The TBI/Concussion Energy Crisis – Part 2 of 2

This is Part 2 of a long post that I’ve split into two parts. The first part is here:

Running on empty?

Long-term outcomes after mild traumatic brain injury — and persistent post-concussion syndrome that doesn’t resolve in the usual couple of weeks — have baffled researchers and practitioners for a long time, but to me it makes perfect sense. There is a cumulative effect of stress and strain that comes over time. There’s plenty of research about the long-term effects of chronic stress. But there doesn’t seem to be a lot of research about the levels of stress among mild TBI and concussion survivors.

Everybody seems to think things just resolve. And they don’t seem to think it matters much, that we are no longer the people we once were. They don’t seem to realize what a profound and serious threat this is to our sense of who we are, and our understanding of our place in the world. At most, it’s treated like an inconvenience that we’ll just see our way through with time.

But it’s bigger than that. Losing your long-held sense of self when you’re a full-grown adult, with a full docket of responsibilities and a whole lot invested (both by yourself and by others) in your identity being stable, is a dire threat to your very existence. It is as threatening to your survival, as surviving an explosion, a flood, an earthquake, or some other catastrophe that nearly does you in.

It’s traumatic. But because it’s not over the top and in your face and dramatic — and it doesn’t register on most imaging or diagnostic equipment — people think it just doesn’t matter.

Or that it doesn’t exist.

Frankly, the professional community should know better — especially those who work with trauma. They, of all people, should know what trauma does to a person — in the short and long term. I suppose they do know. They just underestimate the level of stress that comes from losing your sense of self and having to rebuild — sometimes from scratch. I’m not even sure they realize it exists.

But they do exist. Dealing with the daily barrage of surprises about things not working the way they used to… it gets tiring. Trying to keep up, takes it out of you. I know in the course of my day, I have to readjust and re-approach many, many situations, because my first impulse is flat-out wrong. I have to be always on my toes, always paying close attention, always focused on what’s important. Always reminding myself what’s important. I have to perpetually check in with myself to see how I’m doing, where I’m at, what’s next, what I just did, how it fits with everything else I’m doing… Lord almighty, it takes a lot of energy.

What’s more, those stresses and strains are made even worse by being surrounded by people who don’t get how hard I’m working. I swear, they just have no clue — my spouse and my neuropsych included. They seem to think that this all comes easily to me, because I do a damned good job of smoothing things over and covering up the turmoil that’s going on inside of me. I have trained myself — through a combination of techniques — to at least appear to be calm in the midst of crisis. Even when things are falling apart around me and inside me, even when I am at my wits’ end and am about to lose it, I can (usually) maintain a calm demeanor and chill out everyone around me.

Heaven knows, I’ve had plenty of practice over the years. If I hadn’t learned to do this, I would probably be in prison right now.

No, not probably. I would be in prison. I like being free and un-incarcerated, so I’ve learned to hold my sh*t.

Which is where sleep and proper nutrition and exercise come in. Because after years of thinking that sharing my experience with the ones closest to me would enlist their help, I’ve realized that doing that will never ever achieve that goal. People just don’t get it. Even my neuropsych doesn’t get it. Everyone has this image of me as I present to them, which is totally different from what’s going on inside of me.They seem to make assumptions about how I am and what I am and what life is like for me, that have nothing to do with how things really are.

Inside, I have a ton of issues I have to manage each and every day. Today, it’s

  • confusion & disorganization
  • anxiety
  • irritability
  • neck, back and joint pain
  • noise sensitivity
  • dizziness
  • ringing in my ears that’s not only the high-pitched whine that never goes away, but is now accompanied by intermittent sounds like a tractor-trailer back-up alert beep. Nice, right?

And that’s just for starters. Who knows what will happen later today.

But I’ll stow the violins — the point is, I really can’t rely on others to figure things out for me — even the trained professionals. I can’t rely on them to understand or appreciate what my life is like from day to day. I need to rely on myself, to understand my own “state” and to manage that state on my own through nutrition, adequate exercise, rest… and to advocate for myself to get what I need.

I have to keep those needs simple — rest, nutrition, exercise — and not complicate matters. Getting more elaborate than that just works against me. It’s hard to explain to people, it gets all jumbled up in my head, and the other people try to solve problems they don’t understand, in the first place.

On the one hand, it can get pretty lonely. On the other hand, it’s incredibly freeing. Because I know best what’s going on with me, and I know I can figure out how to get that in place.

The bottom line is — after this very long post — TBI and concussion take a ton of energy to address. It’s not a simple matter of resting up till the extra potassium and glucose clear out of your brain. There are pathways to be rewired, and they don’t rewire themselves. Depending on the nature of your injury — and a diffuse axonal injury that frays a ton of different connections, even just slightly, can introduce a wide, wide array of frustrations and hurdles — you can end up spending a ton of time just retraining yourself to do the most basic things. Like getting ready for work and making yourself breakfast without missing any important steps (e.g., taking a shower or turning off the stove).

And when you’re trying to rewire your brain and retrain yourself to get back on track, at the same time you’re trying to maintain your life as it once was… well, that’s a recipe for a whole lot of hurt, if you don’t give yourself the energy stockpiles you need to move forward, and if you don’t take steps to regularly clear out the gunk that accumulates in your physical system, as a result of the stresses and strains of the rewiring process.

That being said, I wish that someone would do a study on the stress levels of concussion and other mild traumatic brain injury survivors. We need to collect this data, in order for professionals to better understand us and our situations, and to better know how to treat us.

For the time being, however, I’m not holding my breath. I know what works for me, with regard to my recovery — having someone non-judgmental to talk to about my daily experience, keeping records of my daily life so I can self-manage it, regular exercise, pacing myself, good nutrition, intermittent fasting, keeping away from junk food, adding more high-quality fats and oils to my diet, and getting ample sleep with naps thrown in for good measure.

Those are really the cornerstones of my recovery. When I do all of them on a regular basis, I get better. If I overlook any one of them, I slide back in my progress. It’s an ongoing process, for sure.

The TBI/Concussion Energy Crisis – Part 1 of 2

This is Part 1 of a long post that (out of consideration for your time) I’ve split into two parts. The second part is here:

Running on empty?

I’m having my butter-fat coffee this morning, thinking about how I’m going to plan my day. I have some back taxes work I have to do — I need to refile from prior years, because I messed up a couple of times and I need to make it right. Fortunately, I erred to my own disadvantage before, so fixing those errors and refiling will bring in a little extra money, which I can really use.

I had a pretty restful sleep last night. However, I woke up at 5 again, which I did not want to do, and I was pretty stiff and sore from all my activity yesterday. That’s the thing about getting a sudden burst of energy — I want to use it, I want to experience it, I want to feel what it’s like to really move again. So, my body ends up moving more than it has in a long time, and then I get sore.

Fortunately, it’s a “good sore” which is a sign that I’m getting stronger and more active. This is one of those rare cases where “pain is weakness leaving the body”.

I considered getting up, because I would love to have an extra useful hour or two in my day. But I was still pretty tired, so I stretched a little bit, then relaxed with my guided imagery recording, and went back to sleep with earplugs and eye mask. I have light-blocking curtains in my bedroom, but sometimes the light gets in, so I use an eye mask. In the winter when it is cold, I wear a winter cap in bed to keep warm, and I pull it down over my eyes to block the light. But now that it’s warmer, I can’t use the cap. So, the eye mask it is.

Something about the eye mask helps me sleep — it’s a Pavlovian response, I think. I usually use it when I am trying to fall asleep during the day, and it works.  So, I have an ingrained response to relax when I put on my eye mask. And it worked. I got another hour of sleep, and I woke up feeling much more human.

Yesterday I had written about how it’s energy shortages that make me so tired, rather than lack of sleep. Well, let me just say that it’s really both that get me. If I’m over-tired, no matter how many high-quality fats I put in my body, I’m going to run out of steam. And if I don’t have enough high-quality fats in my system to convert into energy, all the sleep in the world isn’t going to fix me up.

One of the things that I think really bites mild TBI and concussion survivors in the ass, is also probably one of the most overlooked — The Energy Crisis. I think that people (especially health care providers) really don’t get how hard we have to work to reorient ourselves and retrain our brains after a mild TBI or concussion. There are so many subtle ways that our regular routines and regular thinking patterns are disrupted, and we can totally miss those subtle disruptions until they balloon in to bigger problems.

One thing after another goes wrong. Sometimes we see it, sometimes we don’t. Sometimes we catch it in time, sometimes we don’t. But so many little tiny things can be so different from before — even just feeling different — that it’s overwhelming. And the end results can be devastating — failing work performance, failing relationships, failing finances… failing everything.

For no apparent reason.

So, we end up either being hyper-vigilant and always on guard. Or we just give up and go with the flow, because who the hell can keep up with everything that’s getting screwed up? We go into either crisis prevention mode or crisis response mode. In either case, our lives are marked by crisis. One. After. Another.

And that is tiring. It is SO tiring.

So, we run out of steam. It can happen from just being overwhelmed by the sheer volume of adjustments — large and small. It can happen from feeling like we’re under constant attack from within and without — which we often are, as our internal systems are disrupted and the “ecosystem” we have been operating in starts to rag on us because we’re not keeping up. It can happen from being on a constant adrenaline rush, just trying to keep up and respond. It can come from crashes from all the junk food we eat to make ourselves feel less pain… to have more energy… or just take our minds off our troubles.  Usually, it’s all of the above.

On all levels, we’re getting hit — our mental, emotional, physical, and spiritual existence is in turmoil. And it takes a huge amount of energy to keep up.

If we don’t get enough of the right kind of sleep, and we also don’t have the right physical support to keep going, our systems short out. I believe this is why mild TBI folks can actually see worse outcomes over the long term, with problems showing up years on down the line. All the little “hits” we take in the course of each day all contribute to our biochemical overload. There’s more and more “sludge” in our system, in the form of waste from stress hormones processing, to buildup from the junk foods we eat to keep going, and that sludge adds to our overall stress levels, causing us physical stress and strain — which then contributes to our mental and emotional instability.

And years on down the line, when we “should be fine”, things really unravel, and we end up in terrible shape, without any clue how or why — and nobody there to support us, because they don’t know why either, and they probably wouldn’t believe us if we told them.

Keep reading here >>

Moving to a different area

Pack up what matters and take it with you

Looking back, looking ahead… As usual, when I start to contemplate a big life change — like career/job, moving, shifting the nature of my relationships, etc — I look back to take stock on where I’ve come from, and I also look ahead to see where I want/need to be.

I have been doing a bit of that, lately, and what really strikes me is just how much my mindset and my cognitive abilities and my overall ability to cope and deal with life have all really improved over the past several years.

When I look back on where I was, only three years ago, and I think back only a year’s time, I’m really amazed to see the difference in how I am handling my life.

I am so much:

  • better able to calm myself down and not fly off the handle over passing things.
  • more present and able to participate in life as it comes along.
  • less anxious – dramatically so.
  • better at humor than I have been in a long time.
  • more focused on what I’m supposed to be focusing on.
  • better able to pace myself and not get stuck in an infinite loop.

All of these things have taken a lot of time for me, and I am profoundly grateful for the progress in my life. I have worked my ass off, I have really pushed myself to do better, to be better, to be honest and allow myself to be humbled by my mistakes and screw-ups. I have made learning from my mistakes a top priority — and there has been no lack of opportunity to do that (fortunately or unfortunately). I have really soldiered through a lot of things that used to throw me

All these things have been central to my recovery, and now as I work my way through the tenth year of my recovery from my last TBI, I can both see and believe that so much more is possible for me. After my fall down those stairs in 2004, my “reset” button got pushed, and I was set back in my career and my relationship about 15 years. In some ways, I had to start from scratch, and I have really had to scrabble to get myself back to even close to where I was, 11 years ago.

Now I’m in that place — in my state of mind and my capabilities. And I can see so clearly now how much more I’m capable of, than I have been allowed to be by my circumstances — because people far junior to me, with far less ability and knowledge and experience, have been setting the pace and controlling the environment. In fact, the whole environment I’m working in now — in my immediate group, the larger organization, and so many of the thousands upon thousands of employees — is far less evolved and far less capable than what I was working in for the 15 years prior to my fall.

My career has been on “training wheels” for the past 7 years, actually, and it’s time to take the wheels off and move on. It’s been a long time coming, and I’ve had to put in a ton of work. But now I can see that I need to move on and get myself in a completely different space, in order to be happy and content in my work.

Now, certainly there’s the immediate environment that’s an issue. On the surface, I would welcome a change. But even more importantly, I need to change my “head space” — my attitude, my demeanor, my approach. I need to step up and really own my expertise, like never before. It’s bad enough to be surrounded by people far, far beneath my skill and experience level. But the thing that’s really done the most damage, is having succumbed to the environment and having carried myself like “one of them” for the past 3-1/2+ years.

I can do better. I can be better. And while I know that moving on from my current job is in the cards, the first step is really moving on from my current mindset, my current ways of interacting with people, my accustomed ways of carrying myself in the workplace with the people I deal with on a regular basis.

I’m better than this, and I need to act that way. I can’t let myself be dragged down by my coworkers to their level, which is embarrassing. They just don’t know how to act in professional situations.

A few examples:

We had a big Division-wide all-hands meeting that was streamed live from the home office overseas, and the Executive VP of the Division was speaking to everyone worldwide, with the camera on him. Behind the EVP, the new head of my group was sitting and talking with their counterpart in another group. Two global managers, who I would expect to behave like adults and show the EVP some respect and pay attention to what he was saying. But no, they were sniggering and whispering behind his back… as the camera recorded them rolling their eyes and giggling.

Classy, right?

Not.

Another prime example is one of my teammates who has some serious working dynamics issues with their counterparts at the home office. Those counterparts have been with the company a lot longer than they, and they also are natives to the country where the parent corporation is based. So, they clearly out-rank my US coworker, in terms of politics and connections. But my US coworker seems determined to spend all their time trying to spite and outmaneuver the folks overseas, talking about them behind their back within earshot of everyone. And what’s worse, this person puts on a good show, coming across as professional and capable, but under the facade, they’re lazy, don’t show initiative, can’t be bothered to get their hands dirty doing the drudge work that every position has, and they laugh at everyone behind their backs. They’re one way in front of others, and completely different when others aren’t looking.

The most embarrassing thing is that these two exemplars have a lot of visibility and go out of their way to carry on like they have everything squarely under control. The truth is completely opposite. They’re legends in their own minds, and they’re not paying attention to how they are truly perceived by others.

This has been bothering me for months, now — even longer. Neither of these people is someone I care to spend any time with, but I’m stuck working with them as part of my group. Plus, they’re making a ton of money, carrying on as they are, which just rakes me over coals of righteous indignation.

So, rather than let them drag me down and ruin my peace and affect how I feel and conduct myself, I need to just move out of that “space” and maintain my own level of professionalism that stands on its own.

I know that others can see what level I’m at. The fact that I’ve got a lot of very solid relationships with professionals in my organization, who are both in the States and overseas says a lot about my reputation. I’m known as someone who gets things done, and that’s a good thing.

Now I need to really embody that on a daily basis — live it, breathe it, eat-sleep-drink it, and make sure a higher level of professionalism completely permeates all my dealings with people at work. If people I work with can’t respond in kind, then I am positive that I will be able to find another situation where that kind of behavior and demeanor is appreciated and rewarded.

I know there are other places this happens — I’ve worked in them for most of the past 27 years. I’m just not in that kind of environment now.

So, I have my mission — to raise the quality of life in my daily work, to do my job in the way that I want to be doing it, and to build out my resume in ways that will “slot” me into my next position in good shape. I really do have the right stuff. I’ve got what it takes to really go far, and physically, mentally and emotionally, I’m finally in a place where I can make the most of that again.

It’s been a long time coming, that’s for sure. And I realize now that losing sight of my innate professional abilities and behavior was one of the most debilitating aspects of my TBI. I just lost it.

But now I have it back, and I’m going to take my situation to its next logical step in the progression — up, up… and ultimately away.

Onward.

Six years and counting

How time flies…

Today is the six year anniversary of this blog. To say that it has changed my life for the better would be an understatement.

Six years ago, I was at my wits’ end, unable to make sense of my life or understand why everything that once was so familiar, now seemed so strange to me. I was in a pattern of learned helplessness that kept me stuck in behaviors and choices that sabotaged me on a regular basis.

I was convinced that I could not understand what people were saying to me — and never would.

I was convinced that I was a total loser who was good for nothing.

I was battling difficulties with balance and distractability and agitation and irritability and aggression that shredded relationships and put my marriage in dire danger.

I could not read and comprehend what I’d read, and I couldn’t remember a plot line of a book from one page to the next.

I had become slightly dyslexic, getting letters turned around when I wrote.

And I could not keep a job. My life was a shambles, my money was disappearing on a regular basis, and people took advantage of me – left and right – because they could “smell” that I was an easy mark.

To say that this has changed would be an understatement.

I now know how to listen so I can understand what people were saying to me — and ask for clarification when I need it.

I know that I am NOT a total loser who is good for nothing. I have a lot to offer, and I have what I would describe as a very successful life.

I know how to handle my difficulties with balance, I understand what exacerbates my distractability and agitation and irritability and aggression, and I know how to head off problems before they trash my relationships and threaten my marriage.

I can now read and comprehend what I’ve read, and I can remember a plot line of a book from one page to the next.

I am still slightly dyslexic, getting letters turned around when I wrote, but I don’t let that stop me or hold me back. I just make the corrections and move on.

I can keep a job. In fact, I have won awards at my job. My life is no longer a shambles, my money situation is turned around and I have much better handle on things, and I am learning how to change my behavior and outlook so that people cannot take easy advantage of me – because I am learning how to be a “hard” mark.

It’s pretty amazing, when I think about it. And I’m profoundly grateful for all the good I’ve received in the course of the past six years, as I’ve pursued this journey of TBI recovery.

Many of you have helped me a great deal – both by supporting me, sharing your own stories, or calling “B.S.” on me, when I was being ridiculous. I have learned so much from you, as well as from my own life, and I have been truly blessed by this whole blogging process.

So, that being said, thank you all for your contributions and continued support here. I wish you all the very best of New Years — and an amazing year to come.

Onward!

Steady as she goes…

It’s not always going to be smooth sailing

I had a bit of a revelation, this morning. I’ve had a pretty rough 48 hours, and it’s gotten me thinking that maybe I should take my neuropsych up on their offer to help me find a medication that will take the edge off my irritability, so my temper doesn’t flare so violently.

They say that they can manage the dosage so I will have very few side-effects, which I’m taking with a grain of salt, because I have never taken a prescription medication that didn’t have side-effects, and I’ve had some pretty hair experiences.

The thing that really worries me about using meds to take the edge off my experience, is that I may become dependent on them, and if by some chance they get taken away, I forget to take them, or I (like so many other people) decide I really don’t want to be on them anymore, then I will crash even harder, and some serious damage will get done, not only to myself but to others around me. I have such intense “fits” of rage, that it really frightens me after the fact.

While I am in the midst of it, I do not care. There is a coldness to me that doesn’t care who gets hurt or how it affects anyone. I have no empathy, I have no compassion, I have no patience, and I have come close to breaking things in my home (where I literally cannot afford to break things, because I don’t have the money to replace them). Over the past couple of years, things have gotten worse with me, and my outbursts are becoming even more violent than before.

Maybe it’s me, or maybe it’s my spouse, who gets so afraid. I think it may be me. I will need to check with my spouse on this, to see what they think. Again, I need to take what they say with a grain of salt, because it doesn’t take much to frighten them.

I do know that I have had several pretty intense blow-ups in the past weeks, and I had a run-in with the police that could have ended badly for me, had I followed through on what I intended to do — actually seek out and verbally challenge an officer who pulled me over one night for a broken headlight, after they gave me a warning and sent me on my way. I was going to find them and give them a piece of my mind, later on that night. Crazy, right? Well, it seemed like a good idea to me at the time. Fortunately, I did not do it. Or I might be writing this from jail.

Anyway, all this has got me thinking very seriously about how I handle my stress and the situations in my life. I am concerned that I may start acting out at work, with the increased pressures of my position in the new organization. I am concerned that I may do the same sorts of blow-ups that I have at home — that cost me my job in the past, and it will not help my current situation one bit. I have mentioned some things to my neuropsych — and yes, they have suggested a medication to help with the moderation of my agitation.

Once again, I’m concerned that I will become dependent on this for my well-being, and that gives a pill and the medical establishment control over me, which I do not want. I understand that many people are helped by medications. I have no problem with others taking them. I just feel very vulnerable about the thought of doing it myself.

So, I need to find a way to navigate these stormy seas, and better manage my stress and my behavioral responses to pressure. It does no one any good for me to assault people or tangle with the cops. It achieves nothing. It seems like such a good idea at the time. Just a relief — a release… but it can end up with me in some pretty hot water. I need to find a way to #1 keep my stress levels manageable, and #2 keep from letting every internal storm carry me away.

I have done meditation in the past, and I have done sitting practices that helped me keep my fight-flight balanced. I haven’t done that in a while, and I’m sure that’s not helping me. So, I need to get back to that regularly.

In the moment, too, I need to have a coping mechanism that will chill me out and keep me from going overboard. I think of a ship at sea… and I think about the sailors aboard who are navigating. Just steer the ship, keep the sails trimmed, and just keep on board… and hopefully the storm will eventually pass. There is nothing the sailors can do about the storm — it is just there. They simply have to keep steady as she goes, and take care of the basics, to keep the ship righted.

That’s what I need to do for myself – just keep my ship from capsizing. Focus on the essentials, the basics, and keep going. Just keep going. Don’t get worked up over the fact that a storm has arisen — just accept that it has, and keep my “ship” from capsizing due to my own emotional upheaval.

See, this is the thing — emotional volatility (or lability) just comes up. It just happens, as a result of many factors, some of which can be controlled, others of which not so much. If I can see the inner storms that wrack me and rake me over the coals, as something outside myself that just happens — as a storm that comes up as I’m sailing through my life — that makes it less about me being damaged beyond repair and makes it about me dealing with an external force — like thunder, lightning, high winds, high seas — to keep myself afloat.

When I have an image in mind, it helps. Like when I was going to take on that cop — I was this close to pulling into the parking lot where they were lying in wait for more motorists like myself, when I had a visual of a video of one of those “world’s dumbest criminals” who was acting like a complete mad person with a copy — on camera. I watch those “world’s dumbest” shows for a laugh — and this time it probably saved my ass, because I had a very clear sense that if I did take on that cop, I would look a lot like that idiot I was laughing at, not very long ago.

So yeah — visuals. Video clips in my head. I also need to break out my old copy of “Two Years Before The Mast”… or get the DVD of “Captains Courageous” from the library… and get some of that imagery in my head.

Because it’s no good for me to hurt the people I love, or end up in jail, or trash my home, because some storm comes up.

And I don’t want to take a pill to stop this.

 

 

 

 

“how to fool a neuropsych exam”

To whomever found this blog by Googling “how to fool a neuropsych exam” yesterday:

Dude, you’re wrecking things for the rest of us. Cheating on a neuropsych exam (NPA) is no laughing matter, and given how difficult it can be to get real help — especially for those of us with legitimate issues of us who really need help — your cheating is helping the system to trash countless lives.

So, knock it off.

I have been wondering who searched on this term, and what the context was. Could be, it was a student athlete who needs to take an NPA, and they know they’ve been hurt but they still want to keep playing, even though doing so could cost them their health (even their life, thanks to second impact syndrome). That’s very unfortunate, and I wish to God I — or anyone — could talk some sense into that individual.

Or it could be someone who is trying to “game” the system and get some sort of disability compensation. That just pisses me off.

Or it could be someone who genuinely needs help, and their neuropsych is being a dick, so they feel they have to cheat – just to level the playing field.

In all cases, none of the scenarios are good – and they all have their own little tragedies wrapped up inside, just waiting to unfold.

I have a lot of issues with how things are set up for those who need help after TBI. Hospital staff often don’t know nearly enough to be truly helpful, rehab facilities have varied levels of quality, insurance companies are notoriously stingy, and general knowledge in the population is sorely lacking.

Our current “system” for addressing concussion/TBI is a partial solution, no matter how you look at it. The real problem is, people seem to think they are going to get all the help they need from the systems that are in place.

It’s not going to happen. These are all systems, and they cannot possibly meet all the needs of individuals who turn to them. The system is a collection of frameworks and procedures and approaches put in place based on knowledge from years ago, vetted by intensely risk-averse authorities, and implemented by underpaid people who often have huge gaps in their knowledge as well as a ton of compassion fatigue. They’re set up to deal with acute situations to keep you from dying and address the most basic initial problems, but long-term, they run out of benefits pretty quick.

So, if you’re looking to the system to help you with your most pressing TBI needs, I fear you’re going to be sorely disappointed. Maybe not in the first few days or weeks, but over the long term, the TBI/concussion recovery systems we have in place are woefully lacking. And the people behind those systems have a variety of motivations — money, power, influence, being a VIP, making a name for yourself, etc. Every now and then you’ll come across someone who genuinely wants to do the right thing for the right reason, but human nature being what it is…

Anyway, I can understand someone’s desire to “game” the system and cheat on a neuropsych exam. Sometimes it seems like the only way to get what you truly need. I know when I was first starting to look for help with my own TBI issues, my insurance would not cover me for the help I needed, unless I went to a neurologist and got an assessment. But finding a neurologist who would talk to me about TBI — who was in my network — was next to impossible. And then finding someone who could tell that I was having neurological issues, rather than mental health ones… that was a source of pain and hardship for me, for a couple of years before I finally got focused 100% on dealing with TBI.

The first neurologist I saw was a “TBI expert”, but they were in charge of the TBI group at a big mental health hospital (one of the best in the nation). Before long, I found the discussion moving towards mental illness issues, rather than TBI issues. Dude, I’m not here to talk about my relationships with my parents. I got clunked on the head a bunch of times, and my life is falling apart. Now.

The second neurologist I saw was a specialist in Multiple Sclerosis, which is in another ballpark entirely, but they were in my network and I had dealt with them before with regard to a family member’s neuro issues. I thought they might be sympathetic enough to my situation to at least listen to my issues, and my PCP willingly signed off on them. Unfortunately, I was in a pretty diminished state when I went to see them, they were suspicious of me because I’d gone to see the other neuro first, and the whole experience felt more like a colonoscopy than a consult. Dude, I’m not here to get drugs. I just need some answers with regard to TBI.

Yeah, it was pretty bad.

The thing is, I was forced into that situation because A) my insurance required that I see a neurologist before going to see a neuropsych, and B) my coverage also required that I stay “in network” and there weren’t any TBI-savvy neurologists in that network.

So, I was stuck. I did the best I could, but it wasn’t very good. And until I pitched a holy fit with my PCP’s office and demanded that they just sign off on the damned request to go out of network, and I found a neuropsych who actually knew how to fill out the forms, I was stuck dealing with these hostile individuals.

Who were probably hostile because so many other people try to cheat the system.

When you try to cheat the system, you just ruin it for everyone else. The thing of it is, the system lends itself to that, because sometimes it seems like it’s the only way to get what you need out of it. I sometimes wonder if it could ever work even if we all told the truth all the time. I’m not advocating cheating. I’m just saying…

Again, we come back to the underlying issue — that the people who are most in need of help, are required to step up and advocate for themselves and manage the whole neurological kit-n-kaboodle, exactly when they’re least likely to do that well. It’s like asking someone who’s broken their leg to run after a speeding ambulance in order to get treatment. You would never ask someone who’s broken all the fingers in both hands to sign a piece of paper with their precise signature, would you? Nor would you ask someone who’s blindfolded to direct a physician who’s removing a piece of shrapnel from their neck.

So, why are TBI survivors and folks who have been through concussion required to advocate for themselves and independently herd all the “cats” involved in getting adequate care?

It makes no sense.

Small wonder, people feel like they need to pull a fast one on the system, just to get their basic needs met. All the rules, the labyrinth of requirements, the criteria, the qualifications… who can make sense of it? Especially someone with TBI.

Of course, there are genuinely bad-hearted people out there who are trying to pull a fast one to get over on the system. But I’d bet good money that 9 times out of 10, the person who’s “cheating” is just trying to get their most basic needs met, and they neither understand the complexities of the system, nor are they equipped to deal with the ongoing intricacies. With TBI, you can think that you’re telling the truth and providing all the right information, but confabulation has you sounding like a bald-faced liar.

Not good.

On the other hand, once you get past all the system stuff and learn how to handle things for yourself, a whole new world of possibility opens up for you. And then true recovery can begin.

But first you gotta get there.

Speaking of getting there, the day is waiting. Onward.

No, stress is NOT all about our interpretation of TBI…

There’s more going on here…

So, I have some time to catch up on some reading, and I just came across a stress management consultant with many years’ experience coaching and counseling, who says “the source of all stress is the subjective meaning we attach to events”. I won’t say who it is, to protect the not-so-innocent.

Okay, that’s fine. I get that to a certain extent. Stress can be a killer — and it is, for many, many people. And the subjective meanings we attach to events can indeed add to the stress of our lives.

Here’s the thing, though — when you look at stress from a broader point of view that includes the physical part of life as an integral part, things start to be a whole lot less clear-cut. Or maybe they become even more clear. Because over time, you can build up a lot of physiological stressors which contribute to your overall stress levels… to the point where it doesn’t really matter how bright and shiny and positive your psychological outlook is — you feel like crap, and that stresses your system… and it also impacts your frame of mind (which is now inclined to look on the dark side, for reasons it cannot cognitively identify).

Even if you can get your mental, spiritual, and emotional stresses down, if you don’t have a handle on your physical stresses, there’s only such much progress you can expect to make.

Take for example, this scenario, which shows the relative stress levels of the four different areas over a time span that has a lot of the usual stresses we experience on a daily basis: trouble with the boss, re-org at work, $$$ worries, health problems, marriage troubles, promotions, raises, recovery, family problems.

Cumulative stress effects over time

Even if you do manage to cut down on the mental and emotional and spiritual stresses of your eventful life, you can still have a buildup of stress in your body that, if not dissipated or reduced in some way, will still keep your overall stress levels high.

Even when everything is going great.

Now, with a situation like TBI, where all of a sudden, sh*t is all effed up for no reason that you can explain, something as simple as making breakfast or getting ready for work can be a huge physiological stressor, because things that used to be so simple for you — like buttoning your shirt or combing your hair or getting milk and cereal to end up in the bowl instead of on the counter — aren’t going so well, and it’s just one surprise after another… one little “micro-trauma” after another, getting those fight-flight juices flowing like never before.

On a daily basis — and this is what a lot of folks fail to understand about TBI — you can experience hundreds of these little surprises, which pump up your adrenaline and alternately make you high as a kite and downright depressed. It makes you seem/feel bipolar to those who are fond of that label, and it keeps you on high alert, just trying to make it through the day trying to do all the things that used to come so easily to you, but now require a different sort of attention.

And those stresses add up. The biochemicals keep collecting in your system, by default. Because you have to stay ON, to keep from falling off. And you end up on constant alert, a perpetual first responder to your own personal mini-disasters… which may not be that big, objectively, but seem bigger and bigger and bigger because, well, you’re really pretty tired from all the adjusting, and that adrenaline and ephinephrine and norepinephrine is actually making it harder for your brain to learn the new things it needs to learn.

Which is yet another source of stress… which has next to nothing to do with how you look at things.

Now, I’ve talked with neuro-rehab folks who were of that same philosophy — that the thing that gets us into trouble with our stress levels is the way we interpret what’s happening to us. And I agree, to some extent, that interpreting everything along catastrophic lines raises our stress levels and is a big culprit in frying our systems. At the same time, people seem to be overlooking or discounting the role that the body plays in all this — in the role that physiological stressors play in our lives. It’s NOT all about how we look at things and the meaning we ascribe to what happens. It can be just as much — sometimes even moreso — about the physiological burdens that we have to deal with.

Does our mindset affect our physiological stress levels? Absolutely? We can flood our systems in an instant with a reaction of our choosing. Can our mind reverse physiological stressors on its own? I’m not so sure. I think the body needs to be directly involved to do that to the fullest.

All this being said (and I wish I could say everything that’s in my head, but I’m still a bit foggy from the past week), I think that any stress management program needs to incorporate the body. Actively. On purpose. As a full partner in the whole process. We need to use our bodies to move all that biochemical sludge along. Can you say lymph?

And I also want to say that I don’t think that stress is necessarily a bad thing. It’s the long-term effects of stress that do the job on us. I personally believe that when we develop ways to discharge the effects of stress and use the energy for good instead of evil, we can build up a sort of immunity to the downsides, and stress can actually become a vital and productive part of our lives. Rather than being something to dread and try to control and “overcome”, stress can be our friend. One of our best friends, in fact.

I have friends who would cringe to hear me say how much I love stress. But I can’t help it – I do. I really thrive on it. The thing that gets me in trouble is when I don’t allow myself enough recovery time from tough stints. I also work in a stupid job that is constantly stressful and doesn’t let you stop moving for a minute, so that’s another effing culprit. I work at a very high, fast pace, and I can get pretty intense. I get a ton of stuff done on a regular basis, and I enjoy it. I’ve figured out how to be ultra-productive after years of experimentation and trial-and-error, and it works for me. I just know how to get sh*t done. And Stress (capital “S”) is a big part of that. So removing stress from my life — rising above it, overcoming it, keeping it within “liveable levels” — is the kiss of death for the parts of my life that I love the most. Hey, I’m a jock, okay. I want to run faster and lift more and be stronger… It’s in my nature, so if you take that away or diminish it or talk it down, then you’re hacking away at my innermost core and you’re pulling the rug right out from underneath me.

The thing is, I know what a toll all this can take on me. It gets me hurt. It ruins my life. I burn out  in a very big way. So, I need to find a middle ground that lets me keep going, without heading right off the cliff.

Nowadays, what I’m working with — especially with my 90-second clearing — is letting my energy spike, then bringing it back down, consciously, to restful levels. I push myself hard for a period of time, then I stop, slow it down, get myself out of that frantic mindset that drives me forward, and put myself in a calm, relaxed state that actually feels really good.  For me, it’s not the pushing hard that does the number on me — it’s not having a rest/recovery period to let it all sink in and integrate. I’ve been recovery-deprived for a long, long time. Only in the past few years have I actually learned how to relax and feel good. And only since I learned how to feel good while relaxing, has it truly become clear to me that my continued growth and improvement depends on recovery as much as it does on testing my limits.

It might even depend more on it.

For my money, one of the most important things anyone recovering from TBI can do, is figure out how to get to that sweet spot of emotional/spiritual/mental balance, where it’s possible to feel physically good. If you don’t know how to get there, and you don’t get there on a semi-regular basis, your recovery is going to be hampered. You’re going to stay amped up on fight-flight biochemicals, and you’re not going to learn as well as you can, when you’re able to relax and just enjoy yourself. Feeling good doesn’t have to even be a huge deal — if you can just manage it for a few minutes a day, and remember what it feels like to take the edge off, that can help. Absolutely positively. But if you never figure out how to get there, and you find yourself unable to relax and settle into a sense of being OKAY, I predict you’re going to have a tough row to hoe.

And we don’t want that.

Anyway, it seems I found the words I was looking for.

Bottom line is, as much as some folks would have us think that it’s our interpretation of events that does a number on us, rather than the events themselves, I have to respectfully disagree. The stresses and physical reality of dealing with one surprise after another, having to pump yourself up to keep going, and having to constantly be aware of ways you need to shift and change, can be physiologically stressing in ways no change of mindset will reverse.

We need to recognize the role the body plays in stress, and find ways to address our physiological stressors, so that our minds can relax and we can learn the lessons we need to learn.

It’s all a process, of course, and an imperfect one at that. But if we pay attention and keep an open mind and realize that 9 times out of 10 we are unconsciously deluding ourselves — and then take corrective action, we just might get somewhere.

Onward

Finding progress after TBI

It’s there if I look for it

It’s been a real roller-coaster of a year, thus far. Work changes, home life changes, and trying to “reboot” my life for the better.

I’ve been noticing that I get pretty FIXated on what needs to be “fixed” in my life — what’s wrong, what’s going worse than I want it to, what needs to be addressed so that I can relax.

Relax… hm. There’s an idea.

But here’s the thing — a lot of what I think is “wrong” is going to change on its own, so I don’t actually need to do anything about it. A lot of what I really struggle with isn’t going to last. The job situation changes, as people come and go and the company decides to do something completely different. Family situations change, as people get sick and get better and learn their lessons and talk things through. Everyday life situations change, too. It’s just the nature of things.

So, getting too caught up in fixing something in my life that’s going to change, eventually, anyway, doesn’t actually make a lot of sense.

What makes more sense, is to settle into my own life, my own pace, my own way of thinking and doing things… figure out what I want to do with myself in my life… and stay the course as I get there.

All around me, things are crazy. People are genuinely insane, and they’re not making much attempt to hide it, these days. I can’t even look at the news these days, because all that’s there is drama and pain and blood and explosions. There’s no news of anything really good going on on mainstream media. Seriously, there’s not.

So, I have to find a different way — in the outside world and internally as well.

There’s Good News Network, for example, which shows all the good things that are happening in the world that don’t get major media coverage. There’s Good News on the Huffington Post, and then there’s Happy News, which is real news of happy things.

Internally, I need to keep my spirits up, as well, and really concentrate on the good that’s happening in my life. I tend to be so oriented towards addressing issues, finding what’s wrong and fixing it, that I neglect the good when it’s there. And I end up feeling artificially bad about so much, when I could feel genuinely good about so much more.

The fact of the matter is, I can now live my life with 1000% more sense of capability, than I could, just a few years ago. The fact of the matter is, even in the face of really difficult conditions, I can function — and function very well. The fact of the matter is, I have learned how to manage my temper and control my anger outbursts. The fact of the matter is, people who used to be afraid of me, no longer are. I have a better relationship with my family than I ever have — I even spent an hour on the phone with one of my siblings on Sunday night, talking in ways we have rarely talked — nothing that heavy, just talking for real about our lives and how we feel about them.

So much in my life has improved over the past years of dealing with my TBI issues. So much has settled itself, or I’ve found ways of handling it all with more capability than I thought I could. I have done some pretty amazing work, and I need to remember that — maybe make up a record book of some kind to remind myself of how far I’ve come, and what I’ve accomplished.

Because I forget. I forget and I lose sight of those things. My memory is not my best friend, when it comes to tracking where I’m at and how far I’ve come. I’m pretty caught up in the everyday, so I tend to focus on that.

But there’s more to life than the present instant that needs to be “dealt with”. There’s a whole world of past and future that’s looking for my recollection and discovery. And the bottom line is, no matter how much I may doubt myself from day to day, I have a whole lot of experience overcoming substantial roadblocks, and I can be pretty proud of that. I need to pace myself… and remember that even overcoming roadblocks, as necessary and encouraging as that can be, does take a lot of energy. And when I get depleted, I get depressed — for no other reason than that I’m depleted and I need to recharge my batteries. I get so tired, I forget that the very reason I’m tired, is because I’ve been doing really good work — and a lot of it — all day.

So, as much as I think about “making” progress in the course of my daily life, I also need to remember to find progress — steps I’ve already completed (and successfully at that), which show me I’m far more capable and resourceful than I give myself credit for.

I can do better about giving myself a rest and letting myself take a break, so I can come back stronger than ever. And I can remember — whether through a note to myself or a sign on the refrigerator — that I actually am making progress, it just seems like I’m not, because it’s lost in the haze of my fatigue and all my future plans.

Progress — it’s right in front of me, if I but look for it.

Relationships after TBI – the road back

tbi-and-marriage-1

Coming to terms can be difficult

Here’s something a reader just shared — a web page full of informational videos on Relationships after TBI from the Model Systems Knowledge Translation Center – a site which shares information on TBI and how to address and recover from it.

The featured video is a great one – about a couple who have made tremendous progress since the husband’s TBI. It’s truly inspirational to see them, and it’s clear that things haven’t been a bed of roses for them.

One of the great things about this is that there’s actually work being done on helping couples to handle the changes and challenges after TBI. It’s absolutely true that TBI affects everyone, not just the survivor, and having people out there who can share the information and help others to do something meaningful with it, is very heartening.

The road is long, but it can be so rewarding

The road is long, but it can be so rewarding

It’s also very heartening when I see and hear stories about spouses who step up and really work at things, instead of just giving up. This varies from person to person, of course, and everyone’s resilience level is different, but TBI doesn’t have to be a death sentence for marriage.

I encourage you to check out the videos at the MSKTC

Brain Injury and Lying – The Rest of the Story

Summary: Brain injury and lying can go hand-in-hand. First, there is confabulation, where the brain-injured individual genuinely thinks they are telling the truth, but they have their details confused. Second, there is the outright lying, which can come from experiencing an intensely emotional “catastrophic response” to situations which seem insurmountable. This is an account of how a good friend of mine changed from a basically honest person to a compulsive liar after experiencing several strokes.

It seems so innocent...

It seems so innocent…

I’d like to write this morning about a friend of mine who had several strokes back in 2007, a couple years after I had my last TBI. In fact, I’d say that working with them after their strokes really make me aware of brain injury issues… so that I could recognize and deal with my long-standing issues, at last.

I have known this individual for more than 20 years, and we’ve worked together on a number of occasions. We have common friends and we have similar senses of humor, so it’s been pretty easy to become – and stay – friends with this person. I am friendly with a lot of people and I make a lot of effort to really be a good person, but this particular friendship is closer than most others I have. This individual knows things about me that I wouldn’t tell most other people. And I know more about them than most others do.

The one exception to this is TBI. When they had their strokes – two of them, a week apart – in 2007, I was one of the few people who didn’t back away from them and run. I have actually known a number of people who had strokes and TBIs, and even before I knew that I myself had traumatic brain injury issues, I was willing and able to hang in there with them. So, this time was no different really. Different strokes for different folks, y’know? ;) But when I was dealing with my TBI stuff, they just couldn’t deal with hearing about it. It was like they thought that it meant I couldn’t be there for them – and since I was one of their main supports after their strokes, the idea that I had neurological issues must have been pretty frightening for them.

Anyway, despite not getting any support from them, I really went out of my way to make time for this friend, to help them get back on their feet and rehabilitate. I have always been a firm believer that the human brain and body and spirit are incredibly plastic — and they can and will recover to a much greater degree than the “experts” believe, if you give them a chance, keep working, and don’t give up.

Working with this friend, we got them on a regular eating and sleeping routine… we got their weight down about 30 pounds… we managed, changed and then regulated their meds… we restored the strength and coordination in their right side… we got their speech and organization together… and – together – we got them back to functioning again.

We had to do it ourselves, and we had to do it alone. Because even though the MRI showed even more damage to their brain than “just” the strokes — they had other evidence of brain injuries that they couldn’t remember having — the doctors never gave them any indication that they needed any neurological or neuropsychological help, and their strokes weren’t “disabling” enough to warrant official rehab.

The impact was pretty noticeable to me, though. Their processing speed had really slowed down. They got confused a lot more than before. They had extreme emotional reactions to things that are sad or frustrating but aren’t exactly the catastrophes they thought they were. They had trouble keeping a conversation going. Their ability to multi-task was pretty much out the window. They basically went from having six gears, to having two, one of which was reverse, and when pressed to do more, they blew up or broke down in tears.  But since I’m not an “official” family member, there was only so much the doctors could offer me. Unfortunately, they and their family weren’t really emotionally or logistically able to deal with all of it. They just wanted things to go back to normal.

Out of everyone, I turned out to be the only one who was A) able to deal with the fact that they’d had several strokes (and evidence of previous TBI), and B) willing to do something about it. I’ve worked with relatives who had strokes and TBIs in the past, and this time was a repeat of those past experiences.

It took several years to get them back on track, but we did it.  And it was really gratifying to see. Plus, in the process of helping them, I realized I had my own set of issues I needed to deal with — which I’ve written about plenty in the past. Again, it’s taken me years to get back on track — more years than my friend, actually — but I’ve done it.

The only thing is, this friend of mine didn’t continue to take care of themself. They didn’t have the support of their family and friends, and I couldn’t be with them 24/7. One of the reasons that I’ve “gone off” on therapists in the past, was that I was being actively undermined by their friends who were therapists, who kept telling them that their issues had to with their terrible father, their hell-on-wheels mother, or other past relationship issues. When I tried to get support from these therapist friends, to deal with the neurological issues, I got either blank stares or active opposition, because they were so sure it was an emotional thing, not a neurological thing.

So, with family pressuring them to just get back to how things were, their friends telling them that they just needed to make peace with their parents, and me not being able to be around as much as I wanted to, because I had a lot of work commitments, they just went back to how things were before.

They stopped eating the right things and they stopped eating at regular hours.They started eating the wrong things, too — lots of sugar and fats and junk food, which has put the weight back on them — and is how they got into their situation to begin with. They let their sleeping schedule go all to hell, and by now they are pretty much nocturnal and they are rarely available during daylight hours.They stopped cleaning up after themself, and they live surrounded by piles of stuff that they can’t seem to figure out how to clear away.

It’s been really weird — it’s like they just got to a point where they decided, “Oh well, I’ve had some strokes, and I’m getting old like my parents did (my friend is  now in their 60s, and their parents both died in their late 60s/early 70s)…. so I really don’t feel like doing all this work anymore. I’m going to take a break, because I’m going to die pretty soon, anyway.

And it hasn’t had good consequences. A lot of times when I see them these days — which is more rarely than before, because I’m on a “real world” sleep-wake schedule — they look more and more like a “stroke victim” — and less and less like the person I know they are. I try to bring up their progress with them, but they always shut me down. I try to hint that they may want to take better care of themself, but they either start to yell at me, or they change the subject, or they start to cry. It’s that catastrophic response, for sure — a reaction that is just dripping with the emotion of fear and overwhelm.

Fear that there is something terribly wrong with them.

Fear that they are damaged beyond repair.

Fear that others will hate and look down on them because of the strokes.

Fear that they will never be “normal” again.

Fear that they’re going to die a horrible death and go to hell forever.

Fear that it is all TOO MUCH to handle.

So, even though I have seen changes in their behavior and their functionality, I am helpless to change any of it. I can’t even bring it up – not with them, not with their family, not with their friends. People tell me that I have no control over others, and that I should take care of myself first, but it is so painful to watch them do this to themself. Not only do they have physical and logistical issues, but there’s more.

There’s the lying.

I’ve written before about confabulation and how traumatic brain injury can mix things up in your head and make you think you’ve got it right, when you have it completely wrong. I have a had a long history, myself, of accidentally “lying” about things  — it wasn’t my intention to lie, and I didn’t actually think I was lying, but I had my facts all turned around… which looked a lot like lying. I still do it today — I miscalculate, or I get things turned around — but fortunately I have a lot of people around me who genuinely care about me and want to help, and they don’t hold it against me. So, the consequences are less, even if the problem persists.

I have seen confabulation happen with my friend, as well. They were so sure they had things exactly right… but they didn’t. Not even close. Over the past few years, however, I have seen their accounts turn into outright lies — some of them more extreme than others. They know they’re lying, but they either can’t seem to help themself or they just LIE, and then make excuses.

It’s getting really bad. On a number of levels.

First, there’s the routine lying to people about what they do with themself all day — they paint a picture that makes them look quite functional, when the opposite is true. They talk about doing things that they aren’t even close to doing — like running errands or working on important projects and going about their business like they’re “supposed to”. They’re just thinking about doing them, but they tell others that they actually have done them.

And then there’s the deeper sorts of lies — the adulterous affairs, where they aren’t only sneaking around behind their spouse’s back and flirting with people who seem intriguing, but they are actually having sex — a lot of it, and really wild stuff — with these adulterous interests, lying about it, getting hotel rooms, visiting the long-time family vacation spots with the object(s) of their adulterous affairs, and openly talking about their affairs with people who know both them and their spouse. I found out about it by accident, and I got a lot more details than I wanted to. I almost wish I’d never found out, to tell the truth.

And that’s a pretty extreme turn of affairs. Not only are they spending money that they (and their spouse) cannot afford to spend on hotels and meals and entertainment, but they are also doing it in plain view of people who know them and their spouse. But when I have confronted them about it, my friend has lied right to my face about what was going on. They have sworn – up – down – left – right – that there was nothing untoward happening, just a “close friendship”, and when I have pushed them, they claimed it was just for “emotional support”.

Right. Emotional support. Unfortunately, I know differently.

This, dear readers, is very out-of-character for my friend. For as long as I have known them, they have been stable and loving and committed to their spouse. And they’ve at least tried to be honest. Until the strokes. Since the strokes, and especially they stopped taking care of themself, their behavior has become so erratic, so chaotic, so extreme — with the cursing and laughing and crying and lying — that I frankly don’t want to be around them much. I can’t just abandon them, but it’s hard to be around it all. And when I try to bring this up and discuss with them, they just can’t hear anything about how their strokes have affected them. It’s too much. It’s just too much for them to handle. And they pitch headlong into yet another mother-of-all-catastrophic-reactions. Yelling, cursing, crying… and more lying.

Watching someone who used to be level-headed, strong, secure, and self-confident burst into tears or blow up in a rage or come up with some cockamamie fantastical version of “reality”, because you’ve drawn their attention to something that everyone else on the planet can see clearly… something that is really and truly wrecking their life (how long till their spouse finds out about the affair(s)?)… well, that’s a pretty bitter pill. Trying to reach out and help one of your best friends — only to have them freak out on you and become threatening… it’s a hard one.

And it’s complicated. There are a lot of factors in play. And I can understand why a lot of this happens. But the lying doesn’t help matters any. It’s one thing to confabulate, but outright telling a falsehood deliberately is something that doesn’t sit right with me.

It’s just wrong. And to see them do it so compulsively… that’s pretty hard to take. I am almost neurotic about telling the truth — I get myself in trouble all the time, because I’m not willing to lie to people. And when someone who matters this much to me just runs around lying through their teeth, left and right, to everyone — including their spouse — it really works on my nerves.

But when I look at this in terms of catastrophic reaction, it starts to make sense. It’s like there’s all this conflicting stuff rattling ’round in their head that they can’t make sense of, and it puts them on edge. They have a history of trauma, too, with a father AND a mother who were each a real piece of work, so that personal history has biochemically primed them to go into fight-flight over just about anything that looks like a threat. From what I’ve seen, they are geared towards a fight-flight response to life in general… and their blood sugar is out of whack, so that it’s making that fight-flight even worse, and every little uncertainty looks like an enormous THREAT!!!

So, being on edge, and having the perception that there are things that are too big for them to handle, and they’re not going to be able to handle them, and they are in DANGER because they can’t handle them… well, that sets up the perfect “petri dish” for growing lies. Because lying is the one (and only) way they can immediately cope with an imminent threat — which of course everything looks like, especially when a social situation calls for the kind of quick thinking they cannot do anymore.

When I look at this whole business through a neuropsychological “lens”, I can understand the reasons for their behavior. And bottom line, knowing what I know, I actually don’t blame them. Yes, they are an adult, and yes they are responsible for their actions, but this is a neurological condition, not a psychological or emotional one. I’m not letting them off the hook — lying is still wrong, and I am still very uncomfortable with it.

At the same time, I’m seeing the real reasons behind it. I’ve discussed this a few times with my neuropsych, and they propose that their brain might be experiencing further vascular damage, because not only do they have a history of strokes, but their blood sugar is on the diabetic side, as well, which can cause more vascular “insults”. And that’s a whole other ball of wax to deal with.

But still, the lying… I keep coming back to that. It’s really tough to watch, really hard to handle. One of my best friends is self-destructing before my very eyes, and I am helpless to do anything about it. All I can do, is learn from their actions and their mistakes, and do what I can to help them as best I can. To be honest, it motivates me to take even better care of myself and better manage my physical and neurological health, because I don’t want to end up like them. I have noticed myself lying at times, when I felt cornered and felt I couldn’t handle everything that was coming at me. That is something I DON’T want to make a habit of, and seeing my friend go through everything they’re going through, is lighting a fire under me to do better. To be better.

None of us has control over others, which is probably a good thing. But we do have control over ourselves, which is an even better thing.

Here’s to life – onward.