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  • Dr Clara O'Brien

Let's talk about....fatigue.



Let's talk about Fatigue. It's one of the most common symptoms of brain injury or concussion, multiple schlerosis and many other neurological conditions, and yet is the most poorly understood. It's not the same as feeling tired or sleepy, very difficult to explain to other people and yet something that limits what you are able to do. The first trick when trying to understand fatigue is to identify what type of fatigue you have. Is it physical fatigue, where you feel wiped out after a walk or if you have been on your feet for a while? Or perhaps it is cognitive fatigue, caused by having to concentrate, look at a screen or read, or even after a conversation with someone? Or alternatively you could be experiencing emotional fatigue, caused by ongoing stress, low mood and anxiety? Many people experience more than one type of fatigue.


So, once you have identified what kind of fatigue you are experiencing, what can you do about it? You should probably start by keeping a fatigue diary for a week or so to see whether there is a pattern to your fatigue. Are there certain events or activities that are more of a trigger? Is there a time of day that is worse? Once you have done this, then you can apply the 'three P's' of fatigue management:

  • Plan

  • Prioritise

  • Pace

Plan ahead so that you are not doing too much in one day, and allowing yourself time to pace. Prioritise your workload. What must you do today? Get this done first and put off anything that can be done tomorrow, or by someone else. Finally pace yourself well. I meet a lot of people have got into a 'boom or bust' routine, where they feel better one morning so they do as much as possible, and are then wiped out for several days. This might seem sensible, but is counter-productive and in the long term you will end up achieving less. To 'flatten the curve' you need to pace effectively, even when you think you have more energy. You can think of it in terms of a cricket match - your fast bowler would not bowl for the whole match! They would bowl a few overs and then they would rest to ensure that they are at their best when they are next called upon to bowl. You should employ the same approach - periods of activity followed by periods of rest, or a change in activity. For example, if you are prone to cognitive fatigue, work in short sprints and take a break in between where you have a break from the screen/ cognitive activity, and move around or get some fresh air. You then repeat this until you have finished the task.

This approach, also summarised in this leaflet from Headway may help, but if you are continuing to struggle, then talk to a medical professional about getting some further help.

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