We wish we had known about neurofatigue in the beginning.
Fatigue with brain injury is real, including physical, mental, and neurofatigue. In fact, it is universal with brain injury, meaning everyone will experience fatigue.
Everyone understands how it feels to be physically tired. A day of moving furniture will leave you physically exhausted. We can relate to this. Studying late into the night for a big test will leave you mentally tired. It will be harder to mentally retain the information read at the end of a long study session. We can relate to this. Emotions might also play a part. Even a healthy person will be more emotional when they are physically or mentally fatigued. However, when I talk about the neurofatigue I experience with brain injury, people always seem to think they understand… they often say things regarding their age, forgetfulness, brain fog, or try to commiserate as if it happens to them, too. No, it probably doesn’t happen to them, too.
Harder to explain, neurofatigue is extreme, debilitating mental fatigue.
With slight or massive damage in our brains, our brains need to reconnect the once built pathways connecting the neurons within our brains. This process is called neuroplasticity and takes place with all sensory input.
So, for example, it used to be normal to sit in a restaurant, listen to background music, converse with friends, watch the children play, and smell the wonderful food all at the same time. Now, the brain needs organize each of these sensory inputs. You cannot listen to both the conversation and the music, which one should you focus on? Are you able decide what to eat while someone is talking to you? Can you hear the music over the noise of the plates being cleared from a neighboring table? Truthfully, in the beginning things as insignificant as the noise from a fluorescent light bulb could grab all my attention and send me over the edge! As the brain prioritizes activities, it reconnects these neurons around the damaged area. This process takes energy, often more than we have. As our energy is depleted, these tasks become even more difficult.
When working on projects, I often set a timer to accomplish a task within the hour. There have been times when I was literally still staring at a blank screen with NO RESULTS when the timer rang! I knew it was not productive to continue sitting there and it was time to switch activities or take a nap. My brain simply shuts down. When my physical and mental energies are depleted, neurofatigue will surely be at its worst. I try to get my writing done in the morning and save “brainless” chores like washing dishes for the afternoon when neurofatigue will be high. Most people can relate to brain fog or forgetfulness, but this is so much more. Neurofatigue is debilitating, an invisible disability.
So,what can we do about neurofatigue?
- Plan for it.
- Do memory required tasks in the morning.
- If allowed, exercise regularly. This will help stimulate oxygen rich blood flow to the brain and promote healing.
- Eat healthy foods that support brain function and healing. See our post on brain healthy foods and our brain healthy recipes.
- Build up stamina gradually. Working one hour may be all you can take in the beginning, build up the number of hours over time.
- Take frequent breaks from mental activities.
- Plan naps to rejuvenate.
- Learn to recognize the signals that energy is low – tense look, glazed eyes, irritability, headaches, dizziness, tension in back or shoulders, and feeling hopeless/emotional are all examples of signals to watch for.
Probably most importantly, I encourage caregivers to recognize this as a serious change and to encourage rest when you see these “symptoms”. Your survivor may not realize how much this will affect their daily activities. They may try to “push through” the way they used to work and for many reasons this is not wise.
Fatigue is something we all deal with to some degree. Luckily, neurofatigue does lessen with time as our brain heals. But, it is often the reason survivors feel unable to return to work. The fatigue is unpredictable. You may have 40 good hours in a week. But, those good hours probably won’t occur during the scheduled work hours! We wish we had known about neurofatigue in the beginning.