This is a continuation of the discussion about PTSD from TBI – Exploring some possibilities.
The next factor in the development of PTSD, according to Belleruth Naparstek, is “a longer duration of exposure to the trauma, or a greater number of exposures within a certain period of time — in other words, the “dose” experienced.” (Invisible Heroes, p. 49) Victims of domestic abuse that lasts for years and years, those exposed to war, and also helpers and first responders, are particularly susceptible.
As I discussed in my last post PTSD from TBI — Like being trapped in an abusive household, TBI can – and often does – result in repetitive “micro-traumatic” experiences which all add up over time to clog the system with biochemical stress sludge. What’s more, in the initial period after the injury — and even weeks, months, and years after the TBI — you’re pretty much bombarded by a constant stream of “micro-traumatic” experiences, which all adds up to a hefty dose of post-traumatic stress.
There really is no way around it. Your brain is functioning differently from how it used to — and as far as you’re concerned (and everyone else), it’s functioning wrong. Everything is starting to slide, nothing seems familiar anymore, and there doesn’t seem to be anything you can do about it. Chances are, your wits aren’t about you, so you’re not 100% aware of how different you are from how you used to be — your behavior and your thinking are all sort of jumbled up, so nothing is really clear. But still, you’ve got this mounting sense that something is not right, and you can’t figure out what it is, or what to do about it.
Depending on your reaction, and depending how you interpret your experiences, you can be primed for some real PTSD in the weeks and months following a TBI. If you’re determined to do and be and work and live and play exactly like you were before your injury, you’re in for a lot of rude awakenings. And if nobody is around to explain to you how the brain is affected by TBI, it can be frightening – terrifying, even.
So, yeah, it’s a big dose of trauma. Over an extended period of time. And if your family and friends and surroundings aren’t understanding or helpful, it can prolong the pain and also exacerbate it. Ignorance and fear rarely help anything. And when pushing you to “just be normal again” is the chief strategy, it can open the door to even more traumatic experiences over time.
Adjustment on some level is necessary, but when you’re under intense pressure to be something you’re no longer inclined to be, it adds even more stress — and more trauma. And the longer you put off making necessary adjustments, the longer you prolong your suffering, and impact your mental health.
It’s hard to describe this whole process to someone who’s never experienced TBI or some other condition that puts them at odds with how they “should” be, but if you’ve been there, I’ll bet you know what I’m talking about.