The following tips can help you start learning more about your fatigue and how to manage it. Not every tip may work for you, and you may find solutions we haven’t listed here. If you have specific questions about fatigue, make sure to talk to your doctor.
Ask for help
If you feel fatigued and need help with an activity, ask your parent(s), caregiver, family member, or health care worker for support. It may feel hard to do this, but by asking for help when you need it, you make sure you’re taking care of yourself so you can try the activity again next time.
Cognitive behaviour therapy (CBT) and occupational therapy (OT)
One of the leading causes of fatigue is the extra mental and physical effort involved in completing tasks. Cognitive behaviour therapy and occupational therapy can be effective tools to help. For mental fatigue, cognitive behaviour therapy can be helpful in building endurance, 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 can take less and less energy for you to complete them, which can eventually lead to fewer instances of fatigue.
Remember: the positive effects of rehabilitation happen over time and recovery is long-term. You’re not going to see changes overnight, but that doesn’t mean it’s not helpful!
Share how your fatigue is impacting you
Your parents/guardians, siblings, teachers and/or friends may not understand how deeply fatigue can impact your daily life. They may make assumptions about how you’re feeling because of how you look. It’s okay to tell them you struggle with fatigue. Openness and honesty will help educate others on the experience of living with a brain injury and on the kind of support you need.
Create schedules to manage your day and your fatigue
As much as you may want to go with the flow, that can be tiring. You only have so much time and energy and you want to make sure it will get you through the day. This means you will have to practice pacing yourself, which means taking a bit more time to complete tasks and spreading out demanding ones throughout the day or week. Creating a schedule and planning out your appointments, tasks, and downtime will help you with that.
Make sure to do the following things when scheduling:
- 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.
If scheduling is new to you, ask your parent or guardian for help.
Have you ever heard of spoon theory? It’s something people with disabilities use to show how their energy is used throughout the day. Paul lives with a brain injury, and created a great video on spoon theory that may help you understand your own energy levels and explain it to other people.
Exercise and physical activity
Physical activity is important for overall health—not only can it help your body, but it helps your mind as well. After a brain injury, it may become a lower priority, particularly if you aren’t feeling like yourself. Physical activity should be undertaken on doctor recommendations, reintroduced slowly, and under supervision. Over time you will build up your skills and endurance, meaning you can do more without feeling as tired.
Have plans in place for unexpected fatigue
Even the best-laid plans with lots of rest built in can be affected if you get unexpectedly tired. When that happens, it’s important to have a plan in place in case you become fatigued at school, in a public place, or hanging out with friends.
The best way to plan for unexpected fatigue is to tell the people you are with that you’re fatigued and how they can help you. You should also have an emergency contact that you can call if you need to go home.
If you’re worried about fatigue catching you off guard, try the following tips:
- Keep a journal to track your episodes of fatigue and what may have brought them on.
- 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
If you are feeling stressed, you’re using a lot more of your mental, emotional, and even physical capacity. Think about how you feel when you get stressed. For a lot of people, their mind races, they have negative thoughts, and they may struggle to engage in physical tasks. Stress alone can make you feel fatigued and brain injury can make the fatigue come on faster and more intensely.
When you identify what causes you stress, you can either remove those stressors or start dealing with them on a gradual basis. The more stress you can eliminate or reduce, the less fatigue you will feel related to it.
Stress is different for everyone, and it’s best to talk to a professional about the best stress-management strategies for your situation. There are a few things you can start with to help manage stress [1]:
- Figure out why you’re stressed. It could be school, life changes, travelling, or other activities of daily living (ADLs). Ask yourself: how do I feel about school right now? How do I feel about driving to rehabilitation? Write down your honest answers to questions like these.
- Don’t avoid decisions. One of the main causes of stress is avoiding problems or decisions, which makes them bigger and more challenging the longer they go unsolved.
- Ask for help. Parents/guardians, caregivers, and mental health supports are available to help you cope with stress.
- Do one thing at a time. Breaking down tasks into smaller chunks can help reduce stress and make it easier to complete tasks.
- Give yourself a break. Build free time into your schedule so that you know for a period of time each day, there’s nothing you have to do but just exist.
Manage your expectations
A brain injury is a major life change. 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. Instead, break your goals up into smaller steps so you can work towards them at a pace that makes sense for you.
Track your fatigue
Your fatigue is specific to you and could be caused by unexpected things. Identifying the causes of fatigue by keeping a journal can help you manage fatigue, inform your rehabilitation team about how it impacts you, and give you a guide on how to support yourself through school, activities, and social interactions.
For example
When you ride the bus to school, it takes a bumpy road full of turns. You find that you tense your body up so you don’t get bumped around. By the time you get to school, your body feels fatigued. Write that down, and talk to your parents about alternative ways to get to school.
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
Much like pain, fatigue is subjective. This means that it’s specific to you and how you experience it. It’s hard to explain fatigue to someone else. One way to help navigate that challenge is creating a rating chart.
Make a scale from 1-10 and measure your fatigue on that scale. For example, a 1 is not fatigued at all while a 10 is incredibly fatigued.
You should rate your fatigue levels before and after you complete an activity. For example, you can rate it before and after doing homework. If you find that it takes you from a 1 to a 5 on your fatigue scale, then you know you need to take more breaks or ask for help.
This rating system can not only help you identify what makes you feel fatigued, but also when to take breaks and improvements you make over time [2].
Understand what environments work for you
Some environments will make you more tired. For example, a crowded space with a lot of visual stimulation and noise might make you more tired than an environment with just one or two people with little to no noise and softer lighting.
You will figure out which environments work for you over time. When you know what environments work for you, make sure to let people in your life know.
Keep in mind
While it’s important to have a comfort zone, it’s also important to try reintroducing more complex environments gradually as part of your rehabilitation. Health care professionals on your team can talk to you more about this.
Use assistive technology and tools
Assistive technology and tools help individuals with acquired brain injury manage their symptoms and complete activities of daily living [3]. There are ways to use assistive devices to cope with fatigue. For example:
- Wheelchairs/walkers during walking rehabilitation
- Checklists to help manage tasks and minimize stress
- Sturdy, cushioned shoes to help with standing
Your health care team can help you find tools that may work for you.