Fatigue after brain injury: Fighting the winter slump

If you’re living with the effects of a brain injury, you’ll know that fatigue doesn’t feel like ordinary tiredness. It can be sudden, overwhelming and unpredictable - one moment you’re managing, the next it feels like someone has pulled the plug.

In winter, fatigue can hit some people even harder. Shorter days, darker evenings and colder weather affect motivation and mood.

Headway regularly hears from people who say fatigue is one of the most invisible and misunderstood effects of brain injury.

The main thing I wish people could understand more about brain injury is the significant change in fatigue, if I or another brain injury survivor are feeling mentally fatigued, we find it extremely hard to have motivation for basic tasks, to have any form of conversation even with loved ones, and sometimes to be able to get up and out of bed in the morning. - Liam Hamilton

Why does fatigue happen after brain injury?

After a brain injury, the brain has to work harder to do things that used to be automatic, like thinking, planning, filtering noise, remembering, or concentrating. Some areas involved in keeping us alert may also have been affected.

This means tasks such as holding a conversation, going shopping or navigating noisy environments can drain energy quickly.
Learn more about fatigue after brain injury.

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Spotting your early warning signs

Recognising fatigue early gives you the chance to rest before you hit the wall, reducing the impact.

Common early signs include:

• Difficulty finding words
• Muddled thinking or brain fog
• Irritability or overwhelmed emotionally
• Sudden need to withdraw from others

Read more about the early warning signs of fatigue. 

We've put together these practical tips from our own resources and lived experience from brain injury survivors.

1. Pace yourself (activity → rest → activity → rest)

Think of energy like money - you only have a certain ‘energy budget’ each day. Break activities into smaller chunks and schedule rest deliberately, not as a last resort. Pacing is one of the key ways to manage fatigue after a brain injury because trying to do too much in one go can quickly drain your limited energy.

“My friends and family can see the change in my face, sometimes before I’ve even noticed it myself.” – Catherine Hammond

Download the fatigue factsheet & planning tips here.

2. Create a “protected rest zone”

Pick a chair or quiet corner where there are no screens or conversations and use it at the first sign of fatigue.
Resting in a calm, distraction‑free space gives your brain the break it needs because after brain injury even normal tasks can use up a lot of energy and lead to overwhelming tiredness. Taking regular short rests in this protected zone, it can make it easier to pace yourself through the day and may help sustain your energy for the things you want to do.

3. Reset your sleep rhythm

In winter, daylight is scarce - but it’s more powerful than we think in promoting healthy sleep.
In the daytime, try the following:

• Open curtains fully to let in as much natural daylight as possible
• If you can, take a short walk in the morning to benefit from daylight exposure
• If going outside is challenging, simply sitting in natural light can help regulate your sleep and mood

Discover more about sleep problems after brain injury.

"To start with, the fatigue would always get the better of me and I'd be unable to do anything for days. But I've since found that if I stick to a sleep schedule and take a nap in the afternoon, the fatigue is more manageable.” – Candice Ridley

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4. Reduce unnecessary effort

Save energy by pacing your activities. Some things you can try include:
• Planning your time and being organised – easier said than done, but read our 9 ways to help with planning problems after brain injury for guidance.
Prioritising where to use your energy and adding breaks to your plan
• Making small changes to each task, like sitting while cooking or trying to park closer to the supermarket entrance
• Knowing what your triggers are and working within your available resources
Small changes protect your energy for things that matter most.

5. Try 'brain breaks'

Set a timer for 20 minutes while you try to focus on just one thing. When the timer ends, rest, even if you feel fine.
This can help to prevent fatigue before it strikes. After a brain injury, fatigue can build up quickly and is your body’s way of signalling that it needs a break, so recognising when to pause is key to managing energy levels effectively.

6. Keep a fatigue diary

Keep track of:
• What you did
• When you did it
• How long it took
• How you felt afterwards

Patterns appear quickly, helping you plan better and explain fatigue to others. Keeping a fatigue diary encourages you to note not just activities, but how your energy levels change before and after them - for example by rating how tired you feel on a simple scale - which can make it easier to spot activities that drain you more than others. By regularly recording this information, many people begin to see trends in what triggers their fatigue, and it becomes a useful tool for planning rest breaks and structuring their day in a way that conserves energy.

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Look after your mental health in winter

Fatigue affects mood, and low mood drains energy. The two feed each other and this can be a particular problem through the long winter months.

For mild changes to your mood, you can try some of the self-help tips in our mental health and brain injury publication. This also contains a wealth of information to help you understand and improve your mental health.

Always seek medical advice if you have concerns about your mental health.

“It’s so important to speak out. When I did, I realised I wasn’t alone and others have overcome the same challenges.” – Sam Hulse

When to ask for more help

Speak to your GP or Headway if fatigue is getting worse, affects daily functioning, impacts your mental health, or if you suddenly have new symptoms.

You’re not being dramatic. Fatigue after brain injury is very real and requires support, so don’t delay seeking support.

Practical strategies, being kind to yourself, and getting the right help at the right time can make a real difference.