Neuro-Fatigue: What it is and What You Can do About it

Neuro-Fatigue: What it is and What You Can do About it


This week, in my continued quest to honour National Brain Injury Awareness month, I’d like to discuss a topic of great concern to many brain injury survivors - mental fatigue or “neuro-fatigue”. 

As fatigue, both mental and physical is a common complaint of people with a brain injury, I’d also like to offer some tips to help you manage it.

So, if you or a loved one suffers low energy from a weakened brain and can relate to the following symptoms, please read on. This blog post is for you!

  • Afternoon energy slumps

  • Lack of mental clarity or fuzzy thoughts (brain fog)

  • Fatigue and muscle weakness

  • Sudden reduction in grip strength

  • Sleep that isn’t refreshing

  • Extreme exhaustion after physical or mental exertion

  • General malaise

Neuro-Fatige vs. Physical Fatigue

We all have an understanding of what it means to have physical fatigue. Being tired after exercise, after a brisk walk, after strenuous physical activity, or after housework is to be expected.

Mental fatigue is different. It comes from thinking, learning, processing information, watching a lot of TV, spending time in front of a computer, interpreting the behaviour of others, and thinking logically.

A healthy person can also experience mental fatigue - if they perform any of these activities intensely and long enough. Healthy people can also come to a point that they become annoyed when their "energy" is low. This is compounded and can become even more frustrating if the mental activity in which they have been engaged was coupled with noise, and their brain became overstimulated, over used, and over tired.

This is neuro-fatigue. For brain injury victims these feelings are many times worse. And not only are they amplified, but they occur even after small bouts of stimulation or activity. 

Their mental energy gets used up quickly and they become exhausted after a short period of time. They use more parts of the brain in completing any task, because the injured area of the brain must be by-passed as brain cells try to communicate with each other. This requires extra energy and longer distances for neuronal messages to travel. Reaction times become slower or are delayed, which in and of itself requires more energy. If their brain is processing information slower, then it takes more energy to do things. Tasks that require a lot of thinking and concentration will drain their brain’s energy faster. And every brain signal between brain cells require electricity to be formed, which takes energy, too. 

All this can make someone really tired.

The resulting neuro-fatigue can be debilitating, as it influences everything the injured person does, both physically and mentally. A person’s emotions can also become raw when they are tired.

Initially, the brain injury survivor is likely to discover that he will tire easily during or after any activity like chatting to friends or watching TV, but especially after tasks that require concentration or physical effort. 

They will often try to push themselves to complete a task thinking they may be able to overcome their fatigue. Unfortunately, this is not the right thing to do, as it can lead to increased fatigue in the long-term. It takes time to build up energy, so taking rest periods between activities and when feeling tired is essential.

They may also feel as though they need a lot more rest periods and sleep than they used to, and that it’s harder to think, process, and organize information. Neuro-fatigue makes these processes even harder.

Additionally, they may feel as though their energy fluctuates from day to day or even from hour to hour. Thinking is a fragile function for a brain injury survivor, and pushing themselves too hard usually results in setbacks

What Causes Neuro-Fatigue?

The moment someone acquires a brain injury, certain things happen physiologically within that person’s body and brain.


The first is a loss of normal energy production from the mitochondria within the neurons in the brain. Second, these damaged mitochondria cause the oxygen they breathe to become toxic to the brain, which results in oxidative stress. And third, this oxidative stress promotes inflammation in the brain. 

It is this inflammation that can ultimately lead to various degenerative diseases and long-term effects if the inflammation persists. These 3 events underlie the development of fatigue, sleep disruption, depression, impulsivity, irritability, and cognitive decline.

Everything for a brain injury survivor takes effort. In fact, for most, the energy for the whole day is often consumed completely within the fist few hours of waking. Some brain injury survivors also suffer insomnia, while others have an increased need for sleep. Regardless, fatigue is a common complaint. 

If you are healthy, when you wake up in the morning, your battery is fully charged with energy. By afternoon, some energy has be used up on mental activities, but you still have a a lot of energy left. By evening, a substantial part of your energy has been used, and when you sleep at night, your battery has the opportunity to recharge itself so that you can have renewed energy the next day.

In a person with a brain injury, when they wake in the morning, their battery is only partially charged - as that is all it is capable of being. By afternoon, after a few mental activities, the battery is almost empty. In the evening, or sometimes even before that, the battery is completely drained. Then at night, their body tries to recharge itself, but they don’t have a very powerful battery to begin with, so it can’t fully recharge.

This is what living with a brain injury and neuro-fatigue is like.

The resulting lack of sleep has negative consequences on cognition, mood, energy levels, and even appetite. Unfortunately, suffering a brain injury can often lead to a sleep disorder - typically difficulty sleeping as well as frequently waking throughout the night. The American Academy of Neurology reports that as many as 40-65% of people with mild traumatic brain injury complain of insomnia.

A major cause of this inability to fall or stay asleep has to do with the release of certain neurotransmitters in the brain. Other causes can include being in chronic pain such as headache discomfort, neck pain or back pain. Depression, common after a brain injury, can also cause them to stay awake or wake up several hours before dawn, unable to fall asleep again. Anxiety and an inability to handle stress are other problems for many, as negative thoughts whir through their mind, making it very hard to fall asleep.

“Brain injury rehabilitation takes a very long time, and is usually measured in years.”
— Kelly

Managing Neuro-Fatigue

Fatigue management is a good place to start on the road to recovery for a brain injury survivor. In order to manage fatigue, a person first needs to accept that he or she does not have the same stamina he or she once did (before the injury).

He or she must also understand that fatigue decreases their ability to concentrate, affects memory, and reduces their ability to cope with social interactions. At the same time, fatigue increases irritability, distractibility, depression, and anxiety.

Because fatigue affects so many factors that are important to one’s rehabilitation, the success of their rehabilitation program depends largely on how well they learn to manage their fatigue.

One way to improve mitochondrial strength and regain some energy is by reducing ones toxic load. Environmental toxins are a leading cause of mitochondrial dysfunction. We are exposed to thousands of toxic chemicals and pollutants every day that make their way into our bodies and mitochondria, requiring a great deal of energy to get rid of. 

For brain injury survivors or those showing signs of age-related cognitive decline, start by reducing the amount of toxins you are exposed to. This includes toxins in the food you eat (pesticides, herbicides, and heavy metals), toxins in the personal hygiene products you use (creams, lotions, and makeup), and toxins in the air you breathe (car fumes, electromagnetic radiation, and aerosol sprays).

In addition, what follows are 12 tips and suggestions made by and for brain injury survivors to help them manage neuro-fatigue.

12 Tips to Managing Neuro-Fatigue

  1. Recognize that everything costs effort, everything takes energy, and everything consumes energy - so be selective in how you choose to spend that energy.

  2. Alternate exercise with relaxation on a regular basis.

  3. Don’t plan too much for one day.

  4. Plan days to rest, especially after a known energy-draining event is going to take place.

  5. Plan regular, frequent breaks.

  6. Avoid time pressure. Take your time, and take your rest.

  7. Avoid sensory overstimulation if you get overstimulated easily.

  8. Keep a regular daily and weekly routine and schedule.

  9. Adjust activities to create realistic expectations. Don’t compare what you used to be able to do with what you are capable of now.

  10. Do not try to do two things at once, like making coffee while having a conversation.

  11. Create your own place or space at home to pull back, to rest, and to escape when overstimulated.

  12. Ask others to help you discover your over-sensory signals - some one else may notice them before you.

In addition to managing fatigue, proper nutrition for the brain (or neuronutrition) following a brain injury is essential.

Providing the brain with specific nutrients that increase various neurotransmitters while removing non-nutritive inflammatory foods can go a long way in promoting neurological health.

Doing so can aid those who have sustained a brain injury or have early signs of age-related cognitive decline by reducing both inflammation in the brain and oxidative stress while restoring energy production to dysfunctional mitochondria. 

Neuronutrition can also be used if you want to take measures now to prevent cognitive decline associated with aging, or simply want to improve mental focus, cognition, and personal productivity.

Exactly which foods to eat and avoid for optimal brain health will be the main focus of next week’s blog post. Be sure to register for my newsletter so you don’t miss out on this very important information.

In the meantime, please let me know what you think. Email me, or add your comments below. I’d love to hear from you!

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