Returning to a New Job After a Brain Injury: Living With Fatigue

My CV tells one story. My life tells another.

On paper, my CV looks strong. I have over thirty years’ experience in healthcare: managing teams, shaping strategy, developing propositions, and managing providers.

But there is something the CV doesn’t show.

Three years ago, at 51, with a job I loved and a teenage daughter I adored, I had a brain haemorrhage. I required seven months off work. When I returned, it was painfully slow and carefully paced, following the advice of my specialist team. Two years later, I was made redundant.

Three months after that, I applied for a contracting role and told no one about my brain injury.

Why? Because I believed I carried a stigma. I feared employers would see risk rather than capability. I believed—rightly or wrongly—that many people hold preconceived ideas about brain injury, largely because it is poorly understood.

Recovery from a brain injury is not a straight line. It is long, invisible, and different for everyone. And at the centre of it all—for me—was fatigue.

Not “tiredness.”
Not something solved by an early night.

But a deep, relentless, cognitive fatigue that drains energy before the day has even begun.

Over time, I adapted. I relearned how to function in a world that assumes endless capacity. From the outside, I look fine. Inside, everything takes effort. Processing information, remembering details, managing light and noise, concentrating, finding words—all of it consumes energy. Migraines, visual strain, and mental overload follow closely behind.

Fatigue is the backdrop to everything I do.

It means constantly explaining, reminding, advocating. It means being misunderstood because people can’t see it. This is the reality of hidden disability: it quietly dictates how you experience work, communication, and life.

For a long time, I felt like I had lost myself. I was confused, angry, and deeply ashamed. Every forgotten name, wrong word, or missed detail felt humiliating. Each mistake was a reminder—several times a day—that I was no longer who I used to be.

Fear dominated my thoughts.
What if I can’t work again?
What if I don’t live to see my daughter grow up?

The energy required to do even the simplest tasks was overwhelming. Some days, I could do nothing but sit and stare out of the window, completely spent.

Reading became exhausting. My eyes rebelled, pain built at the back of my head, and my vision blurred. Listening was easier, but my working memory was poor, so information slipped away as quickly as it arrived.

Every symptom fed the fatigue: dizziness when moving too fast, nausea, constant migraines, light sensitivity, slow processing, difficulty finding words. Conversations drained me. Multitasking was impossible. I could only focus on one thing at a time, and even that came at a cost.

Sometimes, forming full sentences was too exhausting—I would manage words, not thoughts.

I would sit at my desk fighting the urge to put my head down and sleep. Pushing myself felt like working while drunk—everything slower, fuzzier, less reliable.

Brain injury is exhausting not just physically, but emotionally. The internal battle between “keep going, it will get better” and “I can’t do this anymore” is relentless.

The first time I returned to work, I was unprepared. I had no occupational health support and encountered negative comments that shattered my confidence. I struggled to explain my injury, and no one seemed to truly understand it.

Three years later, starting a home-based contracting role, I knew myself far better. I knew my limits, and I knew that managing fatigue would determine whether I succeeded or failed.

By chance, it was the summer holidays and my daughter was away for a month. That gave me space to focus entirely on work and recovery. I deliberately cleared my diary of everything else. I went to bed at 8pm most nights—not by choice, but necessity.

There was no pressure at the start. I was allowed to work at my pace, to find my feet.

Everything I did was designed to conserve energy:

• I diarised my induction with reminders so I didn’t have to rely on memory

• I broke policies into small, manageable chunks

• I created clear digital structures—folders, SharePoint, bookmarks

• I wrote my immediate team’s names on the wall

• I took frequent breaks, always away from my desk

• I tackled cognitively demanding tasks in the morning, when my energy was highest

• I wrote everything down and recorded information on my phone

• I followed a strict daily routine

• I asked colleagues to write instructions down

• I avoided multitasking—it slows my brain, increases mistakes, and intensifies fatigue

I trained myself to finish one task before starting another. I blocked out focus time and gave tasks my full attention, because partial attention costs more energy than it saves.

I printed documents, highlighted key points, took photos during training, and rehearsed routines until they became automatic—because automation saves energy.

I walked daily with my dog in the countryside. I practised positive self-talk and cognitive reframing. I managed my anxiety by only taking on new challenges when I felt ready.

I was fortunate to work with kind, respectful colleagues and a supportive manager who checked in regularly and trusted me to manage my workload.

The tactics that stopped me giving up were simple but hard-won:

I didn’t dwell on mistakes.
I didn’t stop believing in myself.
I tried not to let fear define my future.
I visualised what was still possible.
I didn’t see setbacks as failure.
I accepted change instead of resisting it.

This was my responsibility.
The world owed me nothing.
I refused to let this beat me.

Some days, I did feel sorry for myself—and sometimes still do. I’m human. But ongoing support from my medical team and follow-up cognitive testing reassured me that, overall, I was improving.

After two months in the role, I felt safe enough to disclose my brain injury and request adjustments. Fatigue, migraines, and working memory issues remain, but I am fortunate to have a manager who is empathetic and allows me to work in a way that protects my energy.

I’ve learned that some things can’t be fixed by trying harder. Fatigue doesn’t respond to willpower. It responds to acceptance, structure, and compassion.

Note to self:
When things feel overwhelming—one thought at a time, one task at a time, one day at a time.

No matter how you feel: get up, dress up, show up, and never give up.

And my favourite reminder of all:
“We cannot direct the wind, but we can adjust the sails.”

Written by Mary.