Neurological fatigue

Neurological fatigue

Neurological fatigue is a common complaint associated with acquired brain injury.  It will be most severe immediately following your brain injury but can improve over time.  However, for some individuals neurological fatigue persists long after other symptoms have disappeared.  It can occur at any time of the day and often without warning.  The following information is to help you understand neurological fatigue and how you can learn to self manage it. Mental Fatigue can affect your ability to process and retain information.  Physical Fatigue can impact on the amount of physical activity you are able to do.Mental Fatigue can affect your concentration and attention  Neurological Fatigue can make you feel irritable, distracted, depressed or anxious.After a brain injury your sleeping pattern may be disturbed which may impact on neurological fatigue.Tasks that require a lot of concentration will drain your ‘brain energy’ faster, leaving you feeling fatigued. Neurological fatigue can affect your ability to cope with social situations.

The recovery process

During recovery, other areas of the brain take over the activities of the damaged areas.  This means that your brain is working hard to compensate for your injury as well as managing essential functions i.e. heart beat, kidney function etc.  Your brain will also be working less efficiently at this time and it will use more energy to perform simple everyday tasks, such as getting washed and dressed, causing you to feel more fatigued.    

Physical fatigue

Physical fatigue can occur from muscle weakness this means your body needs to work harder to do things that previously did not take much effort.  Your stamina may be low and it is important to gradually build up your stamina after a period of being physically in-active.  Lacking co-ordination or problems with balance and movement means extra effort and concentration is required which can in turn increase fatigue levels

Mental fatigue

This is often more difficult to recognise than physical fatigue as the effects of mental fatigue are less obvious externally.  Mental fatigue is sometimes evident in changes in behaviour for example increased irritability, difficulty controlling emotions, etc.  People may also avoid certain social situations as it is difficult to follow a conversation or think of topics for conversation.  People suffering mental fatigue may find it difficult to filter what they see and hear and find it harder to concentrate in busy, noisy environments.  After an acquired brain injury, your brain requires  to work harder to think through a task and this can increase mental fatigue whereby previously common straight forward tasks, i.e. managing finances, can require more concentration than they did before. Sensitivity to stress is also common as your brain struggles to quickly think on your feet or weigh up the pros and cons of situations.

Fluctuations in fatigue

People often find that their level of fatigue varies and find it difficult to explain to others why they may be able to complete a task one day but struggle with the same task the following day.  Fluctuations in fatigue levels are common as people recover from an acquired brain injury, this is because the brain often has to re-learn tasks and the extra brain effort required as people begin to complete more tasks impacts on their level of fatigue until their brain re-learns the task.  

Fatigue management

Fatigue management is the starting point for your recovery.  In order to manage your fatigue, you first need to accept that you do not have the same physical and mental stamina that you had before the accident.  Recognising what kind of fatigue you are experiencing is important – you may experience both physical and mental fatigue – and setting goals to gradually increase your tolerance for mental and physical tasks is essential.  Your Occupational Therapist will help you to identify triggers and further discuss strategies for effective fatigue management. Consider your energy levels as a battery, whenever you perform a task whether it is a physical or mental activity you are reducing your energy level.  However, it is possible to recharge your energy levels through rest and structured activity.  Have a look at the diagram below to help you to understand how basic daily tasks can have an impact on your fatigue following an acquired brain injury.

Strategies to Help Manage Fatigue

PACE YOURSELF: Gradually build up your activity levels ensuring a balance to include physical tasks, mental tasks and rest periods.

PRIORITISE: Work out what you need to do in a day and do this first.

GOAL SETTING: Set yourself realistic, manageable and timely goals you wish to achieve in a week to give you something to work towards.

DELEGATE:  Consider what needs done, what you want to do and what can be given to someone else.

CONSERVE: Consider how you can make tasks easier and conserve energy.

PLAN: Balance high demand thinking tasks with low energy activities and factor in rest breaks throughout.