Fatigue after a brain injury – what is it and tips to help manage it

Pathological fatigue is one of the most common consequences of a brain injury.  Its effects can be life changing for brain injury survivors and those close to them.  Despite being one of the most commonly experienced effects of a brain injury, fatigue can be the most difficult to manage and is often misunderstood.

What is the difference between ‘normal’ fatigue and pathological fatigue?

Most people will suffer from ‘normal’ fatigue at some point in their lives – it is our bodies’ way of telling us to take a break and is generally remedied quickly and easily, by rest.  This is different to the ‘pathological’ fatigue experienced by people who have suffered a brain injury.  Pathological fatigue can be present almost constantly and may not improve even after rest.

Why does fatigue occur after a brain injury?

The Ascending Reticular Activating System (ARAS) is the brain system responsible for regulating wakefulness and the transition between being asleep and awake.  It also maintains alertness and is instrumental in relaying information.  The ARAS links the brainstem with thalamus (which passes sensory information and regulates sleep), hypothalamus (which controls the pituitary gland) and cerebral cortex (responsible for the higher functions of the nervous system).

It is the ARAS which appears to be linked to pathological fatigue, however, relatively little is known about the underlying causes of fatigue following a brain injury.  It is possible it is linked direct damage to the brain, but it may also be due to the extra effort needed to carry out activities such as speaking, moving or thinking post-brain injury.

Symptoms of fatigue

Fatigue is experienced differently by each person, but symptoms include a feeling of exhaustion or overwhelming tiredness; weakness and a lack of energy; little motivation; difficulty concentrating and thinking clearly; struggling to make decisions and difficulty controlling emotions.

Common signs that fatigue is building up include yawning, losing concentration, blurred eyesight, a fuzzy head, heavy limbs or nausea.  However, due to problems with sensory feedback in the brain following a brain injury, it can be very difficult for a brain injury survivor to notice these signs and take action.

Effects of fatigue

Unsurprisingly, pathological 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.

For some sufferers, fatigue may exacerbate their other brain injury symptoms such as irritability or forgetfulness.  As a result, fatigue can negatively affect a person’s relationships, social life, work and finances, not to mention their self-esteem and sense of independence.

Some symptoms of fatigue, such as slurred speech and lower information processing mean that sufferers are often unfairly judged, and with these symptoms in mind, it is easy to see how suffering from pathological fatigue can be an incredibly isolating experience.  Often, survivors don’t receive adequate practical and emotional support.  A lack of awareness can mean even those closest to a brain injury survivor don’t fully understand the impact of brain-injury related fatigue – a common side effect of a brain injury being a hidden injury.

How to manage fatigue

For some survivors of brain injury, the symptoms of fatigue will decrease overtime.  For others however, strategies are needed in order for the sufferer to adjust to life with fatigue.

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.

Fatigue can exacerbate forgetfulness, so strategies such as writing lists and using a diary can help combat this, while setting alarms to remind you to rest at regular intervals throughout the day is a great way to stop fatigue becoming overwhelming.

NHS guidelines suggest that sticking to a healthy, balanced diet can improve symptoms of sluggishness and improve overall health, while a regular night-time sleep routine can help, as can avoiding caffeine, alcohol or nicotine before bed.

Moderate, relaxing exercise can be very beneficial, as can getting plenty of natural sunlight, so yoga, Tai Chi or even thirty minutes walking in the park can make a difference.

Most importantly, remember to be kind to yourself by celebrating daily accomplishments and not worrying about things you haven’t managed to do that day.  Focus on one task at a time and do not suffer in silence: if you are struggling, say so!  Sharing your experience will raise awareness of the condition and surrounding yourself with an understanding support network is key.

Further help and advice

If you are suffering from fatigue after a brain injury and would like further advice or support, you can contact Headway, the Brain Injury Association www.headway.org.uk who are passionate about raising awareness of fatigue.  To discuss fatigue or any other symptoms of brain injury call 0808 800 2244 or email helpline@headway.org.uk.

How can a legal claim help?

Bringing a claim for personal injury or clinical negligence can seem incredibly daunting, particularly if you are struggling with the symptoms of fatigue.  At Bolt Burdon Kemp we understand the impact a brain injury can have on someone’s life, so we work had to provide support and care throughout every step of the claim’s process.

We are able to recommend care workers to provide day to day support and assistance, while interim payments can provide financial security and peace of mind if your employment has been affected by your injury.  Our friendly team of solicitors are always available to talk, so for guidance or advice call 020 3603 3818.