Enrustration Nation: How to Survive Decision Fatigue Without Snapping
Tell me if this sounds familiar:
You come home after a brutal workday. One where you had ten hours to do twenty hours’ worth of work. Every patient had complex comorbidities, and you had to figure out not only new medications and additional tests, but also whether subspecialty consults might be necessary. Every family member needed more compassion than you had minutes to spare. Your office manager needed “five minutes” (it took twenty). You’re still not caught up on notes from two days ago.
You drop your bag. Your partner asks, “So, what do you want for dinner?”
It’s not even an ask to cook, just a question of what you’d like. But your brain shorts out. It’s like hearing English in a heavy accent. Recognizable, but not quite landing immediately. When the question finally registers, a weird mix bubbles up: rage, exhaustion, guilt. Let’s call it enrustration: part enraged, part frustrated, all deeply depleted.
You snap something like, “I’d rather go to bed starving than make one more decision tonight,” and stomp off to change into pajamas. Your partner is confused and hurt. You’re mortified, wondering why such a simple question felt like an ambush.
Welcome to the world of decision fatigue.
What Is Decision Fatigue, Really?
Decision fatigue is a psychological phenomenon where your brain’s ability to make good decisions gets eroded by the sheer number of decisions you've already made, big or small. As mental energy depletes, you become more impulsive (snapping at your partner) or more avoidant (ignoring the question entirely).
That dinner meltdown? It wasn’t just your patients or your EMR inbox. It was all the choices you made before your first patient:
Get up or hit snooze?
Wash your hair or dry shampoo again?
Scrubs or real clothes?
Is there time to stop for coffee?
Take the shortcut or trust the traffic app?
Your mental bandwidth was being siphoned before your work day even began.
Even more sobering? A 2011 study of Israeli judges showed that decisions made earlier in the day were far more favorable than those made after hours of hearings. Whether you’re in a courtroom or a clinic, your decision-making capacity has a shelf life.
Red Flags That You’re Decision-Fatigued
You're irritable or impatient about routine questions.
You impulsively say "yes" or avoid answering at all.
You second-guess every choice, even the easy ones.
You default to what’s easiest, not what’s best.
You’re deeply burned out and can't pinpoint why.
Sound familiar? You’re not alone. And you're not failing. You're just maxed out.
How to Protect Your Brain (and Your Relationships)
Let’s be honest: we can’t opt out of decision-making. However, we can work smarter to conserve the cognitive energy we do have. Here’s how:
1. Front-Load High-Stakes Decisions
Make critical choices early in the day or after a meal. Leave the emails and admin for later.
2. Create Protocols & Defaults
Use “if/then” rules for predictable scenarios. I’ve stopped scheduling gym workouts post-call. I never go, and get charged for cancelling late, so I’ve just decided that if I’m post-call, I don’t schedule time at the gym.
3. Automate or Delegate the Mundane
Pre-plan meals. Wear the same style every day (scrubs FTW!). Let your kids choose the dinner playlist.
4. Build in Micro-Restorative Breaks
Five minutes of movement or a snack can recharge your frontal lobe. Resist major decisions right after code browns or code blues.
5. Limit Choice Exposure
Fewer open projects. Fewer meetings. Fewer outfit changes.
6. Practice “Good Enough” Thinking
Perfectionism is a cognitive parasite. Embrace what’s workable, not what’s flawless.
7. Decide When to Decide
If you’ve put off a decision more than twice, schedule a time to make it and add it to your calendar. This relieves the weight of uncertainty and the shame spiral of procrastination.
The Takeaway
Decision fatigue is invisible until it’s not. It hijacks your patience, clouds your thinking, and damages your most important relationships (including the one you have with yourself).
But you can meet it with awareness, kindness, and practical tools. You don’t have to make every choice right now. You just have to reclaim your brain, one decision at a time.