The downward spiral of fatigue

It’s wild – it starts with the best of intentions. It’s exciting… very exciting to life my life, to go-go-go, to do lots of things and get tons of stuff done.

But if I don’t watch myself, I can get into trouble pretty quickly. If/when I get over-tired (and at the rate I tend to to, it’s usually a question of when I’ll get over-tired, versus if that will happen), a downward spiral starts in, that just won’t quit, till I start to rattle and shake like the USS Enterprise being pushed through an asteroid field at full speed. (And I hear Scotty yelling, “Cap’n, she’s breakin’ up! I can’t give ‘er anymore!“) I question my sanity, my ability to cope, my ability to live, and I’m exhibiting symptoms that someone who doesn’t know better would interpret as mental illness.

It’s not mental illness, per se. It’s my brain acting strangely under abnormally taxing conditions.

Here’s how things steadily go downhill…

The Downward Spiral of Agitation and Fatigue

And before I know it, I’m in trouble. I’m angry, I’m emotionally volatile, I’m raging, I’m blowing up at people, I’m melting down into a pile of quivering agitation, I’m irrational, I’m over-reactive, I’m hyper-active, I’m everything I know I should not be, but I am powerless to prevent it.

Also, I am in pain. Not just the muscular/skeletal pain that comes from over-exertion, but the surface pain that comes from fatigue, that makes everything hurt, from my clothing to human touch. It’s awful, and there’s nothing to do to stop it, when it’s full-on.  Advil doesn’t help. Only sleep does — days and days of extra sleep.

The thing is (the pain aside), a lot of the behavioral problems that come up are a result of how I perceive myself in relation to the rest of the world. Yes, I’m emotionally volatile. Yes, I’m losing it when I should be keeing cool, but it’s not so much that I am in trouble over things I’m doing — the real trouble happens and I get bent out of shape, when I misinterpret what I’m doing. I assume that because I’m having problems keeping things straight in my head and I’ve gotten turned around, that I’m screwing up (yet again) and I’m a mess, I’m broken, I’m damaged, I’ll never amount to anything, yada-yada-yada-yada-yada-yada-yada-yada-yada… an unbelievable amount of agitation results, which feeds back into the insomnia/fatigue loop. And that just makes my behavioral issues worse.

I’ve been seeing this more and more, lately, as my sleeping habits have deteriorated. They truly have. It’s been very fun and exciting to do things late into the night (as in, after 10 p.m.), but it’s cost me dearly, in terms of peace of mind, not to mention being able to deal effectively with increasing demands and challenges.

Stop the madness!


So, I have re-prioritized rest. I’ve bumped it up to the top of the heap. And I’ve made some small but important adjustments in how I do my work, so I have a better handle on things.

Objectively speaking, I’ve actually been dealing with some of the challenges and demands quite well — but because I’m so tired, I can’t really accurately assess how well I’m doing. So, when I feel like I’m having trouble, I assume I’m not doing well at all… and my successes are nearly lost on me. Unless someone can talk me through them. Like my spouse or my neuropsych.

Speaking of my neuropsych, I had a really great meeting with them  last night (thank heavens), on the spur of the moment. I was in town, they were in town, they had an opening in their schedule, and I had a sudden cancellation on mine. So, we managed to meet for a few hours. And after checking in with them about some recent experiences that had thrown me for a loop, I realized that I had actually done extremely well under very demanding and challenging circumstances. The biggest hurdle in all of it, was me being so tired that I couldn’t think clearly about what had really happened that was good.

I was so tired, nothing seemed good. But it actually was. So, my neuropsych talked me back from the brink of despair. And then I went home and  got to bed at a decent hour — 9:30 p.m., thank you very much! — and I woke on my own after 8 solid hours.

Wonder of wonders.

And suddenly, the world looked a lot better. The “mental illness” subsided, my mood disorder cleared up, my crappy attitude and biting self-criticism subsided, and I was able to get on with my life. Like a normal person.

And I’m back on track with watching myself more closely than I had been, taking my issues one at a time through the course of each day, and addressing the real underlying problems when they come up, so I can get on with my life, despite them. I’ve refined my daily log for what I have planned and what I really do. I’ve become quite diligent about keeping notes on my daily activities, and now I’m furthering that even more with a better kind of journal that helps me a lot.  Tracking my activities and the results is one sure way to see how I’m doing, from day to day. My brain will tell me any number of things about how I’m doing — many of which may in fact be untrue. But if I’ve got my notes, I can see for myself how I’m doing.


Author: brokenbrilliant

I am a long-term multiple (mild) Traumatic Brain Injury (mTBI or TBI) survivor who experienced assaults, falls, car accidents, sports-related injuries in the 1960s, '70s, '80s, and '90s. My last mild TBI was in 2004, but it was definitely the worst of the lot. I never received medical treatment for my injuries, some of which were sports injuries (and you have to get back in the game!), but I have been living very successfully with cognitive/behavioral (social, emotional, functional) symptoms and complications since I was a young kid. I’ve done it so well, in fact, that virtually nobody knows that I sustained those injuries… and the folks who do know, haven’t fully realized just how it’s impacted my life. It has impacted my life, however. In serious and debilitating ways. I’m coming out from behind the shields I’ve put up, in hopes of successfully addressing my own (invisible) challenges and helping others to see that sustaining a TBI is not the end of the world, and they can, in fact, live happy, fulfilled, productive lives in spite of it all.

8 thoughts on “The downward spiral of fatigue”

  1. I like how you isolate the role the mind plays in the ‘mess’ – the chatter about messing up, being tired, not getting enough sleep, what a screw-up we are – I do that also. I’ve been having insomnia issues, and I know my brain’s agitated comments about how I’ll never cope make things a lot worse than they need to be. You are incredibly methodical BB, and I hope to try some of these things. I’m worried about coping at work, starting a new job when I’m not getting enough sleep, so maybe I’ll try tracking my activities also.


  2. Hey,

    Well, that about describes the past week. In my case it was brought on by illness, then pushing myself too hard to finish a few things when I should have let go. I didn’t blow up at anyone, but I got pretty irritable. I get to the point where I can’t stand to listen to people – sometimes I feel like if I have to take in another word, I’ll blow up like the dude in Monty Python’s ‘Meaning of Life’ (“just a little mint, monseuir”). It’s intense and the worse it gets, the the worse the insomnia gets and even after it gets better I feel pretty ragged and unsettled after the fact.

    Funny thing is, in the middle of it all, I usually forget that I’ve gone through this a hundred times before, that it always follows the same pattern, and if I just stop, and tell myself to stop for a couple of days and accept that this is what I need, it will all go away. But that’s hard to do. I remember a post by m, some months ago, where he said a lot of people with brain injuries are type-A people, they like to be active, get things done, etc. I like to work and push myself – I hear you about staying up past ten pm – but it always leads to the same place, and when I get into that place all kinds of other anxieties about being unemployable etc come back. So it really is like a vicious cycle . . .

    I have to remind myself that there’s nothing wrong with taking days off, not necessarily doing anything productive but relaxing and doing the things I like to do. I’ve harped on this before, but yoga helps as well, stretching out tense muscles, and clearing out some of the white noise in the mind. Helps, but does not cure . . .

    Anyway, hope you get some rest . . .



  3. Hey Ellen –

    Thanks for writing. Being methodical is the one way I have to counteract the sabotage my brain tends to flirt with. If I just take things step by step, I can not only figure out where I want to go, but how to get there — and see where I’m falling short.

    I highly recommend tracking your activities, especially at work. I’ve got a new version of a form I have myself fill out on a daily basis. I’ll post it to this blog so others can use it.

    Good luck



  4. Ah, rest… I did get some the other night, largely because I had pissed off everyone in my household, and they refused to tolerate me after 9 p.m. 😉 Oh, well, you work with what you have, I suppose.

    Dealing with being sick is the WORST — you have to deal with external AND internal challenges. When I get sick, my judgment is usually the first casualty.


  5. BB,

    You’ve mentioned a few times using Excel spreadsheets to track your day, activities, etc, and how helpful it was. I’m curious as to how this is done – did you get this off Take Back Orlando?




  6. Hey Cos –

    I got the initial idea of identifying my issues from – they have a checklist of common issues post-TBI at

    I found their list to be helpful, but not quite as helpful as it could be, so I created my own version of it and I tracked my issues on a daily basis for a number of months. I did this just to become more aware of my issues and see how often and how intensely they affected me.

    Then I came across the Give Back material, and I read about their head injury moments analysis and their daily planner, and I thought it would be good to do that. So, I tried doing it for a little while, with varying degrees of success. But again, I found it not as helpful as I wanted — plus, the lines on their daily planer pages were too close together, and I didn’t have enough room to write.

    Plus, I didn’t want to get into locking myself into certain types of analysis and explanations of what I was up against. I really wanted to improve my daily effectiveness AND track my issues in greater detail, putting the main emphasis on my daily effectiveness, while allowing for analysis after the fact.

    So, that’s where the idea(s) came from and evolved.

    I’ll post shortly about how I track my daily activities and improve my life in the process.



Talk about this - No email is required

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.