Attend Factsheet 1e:
What is fatigue?
Fatigue is a feeling that everyone experiences after a time of physical or mental activity. It usually is used as a signal to tell the body when to take a break. “Normal” fatigue is usually limited and can be cured easily by rest. “Pathological” fatigue (fatigue experience after a brain injury) on the other hand can be present more often. It won’t always be cured with rest and can really affect the activities one does.
Fatigue after brain injury
Fatigue can easily affect what people think, feel and do. After a brain injury, fatigue may be caused by damage to brain structures or other factors such as needing to make more effort to think or move. Many factors that make people vulnerable to experiencing fatigue are anxiety and depression, sleep difficulties, medication side effects, reduced stamina, pain, physical difficulties, cognitive(thinking) difficulties, impaired sensation, hormonal changes, poor diet, individual ways of coping, knowledge of brain injury and its consequences, adjustment to changes in their lives, environment, social roles and other medical conditions.
Recognising fatigue
The first step to start to help manage fatigue is recognising it. Some indicators may be yawning, losing concentration/attention, eyes feeling heavy or blurring, head feeling ‘fuzzy’, fidgeting/getting irritable, limbs getting heavy, and feeling sick to your stomach. It is possible with a brain injury you may not notice these signs due to sensory feedback to the brain problems. If this is the case you should ask family or friends what signs they notice.
Mood-related factors
Feelings of depression, stress and anxiousness can leave one feeling tired. It is also shown that high levels of fatigue can stop someone from doing what they want to, which makes one feel awful. Ways to help are, being realistic in planning/pacing activities, don’t dwell on things you haven’t achieved, instead celebrate what you have, schedule time to do activities that you enjoy and give you confidence. If you’re really struggling with your mood see a professional about medication, counselling or psychotherapy.
Pacing
Pacing is a great way to balance activities done throughout the week. It is a good strategy to help spread out tasks and reduce fatigue. It’s a good idea to have regular rest breaks, plan time and be organised, prioritise energy and know what the triggers are and work with the resources given. It is better to have a lot of little breaks than one big break when fatigue hits. Relaxation can help improve energy levels. Power naps are helpful if you sleep no longer than 30 minutes and this nap is taken before 4pm.
Sleep hygiene
Regular sleep routine is important it helps the body prepare for going to sleep by winding down and feel more alert when waking up. It is a good idea to set a routine, use your bed for sleeping only, developing sleep rituals before going to bed, get exposure to the outdoors and bright lights during the day, do not to eat heavy meals late at night or consume caffeine or nicotine.
Exercise
Exercising has been proven to improve our capacity to undertake physical activities. Current government guidelines suggest 30 minutes of intense exercise five times a week improve our physical fitness. Choosing something you enjoy will help you more likely to stick with it. Exercising can even help you sleep more deeply, if it is not done within 3 hours of going to bed.
Nutrition and hydration
Types of food can affect our mood; some can make us feel tired while other types of food can help us maintain our energy for longer. If you eat the right types of food at the right times based on what activities you’re doing, eating can be an important factor in managing fatigue. Sugary sweets and white bread can lead to high blood sugar levels. High blood sugar levels can result in fatigue, slow releasing foods like whole wheat, fruit and vegetables can slow down the release of sugar helping maintain energy levels. Water help keeps the brain and body hydrated, which is important.
Medication
There is little research to show the effectiveness of medication for managing fatigue after a brain injury, but it can be helpful with some of the other conditions of fatigue. Medication like anti-depressants can help low moods, but it can make you drowsy or more tired in the day.
Environment modification
It is best to fix the environment you live and work in so you can use the best of your abilities. Be organised and avoid distraction.
Cognitive (thinking) strategies
When fatigue hits cognitive difficulties from your brain injury may be more present. When this happens it is good to use checklists to help you stay on track, schedule time with diary, use alarm to prompt you to stay on task and take breaks, doing only one thing at a time, using flow charts for planning, and using post –it notes for reminders.
Contact
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