Before getting in the core of the blog topic, let’s explore what neurofatigue, or cognitive fatigue, is.
Cognitive fatigue is often described by brain injury survivors as being worse than physical fatigue. It is as if joining the dots becomes extremely exhausting and making sense of what is in front of you becomes the hardest thing to process. It can present in various ways and if you’d like to read more about this, I’d like to invite you to read my blog “Neurofatigue After Brain Injury”.
How does cognitive fatigue impair our functioning?
Cognitive fatigue can impair the way a person functions. Some might find themselves being more forgetful, some may find that they are struggling to process information, have a slower reaction time, some might find that they are struggling to pay attention or concentrate, it can make some less tolerant (emotional lability), it can affect speech, perception, lead to muscle weakness, feeling overwhelmed and lead to a complex flow on effect where your mind and body start operating less efficiently.
Cognitive fatigue or neurofatigue is invisible, but its effects can be far reaching for a person recovering from a brain injury in the context of their day to day activities. In the next sections of this blog, I’ll describe how neurofatigue can affect specific types of relationships.
Neurofatigue’s impact on social relationships
My experience of how neurofatigue has affected my personal relationships is quite varied. For the most part, I’ve had to adjust the way in which I’ve been spending time with people. For example, smaller groups were less taxing and allowed me to better follow conversations. I’ve had to pay close attention to the environment where catch ups would occur, i.e. minimising sensory stimuli. Also, in the early days of recovery, I couldn’t drive so it meant that I was relying on others to get places.
Aphasia could make communicating with others quite difficult too. I felt like I was always a few steps behind, I couldn’t find the right words and gathering and putting my thoughts across required so much effort. My entourage had to be patient. I've found that not everyone allowed me the extra time I needed to be part of a conversation. My memory also wasn’t as sharp as before the brain injury. I often couldn’t recall if I had had a conversation or I wouldn’t remember things that had been shared with me which could have been perceived as a lack of interest from others. Other times, I had to decline invitations all together. All of which I’ve I found to be very isolating.
I had gone from being a social butterfly to a hermit crab and didn’t quite know how to process all this. I felt lost.
Neurofatigue’s impact on work relationships
Cognitive fatigue may also affect work relationship. For example, you may require more time to complete a task, you may wish to break tasks in smaller steps, you may find meetings to be very draining, you may misinterpret a task you need to complete or mis-communicate with other colleagues. Although the effects of neurofatigue are often out of our control, interactions and some tasks may require to be handled differently for a while. Some colleagues may have to take on additional tasks, your employers may implement a gradual return to work plan, you may need to check your understanding of the task ahead or double check your work to pick up mistakes that may have crept in due to neurofatigue. All of which have somewhat of an effect on your interactions with colleagues and employer. It may also be that you don’t find yourself in a position to resume your work. This can have for effect to minimise your social circle further, affect your financial situation and take away your sense of purpose as we often describe who we are by talking about what we do for a job.
Neurofatigue’s impact on the family unit
Brain injury affects the survivor deeply, but it also affects its close family network. For example, due to neurofatigue, I had to allow for regular rest periods which could be limiting when making decisions around the type of family activities that we would undertake. Due to emotional lability, I was less tolerant and patient which had a flow on effect on the family dynamic. I had to learn to recognise the early signs of emotional lability and we had to put measures in place to avoid outbursts. It often meant seeing my partner take on extra responsibilities and tasks. My partner also had to take time off to accompany me to the numerous medical appointments, which put additional pressure on his own work commitments. The kids also had to help more around the house and take on a range of small tasks that would relieve cognitive and physical demand. They had to show resilience. Although we tried our best to keep « life as usual » when it came to our family unit, my personal situation had an effect on them. At times, it also translated in them missing out on social opportunities.
What I wish people had known about cognitive fatigue
I often remember thinking..."if only people could walk one day in my shoes to get an appreciation for how much things have changed and how lonely it can be." My personal experience is that neurofatigue has often led to social isolation. It’s added a level of complexity when managing relationships and I had to learn to let go and prioritise to avoid sinking deeper into anger, sadness and depression. I had to find ways to move forward…while managing my brain battery and filling my social cup. Connecting with others plays an important role in anyone’s life and this wasn't any different for me after brain injury. Although it comes with additional challenges, I believe socialising can truly support brain injury recovery.