Fatigue affects many people at some point in time, but it’s not always understood as a significant consequence of brain injury. This type of fatigue feels completely different; more intense, longer lasting, and doesn’t necessarily seem to relate to what we have just done. And it doesn’t seem to go away after rest either… so what’s going on? Why does fatigue occur? And what can we do about it?
Our brains control everything we do, what we think and feel, and the pace at which this happens. After a brain injury, it seems as if more physical and mental energy is needed for daily life and it feels as if this energy drains far more quickly than before. It’s like having lots of apps open at once on a smartphone; things slow down and the battery drains very quickly until ‘the computer says no’! This is frustrating, can feel unpredictable and difficult to explain. Fatigue can impact work, family and social life, as we may struggle to keep up with conversations, feel more irritable, find it hard to make decisions and keep cancelling plans as we feel too tired. It seems to make other consequences of the injury even worse!
Despite physical and mental fatigue being so commonly reported, scientists are uncertain exactly what fatigue is and why it occurs. They do agree that many different factors contribute to everyone’s experience of fatigue; these can include physiological, cognitive, physical, emotional, personal and social factors. It takes a lot of detective work to figure these out for each person, what particular activities or situations may be triggers, and what combination of management strategies are likely to help each individual.
There are things that, in combination, can help and information is available on the Headway website, for example this article on coping with fatigue.
However, it’s not easy to use these strategies in our daily lives consistently. A healthy diet, exercise and getting a good night’s sleep are common sense but can be difficult to implement after brain injury for a variety of reasons. Changes to mood and emotions are not easy to manage without support from people who understand, and we at HIP aim to help with other professionals to support and share strategies. Strategies to compensate for memory slips may seem logical, but hard to action in the moment. And pacing – an easy thing to say, but it’s not as simple as having a break every few minutes!
There is no quick fix or magic pill to take, although scientists are looking, so do speak to your doctor about whether medication may help. There may be other medical conditions affecting your energy levels to consider. Working with an occupational therapist is a good idea, as they can work with you to find out what factors are relevant for you, how to make activities take less effort, and manage the environment to help you process information more effectively so you can participate in the activities you value most. Sometimes fatigue improves, it may even go away, but some people may need to be more consciously aware of their energy levels on a day-to-day basis.
To cope with fatigue you must first be able to recognise it. So how do you know when you are getting fatigued or fatigue starts to build up?
The most important thing that you can do is to learn to 'tune in' to your body. Fatigue is your body's way of telling you to slow down and rest. Learning to spot the early signs of fatigue in your body can help you manage it effectively.
Some signs may include:
You can also start trying to identify situations that cause you to feel fatigued. For example, if you notice that travelling on the bus makes you feel fatigued, then next time you need to travel on a bus you can plan your day more carefully to minimise the impact of this.
It may take time to work out what your triggers are, so fatigue might feel difficult to control. However, it is likely that certain activities are more tiring for you; what are these? People around you may be able to help you to identify what these are.
You might want to consider monitoring your fatigue by rating how tired you feel before and after different activities, perhaps on a scale of 1-10. This may give you an idea of which activities you find fatiguing.
It is important to recognise those activities or situations that are more tiring so that you can plan for them in your daily routine. Once you are aware of which activities are tiring, then you can prioritise and set realistic targets of what is achievable in a day.
Sharing experiences is a good place to start as it can feel so confusing and that’s where HIP comes in we through our informal meetings and support groups provide a safe place to share.
