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Understanding The Boom - and - Bust Cycle in Chronic Health Conditions

Living with a chronic health condition often feel like riding a rollercoaster. One day, you might feel energetic, productive, and relatively symptom-free, while the next day, you're drained of energy, experiencing debilitating symptoms, and struggling to carry out even the simplest tasks.

This phenomenon of cycling energy and productivity is commonly referred to as the "Boom - and - Bust" Cycle, and it's a significant challenge for individuals managing chronic health conditions, such as chronic pain, fibromyalgia, chronic fatigue, inflammatory bowel disease, arthritis, COPD, Mental Health Conditions, and more.

What is the Boom-and-Bust Theory?

The Boom-and-Bust theory describes the pattern of high energy expenditure and subsequent fatigue or symptom exacerbation that many people with chronic health conditions experience.

The “boom” is characterised by periods of increased activity or exertion followed by the “bust”, a crash or significant decline in energy and functioning.

Understanding the Cycle

Imagine waking up one morning feeling relatively well-rested and with little to no symptoms, pain or discomfort. Motivated by this temporary reprieve, you decide to tackle a list of tasks that have been piling up – perhaps cleaning the house, running errands, taking on extra work or engaging in social activities; maybe even all of these! During these periods of heightened activity, you might feel a surge of productivity and even a sense of accomplishment. You might think “it feels great to feel like myself again!” and continue in this pattern for the rest of the day, week or even a few weeks. This is a typical “boom” period.

However, as time, you start to notice signs of symptoms creeping in. You find yourself utterly exhausted, perhaps experiencing increased pain, stiffness in joint, or other symptoms. Maybe you wake up one day and find it difficult to get out of bed, cannot carry out daily tasks, have little to no appetite and feel totally deflated. This crash can be both physically and mentally draining, often necessitating a period of rest and recovery to regain energy and functioning. Often, during this “bust”, you may beat yourself up “why can’t I be like everyone else? Why is this happening to me again?”, feel down, or even totally fed up. Times of bust may even lead to hospital stays, increases or changes in medication, and extended periods off work.  

Graph with visual representation of the Boom and Bust process

Factors Contributing to the Boom-and-Bust Cycle

Several factors can contribute to the Boom-and-Bust cycle in Chronic Health Conditions.

  1. Limited Energy Reserves: Living with a Chronic Health Conditions can mean that energy reserves are depleted more quickly than in healthy individuals. This limited energy supply makes it challenging to sustain prolonged periods of activity without experiencing fatigue or symptom exacerbation.

  2. Unpredictable Symptoms: Chronic Health Conditions often present with unpredictable symptoms that can fluctuate in intensity and frequency. This unpredictability makes it difficult for individuals to plan and pace their activities effectively, leading to periods of overexertion followed by crashes. This unpredictability can also contribute to frustration, upset and being mentally tough on ourselves.

  3. Poor Sleep Quality: Sleep disturbances are common in many Chronic Health Conditions, in part due to systemic inflammation, needing to wake during the night to use the toilet, or even due to worrying about your condition or other things. Sleep disturbances contribute to fatigue and diminished energy levels. Even if individuals attempt to rest and recuperate after periods of increased activity, poor sleep quality may prevent them from fully recharging, further perpetuating the Boom-and-Bust cycle.

  4. Psychological Factors: Living with Chronic health conditions can take a toll on mental health, leading to stress, anxiety, depression, and other psychological symptoms. These factors can exacerbate physical symptoms and contribute to fluctuations in energy levels, further perpetuating the Boom-and-Bust cycle. Our mental health can also perpetuate this cycle by trying to “push” us to try harder and harder, leading to a bust.

Managing the Boom-and-Bust Cycle

While the Boom-and-Bust cycle can be challenging to navigate, there are strategies individuals can employ to manage their condition more effectively:

  • Pacing Activities: Learning to pace oneself and break tasks into manageable chunks can help prevent overexertion and minimize crashes. Prioritising tasks and incorporating regular rest breaks can help conserve energy throughout the day.

  • Listening to Your Body: Paying attention to signals from your body and recognising early signs of fatigue or symptom exacerbation can help you avoid pushing yourself too far. Learning when to rest and when to scale back activities is essential for managing the Boom-and-Bust cycle.

  • Establishing Routines: Establishing consistent daily routines can help stabilise energy levels and minimise fluctuations in symptoms and energy. This includes maintaining regular sleep patterns, incorporating relaxation techniques, and practicing self-care activities that promote overall well-being.

  • Seeking Support: Don't hesitate to reach out for support from healthcare professionals, family members, friends, or support groups. Building a strong support network can provide encouragement, guidance, and practical assistance in managing your Chronic Health Condition.


The Boom-and-Bust theory sheds light on the challenges faced by individuals living with Chronic Health Conditions, highlighting the importance of pacing, self-care, and support in managing symptoms and improving quality of life. By understanding the factors contributing to the Boom-and-Bust cycle and implementing effective coping strategies, individuals can better navigate the ups and downs of life with a chronic health condition. Remember, managing chronic health conditions is a journey, and it's essential to be patient, kind to yourself, and persistent in finding what works best for you.


Do you Boom – and – Bust?

If you recognise yourself in this Boom – and – Bust pattern, and would like to explore it more in a safe, therapeutic space, please do not hesitate to reach out and book a session with a qualified Health Psychologist at

Take Care,

Aideen Stack

Health Psychologist

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