Only the connected survive

board-connectionOn my morning exercise bike ride, I came across a great blog post about rising suicide rates in America and the treatment gaps that may contribute to the sudden rise – http://1boringoldman.com/index.php/2016/04/25/whats-missing-2/. There were some great points made.

There’s a second post following that about how our official approach to mental health problems — develop drug therapies — correlates with less focus on actual treatment beyond a pill. Both of them are good food for thought.

The thing that strikes me is that I’m not surprised.  I have been suicidal a number of times in the course of my life — although I never acted on it. And I know very well the feeling that it’s pointless to go on, because there’s nothing I could ever do to change my circumstances, and nobody really cares, anyway. Personally, I think that if I’d grown up with a mobile device, I probably would have put an end to my suffering many years ago, because even if your device does make you feel connected, it’s doing the exact opposite.

“The one thing we know for sure is that interpersonal isolation is a part of suicidality,” says the author of the blog, and that sounds about right to me. Feeling cut off from your world, unconnected, alienated, adrift, with no direction, no anchor, nothing to give you a sense of where you are in the world… what’s the point of going on? What indeed?

And with traumatic brain injury, that can be a real problem. Because we can lose our sense of our Selves. We can lose all connection with ourselves and who we are. To me, loss of a Sense-Of-Self is a major contributor to suicide risk. Because you’re not just losing your sense of connection to others. You’re losing your sense of connection to yourself. If you can’t feel yourself, how can you feel connected to anyone else?

It’s a problem.

But I didn’t actually start thinking about this post, in terms of suicide. Rather, I was thinking about my work situation, and how isolated I felt myself become in the years after my TBI in 2004. I’ve been thinking a lot about why — after 25+ years in high tech — I feel like an outsider and an amateur at times. It makes no sense. I have a ton of deep experience, and I have the kind of expertise and insights that you can only get from doing what I do for two and a half decades — and longer.

So, why do I have such a skewed vision of myself and my place in my chosen industry?

I believe it’s because of my lack of connection with the larger community. Fatigue is a major challenge for me, as is extreme sensitivity in groups and crowds where a lot of people are talking, and conversations shift and change with the winds. There are a number of tech meetups in a nearby city, but I haven’t got the energy or the inclination to go out and meet people. There was a professional conference just a few weeks ago that I had signed up for, but I was too tired to go.

So, I missed a chance to connect with others and widen my professional circle.

And that’s a real problem. To stay current and “relevant” — as well as find out about decent jobs — I need to get out there, mix and mingle, and get seen.  Talk to people. Connect with my community, my tribe. I’ve been far too isolated for the past 10+ years, and I need to do something about that.

Of course, I’ve been getting myself back on the good foot, and I’ve needed to heal. But now seems like an excellent time to start branching out again, to see what more I can make of my life and my career. That includes branching out in my current job, even though it may not actually be around for much longer. I just need to do more connecting with others. Because like life in general, the more connected you are, the better your chances of survival.

So… onward.

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Making the most of everything you’ve got

It happens

So, you hit a rough patch. Maybe you literally hit something. Or it hit you. Or someone hit you. Or you got roughed up in some other way by this thing called Life.

It’s not fair. And it’s not fun.

No doubt about it.

And now you’re left feeling like you’re damaged. Broken. Down. For the count, or permanently.

I’m not going to give you a think-positive pep talk and lecture you on happiness being a “choice”. I heard a conversation like that yesterday while I was waiting for my turn at the chiropractor. Someone in the waiting room was depressed — really struggling with that wretched sense that comes with depression — and one of the other patients (who apparently helps others with alternative healing modalities) started in on this lecture about how you have a choice between depression and happiness. You can choose to take action, or you can choose to “wallow” – not in those words exactly, but that was the gist I got.

I kept my comments to myself. I was busy reading an eBook about neuroplasticity, which was far more useful to me. And I did keep my eyes from rolling, as the person trying to help started in on this (seemingly) oversimplified explanation about a technique that supposedly helps “break up old patterns”. But it got my blood boiling a little bit, hearing all the platitudes that they picked up along the way in who-knows-how-many Saturday morning workshops about all these different modalities.

I managed to put it out of my mind after that. I’m just now remembering it.

And I think about all the folks in the world who struggle with some hidden difficulty of one kind or another… who are just so beaten down by it, without a lot of fresh ideas about how to get past it, or manage it. The last thing I want to do is add to the heap of suffering by waxing eloquent about how choice trumps everything, we make our entire world with our thoughts, we manifest the lessons we need, etc. There is some truth to that, but some days, life just roughs you up and you have to work with what you have.

When you’re just trying to stay functional, all that talk is like serving goose liver pate to someone who hasn’t eaten in a month. It can seriously screw them up, when all they really need is some basic nutrition, eaten slowly, so the digestive system has a chance to catch up with itself. If you go too fast, or the food isn’t right, you can do harm.

Not to mention it can sound pretty uncompassionate and clueless about the true nature of certain brands of suffering.

Anyway, enough complaining about that. In my own life, there have been plenty of ups and downs. Bumps in the road. Sinkholes, really. And I’ve spent a lot of time down in the pit. I don’t like to think about it nowadays, but I used to be intensely depressed. A lot. To the point of suicidal thoughts. I didn’t want to live anymore. There didn’t seem to be a point to anything at all. I felt useless and clueless and lost, and I had no idea what the true nature of my difficulties was.

It’s been several years since I felt the kind of desperation and despair that used to pull me down. The last time I seriously considered ending my life, was 3 or 4 years ago, when I found out some things about what was really going on in my marriage. There didn’t seem to be any point to continuing, because being a capable spouse with a loyal partner is a huge part of who I am and how I define myself. When I realized that things were not as I imagined, on both counts, I decided to drive out to a bridge within a day’s drive of me that spans a massive chasm with a river at the bottom. It’s not hard to climb up, and there’s a parking lot at one end, so I could just park my car, leave a note (or not), climb over the railing, and jump to the end of my suffering.

That’s the closest I’d been to actually killing myself, in over 20 years. Back when I was struggling after a couple of automobile accidents (I got rammed two times in the space of a year), I was so low, screwing up on different jobs, lost, dazed, disoriented… I was planning on killing myself by driving head-on into oncoming traffic. I had the location all picked out, not far from my home, where I knew traffic sped up and there was a blind corner that everyone flew around. The health and safety of others in the oncoming cars never occurred to me. I just wanted to end it. Fortunately, I got some help and found people who could help me before I could act on it, but that sense of just wanting everything to be over was very other-worldly. And if I hadn’t gotten the right help at the right time, I wouldn’t be writing this, right now.

Anyway, over the years, severe depression has followed me — often following TBIs… the “mild” kind, no less. The world dramatically under-estimates the impact of mild traumatic brain injuries, just calling them “concussions” and shrugging them off, like they did with those two soccer players in the FIFA Women’s World Cup. Because you can’t see what’s going on inside the skull, they think it’s not that big of a deal. If you can get back up and walk, you’re fine, apparently. And that mindset includes the folks who sustain the TBIs. Because our thinking is addled. Confused. Distorted. And we have about the worst judgment you could ask for — especially when it comes to making decisions about whether to play on, or not.

And for many of us, with all that confusion comes depression. Frustration. Despair. We just don’t know who we are or where we fit, anymore. Likewise, the people around us don’t understand who we are or where we fit, and because their own identities are tied up in their interaction with the person we used to be, they lose part of themselves, when we get hurt.

I believe that’s why so many people abandon folks with TBI — we are all so interconnected, that our identities are tied up in how the people around us are, so when those people change, we lose part of ourselves, as well. We don’t know who we are, anymore. It’s uncomfortable. It’s a scary thing. So, we drift away, rather than hanging in there and finding out who else we may all become, as our lives unfold.

Anyway, I realize I’m really going on, here. I started out wanting to say:

Life throws some tough punches, at times. So, what do we do with the aftermath?

I started this post wanting to explore the ways that we can use our own difficulties and suffering to reach out to others and help them. I guess maybe I am still saying that. Life is a challenge for so many, many people, regardless of how they look on the surface. And sometimes the folks who seem to have it the most “together” are the ones who are carrying the heaviest load of pain and isolation. There’s no isolation like having everyone around you believe — or expect — that everything is fine and cool, and you’re doing just fine… when you feel like you’re dying inside.

For me, it comes down to this — because I know how hard it can be, because I have stood at the brink of my own self-destruction, because I have been through fire after fire, struggled through so many seemingly impossible situations, and I’ve pieced things together for myself, even while the rest of the world refused to see what was going on with me (and still does, in fact)… it makes it all the more possible for me to accept others’ limitations and not jump to conclusions about how capable or “well” they are.

As someone dealing daily with hidden issues that I am either too proud or too busy or too confused to reveal and discuss with others (or even sometimes acknowledge), I can never be positive that the person across from me isn’t in the very same (or similar) situation. It could be, we’re both putting on a good show.

Knowing what I know makes it possible for me to hold my tongue and not lash out, when people are trying to be helpful (and doing a sort of bad job at it). It makes it possible for me to be patient with others who are “under-performing” or aren’t living up to my expectations. It makes it possible for me to see past the scars and disfigurement to see that there is really a person in there who is very likely smarter and more capable than I can imagine, and who has been dealt a rough hand they can’t help but play.

It also makes it possible for me to encourage others to expect more of themselves, to do more with themselves. Sometimes you just have to cut the B.S. and get on with it. There is no point in sitting around feeling sorry for yourself, when there is a whole world out there waiting. And while my experience makes me more patient in some ways, it makes me more IMpatient, in others. Because after all the crap I’ve been through, I know from personal experience just how much is possible, if we get the right information, really apply ourselves, and stop making lame excuses that are just meant to get us off the hook and relieve the pressure, rather than addressing root causes.

It’s a double-edged sword, but it’s a useful one.

And that’s all I will say for now.

Onward.

The loneliness of PCS

Recovery can be a lonely experience

I’ve been spending some time over at the Neurotalk – Traumatic Brain Injury and Post Concussion Syndrome forum at PsychCentral, and it never ceases to amaze me, how hard it can be to find help after concussion or TBI. Especially for kids who are concussed in high school sports, this is a tough one. So much of your identity can be wrapped up in being an athlete, being part of a team, playing your role in a specific way that clearly tells you whether you have succeeded or not. Sports are a great way for kids to gain confidence, find a place where they “belong”, and teach them important skills for working with others.

But take that away, thanks to concussion, and you’ve got problems. They can cut so deep that you can end up intensely depressed, even suicidal, and turning to drugs and/or alcohol to numb the pain and dull the confusion.

Here’s what I wrote in response to a parent to talked about their son’s slide into depression:

As a former high school athlete, I experienced a number of concussions, none of which were diagnosed, but in retrospect, they were definite mild traumatic brain injuries. My senior year in high school, after sustaining several concussions over the past years, I was unable to compete as part of the team I had been captain of, for two years running. I just couldn’t do it. Thinking back, it’s clear to me that my PCS had gotten the better of me — I was un-coordinated, I had trouble concentrating, I was emotionally volatile and explosive, and I was getting into trouble at work and at school. So, I took myself out of my favorite and best sport, that fall, and I really suffered as a result.

In retrospect, it was good that I “sat it out”, but it was really painful and depressing, and I spent a lot of time drinking and taking drugs to cover up the pain.

One of the things that makes concussion recovery so hard for high school athletes is that so much of their/our identity comes from being part of a team and playing with the team. The isolation of losing that and needing to recover (as well as the judgment from other kids that you’re “faking it” or making more of it than need be), can be extremely difficult and depressing in itself. Add to that the loss of identity that comes when you are no longer a team member, and that’s a double-whammy. With all the talk about recovery from concussion, it surprises me there is not more talk about the loss that comes from being cut out of sports just like that.

It really can be a crippling loss. It’s not just the PCS, it’s like losing a limb. You lose one of the biggest and most important parts of your identity.

… Unless you can replace that sense of belonging to a team with something that’s safer and has actual meaning, that will continue to be a dark void in his life. For players of team sports, especially, being able to transcend your individuality for the sake of the greater good, is critical, so focusing all your attention on your own recovery goes directly against that deeply felt value system — and that’s a problem.

I really wish this were talked about more. Concussion management isn’t just about managing the conditions that come with a mild traumatic brain injury – it’s also about managing expectations and working with the identity of the individual involved. In one fell swoop, the things that made your life worth living — a clearly defined role in a group of kindred spirits, regular exercise (which is good for the mood anyway), structure, direction from coaches and the rules of the game, and the ability to publicly achieve something and gain recognition — that’s all taken away.

And nobody seems to think that’s a problem that needs to be addressed… at least, not from what I’ve seen in the sports concussion literature.

Concussion can be a tough one, especially with youth, because so much is changing with them all the time, and it’s hard to know if they’re suffering from PCS, or if they’re just being teenagers. It’s hard to know what the deal really is, and so much can be amplified, just because they are teenagers. They don’t have the long-term view to put things into larger perspective, they don’t have the life experience to tell them there IS life after sports, and everything feels so intense.

In many ways, I think the situation with concussed athletes also relates to that of veterans with TBI, who are also removed from their respective teams and have the things that made their lives worth living, simply taken away because of brain injury.

Recovering from TBI can be a terribly lonely thing, even if you do have a regular job and friends and family around you. But remove all those things, and it can really turn into hell.

So, what do we do and were do we go from there?

I’m not sure. I think that connecting with people online can be a huge help, especially for folks who don’t have a lot of mobility and can’t be up and around. There’s really nothing like face-to-face contact to help, but for many of us — including me — that tends to be limited due to fatigue, sensitivities to light and noise (and sometimes touch), and difficulties with hearing and speaking and other communication, which isolate us in the midst of others. For me, the effort required to interact with people at my day job pretty much exhausts me, so I don’t have much left for extra-curricular activities. On the weekends, I just want to hide myself away and be left alone.

In any case, it’s lonely. It’s tiring. It’s frustrating. And these things add stress to our systems, which actually makes it harder for us to recover. It can become a vicious circle that turns our deepest fears into a self-fulfilling prophecy.

But at the very core of it all, we need to find ways to make peace with where we are at — and also learn to self-regulate. Knowing that concussion recovery can be isolating and lonely, allows us to take steps to avoid that becoming a problem in itself. And actually, having some time to yourself can be a really valuable opportunity to get to know yourself and learn skills at self-regulation that you wouldn’t normally get, were you in the midst of all your friends and teammates, 18 hours a day.

The world we live in right now is an extremely social one. Social media. Social sharing. Social this, social that… I worry that today’s young people are not learning how to think and act independently, and they’re missing that important piece of becoming a whole human being, in the process.

Taking time away from all of the social interaction to recover from concussion need not be a bad thing. Being alone doesn’t have to mean you’re lonely. It can mean you’ve got time and space to listen to what’s going on inside you, and get clear on what you want for your life… not just the latest distractions from the crowd.

Far from being the worst thing that ever happened to you, taking a break from the crowd might turn out to be a good thing, after all.

Onward.

Finding full range of motion

This week has been crazy. I’m six weeks away from leaving this wretched job, and I’m full-speed-ahead on finishing everything that I need to finish, so I can go in good conscience. I friggin’ hate the company and its hare-brained policies. Not the people.

Well, most of the people I work directly with. The folks at HQ elevate being an a$$hole to an art form. They really seem to delight in it and take pride in it, which is not very smart on their part. I guess they didn’t get the memo that you can’t treat other people with disdain and disregard, and still be productive and get things done.

A$$holes.

Anyway, enough about them. I’m done with them in seven weeks — less than two months. Ha. No longer will I need to be hindered by their lack of vision and foresight. No longer will I be held back by their delusions and autocracy. No longer will I be subject to their silly little games and jockeying for position in a domain that is nothing to get excited over.

Seven weeks, and that’s it. I’m done. Finis.

I’m back into doing my daily exercises, with a somewhat different approach than before, when I was really focused on cardio and strength training and specific exercises to strengthen specific parts of my muscular structure. As it turns out, even though I am stronger than the average desk jockey, my range of motion sucks. I’ve got a lot of pain that I need to get rid of, so I’m taking time in my mornings and evenings (when I get home from work), to stretch and do some light yoga and body-weight-bearing exercises. I’m making it a priority to MOVE first thing in the morning, no matter how creaky and painful I feel. Just moving, getting the blood going, getting the muscles moving over bone, and getting all the tendons and ligaments engaged… it’s made a big difference in how I start my mornings.

Back a few years ago, when I was working out every morning, it really gave me a boost. Then I hit a plateau and I didn’t want to shake things up. I was comfortable and familiar with the routine I had in place. It helped me get going, and it was a valuable jump start. But after a while I got locked into that routine, and it actually started working against me, limiting what I was willing to do, physically, first thing in the morning.

Now I’ve got this focus on movement. On seeing how my body feels, first thing in the morning, and doing something about it, if I’m not liking how I’m feeling.

The first step is being able to tell how things are going with me, physically. In the past, I have had a hell of a time actually feeling what was going on in my body. I tend to be so “up in my head” that I don’t pay any attention to how I’m feeling physically. This is also the case because I have been in pain for so long, and I haven’t been able to do anything about it, so I just ignore it and move on. Seriously, what’s the point in “getting in touch with my pain,” as so many have encouraged me to do, when there’s not a damn’ thing anyone — including doctors and chirpractors and all sorts of experts — can do about it?

Trust me, I’ve checked. They either don’t believe how much pain I am in each day and tell me I’m exaggerating, or they launch an all-out pharmaceutical offensive on the offending experience, doping me out of my mind in the process — and accomplishing nothing, other than destroying what quality of life I have left.

It’s infuriating — not least of all, because they have a mixture of hubris and cluelessness about how the body actually works, that makes them uniquely qualified to completely f*ck up my life, along with the lives of countless others who have the great misfortune to cross their path. And magically, it doesn’t seem to bother them that they’ve done far more harm than good. Hey, at least they tried, right?

Idiots. The scary thing is, I have relatives who are freshly minted doctors, and you can see the “Stepford” progression with them — they just become so taken with themselves and so enamored of medicines and chemicals and what-not, that it totally blinds them to any real ways they could help.

But enough of my ranting and venting. That’s just how things are, and the one thing I can do about it, is remove myself from the presence of any offending individuals. I’m actually in a good space today, and I’ve got a ton of energy (hence the energetic ranting).  I have a full list of activities planned for this weekend, that are all interesting and engaging and will take me down a path to something better than where I’m at today.

Now, plenty of people will pooh-pooh me and say, “Be careful what you ask for… things don’t get better, they just get different” but they can go pound sand.  My life is getting better. My memory is for shit, I’m completely wiped out half the time, and I’m having a hell of a time following conversations, but that’s largely a function of me putting a whole lot of my energy in specific areas and not really making the effort to pay attention to the same-old-same-old that I’m getting away from. I’m nominally functional in tons of ways each day — but that’s for a very good reason: because I’m hyper-functional in a few select ways, and I need to save my energy.

Save my energy and build it up, too. With my morning (and evening) exercises. I also nap regularly — not for long periods — maybe 40-60 minutes at a stretch, tops. I just step away, lie down and crash into darkness, then get up and get back into everything. It makes a huge difference, and when I come back from my naps, I feel like a whole new person, ready to do what needs to be done.

You know, it’s funny. It’s nearly 10 years after my last TBI — the one that nearly did me in. I still don’t really “feel like myself” and half the time I feel like I’m walking around in a daze, trying to figure sh*t out on the fly. Nothing I plan actually seems to turn out the way I plan and expect it, but I am adapting much better and much more quickly than ever. And in a way, I feel like I’m adjusting to that state of being. It’s not throwing me for a loop anymore. I’m learning to expect it. I can’t say that I’m all that happy about it, and I can’t say that anyone is actually helping me deal with this loss of my old self and the experience of walking around in a life that feels so foreign to me, nearly every waking moment. But it’s not taking me by surprise anymore. And I’m finding moments where I can have some actual peace in the midst of it all.

What’s more, I’m finding ways to get where I want to go… I’m discovering new ways to identify and pursue my dreams, and deal with the surprises that crop up, every single day — sometimes by the hour. And despite not feeling like “myself” anymore, and not recognizing the person I have become, I am a whole lot more functional than I was 15 years ago, when I was struggling on a daily basis with the long-term after-effects of multiple mild traumatic brain injuries. I was really, really struggling. Even though I was making good money at a good job, and I had all these “secure” situations around me, my head was a mess, my relationships were superficial and extremely rocky, I got roped into doing a heck of a lot of crap I had no interest in doing, and I struggled on a regular basis with debilitating panic/anxiety, violent mood swings, crippling depression, and suicidal thoughts.

I was no friggin’ fun to live with, at times, I can tell you that.

Now my situation is completely different. Learning about TBI and how it affects me, has literally turned my life around.  It gives me information I can use to manage my situation, know what to look out for, and continually improve. It’s not just learning about TBI and all it brings with it — it’s also learning how I individually experience and react to my TBI symptoms, and learning how I can do something about it. There’s a ton of room for creative problem-solving in this new world, and the results I see are often instantaneous. It’s really gratifying — like mowing my lawn and seeing how much better everything looks after the fact. Sometimes it just takes a little bit of effort to make a big difference.

That being said, this morning moving exercise routine of mine is really working out well. I do something different each morning and evening. I have a few core exercises I do, and then I improvise around the others. It gets me out of my head and gets me “in touch” with my physical sensations — which in turn helps me for the rest of the day, because the clues that I am becoming tense or stressed or frustrated, are physical clues — before anything else.

So, knowing how my body feels and being able to “check in” to see how I’m doing, helps my mental health and my interactions with other people. Each and every day. So that my range of motion improves — not only physically but also socially as well.

Speaking of motion, it’s time to get going. The day is waiting.

Onward.

Reblog: Sports discourse in the aftermath of Junior Seau’s suicide

This is an awesome piece on the death of Junior Seau and what it means for the current sports concussion dialogue. Nice work!

Exploring the link between suicide and TBI

Blogging this from http://www.apa.org/monitor/2012/12/suicide-tbi.aspx from the American Psychological Association

With funding from the Department of Defense, Lisa Brenner is developing a suicide prevention program for military personnel and veterans with traumatic brain injuries.

By Rebecca Voelker

December 2012, Vol 43, No. 11

Print version: page 38

Recognizing opportunities is one of Dr. Lisa Brenner’s strengths. “She meets someone at a conference and realizes a shared interest they have. Before you know it, they’re putting in a grant application together (credit: Kim Cook)

Earlier this year, the Pentagon reported an extremely grim statistic: In the first months of the year, a soldier was more likely to die from suicide than from war injuries. From early January to early May 2012, the suicide rate averaged nearly one per day among active-duty troops — an 18 percent increase from last year. Suicide rates among veterans are equally daunting. According to an estimate from the Department of Veterans Affairs (VA), a veteran dies by suicide every 80 minutes.

In August, President Barack Obama signed an executive order that strengthened suicide prevention efforts for service members and veterans. Among the many efforts being funded and watched by the Department of Defense (DoD) are those of Lisa Brenner, PhD, who is working with colleagues to adapt a civilian suicide prevention intervention for military personnel and veterans with traumatic brain injury (TBI).

Brenner directs the VA’s Mental Illness Research, Education and Clinical Center (MIRECC) in Denver and Salt Lake City, one of 10 such VA centers designed to be incubators of innovative research and treatment. Each center has a specific mission; in Denver, Brenner and her colleagues study ways to prevent suicide among veterans. They have about 30 ongoing research projects. Funding is from the VA, DoD, and non-federal sources including the State of Colorado TBI Trust Fund.

One project explored whether a history of TBI increases suicide risk among veterans and service personnel. “We’re just beginning to figure that out,” she says.

Brenner led a study examining suicide risk in 49,626 VA patients with a history of TBI. The team’s findings show that, overall, veterans with TBI have an increased risk of dying by suicide compared with veterans without brain injuries. This is consistent with findings among members of the general population. The analysis was published in the July/August 2011 issue of the Journal of Head Trauma Rehabilitation.

Brenner is quick to note that more severe brain injury doesn’t necessarily correlate with an increased suicide risk. “The really important point is that TBI is a very heterogeneous condition,” she says. “In terms of death by suicide, research in the field is beginning to suggest that mild TBI is a very different condition than moderate to severe TBI. We’re trying to explore key factors for those with mild or moderate to severe TBIs. We hope that looking at them separately will help us create appropriate intervention.”

Evidence-based interventions for those with TBI are needed, Brenner adds. That’s where her work with Grahame Simpson, PhD, of the Liverpool Hospital/Ingham Institute of Applied Medical Research in Sydney, Australia, comes in. He developed the Window to Hope program, which focuses on relieving feelings of hopelessness among patients with TBI. Previous research has shown that hopelessness is a stronger predictor of eventual suicide than depression. Based on the principles of cognitive behavioral therapy (CBT), the intervention consists of 10 two-hour sessions aimed at building patients’ problem-solving abilities and feelings of hope and self-esteem.

In a randomized, controlled pilot study of 17 civilian patients with severe TBI, the intervention reduced feelings of hopelessness to a similar extent as CBT in earlier studies of depressed patients without TBI. The study is believed to be the first to examine an intervention that’s tailored to address elevated suicide risk among brain-injured patients (Journal of Head Trauma Rehabilitation, July/August, 2011).

With Simpson’s input, Brenner and her team have adapted Window to Hope for military personnel and veterans. The Department of Defense’s Military Suicide Research Consortium (MSRC) is now funding a randomized clinical trial of the intervention within the VA.

Brenner’s Window to Hope collaboration is an innovative research approach for the VA, says Peter Gutierrez, PhD, a clinical/research psychologist at the VA’s MIRECC in Denver and co-director of the MSRC. “This is a much faster way to do treatment development,” he says. “A big chunk of the work is already done, so that allows you to start testing things out much more rapidly.”

Recognizing opportunities for collaboration is another of Brenner’s strengths as a researcher, Gutierrez adds. “She meets someone at a conference and realizes a shared interest they have,” he says. “Before you know it, they’re putting in a grant application together.”

Her dedication to helping brain-injured veterans earned Brenner the Special Contribution Award from the Association of VA Psychologists, presented at the APA’s 2012 Annual Convention in Orlando, Fla. “So far, this has really been a rich career,” she says, “but there is still much work to be done.”


Rebecca Voelker is a writer in Chicago.

Wanting to die after TBI…

Just a quick note – I checked my blog stats earlier and found that someone found their way to this blog with the search “want to die after TBI”.

For everyone who has ever felt that way, you are not alone. I have felt that way myself, many times. I felt that way last weekend during my meltdown — what was WRONG with me? everything was messed up, and I couldn’t seem to figure out a way out of it. I really wanted to just stop existing, just to ease the pain and stop suffering. In the past, before I learned what it could do to me, I used to bang my head until the pain stopped, the confusion stopped, and I could get some relief.

Then I learned about TBI and realized that the “solution” was probably contributing to my problems. So I stopped.

The thing to keep in mind when things are so rough — and I had this very clearly in my mind, last weekend — is that things change. Things become different with time. And my perception of them being worthy of not-existing-anymore is only that — a perception, which will change. Even when I was most desperate, feeling like I was in the claws of a gigantic beast that was tearing my guts out, I had the very clear knowledge that this was just my perception — and the feelings were not real. Even though I felt like I wanted to die, I was never close to acting on it.

Because I knew this would change. I knew my desperation would ease over time. I knew that I would come out of the dark place in one piece, even if it took a while, and I would learn from it. And grow. And get better.

I never felt like I was not going to get better. Because I know something else is true. I know that things do get better. They change. They get different. And that knowledge was what I held onto, when I felt at my lowest.

I’m not going to say “suicide is not an option” for anybody else. Who am I to judge? But I will say it for myself. There’s really no point. Because the minute I stop living, that’s the minute I stop having a chance to change. And because I know and feel and believe with all my heart that I cannot help but change — I’m human, after all — ending my life makes no sense, and it’s not an option for me.

I’ve got plenty more living to do, and I have no intention of cutting that short by my own hand. I know things change. I know that I change. And I know that I am able to make the kinds of choices that are required, in moving from a rough place to a better place. I’ve done it before, and I’ll do it again.

It’s perfectly understandable, to want to die after TBI. But in my own personal case, it makes no sense to follow through.

Now, back to my day.

Last batch of quick responses to loaded TBI questions

What lies within...

This concludes my little series of quick answers to queries people have entered into search engines to get here. You can read the previous posts here:

  1. head banging leading to brain injury  – This happens. Not all the time, but it can. If it happens in conjunction with other conditions, like mental illness or some form of autism, I would expect it to complicate matters even more. Add TBI to the list of other issues… wow.
  2. brain injury learning to read again – I had to do it. The thing that really made reading difficult for me (and this isn’t true of everyone) was my attentional issues. Getting constantly distracted by every little thing, so that by the time I was done with reading a chapter – even a page – I had forgotten what the beginning was about, and how I’d gotten there. I’m much better at it now. I’ve been practicing. And I try to practice with things I really enjoy, so that keeping my attention trained on what’s in front of me is enjoyable.
  3. brain injury if consciousness was lost can you remember thing prior to the accident – Maybe. It depends. Some people have memory loss about events prior to the accident, others lose their memory during, others lose the memories immediately after. It’s very unique.
  4. brain injury and lying – Could be anxiety causing them to say whatever will get them off the hook. Could be confabulation, where they literally don’t know they’re lying. Could be impulse control issues. Not easy to “diagnose”. Pay attention and see if there’s a reason. And see if you can get rid of that reason.
  5. coping with anger brain injury – I’ve written a lot about that. Search this site for various ideas.
  6. is there a difference between a minor head injury and a concussion?  – Depends. Some people say concussion IS a head injury, while others say concussion is the initial hit, and injury applies if the injury and effects are lasting. I think it’s safest to treat any concussion like a brain injury and err on the side of caution. I think… Then again, it might be counter-productive to make a HUGE deal out of a concussion that clears after 3 months. This is one of those annoying “wait and see” things.
  7. traumatic head injury transposing numbers, can’t spell out loud – That happened to me. The transposing numbers thing. After my last head injury, all of a sudden, I was turning numbers and letters around, and I was having trouble spelling. I’m not sure about the spelling out loud, but it’s quite possible that I just never tried, because it was so challenging for me. I did have a lot of trouble reading numbers out loud — they would be right in front of me, but I’d have a hell of a time reading them off in sequence. It’s been really terrible at times — those were some of my strong suits.  I still have trouble doing these kinds of things as easily as I used to. When I’m tired, I tend to get my words and numbers turned around. And I sometimes have to get people to repeat numbers to me several times, even if I’m looking right at them.
  8. best way to get a buzz even with a head injury – Chances are, you’ll have no trouble at all, because head injury can make you more susceptible to drugs and alcohol.
  9. head injury vague nerve – I think they mean “vagus” nerve. The vagus nerve is the largest, longest nerve in the body, and it helps to regulate and stimulate the parsympathetic nervous system — that part of our bodies that helps us rest and digest and get off the fight-flight-freeze roller coaster. It’s really important, especially for folks with TBI, because we can often get jammed in high gear, which makes everything worse. Developing a good working relationship with your vagus nerve can help repair a lot of damage from TBI — especially in the years to come.
  10. how do you tell the diffrence cuncusion and just a minor head injury – See #6 above
  11. head injury “delayed loss of consciousness” – I’ve heard of this happening. Get hit, walk around, then all of a sudden — boom, you’re down. I think it sometimes has to do with swelling/bleeding in the brain… it can take a while for the pressure to build up, then when it does, the brain can “conk out.” This is dangerous – remember Natasha Richardson? By the time she lost consciousness after her fall during skiing, she was almost beyond help.
  12. broken head injury – There are different kinds of head injuries – closed, open, and ones that involve varying lengths of unconsciousness.
  13. blog head injury beautiful mind – I think they meant me? Or not. I hope there’s someone else out there who fits this description.
  14. head injury effect on mental illness – Search this site – I’ve written about this a fair amount.
  15. aggression in the brain – Ditto – see above
  16. photo sensitive brain – Since my last head injury, I’ve been very sensitive to light, especially when I’m tired and/or stressed. Sunglasses help. So does getting enough rest.
  17. mental issues following brain aneurysm – See above. Search this site. Mental issues following a brain aneurysm are probably very similar to TBI issues.
  18. what can a lot of head cuncushins do to u – First of all, they can mess up your spelling. And they can reduce your patience and impulse control. I suspect the person who searched on this phrase has had a few — witness the spelling, and the quick use of “u” instead of the longer “you”
  19. overcoming mental damage – In some ways, “mental damage” is all in our heads. We tend to think we’re much worse or much sicker or much less capable than we really are…. for a number of reasons. The main thing is – there are many, many ways to overcome these kinds of things — either through fixing them, adapting to them, or avoiding situations where they get worse. You just have to keep at it. Consistency can save your ass.

More quick responses to loaded TBI questions

question-brain
More Questions…

Here are some more answers to questions I found in my search stats the other day. It’s a continuation of this post: Quick responses to loaded questions

  1. tbi and no setbacks what does it mean? – It means you’re very, very fortunate. More fortunate than many. And you have every right to be happy about it. But it’s a double-edged situation. If you have a TBI and you have no real setbacks, are you actually injured? Do you need help? Do you need special consideration? Does your injury even count?
  2. broken bodies shattered minds book tbi and vision loss – This is a tough one to give a quick response to. It’s out of my league. A broken body is a hard, hard thing. It may come back, somewhat, depending on the nature of the injuries, but it can be a long road back. And the mind can be shattered by the experience. Mind and body are so closely connected — break one, and the other can easily follow. Likewise, healing one can help heal the other. Focusing on physical fitness and physical healing can do wonders for the mind. And putting the mind back together can help you see clear to healing the body. But in my experience, the body comes first and then my mind follows. As for vision loss and tbi, traumatic brain injury can result in spots in your vision, double-vision, vision loss, light sensitivity… the optic nerve is managed by the brain, so if that part of the brain is injured, your vision can be affected. See http://www.afb.org/Section.asp?SectionID=93&TopicID=417 or http://www.lowvision.org/traumatic_brain_injury.htm for some info. I’m not sure about how to fix it. I think there are corrective lenses — especially Irlen lenses for light sensitivity — and I think there are therapies you can do. But it’s not something I know much about; aside from being sensitive to light, I don’t believe my vision has been affected by TBI. Although… now that I think about it, when I was seven or eight, I had to get glasses. I looked up at the moon, and I saw double. It could have been a result of my TBI(s) when I was a kid. I really don’t know.
  3. how to keep a tbi journal – Journaling has proved to be very helpful for people with TBI. I used to journal a LOT to track my issues and come up with alternatives and solutions. I kept track of the things I needed to do each day, and I tracked how well they came out. If they didn’t come out the way I wanted/planned, I spend time figuring out what I needed to do to have them turn around and be better the next time. It helped me immensely, just to write it down and see what was going on in my life from a distance. It also helped me get in the habit of thinking things through while I was doing them. What I had been writing in my journal stuck with me through the following days, and it made me more present, more mindful. There are a number of different ways you can keep a journal that works for you. You can keep a diary where you write about your life experiences in general. You can keep a journal where you track specific issues. You can even keep a blog, as I do. Whatever works for you is important — and make sure it works for you, doesn’t pull you off track. I kept journals for years, where I simply perseverated on the same topics over and over and over and over and over and over and over again. Looking back, I used up a lot of notebooks and paper, saying pretty much the same thing, day in and day out. This blog is a better way for me to manage things, because chances are someone else will read it, so it keeps me honest. It also keeps me in touch with the outside world, instead of being off in my own private Idaho.
  4. tbi and evil – I once heard about a doctor who said that TBI survivors have no sense of good and evil. So much for their medical education. I think that when it comes to “evil” people’s perception of it can be relative. TBI can certainly reduce your inhibition and impulse control, causing you to mindlessly do things that seem evil to others. Or maybe they really are evil. But I’m not sure TBI actually causes people to do evil — I believe it makes them more inclined to do what they already do, but without the impulse control. If someone is already an evil person, an angry person, an aggressive person, TBI can make them worse. If they are a good person, an easy-going person, or an accommodating, gentle person, TBI can change them to seem more evil than they were before. I think it’s really about mindfulness and intention. Paying close attention to what’s going on with you and not giving in to whatever impulse comes up. But does TBI automatically make people evil? I vote no.
  5. discipline techniques for children with tbi – This can be quite a challenge, as kids with TBI respond differently to discipline than other kids, and the techniques everyone assumes will work with them, simply don’t. Project LearnNet has a nice tutorial on Discipline for kids with TBI – http://www.projectlearnet.org/tutorials/discipline.html – where they talk about different kinds of discipline styles, which involve different combinations of authority by parents, reward and punishment, arbitrary punishment, and permissive approaches. It’s a really great tutorial, and well worth the read — not only for people dealing with kids with TBI, but for all of us. My understanding about discipline for children with traumatic brain injury, is that you need to be consistent, clear, and not only rely on punishment to keep kids in line. Being positive and focusing on what they should do, instead of what they shouldn’t, is very important.
  6. +alarm with finder for tbi patient – I suspect this question is about locating a TBI patient who is prone to wandering off and getting into trouble. I’ve had elderly relatives with dementia who would do that. It’s very scary. There must be some products out there to help. Check with your local Brain Injury Association chapter for tips.
  7. tbi screaning for cognition/communication – again, I’m not sure about the screening possibilities. Check with your local Brain Injury Association chapter for tips.
  8. adolescents with tbi isolation – That would have been me. It still is me, to some extent. With TBI, you can get so turned around in social situations, and have so many bad experiences, that the anxiety becomes overwhelming, and it’s just easier to keep to yourself. It’s REALLY hard when you’re an adolescent with TBI. I was in the situation where I entered adolescence with TBI issues, so nobody knew me any different, and I was able to make some friends after some effort. I have to say, though, that the effort was often on the part of others. People actively worked to bring me out of my shell — I was more content being by myself. I was incredibly fortunate to have people reach out to me. But when I had a couple more concussions in high school, I withdrew again. Got into drugs and alcohol. Distanced myself from the people who tried to be my friend. Just isolated. It was easier. It was disorienting and depressing to always be surprised by the unexpected. Things just got jumbled in my head, and it was overwhelming. So, I withdrew. “Who needs ’em?” is what I told myself.
  9. tbi rage management – Classic TBI issue. Manage the fatigue and the anxiety and stop telling yourself you’re a broken-ass loser, and the rage may be reduced. That’s what I do, and it works for me.
  10. mbti and tbi – Traumatic brain injury comes in various shapes and sizes. Mild (mtbi), Moderate, and Severe. These definitions relate to the initial type of injury, not the long-term outcomes. The BIA website has a page all about brain injury severity at http://www.biausa.org/about-brain-injury.htm#severity. The important thing to remember is that mtbi and concussion ARE brain injuries.
  11. anger from a tbi – See Quick responses to loaded questions for discussion of anger and rage. Keep in mind, TBI alone can make you angry. And fatigue, anxiety, confusion, frustration, all that, can make it even worse.
  12. is it harder to suffer a tbi at a younger age or an older age? – It’s never easy. But there are differences between the injuries. People used to think that kids who had TBIs would recover better, but now research is showing that this may not be the case. A young brain is still maturing, and traumatic brain injury may affect development. It’s hard to say what the real deal is, but more people are studying this issue, and I would imagine we will learn more in time. In my case, having sustained TBIs both as a kid and as an adult, the concussions/head injuries I sustained as a grown-up were much more impactful, because I am dealing with the cumulative effects of past injuries, and they tend to affect you more if you’ve had ones in the past. I also had more to lose, so the job troubles, relationship troubles, money troubles all made for more serious impacts in my everyday life. But the impacts to me when I was growing up had to do with my development, so I’m sure that those setbacks affected me psychologically as well as cognitively. I think a lot of it depends on the person and the injury, but there’s no one simple answer to this question.
  13. husband is a tbi survivor– See these documents:
  14. mtbi online courses – Check out this course: http://www.neuroskills.com/edu/ceumtbi1.shtml to learn about MTBI and get continuing education credits. Also, check out Brain Injury Tutorials – LearnNET from BIA of NY State. They are really, really good, if you want to learn about how TBI can affect kids in school.
  15. how do you think after a tbi – Very carefully. Seriously. I’m not being flippant. After a TBI, you have to think pretty carefully, often about things you used to take for granted. It can be a long process getting back, but you have to keep at it. Remember, you’re building up connections where they have either been damaged or they didn’t exist before. Thinking things through, planning activities, and following through are very important.
  16. career change after tbi – I kind of did this. I used to do a lot of computer programming, but now I’m doing more general work that involves a wider array of activities. It’s actually better for my career. Staying specialized in that old programming area was not something I could do very well, anymore. I had a few false starts with trying to make it happen — made some poor job choices — until I found this present situation, which is working out much better for me. It’s important to be realistic about a career change. First, can you afford to do it? Second, do you HAVE to do it? Third, what can you do that is going to move you forward, not set you back? I had it in my head for some time that I was going to have to “downsize” my career and do things that were simple for me. But it turns out that I needed to go in the opposite direction – do things that involve more learning for me. One of the saddest things I’ve experienced is hearing a person with TBI telling everyone at a support group that they had to give up the career they loved so much, and they had to throw away all their materials and supplies, because it was out of their reach. I’m not sure that was true. TBI survivors often overstate our difficulties and understate our abilities, so we can make choices that work against us. Keep that in mind, if you’re considering career change after TBI.
  17. how long can’t i do things with tbi? – That depends on your TBI and it depends on what you want to do. If you are still healing, then you have to take it easy and rest and let yourself heal. If you’ve been dealing with TBI for a while, and your physical situation has healed, and you’re still not doing things because of your injury, maybe you need to start doing those things. It’s a fine line. On the one hand, no one is in a better position to re-injure us, than we are, ourselves. We can have poor risk assessment skills. We can misjudge situations, and we can overstate our abilities. But at the same time, we can really benefit from trying and practicing things that we want/need to do. Too many times, we are held back by the people who love us, because they are trying to protect us — trying to protect themselves — from another injury. Finding a balance between what you can and cannot do, what you can’t do now but can do later… it’s one of the great challenges of TBI.
  18. effects of tbi on schizophrenia – I have no idea. It might make it worse?
  19. tbi recovery gunshot – Here’s a great article on this subject: http://main.uab.edu/tbi/show.asp?durki=85704. From the article:
    Outcome After Brain Injury Due to Gunshot WoundIt is difficult to predict what type of physical and mental problems a person might experience following a gunshot wound to the brain. It depends on what areas of the brain have been injured, which varies from case to case. Some areas of the brain may have been spared injury, meaning that the functions controlled by those parts of the brain are unaffected. Because the frontal area of the brain is often injured, many people with gunshot wounds have difficulty with attention, learning, memory, and problem solving. These mental difficulties, along with physical problems (for example, paralysis of one side of the body) can impact the independence of the injured person. It is common following a gunshot wound for the injured person to need some assistance and supervision from family members. Sometimes people are able to return to work and to live independently, but that cannot be guaranteed. Return to driving may be impacted by the presence of seizures.A person can experience emotional problems following a gunshot wound to the brain. In part this may be caused by the area of the brain injury. In many cases, problems with depression are caused by the change in lifestyle for the injured person. The sudden lack of independence and the presence of significant mental and physical problems weighs heavily on some people, leading to depression. In some cases depression was a problem before the injury, particularly among those whose brain injury was caused by a suicide attempt. It is important that people experiencing emotional problems after brain injury receive treatment. In most cases, there is a good response to anti-depressant medication and counseling.So, it seems like TBI from a gunshot wound can be extremely challenging. If the gunshot is from a suicide attempt, you clearly have to address the problems around deciding “I’m going to kill myself.” TBI recovery is never easy, however.
  20. tbi brain stem injury disequilibrium after walking – See this web page: Balance Problems after Traumatic Brain Injury – it explains a lot. My own balance problems seem to be related to food allergies. If I eat/drink something I shouldn’t, my inner ear feels like it’s filling up with fluid, and then I have balance problems for days. I’m not sure my brain stem was ever damaged. There doesn’t appear to be damage on my MRI from several years ago. But balance issues are a real problem. With me, they create tremendous stress and anxiety, which in turn exacerbates everything else.

More to come…

Quick responses to loaded questions

The life of the mind

Jump to the 2nd part

I checked my site stats this morning — since I started this blog, WordPress has recorded 98,278 views, all-time. Getting towards 100,000 — cool. I’m not sure what it is with us humans and round numbers, but it feels momentous. And the thought that people have looked at this site 100,000 times is pretty gratifying. So, thank you for your support.

I checked the search terms for the past week, and I pulled out all the ones that relate specifically to TBI/head injury/concussion. Here they are — 101 search terms, with quick responses. I know that this is hindsight, and people have probably since moved on, but just in case anybody comes back to see more, here goes:

  1. difference between concussion and tbi – Check out this post: The difference between concussion and mild traumatic brain injury
  2. will i ever get better concussion – Probably you will. A lot depends on what you mean by “better” and a lot depends on how well you take care of yourself and do the things that will help you get better. Concussion is not a death-sentence. It’s a disruption. It doesn’t need to completely derail your life, but all too often, that’s exactly what happens. It happened with me. Several times. Yet, I continue to get better… because I’m now doing the kinds of things that help me get better.
  3. life after a concussion – Never boring! You just gotta roll with it.
  4. will concussions make you stupid – See this post: After concussion – you’re not stupid, it just feels that way
  5. brain gym after concussion – I’ve seen this advertised online, but I have no idea if it really works. Try it, it might help. It certainly can’t hurt to try.
  6. can you get stupider from concussion – See #4 above
  7. can you drive if you have concussion – That depends on the concussion. If your vision is screwed up, and your balance is off, and you have executive management issues (as in, you fly into a rage over people behaving badly while they drive), you probably want to have someone else behind the wheel, at least until you can function normally again. Also, if your concussion was/is accompanied by seizures, then you should not drive. Some states even prohibit it. But over time, if you are getting back to some semblance of normalcy, then you may be able to work your way back to driving again. Just be smart. And realize that your brain is going to over-state its readiness, more often than not. Get a second opinion from a friend or relative. And don’t take it personally, if they tell you something that doesn’t sit right with you.
  8. dif between a busted head and a concusion – See #4 above
  9. how to convince a doctor you’ve got concusion – The CDC has a great Heads Up program with information for doctors called Facts for Physicians  — print a copy and take it with you to your doctor. Also, list out all the symptoms you have, explain to them how it is impacting your life, and emphasize that you want this information so that you can improve and get better… not get your doc to convince your employer that you need to go on disability, or you want an insurance company to cover all the expenses. When I was first seeking help for my TBIs, I made the nearly fatal mistake of mentioning the insurance issue to one of the neurologists I met, and it snapped the door shut on any productive interactions with them. Why do you want to convince a doctor you’ve had a concussion? If you’re looking for a way to get out of work or other responsibilities, don’t bother — it’s a pain in the ass, expensive, humiliating, and frustrating. But if you’re looking for a way to improve your life and heal from a potentially catastrophic injury, then use the CDC material, and call your local Brain Injury Association chapter for help.
  10. kill myself concussion – Don’t do it. Concussion and its effects can be temporary and can be managed and dealt with. Death, on the other hand, is permanent. And it does a lot more damage to the people around you who care about you, than your concussion ever will. It is very easy to fall into depression and want to give up, when you have to deal with this crap, day in and day out. Just this morning, I woke up feeling just awful, like nothing would ever work again, and I’d be better off not being around anyone. This was just my brain telling me stories that simply aren’t true. Concussion is NO reason to kill yourself. Remember, your brain has been injured, so your injured brain is about the last one that should be running the show. Give yourself and your brain time to rest and heal, and then see how good life can get. But don’t just give into it.
  11. post concussion syndrome reinjury – This would be the story of my life. It’s happened to me a number of times, and believe me, it’s no walk in the park. Reinjury can happen because the injured brain is not quite up to the job of protecting itself from getting dinged again. After concussion — especially in sports — there can be a huge, overwhelming impulse to get back into the game and keep going harder, stronger, faster. But the brain and body aren’t capable of doing that. Reaction times are slowed. risk assessment is dulled, coordination is off, as may be sight and hearing and balance. It’s a potent recipe for disaster, and if an injured brain is reinjured before it gets a chance to heal, you’re asking for a whole new world of hurt.
  12. concussion intelligence – See #4 above
  13. do concussions make you dumber – Likewise
  14. are there lasting effects from a concussion – There can be, but sometimes there aren’t. The vast majority of people do get better. And then there are people like me. Lasting effects can range from mood disorders to physical disabilities. See this page: Then And Now – Managing TBI Issues Over the Long Term for a list of issues and more discussion.
  15. what is the difference between a cracked skull and a concussion – Check out this post: The difference between concussion and mild traumatic brain injury
  16. is concussion baseline testing a good idea – It depends who you talk to. And it depends on the test, the tester, the test-taker. There are many critics of the Impact system, which is a computerized test that is not 100% comprehensive. Some testers will be numbskulls, while others will be sharp and smart. Some people taking the test will “game” the system and create an artificially low baseline, so that if/when they get concussed, they will not look worse than they were when they started. I also believe that you can have good days and bad days, so creating a baseline from a single test on a single day is a problem. I am not a neuropsychologist, but I can figure that much out.
  17. concussions make you smarter? – Who knows? They may. When the brain is injured and heals, it may create new connections that reshape the brain in new ways. I have heard a number of stories about people who started painting after their TBI, and they became amazing artists. It might not have happened without the TBI, probably. Not that aspiring artists should go out and hit their heads, mind you. Also, someone once suggested that my history of TBIs may have forced me to become more mentally flexible and open to different solutions to problems. I can totally see that. When you have your “standard set” of life possibilities altered or removed for no apparent reason, and your brain just doesn’t behave the way it should, you tend to come up with alternative coping solutions. In that way, perhaps concussions have made me smarter. But they’ve also made me a bit of a bonehead in some ways.
  18. things people do when they get concussion – Not sure what this is about — Good things they do? Things they do to heal? If you’re looking for healing ideas, rest is at the top of the list. And eating right. And getting plenty of exercise. And taking up some sort of meditative activity. Being mentally active, even when it’s a challenge. Just keep living your life, and don’t stop looking for new and different ways to approach things.
  19. impact concussion testing wiki – see #16 above
  20. life stressors after concusion – You mean… everything? Concussion has a weird way of turning little molehills into vast mountain chains. Depending on your injury, it can make the smallest of events seem like an epic drama. I’m just coming off a harried weekend after falling down that rabbit hole on Friday. The problem with life stressors and concussion is that concussion makes little things seem big… then the big things get out of control… the big things wear you out and fatigue you and stir up all kinds of drama you have to sort out later… and the fatigue makes you even worse at thinking. Bad brain days and all that. TBI issues and life stressors can become self-fulfilling prophecies and feed off each other. It’s often not very pretty at all.
  21. computerized concussion testing – see #16 above (… looking at the clock, I need to get ready for work. I’ll pick up on this later…)
  22. … Okay, starting again… tbi and road rage – You’re on the road, driving… Maybe you’re fatigued from not having enough sleep. Maybe you’re fatigued from a lot of traffic. Maybe you’re stressed from the “antics” of other drivers. Maybe you’re restless and anxious about work or something else. Being in a car, by yourself, alone with your anger, is a potent environment for road rage. Especially when TBI is involved. TBI can cut down on your impulse control, causing you to completely miss the warning in your brain that tells you it’s not such a great idea to race after someone to teach them a lesson. Agitation and fatigue feed into each other, and when you’re behind the wheel of a car in traffic, being on high alert from the activities of others can really wreak havoc with your peace of mind. The big problem is, TBI will tell you you’re perfectly justified and correct in behaving like a jerk in traffic. It will tell you that you have every right to fly off the handle, race after people, threaten them, rage against them… all that. Just not good.
  23. rage and tbi – see above. Especially when you are feeling helpless and defenseless and small and vulnerable, rage can well up — quickly. Fatigue feeds restlessness and agitation… and they tire you out even more. The brain needs energy to function, and when you’re tired and stressed, it can go haywire. On top of that, you can have a lot of stress hormones — adrenaline and whatnot — coursing through your veins, so the agitation and concern gets even more amped up by that chemical cocktail. For me, rage comes up most frequently when I feel vulnerable and attacked. Nobody has to even do anything to me. If I just feel like I’m defenseless against a threat, I’ll go after whatever it is I feel frightened by and “hit it harder” than it will hit me. Keep in mind, the threat only needs to be perceived. It doesn’t need to be REAL. This is how wars start with me — and then drag on, as I feel the need to justify my boneheaded attacks, throughout the ensuing hours, days, weeks, months, years… Rage and TBI – intricately connected and a huge pain in the ass, for me and everyone around me.
  24. tbi and mental health video – Check out YouTube here
  25. no dreams after tbi – That’s happened to me. In fact, compared to how things were before my last fall, I’ve had far fewer decent dreams than in the past. I’m not sure why this is. Maybe my brain has become more literal, or maybe I’m just too danged tired to dream. I’ve had some really great dreams over the course of my life, but since 2004, not so many great ones — and the ones that were good have been fewer and farther between. This changes over time, however. But I do miss having more interesting dreams.
  26. treatment for slowness after tbi – Just keeping on doing the things that I want to do, which I have been doing more slowly, is the ticket for me. For example, once upon a time, I had real issues with getting ready for work. I would forget what I was doing, what I needed to do, if I had washed my hair in the shower, if I had done the things I needed to do… and the things I did do, I did far more slowly than I cared to. What I had to do, was create tools and props for myself to help me do the simple things. I made lists. I put stickie notes around the kitchen. I kept a timer in the bathroom so I wouldn’t spend half an hour in the shower and be late for work. I also made checklists that I followed step-by-step. Eventually, I got to a point where I was able to do without them. But I used them as long as I needed to, and it helped me speed things up. People around me thought I didn’t need the lists and tools, but I did. I used them anyway. And they helped me.
  27. hate my tbi husband – And he probably hates himself. It’s not much fun turning into another person. If you want to relieve yourself of the burden of that hate, learn as much as you can about TBI and learn to help him avoid the kinds of behaviors that cause you to hate him. Is he over-tired a lot? Does he melt down a lot? Maybe he needs more rest. Does he do all sorts of things that annoy you? It could be he’s having trouble in ways you can’t tell. I really encourage anyone who’s dealing with a difficult TBI person to seek out help from their local Brain Injury Association chapter to help them better understand the situation and get support from others who have similar issues.
  28. assessment of tbi – I believe this is best done by a qualified neuropsychologist, not a computer program.
  29. tbi and lying – MIght not be lying, exactly. See this post: Growing up with TBI – The Confabulation Kid
  30. schizophrenia from tbi – I think this can happen. Google it… I’m no expert.
  31. tbi and psychiatric illness – TBI can lead to a number of mental disturbances, which can feed into full-blown mental illness. The problem is, lots of mental health care folks don’t know about TBI, and they think it’s trauma or some other abuse issue. Or some purely psychological thing. It’s a problem. I really encourage therapists and other psychiatric professionals to learn as much as they can about TBI and how it affects thinking. Too many people are “treated” the wrong way, when they need a specific kind of approach, which they just can’t get, because their care provider is clueless about TBI.
  32. tbi anger blurting – Impulse control issues. A real problem. I’ve dealt with this many times over the years, and in some ways, it’s one of the most problematic issues I’ve had. Embarrassing. For everyone. Not good. What to do? Take a breath before speaking, and when in doubt, keep really quiet. People sometimes give me crap for being “too quiet” but trust me, it beats the alternative.
  33. tbi screening tools – I’m not sure about this one. ImPACT comes to mind – the computerized testing system, but I’m not sure how great it is. Divided opinions.
  34. ptsd and tbi – go hand-in-hand, in my opinion. A Traumatic Brain Injury is trauma-inducing by nature, and that means you get not only the injury, but the complications of trauma that go with it. I personally believe that trauma plays a much more significant part in TBI outcomes than a lot of people talk about. I think people don’t talk about it as much, because the trauma field has been dominated by sexual abuse issues, as well as war wounds, and those are two areas not everyone feels comfortable exploring. I feel the focus on sexual trauma, while important for many, short-changes the whole field and brings too narrow a set of concerns to the issue. More research and writing should be done on the traumatic aspects of TBI. I hope to add to that discussion over the coming years.
  35. skin rash and tbi – I looked this up, and I found some web pages where they talk about medications prescribed for TBI symptoms. Anti-depressants can cause them. The one thing I can think of that might be a possible explanation of a connection is the stress that can come after a traumatic event, as well as the stress that comes during the process of healing from the injury. TBI can be very stressful to deal with — socially, personally, mentally, spiritually, physically — and if you’re susceptible to rashes when you get stressed, I can see how that could happen. Other possible explanations are some sort of infection getting into an open wound, or another medical issue that’s overshadowed by the TBI issues.