The really stupid thing that got me back on this blog…

Last week, I was on a call with a life coach who was pitching their neuro-based approach to peak performance. They’re a trained neuropsychologist, and they had a handful of ways to “hack” the brain so you can basically flip the switch on your success. Super-charge it. Turn it on in ways that we usually instinctively turn it off.

Okay, great. I’m always up for ways to do that. I’ve been doing it, myself, for years, using neuropsychological principles.

But a couple things jumped out at me during that call, that seemed really really stupid. And I don’t mean “stupid” in a way that belittles people with cognitive difficulties. I mean it in the way that professionally trained people who should know better are leading people down a path that goes directly against what they should know, due to their professional training.

Before I go on, let me say that one of the things that discouraged me from keeping up this blog has been all the professional input about concussions, over the past several years, that has not helped. There’s a whole “concussion industry” that’s giving people really mixed messages – from people who have never sustained mTBIs or other sorts of brain injuries (that they’re admitting, anyway). And it’s made it all the harder to have a conversation about what mTBI is, how it affects you, and what you can actually do about it. I mean… I just don’t know where to start.

More on that later. Let’s get back to the professional stupidity.

Okay, so I was on this call, and the neuropsych was telling people that we can turn our lives around by breaking mental barriers. Find something that you’re afraid to do, and do it over and over and over again, using “exposure therapy”. Address your core beliefs about who you are and what you think you can do. Overcome those beliefs by not telling yourself over and over that you can’t do something. Use visualizations to “pre-wire” your system for success. And get comfortable with uncertainty.

All sorts of alarms went off with me on this, especially because the person talking admitted to having been very close with someone who had sustained a TBI years before they met them, and they had ignored the warning signs of suicidal thoughts… they’d even encouraged them to just take some anti-depressant meds — the very same meds which will set off someone with a history of TBI. Long story short, just after they told their friend to take some meds, that friend killed themself. Traumatic, to be sure.

And just as traumatic was the idea that someone who was trained as a neuropsychologist was telling someone to do something (take meds) that even I, from passing conversations with a neuropsych, know can be hugely problematic for a brain injury survivor.

Not only that, but this person was positioning themself as an expert in brain topics, immediately after revealing this massive “tell” about just how clueless they were/are.

Um. Okay.

And then they proceed to talk about how doing things like facing your fears, visualizing, and self-talk will get you on the right track and turn your life around.

Well, okay, so for a lot of people it will do that. But for someone with underlying physiological neurological issues (e.g., someone whose wiring has been rearranged by concussion/traumatic brain injury), those things will only go so far.

It would have been much more helpful, if they’d called out the fact that people with organic/physiological brain issues operate by different rules. And we have to live by those rules, day after day, if we’re going to be able to do things like visualize and self-talk our way to success.

Things like:

• Get enough sleep
• Drink enough water / stay hydrated
• Get regular exercise
• Find ways to calm down the over-active and easily amped-up system
• Keep your blood sugar steady by eating decent meals regularly (and stay away from junk food)
• Have a daily routine that reinforces your understanding of who you are and what you can reasonably expect of yourself, day after day.

If we TBI survivors don’t take care of the basics — food, water, sleep, routine — nothing else is worth much. At all.

And my heart aches for all the people (like me) out there who are being told, each and every day, that their failures are due to bad messages they’re giving themselves, or letting their fear run their lives. I think it was such a waste for the neuropsych’s friend to lose their life (in part) because of the terrible advice that they should have known better than to give. I also get so sick and tired of people lecturing me/us about how we just need to get our attitudes aligned with the right sort of mentality, and then our lives will dramatically change for the better. Never mind the underlying issues with fatigue and irritability and not knowing what the h*ll to expect from ourselves and our systems, from moment to moment, because our brain injury has turned us into someone we don’t recognize anymore. We’re being blamed for results that stem directly from our organic/physiological situation, without anyone even admitting that getting your wires crossed by a car accident, a fall, an assault, or a tackle gone wrong, can and does have an effect on your brain’s function.

Now, don’t get me wrong. I do believe that pretty much all of us spend way too much time being afraid and telling ourselves the wrong things about ourselves and our chances. We don’t do enough of the kinds of things that can and will make us successful.  And we generally don’t have the right mentality that sets us up for success.

But none of those performance-enhancement approaches are going to get much traction, if we don’t address the physical facts of our neurological situation. Failure is not all in our minds. It’s also in our brains. And until we learn to support / heal our brains and do the things we need to do — regularly, routinely, predictably — all the self-talk in the world isn’t going to be much help. At all.

Until we get ourselves on a good schedule – and stay there – eat the right foods (for us), drink enough water, exercise on a regular basis, and get decent amounts of sleep on a regular basis… Until we develop a new Sense Of Self that tells us who we are and what we can expect from ourselves… Until we redefine ourselves in ways that are solid and predictable… those mentality tactics are just going to be all in someone’s mind.

And the fact that a neuropsychologist was spouting all this stuff without prefacing their talk with a disclaimer… well, that just pisses me off. If they’d said something like, “What I’m about to share is intended for people without underlying neurological issues, some of which may have been sustained a long time ago, but are still having an impact in you life”, it would have set much better with me.

But they didn’t. So, there we are.

Oh, well. It’s a beautiful Sunday, and I have another 24 hours till I have to be ON for work again. So, I might as well enjoy myself. This isn’t the first time this sort of professional stupidity took the steering wheel. And it certainly won’t be the last.

Life goes on.

So, onward.

The one sure way I can tell I’m not feeling well, physically

Exercise turns on my brain – in more ways than one. So does this blog.

I tend to have a hard time figuring out when I’m not doing well, physically speaking. When I’m in pain, or when I’m not getting my exercise, or I’m generally not feeling great in my body.

I can get so wrapped up in my life — like for the past three weekends, when I had so much to do, and work was full of pressure — that I don’t get regular exercise, and the pain starts to bother me… including headaches. But I’m so busy, I don’t notice. It’s all I can do, to keep up.

Of course, eventually, I don’t keep up. I get bogged down. My head doesn’t work right. My thoughts are scattered and unreliable, and I stop using my adaptations to make sure I’m okay.

The one sure way I can tell when I’m headed off the rails, is when I don’t blog here. It doesn’t take me long to write a post. It takes 10-20 minutes to put something together. And I have more than that much free time, each morning, the way I’ve structured my days. If I can’t spare 10-20 minutes to write something here, then my life has really taken a turn for the worse, and I need to get myself back on track.

That means… exercise. Like I did this morning. I had an extra-long bike ride, then I did an extra set of lifts with my little weights. And while I was doing that, I thought about how I can get more weight lifting (with machines) in my life. There are some great gyms at the different buildings of my work campus, and one of them has a pool. So, I need to avail myself of the resources and take steps. Because I’m gaining weight, losing muscle tone, and my thinking has not been as sharp as I’d like it to be.

If I can manage to blog here regularly, it means my executive function is firing on all cylinders. It means I have enough energy to get into my day. It means I’m being pro-active and taking initiative in my life. It means I have left myself some wiggle room to do what needs to be done, and that’s exactly what I need to in my daily life.

I’ve been letting myself get too tired, lately. Work has been very, very busy, and also stressful. Long hours, especially every other weekend when we have software releases and I need to work overnight hours. This weekend is one of those times, and after starting work at 8:00 a.m. yesterday, I was till 4:00 a.m. this morning, working on problems that other people caused.

I’m not in a position to change jobs, right now, so I just have to tough it out… or look for another position at the company, so I don’t have to get dragged through the horror of outside interviews and having to prove myself all over again. Toughing it out and managing things as they are is actually more appealing to me than switching positions, at this point. I like most of the people I work with. Some of them make me crazy, but most of them I love… and they love me. So, there’s that.

Can’t put a price on love, you know?

Anyway, I’m a little delirious after getting only 4 hours of sleep last night (and I need to check in later today to see how things are going with work). I just need to get back in tune with myself and get myself back on track about my physical health and my mental state — support the body, and the brain will follow suit, is what I say. That’s always been the case with my TBI-addled brain. Not until I got into regular exercise and focused on taking care of my body, did my brain start to cooperate… and heal.

Until then, all bets were off. And I was miserable.

So, it’s better if I get my act together and get my exercise back on track. And keep blogging here. Each and every day. Or at least as often as I can manage.

Concussion / mild TBI recovery is not only possible, but highly likely. As many people need to know this as I can tell in one lifetime.

ONward.

UPward.

The up-sides of the down-sides

It’s been a wild couple of days. I had to work overtime twice in two days, which meant I was up from 4 a.m. on Tuesday morning till 3 a.m. yesterday, and I was working intensely for most of that time. We had a big project we had to get done, and we were missing two people on the team, since they had previously scheduled vacation and the big project’s schedule got changed to the worst possible dates.

Oh, well. We just had to deal with it.

And deal with it, I did.

I got 90 minutes of sleep between the two marathon testing sessions, and that was it. Half the time, I felt like I was dead on my feet, and my brain was mush. I was doubled over in pain, part of the time, because of eating the wrong stuff to keep my energy up, which led to digestive problems.

I have to be honest – it was pretty rough. But I got through it. And I ended up lasting longer than just about everybody else, which is typical. One of the upsides of dealing with fatigue and confusion and pain all the time, is that when things get really rough, all across the board, I can  — and usually will — persevere. I can stick it out and still perform. Because I’ve had plenty of practice. I know how to do it, because I do it, every single day, pretty much.

I’m usually tired, usually brain-fogged, usually struggling a bit at something or another. That’s pretty much the cards in the hand I’ve been dealt, because even if I weren’t dealing with TBI issues, I’d still be pushing myself — always harder, always farther, always faster. That’s just how I am. I’m not all that competitive against others. I’m mainly competitive against myself, and I always want to see how much better I can be, how much I can improve.

That’s just how I’m built.

So, of course, I’m going to experience these kinds of stresses and strains, these challenges, these difficulties. And when I’m called upon to kick in and contribute, I’ll do that to the max. To the utmost. I’m not going to hold back. It can be a problem, of course, because I can push myself too hard and overextend myself, but I’m aware of that risk, so I do something about it.

Bottom line, all the difficulties I’ve been up against, over the course of my life have strengthened and sharpened and honed me to this point. And even if I’m not as sharp and strong and honed as I’d ideally like to be, I’m still able to persevere, to hang in there. To stick it out and really do my best, no matter what.

That’s a huge up-side, for me and everyone around me.

And it makes the down-sides manageable.

It’s all part of it.

Onward.

Move movement

All this immmobility is seriously giving me problems. My day job is very sedentary, and I don’t move nearly enough. And it’s been taking a toll on me physically.

If I’m going to last for the long run, I absolutely have to get moving more often. Even if it’s just adjusting my posture or moving my shoulders, I must move on a regular basis.

I’ve been doing a bit better with that, lately. I do my morning exercise bike ride, then I do some new movements, similar to martial arts and Qi Gong, that wake me up. In the past, I’ve done a lot of weight lifting, in combination with my bike riding, but the repetitive motions actually worked against me, and I developed back and shoulder problems as a result. Now, I’m doing more natural, more complex movements, to stir the energy and get my body woken up.

The way I see it, the real danger of brain injury is to the body. We can become so stressed, so preoccupied with what’s wrong with us, that we stop living our lives, we stop actively taking chances, and we stop learning. We can also stop moving. It’s so easy, these days, to “veg out” in front of the television and not do anything, or lie in bed looking at social media on your phone. Plus, the cocooning that’s often recommended after a concussion encourages immobility.

As it turns out, cocooning might not be the best thing for folks after a concussion, after all. We need to move more. And if you think about it, it makes sense. Concussion releases a lot of chemicals into the brain that need to be moved out. How does the body move things — by moving itself. Increased blood flow. Increased circulation. Increased breathing. Over-exertion isn’t a great idea — in fact, it may expose you to additional injuries, because your coordination may be impacted, and you may also not be able to gauge risk, or react to the environment as quickly.

You need to be careful. But you also need to move.

But I digress. This is really about me and fixing decades of sedentary life. I’ve allowed myself to get comfortable in non-movement, and now it’s almost like my body seems to have forgotten how to really move freely. In fact, that’s what happens. You get muscle amnesia, and your brain stops understanding how to move your whole body.

I need to do something about that. I look around at my peers, and I’m not impressed by how non-active they are. It’s pretty bad. They can’t move freely. They might play sports, go skiing, or run, but they don’t have fluidity of movement. They’re too busy looking the part of a respectable adult — and it amazes me, just how restricted your movements have to be, when you’re doing an impression of a respectable adult. Especially for women. Don’t run, don’t spring into action, don’t move in unexpected ways… No wonder our bodies run out of juice. We don’t use them.

Well, I for one am not going to end up like that. Yeah, I’ve got some pain going on. I messed up my shoulder again over the weekend. But I’m working through it. I’ve got my movements, I’m getting into motion. I’m also using my stand-up desks at home and at work, to get me off my a**. I’m going up and down stairs at work, instead of taking the elevator. Even if I’m carrying a heavy load — especially then.

And that’s good. It’s helping. It’s working itself out.

Onward.

When you find something that works… work it

I’ve been having a lot of trouble with my shoulder and back, over the past months. Dealing with all the snow, along with spending a lot of time being sedentary — alternating between slothfulness and frantic activity — has done a number on me.

I’ve been trying to get my shoulder to loosen up, so the pain in my arm eases up. I’ve got a lot of shooting pain, tingling, weakness, etc. in my left arm, and sometimes it also goes over to my right side.

And that’s no good.

I need to keep myself in good working order. Life goes on, and I absolutely need to be up for it all. I can’t afford to get waylaid, especially when we’re talking about just regular life. I know I’ve got some disabilities, and I know I need to make accommodations for myself, but once I do that, I need to stay in the game. I can’t use my intermittent issues as an excuse. No way, no how.

After months of wangling with this pain, I finally found something that really seems to work. I’d been doing stretches and trying to release the tightness in my muscles with movements designed to lengthen them. But that seemed to be doing the exact opposite.

So, I tried something that’s worked for me in the past — doing muscle releases by doing slight tightening and then relaxation. Apparently, a muscle contraction will actually loosen the muscle, where a stretch will shorten it. So, I did some exercises I’d read about (and used with some pretty amazing success) a few years ago.

And lo and behold, I’m finally getting some relief. It’s pretty amazing, actually. The sense of relaxation that comes from it, is a welcome change, compared to what I’ve been dealing with for months, now. It’s not always perfect, and I still have to refine my technique, but I’m learning how to move so that my body isn’t at war with itself.

That’s huge. Immense.

So, now it’s time to get moving, and get on with my day.

Onward.

Brain: Yeah, that’s enough. Body: Nope, we’re just getting started

It’s ALL connected

Life has thrown me a bunch of curve-balls, lately, and I’m feeling it physically. It’s been a while since I’ve been this sore — lots of lifting and carrying and pushing and pulling, over the past few days. And despite the pain, my body is actually responding well to it.

I’m sleeping better. I’ve been getting about 8 hours a night, for the past few nights, where I was stuck at 6 hours for quite some time. I need 8, or I can’t function well, and things start to fall apart.

I’m also thinking more clearly, with less static and “clutter”.

I’ve been doing more stretching, which has really helped, too.

Spending less time in front of the computer has been great. Because let’s be honest, not that much changes, from day to day, despite the steady stream of sensational headlines and “news” stories that are all just different angles about the same-old-same-old.  I can literally check in every week or so, and the story will still be the same. So, I’m leaving it alone, and that’s making me happy and freeing up a lot of time.

Also, spending more time exercising is helping. I’ve been riding my bike for 20 minutes a day for years, but now I’m changing things up and focusing on burning calories. I’m keeping at it, till I burn 400-500 calories, and not stopping before then. That’s making a difference, I think. Ultimately, it’ll help my weight (I’ve regained weight I thought I could keep off). And it’s also good for my mental health, because I feel like I’m actually doing something. Plus, I can be more involved with my diet and its effects, overall. I need to do that. Eat more variety. Get better nutrients in me.

It’s funny, yesterday I was feeling really hungry, and I started to go after my usual crackers and cheese (protein helps). But then I stopped and decided to take some of my multivitamin “gummies”. And when I did that, it cut my hunger. I suspect that craving feeling is my body telling me it needs more nutrients, but when I go for the cookies or crackers, instead of actual vitamins, it just disguises the need and distracts my system with the sugar rush.

So, now that’s going to be my go-to. Instead of snacking, take some vitamin gummies. Not overdose on them, but just the usual recommended amount. I’ve got a number of different types that have been sitting in my cupboard, instead of me taking them. So, now I can take them. I just need a way to work them into my life, in order to get with the program.

Huh, it’s funny. My brain very quickly decides that it’s done with stuff — exercise and physical activity, especially.  But my body wants to keep going. Like with the bike riding. If I can just get my mind off its desire to go do something else, I can keep going with my workouts. And when I’m working hard, my distractable brain can come up with all kinds of other things it’d rather be thinking about. But I need to keep working. Keep my body going.

So, I just need to keep this in mind, when I’m trying to keep myself on track. Keep my mind out of the picture, and let my body continue on its pace. And watch what happens. To my health — physical and mental.

My brain wants to quit, but I should know better than to listen to it.

I should know that by now. And yeah, I do. I just need a reminder. Like now.

Onward…

Ouch – time to get back to my regular exercise

Okay, enough work. Time to get some balance back in my life.

Last week was incredibly busy. I had meetings for work from dawn till dusk, and beyond, and I spent a lot of time hunched over my computer or sitting at a table concentrating on what was being said, not to mention the ramifications of what people were saying.

I was so intent on keeping up, I didn’t keep up with my exercise, and now I’m feeling it in a big way. My bum shoulder is acting up again, and so are my elbows, back, and knees. I’m in a fair amount of chronic, low-level pain that keeps flaring up at odd times. It’s tiring. And it puts me in a bad mood.

Typically, I start the day with exercise. I ride my bike for 20 minutes (sometimes more), then I lift weights. If I don’t, I start to feel the ill-effects within a few days. And last week was so packed, I didn’t do much of anything in that department for over 5 days. Not good.

What I notice most is the drop in my strength. I lifted a little this morning, but the weights felt much heavier than usual. And it humbling, to feel that. They shouldn’t feel that heavy to me. Not under normal conditions.

But these aren’t normal conditions.

Well, anyway, enough regrets. I know what to do, and I can do it. Now I can get back to my regular exercise — and then some. I really need to do more, anyway. I used to swim several times a week, but that dropped off, for some reason. I need to get back to that, if only because it exercises my entire body all at one time, instead of just focusing on one muscle group at a time. It also feels good to be less weighted in the pool.

And on the weekends, I need to move more, do more lifting, do more … period. I’m here in the house. And I need to get out, go for the kinds of walks I used to. Get myself moving. Get myself up and at ’em.

It’s kind of strange, how I’ve gotten away from being as active as I used to be. I don’t go out for those time-honored walks, like I used to. I don’t putter around outside, like I used to. I don’t do as much physical activity as I need to — I’ve been working on thinking projects for the past couple of years, sitting at my desk or the dining room table, coming up with ideas. And that’s fine. I’ve made a lot of progress. But I can also think while I’m walking — in fact, I’ve had some of my best ideas while hiking through the woods.

So, it’s time to get back to that. It feels like a New Year’s resolution, but it’s really just common sense.

And not wanting to be in so much pain…

That, too.

Onward.

Keeping safe, keeping sound, keeping rested

One of the major long-term issues I have, thanks to all those mTBIs, is that I tend to get tired… but I don’t realize it, until I’m so tired I can’t rest enough to catch up. When I’m tired, my thinking is off — as in off. I get more impulsive, and I also get angry quickly. It kicks off a self-fulfilling prophecy of lots of activity, followed by increasing fatigue, followed by lots of activity (to pump myself up with adrenaline), leading to increasing fatigue…

And before I know it, I’m so tired, I can’t rest.

I’m tired. I’m wired. And I’m unbelievably impulsive. As in – reserve a new domain name and launch a new online business impulsive. As in – push myself to make poor choices that pump me full of adrenaline that make me feel like myself again, even though I’m putting myself in danger. These choices can range from driving while exhausted, to starting a  new thing before I finish something else, picking a fight with someone over something stupid, or staying up even later to watch a movie I’ve seen a hundred times before.

Of course, the whole “new thing” crashes before long, because I run out of steam, I implode, or I rapidly lose track of what I’m doing. And after I get a nap or a couple of good nights’ sleep, I realize what I’ve been doing – and I know for sure, it’s never going to work.

That happened to me, last weekend. I had a lot going on. Too much, as it turns out. And I was tired. I was tweaked about things going on at work, and I was feeling the burn of the long winter and a lack of sunlight. So, I pushed myself. And pushed myself. And I ended up frittering away a lot of time over the weekend on things that I didn’t need to be doing — that I shouldn’t have been doing. And I tired myself out, even more.

I didn’t exercise as much as I should have. Because I was tired.

I didn’t finish the things I’d started earlier in the week. Because I was tired.

And I ended up eating a lot of junk food to keep my energy up… and also due to an impending migraine. I get ravenous when a migraine is brewing. And I ate a bunch of stuff that put on some pounds, made me feel worse, and screwed up my energy… so I was more inclined to eat more junk food, stay up later, and basically waste my week.

I don’t have weeks to waste. Only in the past several years, have I even felt like a real human being, thanks to my TBI rehab. I’ve lived for decades in the shadows, not feeling even remotely real. I’ve struggled to keep up, year after year after year, and I’ve never had the kind of connection with my work that I have now. I can’t afford to waste any time in my life, because I only have this one. And I’ve been wanting to do so much, for so long, only to be blocked and thwarted at every turn… I can’t waste any time, now.

So, all that being said, it’s incredibly critical that I keep myself in line and properly manage my energy, my eating, my exercise.  And always keep in mind the fact that, just a few years ago, I wasn’t able to maintain this level of activity, let alone have a realistic expectation that I’d be able to live up to my plans and dreams. It was all just “throwing stuff at the wall to see what sticks”.

Now, though, things are very different. Indeed, they are. And I have to keep that in mind, when I’m tempted to fritter away time on things that have no ultimate purpose.

It’s good to take a break, every now and then, but it’s important to stay on track and follow through. I can finally – finally – do that.

And I don’t want to take it for granted.

Onward.

Emotional Problems After Traumatic Brain Injury – Peer and other support

After brain injury, you need support

Peer and other support

Remember, too, that not all help comes from professionals! You may benefit from:

• A brain injury support group — some are specialized for the person with TBI, others are for family members, and others are open to everyone affected by brain injury.

BB: Not everyone has access to this. But if you're reading this, you have access to the Internet, and there are support groups online, like the forum Traumatic Brain Injury and Post Concussion Syndrome

• Peer mentoring, in which a person who has coped with brain injury for a long time gives support and suggestions to someone who is struggling with similar problems.

BB: Again, it can be difficult to find someone who can help you. But if you reach out online, you may find someone. Also, you never know who's had a TBI. We're everywhere.

• Check with your local Brain Injury Association chapter to find out more about these resources. Go to http://www.biausa.org/ to find brain injury resources near you.

BB: I got some great info from my local BIA chapter. I attended some support group meetings. But I wasn't "impaired enough" for some people there, so I quit going. I guess I've gotten too good at hiding my difficulties.

• Talk to a friend, family member, member of the clergy or someone else who is a good listener.

BB: They definitely need to be a good listener - and able to deal with you. Family and friends may not be able to help, because they may be too invested in you being like you always were before. It's a tricky line to walk, but it's important to reach out for help.

Read more at: Emotional Problems After Traumatic Brain Injury

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Emotional/Behavioural Changes after Brain Injury – Part 2

Continued from Part 1

From The Toronto Acquired Brain Injury Network.

My comments are in bold like this.

Emotional/Behavioural Changes

Impulsivity and disinhibition

A person may lose their ability to control their actions or their speech. This problem often goes hand in hand with lack of awareness, and the person may not be aware of breaking any social rules or etiquette. There are strategies that can help to improve the situation, and prevent a person from developing unacceptable behaviours through habit.

BB: The first thing that we need to know, as we recover, is that we're breaking social rules. We may not be aware. And while the people around us may not be comfortable "calling us out" on our behavior, it's important to do it. And it's important to persevere in convincing us that our behavior is just not good. Because we may literally not know. We may also resist accepting that fact. But brain injury and "bad manners" often go together - and if you  never realize you're behaving badly in the first place, it's impossible to fix it.

Emotional Lability

This describes a person’s tendency to laugh and cry very easily and to move from one emotional state to another very quickly. Loss of control over emotions means the person may express their feelings inappropriately or at the wrong time. This can be very tiring and embarrassing for family members to deal with, but in time a person can begin to re-learn emotional control.

BB: I am not a fan of emotional lability. Nor is anyone around me. It can be embarrassing and stressful, and it can make things worse. The best thing to do, for me, is find some humor in it. Over time, this can sort itself out and become more manageable. In the meantime, you just have to make the best of it -- and remember to not over-react to every emotional storm that comes along.

Self-centredness

Someone may become self-centred. For example, the person may not show any interest in family matters and only be concerned with their own needs. Brain injury can affect a person’s ability to judge how someone else is feeling. The person may also become used to the huge amount of attention they receive while in hospital.

BB: Recovering from brain injury requires you to become self-centered, in my opinion. You have to pay attention to yourself in new ways. You have to get familiar with yourself again. But it's easy to get too caught up in yourself, and that can distance others. Ultimately, the thing that's saved me, time and again, is getting past myself. Learning now to be less self-centered. It helps me with depression, it helps relieve my sense of being disconnected from others. Putting others first... that's been a big benefit for me.

Apathy and poor motivation

Lack of motivation, or apathy, is a direct result of injury to the part of the brain that controls emotion, motivation and forward planning. Over time, lack of motivation can lead to social isolation and lack of pleasure. For example, a person may show no interest in hobbies enjoyed previously, or they may not get out of a chair all day. To help, activities can be broken down into small steps to avoid overwhelming the person.

BB: This is a big one for me. Most of the time, I just don't care about much of anything at all. Seriously, I don't. And so many things I've started... well, they've just fallen apart and went nowhere, which made me feel like a total loser who wasted everyone's time. My motivation generally sucks. I wish it didn't, but then again... a lot of times, I just don't care, one way or the other.

But yet, I need to keep moving. I need to stay productive. I need to keep myself from falling into "disrepair" and ending up feeling worse than I already do. Life has always been painful for me. It hasn't been a long exercise in glee and joyfulness. It's been awkward and uncomfortable, and I've been in multiple kinds of pain for as long as I can remember. 

But something in me needs to keep moving. I find motivation where I can get it - generally not from the things that other people get motivation from. Just staying alive. Feeling like I'm doing something productive with myself. And constantly coming around again to take another shot at what I want to do.

Motivation is a tough one for me. I guess I've just developed habits around getting stuff done, and they work for me when I have no motivation to do anything, at all.

One thing that keeps me motivated, is doing things for others. Serving others. Being available to others to help, so they can have the best life possible. That motivates me, I guess. It's probably my biggest one. The rest of the things -- money, success, fame -- nah, I'd rather do something useful that benefits others, to be honest.

Depression

Depression is a very common emotional reaction experienced in the later stages of rehabilitation—often when a person realizes the full extent of the problems caused by the accident. This can be seen as a good sign: the person is aware of the reality of the situation and is coming to terms with the emotional consequences. “Healthy” depression can be worked through in time, as adjustments are made. If a person feels emotionally blocked and unable to move on, professional counseling from someone who understands head injury may be helpful.

BB: I never gave much thought to this before, probably because I've always been depressed, and it's nothing new for me. When I was in high school (I had a handful of mild TBIs in the course of three years), I went through a period that was utterly, completely black. Literally. I couldn't see anything, at some points. Everything was dark for a little bit, and my vision wasn't working.  Fortunately, it seemed to happen when I was sitting down. But the emotional darkness was the worst. I just felt like I didn't even exist, and I didn't care, one way or the other. 

I'm not sure that it had anything to do with realizing how messed up I was. I didn't realize those blows to the head had any effect on me at all. I just felt awful. Whether it was the mTBIs or just being a teenager, is anybody's guess.

Someone asked me once, if I had a history of depression. I said, "Of course," and they seemed sad. I didn't mean to make them sad -- just tell the truth.

Anxiety

It is natural for people who have had a traumatic experience to feel anxious afterwards. Individuals may experience a loss of confidence when they are faced with situations and tasks that are difficult to cope with. However, problems can occur if difficult situations are continually avoided, or if those caring for them encourage dependence rather than independence. Talking about fears and worries is very helpful. Learning ways to stay calm under stress can also reduce the effect of anxiety on everyday life.

BB: I know this one all too well. And what most people don't realize, is that anxiety isn't just about the injury itself. If anything, the injury is just a small part of the total anxiety-generating stuff. Insecurity and instability builds throughout the course of your recovery (because some recovery is invariably happening, even if it doesn't seem like it), as you walk into different situations that you feel should be OK, but then you screw things up -- many times without even realizing it -- and it happens over and over again. Everyone around you is afraid to say anything, because you might A) blow up, B) cry, C) fight them on it, D) feel terrible. Everybody's walking on eggshells, so you never get the information you need to recover sufficiently, or adjust your behavior and adapt to situations.

So, people just basically leave you to your own devices, which is a terrible idea, because it leaves you alone with the very thing that's causing you problems -- your brain. And the anxiety builds over and over and over, because you can't get the help you need to adjust and recover -- and regain your dignity.

Small wonder, that we start to avoid situations. Sometimes it's just easier to not even bother, than get dragged across the hot coals of embarrassment all over again.

Inflexibility and obsessionality

Examples of this behaviour include: unreasonable stubbornness; an obsessive pattern of behaviour such as washing or checking things; or fear of possessions being stolen. The person can lose the ability to jump from one idea to another, and becomes “stuck” on one particular thought. This type of behaviour is often made worse by anxiety or insecurity, so it is helpful to reassure the person and and redirect their attention to more constructive ideas and behaviour.

BB: You never know if the stubbornness is unreasonable or not. There may be a very good reason for it - but nobody's asking the right questions, so you end up looking "unreasonable" to people who might be able to help you, if they just took a different route or opened their minds.

Getting stuck on an idea or a frustration is a big problem for me, to this day. If I'm tired, I can get "stuck in a loop" where I'll keep arguing about the same point, over and over and over again, making everyone around me absolutely nuts with frustration. And they don't know how to get me out of it. 

It's impossible to argue with me at those points. Best thing to do, like they said, is redirect my attention in another more productive direction.

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