the 80-20 Approach to Chronic Illness and Fatigue FB

It may be hard to believe, but over a century ago, an Italian economist published a paper on wealth distribution that would eventually revolutionize time and energy management for the chronically ill.

It’s a good thing too because I suffer from a chronic illness called Meniere’s disease. And for a long time, fatigue was the bane of my existence. Even on my best days, when I felt healthy, happy and worry free, I still usually had to deal with fatigue.

It can make life so difficult. When you live with a chronic illness, you are forced to make hard choices. And more often than not, those choices have to do with how to spend the limited amount of energy you have left. Most people don’t realize that even the simplest tasks can take a toll on you.

It also doesn’t help that managing a chronic illness takes a lot of work. On a daily basis, a portion of your available energy will almost always be spent dealing with your symptoms, in one way or another.

But there is a good reason to have hope and a better way to manage your time and energy.

Introducing Mr. Pareto Vilfredo:

Pareto Vilfredo (Source:

The year was 1896. Pareto Vilfredo was the forty-six-year-old, controversial, Chair of Political Economy at the of the University of Lausanne in Switzerland. And on the verge of publishing a paper that would go on to send ripples through time and space.

You see, Pareto had come to realize that in his native Italy, there was a completely uneven distribution of wealth: 80% of the land was owned by 20% of the population.

But astonishingly, Pareto also discovered that the same distribution pattern could be found outside of economics and land ownership. In fact, it could be found almost everywhere. In Pareto’s garden, for instance, 20% of his peapods produced 80% of the peas.

Basically, Pareto’s work can be summed up like this: 20% of any inputs generate 80% of the outputs.

As the years went on, Pareto’s distribution pattern, eventually known as “Pareto’s Law”, was found to accurately describe countless aspects of our society.

For example, in business, 80% of a company’s profits are typically generated from 20% of its customers (Or 20% of its products).

But it also turns up in our personal lives, whether we realize it or not. And it if you can ask yourself the right questions, it’s a powerful tool to help you find the most valuable ways to spend your limited time and energy. It can make all the difference.

How Pareto Would Manage a Chronic Illness – The 80-20 Approach:

When you suffer from a chronic illness that causes fatigue, your life becomes limited in ways that most healthy people will never truly understand. You always have so much to do, but so little energy to do it. It’s hard to budget what little bit of energy you have properly.

But if you apply Pareto’s Law to your daily struggles, you can identify the 20% of your efforts that are responsible for 80% of your results. It will show you the most valuable places to focus your energy. It will show you what’s most important.

Take a moment to answer the following questions:

  • Which 20% of your treatment efforts are responsible for 80% of your results?

When you have to do so much, every day, to take care of yourself, it’s hard to know exactly what’s working and what isn’t. But if you can answer this question, and first focus on the 20% of your efforts that are responsible for 80% of your results, you will take care of what’s most important. You will be able to conserve energy and feel better throughout the day.

For me, there are three things that make up 80% of my results: eating a healthy low-sodium diet, getting regular exercise, and getting enough high-quality sleep. I do a lot of other things to manage my Meniere’s disease, but when I prioritize these three, I feel considerably better.

  • Which 20% of your stressors are causing 80% of your stress?

Stress management plays a big role when you live with a chronic illness. If you can focus on the 20% of your stressors that are causing 80% of your stress, you can quickly and drastically reduce your stress load.

  • Which 20% of your fears are responsible for 80% of your anxiety?

Living with a chronic illness can create a lot of fear in your life, and it will often manifest as anxiety. The fear exists for a good reason, but if you can focus on, and work though, the 20% of your fears that are causing 80% of your anxiety, you will be in much better shape.

After my Meniere’s disease diagnosis, I lived in constant fear for a long time. I was afraid of a lot of things, but the fear of having a vertigo attack dominated my thinking. I would try to rationalize the fear and create excuses for why everything wasn’t possible. But eventually I began to take risks and seize opportunities when they presented themselves. It took a long time, but by working through my one defining fear, I was able to reduce my anxiety by at least 80%, if not more.

  • Which 20% of your support network is providing 80% of the benefits (or 80% of the problems)?

Having a strong support network can make all the difference in how you are able to cope with a chronic illness. But not everyone in your support network is providing equal benefit. In fact, our family and friends can often make us feel worse for wear. Nurture the 20% of your relationships that provide 80% of the benefits. And avoid, when possible, the 20% of your relationships that cause 80% of the problems.

  • Which 20% of sources are responsible for 80% of your happiness?

This is an important question. When so much of your life is a struggle, finding ways to increase your happiness and satisfaction is crucially important. By identifying the 20% of activities that provide you with 80% of your happiest experiences, you can spend your limited energy on what really matters. You can be happy more of the time.

When I first answered this question, I found that source of most of my happiness could be distilled down to three important themes: Spending time with loved ones (my Fiancée Megan, friends and family), learning (reading books, learning new skills), and being creative (art, writing, etc.). When my energy levels are low, I find I am much happier if I spend my time doing one of these three things.


If you take a moment to really analyze each aspect of your lifestyle, through the lens of Pareto’s law, you will quickly be able to find the best ways to manage your limited supply of energy. By prioritizing and addressing the 20% first, you will be able to accomplish much more than you previously thought possible.

Pareto most likely had no idea that his work would eventually help people manage chronic illness. But he created an amazing framework for effectively prioritizing your daily tasks.

I still deal with fatigue, but by applying Pareto’s law to my decision making, I’m able to spend my energy much more carefully. And on my worst days, I can still take care of what matters most.

  1. This is an informative article. Very spot on! I go, go, go every day, but always watch my duet, get plenty of sleep, and exercise 5 or 6 days each week. Fear is what I always battle…I worry that I will have an episode, then I stress, then everything gets worse. Thanks for sharing!

    • Hi Carolyn, Thanks and I’m glad you liked this one. It was harder than usual to write, but I think it’s an important concept.

  2. Great article again. You have the wonderful gift of writing something that I totally need to read right now in my life ! Fear is my biggest issue too Carolyn and I am trying slowly to work through this. This horrible illness has once again brought back my agoraphobia. But after reading the previous article on fear by Glenn I went out on my bike just for 10 minutes. What a wonderful feeling ! I’m sure it takes effort but it is possible to get through this fear issue. Thanks for another great article Glenn. x

    • Wow Suzi thats great! I’m so happy to hear you are having success! And I’m glad you liked this article. It was much harder to write than some of the other ones.

  3. This is a great article, it is similar in a lot of ways to the way I approach my own recovery. It is always neat to see the other twists and details people use to define away to live their life with Meniere’s and other chronic illnesses.

    • Thanks Syn, I’m glad you liked it! I find it makes decision making a lot easier when you can define your priorities. It helps you focus on what really matters.

  4. Really enjoyed this piece. I don’t have Meniere’s but a form of Dysautonomia and have been applying this rule without realising. I learnt about Pareto way back in the dark ages when I was doing economics back at uni, but had never thought about making the link to life with chronic illness. It took me a long time to get to the point of understanding that I was wasting so much of my limited energy on meaningless and unfulfilling activities. Now I am much more discerning and want bang for my buck.

    • Hi Michelle, thanks for leaving the response! And I feel the same way. Ultimately, we only have so much time, and living with fatigue already puts us at a disadvantage. It’s important not to waste energy (and time) on meaningless activities.

    • You’re welcome Alicia! Thank you for the kind words and I hope this style of thinking can help you manage your energy better too!

  5. As a retired RN Professor I found your article very refreshing. I suffer with CFS secondary to FM, you reminded me of what I already knew and gave great examples of how to apply this theory. It really works…..

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