Soldiers Who Suffer Mild TBI During Combat May Be More Vulnerable to PTSD

Study Links PTSD to Hidden Head Injuries Suffered in Combat.

Even when brain injury is so subtle that it can only be detected by an ultra-sensitive imaging test, the injury might predispose soldiers in combat to post-traumatic stress disorder, according to a University of Rochester Medical Center study.

The research is important for physicians who are caring for troops in the years following deployment, as they try to untangle the symptom overlap between PTSD and mild traumatic brain injury (mild TBI) and provide the appropriate treatment. Until now, the nature of the interaction between TBI and PTSD was unclear. URMC researchers believe they are the first to find an association that can be demonstrated with advanced imaging techniques.

The study is published online by the Journal of Head Trauma Rehabilitation.

“Most people believe that, to a large extent, chronic stress from intense combat experiences triggers PTSD. Our study adds more information by suggesting that a physical force such as exposure to a bomb blast also may play a role in the genesis the syndrome,” said lead author Jeffrey J. Bazarian, M.D., M.P.H., associate professor of Emergency Medicine at URMC, and a member of the 2007 Institute of Medicine committee that investigated brain injuries among war veterans. (continued…)

Read the rest here >>

This is Your Brain on No Self-Control

Click here to learn how to “painlessly activate the self-control muscle”

Check out this article. It sheds a lot of light on a problem that plagues many of us – loss of self-control.

MRI images show what the brain looks like when you do something you know you shouldn’t.

New pictures from the University of Iowa show what it looks like when a person runs out of patience and loses self-control.

A study by University of Iowa neuroscientist and neuromarketing expert William Hedgcock confirms previous studies that show self-control is a finite commodity that is depleted by use. Once the pool has dried up, we’re less likely to keep our cool the next time we’re faced with a situation that requires self-control.

But Hedgcock’s study is the first to actually show it happening in the brain using fMRI images that scan people as they perform self-control tasks. The images show the anterior cingulate cortex (ACC)—the part of the brain that recognizes a situation in which self-control is needed and says, “Heads up, there are multiple responses to this situation and some might not be good”—fires with equal intensity throughout the task.

However, the dorsolateral prefrontal cortex (DLPFC)—the part of the brain that manages self-control and says, “I really want to do the dumb thing, but I should overcome that impulse and do the smart thing”—fires with less intensity after prior exertion of self-control.

Two fMRI images of brain activities are shown.
fMRI image of brain activity when people exert self-control. Image adapted from University of Iowa press release image.

He said that loss of activity in the DLPFC might be the person’s self-control draining away. The stable activity in the ACC suggests people have no problem recognizing a temptation. Although they keep fighting, they have a harder and harder time not giving in.

Which would explain why someone who works very hard not to take seconds of lasagna at dinner winds up taking two pieces of cake at desert. The study could also modify previous thinking that considered self-control to be like a muscle. Hedgcock says his images seem to suggest that it’s like a pool that can be drained by use then replenished through time in a lower conflict environment, away from temptations that require its use.

The researchers gathered their images by placing subjects in an MRI scanner and then had them perform two self-control tasks—the first involved ignoring words that flashed on a computer screen, while the second involved choosing preferred options. The study found the subjects had a harder time exerting self-control on the second task, a phenomenon called “regulatory depletion.” Hedgcock says that the subjects’ DLPFCs were less active during the second self-control task, suggesting it was harder for the subjects to overcome their initial response.

Two fMRI images of the brain are shown.
Brain activity after people have been engaged in self-control tasks long enough that their self-control resources have been depleted. Image and description credit to University of Iowa.

Hedgcock says the study is an important step in trying to determine a clearer definition of self-control and to figure out why people do things they know aren’t good for them. One possible implication is crafting better programs to help people who are trying to break addictions to things like food, shopping, drugs, or alcohol. Some therapies now help people break addictions by focusing at the conflict recognition stage and encouraging the person to avoid situations where that conflict arises. For instance, an alcoholic should stay away from places where alcohol is served.

But Hedgcock says his study suggests new therapies might be designed by focusing on the implementation stage instead. For instance, he says dieters sometimes offer to pay a friend if they fail to implement control by eating too much food, or the wrong kind of food. That penalty adds a real consequence to their failure to implement control and increases their odds of choosing a healthier alternative.

The study might also help people who suffer from a loss of self-control due to birth defect or brain injury.

“If we know why people are losing self-control, it helps us design better interventions to help them maintain control,” says Hedgcock, an assistant professor in the Tippie College of Business marketing department and the UI Graduate College’s Interdisciplinary Graduate Program in Neuroscience.

Hedgcock’s paper, “Reducing self-control depletion effects through enhanced sensitivity to implementation: Evidence from fMRI and behavioral studies,” was co-authored by Kathleen Vohs and Akshay Rao of the University of Minnesota. It will be published in January 2013 in the Journal of Consumer Psychology.

Oh, wow – I am really sick

Ugh

The change of the season is upon us, and with it comes a host of adjustments. That includes physical adjustments, as the daylight gets shorter, the weather starts to get colder, and the bare-feet-and-shorts way of life becomes less practical.

I guess I’d been in shorts and bare feet a little longer than I should have, because I’ve felt myself getting cold in the evenings… and I’ve been sneezing. Also, kids are back in school, so the parents I work with are getting exposed to their kids who have been exposed to other kids back from summer vacation. My spouse was also out and about with a bunch of folks, last weekend, some of whom were fighting off colds.

Between all the different sources of infection, and my run-down attitude and over-run schedule, it’s no surprise that I’ve gotten wallopped by a major sinus infection. I went into work yesterday because I had so much to do, but I was home today… and then I found myself unable to function at all, so I called my doctor, and called it a day. Talk about feeling crappy… jeez, what an infection I have. It’s also affecting my ears, which as my doctor worried – they’ve ordered me back to see them in a week, to make sure my ears are okay.

All in all, the day wasn’t a total waste. I did get some things done this morning, in the hour or so that I was able to answer email. And I managed to get my car inspected (I remembered last night that today is the last day in the month, and after today, my registration is expired). My car sailed through with flying colors. That’s done for the year. I’ve got to take the van in next month (starting tomorrow). Maybe I’ll do that sooner rather than later, just so I can have it out of the way.

Then I came home, had some chicken soup for lunch,  and crawled into bed for three hours. I just got up a little while ago. I made myself some hot tea — nasty, foul “cold season tea” that has to be some of the most vile tea on the planet, but hey, it works — and if I can smell its nasty odor, I know my sinus congestion is being relieved — it’s a mixed comfort.

What’s really a comfort is knowing I have three days ahead of me to convalesce. I would feel cheated, if I had a bunch of things I wanted to do for the long weekend, but honestly, it was all plans for study-study-study and practice-practice-practice for me, and I can do at least some of that while I’m on the mend. Plus, being sick kind of gets me off the hook, when people call ’round to see if they ca scare me out of my corner of the world and go have some FUN!

My idea of fun is a bit different – study-study-study and practice-practice-practice are my idea of a good time… out on my deck in the late summer sunshine. It’s all good. And I do need to take some time to study and practice because I have a technical screening next week for my possible new job. At first, when I heard about the screening, I was really nervous, because the last time I had a technical screening, I fudged my way through it and I was given a pass by the people who wanted me to work with them. This won’t be happening this time, probably, because the people I’m interviewing with are not my friends and they have a vested interest in screening out duds. I need to make sure I don’t come across as a dud. I’m not one, and I need to really chill myself out, so that I can function at my peak.

I got a little boost from another blogger who wrote:

Attitudes are truly contagious. I make an effort to keep my attitude positive especially in the face of negativity, challenges and emotional vampires (people who literally exhaust you emotionally). When I continue to share love and kindness in all my actions with no expectation of anything in return, I ultimately feel better. My energy level is higher.

Have you seen this in your own experiences? Go into any situation with a positive attitude and you will feel great afterward. It is a double blessing when you receive a winning outcome, especially if the others involved come out of it with a positive attitude. This builds positive relationships with people.

On the flip side, when you go into a situation with anger or another negative attitude, most likely you will infect others. They will be negative right back at you. That would benefit no one! Nothing invites more positive attention than a great attitude. Awareness is key; keep your attitude in check. Remember, attitudes are contagious. Is yours worth catching?

True, true, true. Good words. I’ve bookmarked their blog, so I can come back again and get a good reminder of where my head needs to be.

I think my head is at that place right now. Despite being sick as a dog and feeling like week-old roadkill, I’m feeling pretty positive and focused. Until this evening, when I usually start to feel worse and I spiral down into a ball of dark pain before I sleep — hopefully through the night. Then again, there’s no guarantee that I’ll feel that way tonight. It’s just what I expect.

But it doesn’t have to be that way. It might be completely different. You never know.

Keeping the compass true

So, I had a really good session with my NP yesterday. We talked about all the things that are going well for me, and my future job prospects. Of all the people I know, they really get the importance of staying positive and moving forward. And they also help keep me headed in that direction.

The one way they really aren’t much help to me, is in dealing with my setbacks and difficulties. When I start to discuss things that are challenges to me that I really need to work on, they have a standard line about how it’s more about my perception of things than anything else. They’re convinced that I don’t have substantial cognitive issues, and that any other issues I do have, I am perfectly capable of overcoming with the right attitude.

Okay, fine. That working relationship has been extremely productive in terms of helping me get my self-confidence back and figuring out what excites and moves and motivates me. But when it comes to the things I need to overcome and things that are going wrong, it’s a bit “fair weather” and the discussions start to fall apart, because we have completely different perceptions of how people and the world work. I believe that human beings are driven by biochemistry and internal wiring and instincts which kick in long before conscious thought gets a chance to step in, and they believe that the whole of the material world (including the human body) must necessarily bend to the will of an enlightened and highly trained mind. I believe in recognizing issues, understanding them, and either fixing them or learning to live with them and manage them, while my NP seems to believe that you can drive out all perceptions of problems through the power of the mind. They’re a bit “command and control” in that respect, while I have are more inclusive and — I think — accepting outlook on what goes wrong, and why.

When things are going great, and I have good things to report, then our discussions go well. At the same time, I don’t really have anyone to use as a sounding board when things are going poorly or my issues are catching up with me.

Oh, well. It’s pretty much standard fare for me. Most of my relationships and friendships offer me something significant and unique, but they’re limited in that way. Like any of the situations or relationships in my life, I have to accept that it can’t provide everything to me, and I have to figure out if what it does provide makes it worth it to continue. In this case, yes — with the understanding that I’ve got to fill in an awful lot of blanks, and I have to seek help in other arenas, when the going gets tough.

This is where the books come in, I guess. And Give Back LA. I really need to break out those reading materials again and get back into studying them. I also need to do a check-in about where I am, today, compared to where I was back in 2005, 2007, and 2009. I figure two-year checkpoints could be good. Lord knows, I’ve got notes. Have I ever got notes. I’ve got big three-ring binders in my storage closet filled with notes from 2007-2008, when I first realized that my fall in 2004 had screwed me up.

Should be interesting. I’ve actually avoided looking at those notes, for the past several years. I just wanted to get on with my life. And I have. I think looking at the notes can give me an appreciation of how far I’ve come, how much I’ve progressed. I don’t want to get lost in it, just check it out. I’ve got vacation coming up in September (after 3 years), so I’ll have some time to review and pay attention to this stuff.

All in all, I really have a lot to be thankful and grateful for. And I have made a huge amount of progress. In many ways, I’m even more functional now, than I was before, because even with the limitations on my energy levels and my working memory and my processing speed, I’m still functioning at a pretty good level. I’m talking quality level, not quantity — I’m talking quality of life, presence of mind, awareness, and a real sense of purpose. I’m talking about finding what moves me, what matters to me, and staying true to that direction, keeping my compass directed towards that and not getting pulled off in all different directions.

It’s like improving distractability at a meta level — the concept of fractality is about patterns that repeat themselves time and time again, on different levels and in different sizes, throughout a situation or picture. In a way, my distractability, my attention deficit, ballooned up to a whole-life scale, and it kept me constantly on the go, flitting from one shiny object to another,  distracting and diverting me from what meant most to me, my core values, my deepest priorities, and the actual foundation of my life. People talk about having a moral compass, and I think that’s important. Perhaps even more important is having a compass that is true to your innermost values that aren’t dictated by an outside individual or belief system. I guess it’s an “ethical compass” I’m talking about — our own personal ethics, versus the morality of the culture you live in. It’s great to have a moral compass, but if your own inner compass is not true to what you yourself believe, then you can get really lost and do things for reasons that may not be the best or most true.

After I fell in 2004, my own inner compass went haywire. And I got lost. I got pulled off in a thousand different directions, and I’m really feeling that burn as I look for another job, and people ask me why I moved from one job to the next from 2006-2010. A year here, a year there… three months here, six months there… it adds up, and when you’ve had 6 jobs in 4 years, potential employers are going to take notice. Of course, I can’t tell them that my irritability, distractability, and rage were out of control. That’s no way to present yourself well ;) But I’m figuring out how to frame those moves in positive ways, and have them work in my favor, which is the best that anyone can do, really.

And I’m not getting hung up on it, because ultimately, if one thing doesn’t work out, something else will. It’s fine. Because my job is presently not in extreme danger (that I know of – could be wrong, who knows?) and I have a regular paycheck coming in. I also work with people who love me — and I love them, too. I just can’t stand the work environment and what our employer is foisting on us, and that’s a shame. But again — no hang-ups about this. As my neuropsych reminded me yesterday, working memory is a limited capacity resource, and if I spend a lot of time getting hung up on things, then I don’t have room for the good and productive stuff.

So, today I’m making room for the good and productive stuff. I’ve got another interview this afternoon with a recruiter, and I’m looking forward to it. Things are lining up. The big project that I’ve got going on is going to roll out in less than two weeks, and I have a handful of things I’m going to be able to get accomplished before I go. Every time I talk with people I work with, who are in other parts of the world, I’m reminded that this could be one of the last times I talk with them, so I make the most of it. It’s a good way to go out, and I’m sure that I will keep in touch with a lot of these folks — maybe even see them again in my future travels.

There’s a lot to look forward to. My compass is true, I know where I’m going, and I’m holding my own. That’s the best that I could ever ask for, right here, right now.

Wake up, brain, wake up

Yesterday was a rough day. But it happens. Mondays tend to be difficult for most people, and the folks I work with are no exception. I think everyone is feeling the passing of summer, and we’re not liking it, much. On top of that, get people started on Monday mornings with a full weekend of activity behind them, and they’re going to be tired. Tired and not really wanting to be at work.

So, people get fired up. All fired up. Pissy and vinegary and ready to rumble. Which is fine, if you don’t understand what that actually does to you and the people around you. When you are aware of the short- and long-term effects of getting riled for the sake of getting riled, it looks like a lot less fun.

So, yesterday started off pissy, and it went a bit downhill from there. Our uber-boss likes to wrangle and tangle, and they like to dominate conversations and “drive the action”. Good God, I cannot wait to get away from this individual. They’re definitely driven by demons beyond most people’s control, and they love to just stir things up and put people on the defensive. They see challenges and threats, and they respond in ways they feel are appropriate. Of course, they could see them as opportunities to come up with something new and different, but a scrappy fight… well, that’s a lot more fun, I guess.

Anyway, it has occurred to me that this individual has some serious attention deficit issues, and those issues drive them. They skip from one thing to the next, and they’re always looking for the next exciting thing to make happen. They have tons of great ideas, but their execution frankly sucks. They don’t even care about the execution. That’s so boring. It’s so drab. It’s not invigorating and stimulating for them, so they just don’t want to know about it.

The thing is, that’s what actually makes their dreams come true.

Well, anyway, it’s all grist for the mill. This is all a bunch more lessons about what I don’t want in my life, and how I don’t want to be in my relationships with others. It’s also really great experience holding my own in the face of a whirlwind of intimidation and posturing. Learning to keep my cool in the face of this type of behavior will only help, in the long run. Because this individual, emotional and flighty as they are, is certainly not alone in the world. And it seems that people in charge are often driven to extremes, so knowing how to maintain my cool no matter what the circumstances, is something I really need to work on.

I used to be able to handle it. Years ago, before my last TBI, I wasn’t nearly as susceptible to the influence of (crazy) others, and I had a lot of success as a result. Now I need to build back that capacity… all the while not letting my attention drift from my ultimate goal of moving on. It’s all connected, and there’s something good to be gotten from almost all situations, so I have to look for that and keep my spirits up.

That involves making sure my brain wakes up in the morning. One of the things that got to me yesterday was how tired my brain was. I started out sluggish, and it didn’t get any better over the course of the day. I didn’t bother to exercise or get myself going in the morning – I just went through the motions, and I could definitely feel it.

This morning, I did things differently. I warmed up and really moved, while I was getting my breakfast together. It’s not Monday anymore, so that’s an obvious improvement – I’ve managed to switch gears and get moving – and I have my agenda for the day pretty much set. Yesterday I couldn’t get away from the intermittent meetings, which kept me from actually getting any work done. And I had to answer a lot of emails. My pace was totally screwed up. But today I’ve put a lot of stuff to rest, and I’m going to stake out my corner of the world, close the door, and get some work done. For real.

That’s the plan. That’s my story. And I’m sticking with it.

All that the world offers us

I’m a “fixer”. That means I look for things to fix. I like to take what’s wrong and make it right. I like to help people who are in need. I am committed to working out my own issues, so that they don’t affect others.

But sometimes, it blocks my vision.

I get so focused on finding what is wrong and fixing it, that I lose sight of what is right, and I miss the chance to appreciate it and make the most of it. My present job situation, as tough as it is, offers me a lot of benefits and opportunities that I have never gotten elsewhere. It’s not a total waste of my time. I do know some things don’t work and those things need to change, but I realize I’ve been throwing the baby out with the bathwater, and I’ve been failing to appreciate the benefits I’ve gotten from this job.

This is important to remember, especially when I am talking to new prospects. I cannot paint my current situation as all-bad, because it reflects poorly on me. Likewise, it makes me come across as a complainer and a bit of a wimp. So, I’m stopping that. And I’m starting today with a list of things that I really like about my current job — the things that make it a good place to be and work. There are some. They aren’t enough to change my mind about moving on, but they are enough to ease the daily stress of this tough situation.

I have a ways to go, before I am as proficient in the new technologies as I’d like to be. I have a lot of studying to do, a lot of practicing to do. I spent much of Saturday and Sunday working on it, and it feels really good. And I know it is just the start. Even if I don’t land a job doing what I love immediately, I still am able to do what I love in the evenings and on the weekends, and I need to make the most of that.

So, I shall.

And now, it’s off to work… for another day.

Studies are going well

I’m remembering again why I went into this line of work, doing web development. It’s friggin’ awesome. I love it. And it loves me, too.

I’ve been having a much easier time working through all the logic and the new developments in the technologies, since I was last able to really work full-time in it. When I fell in 2004, I found I couldn’t read and understand what I was reading, and I could not focus for extended periods of time.

This has changed. This has improved. I’ve spent many hours, this weekend, working on this. And it feels great.

I guess it was a matter of time… and learning how to focus in and keep from giving in to constant distraction. Whatever the reason, I’m feeling incredibly fortunate right now.

brokenbrilliant:

Great pictures and great words.

Originally posted on Have A Dream:

At the “Kek Lok Si” Temple in Penang ……..

Are you searching for answers how to live a peaceful and rewarding life?

No man is an island. None of us are alone and isolated. Even the hermit in the cave is in relationship with the living creatures around him. For instance, the birds, trees, the earth, the mountain creatures and the sky. We are in touch with others, I mean, other people, other creatures, other things – and like it or otherwise, they will bring us pleasure and pain.

Due to the long weekend, this place was unusually crowded. There were visitors of different nationalities, cultures and religious backgrounds. As I descend from the “Kek Lok Si” Temple, on an extremely hot and dry afternoon, I have to admit this brief visit was worth every drop of sweat. Most of the visitors I came across were young and I am impressed…

View original 49 more words

All the things we want to do…

So, I’ve been poking around WordPress a little bit, finding different blogs by people who travel, who take pictures, who list out things they want to do before they die. There are tons of great travel blogs out there, as well as action/adventure blogs – everything a couch-potato needs to feel connected with the rest of the world.

As long as you don’t forget to actually go out and get involved in it… which is what I’m going to do right now.

Later