Patient Resources : Common Questions

Why am I so Tired?

The topic of fatigue is important to every brain aneurysm survivor. Fatigue is a commonly experienced symptom after an aneurysm and problems with fatigue may persist for a long time after the event. Many survivors say that fatigue has a significant impact on their everyday lives.

After an aneurysm, many people report that their energy is diminished after relatively little activity or effort. It is natural to want to return to previous activity levels as quickly as possible and many survivors become disturbed when fatigue gets in the way. Their frustration is often rooted in the belief that inactivity equals “laziness” or poor effort. Survivors who are less active and productive because of fatigue may become self-critical and discouraged.

You should keep in mind that fatigue is a necessary part of the recovery process. Fatigue should be considered a positive sign of progress, rather than a negative sign that indicates poor effort, or ongoing disease process, or a “plateau” in the rehabilitation process.

What are some of the possible reasons that you experience fatigue? After a brain aneurysm, brain function is disrupted by damage to complex networks of brain cells (neurons). These networks must be repaired for improvement in function to take place, an internal process that occurs over time. The healing process takes energy that the brain did not have to expend before there was damage to the neural network. The brain works at recovering function 24 hours a day and in many different ways, including the reorganization of functions, the re-growth of damaged brain cells, and the cleaning up of debris. Without your knowledge, the brain diverts some of its energy to the process of healing, a process that significantly subtracts from available energy levels.

A second possible reason for your fatigue is that many activities that once were effortless now take longer to accomplish and require more effort. Your pre-aneurysm brain was a fully refined neural network that could go on “automatic pilot” to do many things. After the aneurysm, those automatic tasks, once done quickly and efficiently, require more effort and time.

Researchers continue to explore other causes of fatigue. Some studies suggest that neuroendocrine function related to the pituitary gland is in part responsible for fatigue after some types of aneurysm. There are many medical reasons for fatigue. Different types of medications, sleep disturbances, depression and other psychological disturbances may all be the source of lethargy and fatigue.

It is important to emphasize that fatigue cannot be overcome by an act of willpower, or by making an extra effort. The human body knows when it needs rest and that rest is a restorative process. On the other hand, it is possible to rest more than necessary, with resultant loss of physical strength. Talk to your doctor about developing an exercise and rest plan that suits your individual needs. A physical therapist or occupational therapist can assign exercises designed to build stamina, offer ways to conserve energy and alsoprovide suggestions for functioning more efficiently. A psychologist can assist persons who are depressed, highly self-critical or experiencing problems adjusting to fatigue and other symptoms associated with the aneurysm. A physiatrist (a physician specializing in rehabilitation medicine) or general medical doctor can also help diagnose any medical condition which may contribute to high levels of fatigue.

Above all, remember that fatigue is not a sign of laziness, a lack of progress, nor a sign of personal weakness. It is the natural course that your body requires to restore itself. There is no reason to feel embarrassed or ashamed of your symptoms of fatigue.

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