I have rheumo and osteo arthritis too, DDD, DJD, the list goes on......autoimmune hepatitis, and on and on and on.......I hear you, if I am not careful I am off track for an entire week! Going to bed early and getting up early seems to work for me. I would like to somehow be able to do something in the evening without it bowling me over for an entire week afterwards. I am noticing some occasional spurts of energy the better I am doing in psychotherapy. Which meds does your rheumo have you on? I used to be on Celebrex and Cymbalta but a local doctor caused me liver problems by not getting my blood tested for over a year and now I can only take meds that are metabolized in the kidneys. So, no more Celebrex or Cymbalta for me ever. I am on Elavil and it seems to be helping mood wise but I still have a lot of pain.