The Overwhelming Complexity of Modern Life: A Reflection on Brain Injury and Fatigue

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a man sitting with his head in his hands

‘The fatigue is not only real, it is absolutely legitimate’: why are so many of us so tired right now? | Australian lifestyle | The Guardian 

I saw this article today and it resonated with me; the feeling of so many things to deal with, too many complex issues that I just can't fix, not enough time, not enough emotional and cognitive bandwidth. I feel tired and weary and wonder whether its just me, is this part of getting older?

Or is this feeling of exhaustion and weariness a response to modern life and our rapidly evolving digital landscape?

The Parallels with Brain Injury

I think back to the people I met through public engagement and involvement in research, those living with brain injury. I particularly recall one young women talking about the sense that time is moving faster for her than other people. She is going as fast as she can and everyone wonders why she is so slow. 

Mental Slowness

After a brain injury, survivors often experience slower information processing which means they struggle to keep up with conversations, it takes them longer to make sense of information around them. The more complex the information, or the more distractions there are, the worse it becomes. Winkens et al ( 2006) describe mental slowness as "an unpleasant feeling that there isn't enough time to think and act properly" during a task. In their interviews with 13 stroke survivors, they found that people struggled to make decisions or learn new skills. They were exhausted by everyday tasks such as making a phone call.

The Information Processing Bottleneck

I remember going to a "starting out in stroke" course for occupational therapists a few years ago and the lead therapist described how our ability to process information was affected by the speed at which information is delivered, the amount of information (capacity and then the complexity of the information. She likened it to pouring water into a bottle - the bottle neck restricts how information is processed. Slow processing narrows the bottle neck ( if we keep going with this analogy) so reducing the amount of information to be processed at any one time and reducing the complexity of information helps to compensate for the bottle neck. In Winkens study, participants reported using coping strategies such as reducing distractions, planning ahead and doing one thing at a time. Yet we are living in an age where doing one thing at a time is a luxury.

Chronic Fatigue and Its Perpetuating Factors

Going back to the Guardian article - I was also reminded of a study by Chen et al (2018) where they investigated factors that possibly perpetuate chronic fatigue after stroke. Perhaps unsurprisingly, they found that being female, having other health conditions (such as arthritis) and feeling depressed were associated with long term fatigue. They suggest that medication used to treat underlying health conditions may exacerbate fatigue. They don't consider the added burden of managing multiple health conditions, nor did they explore socioeconomic factors and the impact on not being able to work or go back to work full time. 

 I also look back on my career working with people with stroke and brain injury 25 years ago and fatigue was something that was rarely mentioned. The received wisdom is that people just didn't talk about it. But I wonder whether the rapid digitalisation of our society is making things so much harder for all of us, but particularly for those living with brain injury and fatigue? Consider this along side the economic hardship faced by many, the challenges of engaging with health, social care and welfare services. Is it any wonder that so many people who have brain injury also struggle with long term fatigue?

Conclusion

The complexity of modern life, coupled with the digital revolution, creates a perfect storm of cognitive and emotional demands. For those with brain injuries, these challenges are magnified, potentially contributing to long-term fatigue. As we navigate this increasingly complex world, it's crucial to recognize and address these issues, not just for those with brain injuries, but for society as a whole.

Written with just a little help from Perplexity AI.

References

Chen K, Marsh EB. Chronic post-stroke fatigue: It may no longer be about the stroke itself. Clin Neurol Neurosurg. 2018 Nov;174:192-197. doi: 10.1016/j.clineuro.2018.09.027. Epub 2018 Sep 17. PMID: 30266010.

Winkens I, Van Heugten CM, Fasotti L, Duits AA, Wade DT. Manifestations of mental slowness in the daily life of patients with stroke: A qualitative study. Clin Rehabil. 2006 Sep;20(9):827-34. doi: 10.1177/0269215506070813. PMID: 17005506.

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