What to know about decision fatigue during the pandemic

Decision fatigue happens when a person becomes fatigued or exhausted from making too many decisions. It affects a person’s ability to make further decisions, whether simple, such as deciding what to eat for dinner, or complex, such as determining whether or not to change jobs.

The concept of decision fatigue originated in 1998. It centers on the idea that humans have a limited capacity to regulate their behavior.

This means that after a certain point, people simply run out of energy to make decisions, much like a car running out of fuel once its petrol tank is empty. Running out of “decision making fuel” is also known as ego depletion.

Ego depletion changes the way we focus on and process information to make decisions, as well as our motivations. These motivational shifts can make a person more likely to make impulsive decisions that, under normal circumstances, they would not make.

“Doing repeated decision making [that] involves trade-offs between multiple competing values, such as risks and benefits” increases a person’s risk of experiencing decision fatigue, Dr. Gustav Tinghög, an associate professor at Linkoping University in Sweden, told Medical News Today.

“Careful consideration of pros and cons in decision making is mentally taxing and may lead to decision fatigue when we feel stressed and mentally overloaded. This can lead people to shy away from engaging in cognitively demanding reasoning when tired and instead turn to decision‐making heuristics, that is, mental shortcuts that allow us to make decisions on the basis of simple rules of thumb without engaging in cognitively demanding reasoning.”

– Dr. Gustav Tinghög

But decision fatigue does not just happen from making decisions. It can happen from any activity that demands the exertion of self-control.

Dr. Grant A. Pignatiello, an instructor and clinical research scholar at Case Western Reserve University in Cleveland, told MNT that “[d]ecision fatigue can manifest after repeated or effortful attempts of self-control.”

“The most common example is from making decisions. But it can also result from controlling your emotions, doing things that require cognitive effort, or intense physical exertion,” he noted.

Several factors are associated with a higher risk of decision fatigue, including:

Dr. Pignatiello said that everyone is susceptible to decision fatigue. However, the exact causes will differ from person to person:

“It’s important to know that the circumstances that lead to decision fatigue are unique for every person — for example, two individuals doing the same thing may experience different levels of decision fatigue. For a literal example, running a 5K may deplete your tank more than it would a person who runs every day.”

He added that the demands of modern everyday life, alongside modern work environments, necessitate complicated decisions that may make some more susceptible to decision fatigue than others.

There have not been many studies exploring the direct impacts of COVID-19 on decision fatigue. However, as research has shown that mental health generally deteriorated at the beginning of the pandemic, it is possible that rates of decision fatigue increased too.

“I’m unaware of any data that examined the pandemic’s unique contribution to decision fatigue,” said Dr. Pignatiello. “However, […] our day-to-day lives are further complicated by decisions about where to go, who to see, and how to spend our time.”

“Also, our work environments have changed dramatically — most of us have needed to adapt to working at home, healthcare workers are burnt out from the intense demand placed upon healthcare systems, and many have flat-out lost their jobs. All of these things in [themselves] can be stressful,” he explained.

“Simply put, living in society has become much more complex, and we have had to adapt to these complexities very suddenly. These complexities have introduced new problems that have required more effort to deal with than we are used to,” he continued.

However, how long any knock-on effects of deteriorating mental health on decision fatigue persist is debatable without further research. Studies have found that negative impacts on emotions and mental health tended to subside after the initial months of the pandemic. The same may thus be true for decision fatigue.

Nevertheless, the impact of decision fatigue on healthcare workers — especially nurses — may have lingered beyond the first few months of the pandemic. A commentary published in September 2021 cautioned that healthcare organizations should provide facilities for nurses to prevent decision fatigue arising from COVID-19-related strain on healthcare systems.

Another study from last year validated an instrument to assess whether nurses were experiencing decision fatigue. They found that decision fatigue scores were strongly correlated with traumatic stress and moderately correlated with the nursing practice environment.

“In the healthcare context, medical staff in many areas are under a lot of pressure and engage in difficult repeated decision making that is likely to deplete their mental resources, which in turn impairs subsequent reasoning and makes them more prone to make decisions based on the most prominent value,” said Dr. Tinghög.

“Health care priority setting typically involves trade-offs that pit the lives and well-being of some individuals against the lives and well-being of more distant others. People are inherently bad at weighing valued objectives against each other and instead base choice on the emotionally most prominent value,” he added.

“That is the most defensible value. This is problematic because it means that opportunity costs are likely to be neglected in health care priority setting as a consequence of decision fatigue.”

– Dr. Gustav Tinghög

Signs of decision fatigue include brain fog, feeling tired, and other signs of physical or mental fatigue. These may intensify the more decisions a person makes throughout the day.

When asked how people may be able to spot whether or not they are experiencing decision fatigue, Dr. Tinghög said, “If there are drifts in the type of decision you are making throughout the day, without there being a logical explanation, this could be due to decision fatigue.”

“But also, it is possible to identify decision fatigue through introspection,” he added. “When we feel that we don’t have enough mental energy to make a thorough deliberation before an important decision, we are suffering from decision fatigue.”

Dr. Pignatiello also noted:

“It requires some self-awareness for us to know when we may be in a state of decision fatigue. Some common signs include struggling with decisions that otherwise would not require much thought, e.g., ‘What do I eat for dinner?’ ‘What should I wear?’, feeling overwhelmed by our emotions, having a harder time remembering things or focusing, or simply just feeling more ‘drained’ than normal.”

When MNT asked how a person can overcome decision fatigue, Dr. Pignatiello highlighted three ways to either “refill our tank” or use our so-called decision making fuel more efficiently.

In his words, these are:

• Eliminate the mundane decisions in your life so you can use your energy for decisions that require more thought. This can be as simple as planning out your outfits, meal prepping so you have left overs, and establishing daily routines.
• Be compassionate to yourself. If you need time and space to refill your tank, do it. Take that nap, watch that new episode, read your new mystery book. If you find it replenishing for your mind and body, do it.
• Take care of yourself — make sure you’re getting enough sleep. My work has shown that sleep problems and decision fatigue are related to one another. Eat healthy, take care of your body by exercising, find healthy outlets for your stress, etc.

Dr. Tinghög added three more points to bear in mind:

• Advise someone you trust to check your thinking. Deliberation with other[s] often relives some anxiety related to decision making.
• Don’t let the fear of making the wrong decision paralyze you. Making a good enough decision is often good enough. Not every decision needs to be perfect. Remind yourself that most decisions are revokable if something goes wrong.
• Review your past decisions, not all the time but with some regularity. Identify cases of poor decision making and try to understand why it came about. This might be good to detect where decision fatigue has affected your behavior and learn from it […].