4. Your ability to plan and follow through may be affected, and you might not be able to make good judgments.
You may think it’s safe to drive… when it’s not
One of the worst things about TBI is that it can hide itself very well from the very people who are having trouble. An injured brain doesn’t always know it’s injured, and it usually wants to jump back in the action before it’s ready.
But it doesn’t know it’s not ready, because it can’t tell that it’s injured.
If you remember nothing else, at least remember this:
… And then this happens
After concussion, your brain will usually over-estimate your ability to do regular things again. And it will often tell you that you can do things even better than before… but you can’t.
I wish someone had told me about this danger after so many of my concussions.
Of course, even if they had, I probably wouldn’t have believed them. I interviewed for jobs that were far, far above my professional grade. Somehow, I was convinced that if another person could do the job of a C-level executive, I could, too. I told interviewers that I was capable of becoming an executive at companies where I had little to no experience because, “If they can do it, so can I.”
If you think I got a lot of strange looks at job interviews… you’re right.
I also had many close calls after making poor judgments around people carrying guns.
I nearly got myself killed while walking down a deer path in the early morning hours during deer hunting season, wearing no bright colors, and actually wanting to blend in like deer, so I could catch sight of one. I was nearly shot by a hunter, who pulled up before he pulled the trigger.
I also got into numerous scrapes with police officers, because I misunderstood what they were saying to me, and I got aggressive in response. I’ve resisted arrest, went out of my way to get confrontational with armed officers, and I’ve barely escaped a number of close calls with jail, thanks to lack of impulse control and terrible judgment – thanks to all those TBIs I’ve sustained.
And that’s just scratching the surface. I can tell you from plenty of personal experience that brain injury screws with your ability to think clearly and make good decisions.
This is to be expected. It’s completely normal for people who sustain concussions / TBIs.
Planning and good decision-making are some of the top casualties in brain injury, for a number of reasons:
A) You’re not getting all the info you need to make good choices.
B) The thinking process that decides what’s good or bad may be impaired.
C) You might not have the energy or patience to sort through all the details and come up with a good plan.
D) Your impulse control might not be great, so you jump into things before you think them through.
E) You may be extremely anxious, which makes you do things too quickly – or not at all.
There are plenty more reasons, but these are the Big Five that cause many problems.
Basically, you may find pieces of information missing, here and there… or you may not pick up on every detail that you need to make the right decisions.
It’s kind of like a contestant in a beauty pageant who has a salad for lunch and then is so caught up in thinking about her hair and her dress, that she doesn’t check her teeth in the mirror before she goes out for the next round on stage. The camera pans across the line of smiling contestants, and there she is with a big piece of dark green spinach on her teeth.
Not good. Chances are, her shot at the title is gone.
Even if you really, really want to do the right thing in the right way, your brain might not be up to the task of doing it… yet. Here’s why:
The frontal lobes – the very front of the brain in your forehead above your eyes – is the part of the brain that helps us plan our lives, follow through, and make wise decisions. And because it’s out there in front, it’s especially susceptible to injury.
Even if you get hit in the back of the head – like when you get rear-ended in traffic – your brain can smack up against the inside of the front of your skull. This is not good news for anyone, because the inside of the skull is sharp and bony, and the brain is soft like Jell-O.
When your executive function is impaired, your brain can get you into a ton of really bad scrapes. That includes telling yourself that you’re ready to get back into playing, working, or learning long before you’re ready to. It also includes telling yourself that you’re a lot better at something than you are.
Impaired executive function can go hand-in-hand with impaired risk assessment (where you can’t really tell how dangerous a situation is before jumping in), so you can put yourself in real danger without realizing it.
- Getting back into extreme sports when your coordination and timing are not nearly as good as they used to be.
- Starting classes again and taking even harder ones than before, when your brain isn’t processing info as well as it once was.
- Taking up a new sport you never played before and trying to jump to expert level participation right away.
- Getting involved with illegal activities.
- Confronting an armed motorist who’s caught up in road rage.
These can all get you hurt. They can also get you killed. But if your executive function is impaired, you’re not exactly qualified to make those kinds of decisions.
One of the biggest problems with brain injury / concussion is that it also tricks you into thinking that there’s no problem at all with your thinking. You’re sure that you’re fine!
This special brand of confusion is so common that there’s even a word for not knowing that you don’t know you’re impaired: anosognosia.
Your brain can be so injured that it’s literally incapable of telling how good or bad it is at…well, anything. This is common after stroke, as well as more serious brain injuries.
And it’s very, very dangerous. Combine poor judgment with the impatience and anxiety that often comes with TBI, and you have a powder keg just waiting to go off.
It’s nobody’s fault, and it doesn’t mean there’s something wrong with you, if you keep making bone-headed mistakes.
It just means that part of your brain that’s responsible for “executive functioning” is impaired and needs some help.
What to do?
In many concussions, poor judgment is either temporary or it can be offset by some help from other people or tools you can use.
The most important thing is to understand that your brain can – and will – play tricks on you after a concussion or TBI. It doesn’t mean you’re permanently damaged, it just means you need to re-train that part of your brain to A) slow down to notice the right details, and B) get in the habit of thinking things through.
If you’ve got friends to bounce ideas off, this is the best time to use them.
If you don’t have friends in the “real world” (they may have ditched you after your injury, or you might be isolated by your problems), you can find online support groups who can help you sort things out.
Also, there are professionals who can help you with your decision-making. You may be able to find a counselor or neuropsychologist who can help you retrain your brain to think more systematically and come up with better solutions to problems.
The best thing you can probably do, is reach out for help. Because your brain is going to tell you some interesting things – many of those things may be 100% wrong… but you’ll never know it, because your brain doesn’t.