Fatigue is one of the most commonly reported effects of a brain injury. Unlike 'normal' fatigue, which is time-limited and alleviated by rest, the intense feeling of fatigue after brain injury may be present most of the time and can have a significant impact on quality of life.
We've put together eight effective strategies to help.
Fatigue is one of the main criteria used when diagnosing depression. However, not everyone who experiences fatigue is depressed. Brain injury can have a significant impact on mood and behaviour. This may be a consequence of direct damage to the brain itself or because of the impact the injury has had on an individual’s life.
Feeling depressed, stressed and anxious can leave you feeling tired. Equally, when people experience high levels of fatigue, which stop them from doing what they want to do, they may report feeling low and irritable.
Pacing is a way of balancing activities that you do throughout the week. By spreading tasks out you may be able to reduce fatigue.
Sleep hygiene is nothing to do with personal hygiene, but is simply about having a regular sleep routine. This helps the body to prepare for going to sleep by winding down and helps you to feel more alert on waking.
Fatigue always starts with losing half of my vocabulary, I can’t recall the word for anything or I use the wrong word and then start stammering and getting confused.
- Steph Healy
Exercising improves our capacity to undertake physical activities. Current government guidelines recommend 30 minutes of moderately intense exercise five times a week to improve our physical fitness. Try to choose something which you enjoy as you are more likely to stick to it.
Some people report that exercise has an energising effect and research shows that it can have a positive effect on mood. Exercise can also help you to sleep more deeply.
Some types of food can make us feel more ‘sluggish’ and lacking in energy, while others can help to maintain energy levels for longer periods. Thinking about eating the right things at the right times, according to what you are doing, is important in managing fatigue.
Fast-releasing carbohydrates, in foods such as sweets, sugary cereals, white bread and sugary drinks, break down quickly and flood the blood with too much sugar. Surges in blood sugar levels may result in a short term increase in energy, followed by decreased energy and concentration.
Slow-releasing carbohydrates, in foods like brown rice, wholegrain pasta, fruit and vegetables, are more ‘complex’ and contain fibre that helps to slow down the release of sugar and so maintain energy levels. It is important for the diet to have a balance of ‘complex’ carbohydrates and protein from foods such as meat, fish, dairy products and nuts.
Drinking enough fluid, particularly water, keeps the brain and body hydrated. This is important to help the brain and body to work effectively. Drinking lots of caffeine, such as in tea, coffee and some fizzy drinks, may increase your alertness initially, but this is often short-lived.
There is currently very little research into the effectiveness of medication for managing fatigue following brain injury, although some types of medication have been found to be helpful with other conditions where fatigue is a symptom.
Medication may be helpful in managing other factors associated with your injury, such as anti-depressants for low mood, but it may also influence the fatigue you experience. Some side effects may include drowsiness and could make you feel more tired during the day.
It is important to discuss these issues with your GP, who should be able to advise you on the benefits of medication and suggest any alternatives.
To make best use of your available mental and physical abilities you may want to think about the environment in which you live and work. Being organised and avoiding distraction can help to minimise the physical and mental effort that is required to complete an activity.
My friends and family can see the change in my face, sometimes before I’ve even noticed it myself. Probably because I want to plough through as I’m fed up of giving into it.”
- Catherine Hammond
Following brain injury you may need more mental effort to perform a task and you may experience difficulty sustaining this effort over time. Some people have described reaching a point at which their brain ‘shuts off’. When experiencing ‘mental fatigue’ people describe being unable to think clearly and have difficulty concentrating.
It may be that cognitive difficulties resulting from your brain injury may be more noticeable when you get fatigued. Everyone tends to become forgetful and make more mistakes when they feel tired. Therefore, making best use of your thinking resources through applying strategies may be a way to make fewer mistakes and make things take less effort.
“In those first few months especially, I didn’t realise the difference between physical and mental fatigue. However with time, I eventually learnt to treat my brain as a battery – with some things draining it quicker than others.”
- Belinda Medlock
This information is taken from our booklet Managing fatigue after brain injury (PDF). You can download a copy from our information library, or contact our helpline, who can send free printed copies to people with a brain injury and their families.
If you are affected by fatigue, you should speak to your GP and seek referral to specialist services such as a neuropsychologist or occupational therapist. Many Headway groups and branches can also offer support.
Friends of Headway Individual membership Join/Renew