Follow us: hu Improving life after brain injury Need to talk? 0808 800 2244 Donate Home About brain injury Individuals Effects of brain injury Fatigue Fatigue after brain injury Fatigue is experienced by everyone at some point after a period of physical or mental activity and is a signal from our bodies telling us to take a break. ‘Normal’ fatigue is time-limited and alleviated by rest, whereas ‘pathological’ fatigue, such as that experienced following brain injury, may be present most of the time. It may not improve with rest and is likely to significantly impact on people being able to do the activities they want to do. This page provides an overview of fatigue, a common effect of brain injury: What is fatigue? Causes of fatigue after brain injury Signs of fatigue after brain injury Triggers of fatigue Ways to manage fatigue Find out more in our booklet Managing fatigue after brain injury (PDF), or by exploring the links at the bottom of the page. What is pathological fatigue? Fatigue is a personal experience that is different for everyone. For some it may feel like overwhelming tiredness, which makes them unable to complete normal activities of daily living. People may say they feel exhausted, lacking in energy, weak, unable to motivate themselves, or sleepy. For others it may worsen difficulties associated with their injury, for example, forgetfulness, irritability, slurred speech, distractibility or dizziness. Fatigue often makes resuming previous roles and daily activities more difficult and can contribute to people becoming socially isolated. Therefore, fatigue may affect: what we think (for example, “I shouldn’t feel like this, I’m useless”) how we feel (for example, frustrated, unable to cope, irritable) what we do (for example, avoiding activities, or increasing effort) What causes fatigue after brain injury? Fatigue may be a result of direct damage to brain structures or due to other factors such as needing to make more effort to think or move. The brain system that appears to be linked to fatigue is the part that maintains alertness. This is known as the ascending reticular activating system (ARAS), and it links the brainstem with the thalamus, hypothalamus and cerebral cortex. The ARAS affects alertness by influencing the amount of information that the thalamus relays to conscious awareness. Many people experience fatigue following brain injury, but the underlying causes are still poorly understood. Research studies have shown that there are many different factors that make people vulnerable to experiencing fatigue and can affect how they respond to it. Some of the factors involved include: 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 other medical conditions Some of these factors may be managed more effectively to enable you to cope better with everyday activities that are important to you. What are the signs of fatigue after brain injury? In order to cope with fatigue you must first be able to recognise it. So how do you know when you are getting fatigued or fatigue is starting to build up? Some signs may include: yawning losing concentration/attention eyes feeling heavy, or eyesight blurring head feeling ‘fuzzy’ fidgeting/getting irritable limbs feeling heavy stomach feeling sick However, following brain injury it can be difficult to notice these signs. This may be due to problems with sensory feedback to the brain. What signs do you have that tell you that you are starting to get fatigued? How does it feel, what do you think and how do you behave? It may be helpful to ask your family and friends what signs they notice. What triggers fatigue after brain injury? Things that trigger fatigue will be different for everyone. Some examples of activities reported to be more tiring following a brain injury include: working at a computer dealing with paperwork/correspondence being in a busy environment such as a shopping centre concentrating on one conversation in a noisy place like a pub driving or catching public transport It may take time to work out what your triggers are, so fatigue might feel difficult to control. However, it is likely that certain activities are more tiring for you; what are these? People around you may be able to help you to identify what these are. You might want to consider monitoring your fatigue by rating how tired you feel before and after different activities, perhaps on a scale of 1-10. This may give you an idea of which activities you find more or less fatiguing. It is important to recognise those activities or situations that are more tiring so that you can plan for them in your daily routine. Once you are aware of which activities are more or less tiring, then you can prioritise and set yourself realistic targets of what is achievable in a day. How do I manage fatigue after brain injury? For some people fatigue improves over time. However, for many people fatigue is a condition that they have to learn to manage in the long term. There is no single cure for fatigue following brain injury, although recent research has found that cognitive behavioural therapy can help with managing fatigue by increasing a person's understanding of their experience of fatigue, triggers and ability to respond. Managing fatigue requires a variety of strategies to address the factors that are contributing to it. Some of these strategies may seem like common sense and some you may already be applying. Taking the time to consistently put some of these principles into practice will hopefully allow you to cope better with everyday activities and feel more in control of your life. Explore the links below and download our booklet Managing fatigue after brain injury (PDF). My story Lottie Butler "Despite it being difficult to come to terms with my brain injury and its effects initially, I'm now eager to get my fatigue under control and start learning how to live with a brain injury." Read story Drained by fatigue? Try these 8 ways to cope after brain injury Find out more Brain Drain: Wake up to fatigue! Through our Brain Drain campaign, we aim to give a voice to those affected, helping to raise awareness and break the stigma of brain injury-related fatigue. Find out more Hormonal imbalances Brain injury may occasionally cause damage to the hypothalamus and/or pituitary gland, which can lead to a range of symptoms caused by hormonal imbalances. Find out more Top tips for a good night's sleep Sleep and rest are effective ways to reduce the symptoms of fatigue, one of the most common effects of a brain injury. However, for many brain injury survivors, a good night’s sleep isn’t always easil... Find out more Related resources Managing fatigue after brain injury Sleep problems after brain injury Brain injury and me Stories of life after brain injury Supporting you Find out how Headway can help Headway in your area Find support near you Friends of Headway Individual membership Join/Renew Contact Us t: 0115 924 0800 e: enquiries@headway.org.uk Help us improve life after brain injury. Donate Improving life after brain injury 0808 800 2244 Call our free helpline 9am - 5pm, Monday to Friday. 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