Fatigue and Brain Injury

The University of Washington TBI Model System and the University of Washington Medical Center
Fatigue and Brain Injury

What is fatigue?

“Fatigue” is an overwhelming lack of energy. Fatigue can be mental or physical tiredness. It can make it hard to do even basic activities in your life. You may also feel like you cannot think clearly. Fatigue may change the way you do things or limit the things you can do each day. Fatigue usually improves as a person heals from a brain injury, but often does not completely go away.

Why does a brain injury affect fatigue?

You may have fatigue because your brain is working harder than it did before your injury. You may also be recovering from related problems, which can also take energy to heal. Your brain is trying to heal itself and do its best to help you function. It needs more energy than usual.

Brain injury can also disrupt sleep. If you often felt tired before your injury, you are at a higher risk for having fatigue problems after your injury.

What happens when you have fatigue?

When you get fatigued, it may be because you have done more than your mind or body can manage. Sometimes fatigue happens for no obvious reason. When you are fatigued, you may feel exhausted without much warning, and you may not have the energy to do even a small task that you can usually do well.

What makes fatigue worse?

  • Doing too many things.
  • Not taking breaks during the day.
  • Stress or illness.
  • Chronic pain.
  • Too little exercise.
  • Poor nutrition, such as eating junk food.
  • Feeling depressed or anxious.
  • Poor sleep.

When should I ask for help with my fatigue?

Talk with your health care provider if:

  • You are too tired to get out of bed during the day.
  • Your fatigue is getting worse.
  • You have cut back on doing things you love to do.
  • You are not sleeping well at night.
  • Your fatigue seems to be related to your emotions or pain.
  • Your thinking is often affected by fatigue.
  • You are having trouble taking care of yourself or your family.

What can I do about fatigue?

Take care of yourself:

  • Exercise regularly.
  • Eat a well-balanced diet.
  • Avoid alcohol and too much caffeine, especially at night.
  • Get a full night’s sleep. Wake up at the same time every day.
  • Avoid napping if possible, or take one brief nap per day for less than an hour.
  • Take your medicines as prescribed.
  • Limit the amount of stress in your life.
  • Do relaxing activities during the day.
  • Make sure you do at least one enjoyable activity each day.

Save your energy:

  • Be realistic about how much you can do in a day.
  • Build your stamina slowly, and be patient with yourself.
  • Take small breaks throughout the day instead of trying to do as much as you can and then “crashing” for the rest of the day.
  • Alternate hard tasks with easy tasks.
  • Do not do tasks that do not need to be done.
  • Plan ahead and organize your work.
  • Sit during tasks (such as cooking), when possible.
  • Use lightweight or electric utensils and tools. Let gravity help you do the work.
  • When possible, ask friends or family to help you do things that use the most energy.

Set priorities:

  • Prioritize things you want to do in the day, so you have the energy for the most important things.
  • Do activities that make you tired at the times of day when you have the most energy. Many people find the morning is the best time to do big tasks.

Pace yourself:

Do a little bit at a time. Break down tasks and do each part separately, with rest periods in between. For example, instead of vacuuming the whole house at one time, take a break between vacuuming each room.

Where can I learn more about fatigue?

Ask a professional:

  • Your doctor or health care provider.
  • Your psychologist.
  • An occupational therapist, physical therapist, or a speech and language pathologist. They can give you ideas on ways to pace yourself and save your energy.

Check out these resources

Brain Injury Association of America
8201 Greensboro Drive, Suite 611, McLean, VA 22102
Brain Injury Information Hotline: 800-444-6443

Brain Injury Association of Washington
3516 S. 47th Street, Suite 100, Tacoma, WA 98409
Helpline: 800-523-5438
E-mail: info@biawa.org

Multiple Sclerosis Association of America
706 Haddonfield Road, Cherry Hill, NJ 08002

National Brain Tumor Foundation
22 Battery Street, Suite 612, San Francisco, CA 94111
Patient Line: 800-934-2873
E-mail: nbtf@braintumor.org

National Multiple Sclerosis Society
Greater Washington Chapter
192 Nickerson St., Suite 100
Seattle, WA 98109
E-mail: greaterWAinfo@nmsswas.org

National Stroke Association
9707 E. Easter Lane, Englewood, CO 80112
800-STROKES (800-787-6537)

Alzheimer’s Association
225 N. Michigan Ave., Fl. 17, Chicago, IL 60601
Helpline: 800-272-3900

National Parkinson Foundation
1501 N.W. 9th Avenue, Miami, FL 33136-1494

Posted on BrainLine June 19, 2009.

From the University of Washington TBI Model System and the University of Washington Medical Center. Used with permission. http://uwmedicine.washington.edu.

Comments (8)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

the doctors here in Sweden did not do anything like this for me, i got no explanations on what I was and am still going through.

Chicago Illinois. I have had 3 open brain surgeries to treat aneurysms as well as a 13 stair headfirst dive 2 weeks post op w significant bleeding...after 3 years, I fell upon a research paper about mental fatigue...while reading it I felt such a validation of everything I have felt or not felt...god- what I need now is support to find the right place to diagnose and treat me...

Thank you for raising the topic of alertness, energy, and stamina.  Defining what energy is can take time:  glucose, Krebs Citric Acid Cycle, alerting agents/stimulants like coffee, caffeine, Ritalin, Dexedrine, Provigil, etc., paying attention vs inattention, attentiveness vs foggy, blank, etc., and so forth.  Consequences of brain concussions, sports concussions, repeated sports concussions, etc.

I had a TBI in 2007, and the area most effected was my pre-fontal cortex. Organization is HUGE. I just graduated from Portland State University, and w/out organization that wouldn't have even been feasible. 

You may have been lucky enough to not have as severe long term injuries to certain areas of the brain that others had and were able to function at a level that allowed you to study, complete your education but each TBI case is as individual as a snow flake is.
I don’t know of any two individuals that can say their symptoms are exactly

I completely agree. Most days you wonder how you got anything done. No such thing as organized.

I did have a severe TBI to my frontal lobes....I totally concur with that last comment.....organize??? Are you kidding me?
Are you kidding me?? Did they actually suggest that someone with a severe TBI organize their work....really? Maybe they should learn about what happens when someone has brain damage to their frontal lobes.