Managing fatigue after a brain injury
Fatigue is a common and very disabling
symptom experienced by people with a brain injury.
It may be a continual sense of mental fatigue or it can happen
when a person is trying to do too much and the brain is overloaded,
often resulting in mind-numbing fatigue that can last for several
Brain disorders such as traumatic brain
injury can be likened to a highway when one of three
lanes is closed down. If traffic is light, there will be no
difference but once the traffic reaches a critical point, the cars
barely move and it can take ages for the traffic jam to
It is important to avoid fatigue as much as possible, as any
other problems are worsened as well, such as:
- Vision problems
- Slurred speech
- Difficulty finding words
- Poor concentration
- Cramps or weak muscles
- Poor coordination or balance.
Fatigue can occur for no apparent reason
or after physical activity, but is quite likely to occur from too
much mental activity. Examples include planning the week's errands,
organizing a work schedule or simply reading.
Fatigue can be managed with good planning
and rest periods, but carers and the family member must realize
fatigue is a very real problem.
Symptoms of fatigue
The following symptoms may all suggest
- Withdrawal, short answers, dull tone of voice
- Loss of appetite
- Shortness of breath
- Slower movement and speech
- Irritability, anxiety, crying episodes
- Increased forgetfulness
- Lack of motivation and interest.
What are the triggers of fatigue?
Work out what triggers it and what
factors make the symptoms worse, such as long conversations, noisy
shopping centres, movies with complicated plots, or talking with
two or more people at once.
In some cases, fatigue could be a
side-effect of certain medications, in which case you should
discuss options with your doctor.
Be aware of the first signs of fatigue
and immediately stop and rest - overloading your brain can easily
result in several days of extreme tiredness. Make a note of how
long you can do certain activities before fatigue starts e.g. if
fatigue starts after 30 minutes of reading, only read for 20
minutes in future.
Fatigue may occur at the least convenient times - on public
transport or during a meeting. You need to negotiate ways of coping
when this happens. You can use specific strategies or call in extra
support. Work out contingency plans with your family member. Your
rehab team, occupational therapist or physiotherapist can help with
Assess best hours:
Some people function best in the mornings, so complete demanding
tasks then. Others function better in the afternoon or the evening.
Organize your routine accordingly. Don't drive when you are
Assess your environment:
Provide an uncluttered environment that is easy to move around and
work in. Think about how and where things are stored; bench
heights, entrances, types of furnishing and lighting. For example,
some people may find fluorescent lighting or dim lighting more
Schedule rest periods:
Make a daily or weekly schedule, and include regular rest periods.
"Rest" means do nothing at all. If you have a nap, don't oversleep
in case this affects your normal sleep cycle.
Use aids: Use mechanical
aids to conserve energy for when it really counts. One man spared
his legs extra effort by using his wheelchair to get from his house
to the car, then from the car to the church, before walking his
daughter, the bride, down the aisle.
Break it down: Break
down activities into a series of smaller tasks. This provides
opportunities to rest while allowing the person to complete the
task. Encourage sensible shortcuts.
Set priorities: Focus on
things that must be done and let the others go.
Medication highs and
lows: Be aware of changes throughout the day that relate
to medication. Is the person better or worse immediately after
their tablets? Plan their activities around these times.
Weather: Hot weather can
also increase fatigue. Plan around this.
Seek support: Ask for
advice. In particular, an occupational therapist can visit your
home and advise on an energy-conserving plan. For more information,
talk to your doctor or condition-specific support organization.
AS with virtually every aspect of a
traumatic brain injury and similar brain disorders,
fatigue will be less of a problem if you focus on a healthy
- Sleep well
- Get regular exercise
- Avoid alcohol or limit your intake
- Eat a healthy diet and watch your weight
- Learn stress management techniques
- Maintain contact with friends and family.
References and further information
This article has been reproduced with the permission of BrainLink from one
their excellent brain injury resources. Their website has a wide
range of fact sheets on many other issues. BrainLink is a Victorian
service dedicated to improving the quality of life of people
affected by conditions of the brain, and providing support to their