Intermittent Fasting for Emotional Discipline

Running the gamut – emotional style

Now that the New Year is here, a lot of people are focusing on resolutions for how to change their lives. I think this is a good intention, and this is the perfect time to think about these things, after the last six weeks of holiday upheaval. The holidays give us time to step away from our usual routine, and when we do, it can be easier to see the shape of our lives more clearly, than when we are in our regular routines and regimens.

One thing that has been really evident to me, is my persistent need for emotional discipline… maybe even control. That is, I need to be able to manage my own emotions and feel what I feel without going off the rails over it. My recent close encounters with a police officer and my meltdowns at home over the past few months have made it pretty clear that I need to “get a grip” and quit being so volatile.

Emotional volatility (or “lability” as they call it) goes hand in hand with TBI. You know how it goes — those temper flares, the anger, the rage, the ups and downs that can really turn into a roller coaster… It can be hell, not only on you, but on everyone around you. Fatigue makes things worse. Sensory overload can really do a number on you. And there are the many, many emotional challenges that come with having to reconstruct your life after a traumatic brain injury.

So, what can you do? Are you just stuck — at the mercy of your mysterious brain, which may or may not agree to mend itself the way you want? Or is there something more that can be done, to address emotional lability?

I have been “on the bandwagon” with the idea of hormesis for some time — stressing your system slightly, so that it develops strengths to offset the stresses. Exercise is a form of hormesis, where you stress your body a bit, in order to develop strength or endurance. Vaccinations are also a type of hormesis, where a tiny bit of a disease is introduced to your system so it develops resistance to it. Also, there is the concept of “stress inoculation”, where you subject yourself to certain types of stress to teach your system to respond to it and overcome it. The book Stress for Success talks about that.

I think that fasting can be used as a way to foster greater emotional discipline (even control) in my life. I know that fasting has long been recommended (and mandated) by many religious faiths, to foster greater spiritual growth. Fasting and prayer are often combined, to bring a person closer to the God they worship. It is a challenging thing to do — go without food for a certain period of time — and it brings up a lot of emotions and insecurities and frustrations… the underbelly of your emotional life. So, combining it with a spiritual practice can be a powerful formula for personal growth.

I didn’t combine my fasting yesterday with any spiritual practice, other than lifting weights while I did slow, measured breathing. Basically, I really paid close attention to my state of mind and heart, and I was pretty vigilant about my reactions to things. I had a few minor flare-ups, but they were like little lessons that prompted me to adjust my mindset and activities, so I could be more balanced.

Intermittent fasting also helps the body to clear out the “sludge” of everyday living. It prompts elevated activity of organisms called Macrophages, which engulf and destroy bacteria and viruses and other junk that builds up in the course of everyday living. They literally eat dead or abnormal cells (anything with “-phage” at the end of its name eats something else — glucophages like Metformin eat glucose), and that does a body good.

Aside: You know, when I think about it, if there is a whole boatload of messed-up junk that floods your system after a TBI/concussion, and there’s all this sludge floating around in your system, wouldn’t it make sense for people to fast intermittently after concussion/TBI? Just thinking aloud…. Oh, after Googling the topic, I found this: Fasting is neuroprotective following traumatic brain injury.

Anyway, from an emotional standpoint, I think that intermittent fasting can become one of my important tools to fostering more stability. Just going without food for 24 hours or so puts me in a slightly stressed state — which I know will end soon. It both stresses me and un-pressurizes me, and it introduces a temporary change in my routine which I can learn to handle with greater success and ability each time I do it.

The first time I did short-term fasting was about five months ago, and it was pretty stressful for me. I figured it was not for me, thinking that if it didn’t work that one time, it was never going to work. Then I took another shot at it yesterday, and it went much better. Worlds better, in fact. And I didn’t regret it at all. Because I knew that it was going to be challenging for me, and I figured out some ways to handle myself better than I had the last time. I also got it through my thick head that my hunger wasn’t going to last forever, I knew I would be eating later that night, and I actually made it through the day without completely panicking.

This is all good news. And I think I am onto something. Because not only does fasting prompt the body to clean out the junk that’s been accumulating there, but it also gives me an opportunity to learn to manage my emotions better — within a controlled and limited context. I’m not looking at an eternity of emotional challenge. I’m just testing my limits a bit, to learn how to better handle my ups and downs.

I’m feeling a lot better about fasting, now that I’ve had a fairly successful run. And since I made a specific goal out of keeping an even keel during my fasting, yesterday, it gave me something to work towards. And it’s giving me a huge sense of reward and accomplishment (and I hope some much-needed dopamine), to know that I was able to get through that day without too much drama… and that I’ll be able to do it again sometime.

I don’t want to go overboard with this all, and I need to keep in within reasonable limits. Part of me wants to dive head-first into fasting every other day, but that would be completely impractical and set me up for failure, I’m sure. It would be too much, and going overboard and melting down would set me so far back. I think fasting for 24 hours once a month would do it. Maybe every other month. We’ll see when another good time comes up for me to do it — preferably when things are chilled out and mellow and I’m not all stressed out about my life in general.

I need to be smart about this — measured and cautious and deliberate. Because if I can do this properly and with good balance, it could turn out to be one of my building blocks for a continued positive trend in my life.

Onward.

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Debunking Ten Myths of (TBI) “Recovery”? – Myth #1

Activation of Brain Region Predicts Altruism.
What do the experts have to say?

I recently was sent a comment by a reader who referenced the following 10 myths of Head-Injury in their comment. I wasn’t able to publish the comment, but I’ll share what they sent along to me. I’m not sure how I feel about the 10 myths which are discussed. The first one, for starters, is full of things I don’t really agree with. And I’ll tell you exactly why in this post. It’s only fair, since the book/writing in question is by some very famous and authoritative experts who (as far as I can tell) aren’t actually brain injury survivors. I’m sure they have their reasons for saying what they do, but I’d like to weigh in with a different perspective

DEBUNKING TEN MYTHS OF “RECOVERY”
~from CH2 “The Nature of Head Injury” by Thomas Kay, Ph.D. and Muriel Lezak, Ph.D., the book is entitled “Traumatic Brain Injury and Vocational Rehabilitation”, Published by The Research and Training Center, University of Wisconsin-Stout.

Myth #1: The Concept of “Recovery”
Throughout this chapter we avoid such phrases as “recovery after head injury,” There is a reason for this. Most people’s experience, and therefore expectations, regarding illness and injury is one of temporary reduction in functioning, followed by a gradual return to normalcy. People get sick, go to hospital, and get better. Bones are broken, casts applied for a period, muscle strength regained over several months, and scars fade.

BB: The refusal to use the word “recovery” in terms of brain injury is, in my opinion, a huge mistake. It deprives us of hope, and it gets us thinking that we’ll never, ever be able to regain our lives as functioning human beings. It strips us of our humanity — and for what? Semantics? Some overblown sense of self-importance that certain “qualified” people can (and are allowed to) decide what words others should and should not use to describe their journey back to functioning?

I think that clinicians and other experts are using it in the narrow sense — regaining the full use of every single faculty that was impacted by brain injury exactly the same way it was before. And that narrowness does us a disservice, in a number of ways.

First, as we grow and change and mature, our brains are constantly changing, anyway, so the idea that any person — after a significant experience — would be the same after the event, as they were before doesn’t hold up, either with or without brain injury. We are constantly changing, constantly growing. We move forward, and we slip back. That’s just the human condition, and we are built to overcome setbacks. Implying it’s impossible for us to regain our ability to function after brain injury is one of the dumbest things I’ve ever heard. If that were true, I’d be a vegetable by now.

When commonplace notion of recovery is applied to head injury, however, considerable harm can be done. Almost never does a patient “recover;” the residual deficits are usually significant and permanent. The continual expectation of recovery can lead clients and families into denial, frustration, disappointment, and even worse, extremely unrealistic expectations and planning.

BB: Yes, I get that people get their hopes up about being able to get back to where they were before, and sometimes it doesn’t happen. But it seems to me the real harm is in people who are supposed to be helping and caring, not bothering to help people move on. “Almost never does a patient ‘recover’?!” WTF?! That’s ridiculous. Maybe they’re talking about moderate or severe brain injury, where large portions of the brain are destroyed. Okay, then… but still, it’s possible for the brain to reorganize itself. If this is true all across the board, then how about Paul Bach y Rita’s father, who had something like 75% of the motor ability section of his brain destroyed by stroke, yet recovered and went on to take up mountain climbing? Please. Significant and permanent residual deficits are not going to be helped by people giving up and saying, “Oh, well… you’re brain injured, so I guess you’re screwed.”

A continual expectation of recovery is NOT bad. You just have to define what kind of recovery you want. Okay, so maybe you can’t keep your balance as well as you once did. Maybe your coordination isn’t as great. But we know much more about brains and neuroplasticity now, than ever before, and who’s to say it couldn’t happen in the future, with the right approach and the right dedication? I’m really convinced that it is possible to restore functioning in ways that these experts think is impossible — largely because I’m doing it.

Four years ago, I was putting myself directly in harm’s way, hiking down deer paths in camouflage during deer hunting season (no kidding). I was spending money like there was no tomorrow. Six years ago, I would sit in front of my computer at work and just stare at it for hours. I would flip out on people who came into my cubicle. I would try to pick fights with on-duty policemen. I don’t do that anymore. I am recovering.

Moreover, the successful rehabilitation of the head injured person cannot take place until they and their family are aware of the new limitations, accept them, and formulate new goals based on changed expectations.

To speak of, and implicitly believe in and hold out the hope for recovery as defined in the first paragraph can severely impede this process. Of course, this process of awareness and acceptance, on the part of the family, is a process that takes time. Certainly families, especially in the early stages, must hold out hope. However, we prefer to speak in terms of hope for as much improvement as possible, to build in realistic expectations from the beginning.

This is crap, if you expect this to apply to everyone all across the board. There are so many exceptions to this, I can’t even begin to say — starting with myself. I do implicitly believe and hold out hope for my own recovery — precisely as it is defined in the first paragraph. I don’t care what they say. It has NOT impeded my progress. If anything, it’s improved it. Holding out hope for “as much improvement as possible” is beneath us — as human beings and as survivors of brain injury. And “realistic expectations”, as far as I’m concerned, are just ways for experts to help caregivers who are totally tweaked by the experience of having a loved one sustain a brain injury, to shield themselves from the rigors of building back what you’ve lost.

Seriously, the big myth of this first point, from where I’m sitting, is that there can be no recovery. That’s crap. My neuropsych says so, and so do I.

after 6 brain concussions should i do pot or any drugs?

TBI can affect how you react to pot and drugs in some strange ways. You may not turn into a toad, but you might end up feeling like one.

Someone found their way to this blog by this search question today.

“after 6 brain concussions should i do pot or any drugs?”

Short answer — Probably not. The thing is, concussions/brain injuries can change how your body responds to drugs of all kinds. My neuropsych has repeatedly cautioned against me just taking whatever my doctor prescribes, because it can affect my cognition — often in unexpected ways. Certain antibiotics can actually trigger seizures, which I never heard of till they told me. Also, some meds can dull your thinking, which can make you more irritable and agitated, which isn’t good for anyone, including all the people you deal with each day.

As for pot and other controlled substances, if you have to, you have to, and there’s not much anyone can do for you, unless you seek out some help. But if you don’t have to and you can do without, it may be a good idea to lay off them. Brain injury can make the body even more susceptible to drugs — you may find that you react more to them, that you get a bigger high off less… or that you have less of a high off a larger amount. It’s tricky. You have to be careful.

Of course, once you’re off to the races, caution has a way of flying out the window, but it may be good to keep in mind up front.

One of the big problems many people face is that they have friends and family and drinking buddies who are way into drugs, alcohol, and weed. So, they keep going along with them, and they get in trouble, because they’re much more susceptible, while everyone around them is partying at the usual rate.

Jail time, anyone? I have a theory (unconfirmed as usual) that our prisons are chock full of TBI survivors who did drugs and alcohol, were affected intensely by them, and went out and did stuff that got them arrested.

6 brain concussions and pot and drugs… Warning Will Robinson! Danger! Danger!

Hello, Officer… A Temper Flare (Almost) Gone Wrong

What a beautiful day it was! The mid-winter sky was bright and blue, and the sun was finally showing its shining face after days of inclement weather. Driving home from work, I gazed around me at the gorgeous landscape. A thick blanket of fresh new snow covered the fields on either side of the back road home, softening the stubble-covered terrain. Intermittent stands of woods were silent with insulating white, trees sleeping silent beneath a delicate frosting that broke loose in passing breezes and showered to the forest floor in a sparkling cascade. Babbling brooks flanked the country road, here and there, cascading cheerily down rocky beds, icicles dangling from sticks and grasses which hung close enough over their splashing course to catch — and instantly freeze — splashes from the snow-melt swollen streams.

I was on my way home from my new job to my new house, and as I gazed around me at the beautiful scenery, it felt as though my life were being made new again. The stress and strain from the recent move from the suburbs to the country had tested my endurance sorely, and all but exhausted my strength. The transfer from my old job had not been without some challenge, as well. Change is never easy for me, and adjusting to not only a new home in a new place with new neighbors, but also a new job with new responsibilities and new coworkers, had turned my post-holiday season into a see-saw of elation and despair.

But after weeks of settling in, getting acclimated, developing my new routines, and finding better ways to drive to and from work than the freeway filled with aggressive drivers, I was finally starting to feel my balance returning.

That day, as I motored happily across the countryside, making it home before dark (for once), everything seemed like it was falling into place. I had the radio on — loud — and my spirits rose with the energetic dance beat. My little car — a late model hatchback with a funky heater — had finally warmed up, after running for 10 minutes. I was making good time, and I’d be home soon.

Or was I? I suddenly looked up at my rear-view mirror, and lo and behold, there was a local cop with his lights flashing… coming on fast. I instinctively took my foot off the gas and glanced down at the speedometer. The needle drifted quickly south from around 45 mph… and I looked up as I passed a sign that said I was in a 20 mph speed zone. Shit! I had been so busy listening to music, and thinking about getting home, I hadn’t even noticed the speed limit. Maybe he was after someone else, I thought for a moment… But no, as I slowed down, so did he. I braked, signalled, and pulled over to the side of the road, and he pulled in right behind me.

*&%! I thought to myself. How could I do something so stupid?! I knew that this stretch of road was where the local cops hung out. I’d passed them plenty of times before, as they lay in wait of commuters taking the back way home. A wave of angry frustration welled up in me, and my head began to spin as the officer got out of his car and approached. I could feel my pulse quickening, a roar in my ears starting, and my gut churned as I started to build up a head of steam. All I wanted to do, was get home. All I wanted to do, was get through this town. All I wanted to do, was put the tough day behind me and relax in front of my fireplace. I didn’t ask for much. And I didn’t mean to speed through this town. I just lost track of how fast I was going! What the hell was this cop pulling me over for? Didn’t he have other real criminals to catch? What the fuck?!

I could feel the indignation rising in me, with every approaching step of the cop. Strings of profanity coursed through my head, and my gut continued to constrict as my hands tightened around the steering wheel. I couldn’t believe I’d been stupid enough to speed. I couldn’t believe this cop had been that stupid to pull me over. Everybody was a fucking idiot. Jesus fucking Christ.

The cop reached the side of my car, and I rolled down the window.

“Do you have any idea how fast you were going?” he asked.

“Too fast?” I heard myself say. It sounded smart-assed, and he didn’t like that.

“License and registration please,” he said, and I pulled my license out of my wallet and handed it to him. Still seething, I reached into the glove box to find my registration. I always kept it in the same place — in a long sleeve that held my insurance papers as well. But as the crashing ocean of agitation crashed in my head, I had trouble finding my papers. I couldn’t find my registration. I couldn’t find my insurance stuff. I couldn’t find anything… and I started to lose it. The cop at my window was getting impatient, and when he prodded me to come up with my papers, I snapped at him that I was looking as fast as I could. I finally just pulled everything out of the glove compartment and spread it across the passenger seat.

“Is this your car?” the officer asked, with a wary edge in his voice.

“Yes, it’s my car!” I barked. “I’ll have the registration in just a minute. I know it’s in here somewhere…”

My vision was getting cloudy and blurred, as I sorted through the mess on the seat beside me. Finally, I found the sleeve, pulled out the registration paper, and handed it to the cop. But after taking a look at it, he handed it back to me.

“This isn’t current,” he said. He sounded like he was talking to a criminal.

A wave of resentment washed through me, pushing to unleash some crack or curse.

I took the paper from him and examined it more closely. Sure enough, it was from a few years back. Consternation welled up in me, and I bit back the curse that sat on the tip of my tongue. I ran through the rest of the contents of the sleeve — there were plenty of registration papers there, but none were current.

The cop pressed me for the papers, and I snapped at him again, “I’m working on it!” I couldn’t believe this shit. I rummaged once more through the pile of stuff on the seat beside me — ice scraper, breath mints, tissues, various receipts, notepads, souvenirs, tools, more papers… where was my goddamned registration!?

“Are you sure this is your car?” the officer asked.

“Yes, it’s my car!” I snapped. “Just give me a second…!” I cringed at the edge in my voice, knowing — from past experience — that police officers don’t respond well to aggressive disrespect. I’ve had several run-ins with cops over the years that escalated when I spoke out of turn or got verbally aggressive with them. A few times, I came close to being arrested, and I couldn’t afford to have something like that happen today. Not when I had this new job and a new house. I just couldn’t afford to get on the bad side of the local cops.

If only he would give me a second. Just one more moment…

But he wasn’t having it. I heard him turn and go back to his car, and when I looked up in the rear-view mirror, I saw him back in his car punching something into his onboard computer. He kept looking at my license plate and then back at his computer, and it looked like he was talking on his radio, too.

What the hell…? I couldn’t believe I’d gotten pulled over… I couldn’t believe I couldn’t find my registration papers. I distictly remembered renewing my registration just a few months before, and I distinctly remembered putting the papers in my glove compartment. Where the hell were they? Where the fuck had they gotten to?!

Suddenly, as though by magic, an envelope from the Registry of Motor Vehicles appeared before me. Inside was my current registration. It wasn‘t in the sleeve where I always put it. It wasn’t in the one place I was sure to find it. Like an idiot, I had just tossed it in the glove compartment. Stupid, stupid, stupid. I pulled out the paper and double-checked the dates to make sure I wasn’t going to make an ass out of myself — again. Then, I waited for the cop to return.

He did… with a citation in hand.

“Here’s my registration,” I said, using as neutral a tone as I could muster. I handed him the delinquent paper.

He took a long look at it and then took a longer look at me and my license.

“You should have found this sooner,” he said, handing them back to me, along with the ticket. He sounded like he wasn’t sure what to do with me — let me off the hook or cuff me and haul me into the station.

I shrugged, biting back words that I was afraid might provoke him even more.

“I had to run your plates, so now I have to have a record of this stop. I’m just giving you a warning, this time, but it’s on your record.” He sounded a little regretful, but also irritated with me. “If you had gotten your registration, I wouldn’t have had to run your plates.”

I wanted to say, “If you hadn’t been in such a godawful hurry and had given me a minute or two, I might have found it in time!” But I held my tongue and just nodded.

As he drove off, I started to shake, my stomach in knots and my torso damp with sweat. I felt like I’d just dodged a bullet… a bullet I’d stepped right in front of.

More attention for the invisible disability – TBI

Over at New York Brain Injury Lawyers, there’s a great post, Brain Injury The Invisible Disability

I’ve copied and pasted a fair amount of the post here (their content is indented), and I’m going to add my editorial commentary to it, as well.

Brain injuries can affect people’s compulsive nature and decision-making skills. It is a very sensitive area of personal injury law and quite rightly so. Brain injury varies greatly from person to person because each person’s injury allows for differing affects due to the location of the damage.

I love it that they start out on this note. It’s interesting how, of all the people who talk about brain injury, the people who seem to be the most sensitive to the issues and complexities are attorneys. Lawyers tend to get a bad rap, but in the big wide world of brain injury blogging and generally available information, I’ve found their sites/blogs to be some of the most helpful. Indeed, some of the most reliable and insightful and encompassing (as in, approaching the complexities of the situation without succumbing to the temptation to oversimplify) pieces of truly useful information (at least, for me) have come from lawyers. So, my hats are off to them — the ones who use their powers for good instead of evil, of course 😉

A traumatic brain injury is potentially one the most devastating disabilities. It not only affects the person suffering from the injury but can turn whole families upside down.

Amen to that. TBI does turn families upside down. It sneaks into the most secret and obscure places of one’s life, and it not only causes the affected brain to do and say things it wouldn’t normally say, but it often masks its effects by blinding the TBI survivor to the true nature of their words and deeds. I cannot stress this enough. We live in a society that lusts after self-determination and stigmatizes anyone who “can’t help themself” from doing or saying bad/inappropriate/embarrassing things. Our society is founded upon the idea that everyone has the ability to make themself and their world over in exactly the fashion they please. But though this may hold largely true, sometimes other factors come into play that are beyond our control. And that includes brain injury.

The range and severity of problems arising from a brain injury will vary significantly from person to person because every person’s brain injury varies in the extent and location of the damage. Some of the affects of a brain injury are not immediately obvious and only become apparent as time progresses.

Again, good information. It is so true that the range and severity can and will vary from person to person. No two bodies are alike, and no two brains are alike. It’s just impossible for them to be identical, as they are shaped by events and circumstances and body chemistry in unique and individual ways. So, the range of our injuries will vary… and the severity of our problems will, too. After all, the severity of our issues depend on not only the scope and nature of our injury, but also upon our own personality makeup — how we respond to different circumstances — as well as environmental factors. Things like jobs that allow us little flexibility in our daily schedule, financial difficulties that add stress to our experience, living environments that are intolerant of our shortcomings, and any number of other factors like the food we eat and the amount of sleep we get, can and will affect the degree to which we are impacted.

What’s more, some affects are not immediately obvious… subtle changes in mood, shifts in attentional ability, our cognitive capacity, our processing speed… these things aren’t always immediately detectable to the outside observer. What’s more, changes can take place over the course of one’s life, due to hormonal fluctuations and body chemistry changes.  The brain changes with age, just as the body does, and events like puberty and menopause (male and female), which alter the body’s hormonal makeup, can cause brain changes, as well, which can cause issues to arise that weren’t there before. If the part of the brain that is affected by a certain hormone was injured, and a scar develops, but that hormone remains relatively stable in the body over the course of one’s adult life… then it starts to fluctuate later in life, it could trigger some unexpected activities.

The following are pointers to look out for in a persons make-up if you feel they may be suffering from a brain injury after a nasty knock or have suffered a serious injury.

Note from BB: Keep in mind that even a “mild” brain injury, such as a hard bump or sudden impact or “whiplash” from a car accident (or even head-banging at a rock concert) can cause shearing of the connectors in the brain/brainstem, which can have the following affects. One of the biggest misconceptions about traumatic brain injury, is that it would have to be an open wound or something really dramatic, like losing concsciousness for hours or going into a coma, to cause problems. Trust me, you don’t have to teeter on the brink of destruction to be severely impacted by brain injury.

Cognitive changes
A brain injury can cause cognitive changes which affect the individual’s ability to learn new things, to work and to be able to interact socially.

So true! Some examples of this, from my own experience, are:

  • I have a hard time learning new things from books, because my short-term working memory has been compromised. If I’m reading something that’s new, and I divert my attention from it for even as short as a few seconds, I can completely lose the new information — and have to go back and start from scratch again.
  • I also have difficulty with sustained attention — I just can’t study the way I used to. I used to be able to study for hours and hours, and at the end of a long weekend of non-stop reading, I would have a new treasure trove of information to work with. Now, I’m lucky if I can last an hour with my reading.
  • I have difficulties at work, because I get so tired and I tend to space out when I’m fatigued. I find myself, sometimes, just sitting in front of my computer, staring at nothing in particular, or surfing around just for the sake of relieving my over-taxed brain. It’s not productive, but it’s unconscious, and I’m usually not aware I’m doing it, till I’ve done it for a while.
  • Social interaction is a tough one for me, because I have difficulties following people’s conversations at times, and I feel really self-conscious. I also get tired, being around people, and I find I cannot go into places I used to go fairly freely before 2004 — crowds have always distressed me somewhat, but since my fall in 2004, I’m even less tolerant of the noise and hubbub. Also, I have found myself isolating a lot more, over the past few years, and I’ve had trouble managing my emotions and words in social situations, which makes me even less inclined to venture forth.

Lack of insight
Individuals with a brain injury can have great difficulty seeing and accepting changes to their thinking and behaviour. The individual may deny the effects of the injury and have unreasonable expectations about what they are able to do.

I’ll say. Immediately after my 2004 fall, when my job had fallen apart, and I was in the process of quickly depleting my $250,000+ nest egg, I decided I was going to become a financial planner. Talk about a lack of insight! Not only did I not see that I was having an impossible time completing the self-paced work-at-home coursework — in 18 months, I managed to complete only 1-1/2 of the 6 courses, and I got a C on the one I did complete, which is totally out of character for me! But I also was oblivious to the fact that I was mismanaging my own funds so badly that I was quickly running out of money, when I could/should have been making money on it (after I prematurely cashed out of my shares — I walked away with $143,000 instead of the $700,000 I could have had, if I’d just managed to hang in with that job another 18 months — 18 months!!! — I put the money in my checking account that earned no interest and was open-season for my spending). I was doing a piss-poor job of managing my own money and planning what to do with it. What in the world made me think I could be a financial advisor/planner for anyone else? That’s easy — classic p0st-TBI lack of insight. Sheesh!

Memory problems
There may be problems in remembering people’s names, passing on messages, or recalling details read in a book or a newspaper. They may forget what they are doing from one session to the next. Memory problems may cause the individual great difficulties in learning new things.

Oh, please, don’t even get me started on this. If I don’t write down something in the moment, I might as well wave good-bye to it. I am, this very morning, trying to catch up with things I forgot to do over the past three days. If I lived alone or I was with someone who was less interactive and invested in keeping me on track, I would be lost. And quite possibly homeless and jobless, as well.

Poor concentration
A very common outcome is an inability to concentrate and to become easily distracted from what they are doing. This is usually because they are having difficulty concentrating.

Yes, yes, yes. My concentration comes in fits and starts. I found, right after my fall down the stairs in 2004, that I couldn’t concentrate to save my life. I was just flitting from one thing to the next, and I was utterly unable to learn the new skills I needed, in order to keep my job. Of course, I had no idea that I had been brain injured at the time, so I told myself — and everyone else — that I had chosen not to learn the things I needed to learn. I didn’t want to/couldn’t admit (or even see) that it wasn’t that I’d chosen to dig my heels in… I literally couldn’t. Because my concentration was totally shot.

Slowed responses
An individual with a brain injury may now be slower to answer questions or to perform tasks and may have difficulty in keeping up in conversations. Their capacity to respond quickly in an emergency may also be diminished.

Yeah, this is a problem. And it can be pretty scary, too, when you’re in an emergency situation. This has impacted me a number of times.  A couple of  times over the past ten years, in fact, I have had to help friends who were having strokes, but both times, I couldn’t seem to put two and two together. I couldn’t seem to figure out what was going on, and it’s lucky for them that there was someone else there, in both instances, who could see what was happening and come up with an appropriate response. The feeling of being turned around and not being able to respond quickly in such a life-threatening situation is scary enough at the time, but afterwards, it can really haunt you. It’s certainly haunted me. In fact, my inability to respond to a number of emergency situations — some of them life-threatening — was one of the things that “raised a red flag” with me and told me something was just not right with how my brain was working.

Responding to questions and keeping up with conversations is very important when you’re dealing with authority figures and law enforcement, I have found. One of my recurring issues with regard to my TBI is run-ins with the police that nearly went sour, just because I wasn’t following what the officer was saying to me. You have to understand, I’m a very law-abiding citizen. I believe the law is what makes our society livable, and I make every effort to obey it. So when I mess up, go faster than I should, miss a stop sign, or take a left turn too closely, and I get pulled over, I am genuinely confused, because I certainly did not intend to screw up. And my confusion makes it harder for me to focus on the situation, as well as follow the officer’s directions. I have nearly gotten into physical confrontations with cops because of my confusion and frustration and short fuse. I knew better, but my brain failed me at the time when I needed it most. This is probably one of the suckiest things about having a brain injury (or, in my case, several) — it keeps me from being the kind of person I desperately want to be, and from living the kind of life I am determined to live.

On the less dramatic side, with regard to being slower to respond to questions and finish tasks, it can take me forever to get my head around things I’m being asked. That drives my family nuts, and I have a tendency to try to cover up my cluelessness and slowness, so I don’t piss them off. But when I really want to get something, I’ll make them slow down. I also have to be ready to remind them that I am a bit slower than they expect, and they need to not get so upset with me about not following as quickly. Sometimes, they yell at me because I’m “being difficult” when I’m just a lot slower than I’d like to be.

I also often have trouble keeping up with conversations. I can’t tell you how many times people have started talking to me, and I haven’t had a clue what they were saying… for about a minute into the conversation. I tend to have to replay conversations later on, to see if I got what just happened. Socially, I’m fortunate that I have a lot of really gregarious friends who do most of the talking. I just sit back and let them do most of the “work” — and they’re fine with that. Either that, or when I’m in a conversation with someone that I’m just not following, I’ll actually just echo back what they’re saying without fully understanding what they’re talking about. I will appear to agree with them (which they like), but I’m actually just rephrasing what they’re saying. This makes me very popular (people like to be mirrored and they love it when other people agree with them!) but it doesn’t do much for my own sense of self.

Problem-solving
Individuals with a brain injury might have difficulty solving problems and planning and organising things they have to do. They may encounter trouble with open-ended decision-making and complex tasks need to be broken down into a step-by-step fashion.

Oh yes… breaking things down. Can I tell you, my life is filled with detailed step-by-step instructions about how to do the simplest things. When I need to organize my busy day, I fill my planner with the different things I’ll need to do, in the order that they need to be done, and I walk through them in precisely that order. I cannot tolerate changes in routine — it makes me nuts and freaks me out. I desperately need predictability and routine, because backing up and re-configuring my day is a recipe for disaster.

Irritability
Individuals may also have a very low tolerance for frustration and can become easily agitated and may lose their temper quickly.

Yes, yes , yes. Never forget that fatigue factor. Being tired not only makes it harder to think, but it makes it harder to manage emotions and modulate your expression. The thing with me is, too, that my TBIs have made me look more impassive and stoic on the outside than I feel on the inside. So, I may be seething with frustration on the inside, but I look perfectly fine on the outside, so people around me cannot judge my level of frustration — until I blow up.

Another thing that ‘stokes my fires’ is the pain that I’m often in. I have a lot of pain in my body that isn’t helped by drugs or much of anything other than rest. When I’m fatigued, I’m often in extreme pain, which just adds to my irritation level.

Irritation is a huge problem — for me as well as others, because I never, ever want to hurt the people I love, but my irritability gets the better of me all too often. And I have to live with myself afterwards.

Socially inappropriate behaviour
People with a brain injury may no longer know how to act or behave in in social situations. This can be incredibly difficult for families to understand and cope with, particularly as they may no longer recognise their loved ones and not understand their behaviour.

I have screwed up social situations so often, that now I just tend to keep to myself and I don’t respond unless others address me first. Some of the many things I’ve done that have landed me in hot water are:

  • Talking too loud about sensitive issues
  • Forgetting that I promised to keep a secret, and telling the world — in front of the person to whom I promised I wouldn’t tell
  • Behaving in ways that women felt were too familiar or encroaching or sexually intimidating
  • Behaving in ways that men (including security guards and police officers) considered threatening, and triggered an aggressive response from them
  • Coming across like I was making fun of or deliberately embarrassing family members

I really, really hate this aspect of TBI, especially, and it makes it easier for me to just keep to myself. It’s tough, because I want to be social — who doesn’t? But I do it so poorly, at times, that I feel it’s my responsibility to shield others from my ineptitude.

Communication
A wide range of social skills may be affected by an a traumatic brain injury including the ability to have conversations, to interpret and respond to social cues, to show interest in others, to use humour appropriately, and to regulate the volume and tone of voice.

Uh, yah. See above for how my TBI affects communication issues. I generally don’t initiate conversations, and I’m terrible at sustaining them. Good thing I live with very social people who can run interference for me. I usually don’t stray far from them, as I tend to get into trouble with people, when I try to initiate and sustain conversations. At times, I just don’t know what to say. I’m like a little lump of clay that isn’t able to create impressions on others, but can be impressed upon by others. I generally stick with just responding to people’s cues, but even then, I’m often totally lost, and I simply don’t follow. I also am often strangely devoid of interest in other people. Oh, certainly, on a grand cosmic scale, I do care a great deal about what others experience/think/feel, but personally, in my injured brain, part of me just doesn’t care. I want to care (I think), but I just don’t. I’m sorry, world. I just don’t.

I also don’t always use humor appropriately. I usually think I do, but then I find out from others that I don’t. Heaven help me — and everyone around me, who has to put up with my sense of humor when I’m tired.

Regulating my tone of voice is a constant challenge, which is another reason I keep quiet so much. I often use the exact wrong tone – I’m too loud in quiet situations, or too quiet when I’m talking about important things… I sound angry when I’m just riled up… I sound deadpan/stoic when I’m really worked up. In some cases, people I live with have been very afraid of me because my tone was a lot more intense and sounded “hateful” and aggressive, when I was just having a lot of trouble articulating, and I was scared half to death over something. I’m hoping that my family members will learn that my tone doesn’t always match my inner reality, and cut me some slack.

Depression
Depression in an individual with brain injury is a very common emotional consequence that usually comes some time after the injury. Signs of depression include lack of motivation, loss of sexual drive, sleep disturbance and tearfulness.

Okay, here’s one of my pet peeves — interpreting neurological processes with emotional ones. Lack of motivation is not necessarily depression-related, nor is loss of sexual drive, sleep disturbance, or tearfulness. There are a host of neurological reasons why all these can occur, and the fact that they’re commonly lumped together under “depression” tells me that there are probably a lot of people walking around with neurological issues that could be possibly addressed with occupational therapy or other coping mechanisms, but they’re being medicated, instead.

Unraveling neurological issues from psychological ones is in the Top Ten Things I Hope to Promote in This Blog. Calling our neurological, TBI-related issues “psychological” ones and addressing them with drugs just empowers the pharmaceutical companies, not the people who have to live their lives. Don’t get me wrong — I have nothing against a quality pharmaceutical solution. But too often pills are pushed as a solution, when they just add to a problem — like Prozac making certain people suicidal.

Mis-diagnosing neurologica/TBI-related issues as psychological ones and inappropriately medicating patients actually works against the pharma companies, as well. It makes them suspect, when the real culprits are lazy/mis-informed/biased/idiotic psychiatrists/therapists/doctors and it prevents good science and good medicine and good psychotherapy. I want good pharmaceuticals as much as the next one — but I want their power used properly and for good, instead of lazy-assed evil.

Headaches
There are multiple sources of head and neck pain, both inside and outside the head. Headaches arising from a brain injury can be caused by a number of reasons.

When don’t I have a headache? Rarely. Of course, one of the neuros I’ve seen over the last year tells me they’re stress related, and if I just relax and exercise more, they’ll go away. Hasn’t worked so far… Hasn’t ever worked.

Visual problems
Vision and visual functioning is often adversely affected by brain injury. Some of the more common visual systems problems include double vision, rapid eye movement and near-sightedness.

Can’t speak to this much, aside from rapid eye movements I sometimes get when I’m overtired.

Hearing problems
Hearing problems can occur for a number of reasons, particularly when the inner ear and/or temporal lobes have been damaged.

And let’s not forget tinnitis — that constant ringing in the ears. True, it can be more neurological than auditory, but it’s hearing-related. For the record, I have — and always have had — constant ringing in my ears. Sometimes it’s louder than others, but it’s always friggin’ there.  It used to drive me nuts when I was a teenager, but I have since acclimated to it. Now I use it as a barometer of my physical condition — louder means I’m having issues of some kind — stress or fatigue or what-not. It’s actually a useful gauge of my physical well-being. Provided I can tolerate the constant high-pitched whine.

A traumatic brain injury is often called the invisible disability. As there are frequently no outward physical signs of a disability, effects such as fatigue, lack of initiation, anger, mood swings and egocentricity may be seen simply as bad personality traits by others. It is easy to see why a traumatic brain injury can be such a devastating disability, especially when the disability is not obvious to others.

Indeed. In fact TBI is often a double-hidden disability, as it’s so often hidden from the survivor, themself. It’s a real conundrum, let me tell you. Society has so many biases against behaviors and problems that can come with TBI, it can be all but impossible to get people to consider you injured, rather than bad. The real challenge, from where I’m sitting, is learning to detect and live with my own disabilities, find my strengths, and ultimately, finding peace in myself, no matter what the rest of the world has to say.

And if I can get through the day without doing any harm, so much the better.

TBI can be a devastating experience, both during and after — in the short and long-term. But if you can get past the trauma of it and learn to deal with it substantively, it doesn’t have to ruin your life. And the pieces that have been broken, can sometimes be put back together again. Ultimately, the brain is a fascinating phenomenon. We all have one. And the challenge — for us all, at this time — seems to be learning how to use it properly.


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