Episode 21: Facing Fatigue with Jenn Freeburn, Cognitive Therapist
What is one symptom all brain injury survivors have in common? No, the answer we’re looking for is not our overwhelming awesomeness--although that’s also true! It’s FATIGUE. There are several different types of fatigue and many ways to manage it. Join Jenn Freeburn, MS, CCC-SLP as she schools us on the hows and whys of cognitive fatigue. She’ll help us strategize our way through the fog, no loud fog horn necessary.
Covered in this episode:
Types of fatigue
Physical fatigue- the body being tired and needing rest
Psychological fatigue- lack of motivation, trouble starting anything
Cognitive fatigue (mental fatigue)- brain fog, not being able to attend or focus
Theories for brain fatigue
The brain is trying to heal and has less energy for other things. Tasks feel more taxing
The brain is less efficient after injury possibly due to:
the healing process or
additional attentional resources are being put towards other aspects of life and those resources drain energy leading to fatigue
After a brain injury, the brain is more sensitive to things in life that cause tiredness. You used to be able to push through and now your brain can’t
Your brain is healing! And that can make you feel tired
Managing fatigue: it's not just about today; there is a cumulative effect. If you drain your daily “battery” and dip into your reserve battery, it will take more than a good night’s sleep to recover from the cognitive fatigue. When you are running low, you have to be gentle with yourself and not schedule a lot when you are drained
Examples of cognitive demands:
Sensory heavy environments: crowds, bright lights, stores, noisy, socializing
Prolonged attentional tasks: reading especially nonfiction, anything that requires a lot of processing, taking in a lot of information. Tasks where you need to focus in and wouldn’t do with someone watching TV in the background.
Mixing physical, cognitive, and psychological demands
Laundry: has lots of steps mixing physical movement with cognitive aspects
Times when your attention is pulled multiple directions: example parties and conversations
Multi-step processes:
Cooking: lots of steps and movement
What’s one to do?
Understand yourself
What triggers fatigue for you?
Plan your day around those:
know what is going to cause fatigue and be nice to yourself after so you can rest
Do the hardest tasks during the time of day you are feeling your best
Don’t schedule hard/high stakes things during your times of higher fatigue
Structure your day around your fatigue patterns with breaks interspersed throughout the day
What does fatigue look like for you?
Brain fog
Not being able to pay attention
Irritability, everything is annoying or frustrating.
Self-judgment i.e. negative self talk
Making errors
Emotionality
Try not to ignore your triggers
What are your early indicators that fatigue is setting in? It’s important to understand these so you can slow down and not hit the wall
Check in with yourself to see where you are rather than pushing through
Fighting to complete tasks isn’t beneficial for your brain
How do I figure out my patterns?
Keep a simple journal/log of what you do throughout the day and when
Rate how fatiguing each thing was on a scale of 1-5
Look for patterns
Build your day around your patterns
Increase routine
Especially important when you are recovering at home and don’t have much of a schedule or structure to the day
Establish some regularity, especially around sleep
What is restful?
What restores you? I.e. what recharges the battery; how can we make deposits to our energy bank? (rather than constantly drawing from it)
Breaks are something that provides cognitive rest and is pleasurable
What actually restores your energy? Mindless scrolling is not cognitively restful
Identify what gives you back mental energy
Physical movement or “active rest” is activity for your body and rest for your brain
stretching, taking a walk, going outside,
Activities with low cognitive engagement are most restorative--something gentle you can follow along with (not an intensive class with lots of directions)
“Rather than focusing on the negative, ‘what am I doing that is exhausting me? I’m clearly doing too much every day’. Try to focus on how you can do more of these things that give you something back. This is a nice way to flip the script and offer yourself gentleness. This puts the focus on adding something relaxing and pleasurable rather than taking away something that feels productive” (32:40)
Need to set good expectations. Don’t set the bar too high. Need to have a gradual return to activity. You don’t go out and run a marathon without training first
When setting expectations, find someone to talk to that understands brain injury
Other examples of restful activities:
Music
Art
Meditation
Restful activities are highly individualized. What gives back to you and makes you feel good?
Be on the lookout for patterns
Boom or bust: going too far into the overdoing it camp which will lead to needing a lot of rest to restore
Would I benefit more from just taking a break?
Find balance
Is there a way to schedule your day so that you aren’t hitting the wall but having a reasonable amount of fatigue that you can recover from?
Building a strong brain. Brain health activities:
Sleep
Healthy eating: know what works for your body. A colorful plate. Less sugar. Moderation.
Staying hydrated
Is this more than brain fog:
depression (not wanting to do anything)
vitamin deficiencies, low B12
There may be other reasons beyond cognitive fatigue that are causing your symptoms. Talk to your healthcare provider
What are you asking your brain to do?
You may need to say no to things
It’s not that you can’t do something. But it is for how long and at what cost.
You might have to reprioritize to be able to do what is important
Your self-expectations may need to change. Would you have the same expectations of a friend with a brain injury as you would on yourself?
Recovery requires you to take care of yourself and prioritize yourself at the top
If you are struggling with extended fatigue after your injury, bring it up with your neurologist, speech therapist, mental health professional, occupational therapist
Find a knowledgeable thought partner to use as an outlet to discuss your fatigue with, to build strategies with, and to have accountability
You are not alone
Fatigue is very common
You are not weak or doing something wrong if you are feeling fatigued. It might mean you need to shift how you are doing things--you don’t need to do it alone; there’s lots of help out there
How to find help:
Brain Injury Association in your state
Ask your medical team
Be your own self-advocate
Use hospital connections or academic medical institutions
Questions for Jenn:
Shoot us an email at hello@makingheadwaypodcast.com
Find your local Brain Injury Association at: https://www.biausa.org/
HELP US SPREAD THE WORD!
If you dug this episode head on over to Apple Podcasts and kindly leave us a rating, a review and subscribe!
Ways to subscribe to the Making Headway Podcast:
Follow us on Instagram, Twitter, or Facebook.
As an Amazon Associate, Making Headway may earn from qualifying purchases via links provided.