Posts Tagged mental fatigue
Mental fatigue or brain fatigue
Mental fatigue can be a disabling consequence of traumatic brain injury, stroke, infection or inflammation in the Central Nervous System (CNS). The condition is characterized by pronounced mental fatigue after moderate mental activity. Pronounced fatigue can appear very rapidly and, when it does, it is not possible for the affected person to continue the activity. Typical for this kind of fatigue is a profound, long recovery time to get one’s mental energy back. Attention cannot be maintained for more than short periods. Other common associated symptoms are: irritability, tearfulness, sound and light sensitivity as well as headaches.
Read more under About Mental Fatigue.
Measure mental fatigue with an app. Androids and Windows. Coming soon for iPhone.
Lars Rönnbäck, professor and senior physician in neurology
Birgitta Johansson, Ph.D., specialist in neuropsychology
Institute of neuroscience and physiology
Department of clinical neuroscience and rehabilitation
University of Gothenburg Sweden
Have you ever felt so tired that you wished you could hibernate? Or so out of energy that you wanted to plug into a wall outlet and recharge? Even if you haven’t, you’ve probably experienced the fatigue of a long day at work, a workout, or a poor night of sleep. This feeling is not only physical; emotional and mental fatigue can lead to irritability, difficulty concentrating, or in extreme cases, to locking ourselves in our room and watching reruns on television while our friends go out and enjoy themselves.
For people with chronic pain conditions, feelings of fatigue may be the norm rather than the exception. In fact, fatigue is one of the most common symptoms reported by patients with chronic pain, and increases as the intensity of the pain increases [1-2]. Chronic fatigue syndrome is highly comorbid with chronic pain conditions [3-4], and patients with fibromyalgia describe “fibro fog,” a set of symptoms characterized by difficulty with concentrating and performing other mental tasks .
Why does fatigue matter? It predicts low quality of life and poor functioning in a number of chronic pain populations [6-7], including cancer  and lower back pain . In our work, we found that fatigue predicts low satisfaction with life in patients with chronic orofacial pain (pain in the head and face), and partially explains why pain is associated with psychological distress [2,10]. Yet, despite the negative impact of fatigue on functioning, it is still largely treated as a single symptom. Our team wanted to take a more nuanced approach and test whether different subtypes of fatigue (general fatigue, mental fatigue, emotional fatigue, physical fatigue, and vigor), as well as total fatigue (as a single symptom), predicted pain-related interference with social and recreational activities. To do this, we examined medical and psychological data from over 2,000 patients seeking treatment for chronic orofacial pains at a university orofacial pain center. A full version of the report can be found here , but below I summarize the main results.
First, total fatigue (as a single symptom) significantly predicted pain interference, above and beyond pain intensity, depression, psychological distress, and poor sleep! This suggests fatigue is more than feeling tired or lacking energy and is likely influenced by a number of factors. In fact, there’s moderately strong evidence for a central governing mechanism that monitors an array of cognitive, emotional, and physiological inputs and produces feelings of fatigue to prevent catastrophic overexertion [12-13]. A pretty clever protective mechanism! How this central governor influences and is modulated by pain remains an exciting area for future research, and one with much clinical relevance.
A second interesting finding was that the fatigue subtypes did not overlap as much as might be expected (13 – 40% of shared variance). Most of the variance in any one type of fatigue was not accounted for by the other types, suggesting we can feel emotionally tired but physically energized, just as we can feel mentally tired but generally energized, for example. Think of a long airplane ride. After a few hours, you might feel eager to move but unable to concentrate. This nuanced condition of low physical fatigue but high mental fatigue is lost when we treat fatigue as a single symptom. Examples of being fatigued in one domain but not another abound, but pain research takes a less nuanced approach and treats all of fatigue as one and the same.
The reason this matters – and this is the third interesting finding- is that each of these fatigue subtypes predicts outcomes differently. In our study, physical fatigue and lack of vigor were the only two significant predictors of pain interference: general, emotional, and mental fatigue were not significantly associated. The more physically fatigued people felt, or the less energy they had, the more pain disrupted their social and recreational activities. This was the first study to look at how specific subtypes of fatigue predicted pain outcomes.
Clinically, these findings suggest that perhaps we should be looking at people’s fatigue profiles to target individualized treatment. If someone reports high mental fatigue, then simplifying medication regiments (and implementing physical aids that promote medication adherence such as alarm clocks and reminders) may be particularly important. If, on the other hand, someone else has particularly high physical fatigue, then a cognitive behavioral intervention aimed at reducing physical fatigue and improving exercise might be most helpful. And if a third person is particularly high on emotional fatigue, they might benefit most from learning emotion regulation strategies and interpersonal communication skills. Although these ideas sound good in theory, more work is needed on targeted interventions to fatigue subtypes to test if they would indeed promote successful outcomes in pain patients.
About Ian Boggero
Ian Boggero is a clinical psychology graduate student at the University of Kentucky, but is originally from Los Angeles and did his undergraduate studies at UCLA. His research interests involve the psychological and social factors that promote adaptive responses to pain. Clinically, he has worked with orofacial pain, chronic lower back pain, phantom limb pain, and fibromyalgia populations, among others. Aside from pain, Ian enjoys hiking, cooking, playing soccer and chess, but most of all, spending time with his wonderful wife (who also shares his clinical and research interest in management). For more information, please see https://psychology.as.uky.edu/users/iabo222
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-  Boggero IA, Rojas MV, Carlson CR, de Leeuw R. Satisfaction with life in orofacial pain disorders: Associations and theoretical implications. J Oral Facial Pain Headache 2016; 30(2): 99-106. doi: 10.11607/ofph.1526.
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-  Sturgeon JA, Darnall BD, Kao MCJ, Mackey SC. Physical and psychological correlates of fatigue and physical function: a collaborative health outcomes information registry (CHOIR) study. J Pain 2015:16:291-298. doi: 10.1016/j.jpain.2014.12.004
-  de Leeuw R, Studts JL, Carlson CR. Fatigue and fatigue-related symptoms in an orofacial pain population. Oral Surg Oral Med O 2005; 99:168-174. doi: 10.1016/j.tripleo.2004.03.001
-  Servaes P, Verhagen C, Bleijenberg G. Fatigue in cancer patients during and after treatment: prevalence, correlates and interventions.Europe J Cancer 2002;38(1): 27-43. doi: 10.1016/S0959-8049(01)00332-X
-  Feuerstein M, Carter RL, Papciak AS. A prospective analysis of stress and fatigue in recurrent low back pain. Pain 1987; 3:333-344. doi: 10.1016/0304-3959(87)90162
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-  Boggero, I. A., Rojas Ramirez, M. V., & Carlson, C. R. (2017). All fatigue is not created equal: The association of fatigue and its subtypes on pain interference in orofacial pain. The Clinical Journal of Pain, 33(3), 231-237. doi: 10.1097/AJP.0000000000000391
-  Evans DR, Boggero IA, Segerstrom SC. Explaining self-regulatory fatigue and ‘ego depletion’: Lessons from physical fatigue. Personality Soc Psych Rev 2016; 20(4): 291-310. doi: 10.1177/1088868315597841
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Everything takes effort. The energy for the whole day is often consumed completely within two hours. There are many brain injury victims who have insomnia ón top of this all. Another group of brain injury survivors have an increased need for sleep. But the similarity is FATIGUE.
Mental fatigue is different from physical fatigue. We can all get an idea when talking about physical fatigue. Being tired after an exercise, after a brisk walk, after strenuous physical labor, after housework and so on.
Mental fatigue comes in thinking processes, learning and information processing, watching television extensively, doing computer actvities, but also solving problems, interpreting the behavior of other people and thinking logically.
A healthy person can also be mentally tired of all such functions if it is intense and long enough. Healthy people can also come to a point that they become annoyed when the “energy” is low, and especially if that mental activity was filled with noise. It seems like you cannot endure radio or TV, or something like that, anymore.
For brain injury victims that is many times worse. The mental energy has already been exhausted after a short time. They use more parts of the brain, because the dead area must be passed by, in the communication between braincells.
Neuro-fatigue is one of the most debilitating consequences of a brain injury, as it influences everything the injured person does, both physically and mentally. A person’s emotions can also become raw when they are tired.
At the beginning, the ABI survivor is likely to find out that he or she will be tired easily after any activity, even chatting to friends or watching television, but particularly after tasks that require concentration or physical effort. This can be very depressing, particularly if the individual is aware of this change.
They will often try to push themselves to complete a task in the belief that they might overcome their fatigue. This is seldom the right thing to do as it can lead to increased fatigue in long-term. It takes time to build up energy. Taking rest periods both in between activities and when feeling tired is essential.
More brain activity in brain injury patients
Research Reports – Mental fatigue after traumatic brain injury
NeuroRehabilitation. 2015 Apr 16
Johansson B(1), Rönnbäck L(1)
BACKGROUND: Mental fatigue is one of the most significant post-traumatic brain
injury symptoms. It is currently not possible to objectively identify.
OBJECTIVE: This study investigated whether a complex computer cognitive test with
load on endurance, processing speed and attention were more demanding for
participants suffering from mental fatigue after brain injury compared with a
METHOD: Seventy-six subjects of mild traumatic brain injury (mTBI) and 45 healthy
controls were included in the study. All subjects with mTBI had been suffering
from mental fatigue for six months or more. Mental fatigue was screened using the
Mental Fatigue Scale (MFS). Cognitive function was measured for information
processing speed and working memory, and with a novel computer test.
RESULTS: The mTBI group rated MFS significantly higher than the control group.
The results revealed a significantly slower information processing speed for the
mTBI subjects and a poorer performance on the working memory test. The computer
test revealed a less efficient performance over time for the TBI subjects
compared to the control group.
CONCLUSIONS: The results indicate a less efficient performance over time in
complex and demanding cognitive tasks for individuals experiencing from mental
fatigue after brain injury.
OBJECTIVES: Fatigue after an acquired brain injury is common, and is characterized by limited energy reserves to accomplish ordinary daily activities. A typical characteristic of mental fatigue is that the mental exhaustion becomes pronounced during sensory stimulation or when cognitive tasks are performed for extended periods without breaks. There is a drain of mental energy upon mental activity in situations in which there is an invasion of the senses with an overload of impressions, and in noisy and hectic environments. Another typical feature is a disproportionally long recovery time needed to restore the mental energy levels after being mentally exhausted. The mental fatigue is also dependent on the total activity level as well as the nature of the demands of daily activities. For many people, there is an increased risk of doing too much and becoming even more fatigued.
METHODS: We have developed an application for Windows Phone for assessment of mental fatigue. The Mental Fatigue Scale is used. The MFS is a multidimensional questionnaire containing 15 questions. The questions included in the MFS are based on symptoms described following longitudinal studies of patients with TBI, brain tumours, infections or inflammations in the nervous system, vascular brain diseases, and other brain disorders. The app also includes information about mental fatigue.
RESULTS: This application can help people determine the level of mental fatigue and it can also serve to provide an overall picture of the severity of the condition, and detect changes in mental fatigue over time. The scores will be added up and the results will be presented in the form of a rating scale and a diagram. People can then see their results for one week ago, one month ago or a whole year ago. Today, the most important recommendations are to adapt to the energy available by doing one thing at a time, resting regularly and not overdoing things. However, this is challenging for most people and it may take a long time, even years, to adapt to a sustainable level. It may also be difficult for the person to learn by himself/herself and it can take several years of considerable struggle, frustration, despair and depression, to find the right balance between rest and activity. This app can help people to be aware of mental fatigue. If they connect the results to daily activities, the app may also help them to be more aware about what may alleviate and what may make mental fatigue worse.
CONCLUSIONS: With regular assessment of mental fatigue, this app may give feedback and support in order to achieve an enduring balance between activities and rest.
The application can be downloaded without cost: http://www.windowsphone.com/en-us/store/app/mental-fatigue/87d4cb88-c9b5-4ac9-9a92-b63a5d8f4d82