Psychology Chartered

Feeling Fatigued after Brain Injury?

Posted by Lily Hopkins

1st September 2019

By Jasmine Hine

Although fatigue is typically associated with feelings of tiredness and a lack of energy, it is defined as a subjective feeling that can include a prolonged lack of motivation and ability to complete normal daily tasks with usual enthusiasm. Fatigue can present itself mentally, physically or as a combination of both:

What is the difference between mental fatigue and physical fatigue?

MENTAL FATIGUE:

“I am just so tired, I can’t seem to focus on anything or even concentrate, my brain just goes blank and fuzzy, I’m so unmotivated and I just don’t feel like doing anything”

PHYSICAL FATIGUE:

“I’m tired and I just need to rest, my muscles and limbs are just so achy and I’ve got a constant headache”

Individuals who suffer with fatigue describe their symptoms or feelings using a variety of different descriptive words as it is a very subjective experience and can be difficult to express to others. Some of the most common descriptive words include:

  • Exhausted
  • Tired
  • Weary
  • Lack of energy
  • Feeling run down
  • Listless
  • Burnout
  • Weak and Feeble
  • Over-worked

  

What are the symptoms of Fatigue?

There are a variety of symptoms that are present when an individual is fatigued. Most people just assume it is solely feelings of intense tiredness; however there are also some that you wouldn’t normally expect, for example:

  • Dizziness and blurred vision
  • Aching or weak muscles
  • Slowed responses and impaired decision making
  • Increased irritability
  • Affected hand-eye coordination
  • Loss of appetite
  • reduced immune system function
  • Short-term memory recall issues
  • Reduced concentration and attention span

 

Why is Fatigue important to recognise and address?

Therefore, when considering the associated symptoms above on top of feeling permanently tired, you are less inclined to successfully achieve or complete your usual daily activities or routine. You are less able to think clearly or effectively, your attention span will decrease and your concentration will be limited – essentially, you will have less energy to care for yourself and do things you enjoy doing as well as reaching your usual productivity levels. This can increase levels of anxiety, worry, depression and stress resulting in further physical and mental health complications.

 How likely is Fatigue after a Brain Injury?

The answer, sadly, is highly likely.

According to the “MSKTC” (model systems knowledge translation centre) up to 70%of individuals who have suffered from a traumatic brain injury have reported issues with their mental fatigue. Additionally “Brain Drain: Wake up to Fatigue campaign” recognised that nearly 90%of individual who have survived a brain injury are affected by PATHOLOGICALfatigue and 3 out of 4individuals were in need of help to identify, understand and cope with their feelings of extreme fatigue.

What is Pathological Fatigue?

Pathological fatigue is fatigue that does not subside with time; it can be present 24/7 and does not necessarily improve with rest, unlike normal fatigue. It can have a significant affect if an individual is trying to continue with their normal routine. It is most common with those who have suffered a brain injury.

What causes Fatigue after Brain Injury?

It is not 100% clear as to why individuals who have suffered from a Brain Injury develop feelings of fatigue, but it is known that the onset of fatigue is typically much faster and occurs more frequently than those without injury. However, some research does suggest that it could be caused by all the extra effort exerted to complete simple tasks (e.g., walking or talking) that were easy before.

 PHYSICAL FATIGUE– this could be a result of muscle weakness. After brain injury, the body needs to work harder to do things that were previously easily done. However, physical fatigue is proven to be better after a good night’s sleep and will reduce when the individual becomes stronger and more active.

MENTAL FATIGUE– this could be a result of your brain using extra effort to think, interpret and process information that again would have been simple before brain injury. This includes increased effort to concentrate and to maintain focus for long periods of time. Stress can make mental fatigue worse.

Other conditions can also have a debilitating impact upon feelings of fatigue, typically increasing them, these include:

  • Depression
  • Sleep apnea
  • Seasonal allergies
  • Respiratory problems
  • Migraines / regular headaches
  • Limited physical exercise
  • Poor healthy diet

 

 Are there any triggers for Fatigue in Brain Injury?

Yes! It may seem obvious, but it has been proven that being in a busy or noisy environment for a prolonged period of time or concentrating on one specific thing whilst in this environment can increase likelihood of feelings of fatigue. Additionally, spending a lot of time focusing on computer or paperwork can also increase these feelings.

How to cope with Fatigue after Brain Injury?

There are a variety of techniques that can be used to effectively cope with feelings of fatigue after a brain injury, many that can be done independently with practise, for example:

  • Avoidance: Learn to identify what can trigger fatigue as well as early warning signs. Learn to manage and control when to stop an activity before these warning signs commence.
  • Monitor your sleep: Decide how many hours you feel you need to sleep, set a regular schedule of going to bed and waking up. It could be beneficial to include some regular breaks or naps (30mins max.) during the day.
  • Prioritisation. Decide what activitiesare most important to you and are essential, try and get these things done first or ticked off a checklist.

 

There are also a variety of psychological therapies that can help alleviate symptoms of fatigue that can be done with a counsellor or therapist or independently, for example:

  • Cognitive Behavioural Therapy (CBT). CBT encourages individuals to become aware of their triggers and to control their response. Typically CBT is known as a talking therapy that can change the way you think and perceive certain situations.
  • The aim of mindfulness is to become more aware of your thoughts, feelings and emotions as well as becoming aware of the environment around you. This encourages you to view things more positively as well as being able to identify potential triggers.

 

References

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