Emotional/Behavioural Changes after Brain Injury – Part 1

lightning striking the ground under dark clouds
Sometimes the storm seems to come out of nowhere.

From The Toronto Acquired Brain Injury Network.

My comments are in bold like this.

Emotional/Behavioural Changes

Some people are left with changes in emotional reaction or behaviour after a brain injury. These are more difficult to see than physical or cognitive changes. However, they can be the most difficult for the person and their family to deal with.

BB: I had no idea that a TBI would affect me emotionally, or change the way I acted. Like so many people, I figured that a bump on the head was just an external thing. I'd feel pain on my scalp, and maybe I'd feel a little woozy, but it would clear up in a few minutes... or hours. How wrong I was - so many times. Emotional and behavioral issues have been the bane of my existence (and my family's) for years and years, starting back in my childhood when my behavior was erratic, and my emotions were volatile.

Not everybody will experience these problems and their severity will also vary.

BB: The severity can vary from person to person, as well as from situation to situation. With me, I can be fine, one day... be not-so-great (but seem fine), the next... and then completely lose it a few days later. It's often cumulative, but nobody on the outside sees it building up. That happens inside. Where nobody can see. And when it erupts... hooo boy.
fireball explosion
The problem for me, is that when I blow up, it puts people off, and then they think that's how I always am... and then they walk on eggshells about it, all the time.

And I sometimes never get a second chance, because they've made up their minds about me in a negative way.

Agitation

This frequently occurs at a very early stage after the injury. It can be a coping mechanism for the person, who may be disorientated and very confused. It is most often a stage a person passes through, rather than a permanent change. Examples include: restlessness, pacing and pulling at intravenous tubes.

BB: I've been extremely fortunate to never having had intravenous tubes to pull at, but I know the feeling of not being able to sit still, being extremely agitated - especially after a TBI. A number of times, I can recollect getting hit in the head, and then being flooded with agitation and an overpowering need to MOVE! Like when I got hurt during an informal pick-up soccer game in high school, after the hit, when I was lying there, dazed and confused, I suddenly felt like I'd been given super-powers, and I leaped up and started playing like a crazy person. I don't think I played better than I had before I got hit, but I felt like I did. And I was ON FIRE - or so I thought.

In another soccer game, when I got my bell rung, I knew I'd been hurt, but I felt this incredible urge to GET UP AND GO!!! And I started racing around the field -- in the wrong direction, no less. I nearly scored on my own team, which I think was a red flag for everybody on the sidelines. I did get taken out of that game, and I paced the sidelines in confusion and anger, because I NEEDED TO BE IN THERE! But it was wise to pull me from the game. I was not in good shape, at all.

So, while agitation may be a coping mechanism for some, as they say above, I suspect it also has to do with the mechanism of the brain - the release of all those chemicals, and the general confusion that causes. The brain is trying to figure things out - plus, it's firing on ALL cylinders, like there's no tomorrow. In addition to being a behavioral coping mechanism, it's a result of the brain's basic function.

Explosive anger and irritability

If there has been damage to the part of the brain that controls emotional behaviour and the ability to tolerate frustration, emotions can swing to extremes. The stress of coping with even minor crises, such as misplaced shoes or a noisy vacuum cleaner, can be too much and trigger an angry outburst. If these stresses can be identified, it may be possible to reduce them.

BB: Amen to this. The part of the brain that controls emotions is particularly susceptible, as it's out in front and there are so many types of injury that can affect it. Car accidents, where your brain slams up against the inside of the skull... or tackles that snap your head back and forth... falls, etc. Minor events can turn into crises -- just being blindsided by a sudden change or something unexpected happening, can set me off. Little things can turn into huge things, in an instant. One minute, I'm fine, then all of a sudden, it's off to the races with emotional overload and over-reaction.
galloping horse
Prolonged stress will also do a number on me, as will fatigue. The more tired I am, the more irritable I get - a tired brain is an agitated brain. And when I get too agitated, it's not cool.

Sudden outbursts... extreme reactions... it's all part of a day in the life for me, sometimes. Unless I can get enough sleep and take good care of myself. If I can keep on my schedule and be smart about eating and drinking enough water, that helps. So does meditation and just taking time to chill out. 

Lack of awareness and insight

The ability to recognize your own behaviours and change them when needed is a sophisticated skill that can be affected by brain injury. This can affect someone’s ability to: be self-aware; have insight into the effects of personal actions; show sensitivity; or feel empathy. It also means that a person may not fully appreciate or understand the effect that the accident is having on their life, health or family.

BB: I honestly had no idea how my TBI was affecting my household, back in 2005. I'd gotten injured at the end of 2004, and 2005 was the start of the downhill slide. I became incredibly self-centered and obsessed with myself. Small wonder - I had to recover and build myself back up, as my Sense-Of-Self had taken a huge hit. I didn't know who I was or what I was about, anymore, and it was devastating. I didn't recognize myself, and I was so caught up in figuring it out inside my head, that I never realized the extent of the changes on people closest to me (who were outside my head).

It took talking with someone on a regular basis about what was going on with me, to help me see what an ass**** I was being, and to do something about it. Until I started talking to a neuropsych on a regular basis, I had no way to understand myself and objectively examine my behavior, because nobody I talked to actually understood how TBI affects the mind, body, and spirit... so they made all kinds of flawed assumptions about who I was and how I was. It was incredibly unhelpful for me, and it did more harm than good. 

I got lucky. A lot of others don't have that opportunity. And that's a damned shame. It's criminal, really.

I’ll continue this post in Part 2. Watch this space for notifications.

Source: www.headway.org.uk

Source: Emotional/Behavioural Changes | ABI Network

After TBI or concussion – slower brain, craving stress

brain-firingOne of the amazing things about the brain is that it has an uncanny ability to get what it needs in the short term, but which actually hurt you in the long-term.

After injury, it can push you to do things that will feed its immediate need, but the ultimate result is just not good.

Take stress, for example. And danger. And risk-taking activities. All those things look like either bad habits or a taste for self-destruction. But actually, it can be the brain seeking out the pump of energy it needs to function.

After TBI or concussion, the brain’s “tonic arousal” (its general level of wakefulness) can be negatively impacted. The brain is literally more “sleepy” and doesn’t respond as quickly as it once did. Many concussed folks complain of feeling slower than before their injury, and while there may be a number of different reasons for that, tonic arousal can be a big component.

So, what does our brain do? It seeks out opportunities to come alive — to feel like itself again. WOO HOO! And for a little while, when we’re stressed out over our procrastinations, or our altercations with others, or our other poor decisions made in the heat of the moment, we actually do feel alive. We feel like ourselves.

The only problem is, stress and drama actually keep us from learning. The parts of our brain that need energy and information can be literally shut off, when we’re under extreme duress. And as a result, we can end up repeating the same stupid mistakes over and over again.

Because A) We haven’t had the chance to learn from our last mistakes, and

B) There’s a part of us that actually thrives on those stressful situations.

So, it’s a vicious cycle.

And it applies not only to folks with TBI and concussion, but also those with ADD/ADHD, PTSD, or other brain-related issues that slow them down. When you need to go faster, your brain will do what it needs to get its requirements met. The only problem is, over the long term, this can be… just a little disastrous.

You can read more about this here at:

A Perilous Relief

Just something to keep in mind…

Overcoming overstimulation

Lots going on...

I’ve got a big trip coming up next weekend — I’m taking nearly a week to go see family in several states… kind of a follow-up trip to make up for not having been there for the holidays (I was sick and couldn’t travel). There will be lots of driving, lots of activity, lots of interacting with relatives I haven’t seen in many years. There will be a family reunion with relatives, some of whom care about me, others of whom couldn’t care less about me. There will be time with siblings as well as aunts and uncles and cousins. All together in one big melting pot for the weekend.

This is coming on top of some very busy times at work. I’m a bit apprehensive, because I’ve been tired and I’ve had trouble sleeping, and I am concerned that it might affect my ability to deal with my family. I also worry that it will affect my ability to deal with my spouse, who is not a big fan of most of my family. We come from very different backgrounds, and my spouse is not always the most open-minded individual when it comes to differences.

I know I shouldn’t stress over this, but I am a little bit. I have to get a bunch of things done for work before I go — it’s really BAD timing, but there it is. My workload is just crazy, these days, and it will be until mid-September. Then it will probably pick up again through the end of the year. It’s hard to believe July is almost over. August is so packed, it might as well not even exist. Just busy, busy, busy all around.

But it’s a good thing. It beats the alternative. I’ve become a key contributor on some important initiatives, so that keeps me going and it gives me a sense of belonging to something bigger than myself. And I have to keep that in mind. It’s another way of looking at it — it’s a good thing, that going away for a few days is a problem. Because if it weren’t I’d be in trouble.

Likewise, if I think about the upcoming trip with my relatives, one of the reasons it promises to be so full, is that so many people want to see me. They want to talk to me, to find out how I’m doing, to tell me about their lives. They want to share a lot with me, and they don’t realize how overwhelming it can be for me. Over-stimulation has resulted in me going temporarily deaf and blind — I was with extended family members who were very high-strung, and there was so much going on, my system just shut down, and for a short time (maybe 10-15 seconds), I couldn’t see or hear anything. Everything just went silent and black. I came back (of course) and felt dazed and confused. I suspected it might have been some sort of seizure, but then I got checked out, and everything seemed to be fine, actually. So, it was probably just the overwhelm.

Thinking back on that day, which was about six months before I figured out the TBI connections to the difficulties I’ve had in my life, I can think of a number of things that made it more difficult, overstimulating and overwhelming:

  1. I was extremely anxious about a lot of things — if I was wearing the right sorts of clothing (people around me were much better dressed than I, and I felt self-conscious in my jeans and t-shirt).
  2. I was pretty brittle and inflexible in my expectations for the day — I wasn’t going with the flow, and when the group kept changing plans, I got increasingly uptight.
  3. I wasn’t eating properly — I wasn’t eating the same sorts of foods I normally did.
  4. I wasn’t resting enough — I had been pushing myself to go-go-go, the whole time, and I was very fatigued.
  5. I wasn’t exercising enough — I wasn’t exercising at all, actually. I hadn’t been taking the walks I needed, and I hadn’t been working out regularly the way I have been over the past couple of years.
  6. I wasn’t wearing my sunglasses — Big problem on that very sunny day. The brightness only exacerbated everything else, adding to my anxiety and stress.
  7. I wasn’t in command of my thoughts and my reactions — I was being pushed and pulled in a million different directions, and I wasn’t driving the car of my own mind. I was letting everyone else decide for me how to think, how to talk, how to behave. I was trying to fit in and do the right thing so I wouldn’t be as conspicuous (and embarrassing) to my extended family/in-laws. The result was that I stood out even more, I was less able to participate, and I lost it (literally) for a short while that day.

Looking back, I can see how I’ve really come a long way in the past 4 years. I’m nowhere near where I used to be, and I have to remember this as I prepare for this next trip. My anxiety levels have decreased dramatically since I started exercising on a daily basis. And my whole world view has changed as a result. My neuropsych has been a huge help, keeping me honest and realistic — in a good way. They don’t let me get away with the old “stories” about how debilitated I am by my TBIs. They don’t let me easily jump to conclusions about being incapable and incompetent, just because I happen to be human. And they don’t let me make excuses about poor choices I’ve made and things I’ve done. They don’t beat me up over it, but they also don’t let me write myself off with some easy excuse about being impaired.

And that’s quite a feat to accomplish. Because I have a lifetime of experience of reaching the “logical” conclusion that there is something wrong with me, and I am less capable than I actually am. I’ve had plenty of people telling me there was something wrong with me. I’ve had plenty of people “protecting” me from myself. I’ve had plenty of people ditching me or taking me off tasks when I didn’t perform as expected.

It was all a crock, but when you hear it often enough and everyone seems to agree, it starts to sound like the truth.

But it’s not. It’s the farthest thing from the truth.

The real truth is that I have the tools and the experience and the proper mindset to approach this coming weekend in a stable, productive frame of mind. I’ve managed equally — if not more — challenging situations quite well, and I’ve come away a better person as a result.

I know from experience that I don’t have to bury myself in work in advance, trying to keep my mind off things. I don’t have to run away from it, drive myself with all sorts of stress that takes my attention off my anxiety. I can rest and relax and also get good exercise in advance. Eat well and take care of myself, and remember that I’m going to meet and greet people who actually love and care for me, even if they don’t always agree with how I live my life and vote.

That might actually be the hardest thing to handle — that anyone could actually love and care for me. That all my injuries and my issues and my supposed shortcomings might not matter nearly as much as I think they do. It could just be that I have a great time when I go on this trip. It could just be that the only over-stimulation is actually in my mind. And that if I can tame that, all the rest will come naturally to me.

It could be…

concussion now i’m stupid

Someone visited this blog yesterday with the search “concussion now i’m stupid” and it seems like it’s in the air.

I had a great day Saturday — I had a very social day, and I was out and about in town, which rarely happens with me. I either don’t have the time, or I don’t make the time, or I find a hundred other things to do that are more interesting than interacting with other people in a city.

But Saturday, I took a bunch of chances, and I had a ton of interactions that were really positive and encouraging.

Sunday, on the other hand, was a huge challenge. I wasn’t able to rest as much as I had wanted/planned, and I was really feeling the effects of all the exertion on Saturday. Even if the exertion was good and positive, it was still exertion, and I didn’t remember to rest.

One of my big problems is, when I get over-tired, I often forget to self-monitor. That happened to my yesterday. So, I ran into trouble.

With a Capital T. Had a huge meltdown yesterday. As in — rage and tears and being stuck in a loop of anger and shame and frustration and resentment. I hate when that happens. I could feel it coming on, and I thought I could stop it, but I couldn’t. It was like a repeat tsunami of unwanted overwrought emotion. Waters pulling out, then washing in and wrecking everything in its path. Emotion pulling out, then rushing back in and leveling everything in its way.  It came and went for about three hours, and it totally screwed me up — and my spouse. Not pretty at all. And I’m still “hungover” from it this morning.

Ugh.

Looking back on things with a less emotional eye, one of the things that complicated my situation yesterday was that insidious little voice in the back of my head that managed to find everything I’d done “wrong” on Saturday, amplified it about a thousand times, and then commenced to tell me You’re So Brain-Damaged and Stupid. Who would ever love or care about you? You’re such an idiot – you had a concussion — no, wait, you had a bunch of concussions – and now you’re stupid. You’re so stupid you don’t even know how stupid you are.

Stupid.

Well, you get the idea. And sure enough, as always happens when that voice gets going, before long, I was at war with the world, at war with myself, at war with my spouse, at war with my job, at war with everything and everyone who came anywhere near me.

concussion now i’m stupid…

My thinking is too slow, I’m not sharp and quick like I used to be, I’m not even funny anymore (and I used to be a laugh and a half all the time), and who would want to bother with me?

Geez.

It’s bad enough that I have to contend with the physical and logistical issues, but when that voice gets going… well, the only thing to do is go to bed.

I managed to do that eventually, but not on my own steam. I had to be guided to bed and put away like a cholicky baby. I friggin’ hate when I’m reduced to that. But when I’m in the midst of that storm/tsunami, I cannot for the life of me pull myself out.

For future reference, I need to keep the image of the tsunami in my mind, when I feel it coming up. So I can get to higher ground. Tell my spouse I need to take a break, and remove myself to my bedroom or study, to simmer down. Just get myself out of the way of the wave. Maybe go out for a walk in the woods. I did that yesterday at the end of the day,  and it helped tremendously. Yes, the walk in the woods — climbing up to the top of the nearest big hill — helps me a whole lot.

I also have to have a talk with my spouse about this TBI business – it’s not okay for them to talk to me like I’m an idiot, which is what they’ve been doing more and more over the past year. Apparently, they seem to think that because my memory is a bit spotty at times, and my processing speed has slowed, I’ve lost my innate intelligence. Either that, or they have always acted this way, and I’ve just recently stopped allowing myself to be intimidated into hiding my issues from them. That’s always a possibility.

So, there are three main issues I am contending with — the wave of emotion that cannot and will not be stopped and can only be avoided until it calms down… the voice in my head that tells me I’m stupid… and the voice I live with that tells me I’m impaired. The first one, I just have to be mindful of and learn to avoid being swept away. The second one, I have to either ignore or actively argue with. The third I have to have a serious talk with — and possibly involve my neuropsych to explain to my spouse that my relative weaknesses are manageable and don’t mean I’m reduced to a simpleminded shadow of my old self. Some days it feels like that — like yesterday — but it’s not the truth of the matter.

But ultimately, the bottom line is, here’s the #1 Lesson I (re)learned over the weekend:

I have to pace myself. If I have a big day, even if it is a really good big day, I need to take the next day OFF and SLEEP. Rest. For real. Nothing else matters. No distracting entertainment is worth the price I’ll pay for exhaustion.

Achieving more by doing less

I am really resisting writing this post, but I have to put it out there for the sake of honesty — and also to get it into my head that this is the way things are now.

It’s not that what I’m thinking about is a bad thing, or even an unpleasant thing. It’s a new thing — a true thing — that I’ve been resisting for as long as I can remember, much to the dismay of my family, my coworkers, and my neuropsych.

I hate having to admit that I have been wrong, and they have been right… but in this case at least, I have to admit it:

I get more accomplished, when I do less.

Now, it might not seem like that big of a deal, to admit it. What’s the big deal?

Well, people have been “on” me for years, that I do too much. I take on too much. I have too much on my plate. I’m spread too thin. My spouse has been lecturing me for years, that I don’t relax enough and I have too many projects going on. We’ve actually had some pretty bad fights about it. I defended my hyper-busy-ness with every fiber of my being, till the bitter end, and it’s not helped our marriage at all. But I was convinced that I was right, in having twelve balls in the air. I felt so energized. Like I could do anything. And it never seemed like there was a problem. If I didn’t finish things, so what? They were boring, I told myself. And I needed a fresh start.

Well, that outlook has modified somewhat over the past couple of years that I’ve been working with my neuropsych.  Taking a long, hard look at my patterns on a regular basis, I’ve realized that being super-busy is often a direct result of anxiety. It’s not about positive exuberance. It’s not about having a vision of a future I can eagerly step into fully and with all confidence. It’s about existential angst that is welling up and driving me ahead of it, like a wild stagecoach driver whipping the team of horses into a mad gallop… in the meantime not holding the reins or guiding them in any particular direction.

This mad gallop is plain to everyone else’s discernment. It’s obviously a ploy on my part to avoid life, rather than engage with it. But it is disguised from my view by something in my perception that interprets a mad dash towards whatever comes to mind as a positive and life-affirming thing ;}

Over the years, countless people have tried to get me to stop and look at what I was doing, but I resisted — and resented — their “interference” with my grand plans. I wasn’t planning, of course. I was just flying willy-nilly in every and all directions, for the sake of flying willy-nilly. Nothing more. And when I got to a point where I couldn’t continue with what I was doing, I’d drop it… and then wonder, sometimes years later, why I ever quit what I was doing, if I was so devoted to it.

Crazy.

Well, as I mentioned, that’s been changing over the past year or so. Once I started logging all my activities and tracking them — for real, not in some quasi-reflective journal entry that rambled on about this and that for pages on end — I started seeing what was really going on in my life, and I wasn’t pleased. I looked back on all the projects I’d started — each one seeming like the thing that was going to catapult me to greatness and/or solve all my personal problems through professional success. What I saw was not greatness, but whatever-ness. Oh, man… what a wakeup call.

And I started to admit that maybe I was spending an awful lot of time on things for the wrong reasons. Maybe I was spreading myself too thin. No… obviously I was spreading myself  too thin. Judging by what little I was getting done versus what lots I was putting into my efforts, my approach was not effective. It was downright disastrous.

So, I decided to change things up. I swept a whole bunch of projects off my plate. I trimmed the fat off my docket considerably, tabling projects I thought would be cool, but obviously demanded a lot more time and energy and manpower than I could muster. I decided to do without a lot of the lists I made for myself. I also quit imagining I was going to have these multiple career paths, and be able to pick and choose between the cream of the crop, on down the line, whenever I chose to switch my path.

And it was working out pretty well. Suddenly, I had a lot more time to devote to my pet projects — the really pet ones, that is. I could focus more on the details that had slipped by me before. And I had a lot more bandwidth to do the things I enjoyed during my free time. Sleep hasn’t appealed to me much over the past months, because I was still totally into the idea that I could continue to keep up a blistering pace on a select few things — for the fun of it. Literally. I felt really “on” at work — I felt like I was really making headway and was taking the tiger by the tail.  Woo hoo – right?

Um… not so much. Now, months on down the line, I find myself worn out, all turned around by myriad details that once seemed so clear to me, and not delivering at the rate my boss wants me to. My thinking is not clear, my relationships at work are suffering, I feel like I’m slipping into a hole of my own digging, and I’m battling to get myself out. I find myself taxed and tapped, angry and raging and resentful and antagonistic and defensive and increasingly volatile… saying things I wish I hadn’t… and my marriage and work situation are both suffering as a result.

Here, I’d thought I was supporting my family and my coworkers better by driving myself like a crazyperson, taking on all sorts of tasks, when all I was doing was driving myself — and my spouse and my coworkers — crazy.

Which brings me to what I’ve been learning — the hard way — over the past couple of weeks.

I actually perform better, and I accomplish more, when I do less.

… As in, when I work in intervals — planning and thinking things through ahead of time, then mustering my energy and tackling tasks with full attention and focus.

… As in, when I spend less time on busy-work, and I devote the bulk of my attention to strategic and tactical planning and implementation, saving my logistical energy for select tasks — no more than two or three a day.

Indeed, I do better, when I tackle less of the little niggling details work that’s just filler for my time and is more about my brain thinking such-and-such is important, when it’s not really.

And I accomplish more when I don’t insist on taking on this mountain of everything by myself, as I’ve always been prone to do.

Truly, the practice of only doing 2-3 significant things a day, when I used to tackle at least five-to-ten times that amount, is a huge change for me. It’s a difficult change… An unsettling turn of events. It makes me nervous — incredibly anxious. I feel like I should be doing something. But during those stretches when I’m “doing something” to the tune of 20 deliverables a day, and I look back on my notes about what I actually accomplished, well, the results are a lot less impressive, than my fantastical plans.

But if I break it all down and pick and choose from the things I need to get done and don’t worry about the other things, till I get the most immediate couple of things done, it’s friggin’ magic, man.  I get waaaaaay more accomplished if I take things 2 and 3 tasks at a time and do them in an extremely focused and intense fashion, than if I “pace myself” and take on 20-3o items (no joke) at a “reasonable pace”.

They say timing is everything. It’s true. It’s even more true that the right timing in the right way for the person in question is more-than-everything. Some people can go slow and steady through a mountain of small details. I, on the other hand, drown in those details. Just like there are slow-twitch muscles that long-distance runners use, and fast-twitch muscles that sprinters use, I’m more of a fast-twitch kind of person. And if I slow down to go at a “reasonable” pace, I’m toast.

So, there we have it. I’ve had my helping of crow for the day. I have to admit, it feels good to say/write it out loud, but it’s been a long time coming. And I have a lot of work to do, to reverse the damage that’s come from ignoring and denying the truth about how I work best — and worst. But reverse this, I will. I’m the comeback kid. I’m not going to quit till I get where I need to be.

Even though I know it’s good for me and it’s the only way I can really work effectively, the idea of only doing a few things  a day still makes me intensely anxious. I don’t expect to get used to it overnight.

But you know what? Doing a little bit at a time in a very focused, intentional way gets me there. And since actually getting there is what matters to me (and my spouse and my coworkers and my boss) — even more than the “journey” on the way — that’s what I’ve got to focus on. Results. For real. Not plans and methodologies. Results. What works. What works for me.

Onward.

Anger Notes: From mountain to molehill

I had a little difficulty this morning, getting into the day. I go through the same routine every day — wake up slowly… give myself time to wake up enough to get out of the bed without tripping or falling… get up and brush my teeth… go downstairs to put water on for coffee… do my morning workout while I am waiting for my coffee water to boil… think about what I need to accomplish today while I am working out… finish my workout and make my coffee and cereal… and then get into my morning.

Most days, if I have had enough rest, the routine goes like clockwork. But I recently started lifting heavier weights, and I also had a chiro adjustment yesterday, so I’m a little sore and stiff, and I need to get more sleep. Under normal conditions, getting the 7 hours that I had last night would make me very, very happy. I actually slept through till the sun was coming up! And I would feel like enough. But I am still recovering from staying out all night on New Year’s Eve last week, and I need to get even more rest than usual, so I can get back to my regular sleep schedule and get over being stiff and sore from the increased weight and also the adjustment I got yesterday.

Now, for most people, being behind on their sleep and having a little stiffness and soreness in the morning is no big deal. For a lot of people, it’s actually a way of life. They don’t get totally thrown off by lack of sleep. They just muddle through the day somehow. They don’t get all tweaked and freaked out over every little thing, with hair-trigger temper outbursts over every little thing. They just go through their day, like it’s no big deal. And they live their lives like everything is relatively normal, popping Advil or Aleve or having a few drinks at the end of the day to chill out and sleeping in, in the morning.

The people who don’t have issues with sleep deprivation and pain clearly are neurologically intact. They probably have not sustained traumatic brain injuries. They probably don’t have post-concussive syndrome, and they probably haven’t sustained brain trauma/head injury.

I, on the other hand, am not in that “space.” When I am behind on my sleep, it introduces a whole host of issues that make the most basic activities into challenges. When I am in physical discomfort, I tend to push myself even more, perhaps because doing that relieves the discomfort for me. But pushing myself tires me out even more. And when I get over-tired, I have a hard time relaxing and going to sleep… which makes me even more tired in the morning. And then I have all sorts of cognitive-behavioral problems. It’s a vicious cycle that’s very difficult to break.

That’s that cycle that started with me last night. I should have gone to bed around 9:30, but then I had some stuff to do, and I needed to talk to my spouse, who was out at a late meeting till 9:30. By the time they got home, I was ready to go to bed, but the sleepy part of me didn’t want to go to bed, so I stayed up and talked with them about this-and-that.

Finally, they packed me off to bed, seeing that I was pretty much wedged into the couch, and I was making myself comfortable for a long stay-up. It was 10:30, by then, and it took a focused, concentrated, concerted effort on both our parts to get me up off the couch and upstairs to bed. Then — being as tired and as contrary as I was — I stood in front of the bathroom mirror and inspected myself, studying my double chin and looking for gray hairs and trying to make my hair stand up straight by tousseling it and trying to spike it straight out from my scalp. I know, it’s strange. But this is the kind of stuff I do when I’m really, really tired and I don’t want to go to bed.

After about 15-20 minutes of this… and deciding that yes, I am still a handsome individual with good bone structure and not to much saggy skin in the wrong places… I finally got my ass in bed. Then I remembered I needed to stretch and take Advil (my bedtime routine), so I can better relax. I did that, and I then did my progressive relaxation exercises to get myself to sleep, which went really well — even better than I expected. I got to sleep around 11 p.m.

Happily, I slept through till 6 a.m., which is a wonder, because I’ve been waking up around 4-4:30 or so — which sucks — and that felt pretty good. I gave myself some time to wake up, before I got out of the bed. If I roll out of bed right away, I tend to stagger around a lot, which is loud and also a little dangerous. There are plenty of hard surfaces and sharp corners I can hit my head on. Plus, my spouse doesn’t like to be woken up by my clunking around, bumping into stuff — which happens, when I get up too quickly.

I got myself up and started getting into the day. But man, I was clumsy this morning, right from the start. I had trouble holding my toothbrush, had trouble holding onto the water spigot, and it was really really getting to me. I am definitely foggier and more out of it this morning than I’ve been in a while. It’s probably due to the adjustment I had yesterday — the chiro went pretty deep.  And when I’m foggy and clumsy and out of it, I get really, really agitated. Every little thing gets to me, and I have a harder time with those spikes of anger that come up when things go wrong for me. They seem to come out of nowhere, and when they show up, they can be intense — and the intensity makes them even more confusing and frustrating (and damaging) because my mind knows that my reaction to what is happening is wildly out of proportion to what is going on, and I feel like something is terribly wrong with me, that I feel this way. And I start in with calling myself all sorts of names, telling myself I’m a damaged idiot loser who can’t keep their shit together, etc. etc. ad nauseum.

I’ve written about this temper flare stuff before in my posts Flash in the (brain) pan and A constant restlessness (and elsewhere), and it still holds as true as ever.  And this morning, when I was just trying to brush my friggin’ teeth, already,  I could not seem to keep my act together. I had trouble holding the toothbrush, and when I put it down on its rest, something about how it was positioned bothered me intensely. Then I tried to turn off the water, and my hand slipped, and I hit the side of my hand on the edge of the spigot, which hurt.

And that old temper flare jumped out again, like Old Faithful… that geyser that comes up regularly at Yellowstone. Or maybe a better analogy would be, like one of the geysers that erupts periodically without warning. Tori Amos has an album I love called “Little Earthquakes”. Maybe I’ll do an album called “Little Geysers.”

Anyway, for a few minutes, as I stood there nursing my aching hand, I was

absolutely furious!!!!

It was all I could do to keep myself from hitting something or slamming something down. I was angry with the spigot for having hard edges. I was angry with my hand for being so weak that a little bump would hurt so much. I was angry with myself for being so uncoordinated and not being able to simply turn off the water like a normal person would. But most of all, I was angry with myself for getting so bent out of shape over something so simple. “I know better,” I told myself. “Why can’t I act better?

I was really getting whacked-out over this, and it literally threatened to derail my morning. When I get going like this, I descend down into a pit of ugliness, and the whole day can be tainted by my temper outbursts, whether they are internal or external. In fact, sometimes the worst ones are internal, that no one but me sees or hears or knows about, which makes my crabby, short-tempered behavior all the more confusing for people around me. It makes no sense to them — how could it? They don’t know what I’m experiencing, and I’m doing everything in my power to shield them from that.

I could feel that rush of anger, that temper flare, that wild spike of emotion… it tore through me like one of those microbursts I’ve seen on the Weather Channel… and I was starting to get freaked out… and go into one of those wild rages that’s like a forest fire tearing through my head.

Then I checked myself. Something in me — the something that has been observing myself with increasing knowledge of TBI over the past few years — told me to take a break and just give myself time to catch up with myself.

So, I stopped and took a breath and thought about what was happening. And when I took a break from my downward slide, I realized:

  1. I am still tired. I did not get enough sleep, and I am groggy.
  2. When I am groggy, my neuropsych has told me that I am more prone to agitation.
  3. When I am groggy, I also can be uncoordinated. I don’t need a trained expert to tell me this. I have observed it countless times.
  4. When I am uncoordinated, I tend to bump into things.
  5. When I am groggy, I tend to propel myself through events on adrenalin — because I need an extra “pump” of energy — energy I  don’t have from regular sources (like getting enough rest). When I’m fatigued, I have to pump myself up just to do the basic stuff… because otherwise I can’t get going.
  6. When I pump myself up, I move faster.
  7. When I move faster, and I am uncoordinated, I hit things with greater force than I would, if I were rested and had full motor control.
  8. When I’m fatigued, my brain’s constant restlessness and agitation is worse, it makes me snappier and more extreme in my reactions. I am also more physically sensitive, and I feel everything more intensely.
  9. And finally, I remembered — from what I’ve read and what I’ve been told by my neuropsych — this type of reaction from me is actually quite typical of TBI survivors. It’s just what my brain does, when it has to operate on too little sleep/energy.

So, there it was –this drama I was experiencing, standing in front of the bathroom sink, freaking out over hitting my hand on the spigot had everything to do with my brain/body AND it had NOTHING TO DO WITH ME.  It wasn’t me being an asshole loser who’s emotionally inept and a worthless use of space. It was just my brain and body doing what they did, when I am tired and out of it and I am moving too fast.

I did NOT need to make a big deal out of it — just recognize what was happening… And I also realized that it was actually my brain sending me warning signals about what was amiss in my day, thus far. I recognized that this little snap of mine was like a gift from the gods — a hint about where I was at, that day, which I could use to inform the rest of my day to make better choices.

I also realized that if I didn’t take steps to stop this flash in my brain-pan, I was going to start the day on a really BAD note. Temper flares with TBI survivors tend to be quick-on, quick-off affairs, instantaneously coming up out of nowhere and disappearing just as instantaneously for no apparent reason. I realized I just needed to occupy my attention long enough for my system to calm down, and then I could get on with my day.

So, I took action. I kicked into gear and did something with all that agitation and energy — I channeled it into a constructive activity. I looked at the spigot that I’d hit my hand on, and I realized that it was slippery with soap on the handle. I studied the handle and felt where the slippery soap was, then I ran the water and rinsed off the handle, until it wasn’t slippery anymore. That made me feel a lot better. Then I dried my hands and went downstairs to make my breakfast.

Again, I had more trouble with uncoordinated blunders downstairs. I was off-balance and I was clumsy, getting my coffee stuff together. But I remembered what I’d noticed upstairs — I’m tired. I’m uncoordinated. This is not about me, it’s about my brain and body. When I am this tired, it’s perfectly normal — for me — to be agitated and restless and make mountains out of molehills. But it has nothing to do with me and my character… Forget about the supposed stupidity and ineptness and all those other words I use to attack myself. It’s about my slightly broken brain which has trouble when it’s tired, and I know what I can do to make it better — take it easy, take things slow, don’t push myself like crazy, and cut myself a friggin’ break, already.

So, that’s what I did. And by the time I got done with my workout, my day had re-booted nice and fresh. I’m still tired, but I’m not wiped out like I could be, because I made changes to how I was doing things. I had a good solid workout, and I lifted shorter sets with fewer reps, because I realized my body needed to catch up with the heavier weights. I also focused more on my exercise — I had been letting my mind wander more, over the past week or so — and I didn’t lose track of where I was with my workout, like I had been, in the past few days. And as I was planning my day, I made a point of scheduling just a fraction of the number of activities I’m prone to schedule for my day, which takes the pressure off, right off the bat.

AND instead of checking email from friends first thing in the morning, as I’ve been doing for the past few weeks, I am waiting till later in the day to do that, because there is a lot I need to get done, and I cannot be distracted from the work that’s waiting for me to finish it.

All in all, even though the day started out on a rough note, it was for the best.

Because I stopped and thought about what was happening. I learned about the experience as it was happening. And I used my tools. I used the info I got from my neuropsych, and I used the knowledge I had of myself. I used the opportunity to stop and think to really appreciate what was going on with me. I cut my brain and body a break.

I am also planning to lie down for a nap later today. I’m working remotely, plus the weather is not good right now. I can get a lot done, if I focus on what I’m doing. And with the appreciation of how tired I am, I can make the extra effort to take care of myself, take my time at what I’m doing, and manage my energy with intention and discipline.

All because I stopped for a moment and thought about what was really going on with me.

This is progress.

Doing it differently this holiday season

I did something quite unusual last night — I went Christmas shopping by myself at a much slower pace than usual. I didn’t manage to buy everything I set out to, but I got everything I could, and I got through the experience in one coherent piece — and I was able to get my nap after I got back.

Normally, this time of year is marked by team-shopping with my spouse. They contact everyone in the family and find out what people want… or we talk about what we think people want, and then they make up the list. We take the list, hop in the car, and head out to stores that look like good candidates, then we slog through the process of elimination, muddling our way through… with me getting so fried I either completely shut down and become non-communicative, or I melt down and fly off the handle over every little thing.

We usually spend several evenings like this, ’round about this time of year, and we’ve both come to dread it a little. My meltdowns had become more extreme over the past few years, and this year we were both really dreading the whole Christmas shopping business — to the point where we are going to be late(!) with presents for family members in other states. That’s never happened before. We were always good about it. But my meltdowns screwed everything up.

We both recognize that doing a lot of social things, this time of year (when work is actually getting more crazy, what with year-end and all), takes a huge toll on me. Even if it’s with friends (especially with friends), all the activity, all the interaction, all the excitement, really cuts into my available energy reserves. And then I get turned around and anxious… and I either regress to a cranky 9-year-old state, whining and bitching and slamming things around… or I melt down, start yelling, freak out over every little thing, and start picking at my spouse over things they say and do, to the point where neither of us can move without me losing it.

What a pain in the ass it is. Of all things, the uncontrollable weeping bothers me the most. The yelling bothers my spouse. It’s embarrassing for me and frightening for them, and neither of us has a very Merry Christmas, when all is said and done.

So, this year we did things differently.

We split up for the day and took care of our respective activities.

My spouse went to a holiday party that was thrown by a colleague of theirs who’s married to an attorney who deals with financial matters. I was invited, too, but we both realized that it would be pretty dumb for me to try to wade into the midst of 50+ actuaries and tax attorneys and their spouses who were invited to the shindig… and try to hold my own. Certainly, I can keep up with the best of them, but marinating in such a heady soup, especially with everyone hopped up on holiday cheer (eggnog, red wine, punch, etc.) and all animated and such, would have been a recipe for disaster.

So, I didn’t go. Instead, I took our shopping list and headed to the mall to stock up on what our families had requested. We had written down in advance all the names and the specific gifts we were going to get, and we had also written down where we were going to get them. That list was my lifeline. Especially in the rush and press of the mall, which sprawls out in all directions, with satellite stores on either end.

I’m happy to report that I actually did really well. I made a few tactical errors — like not parking in the first lot I came to and walking in. But that turned out okay, because if I had parked in the first lot, it would have been all but impossible to get down to the other end of the mall. I studied the list carefully ahead of time and used a highlighter to mark the stores where I’d be going. I also kept my focus trained on the task at hand — even if it was just sitting in traffic. I also walked a lot more this year than other years. I found one parking space and used it for two different stores. And I didn’t hassle with finding a space that was as close as I could get to the building. I took the first decent spot I could find, and then I walked to the store.

Imagine that — in past years, I was possessed with finding parking as close as possible, and I would move the car between stores, even if they were only 500 yards apart.  This year, I just walked the distance. Even though it was cold, for some reason the cold didn’t bother me, and it actually felt good to be out and moving.

I think that my 5 months  of daily exercise has paid off, in this respect. I think part of the reason I was always consumed with driving everywhere was that I just wasn’t physically hardy. I was kind of a wimpy weakling, in fact — though more in thought than in body, but a wimply weakling, all the same. But having a good physical foundation — even just from doing an hour (total) of cycling, stretching, and light lifting each morning — has made a significant difference in my willingness and ability to walk between stores.

It might not seem like much, but the walking (instead of driving) between stores part of the trip actually made a huge difference in my overall experience. Walking between stores — stopping at the car on the way to stash my presents — helped me break up the activity and clear my head. It got me out of that in-store madness, the crush and the rush, and it got me moving, so I felt less backed-up and agitated. And that let me start fresh at the next store.

That was good, because the first store was a friggin’ nightmare. It was one of those big-box electronics places, that supposedly has “everything” but really didn’t. It was exhausting, combing through the stacks of movies and music, only to find everything except what I needed. The lighting was awful — extremely bright and fluorescent and glaring. People kept bumping into me, or walking so close I thought they would run me down. But the worst thing was the acoustics. Everything surface was hard and echo-y and the place was overwhelmingly loud, and every single sound was at least partially distinguishable, which drove me nuts. I’ve noticed that acoustics have a lot more impact on me than light, when I’m out shopping. The store was one big cauldron of loud, indiscriminate noise, and my brain kept trying to follow every sound to see if it mattered. I couldn’t function there. Not with the place full of people — and very agitated, anxious, aggressive people, at that.

I eventually went with a gift card and got the hell out of there. I doubt I’ll ever go back when it’s that full. When the place is low-key and all but empty, I can handle it much better. But at this time of year? Not so much.

Walking back to my car chilled me out. Sweet relief.

At the second store — a bookstore — I started to feel pretty overwhelmed. They had long lines, and the place was packed — which is good for the retailer, but not so great for me. I spent the longest amount of time there, in part because I could feel I was getting overloaded, and I stopped a number of times to catch up with myself and remind myself what I was there to buy. My list was getting a little ragged, at that point, what with me writing notes in the margins and taking it out/putting it back in my pocket. So, eventually I just pulled it out and held onto it for dear life. I must have looked a little simple-minded, but I don’t care. Everyone else was so caught up in their own stuff, anyway. My main challenge there, was not getting trampled by Women On A Mission — many of them carrying large bags and shopping baskets that doubled as ramrods to get through the crowds.

One cool thing happened, though, when I was taking a break — I had a little exchange I had with two teenage boys who were talking about some book they’d heard about. I was just standing there, pretending to look at a shelf of books, just trying to get my bearings, when I hear this one young guy tell his buddy, “I heard about this book I should get — I think it’s called the ‘Kama Sutra’ and it’s, like, about sex, and it’s got these pictures… and it’s really old… like, from India or something.”

Well, I perked up at that, and suddenly very alert, I looked over at them and said, “Oh, yeah — the Kama Sutra, man… You should definitely check it out.”

They kind of looked at me like deer in headlights, and they got flushed and flustered and stammered something about not knowing how to find it. It was about sex, and they didn’t know how to ask someone to help them. I so felt their pain…

I confidently (and confidentially) pointed them to the book-finder computer kiosk, where they could type in the title and it would tell them where to find it in the store.

“Dude, you should totally look into it. It’s got lots of information — and pictures — and it’s been highly recommended… for hundreds of years.”

They got really excited and headed for the book-finder kiosk. Here’s hoping they — and their girlfriends — have a very Merry Christmas.

That little exchange got me back in the game, so I took another look at my list and managed to find the handful of books and music and calendars I wanted to get. I headed for the line and just chilled/zoned out. I didn’t get all tweaked about how long it was taking; I listened in on a conversation for a while, till I realized it was mostly about death and health problems people were having.

Oh – and another thing that helped me keep my act together, was the 4:15 p.m. alarm that I have set on my mobile phone. 4:15 is usually when I need to start wrapping up my day at work. I need to do a checkpoint on the work I’m doing, start to wind down, and begin keeping an eye on the clock, so I don’t get stuck in town past 6:00, which is what happens to me when I don’t watch my time after 3:30 or so. I have this alarm set to go off each day, and it went off while I was in the store, which was a blessing. I had completely lost track of time and I was starting to drift, the way I do, when I’m fatigued and overloaded and disoriented.

It startled me out of my fog, and I knew I still had a bunch of things on my list to get, so I refocused and started thinking about what I would get at the next store, so I could just march in and do my shopping without too much confusion and disorientation. After I paid for my books and music and calendar, I debated whether to have my presents wrapped for free, which might have saved me time in the long run. But I couldn’t bear the thought of having to interact with the folks who were doing the wrapping. They looked really friendly and gregarious — Danger Will Robinson! Warning! Warning! Even a friendly conversation was beyond me at that point.

I realized I just wasn’t up to that, and I must have looked like an idiot, standing there in the middle of the foyer, staring at the gift-wrappers for about 10 minutes, but who cares? Everyone was so caught up in their own stuff, they probably didn’t notice me. And if the gift-wrappers were uncomfortable with my staring, they didn’t show it… too much 😉

Anyway, after I managed to extricate myself from that store, I headed for my last destination. Again, I didn’t sweat the traffic getting out of the lot, and when I got to the final store, I parked at a distance from the front doors and walked in through the icy cold, which was good — it cleared my head.

Inside, I consulted my list again and headed directly for the section that had what I needed. Halfway there, I remembered that I’d meant to buy a very important present at the first store, but I’d totally blanked on it. I started to freak out and got caught up in trying to figure out how to get back to that first store and not lose my mind in the process.  Then, I slowed down and stopped catastrophizing, and in my calming mind, it occurred to me that — Oh, yeah — they probably carried that item at this store, so I went and checked, and sure enough, there it was – score! I didn’t have to back to big-box hell. At least, not that day.

I found some more of the presents on my list, and although I didn’t get everything I needed, I made a decent dent. My partner can come with me and help me sort out the other items either today or tomorrow. Or possibly when we get to our family — they usually have some last-minute shopping to do, and they can cart us around with them. And I won’t have to drive.

By the time I got home, I was bushed. My spouse wasn’t home yet, so I called them — they were on their way home and were stopping to pickup some supper. I said I was lying down for a nap, and they didn’t have to wake me when they got home. Then I took a hot shower to get the public germs off me, laid down, and listened to Belleruth Naparstek’s Stress Hardiness Optimization CD. I had a bit of trouble relaxing and getting down, but I did manage to get half an hour’s sleep in, before I woke up in time for dinner.

My partner had a pretty good time at the party, but they said it probably would have been a disaster for me — so many people, so much energy, so many strangers, and unfamiliar surroundings. I concurred, and I showed them what I’d bought that afternoon.

We’d both done well. We both missed each other terribly, but we did get through the afternoon without one of those terrible holiday incidents that has dogged us for many, many years. Like Thanksgiving, which went so well, this Christmas shopping trip actually felt normal. It didn’t have that old edginess that I always associate with holiday shopping. It didn’t have the constant adrenaline rush. In some respects, it feels strange and unfamiliar, but you know what? If strange and unfamiliar means level-headed and low-key and plain old sane, and it means I can keep my energy up and pace myself with proper planning… well, I can get used to that.

Yes, I’ve done things differently this year. And it’s good.

My solution for TBI/PTSD rage

Anger (or out-and-out rage) is one of the places where my TBIs and PTSD intersect to cause real problems. I’ve been having some rage issues, lately. Getting worked up over little things — getting angry over nothing, really. Just getting angry. Temper, temper…

In the moment, my anger — my rage — seems completely justified. I feel with every cell in my being that I am entitled to be outraged. I am entitled to be angry. I validate my emotional experience, and I end up spiraling down into a deepening pit of anger, resentment, and acting out. Yelling. Making a fuss. Putting up a stink. And getting aggressive with whomever happens to be offending me at the moment.

This is not good. I’ve done it with police officers, and I’m lucky I didn’t get cited. Or arrested. I’ve done it with family members, and it’s cost me plenty, in terms of peace of mind and my relationships. I’ve done it with co-workers, and it strained our connections to the point of breaking.

Not good.

But lately, I’ve been able to pull myself out of my downward spiral before it gets too much of a hold on me. I’ve started doing some basic things that stop the progression of rage before it picks up so much speed it’s like a runaway freight train.

First, I recognize that I’m angry, and I am convinced that I’m right about being angry. This might not seem like a big thing, but I have trouble figuring out how I’m feeling sometimes, and anger is one of those emotions that I don’t always identify well. It just feels like a rush of energy — and while everyone around me knows I’m pissed off, I usually can’t tell what’s going on with me until it’s progressed to a really problematic point. I recognize that I’m angry, and I remember that I need to not let myself get carried away.

Second, I step away. I take a time-out and just walk away. I stop myself from saying what I’m about to say, no matter how badly I want to say it. I tell myself, I’ll give it some thought and figure out how to say it exactly the way I want to say it. I tell myself… anything … just to extract myself from the situation. I step away, telling myself I’ll come back when I’m better able to express myself.

Third, I take some deep breaths.  This helps stimulate my parasympathetic nervous system, which is the part of the nervous system that chills you out. The sympathetic nervous system is what gets you worked up to respond to a crisis situation — and when I get really angry, it’s often because I think and feel like I’m in a crisis situation, and my body is getting all geared up for fight or flight (more often fight). I consciously take some deep breaths to get my parasympathetic nervous system to chill out.

Fourth, I seek out some kind of tactile stimulation. I need to get out of my head, which is spinning out of control, and just give myself a different point of focus. My head is going so madly, at this point, that I cannot even think straight, so I seek out some kind of physical sensation to get my mind off the madness. I press the side of my face against the cold side of a door that leads to the outside. I pick up something rough and rub my fingers along it. I jingle change in my pocket. Or I find something heavy and hold it. The physical sensation, along with the deep breathing, gets my mind off the crazy cycle it was in, just a minute ago, and it lets me focus on a single point — the feel of the cold door against my cheek or the feel of quarters and nickels and dimes juggling among my fingers. Tactile stimulation, like looking at a flame of a candle while meditating, helps me center and get my mind off that crazy downward cycle.

Fifth, I remind myself that my body and brain are playing tricks on me. I am probably not getting angry for the reasons I think I am — it’s my body that’s getting all worked up into a fight/flight/freeze state, and my mind is interpreting that as a real sign of DANGER. And I’m probably starting to panic a little, too. As a matter of fact, when I take an objective look at things, the rage that’s building inside of me might not even be real rage, rather a response to a hyperactive sympathetic nervous system response. It could very well be my body tricking my mind into thinking the wrong things. And I need to remember that I get to choose how I interpret my life. My mind gets to decide how I’m going to think about things, how I’m going to react. And my well-intentioned body, which thinks it needs help, is just misleading my brain into thinking that I have to do something about whatever it is that’s getting to me. When I remind myself that this is a physiological process that’s taking place, I am able to relax… and the anger subsides.

The thing I have to remember, when all this is coming down, is that It Is Not Worth It. No matter how justified my rage seems to be. No matter how entitled I am to be angry. No matter how wronged I may have  been. It is not worth it, to get so tweaked over things. When I go off on an anger “binge” I end up feeling really hungover and dumb and numb afterwards, which just makes my life more difficult, once it’s passed.

I’m no doctor, but I suspect that it may be connected with the mechanics of panic/anxiety… all that post-traumatic stress stewing in a pot, and my TBI brain being unable to sort it all out in a timely fashion… My processing speed is slower than I’d like, and by the time I figure out what’s going on, the damage is often done.

So, I do my best to recognize when I’m getting angry, I step away, I take some deep breaths and try to relax, and I do something that gets my body’s attention — like feeling something cold or rough or tactile in some way. And I remind myself that my brain and body are playing tricks on me again. They’ve done it before… and they’ll do it again.

Building my cognitive-behavioral exoskeleton

MTBI can do a lot of damage, in terms of shredding your existing skills and long-accustomed habits. It can really undermine your thinking and judgment, so that you never even realize you need to do things differently than you did before. And it requires that you force your brain (and sometimes body) to push harder and harder, even when every indication around (and inside) you is saying, “Let up… let up…”

This can be very confounding. I encounter — all the time — people who are keen on “taking it easy” and doing things “with ease and grace”. They think this is a sign of superior evolution. They think this is a sign of superior character, as though it means they are more “plugged in with the Universe”. They don’t want to have to expend the effort to get things done. They want Spirit/YHWH/God/Creator to do it for them. They don’t want to take a chance and extend themselves, because they are convinced that a Higher Power is more capable than they, and they believe they should just “get out of the way” and let that Higher Power take charge of their lives.

That may be fine for them, but that mindset drives me nuts. First of all, it absolves them of any responsibility for their actions. If things mess up, they can say it was “God’s will” or part of a “higher plan”. If things get really messed up, they can say they just need to be more “in tune with Spirit”.  I have a bunch of friends who are convinced that they are “channels” for Divine Inspiration, and that’s how they should live… just floating along on a tide of holy impulse. And their lives are a shambles. Objectively speaking, they are constantly marinating in a brine of their individual dramas and traumas. It’s just one thing after another, and all the while, they keep expecting Spirit/YHWH/God/Creator to fix all the messes they’ve helped create.

It’s very frustrating to watch this willful disregard of basic cause and effect, but I suppose everybody’s got their stuff.

Now, it’s one thing, if these people (some of whom are very dear to me) are content to live their lives that way, but when they expect me to do the same — and they judge me as being less “evolved” if I do things differently — it’s a little too much to take, sometimes. I don’t do well with living my life from a distance. I don’t do well with telling myself that I’m just floating along on the divine breeze, waiting for some wonderful opportunity to arise to save me from my own creations. I need to be involved in my own life. I need to be invested. I need to put some effort into my life. I need the exertion. It’s good for my spirit. It’s good for my morale. And it bolsters my self-esteem, as well.

Anyway, even if I wanted to just float along, I couldn’t. I’d sink like a rock. I’m not being hard on myself — this is my observation from years of experience. I can’t just ramble about, taking things as they come. I need structure and discipline to keep on track, to keep out of trouble, to keep my head on straight. I can’t just be open to inspiration and follow whatever impulse comes to mind. My mind is full of countless impulses, every hour of every day, and if I followed each and every one, I’d be so far out in left field, I’d never find my way back. I have had sufficient damage done to the fragile connections in my cerebral matter, that the routes that neural information takes have been permanently re-routed into the darkest woods and jungles of my brain. All those injuries over the years didn’t just wash out a few bridges — they blew them up. And they slashed and burned the jungle all around, and dug huge trenches across the neural byways I “should” be able to access.

As my diagnostic neuropsych says, “I am not neurologically intact.”

So that kind of disqualifies me for just winging it in my life. I tried for years to “go with the flow”, and I ended up flit-flitting about like a dried oak leaf on the wild October wind. I got nowhere. I can’t live like that, and I know it for sure, now that I’m intentionally trying to get myself in some kind of order. My brain is different. It has been formed differently than others. It has been formed differently than it was supposed to.

I can’t change that. But I can change how I do things. I can change how I think about things. I can change by facing up to basic facts. As in:

  • My thinking process is not a fluid one, anymore. In fact, I’m not sure it ever was — for real, that is. I’ve consistently found that when I’ve been the most certain about things, was the time when I needed most to double-check.
  • If I don’t extend myself to get where I’m going, I can end up sidelining myself with one minor failure after another. One by one, the screw-ups add up, and I end up just giving up, out of exhaustion and/or ex-/implosion… and I can end up even farther behind than when I started.
  • It’s like nothing internal is working the way it’s supposed to, and the standard-issue ways of thinking and doing just don’t seem to hold up.
  • My brain is different from other folks. It just is. It doesn’t have to be a BAD thing. It just is.

On bad days, it’s pretty easy for me to get down on myself. I feel broken and damaged and useless, some days — usually when I’m overtired and haven’t been taking care of myself. But on good days, I can see past all that wretchedness and just get on with it.

Part of my getting on with it is thinking about how we MTBI survivors can compensate for our difficulties… how we create and use tools to get ourselves back on track — and stay there. There are lots of people who have this kind of injury, and some of them/us figure out what tools work best for us, and we make a point of using them. These exterior tools act as supports (or substitutes) for our weakened internal systems. We use planners and notebooks and stickie notes. We use self-assessment forms and how-to books and motivational materials. We use prayer and reflection ane meditation and journaling. We use exercise and brain games. We use crossword puzzles and little daily challenges we come up with by ourselves.

Some of us — and I’m one such person — use our lives as our rehab. Not all of us can afford rehab (in terms of time or money), and not all of us can even get access to it (seeing as our injuries tend to be subtle and the folks who actually know what to do about them are few and far between). But we have one thing we can use to learn and live and learn some more — life. The school of hard knocks.

I use everything I encounter to further my recovery. I have to. I don’t want to be homeless. I don’t want to be stuck in underemployment. I don’t want to fade away to nothing. And that’s what could easily happen, if I let up. My friends who are into “ease and grace” don’t get this. But then, they’re embroiled in their own dramas, so they don’t really see what’s going on with me. Even my therapist encourages me to “take it easy” a lot more than I’m comfortable doing. (They’ve only known me for about seven months, so they don’t have a full appreciation of all the crap I have to deal with, so I’ll cut them a break.)

It stands to reason that others can’t tell what difficulties I have. After all, I’ve made it my personal mission to not let my injuries A) show to others, B) impact my ability to function in the present, and C) hold me back from my dreams. I may be unrealistic, and I may be just dreaming, but I’m going to hold to that, no matter what. I can’t let this stop me. None of it – the series of falls, the car accidents, the sports concussions, the attack… None of it is going to stop me, if I have anything to say about it. I just have to keep at it, till I find a way to work through/past/around my issues.

And to do that, I use tools. I keep notes. I write in my journal. I blog. I have even been able to read with comprehension for extended periods, lately, which was beyond my reach for a number of years. I keep lists of things I need to do. I come up with ways of jogging my memory. I play games that improve my thinking. I focus on doing good work, and doing well at the good work I’m involved in. I bring a tremendous amount of mindfulness to the things I care about, and I’m constantly looking for ways to improve. To someone with less restlessness and less nervous energy, it would be an exhausting prospect to life this way. But I have a seemingly endless stream of energy that emanates from a simmering sense of panic, and a constantly restless mind, so  I have to do something with it.

Some might recommend medication to take the edge off. But that, dear reader, would probably land me in hot water. Without my edge, I fade away to a blob of ineffectual whatever-ness.

I build myself tools. I use spreadsheets to track my progress. I downloaded the (free and incredibly helpful) Getting Things Done Wiki and installed it on my laptop to track my projects and make sure I don’t forget what I’m supposed to be working on. I have even built myself a little daily activity tracking tool that I use to see if any of my issues are getting in my way. It not only lets me track my issues, but it also helps me learn the database technologies I need to know for my professional work.

I am constantly thinking about where I’m at, what I’m doing, why I’m doing it. I am rarely at rest, and when I am, it is for the express purpose of regaining my strength so I can go back at my issues with all my might and deal directly with them. I am at times not the most organized with my self-rehab, but I’m making progress. And I track what I’m doing, to make sure I’m not getting too far afield. And I check in with my neuropsychs on a weekly basis.

I also use external props to keep me in line. I build exercise and nutrition into my daily routine, so I have no choice but do do them — if I break my routine, I’m lost. The anxiety level is just too high. I commit myself to meetings that require me to be in a certain place at a certain time, so I have to keep on schedule. I work a 9-5 job that forces me to be on-time and deliver what I promise. I surround myself with people who have very high standards, and I hold myself to them. As I go about my daily activities, I do it with the orientation of recovery. Rehabilitation. Life is full of rehab opportunities, if you take the time — and make the point — to notice.

In many ways, my external tool-making and structure-seeking is like being a hermit crab finding and using shells cast off by other creatures for their survival. I don’t have the kind of inner resources I’d like to keep myself on track, and I don’t have the innate ability/desire to adhere to the kinds of standards I know are essential for regular adult functioning. I’ve been trying, since I was a little kid, to be the kind of person I want to be, and it’s rarely turned out well when I was running on my own steam.

So, I put myself in external situations and engage in the kinds of activities that require me to stay on track and adhere to the kinds of standards I aspire to. I seek out the company of people who are where I want to be — or are on the same track that I want to be on. And I “make like them” — I do my utmost to match them, their behaviors, their activities. And it works. I do a damned good impression of the person I want to be — even when deep down inside, I’m having a hell of a time adhering to my own standards.

The gap between who I want to be/what I want to do with my life, and how I actually am and what I actually accomplish is, at times, a vast chasm. I have so many weak spots that feel utterly intractable — and I need to do something about them. So, I use the outside world to provide the impetus and stimulation I require to be the person I know I can be, and to accomplish the things I long to do. I use the supports I can get, and I use whatever tools I have on hand. I fashion the world around me in a way that supports my vision of who I can be and what I can accomplish in my life. and I just keep going, layering on more and more experiential “shellack” that supports my hopes and dreams and vision.

Dear reader, if you only knew how different my fondest hopes and most brightly burning dreams have been from my actual reality throughout the course of my 4 decades-plus on this earth, you would weep for days, maybe weeks. But this is not the time to cry. Not when I have within my reach the means by which to put myself on the track I long for. Not when I have the resolve to take my life to the next level. Not when I have — at long last — the information I need to understand my limitations and my cognitive-behavioral makeup. Not when I have the drive and desire to live life to the fullest, to love and grow and learn and … and …

But enough — the day is waiting, and I have things I must get done.

Peace, out

BB

Then again… not being smart about my energy levels

One of the persistent issues with this recovery business, is how good days can very easily lead to bad ones.

Example:

I am having a banner week. The job situation is improving vastly. I mean, vastly. I am actually in a position to take my work to the next level, and move into a better pay bracket. I’m going to be starting a new position doing something I’ve been wanting to do, literally, for years, but never had the nerve to start.  Now I have the nerve. And I’ve been offered the opportunity.

Dude, I’m so totally going for it.

Also, I’ve had some other opportunities come up around some freelance creative work I do. I’m in the running for a contest that will showcase some of my best work to date. Even if I manage to show, not place, I’ll get some good exposure, and I’m totally stoked about the opportunity.

I’m also having company this weekend, with some of my favorite relatives coming to visit. We’re cleaning and prepping the house so it looks nice — and is nice. We’re planning to spend time driving around “leaf peeping” at the fall foliage, which is just gorgeous this year.

And I have been able to read again! I’m so excited. I had checked The Bourne Identity out of the library, to see if reading action adventure would help my attention and reading abilities, and — wonder of wonders — I was able to read four chapters in one sitting. And I got it. (I think.) At least, I didn’t have to keep backing up every few pages to see what I had read earlier. That is huge progress for me. In the past five years since my latest accident/injury, I have had a hell of a time reading and comprehending what I was seeing on the page in front of me.

So, there’s lots of great stuff going on. Only problem is, I have a hard time knowing when to stop. Knowing when to say when has never been my forte, but this week, especially, when so much good is happening, I’ve pushed myself to the brink of nervous collapse. I mean, things have been falling together so well. I’ve been feeling awesome, thanks to my daily exercise first thing in the  a.m., and I want to just soak up every last bit of normal-feeling-exhilaration I can get. It’s been so looooong since I felt this good, and now that I do, I’m reveling in it like nobody’s business…

To the point of full-blown anxiety attacks. I had a little one last night, and then overnight, I had another one at 3 a.m., that woke me and my spouse up and totally screwed up our night’s sleep. Plus, now I feel that sick, shaky post-anxiety-attack “hangover” that totally knocks me out. All that progress, and I go and blow my wad for the fun of it. 😦

I so hate when I do this. I feel sick and depleted and deficient, and the worst thing is how I get so down on myself. I feel like a steaming piece of  crap, and it makes me nuts. I need to talk to my neuropsych about it. I’m going to be seeing them tomorrow to go over my progress and whatnot, and I need to discuss this with them, so I can come up with some decent tactics and strategies for not killing my buzz.

So, while some days I can figure this stuff out and be smart about it, as you can see, it’s all too easy for me to screw the pooch by overdoing it. Overstimulation is overstimulation, whether it’s good or bad. Too much of a good thing is … a bad thing.