Yet another way of cleaning the brain

Is there more than one way to clear out the sludge?

If you’re like a lot of people who check Google News on a regular basis, you may have seen the news about sleep clearing the brain of metabolic build-up after a hard day’s work. Sleep is an important part of every living being, across all species, but until recently (medical) people haven’t know exactly why that is. Esoteric practitioners have a lot of different explanations for why we sleep, but in terms of hard science, the importance of sleep has been a mystery.

Not long ago, researchers discovered that when we sleep, the glymphatic system (the functional waste removal system for our central nervous system, or CNS), clears out metabolic buildup (read, junk that’s left over from our busy minds’ activities), getting rid of a lot of stuff that we don’t need. It just gets in the way. Which is why we need to sleep.

Here’s a video explaining the new research:

Not getting enough sleep means not getting enough time to clear out all the sludge from your brain that comes from all the mental activity we’re engaged in. It means you’re still — literally — carrying around extra “baggage” (albeit very miniscule stuff) from before, that you should really just let go — via a good night’s sleep that opens up passages in our brains to let the extra junk pass through and out — to our livers, where it’s processed out of our systems.

I’ve been pretty excited to hear about this, especially because concussion / mild traumatic brain injury produces an abnormal and complex neurometabolic cascade that floods the brain with all sorts of extras, like potassium, calcium, glucose, and other neurotransmitters which get our brains all worked up — it can really get us pumping. And afterwards, we’ve got a whole bunch of junk in our brains that we’re not used to having there… and we need to clear out.

This combination of extra junk in your system is one of the things that makes you foggy and dull after a concussion. All that stuff needs to get cleared out, for your brain to right itself — and then it’s got to do the extra work of healing and (re)learning how to do stuff that may seem very simple, but suddenly becomes hard.

So, long story short, sleep helps after concussion / tbi, because it cleans the junk out of your brain. Lots of sleep is good. At the same time, too much sleep can be a problem, too. So, you have to find a balance.

One of the issues that I have with my long-term concussion / PCS / TBI issues is problems with sleep. I have trouble getting to sleep, and I have trouble getting more than 6-7 hours a night. If I get 8 hours or more, it’s like a jackpot. Interestingly, when I get more than 8 hours, I usually feel drugged and not quite right in the head. In some ways, it’s worse than only getting 6 hours.

But when I only get 6 hours, like last night, I definitely feel it. I’m pretty much of a zombie, feeling jet-lagged and depressed and really down. The time change this past weekend did a number on me, for sure. And now that I’ve read about the glymphatic system and what it does, now I’ve got this much clearer sensation that I’m dull for a reason — there’s too much crap still clogging the lines of my brain. It’s bad enough being tired. But having my brain full of metabolic waste, on top of it… geez.

So, if I can’t seem to get at least 8 hours of sleep a night, no matter what I do, how can I ever hope to clear all the crap out of my brain? I mean, seriously, this is a real concern for me. I have been doing daily exercises to warm myself up in the morning and get the blood flowing to clear out the cobwebs and help my lymphatic system fight off infection, but while waking, the pathways in our brains through which waste passes are 60% smaller than when we’re asleep. How can I take advantage of my body’s systems and help them do their job?

Coincidentally (or perhaps not), I got an email from Coherence.com about how coherent breathing may help to wash the brain (you can read the PDF by clicking here), in a similar way that sleep does. A steady cadence of 5 full breaths per minute — about 6 seconds inhale and 6 seconds exhale — helps to not only balance the autonomic nervous system (ANS), getting you out of fight-flight craziness, but may also help to jump-start the glymphatic system which removes the leftover junk from your brain.

I find this encouraging. While it’s not proven by rigorous scientific studies, the logic makes sense to me. And it’s something I can do, even when I’m not getting enough sleep — like this morning, with my whopping ~6 hours.

So, this morning as I lay in bed at 6:15 (I woke up a little before 6 and got to sleep a little before midnight), I relaxed and did my coherent breathing — counting six seconds in and six seconds out. I focused on my diaphragm, making sure I was breathing deeply so that my belly was rising and falling smoothly, and I just counted. I timed myself a few times, to make sure I wasn’t going too fast — if anything, I breathe more slowly than 6-seconds in-out, but I can’t worry about that. The main thing is that I’m in the range and that I’m balanced with the length of time I’m inhaling and exhaling.

I didn’t worry about how many breaths I was taking — I used to count my breaths, back when I was sitting and breathing each morning — and I just lay flat, because that helps to regulate the overall system pressures in the body, which aids the flow of fluids (as in cerebrospinal fluid, or CSF).

I just focused on my breathing, keeping myself in the count-of-6-in / count-of-6-out zone, knowing that I was doing something good for myself, and that not only was I balancing out my nervous system so I wouldn’t start the day in fight-flight mode, but I was also moving the crap out of my system.

That’s an important part of this, because it is incredibly difficult for me to just sit still – especially first thing in the morning, when my head is racing and I want to get going! Getting my system to calm down and focusing my mind is quite difficult – especially after a short night’s sleep, when I’m waking up riding a wave of adrenaline.

Focusing on the idea that I’m making myself more functional and more capable, helps me to calm my system down and keep me focused. Definitely knowing that I did not get enough sleep last night — and haven’t gotten enough sleep in months, if not years — gives me all the more incentive to clear out the sludge that comes from my brain having to work so hard, day in and day out. Heck, even if it’s just conjecture and the folks who promote coherent breathing aren’t 100% correct about clearing out the metabolic waste with that technique, the fact of the matter is, my system chilled out, and I got up feeling a whole lot better than I did when I first woke up. And that’s no small potatoes.

I probably spent about 20 minutes doing this — probably longer than I would have done, were it not so cold this morning. I wanted to stay in bed, so this was good justification. 🙂  And after a few minutes, I started to feel a lot less “jazzed” and amped up. Waking up after a short night’s sleep can be pretty rough — I just jolt awake, all systems GO, with my heart racing and the blood pumping. While it’s sometimes energizing, over time it gets to be a pain in the ass, because it wears me down, and I crash later in the morning, after the pump wears off — major let-down.

This way — as was the case when I was sitting and breathing regularly, back about a year or so ago — I can stay in my warm bed a bit longer, I can work on my breathing to calm down my ANS, and I can also help my brain get a “clean start” on the day.

It’s a win-win all around. Good stuff.

Onward.

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Sleep experiment – next day – 7 hours

Luck… or practice?

So, I’ve gone from 5-1/2 hours to 6-1/2 hours to 7 hours, last night, and I’m starting to feel better. I’m also feeling better about the job business, because I’ve been spending time brushing up on my skills and working with techniques that are in demand, these days. I’ve also been doing my market research to find out what people are looking for, and what they’re paying for.

Things at work have been difficult. There is a lot of tension in the workplace, and I have been so swamped with extra work that people have snuck in as a “favor”, that the framework I had for getting things done has pretty much fallen apart. People are jockeying for position and they are pretty frightened of losing their jobs and/or being yelled at by management, so the tension is high and the atmosphere is tough.

I’m working from home today – my spouse had a doctor’s appointment originally planned for today, then yesterday it got changed. I’m still working from home today – it will give me two more hours to get work done, than I would have, if I drove into the office.

I’m also collecting contact names and companies for my job search. In September, I will start contacting people about work, so I can start interviewing. I have almost three weeks of vacation time left this year, so I plan to take two weeks off in September/early October, and have some time to talk to people, interview, and brush up on my skills.

At this point, the biggest challenge for me is not getting distracted — by drama at work, by problems with coworkers, by indiscriminate, indeterminate fears that I will not be able to accomplish this, that, or the other thing. I am in the process of moving on, and I need to keep my eyes on the prize… not let people get inside my head and try to stop me. I don’t want to end up like an Olympic athlete who gets so caught up in the criticisms of bystanding reporters and drama-driven news cycles that it affects their performance. The static at work has been cutting into my focus, and I can’t let that happen. I need to stop it, stay steady, not let it keep me up at night, and just keep moving on.

I have great things to accomplish. I have to keep that in mind. I’m getting clearer and clearer all the time about where I want to go and what I want to do with myself, and I have to stay true to that, not get waylaid.

One thing that I’ve found surprisingly helpful is prayer. Yes, prayer. It sounds strange to hear myself saying this out loud, because my “prayer life” as my church used to call it, has been pretty much non-existent for the past 10 years or so. Especially since I fell in 2004, I haven’t had much religious inclination at all. It’s just kind of evaporated. And to tell the truth, I don’t actually believe in the same God that I was raised to believe in. “God” for me is less concrete, and less definite, too. In fact, what we refer to as “God” (or whatever other name you choose) I think of in more quantum physics terms — the personal God that my family believes in doesn’t exist for me. And yet, there is a spirit, a presence, that I recognize — and that presence in my life has always made itself known to me in many, many ways.

My life has been a series of miracles, no doubt about that, and the existence of “God” seems as rational an explanation for those amazing “accidents” as anything else.

Now, I was raised very religious. My parents both came from religious families, I have plenty of pastors and deacons and missionaries in my family history. Holiness was a top priority with everyone, and my grandparents used to go to a “holiness camp” each summer where they would go to revival meetings and worship services and live their entire lives around their faith.

That faith had no tolerance for my ways of thinking and living, however, so I broke with that tradition and I have lived a secular but “plugged in” life, for the past 30 years. When I fell in 2004, that schism was widened even more by a rapid loss of any religious or spiritual inclination. I just wasn’t interested anymore in that way of being in the world.

I’m still leery of that way. It just doesn’t seem helpful to me, and I have grown increasingly literal in how I  think about my life. I don’t know if it was the injury that did it, or if it’s been my life experiences since. I know that some people completely lose their faith after war or a terrible trauma. I think it might be both. I do believe that religion has a neurological component. Many neurological conditions are accompanied by “spiritual” experiences, like visions and revelations. And I suspect that having a neurological upset can switch those experiences off as much as they can switch them on.

I suspect that’s what happened to me. Or it could be that I’ve been so busy trying to keep up, and my brain has been so busy trying to figure out how to get from Point A to Point B to Point C without getting detoured through Points X, L, and T, that I just haven’t had the energy for religious experience.

Whatever the reason, a few nights back, I was lying in bed — awake — getting more and more freaked out that I could not sleep. I was all caught up in anger over things that were happening at work, I was bent out of shape over things that I was doing wrong, that others were doing wrong, and I was really upset about having to leave my current job. (For the record, staying is NOT an option — there’s just no point to it.) I was harboring major grudges against people who had slighted or worked against me, and I was really burned up about a lot of things — some of which go back two years, to when I started in this job.

I was pissed off at lots of people, including myself, and I couldn’t get my head off it.

Then these sentence came to me, from out of my religious past: “Love your enemies… Pray for them that persecute you.

Well alright then. Interestingly, I haven’t really thought of my colleagues as “enemies” but technically they are. Someone who deliberately undermines you and works against you and sabotages your work on purpse, pretty much fits the profile of a sort of enemy. And I don’t like to think that others are persecuting me, but if that’s not what middle-management is doing, I’m not sure what they are doing.

So yeah, they’re acting like my enemies, and they’re persecuting me. Enough giving them the benefit of the doubt — let’s call it what it is.

And since I was completely out of practice with prayer, but I was also completely out of ideas for how to spend my time lying there in bed, trying to get back to sleep, I figured I’d at least give it a try. If nothing else, it would direct my thoughts away from my own pain and frustrations. I wasn’t very good at it, at first. I felt like I had to apologize to God for my “absence”, but then I thought about it and realized that no matter how distracted or otherwise occupied I’ve been, there have still been evidences of miracles and great coincidences in my life, so it’s not like that part of my life was completely gone — I just wasn’t actively involved in directly participating in it. Anyway, the whole religious experience thing is something I understand very differently from before… we all change with time. The important thing is not always doing the same thing, year after year, but doing the kinds of things that help… that work… in the ways we find most useful.

Long story short, I started to ask for help, and I asked that I be given the answers I need and the strength to do what I need to do. I asked to have the burdens of cares and worries lifted off me, and for my mind and spirit to be set free from all the terrible weight of it all. And a little while after I started to pray, I was able to fall asleep. I’m not sure I even got through a whole “prayer” before I was down.

A few nights later, I had the same kind of troubles getting to sleep. Problems with work, problems about work, worries and dread about what people were/were not doing to/for/about my work… After lying awake for an hour or so, the thought came to me again to pray, and I did. I asked that the people who were giving me so much trouble be reassured and supported in their work, that they receive divine guidance, and that their worries be eased by divine intervention. I didn’t think about myself so much as I thought about them. And like before, I fell asleep.

Last night, I got to bed an hour later than I planned. The Olympics were on, and for some reason, I had to watch platform diving. I got to bed feeling a bit pressured and rushed, and I was starting to spin with all my worries and concerns about work. So rather than get caught up in that, I started to pray for the people who have pissed me off the most in the past six months. There were a number of them — most of them on my immediate team. And before too long, not only was I feeling better about them, but I was also able to relax and get to sleep.

And I slept seven hours, which is the most I’ve slept in about a week.

Now, I don’t want to get all hyper-religious on you, and I’m not sure I’m even praying to the same deity everyone else is… but this “prayer” business seems to work in a couple of different ways.

  1. It gets my mind off myself. It forces me to think in bigger terms, beyond my own immediate cares and worries.
  2. It humanizes the people who seem hell-bent on making my life impossible. It makes them actually seem human and deserving of respect, dignity, and compassion.
  3. It gives me the sense that I can tap into a source of power that is much greater than myself and any of the cares and worries I have.
  4. It helps me feel not so alone anymore.

Each of these things alone would be enough to make my life better, but all together, they really really help. At least, they have for the past week. Now, I’m not going to go down the road of saying that religion and prayer are the cure-all for the ills of my world — or anyone else’s, for that matter. For me, this is a deeply personal thing, and it’s not even something I can describe and explain exactly the way I want to. I’m really uncomfortable with the “personal God” concept, and I do not like to imagine a human-like God, or even a god-like God.

All the same, the simple act of praying for those who persecute me, really takes the pressure off and lets me get on with my life — or my night’s sleep. I’ve even started doing this while I’m awake — when I start to obsess about what someone has done to me, I ask that they be given the love and support that they need, and that they get the answers and reassurance they’re looking for. If nothing else, the goodwill goes a long way towards easing the animosity that flares up and floods my head — and my behavior — and my entire life… Somehow, prayer has a way of chilling that out, of cutting it off at the pass and letting me focus on what’s truly important.

And God knows, I can always use that.

 

Dangerously dizzy… but life won’t wait

I’ve been increasingly dizzy, the past few days. My left ear is squishy and has been making its presence felt. Pressure in my head, and fatigue… I haven’t had good sleep hygiene, for the past few weeks, and it’s catching up with me.

It’s a scary thing, because it’s so disruptive for my daily life. I have things to do and stuff to accomplish, but if I stand up too quickly or move too suddenly, the whole world starts to rush and spin and I get very sick on my stomach. It also makes me extremely irritable, so I snap out at every little thing, which makes me very difficult to deal with at times.

The only thing that really saves me, is being totally focused on what I’m doing, and not moving much while I’m doing it. Working at the computer is a perfect solution for me, because I have to sit up straight and stay focused on the screen in front of me.

The only problem is, it’s Saturday… a few days before I take off on my marathon trip to see family… and I have a whole lot to get done. Dizziness puts me in more danger of falling or having an accident. If I’m not careful, I can get in a lot of trouble. The last thing I need this holiday season is another concussion — most of my adulthood injuries have coincided with holidays, when I was running around like a chicken with my head cut off and wasn’t paying proper attention. I was fatigued and disoriented… and I fell or had a car accident. Not good.

Yes,  I need to be very, very careful, in everything I do.

I think a big part of the problem I’m having right now is the impending holiday rush. The prospect of driving through several states to see multiple families, over the course of nearly a week is making me a little nervous, and that’s setting off my schedule and my focus.

I have been doing really well with keeping to my daily exercise, which helps.  I just finished my morning workout, in fact, and I feel noticeably better than I did before it. I worked up a sweat and got my heart pumping, which in turn moved the lymph through my system to clear out the grunge. I love lymph. So basic, so essential, so useful. Without it, I’d be in a heap of trouble, and I count my blessings that I don’t have lymph drainag problems, like folks with edema do.

Anyway, I’m feeling better, and I have a full day ahead of me. But I’m pacing myself. And I’ve blocked off time this afternoon to sleep. I haven’t had a good afternoon nap in weeks, and it’s taking its toll. If I don’t nap at least once over the weekend, it catches up with me — and that’s what’s been happening.

And now I’m really dizzy, with a lot of stuff to do, and I regret doing chores last Sunday, instead of taking my nap. I had three solid hours to myself, to use as I pleased, and I frittered away the time on futzing around and doing little chores that took longer than I expected.

Ah, well,  so it goes. At least I’m aware of my dizziness, so I can accommodate it and work with it. When I’m really, really dizzy, I find that keeping my posture ramrod straight and moving very slowly and deliberately helps tremendously. Also, if I sleep a lot and drink plenty of fluids and avoid sugar, that helps, too. I’ve taken medicine for vertigo, but it didn’t help a bit. Anyway, it turns out the medicine is really just for nausea that results from vertigo, not the vertigo itself — at least that’s what the PCP I had at the time told me. Come to think of it, they could have been wrong. They were a bit of an idiot, by average standards. (And it was a scary six months in my life, when they were my primary doctor.)

But now I’ve got a pretty good PCP, and I trust them a whole lot more than the last several I went to. Trusting your doctor is good. It simplifies a lot of things, in many ways, not least of which is the office visit experience.

But more on that later. Right now, I need to stay focused on my dizziness.

Tracking back over the past week, as it’s gotten steadily worse, I have been looking for what I’ve been doing differently that has contributed to this. The one thing that I’ve been doing regularly, that is very different from before, is that I’ve been eating pieces of chocolate to keep myself going. Not just chocolate, mind you, but those little Dove chocolates with peanut butter in the middle. I thought that the peanut butter would give them more staying power, but what I’ve noticed over the past week is how much sugar is in those little puppies.

Zoinks! Who eats this stuff regularly?! They’re dangerous! Sure, they give me a little pick-me-up when I need it — like driving home late from work when it’s very dark, I’m very tired, and I’m having a hard time seeing. But I’m finding that when I eat one, I crave another one about 10 minutes later — like I spike, and then I crash and am worse off than before, so I need another “little” piece of candy to keep me going… and my system gets totally fried by all the sudden, extreme ups and downs.

Which contributes to my fatigue… and apparently my dizziness.

Not good.

So, while I’m doing my errands today, I’m going to remove the chocolates from my car — just throw them out — drink more water, eat more fruit, and be very, very careful when I’m out and about.

The last thing I need is another accident or fall.

Tired of being tired

I don’t like being as tired as I’ve been for the past week. I started losing sleep last weekend in anticipation of my testing results. And then when I had my neuro visit, that threw me off, too. So either way, I can’t seem to catch a break. Even though I got good news, I had been keyed up to possibly getting bad news — I like to be prepared. But when things came back inconclusive, well, my system was still on high alert, I wasn’t sure what to do with all that energy. I think it might have been easier, had I gotten something definitive, even if it were less than positive news. At least then I’d have something to focus on, to aim towards, to measure myself against. Even if it’s problematic, it’s at least something.

But this “we couldn’t get anything definitive” trip has been quite demanding. I’ve got all this energy, all this readiness, all this alertness… and nowhere to go with it. My body has been in a state of high alertness, on and off, for many years, and now it’s starting to really take a toll. I should probably exercise to work it off, and I have been trying to get myself to do just that for months — no, years. But one of the things that my TBI in 2004 did was making me really nervous about being around other people, so going to the gym has not been an option for me. That’s bad. I’m not in as good condition as I should be, and I have a hard time getting motivated to GET in better condition.

It’s a problem. It really is. But at this point, I’m more concerned about my sleeping — ‘cuz if I can’t sleep, then everything goes haywire, and I end up in this downward spiral all over again.

You wouldn’t think that sleep would be such a big deal, especially considering how exhausted I usually am. But I’ve had to really work at figuring out how to sleep, as well as get naps in. It’s wild, how napping feels like my new “hobby”. I do it whenever I can… and I’m actually enjoying it. I’ve been “off” my sleeping patterns since my fall down the stairs in 2004, getting anywhere from 3-6 hours on a regular basis, and rarely getting more than 7 at a stretch. It was such a departure for me — for most of my life I craved 8-9 hours each night, without exception. It was what I used to aim for, even when I was a kid. But I didn’t even fully realize just how bad it was, until the past year or so.

The other crazy thing about my sleeping change, was that for some reason I thought it was an okay thing to do without sleep. I guess I would just get so jazzed up and so charged and so whacked out with agitation and nerves, I would think I needed to work off my nervous energy and “get things done”. Well, news flash — I wasn’t really getting much of anything done. Just spinning my wheels. How crazy is that — I would just start all these writing projects, work like mad on them, write and edit, write and edit, write and edit, but then I would get distracted and go do something else, and completely forget about what I had been so determined to do.

Madness. I was just running like a blind fool, spinning my wheels, just being busy for the sake of being busy. Geez! I wasted so much time imagining myself pursuing success, but I was just churning. And exhausting myself in the process.

I have to say, post-traumatic stress may be a significant factor in all this. I’ve been reading so much about traumatic stress, thinking about it, talking about it with psychotherapist friends, pondering it, looking at it, I’m pretty sick and tired of it always being on my mind. But PTSD must be playing a role in my sleep conundrum. After having gone through so much over the past year, tracking down my tbi and other neurological issues, going through all the testing, changing jobs, dealing with family stuff, having various neurological complications, and trying to put two and two together and make sense of it all… not to mention the hard, hard winter we’ve had… I’ve probably got my fair share of PTSD to deal with. I’ve just been so tapped, week after week, month after month, and it’s taken a big toll on me and my already sensitive system. No, I haven’t been at war, and the past year hasn’t been as hellish as it could have been, but stress is stress, and I have been “on and off” about how well I’ve dealt with it all.

Oh, God, I am so tired. It’s crazy. I can’t even figure out how far behind I am on my daily quota. All I can do, is try to catch up when I can. I had a 2-hour nap Saturday afternoon, and I slept for 3 hours on Sunday. I was still really groggy after both naps, and I didn’t feel like I had caught up as much as I needed, but at least I did manage to lie down for a while, and it feels so good to relax.

This is relatively new for me, in the past years. I have gotten worse and worse at relaxing, especially after each TBI I went through. With each accident, I became a little more wound-up, a little less inclined to sleep. I think it’s become a lot more noticeable in the past years, as the cumulative effects of my injuries is catching up with me, and I’m getting older, too.

When I was a kid, I remember having a lot of trouble relaxing and falling asleep. It was very on-again, off-again. I tended to get tired and go to bed earlier than other kids, but I often had to sleep in a specific position, holding something close to me, like my blankets or a pillow (not so much stuffed animals). I also couldn’t sleep if there wasn’t a blanket over me. I was kind of high maintenance when it came to falling asleep, but at the same time I really craved a good long nap, a good rest, something that would recharge my waning batteries.

I still have trouble falling asleep, if I’m not in a certain position or if I don’t have blankets on me. And I’m still exhausted… by myself and my crazy brain. Some people call me a Type A personality. I am driven. I do push myself. I do tend to get aggressive. And I generally go full-force after whatever I want, not letting anyone come between me and my intended goal. But it’s not all psychological/ego drive that moves me. There’s more to it than that — and sleep plays an important role. In fact, the more closely I examine my life and pay attention to what’s going on with me, the more clues arise about what makes me do the things I do — including not relaxing. And in some ways, it has as much to do with physiology as psychology. In some ways, I’d say it has even more to do with the state of my body than the state of my mind. (I’ll write more on this in a bit — it’s actually a pretty important realization/development for me, and it might help others to understand and accept themselves better, too.)

But I’m operating more and more from a deficit, and it’s just not good. Nowadays, I’m trying to learn how to relax. I used to know how, but I seem to have forgotten in the past years. It helps me to listen to some guided imagery for “training” on how to do this. I’ve lost a lot of my former ability at it, so I have to have someone else walk me through the steps of relaxing… progressive body relaxation, deep breathing, letting myself “go” to an imaginary place where I’m safe (which, for me, is a made-up, imagined place I’ve never physically been to — very few of the places I’ve been in real life are places I can relax in)… At first, I felt kind of inept. I mean, who doesn’t know how to relax? What a strange concept. But when I think about it and am totally honest about it, no, I actually don’t know how to relax. Not anymore. And I need help.

I also need help falling asleep. I have noticed, over the past year or so, that when I have the worst insomnia or am waking up way before my alotted 8 hours, I am often very tense, like I’m spring-loaded. Instantly ready for action. Always on alert, because something might come up that I need to react to. My broken-brain reaction time tends to be slow to begin with, so I compensate by always being on-guard, on-point, on-alert. It’s fine when I’m going through my days, but when I lie down to sleep at night, it makes it mighty difficult to relax, let alone fall asleep. But once I let go of the tension in me… once I relax, I can start moving towards sleep.

One thing that’s really helped me, is starting to go to bed before I “have” to. If I wait until 11:00 to go to bed, and I have to get up by 7:00, I feel like I’m under tremendous pressure to perform — to get to sleep promptly and stay asleep for eight hours. I actually put pressure on myself to relax and sleep. But if I head to bed around 9:30 or so, putter and futz around and take my time getting to bed… and if I can get in bed by 10:30 or so, I have a lot less pressure on me, because I am pretty sure I’ll be able to get my hours in.

I’ve been using some guided imagery to get me “down” too. Fortunately, I get so relaxed by the initial cut on the CD, that I usually get to sleep before the “restful sleep” part starts. So, while I’m sure that it helps me, I’m not entirely sure how. Supposedly, it helps even when I’m asleep and am not actively listening. I’ll just trust that, I guess.

TBI Benefit #27 – An increased refund from the IRS

I got a surprising letter today – actually it came yesterday, but I was napping and resting most of the day, so someone in my household brought the mail in, opened it up, and left it for me on the kitchen counter. Lo and behold, the refund I’d calculated for my 2007 taxes (I filed for an extension and did an estimate, which was conservative — I took all the deductions I could legally take, according to TurboTax, and along the way, when I found some other deductions I was pretty sure I could take, but wasn’t 100% certain, I just didn’t include them. Now the IRS is telling me that they owe me a bigger refund — probably by a couple hundred dollars, since I don’t have my tax returns in front of me.

You don’t hear that every day!

My strategy of claiming less deductions than I suspected I was owed paid off… for now. I actually found some other earnings that I’d completely missed when I filed my estimated taxes, so my refund may actually be lower, but the habit of being more conservative and less hasty worked out for me. Playing it safe, with the understanding that I could be completely wrong in my math, soothes me and gives me something to fall back on. In any case, my thinking about things tends to get fuzzy and I tend to lose my train of thought, so I don’t dwell too intensely on tax anxiety.

I guess my attitude towards taxes is very different from most folks’ — I believe in paying them and paying my fair share. Yes, there are a lot of places my tax monies go that I don’t agree with, but all in all, the tax burden here is far less than in many European countries, PLUS I get a whole lot more freedom here, than anywhere else, so I figure it all evens out. I pay my way. TBI or no, I pay my way.

I like my roads paved and plowed. I like having elected officials. I like the fact that children of poor people have access to milk and cheese and other WIC resources. I’m not one to judge others for “gaming the system” — too many people do it in too many ways for me to get started on that, and it just confuses me. Our governmental system, say what you will, makes it possible for us to live in an amazing country that people are literally dying to get into.

Yes, I pay my taxes.

Paying taxes for me, is actually an important symbolic thing. Sure, I slip up sometimes and have to file for extensions. And sometimes I’ve messed up and even missed the extension deadline. But I do pay up, because being able to participate and contribute to this country is not something I take for granted. I’m a very different person from most folks, and my abilities are varied and my disabilities are often hidden, so the times when I can participate as a “normal” person… pitch in and help out… do my fair share… help make a difference, in however small a way… well, I take that opportunity.

I think a lot of “neurotypical” people take things for granted that mean so much to so many of us who are on the margins — by chance, trick of fate, or horrible accident. I think people tend to take for granted the ability to go out and get a job, the ability to participate in casual conversations, the ability to meet other people and be active in their communities. I think that a lot of regular people just assume that things are done a certain way — you get up in the morning, shower, dress, go off to work, put in your hours, then come home, pay some bills, watch some television, and go to bed… and do it all again, the next day. On the weekends, there are sports games and activities… movies and get-togethers… travel and leisure pastimes that many, many other people are doing… take the boat out on the lake… go skiing or surfing or skateboarding or sailing or hiking or play a ballgame of some kind.

But for someone like me with a history of tbi’s, none of those things are foregone conclusions, and they rarely go as smoothly as regular think they do (or should).

Getting up in the morning can be a challenge, as I’m rarely fully rested, and I tend to wake up either too early (most of the time), or too late. Showering can be a complicated thing, as I often can’t keep track if I’ve soaped up and rinsed off, shampooed my hair, or how long I’ve been under the water. And my lightheadedness and vertigo can make just standing in the shower a really nerve-wracking exercise.

Dressing for work can set me off, because I tend to forget what I’ve worn earlier in the week, and unless I have my clothing all lined up in chronological order, I can easily end up wearing the same thing twice in two days. Plus, if I’m really out of it, with vertigo or sensory issues, I can walk around for most of the morning with my shirt buttoned all wrong or my fly open. (I once went through a whole animated job interview, standing at a whiteboard, sketching out possible solutions to problems posed to me… with my fly open… which is NOT the kind of impression I wanted to make! I still got the job, but jeez, how embarrassing!)

Going to work has its own share of hazards, as bright sunlight is hard for me to handle, and even with sunglasses on, the shifting contrasts of light and shadows play tricks on my eyes. And when I’m tired, there’s always the hazard of road rage… or misjudging a situation. One morning, not long ago, when I was tired and angry while driving to work, I almost ran in to someone who wasn’t obeying the right-of-way rules — just because I refused (on principle) to budge. They were driving right into my path, but I had the right of way, so I motored on like a bull-headed idiot, and I almost got hit — just because “I was in the right” and they weren’t following the rules. On principle, I was correct and I had every right to drive through. But principle won’t pay for car repairs, and I only have one car I can reliably drive to work, so “standing my ground” was a really dumb thing to do. Plus, thinking back, if they had hit me, considering the place that I was in, that morning, I probably would have gotten in a fist fight with them, and I might very well have been arrested.  I was in a really bad place, and I consider myself (and the other person) to have been literally spared by divine grace. If it were up to me, I would have landed in really hot water!

At work, depending on my state of mind and body, I can either have good days or bad days. But it often takes a lot of effort for me to function at a “normal” level. Nobody I work with knows I’ve had TBI’s, and I’m not about to tell them. I hold my own and I do my piece, but it’s a real chore sometimes, just to get going. I have massive issues with initiating, with concentrating, with following through. I have huge interpersonal issues that I do a pretty good job of keeping quiet about — things like rage and hostility and anger and mood swings. On the surface, I try to stay impassive, but under the surface, it’s often a seething swirl of confusion and mixed emotions that are as high as they are varied.

Heading home in the evening, after a long day, I just try to listen to the radio and keep chilled out. I have to work harder at paying attention to traffic when I’m headed home, so that keeps my mind off interpersonal aggressions and whatnot.

At home in the evenings, I’m just so wiped out, so often, I can’t even look at anything that needs to be handled. I’m so exhausted… it’s all I can do, to eat supper and flop down in front of a movie. Now and then, I’ll manage to do things I’m supposed to do, but they often get pushed off till the weekends.

I have to say, in th past, I tended to just push through and not give myself a break and just ignore the fact that I was exhausted all the time. I didn’t pay any attention to myself, and I didn’t take care of myself. I didn’t like the fact that I was tired all the time, so I refused to admit it, and I just pushed through with doing whatever I felt needed to be done.

That was fine for my productivity, but the net result was that I was an impossible person to live with. I was unresponsive, most of the time, moody and volatile to the people closest to me, non-communicative and prone to temper outbursts and meltdowns, and the kind of person whose intense volatility made everyone around me walk on eggshells all day. Yes, I appeared to be productive. Yes, I was getting things done. But I was just a machine — a shell of a person whose only solace was that I was making good money and keeping up appearances. Inside, though, I was wracked with pain and sorrow and exhaustion and hurt and anger and rage and confusion.

Now, I think know I’m much better off. I’m less “productive,” and it takes me forever to get things done or process ideas and conversation, but I’m now communicating with the people who live with me far more than I did in decades… I’m now sleeping more and taking care of myself better than I ever did… and I’m actually aware of what’s going on around me, which is more than I can say for the person I was, just three years ago.

Weekends… well, I won’t even go into them. Mine are very low-key, for the most part, and I do so poorly with crowds and frenetic activity, most popular activities (like the ones I mentioned above) do NOT appeal to me. I spend most of my time gearing up to do basic things – like take the trash to the dump or go food shopping or go to the library or clean something. I spend a lot of time spacing out and not doing much of anything. And by the time Sunday night comes around, I often feel pretty deficient about not having gotten much done.

Daily life for someone with a TBI is often far from simple, and it’s often anything but straightforward. Sometimes it takes a monumental effort, to just approximate “normal.” I accept that as part of my life… just something I need to deal with… and I try not to dwell on it too much, lest it demoralize me and hold me back.

Given all the “normal” things that tend to be so complicated and difficult for me, if there’s something relatively simple and straightforward I can do to participate and contribute to the common good — like pay taxes — I’ll gladly do it.

It’s a small price to pay to be part of something as amazing as the United States of America.

Impulse Control 101

In the past months, I’ve noticed a pattern of behavior that I never really thought about before –my tendency to check out library books en masse when I’m getting over-tired, fatigued, and overwhelmed.

I also tend to start projects, just because they seem interesting to me in the moment and they get my  mind off my troubles… not because I actually plan to follow through and complete them.

I first noticed this for real, in February of this year. From my self-assessment form I filled on on February 6, 2008, I wrote:

I’m drawn to library books, and impulsively check them out, loading up on lots of them. I also impulsively start on a lot of research projects and other projects.

The intensity of my desire to check out lots of library books or start projects was about 3/10 that day, and the impact of it was 7/10, because while the intensity wasn’t that great, it still was very disruptive to my regular life.

From my sheet:

I went to the library today, but I just looked through some of them, rather than checking them out. I returned a book I wasn’t reading. I also sat down and looked at what projects I can realistically complete, and which ones are just interesting/compelling to me at this time.

I managed to get rid of a book, rather than bringing in more.

Now, it might not seem like a huge deal, but this was a big revelation for me. Here, all this time, I had been thinking that I was studying and doing things that would ultimately bear fruit and enrich my life, but it was really just to distract myself and soothe my intense emotions that were coming up because I was fatigued, and I was too tired to realized that I was fatigued.

This is one of the issues of self-awareness that I often face — I won’t realize till later that what I’m doing is not really productive, and I’m actually doing it for a very different reason than what I tell myself.

Discovering this has, since last February, made it possible for me to not only identify the things that I am really interested in doing, because they are important, but also to pace myself and not drive myself so frantically, just because I’m fatigued, and I don’t know it.

Well, as long as no one is getting hurt, checking out library books isn’t the worst way to deal with my stress. But a long nap would be more constructive.

Speaking of which, I am tired. Time for my nap.

TBI Symptom of the Day – Such trouble sleeping!

I had another rough night, two nights ago. Probably had something to do with my visit to the doctor, but then again, I haven’t been sleeping all that well, lately, anyway.

I was up at 2:00 a.m., drenched in sweat — I’m having a hard time moderating my body temperature, these days, as the seasons change. I’m either too warm or too cold, and when I get too hot, I sweat like crazy, when then soaks my pajamas and then I get chilled.

It’s just not good.

I tried listening to my guided imagery CD that’s meant to help me sleep, but it wasn’t working. I considered taking a shower to get all the sweat off me (sometimes the odor of my perspiration keeps me awake).. but then I opted for just changing my t-shirt and changing bedrooms.

The guest bedroom in the back of the house is quieter and smaller, and it feels sheltered. It doesn’t have much furniture in it; it’s pretty bare-bones, in fact. And it’s where we keep our extra stuff, like dirty laundry, shelves I have not taken out of the box and hung, yet, odd luggage that we can’t fit anywhere else, and a half-working multi-function fax-scanner-printer that bought the farm many years ago, but doubles as our outgoing fax machine (which we need surprisingly often). But the room has a nice feel to it, and it’s like a sanctuary to me when I’m not feeling well. It’s also where I take afternoon naps on the weekends, sometimes. It’s a nice room, the humble features notwithstanding.

I pulled a nice heavy quilt out of the closet, spread it across the bed, got my pillow, and climbed in. There’s something about making a “cave” out of my covers that makes me feel safer and more comfortable. I think the difference in the temperature in the room — my usual bedroom tends to be hot, and I’ve had the humidifier running to help avoid sinus issues — and the quiet in the back of the house really helped. Plus, it was a change of pace for me. I usually only sleep in the back guest room if I’m sick and I need to keep away from everyone.

I guess that wee hour of the morning was one of those times. Because I was sick. Tired and overtaxed and worried about my health and wondering if/when this TBI business is ever going to let up on me, and give me a break.

It could be that it never does. It could be, I have to keep dealing with the fallout — emotional, social, interpersonal, logistical, professional — all my live-long days. That probably will be the case. But on days like today, when I’m just so tired and I’m so fed up with having to navigate the world with different and/or diminished resources, I start to lose faith in my ability to cope.

I can cope, of course. I always have and I always will. I wouldn’t have gotten this far in life, with all those head traumas and all those tough experiences with family and friends and jobs and just daily living, if I didn’t have it in me to cope. I’ve been coping since I was seven years old, which means I’ve been at this for 36 years. But on days like today, when I’m tired and feeling like I’m falling behind in everything and I don’t know how I’m going to keep up, I start to lose faith.

Until I find something really great to perk me up. Like the fact that the speed of my broadband connection has improved exponentially, far beyond what I ever dreamed possible from my ISP, and I’m on good terms with my co-workers who also enjoy my company (when I’m absorbed in thoughts that perk me up, of course).

I think that if anything has spared me, in the years after my various TBI’s, it’s my continued sense of … well, adventure. And my tenacity. There’s a joke that with Alzheimer’s you get to meet new people every day, which (even by my fringe standards) is twisted and callous. But in a way, that’s how I feel about my own neurological issues. There is literally never a boring moment. If I approach each new situation with a sense of curiosity, even wonder, and I don’t get too hung up on the fact that I tend to screw up royally the first couple of times I try things… and I keep my sense of humor… and I just hang in there and keep trying, till I get it right… well, then, nothing is too terribly big for me to tackle (within reason, of course — let’s not go hog wild and get our hearts set on space travel or paying off the mortgages of every duped homeowner in America).

Some days, of course, I despair. I mean, it just really sucks when your brain doesn’t function the way you’d like it to — and everybody expects it to. It really sucks, when your own doctor backs away from you in alarm because they’ve discovered their assumptions about how well you can cope in the world are dead wrong. It sucks when your loved ones cannot deal with your temper, your memory issues, your mood swings, your difficulties remembering where to look for the note that’s supposed to tell you what to do today… And it really sucks, when you’re not sure who your friends really are…. and you don’t know if you have it in you to try to find out for sure.

But on the whole, I’m just so stubborn and hard-headed and too in love with life, to just give up and quit the game. Or even sit on the bench. I’m a viable, lively human being with a big heart and a lot to offer and a whole lot of life experience that others might find useful. Why should I live any less of a life than other people who haven’t gotten hit on the head and knocked around? Why should my injuries disqualify me form living my life to the fullest? They shouldn’t!

So long as I get enough sleep. Having enough rest is of paramount importance to me. If I haven’t slept, I can go off the deep end really quickly and start to make life miserable for everyone arund me. It’s the short temper, the extreme (someetimes violent) mood swings, the yelling, the tears, the inability to concentrate, the lapses in my memory over things that should be so simple… It’s all of it… it’s the almost childlike dependency that makes people wonder who I am, really… the reluctance to go out and be social, for fear that my tiredness will wear on me and make me edgy and gruff and put people off, and make me say things I regret and don’t really want to say. It’s the anxiety about any sort of social interaction — even with friends — that isolates me and ties me up in knots, since I don’t really have anyone I can just shoot the breeze with and bounce ideas off of. It’s the anxiety about people I know finding out about my tbi, when they had no idea before, and treating me differnetly, even though they’ve known me even in my most troubled times when my symptoms were really playing havoc with my head and behavior.

When I haven’t slept, I have trouble doing the most basic things — like remembering to zipper my fly. Like remembering to turn on my headlights when I pull out of the driveway. Like remembering a very important task I have been meaning to do. Like being able to understand people when I talk to them on the phone.

It seems like such a basic thing. How could sleep deprivation cause these issues? How could something so simple make my life so hard?

I’m not sure. But it does.

So, this weekend, with the support of my family (who are growing tired of dealing with a tired version of me), I will rest. Sleep. Take it easy. Read a good book. Write a little Draw a little. Just chill out. Take long hours to listen to my guided imagery CDs that I’ve been meaning to listen to. Spend some time doing some self-assessment and looking back over my past week to see what the pain points were. Tomorrow I’m taking time for myself, which is a rare, rare thing. And I’m going to catch up on my sleep, if it’s the last thing I do.

Nothing else matters, at this point. My priorities are clear.


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I really am very tired…

I’ve been thinking, these past few days, about how many things I’ve blocked out over the years of living with a tbi… I’ve effectively blocked out the fact that I usually have a headache, that I have constant ringing in my ears, that I sometimes can’t make sense of what people say to me, until 10 minutes after they say it…  So many things I’ve succeeded at ignoring. Including being tired.

I don’t think I’ve had many full nights of restful sleep since my fall in 2004. I’ve had a lot of job stress and a lot of personal stress… and frankly, it’s worn on me. But I believe a lot of my sleep disturbances have been due to my injury, not just external stress, and I’ve just gotten used to being constantly tired.

Fatigue with TBI is a big problem, and I keep coming across discussions of it.

It’s a theme. For sure.

Of course, it doesn’t help that all of American culture seems hell-bent on adding sugar/aspartame/whatever sweetener to every single form of solid food and drinkable liquid. It doesn’t help that we’re all hopped up on caffeine and pushed to constantly go-go-go. It doesn’t help that our food is full of preservatives and God-knows-what-else. And it doesn’t help that the television and radio and internet are constantly pumping  us full of stimuli that offer us little in return for paying attention to them, other than their agreeing to go away and leave us alone.

This country is full of over-tired, over-taxed, under-served citizens, 2% of whom are walking around with TBI’s… a lot of whom (myself included) are having trouble sleeping.

About the last thing we need, on top of our already challenged sleep patterns, is a nationwide campaign to keep us awake long enough to spend whatever money is left in our wallets or on our over-taxed credit cards.

<sigh>

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Ruminations of a high-fuctioning mtbi survivor

Okay, so this post is purely self-serving, in that I need to remind myself that I am indeed a high-functioning mild traumatic brain injury survivor, who has managed to build a pretty incredible life for myself and my family, despite my injuries at age 7-8 and three years ago at age 39.

I’m in the job market again, and I’m looking at my job prospecting with a whole new eye — keeping tabs on my stressors and trying to navigate the world of recruiters and headhunters, who are all so incredibly DRIVEN and don’t give themselves, let alone me, a chance to breathe. Take a deep breath, folks. Honestly…

I’ve been talking to headhunters, on and off, for a few days, and they’re starting to make me crazy. All that go-go-go stuff and the constant pressure to schedule something with them… to make it happen… make it happen! Can-do shit and all that. I have to admit, I’m a bit tired of all that pushy crap, and it’s making me antsy and short-tempered. I actually snapped at a headhunter today who was just pushing too hard. People can’t push me hard, anymore. Not anymore. No thanks. Give it a break.

Still, one must work, one must earn money, one must pay the bills… If only I could find a job I could do from home, instead of going out into the world. I’ve been thinking I really need to work for a company that can offer me structure and reliability and some sort of regular schedule. I’ve been in and out of the regular job scene for a while, back and forth to a part-time job and futzing around for the past year or so. I’ve been thinking that I need more than that — more structure, more involvement…

But the more I talk to people in the working world, especially recruiters for technology companies, the more it gives me the willies. And I don’t relish the idea of going back to a 9-to-5 position. Especially if it involves driving an hour each way. Just too much.

Especially since I’m starting into dealing with this TBI stuff. I really don’t want to have to put my diagnostic testing and rehab on the back burner, while I try to figure things out. I don’t have an unlimited amount of money in the bank, so something must be done. But really, I’d prefer to work at home… telecommute. Work remotely. Not have to go into an office.

Better yet, I’d prefer not to have to work at all.

But that’s not really in the cards, at this point. Unless people buy so many of my headache journals that I can retire. Or they purchase more of my writing/research/resource guides. That’s always a possibility. A slim and distant one, but a possibility, no less.

But seriously, folks, there must be a better way for tbi survivors to make a living, than having to schlep into an office and be surrounded by people who neither understand nor care about your condition. I’ve worked with disabled people before, and while our employer did accommodate them, and they were great friends with everyone they worked with, the simple fact is, they had to work like the dickens just to get by “normally.” And while people did help and reach out to them, there was always that undercurrent of pity that makes my skin crawl.

I just can’t bring myself to “play the disabled card” as a tbi survivor. I’m still up in the air about whether I’d even mention it to an employer. I certainly will not mention it to consulting clients. That would totally work against me, I believe.

I just need to keep it to myself, unless there’s an expressed need to let people know what’s going on. I guess it’s all in a day’s work for a tbi survivor… trying to figure out how to navigate the working world. Or the world in general.

But I don’t think I started this post to bitch and moan about my job situation… where was I? Oh, yes, now I remember: ruminations of a high-functioning mtbi survivor. That means I’m supposed to focus on my strengths, I suppose 😉

The oddly conflicting fact of the matter is, being a high-functioning tbi person can make things all the more difficult, because if you don’t “present” like a tbi person (like me), it can be pretty difficult to get people to take your limitations seriously. I’m having a getting-to-know-you meeting with a counselor who’s seeing a friend of mine, who’s really struggling with my newly discovered tbi status. This counselor knows a bit about tbi, and they don’t think I look or act like a tbi survivor, whatever that may be like. So, I need to sit down and explain things and hopefully elucidate my situation.

I’ve invested a whole lot of time and energy in making sure that nobody, but nobody, realizes I’ve got a disability, and now I have to sit down and explain to someone how my front is often just a front, which makes me a fraud and a fake, I suppose, on a certain level. I’m not nearly as smart as I pretend to be. Or as quick. Or as inspired. I just do a great job of imitating someone who is. Or maybe that makes me a highly resourceful survivor extraordinaire, who just doesn’t want to miss out on life and sucks at self-assessment, so they can’t see that they’re not quite as smart/quick/inspired as they think they are.

It’s all very confusing, and I’m not helping myself any, right now. I’m actually very tired. And stressed. And worried about these interviews I have coming up over the next few days.

Just remember, on the internet, nobody knows you’re a dog…

Technorati Tags: brain damage Brain Injury cognitive-behavioral issues Emotional Fallout Family Issues Head Trauma journal Mild Traumatic Brain Injury military Motivation and Inspiration mtbi Neurology Neuropsychological Effects of TBI neuropsychology Personal Experiences with TBI psychology psychotherapy rehabilitation Social Issues TBI Physiology TBI Rehab TBI Resources tbi survivor TBI Symptoms tbi traumatic brain injury

When they think your TBI is PTSD

I just checked my blog stats, and somebody came over to this site while Googling for info on soldiers and PTSD.

I want to quickly put in a word for military folks who are seeking help for post-combat/deployment issues, who may be headed down the PTSD treatment road, but may miss TBI treatment in the process.

I started professional counseling about six months ago for “coping issues” that I couldn’t get my head around. Everything in life had just gotten so difficult, and I couldn’t understand why I kept running into dead ends with jobs and relationships and why I couldn’t seem to advance in life. All my peers have “moved on” and “grown up” — many of them now with grandkids and advanced careers, long-term homeownership, and all the accoutrements of adult life… while I languished in a no-man’s-land of false starts, scattered ideas, and a long line of failed or aborted attempts at living a normal life.

Now, don’t get me wrong — on the surface, my life looks like it’s highly advanced. I’ve got a great home, a wonderful marriage, and two cars in the garage. My resume looks fabulous, and I’ve got a lot of respect from folks. But my external circumstances don’t match my internal state… and they haven’t for a long time. Nobody really knows just how deep the self-doubt, anxiety, self-criticism, abysmally low self-esteem, and constant invisible struggle really goes.

Except me. And I don’t breathe a word of it to anyone. Not if I can help it.

So, when my health and career and personal life all started to tank in a very big way, this past year, I sought professional help. The counselor I found is highly experienced, compassionate, insightful, kind, caring, and very adept at what they do. But I found myself over time feeling as though they were looking for some sort of horrific trauma in my past that would cause me to lose big chunks of my memory, be uncertain around people, and erode my emotional and behavioral (and cognitive) foundation.

I got the distinct impression they were looking for emotional trauma. Abuse. Neglect. Some sort of terrible thing(s) others did/do to me that cause me to have PTSD. Or some life-threatening event that brought on PTSD.

We had talked about post-traumatic stress a good deal, and both of us accepted that it could have a part in my difficulties. But no matter how closely I looked at my life, I couldn’t for the life of me find THE Event(s) that had wrecked me for “normal” life.

It just didn’t make any sense to me. And when I dug deep and did my own research and realized that sustaining a traumatic brain injury at the age of 8 (and possibly other times), as well as another TBI three years ago, did actually fill in a huge, gaping missing piece of the puzzle.

It’s not that my counselor was incapable or incompetent. They were just looking for the wrong thing in the wrong place. They’re a wonderful resource for me, and I really value their input, but in the case of TBI, I had to come up with my own diagnosis.

This article was very helpful:

Concerns grow about war veterans’ misdiagnoses – Brain injuries can defy easy detection” – I passed it along to my counselor, and they found it very helpful… as well as a bit disconcerting.

And the blog “A Soldier’s Mind” has some more info.

If you’re in the same boat I am/was, you may need to do your own research & preliminary diagnosis, too. After all, TBI tends to make it very difficult for people to tell what’s going on inside our heads — and it can make it tough for us to figure that out, too. Doing research online is a great way to make a start.

I’m finding that TBI is not particularly well-known in the psychotherapeutic community — I have a bunch of friends and associates who are therapists, and when I’ve talked about TBI, I’ve gotten blank stares. That’s not entirely their fault. They aren’t always trained to look for physical ailments, which are the domain of medical doctors. If anything, they’re taught to look away, in terms of medical issues — liability issues, I suppose. Unfortunately, there seem to be a lot of highly trained individuals who simply don’t have the kind of physiological orientation that treats cognitive-behavioral symptoms as possible neuro-physiological phenomena. They are accustomed to looking at emotionally traumatic life experiences as the root of PTSD problems. They’re looking for the right thing… but they’re looking in the wrong place.

I really want to devote a fair amount of time and energy on this site to explaining to psychotherapeutic professionals the personal realities of living with TBI, as it relates to trauma. There are different aspects of the condition that both mask post-traumatic stress and exacerbate it. TBI adds another wrinkle to the whole scene that complicates matters and requires greater sensitivity to our situation.

When I informed my counselor about my TBI, they seemed a bit concerned that I wouldn’t need their help anymore… or that I’d terminate my sessions with them. They seemed to think that TBI work would replace the cognitive-behavioral work I was doing with them. But in fact, the TBI aspect makes it even more important to do cognitive-behavioral counseling. It doesn’t make counselors superfluous. If anything, it makes them all the more essential.

Other posts about PTSD:

Better today… of pain and ptsd

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