There are some actions you can take to help manage your fatigue.
Ask for help
Fatigue can make it difficult to complete daily tasks, travel, or go to appointments. A caregiver, family member or personal support worker can assist with tasks that may leave you fatigued, and work with you as you build up your endurance.
Cognitive behaviour therapy (CBT) and occupational therapy (OT)
One of the leading causes of fatigue is the extra mental and physical efforts it takes a person with a brain injury to complete tasks.
Cognitive behaviour therapy is designed to help survivors coping with mental and cognitive changes. For fatigue stemming from cognitive changes, cognitive behaviour therapy can be helpful in building endurance and understanding what’s causing fatigue and how to manage it.
Occupational therapy is available to help people living with brain injury relearn skills or find new ways to complete activities of daily living (ADLs). When you practice these skills consistently, it will take less and less energy for you to complete them – this leads to less instances of fatigue.
Remember: the effects of rehabilitation happen over time and recovery is based on several factors. You won’t notice significant changes right away but that doesn’t mean the rehabilitation isn’t helping you. It’s like tracking fitness goals: you notice changes and improvements week to week, not day to day.
These therapies are available both privately and publicly. Private therapy is paid for by you. Publicly funded therapy is available at no additional cost: however, availability of public therapy is limited and differs from province to province based on the services available. Your doctor will be able to provide you with more accurate local information or recommendations.
Depending on your private or work insurance plan, occupational therapy and cognitive behaviour therapy may be partially or fully covered under psychotherapy services. It is always best to check directly with your insurance provider about your coverage.
Communicate your experience with fatigue
Your loved ones and friends may not understand how deeply fatigue can impact your daily life. They may see you at a family gathering or event and make comments like “glad to see you are feeling better” or “great to see you back to normal”. They don’t know that you have had to sleep leading up to the event and will have to sleep for hours after it, just so you could have the energy to attend.
It’s okay to tell them you struggle with fatigue and you are always recovering. Openness and honesty will help educate others on the experience of living with a brain injury.
Create schedules to manage your day and your fatigue
Set out a schedule and plan your activities, appointments, and tasks for each day. You only have so much time and energy, and you want to make sure it will get you through the day. Chances are your energy levels before your injury were a lot different than your energy levels now. This means you will have to practice pacing – taking a bit more time and spreading out your schedule.
When building your schedule, try to do it the night before or in the morning after you wake up. When making a schedule, make sure to do the following things:
- Build in rest periods. One of the best ways to manage fatigue is to give yourself time to rest. Listen to your body and don’t “push through” if you’re feeling fatigued. If you know you need multiple rest periods a day, schedule them before you schedule anything else. Having a schedule with time set aside to rest will help ensure you take the time you need.
- Schedule activities when you have the most energy. Depending on when you experience fatigue, there will be periods of time during the day that make the most sense to schedule activities. For example, many individuals have the most energy after they wake up in the morning and much less energy in the evenings. By scheduling activities and appointments during the times you have the most energy, you will minimize the risk that fatigue will interfere.
Exercise and physical activity
This should be undertaken on doctor recommendations. Exercise and physical activity have all-over health benefits but should be reintroduced slowly and under supervision. Overtime you will build up your skills and endurance, meaning you can do more and feel less fatigued.
Have plans in place for unexpected fatigue
Fatigue can be debilitating and leave a person unable to complete tasks. It can also occur unexpectedly, especially immediately following your injury. For example, you could become fatigued in a public place, at a social event, or at work.
When this happens, having coping strategies can help manage the situation. This could include having hand signals with your caregivers or having an emergency contact come get you. If you’re worried about fatigue catching you off guard, try the following aids:
- Keep a journal to track when you commonly feel fatigued
- Speak with your rehabilitation therapists about strategies for coping with fatigue and public outings
- Share your feelings with caregivers or employers – they can help you come up with a plan
Manage stress
Elevated stress levels can increase fatigue, particularly for individuals with brain injury who have cognitive and problem-solving challenges. When you identify what causes you stress, you can either remove those stressors or start dealing with them on a gradual basis. Giving yourself this time to process and respond to stressors will help manage feelings of fatigue.
Manage your expectations
A brain injury is a major life change, and that means abilities have changed. It’s important during recovery to manage your expectations and focus on what you can do. Don’t always compare where you are today with where you were before the injury. That will lead to negative feelings and fatigue because you’re trying to push yourself too hard. Instead, focus on setting weekly or monthly goals and prioritizing your health and well-being.
Track your fatigue
What causes fatigue for you may not cause fatigue in someone else. It is dependent on the person, their injury, and the environment. While it can be difficult to identify triggers, it’s important that you and your caregivers learn what makes you feel fatigued: if you don’t, you may experience extended periods of fatigue or feel like you have no control over your energy levels.
It can be difficult to track your fatigue through the course of a day, especially if you’re experiencing memory issues. By keeping a journal of your activities and your feelings, you can more accurately identify periods of time where you feel fatigued.
Record all medications you’re taking
Some medications can have increased feelings of fatigue as a side effect. Keep a list of what medications you’re taking, when you’re taking them, and their side effects. This will help you identify when you may feel more tired.
Create a rating system
One way to check in with yourself and how fatigued you’re feeling is to create a rating system. Make a scale from 1-10 and measure your fatigue on that scale. For example, a 1 is not fatigued at all while a 7 or 8 is strong feelings of fatigue.
You should rate your fatigue levels before and after you complete an activity – for example, doing the dishes. If you find that doing the dishes takes you from a 1 to a 5 on your fatigue scale, perhaps take breaks or ask for help with dishes.
This rating system will not only help you identify what makes you feel fatigued; it will help you identify when to take breaks and improvements you make over time [1].
Understand what environments work for you
Some environments can increase a person’s fatigue. This includes places with loud noises, bright lights, overcrowding or that require a lot of travel. By understanding what environments cause fatigue and what environments work best for you, you can more easily participate in activities. Over time, you can reintroduce yourself to other environments for short periods of time. Wear sunglasses if it will help you deal with bright lights and ear plugs to deal with noise if it does not jeopardize your safety. Look for places that offer sensory-friendly settings – for example, some grocery stores have specific sensory-friendly shopping days.
Remember: take breaks as often as you need. You don’t have to stay out for a full day if you’re experiencing fatigue or other symptoms. It’s important to listen to your body.
Use assistive technology and tools
Assistive technology and tools help individuals with acquired brain injury manage their symptoms and complete activities of daily living [2]. There are ways to use assistive devices to cope with fatigue. For example:
- Wheelchairs during walking rehabilitation
- Checklists to help manage tasks and minimize stress
- A sleep journal to track sleep disturbances
Occupational therapists and cognitive behavioural therapists can assist in developing coping methods or introduce you to tools that manage fatigue.
If you need financial support to obtain assistive devices you can explore this assistive devices program. This program assists adults with physical disabilities who are in financial need to purchase assistive devices that increase their mobility and functional independence.
