What I consider MS related is the typical lassitude and that is what troubles me the most. It comes out of nowhere, everything shuts down mind and body. Cognitive issues peak, can't process anything and my speech is even affected. Generally happens late morning or early afternoon, pretty much every day. Some days I wake up with it and can barely walk around my house. To me, that's MS fatigue. Normal fatigue also happens, especially when I'm sleep deprived from insomnia. But to me MS fatigue is distinctly different. I hate calling it fatigue even because that's really not a good descriptor and somehow I don't think it does it justice.

I'm taking Provigil and that has helped quite a bit. it's still not perfrect, but I'm able to work 12 hour day now with only mild difficulty whereas before Provigil it was extremely difficult. To the point I was afraid I was not going to be able to work for much longer.

I consider all my fatigue MS related since nowadays I fight to do anything and what I do is minimal so I don't see how that would cause normal fatigue. I used to work 12 to 16 hour days 6 to 7 days a week and now I wake up and have to talk myself into getting up, hopefully doing some yoga, walk the dog and get something done around the house. If I do something out of the normal for as little as 30 minutes I end up with increased fatigue and pains wherever so I just rack it all up to MS because what I suffer doing now used to be like an appetizer to my huge daily meal of life I used to have and enjoyed before the MonSter stold it all away from me.

It takes a bit of time to be able to read your body and configure what is MS and what isn't, but in my experience you can sense a feeling when it's not normal exhaustion.

Makes perfect sense. Fatigue is weariness, not sleepiness.