a woman thinking surrounded by thought bubbles

Rheumatoid Arthritis and Decision Fatigue

Last updated: February 2023

Should our rheumatoid arthritis always get the final say in every decision we make?

Before I commit to pretty much anything, I always have to check in with my rheumatoid arthritis pain and fatigue levels before I am able to decide anything. RA and decision fatigue is a real thing, my friends.

What does decision fatigue look like?

“What can I do today?” I don’t know, what does my RA say? Have my pain and fatigue levels changed mid-day and now I need to change my plans?

“Can I okay that get-together tomorrow?” Who knows? Let me check with my RA and get back to you on that.

This disease is so unpredictable that I can’t decide if I will be able to do anything tomorrow or not. Perhaps a cold front will come through and I won’t be able to get out of bed. Or a butterfly farted in China, changing the wind currents, causing a 50-degree temperature drop. I have no idea. And I’m tired of trying to guess.

Feeling frustrated, overwhelmed, and tired

"Did I take my medicine? Which medicine? I don’t know."

I just get so tired of making so many decisions related to my RA/RD that I either just want to scream, or just throw my aching hands in the air and say, “Whatever! I don’t know!”

Every single decision has benefits, drawbacks, and unknowns. It is impossible to say for certain about pretty much anything with RA. Heck, you can likely find conflicting information on pretty much any topic related to RA and RA symptom management. It’s no wonder that, as patients, we often feel frustrated, overwhelmed, and simply tired of making so many important decisions every single day.

Even small decisions can mean big pain

Sometimes it seems like the smallest decisions can change the pain, fatigue, and inflammation levels in our bodies — so much so that it becomes difficult to pinpoint exactly which particular choices we've made impact how our symptoms are better or worse.

I chose to eat a piece of cake, and now the next day I can’t walk. Maybe it was the cake, but maybe it wasn’t.

I want a mute button

Sometimes it is utterly exhausting to be so in touch with my body. I think I want a mute button. I want to tell my body, “Just hang on a minute, stop screaming at me! Mute.” Done, easy-peasy.

Instead, I find myself going through a process of elimination trying to pinpoint what I did or didn’t do wrong to put myself in this position. Did I move around too much? Or maybe not enough?

RA comes with many difficult decisions

This doesn’t even include decisions like if I should take a biologic medication or make dietary changes, both, or neither.

Isn’t it all just a little dramatic? Eh. Maybe. Of course, I know that being an adult means making difficult decisions. But sometimes, it feels like rheumatoid arthritis just comes with so many MORE decisions, and decision fatigue is a real thing. And even if I make the “right” decisions, there are a great many other parts of rheumatic disease that are beyond my control, such as the weather, insurance decisions, and even to a certain extent, disease progression.

Do you suffer from decision fatigue as much as I do? I'm secretly hoping that I'm not alone in this.

By providing your email address, you are agreeing to our privacy policy.


This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Join the conversation

Please read our rules before commenting.

Community Poll

On average, how many times per month do you (or your caretaker) go to the pharmacy?