The Cost of Being “On” When Your Body Isn’t

We’ve all had to get through a workday when we’re not feeling our best. Maybe we didn’t sleep well the night before, have some challenges going on at home, or feel overwhelmed by our to-do list. As ambitious women, we want to look strong, polished, and capable at work and thus put on a “mask”. This masking takes on a new layer when living with and managing a chronic illness. We’re working extra hard to hide pain, fatigue, and cognitive strain while still performing at our best and trying to look fine. 

This invisible work of performance can add to the symptoms we’re already experiencing and leave our batteries drained. How can we work to move away from exhausting “masking” to more sustainable “managing”?

Fatigue on Top of Fatigue

I live with multiple sclerosis (MS) and experience MS-related fatigue, something about 80% of people with MS live with, according to the National MS Society. This type of fatigue is much different than just being tired – it’s a full-body exhaustion that occurs daily, comes on suddenly, requires more recovery time, and may even happen in the morning after a full night of sleep. Many people with chronic illness experience this type of severe, profound fatigue that impacts daily life. 

With this level of fatigue often as our baseline, performing at work takes much more energy than it might for the average person. Making strategic decisions on the fly, presenting, problem-solving, synthesizing complex information, socializing, and managing constant notifications requires a lot of energy, which drains an already low battery. Add “masking” on top of that, and the battery starts to die before the day is even over.

Change Your Definition of Showing Up

Women are often expected to do more than just their jobs in a professional situation. We’re expected to appear warm and approachable, manage the room, smooth conflict, and stay composed under stress. Add managing a chronic illness into the mix, and that performance becomes something else entirely: not just showing up but constantly working to appear like nothing is wrong.

One way to give yourself back some energy is to redefine what “showing up” and showing up “well” means to you. Maybe this means giving 75-80% instead of 100%, asking one thoughtful question in the room, or using 10 words instead of 20 to deliver your point. It can also look like being present, clear, and impactful without being high-energy. No one has A+, 100% days every day, so give yourself some grace and get comfortable with doing enough.

Recognize When the Mask Won’t Cut It

There have been days when I know, from the moment I wake up, that it’s going to be a tough one. This is most unfortunate when I’m at an in-person meeting and know I’ll need to be “on” the whole day. My strategy is to budget my energy one moment at a time. I approach the day knowing that each segment isn’t going to get 100%, and that’s ok. If the most important task of the day is presenting to a room full of people, then I might quietly take notes throughout the rest of the meeting, rather than engaging in a high-energy way, and take micro-breaks when possible (even if it means taking a bathroom break just to get a moment alone!). If there is a socializing event in the evening, I make sure to reserve some energy for that activity.

Letting the Mask Fall

Another tactic for managing the mask is to confide in a few trusted colleagues or clients – dropping the “mask”, even briefly, to share the reality of your situation. This is an incredibly hard decision to make, to be so vulnerable, because we might not want to come off as not capable of performing. That said, removing one bit of energy drain could help make a difference to an already-spent battery. 

It doesn’t have to be an over-explanation or even an all-or-nothing strategy (i.e., disclosing your disability or not). This can be as simple as saying, “Please bear with me today – I’m moving a little slower” or “Thanks for your patience – I need a little extra time today.”

Shifting from Masking to Managing

Managing a chronic illness at work is about deciding how you want to show up and what’s possible within the reality of your body.

Putting on the mask might help you get through a meeting or even a full day, but never taking it off can come at a cost, often leading to deeper fatigue and a fully depleted battery. Shifting from “masking” to “managing” asks you to be more intentional and accepting of what “good enough” looks like for you. This doesn’t mean you’re doing less or moving away from ambition. It also doesn’t mean that you’re failing! Making this shift means prioritizing your health and working in a way that’s actually sustainable.

Some days, you’ll still need the mask, and that’s okay. When you’re ready to try loosening it, focus on small, deliberate steps that preserve your energy while honoring your lived experience.