When it comes to understanding the connections between TBI and Traumatic Stress, it’s important to think in terms of the whole person and their whole experience. Neither conditions exists in a vacuum, and they both feed directly into each other in really sinister ways. What’s more, with TBI, you don’t need a particularly bad experience to produce bad results in your life. Even good stress can contribute to a downward spiral that just is NOT good.
Here’s a picture:
And here’s how it all shakes out:
All the Excitement! The drama can be good or bad, positive or “negative”. It can be invigorating, or depleting, but ultimately with TBI, when you have way too much excitement, you can get into trouble.
First you have The Rush
Then you have The Physical Toll
Then you get The Cognitive Collective THREAT to the person & their survival
Then you get Trauma (and hence, traumatic stress)
Here it is, step-by-step:
- Adrenaline is flowing big-time. It feels great! Or maybe it doesn’t. The adrenaline might be in response to something dangerous, something unwelcome.
- Excitement is the elixir of life. Woo hoo! Many times, the degree of excitement we feel depends on how we interpret the experience. If we are convinced we can handle whatever comes across our path, it can be exhilarating. If we’re convinced we can’t handle anything, it can be depleting.
- Thrills, chills, and adventure – makes you feel more alive than ever. In the case where there are unwelcome forces at play, this can dull the anxiety you feel. Or in the case where there are welcome things happening, it can make them feel even more interesting.
- Fear plays into it a little bit — or a lot. What’s a thrilling situation without a little fear?
- Biochemical floods douse your body with all sorts of complexity-dampening goodness that clears your mind and brings your body to life. Only the most critical things come through, which can be a relief. You also get all pumped up, which in itself can feel good.
- Whole system ON so you can handle whatever comes your way.
With Adrenaline, you eventually get a little wired. Maybe a little, maybe a lot. Your body can get taxed from all the adrenaline, if it goes on for a while without taking a break. Like if you’re in combat, day after day. Like if you’re working on a huge, critical project that will have an impact on your career. And with TBI, if you’re not thinking very clearly and you get nervous/scared/anxious about the choices you’re making and your ability to handle the situation you’re in, you can get even more flooded with adrenaline.
All the Excitement at first makes you ALERT, but eventually you get Fatigued. It can’t go on forever without some sort of relief. It’s like driving your car at 95 mph, mile after mile. You need to stop and refuel, every now and then. But with all the excitement, you can lose sight of that and want to just stay in the “zone” where you’re charged up.
Thrills may keep you Always-on, so that you eventually Cannot Rest – you’re like a machine that’s jammed in high gear. You can end up in a self-perpetuating cycle of action/adventure that feeds itself and wants to stay ON, to keep as sharp as it thinks it is.
Fear can be healthy in small doses, but too much of it over a period of time gets you Strung out. Remember all those biochemicals flooding you? They’re not going anywhere until you can take your foot off the gas pedal. But doing that can put you into a fear state, which can plunge you into exaggerated responses to fairly minor provocations. Fear tends to feed itself.
Biochemical floods leave you Physically depleted, and that in itself can make you depressed and unwell. Physical depletion includes the brain — it needs about 20% of the energy in your body, so if your body is low on energy, so is your brain.
Having your Whole system ON over an extended period of time leaves your Whole system TAPPED OUT like nothing else.
As a result of all this excitement and depletion, you can end up having a ard time processing complex ideas. The Excitement and ALERT state leaves you Fatigued, which then can lead to Cognitive fatigue … and that leads to increased agitation/restlessness.
The Thrills, Always-on state, and lacking rest can put you into a Hyper-alert, hyper-vigilant frame of mind, driven by Strung out Fear, Anxiety and thoughts shaded by yet more fear.
In response, Biochemical floods pick up, leaving you even more Physically depleted, and when your Body is that taxed, it can distract the mind with pains, aches, sensitivities… which makes you even less cognitively capable. It can cut down on your capability, your ability to think clearly, your processing speed, and your overall experience of life.
Ultimately, your whose System starts to slow down, you can’t continue at that pace. When you have a Hard time processing complex ideas, you can find yourself thinking, “Why can’t I think? What’s wrong with me?” Cognitive fatigue, agitation/restlessness, can leave you not feeling right — Something is wrong. And you can over-compensate for that sense by being even more Hyper-alert, hyper-vigilant — telling yourself, “I have to be careful, I have to be cautious — WATCH OUT!”
Anxiety and thoughts shaded by fear can practically shout, “Something is going to go wrong! I’m going to be screwed!” Enter paranoia and dread. All that stress leaves your body taxed and hurting, distracting the mind with pains, aches, sensitivities, insomnia, etc. You can’t focus, can’t stay on track. Can’t keep your sh*t together.
Meanwhile, your system is slowing down even more. You push yourself harder, but you just can’t continue at that pace. You can’t keep up, you feel like you’re losing your mind, you can’t seem to hold your own with others. Your life is going to hell in a handbag… and you’re not quite sure why.
And you decide “I’m useless and nobody cares.”
All of these things — this cascade of experiences — contribute to trauma on multiple levels. Physical trauma. Mental trauma. When your system is threatened and you can’t get free, you feel like you’re going to be destroyed — on some level or another. And that’s traumatizing. It’s too much for our systems to take. And if we don’t understand what’s going on, why we’re acting/reacting the way we are, it can put us in a real state of existential threat.
This trauma — the daily experience of having your life, your person, your identity endangered — is very real and needs to be addressed. It needs to be specifically “treated” with proper food and rest and exercise, with information that tells you about your situation, with a positive feedback loop from trusted friends who are there for you and can help you (or some other support group). It needs to be taken seriously by healthcare professionals, and it needs to be integrated into the treatment of mild traumatic brain injury.
Based on my own life experience, and what I’ve learned and contemplated about trauma and the human system over the past three years, I have to say that the traumatizing effects of unaddressed mild traumatic brain injury, is one of the key ingredients in long-term difficulties. And it’s not just the results of the trauma that need to be addressed, but also the somewhat preventable conditions that contribute to the trauma.
Mild traumatic brain injury, in my opinion is a chronically re-traumatizing condition which can be progressive. It’s a little like addiction, in that it’s not going away just by wishing, and the main thing you need to do is not fix it completely, but manage the ongoing impact it has to your life. Many of the traumas, I believe, can be avoided. But to do so requires information and support of some kind. It’s not the sort of thing we can sort out on our own, or that we can handle all by our lonesome. We need to have resources and connections outside ourselves, and we need to have support in regularly using those resources.
This is — again — an area where mTBI folks face challenges. Because so many of our friends and loved-ones just want this to be over with. They want to get back to the way things were. They want to get back to “normal” — whatever that may be. And they often don’t understand that we need ongoing support and resources far beyond the timeframe of our initial injury. Something fundamental about us has changed, and if we don’t incorporate that change into our lives then we’re going to find ourselves in trouble again and again, without really understanding why.
This TBI stuff won’t just go away for good. And it can rear its ugly head, time and time again. Realizing this is a good part of the battle. And using that realization to prevent further traumatization, as we go on with our lives, is yet another part.
2 thoughts on “From Drama to Trauma in a few easy steps”
Wow, thank you for helping me see more clearly what is happening to me. I went through a major life changing event. An accident on the highway that has still left me disabled. Then after long term healing and several surgeries, things got worse.
I borrowed on my home, then combined the debt with mortgage to get debts paid. I finally after 6 years was attending college. Spouse did not support supervision of his daughter and she caught my house on fire. Things got worse and I became more angry and demanding because she got expelled, and an unattended Bi-Polar not taking her meds for weeks at a time lent the threat that the house would catch on fire again. I attended school 100 miles away. Weekends my spouse working the same distance away refused to come home nightly, not wanting to attend to his 17 year old daughter. In much regret I decided to make her stay with her boyfriend during the week. My spouse became furious and left me, and moved into an apartment in the city, thus abandoning his daughter as well. Things got worse and he one was a cop who put animals to sleep and disposed of them in a dump with chemicals for quick decomposition. He verbally threatened me and it was made clear my children would never see me again. I lost 30lbs in six weeks and had to stop college, as my instructor confronted me about changes in my severe anxious behavior. Auctioned all I had after he got most of his things, got took in the process of selling my home, and lived in constant fear. Tried to work only to hurt previous injuries more. Feeling all mentioned and getting professional help for Post Traumatic Stress Syndrome. Taking steps to face things and not be a victim. Life is what you deal with. Have courage, talk to Jesus, pray for good people who will listen to you and be supportive. The Jacque Waller story has sort of had me relive it and if I had it to do over, I would have stood up for myself. Living in fear and out of sorts with constant pain of my injuries had been difficult, but with His help and others I will make it. Been through loss of homes due to floods with many family members and other traumatic events. Refocus and set goals. Listen to music and encourage yourself in the Lord. Attend recovery meetings. Try not to isolate yourself, and get professional help. Study what you can and educate yourself. In time reach out to others. Only God Knows How Your Heart is Hurting, Only God Knows How You Feeling Inside. (song I once heard).
Thanks Joan for your words. It certainly can be a challenge… I hope things turn around for you – it sounds like they are, slowly but surely. We can’t always change the people around us, and we can’t change the choices we’ve made in the past, but we can keep working on ourselves, improving, and just trying our best, with whatever help we can find.
Reaching out for help is so important, as you well know.
I wish you all the best!