One of the most common symptoms following a brain injury is fatigue.
Fatigue is a feeling of exhaustion or extreme tiredness. The degree experienced does not necessarily depend upon the severity of the brain injury suffered. It can affect an individual who has suffered a mild brain injury just as much as it can affect someone who has suffered a severe brain injury.
Causes of Fatigue
The Ascending Reticular Activating System (ARAS) is the brain system responsible for the transition between being asleep and awake. It links the brainstem with the area of the brain which regulates sleep, the area responsible for higher functions (speech, reasoning, emotions, learning, etc) and the pituitary gland.
Researchers believe that the functioning of the ARAS is linked to fatigue, however, beyond this, relatively little is known about the underlying causes of fatigue following a brain injury.
It is thought that it could be as a result of the extra effort and concentration required for an injured brain to carry out activities that many of us take for granted, such as walking, talking or organising our day. On top of this, individuals who have suffered a brain injury often suffer from difficulties sleeping, which may exacerbate their fatigue. Other conditions such as depression or stress may also aggravate it.
Types of Fatigue
People may experience;
- physical fatigue – when a person’s muscles and body are tired.
- psychological fatigue – when it is harder to cope with life following injury. This may be associated with depression, anxiety or other conditions.
- mental fatigue –the extra effort which is required to think or carry out relatively simple activities.
Effects of fatigue
Unsurprisingly, fatigue makes it more difficult for sufferers to continue everyday activities in the same way as before – even cooking or bathing can be extremely challenging.
Fatigue is experienced differently by each person, but symptoms include exhaustion or overwhelming tiredness; weakness and a lack of energy; low motivation; bad concentration; muddled thinking; indecisiveness; nausea and erratic emotions. For some sufferers, fatigue may exacerbate their other brain injury symptoms such as irritability or forgetfulness.
Some symptoms of fatigue, such as slurred speech and slower information processing mean that sufferers are often judged unfairly. This can be incredibly isolating. Often, survivors don’t receive adequate practical and emotional support and sadly, lack of awareness can mean even those closest to brain injury survivors don’t fully understand the impact of brain-injury related fatigue.
This can drive a wedge between survivors and those closest to them at a time when they need them most.
In addition to this, due to problems with sensory feedback in the brain, it can be very difficult for a brain injury survivor to notice the warning signs and take action.
Top Five Tips for Managing Fatigue
Managing fatigue tip 1 – Self-Assessment
If you take some time to reflect on what type of fatigue you are suffering from, how it affects you and what improves it or makes it worse, then you will be better at working out where to go or what to do that might help.
This can also help you notice when you are becoming fatigued which can help reduce frustration and trigger coping mechanisms.
Managing fatigue tip 2 – Diet and Exercise
NHS guidelines suggest that sticking to a healthy, balanced diet can improve symptoms of sluggishness and improve overall health. A regular night-time sleep routine can help, as can avoiding caffeine, alcohol or nicotine before bed.
Moderate, relaxing exercise can be very beneficial along with getting plenty of natural sunlight, so yoga, Tai Chi or even thirty minutes walking in the park can make a difference.
Managing fatigue tip 3 – Honesty and Kindness
Be honest with yourself and those around you about what you can achieve and what is likely to make you fatigued.
This way you can manage your own and other people’s expectations and cut down on the frustration and stress which will only make the fatigue worse.
Remember to be kind to yourself by celebrating daily accomplishments and not worrying about things you haven’t managed to do that day.
Managing fatigue tip 4 – Practicalities
If you know what is going to cause you to become fatigued you can plan for it in advance, this can be as simple as:
- taking regular rest breaks throughout the day
- balancing high demand tasks with low energy activities
- writing lists and using a diary
- setting alarms to remind you to rest
Managing fatigue tip 5 – Seek Help
You do not need to struggle alone – find support from charities, visit your GP and seek out people who are going through the same thing.
Many survivors of brain injury are helped by Cognitive Behavioural Therapy (CBT), which helps sufferers understand the impact of fatigue, identify common triggers and create an ability to respond.
Charities can help point you in the direction of further help and support. They can also put you in touch with people who are going through the same thing. It can make a big difference to speak to someone who really understands what it is like. They might also be able to share tips of things that have worked for them.
As with so much, gains are often hard won, but as many brain injury survivors know there are ways to learn, adapt and overcome fatigue which help people live a happier, less stressful and more fulfilling life.
With thanks to Bolt Burdon Kemp
This article has been produced in association with Brain Injury Group member firm Bolt Burdon Kemp, a leading law firm in the field of brain injury who have offices in London. Their specialist solicitors have over 30 years’ experience in complex claims involving adults and children with brain injuries and they work hard to ensure access to the best rehabilitation and support services to help rebuild lives following brain injury.
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