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Adrienne Dellwo

Fibromyalgia, Chronic Fatigue Syndrome & Multi-Tasking: Why Can't We Do It?

By June 22, 2009

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Have you wondered why fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS) make it so difficult to do things like cook dinner, shop for groceries, or do even the simplest multi-tasking? Some days, I swear I can't walk and chew gum at the same time. This problem, more than anything, is what lead me to leave my TV news-producing career -- producers have to multi-task, and after 8 years on the job I no longer could.

The cognitive aspects of these conditions often take a back seat where research and treatment are concerned, but for many of us they're as debilitating or more debilitating than pain and fatigue. I could work tired, I could work in pain, but I couldn't work with fibro fog. I've known for a couple of years that this was a shared experience, but I only recently read an explanation of it.

Dr. Gudrun Lange, a neuroscientist at the University of medicine and Dentistry of New Jersey, wrote a great article on this recently for the International Association for CFS/ME. She describes how a "simple" trip for the grocery store is overwhelming to our senses and leads to frustration and anxiety, which then lead to a crash. Boy, could I relate -- I've resolved most of my anxiety issues, but a crowded grocery store can still push me into panic mode.

Dr. Lange explains how our brains handle multi-tasking through what are called "executive control systems," which allow us to accomplish many small goals in order to complete a larger task. In order for the control systems to work, they have to have a good information processing speed and intact working memory (ability to remember things for a short time.) We have neither. It's like trying to run an X-Box game on an Atari -- the system requirements just aren't there.

But we can't very well stop doing things that require multi-tasking, can we? Dr. Lange has some suggestions for a new approach to these jobs, and a new definition of success when it comes to goals.

Essentially, she suggests breaking tasks into their component parts. Do one thing at a time, and count every completed task as a success. Then move on to the next.

When it comes to things like grocery shopping, that require lists, she suggests keeping a running list in a notebook that's always in the same place, so you can jot things down as you think of them, instead of trying to figure out everything you need at once. (I keep a magnetized notepad on my fridge.) Prioritize your lists so that if you have to cut a shopping trip short, you know you've gotten the most important things and you can count the trip as a success.

Some other tips from Dr. Lange:

  • Don't wander up and down every aisle. Find the aisles that contain your priority items and only go down those.
  • Don't drive to the store during rush hour.
  • Try to park your car in the same area every time so you can find it when you're done.

I've "lost" my car in parking lots so often that my 7-year-old son now looks for aisle numbers so he can remind me where to go!

For multi-tasking in general, I've been able to improve somewhat by forcing myself to keep things in my head -- essentially exercising my working memory. I started with one thing at a time, and when I got better at that I started adding a second. For example, I'll go into the produce aisle, look at the produce items on my list, and try to get them without consulting the list. Now, at times, I can remember 3-4 items at a time. It can be frustrating, but it pays off.

What helps you with multi-tasking activities? How has the inability to multi-task impacted your life? Leave a comment below!


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June 22, 2009 at 6:24 pm
(1) Sue C says:

I can really relate to this. I find it easier to go to the supermarket at night when there are 2 or 3 other customers at most, and there are no announcements or music being broadcast over the PA System.

Putting the shopping in the bags while listening for the price, getting my money out, paying, receiving change, zipping it up in my wallet, taking the till slip and picking up my bags without causing a hold up in the queue is far too complicated for me these dyas, and the more I get flustered, the less I can do it properly. I can’t imagine how I used to do it without thinking about it.

Another skill I have lost is the ability to understand coins. I know what each coin is but can’t make sense of them when they are to be counted up to a specific amount. I have no problem with banknotes – probably because I don’t have too many of them!

June 23, 2009 at 9:56 am
(2) Shawna says:

Another trick I have learned is to go to small grocery stores like Save-a-Lot or Aldi. The selection is not overwhelming because they only carry one or two brands of each item and the prices will save you money!

June 23, 2009 at 11:28 am
(3) Jodith says:

My husband and I are the same way. We try to do any shopping early in the morning before any crowds hit. If we go when it’s crowded, we often have to leave before we’re done.

Even with a list, we will forget things. We forgot tea on 3 successive trips to the store, even with out list *laughs*. It’s hard when both of you have FMS. Once can’t make up for the other. But then, we never have the problem of a spouse who doesn’t understand our limitations.

June 23, 2009 at 4:54 pm
(4) Nancy A. says:

This has definitely been a problem for me, both at work and in everyday life. I’m on Social Security Disability now but I did work for many years with both CFS and fibromyalgia. I did medical transcription, which allowed me to concentrate on one task at a time. However, I often had to fill in at the front desk — whew — talk about stress overload! It was the combination of pain, fatigue and fibro fog that eventually led to my going on disability.

At work, I had to be very organized and wrote myself lots of Post-It notes as reminders. I also do the same at home.

For me, the cognitive problems have led to social isolation. I feel as if no one (except others with CFS/FMS) could possibly understand what goes on in my head. Add to that the reality that people without these disorders may be somewhat sympathetic but they really don’t understand.

And now I’ll get back to my unreal world of soap operas. I can handle that a lot better than the real world!

But don’t get me wrong — I’ve been hanging in there for 25 years with these disorders and I’ll continue to do so. I’ve also had breast cancer. I’M A SURVIVOR!

June 23, 2009 at 5:00 pm
(5) Nancy A. says:

P.S. for Adrienne:

Honey, get yourself a handicapped parking permit! I finally did it this year. You shouldn’t have to wait until you’re on SSD to do it, like I foolishly did. I can totally relate to the “lost car” scenario. I even have recurring dreams about that!

I go to the supermarket at “off times”, usually early Sunday morning, to make sure I can get a handicapped parking spot — and a less crowded store makes the whole experience a lot easier for me.

June 24, 2009 at 3:20 am
(6) Jeanie says:

interesting information, I always thought the fog had to do with my brain only being abel to concentrate on my pain. In the past, I would have panic attacks in the grocery store, and I knew about part of the oversensory thing a little because I am real sensetive to smells but I never till now connected it to panic at the store.

Jeanie has had FMS since age 12, I am 39yoa now (2009) you do the math

June 24, 2009 at 11:55 am
(7) Judith says:

My 13 year son has dysautonomia and CFS. He has had neuro-testing that shows his working memory is at a low level at this point. He can’t multi-task at all. We are working on just tasking longer than 15-20 minutes.

Now, I understand that beyond the fatigue is the sensory overload. That explains that even if we bring a wheelchair, seat cane and fluids, he is done after 2 hours.

We use a Tracfone cellphone as a reminder device. It rings all day long to remind him of various duties and tasks. Then, we follow up with a checklist that another family member uses to make sure items are completed. His meds are in a daily and hourly container so we can check that he has taken them. We use simple groups to get him to remember multiple items that he needs for a task (like, what four things do you need when you leave the house?)

We also allow him to write down a plan for himself. We find that he will cooperate and remember more if he is involved in the creation of the lists and reminders.

Thank you for this article! It reminds me that the fatigue can be from the mental exertions as well as the physical.

June 26, 2009 at 12:07 pm
(8) Amy says:

I’m so glad to know that I’m not the only one overwhelmed by the grocery store. I had a panic attack once in one of the huge box stores. I suddenly couldn’t remember what I was after and I was sure that everyone else in the store knew that I had no idea what I was doing there. I stick to the small stores now.

June 26, 2009 at 4:35 pm
(9) Linda H says:

I have the same problem as Sue C at the till, can’t co-ordinate zipping purse etc and sometimes have money in hand and can’t relate money in hand to amount needing to be paid. I use list a lot as well as the Reminders facility on my cell phone. I don’t browse either just get what I need.

June 26, 2009 at 4:42 pm
(10) Jane says:

I have also experienced panic attacks at the grocery store, but, I was also having panic attacks when I went to malls, crowded restaraunts, and anywhere else I went that was a little too busy for me. I felt as though I was losing my mind. I tend to go out to these places when it’s not so busy, but even that can be a challenge. I sometimes need to take a miniscule dose of xanax if I know I’m going to a place where there will be a lot of noise or people. This helps me cope in the short term.

June 26, 2009 at 5:03 pm
(11) Kathleen says:

How funny that I just had this very discussion at work today! I cannot multi-task and often forget to do things because I will get interupted in the middle of something and then just totally forget that I have to go back and do it. I have to write myself reminder notes if I am doing something and I get a phone call or a request to do something else and there are still times that I forget.

June 26, 2009 at 5:16 pm
(12) edwards29 says:

I don’t have trouble forgetting things at the grocery store (although I do tend to park in the same place always) because I use my list and go over and over it; but I am extremely exhausted when I’m finished putting the groceries away when I’m finally home. Probably the same monster working.

June 26, 2009 at 7:34 pm
(13) dn527 says:

Maybe the inability to multi-task is why I seem to be on auto-focus while driving? There’s just so many symptoms coming at me so fast now that I can’t keep up. After 5+ years with the pain and small memory problems, all these coming at once seem to have started around the time I got more active (working out, etc). Since I overexhausted myself 1 weekend in Dec08, it’s all been downhill: like a fast rollercoaster. I am grateful to have all u guys comments so I don’t feel so alone!

June 26, 2009 at 7:39 pm
(14) dn527 says:

I used to always be able to remember exactly where I parked – I prided myself on my memory and intelligence! Luckily I now park in the handicap spot(or come back later), so I don’t forget that. A few times though, I’ve noticed suddenly not recognizing where I am – like I’d never been there before. Only lasts a few seconds. I’m 43!

June 26, 2009 at 7:50 pm
(15) Kimberly says:

I can so relate to this topic. I used to be a financial aid director and I can barely balance my checkbook now! Just got groceries–always a nightmare. About a month ago, I was asked if I wanted my detergent in a bag. I must admit it was hour 12 in my day and I was beat. I couldn’t think of any advantages or disadvantages to putting it in a bag. I don’t know how long I stood there, but finally realized it was a yes/no question and just told them no. Figured I’d deal with it if it was a bad decision when I got home. Have to laugh at that now, or I’d scream! Anyone else have costochondritis all the time? Some days, like today, the pain is almost unbearable.

June 26, 2009 at 8:26 pm
(16) Sheila says:

I thought I was the only one! I have to write down everything because I won’t remember it in 10 minutes. And I try to do everything at off times to avoid crowds. I’ve never liked crowds, but these days I get a lot of anxiety from them.

June 28, 2009 at 10:39 am
(17) MartySue says:

I have costochondritis ( Tietze’s Syndrome is what my doc calls it )but learned the activities that bring it on. I avoid doing those but if I have to do it, I break it up
into short episodes. That is why some chores
take a few days now, instead of 2 hours, etc.

Consequences of memory problems, dependence on lists,etc., is that I had to quit teaching art last year, resigned from Art Council, and can’t go to weekend retreats…I do some art at home and put it in shops on consignment but husband has to do all my driving now and carrying my stuff.
I have to consider his limitations too. Loss
of my independence is worse than a death to me.
I was put on Lyrica for recent RSD Dx…slept 2-3 more hours a night the first 3 weeks, now back to old 4-5 hour nights. When they gave it to me a year ago for fibro, I slept 18-20 hours a day and they took me off it. Go figure that bodily reaction!!!

June 29, 2009 at 6:20 pm
(18) chronicfatigue says:


I have costochondritis, and it can be unbearable. Here’s an article that might help you deal with it: Fibromyalgia & Costochondritis

June 29, 2009 at 8:26 pm
(19) Kimberly says:

Thank you Adrienne, MartySue and chronic fatigue for your comments. I have not figured out the triggers yet for costoshondritis, but am trying to figure them out. Thanks again!

July 3, 2009 at 9:26 am
(20) Brett03 says:

TO ANYONE WHO CAN OFFER HELP TO ME! Please “Reply” if that is possible on this site or, if not, please leave a Comment. (I hope the site will forward notice of, or the Reply itself, to me by e-mail, but it does not appear to offer this.)
Has anyone gotten to the point with a combination of ongoing fatigue, and “lack of motivation” or “feeling overwhelmed” and/or anxious by formerly simple tasks or multi-tasking, that they have been put on the road to ECT (after not responding to antidepressants) by psychiatric and neurologist M.D.’s. I think that I am susceptible to a misdiagnosis here because I do have a history of some problems with atypical depression. This “lethary”/”sedentary” symptoms, which, from a psychiatric point of view are more associated with “typical” major depression, are new to me, and they have lasted a over a year. Unfortunately, I see to have become treatment-resistant to every antidepressant under the sun.

July 5, 2009 at 2:14 pm
(21) Steph says:

Costochondritis and Tietze’s are two different disorders. There are many treatments for Tietze’s (including targeting the affected ribs)See this site for current Tietze’s syndrome treatments. You might want to find another doc :)

July 6, 2009 at 8:11 am
(22) HeatherP says:

Regarding the store and purse and all that… the bad thing is that I get so flustered because people are behind me that I just end up throwing it all in either my purse or in a grocery bag just to get the heck out of there. I’m a single mom so trips to the store in the middle of the night are not something I can do anymore, but used to all the time. I used to love grocery shopping when there was no one around (either late night or smaller stores) but now, with a 2 year old, the noise and sounds and everything else make it more difficult. I’m exhausted by the time I leave. Get home and go up a flight of stairs to my apartment and I only take my 32 pound son and perishables. The other has to wait until I have the energy to go get it (usually while my son is taking a nap).

I used to be a personal assistant. I often wondered why my job started getting more difficult. I wasn’t dxed with fibro until this year. Now I know why I was starting to have trouble multi-tasking.

July 6, 2009 at 7:16 pm
(23) Laura says:

I was very sick until I stated getting real medical treatment for CFS and Fibro. A good place to get this information is through the book, “From Fatigued to Fantastic” by Dr. Teitelbaum. He runs several clinics throughout the country for the treatment of these disorders. I have improved to functioning at about 80% of normal. And there is still hope for a complete recovery. I am back at school and doing well, while before I could not attend school. 1 year until I graduate with my B.A. in Psychology. The doctor I see now is Dr. Powell in Sacramento, CA. He specializes in the treatment of CFS/FMS and is actively searching for a cure. Don’t go to a typical doctor, they are of no use! I do not take pain medication and manage my symptoms with mostly natural supplements plus OTC drugs occasionally when I need them. Just wanted to get the word out that there is effective treatments out there. Don’t give up!

July 7, 2009 at 2:44 am
(24) matsuiny2004 says:

Multi tasking is not natural for humans to do.


July 10, 2009 at 11:22 pm
(25) Donna says:

Funny I just went to the grocery store tonight, and thought to myself what the heck is your problem. The store was very busy (I usually go earlier in the day) and I started getting flustered and very anxious and then ended up getting angry at myself for feeling that way. It seemed like everyone was in my way and I was having a really hard time getting by them, I knew in reality that they were not doing anything abnormal and that’s when I thought to myself what the heck is your problem, why are you getting so worked up about this. Truth be told I was probably the one in the way as I had to stop many times to read my list over and over and over again. I know I have a real problem with my memory and multi tasking with CFS and rely heavily on lists and even then forget things. But it hadn’t dawned on me that the anxiety I was feeling tonight was also a symptom of CFS, I was beating myself up about feeling that way. Thanks for the info.

July 11, 2009 at 7:27 am
(26) Maureen says:

I am finding the anxiety hard to cope with,lucky my husband helps with the groceries,found pushing the trolley and the head movement up and down looking for what I need caused to much pain and the dizzies!!I really would like my independance back!!I am also going the natural way ..have a major sensitivity to the drugs.

July 13, 2009 at 4:20 am
(27) Valetudinarian says:

Isn’t if funny, I used to do neuropsychological testing….teting others’ memory and concentration!

I have a very hard time multitasking and putting laundry away where it should go. In essence, organizing things. This is something I used to be VERY good at. Now, it is overwhelming.

For me, going down every aisle helps me remember what I may need if I forgot to write it down. It works more for stuff we eat on a daily basis, not some odd ingredient I forgot to write down.

I am always stressed when going grocery shopping with my kids because they distract me.

July 14, 2009 at 3:44 am
(28) Nola says:

I was so happy to find out that my inability to do the grocery shopping for my family is not just in lmy head. I have almost given up driving completely because from the time I turn on the ignition I begin to get a panicky feeling. My knuckles are white because I am gripping the steering wheel so tightly. I find it hard to explain to my friends that do not suffer from this disease why I feel the way I do and why so often I feel like staying in my home. It has become a safe haven for me and my friends don’t understand why I feel the way I do and I am at a loss as to how to make them understand why I feel this way. I bought a book about Chronic Fatigue after the doctor diagnosed me so that I could understand what was happening to my body. No one else seems to want to read it or try to understand. I feel like some of the people in my life think I am just lazy. How do I make them understand that is is just plain hard for me to do many of the things they want me to do. I absolutely cannot bear to be in a large crowd of people.

August 28, 2009 at 9:44 pm
(29) lkg says:

The lights, smells, P.A. system, air conditioning, rickety carts with balky wheels, all of it combined with making choices between all the different brands, sizes, prices, and various packaging literally keep me from going to the store until I have nothing left to eat in the refrig except condiments! Throw in screaming kids and “aisle-rage” grocery cart drivers and I’m ready to use the drive through at McDonalds!

I now do short trips instead of longer ones, maybe enough for a couple of meals at a time. I use a list and look at a floor plan of the aisles that the store has provided me. I use my scooter to get me through the store quickly and comfortably. I have a CD player and earplug so I can listen to low level, instrumental music or beach sounds to keep from feeling overwhelmed. I carry a sweater with me even in the dead of summer in case the cold of the freezer section bothers me and sunglasses if the lights bothers my eyes….

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