Good Days, Bad Days – Managing cognitive fatigue for a recovering brain

• Guest blog by Jie Chang

Everyone experiences cognitive fatigue from time to time (if you ever procrastinated to study for a test, you probably felt it!), but it can be especially noticeable following a brain-related injury such as a concussion or a stroke.  

Cognitive fatigue may present as “brain fog”, sluggish thinking, concentration difficulties, or simply finding it hard to persist on a task for long periods of time. While it is common for the brain to feel tired more quickly as it is recovering from a head injury, it can be frustrating when feeling mentally fatigued disrupts plans and limits one’s everyday activities.

The level of cognitive fatigue fluctuates and people often describe having “good days” and “bad days”. “Good days” typically start off brightly with a good burst of mental energy. When there is a “good day”, the intuitive thing is to try to do as much as possible – after all, this is the time to make up for all the missed work on a bad day!

However, for a recovering brain, trying to do more on a good day is precisely what can lead to more “bad days” in the future. Now that the brain is freshly recovering, it can be easy to “bust” the brain’s tolerance, just like lifting two bags of heavy groceries will not be helpful for a mending wrist! For the brain, doing too much can lead to cognitive exhaustion, resulting in one or more “bad days” following the exertion, as the brain takes time to recover from the fatigue.

So what should one do on a good day as the brain is recovering? The trick is to “pace” – do a manageable level of activities per day that does not excessively tire the brain, whether physically or mentally. There may initially be a trial-and-error process to pinpoint the best level of activity for the brain, so start with doing only one or two cognitively challenging tasks each day and work up to doing more with time. Refrain from doing more than the typical level of activities when it is a “good day”. Conversely, on “bad days”, try to still engage in some light tasks while putting time towards rest and relaxation. This will allow the brain to rest as needed and but also generate a sense of accomplishment for completing some tasks. While navigating “good days” and “bad days” can certainly be somewhat confusing and frustrating, know that both important parts of the brain’s recovery journey!

Helpful video about how to pace your activities: https://www.youtube.com/watch?v=vcVcW787DQk