Each day, we all make thousands of decisions, starting the second we wake up. Things like how much cream to add to your coffee, if you should get gas on your way to or from work, and where to order dinner from all require at least a little bit of cognitive effort. The mental load of decision-making is even more burdensome if you’re making decisions that have serious consequences for yourself or others. As the number of COVID-19 cases continues to rise in the United States and most people are operating under higher levels of stress than usual, many are facing decision paralysis – but few more so than frontline workers. There are a few factors that play into this: decision fatigue and choice overload. Both are common and likely affect us more than we realize.
Decision fatigue is when you feel overwhelmed and drained by the number of decisions you need to make. This can be difficult to recognize, as we don’t always think of little choices (like going to refill your water bottle) as decisions. As a health care worker, you likely make countless decisions each day that are much more significant—should a person be placed on a ventilator or ECMO machine, do they need a different medication, etc. This burden can weigh on you quite heavily after a prolonged period of time, especially during times of crisis like COVID-19 – the stakes are high, and you’re expected to take action despite uncertainty. For many, it’s causing significant moral distress in the workplace and sheer exhaustion at home.
Choice overload occurs when you’re faced with a decision that requires you to choose between many options. If you have too many options, you may even avoid making a decision altogether[i]. If you’ve ever turned on Netflix and scrolled through titles for 30 minutes before giving up and watching your favorite series for the third time – or calling it quits on watching anything at all – you’ve dealt with choice overload.
Our decision-making abilities are run by the brain’s prefrontal cortex, which is responsible for functions like attention, thought organization, goal setting, planning, and self-control. With normal stress levels, our brains use working memory to connect recent events with long-term memories to make decisions and predict possible outcomes based on past experiences. The prefrontal cortex is also highly sensitive to stress – mild stress can quickly cause loss of cognitive abilities, while prolonged stress can permanently alter our brain. When under stress, certain neurotransmitters may flood the brain, changing the functioning of the prefrontal cortex and the memory centers of the brain. This impairs our working memory and in turn, our ability to make both quick and thought-out decisions[ii].
What can you do to help?
It may be impossible to escape the need for decision-making, but there are plenty of ways to give your brain a break.
- Take 15 minutes to listen to a guided meditation or just lay down and close your eyes with some relaxing music in the background – anything that allows you to zone out for a bit and push all worries and decisions to the side is helpful.
- Getting sufficient sleep is one of the best ways to reduce stress levels. This means both enough sleep (7-8 hours each day) and high-quality sleep. The ideal sleep environment is cool, dark, and quiet – if you work night shifts, use an eye mask or blackout shades to keep it dark during the day and put on a playlist of white noise. Try to keep a regular sleep schedule where you go to bed and wake up at the same time each day. If that’s not possible due to varying shift times, create a pre-bedtime routine, like journaling for a few minutes – having regular before-bed activities will signal your brain to get into rest mode. If you are working nights, you can find some more tips on getting daytime sleep (and staying awake through the night) here.
- Exercise is a great way to actively release stress, even if it’s only 30 minutes a few days a week. It boosts your cognitive abilities as well – studies have found that people who are physically active tend to be better at zeroing in on important information while ignoring irrelevant information, leading to quicker and better decisions[iii].
Everyone gets overwhelmed and it’s completely normal to freeze up and struggle with even the most inconsequential decisions from time to time. As with any stress response, self-care is critical, so build in time for activities that you know work for you. And make sure to share the mental load – defer a decision to a colleague if possible or ask a friend to pick what you’ll have for dinner. By maintaining good habits and taking care of your mental and physical health, you can free up some energy to handle those decisions – both big and small.
[i] Iyengar, S. & Lepper, M. (2000). When choice is demotivating: Can one desire too much of a good thing? Journal of Personality and Social Psychology, 79(6), 995-1006. DOI: 10.1037//0022-35220.127.116.115
[ii] Fellows, L. (2018). The neuroscience of human decision-making through the lens of learning and memory. Current Topics in Behavioral Neurosciences, 37, 231-51. DOI: 10.1007/7854_2016_468
[iii] Zimmerman, L. (2016, May 30). Does regular physical activity help us make better decisions? London School of Economics, Department of Management. https://blogs.lse.ac.uk/management/2016/05/30/does-regular-physical-activity-help-us-make-better-decisions