Managing Cognitive Fatigue
Pain is generally considered the primary symptom of fibromyalgia, but I feel there is another one equal to, if not worse than, pain. That symptom is fatigue.
Now I know everyone has different levels of pain, fatigue, and all the other symptoms, so this may vary from person to person. But the thing about pain is that to a certain extent you can push through it and still get things done. There are pain medicines that can help get rid of, or at least curb, the amount of pain that we feel. There are topical ointments and lotions that help with pain. Heat and/or cold can help with pain.
But what helps fatigue?
A normal person (someone without fibromyalgia) would probably recommend taking a nap or getting some extra sleep at night, but I'm sure we all know that does not always help. Why is that? Put very simply, our brains do not work the way they should.
There are four stages of sleep. The first is when your eyes are closed, but you're easy to wake up. The second is a light sleep. The third is the deep sleep stage. It is during this stage that our body repairs itself and repairs the immune system, among other things. The fourth is the most important for a restful night's sleep, the REM stage. That is when our brain dreams.
People with fibromyalgia constantly have bursts of awake brain activity, preventing them from getting to these last two stages of sleep that are vital for a good and restful night's sleep. This is why, even if we sleep for a long period of time, we still wake up feeling tired and fatigued.
This problem not only causes the feeling of fatigue, it also affects our cognitive abilities, the ability to think and even learn. It is one of the factors in another common fibromyalgia symptom that of cognitive fatigue, often called brain fog or fibro fog.
Another factor of cognitive fatigue is that we frequently do not get enough oxygen in different parts of our brain. It feels like walking around in a fog. It is like you know there is something in the distance, but you just cannot quite make out what it is. That's what it feels like inside our head.
The Impacts of Cognitive Fatigue
This kind of fatigue or fog impedes our memory. It makes concentration very challenging. And it affects our capacity to process information.
Imagine you are a fairly well educated adult, with a large vocabulary. But suddenly, in the middle of a conversation, you can't remember the simplest of words. It seems as though a word that you use on a regular basis has been wiped from your memory.
You struggle to find another word that would work, but you can't think of any. You stand there with no clue how to proceed with your conversation because you no longer remember any words. Meanwhile the person you are talking to is staring at you, trying to figure out what in the world could be wrong with you.
Imagine you are in a grocery store. Suddenly you have no clue what you are there to buy. You wander from aisle to aisle, not able to recall anything you or your family eats. You end up buying a few things, knowing that you likely missed a lot and will have to come back in a day or two. You then realize, you have to drive yourself home. Everything looks far away and a little blurry, but you have to focus the best you can to get yourself home safely.
Imagine you are at work. You are in the middle of a task that you have done numerous times, but you just can't quite think what you need to do or how you need to do it. You start making mistakes. You try and force yourself to focus and complete your work but your brain feels completely blank. You feel like everything around you is going in slow motion.
Someone comes in and is talking to you, but they sound so far away. It takes a while before you can pull yourself out of the trance-like stupor that you are in so that you can listen to what they are saying. But even then the words they are using don't make sense to you. Not because they are saying anything odd, you just are unable to process what they are telling you.
For most of us with fibromyalgia, I'm sure these are not difficult scenarios to imagine. I'm sure that most, if not all, of us have been in a similar situation at some point. In fact, I feel it is probably safe to say that most of us find ourselves in these types of situations on a fairly regular basis.
The thing that makes cognitive fatigue so difficult is that, unlike pain, there is no pill you can take to remove the symptom. A heating pad doesn't help. Topical ointments and lotions don't work. So what can we do?