How beliefs like “my body is broken” keep the nervous system on high alert
A guided emotional regulation exercise
Reflections from recovery
A helpful framework for belief in healing

👉
Listen to Episode 10 of the PRT Podcast: Building Hope and Belief