Emotional/Behavioural Changes after Brain Injury – Part 2

head with brain opening and question marks coming out

Continued from Part 1

From The Toronto Acquired Brain Injury Network.

My comments are in bold like this.

Emotional/Behavioural Changes

Impulsivity and disinhibition

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

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

Emotional Lability

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

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

Self-centredness

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

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

Apathy and poor motivation

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

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

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

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

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

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

Depression

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

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

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

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

Anxiety

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

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

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

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

Inflexibility and obsessionality

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

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

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

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

Save

Save

Save

Hello officer – the tremor you’re seeing is not fear. It’s fatigue.

transportation security administration officer screening a bagI recently had to fly halfway across the country for a work commitment. I had to fly out early, which meant I had to get to the airport really early… and that meant I had to wake up really really early.

Not much fun, to be honest.

But I did it.

I hadn’t been sleeping well, for several days prior to that – I was getting maybe 5 – 6 hours a night, which is no good. But that’s what I had to work with, so… that’s what I worked with.

The drive to the airport felt like it took forever.

And just getting from the parking garage to the terminal was another slog. One of the wheels on my carry-on was “wonky” and it vibrated really loudly, as I pulled it along. Not the best thing, when your hearing is already over-sensitive.

Anyway, by the time I got to Security, I was a little shaky. I was operating on maybe 2 “cylinders” (out of a potential 4), and I hadn’t had my full breakfast like I usually did. I was off balance and out of sorts, and when I handed my boarding pass and ID to the security officer, my hands were shaking a bit, like they do when I’m overly tired.

The officer gave me a look, and I tried to exchange a few words, but I was “off kilter” and my voice was shaky. I started to get nervous, wondering if they were going to alert others that I was a sketchy character. They gave me another look, and I just shut up. I sounded a little drunk and discombobulated, and my hands were trembling. That’s never a good sign, when you’re trying to board a plane. So, I did my best to gather what dignity I could and just moved on to the x-ray screener – hands over head – and then walked on through.

Fortunately, my luggage made it through without incident. At the last minute, I remembered to pack only small bottles of liquids and creams. That was a last-minute change, because I was going to take full tubes of toothpaste and a special skin cream I need to use for my beat-up hands. At least I got that right.

In the end, it all turned out okay. But I really hate that feeling, when my neurology is acting up on me, and I’m interacting with someone who can flag me as a risk, take me aside, pat me down, possibly strip search me (worst case). The worst case didn’t happen – not even close. So, that was good.

And the trip went pretty well, from that point on.

So it goes.

And so I go… onward.

From Ken Collins: When we injure our brain, we injure an important part of our body.

Piecing it all together
Piecing it all together

When we injure our brain, we injure an important part of our body. Our brains control our ability to think, talk, move, and breathe. In addition to being responsible for our senses, emotions, memory, and personality, our brain allows every part of our body to function even when we’re sleeping.

The brain can be hijacked by the Amygdala in the limbic system after our brain injuries as outlined in this source:

Wikipedia: Daniel Goleman speaks about Amygdala hiijacking – Amygdala hijack is a term coined by Daniel Goleman in his 1996 book Emotional Intelligence: Why It Can Matter More Than IQ.[1] Drawing on the work of Joseph E. LeDoux, Goleman uses the term to describe emotional responses from people which are immediate and overwhelming, and out of measure with the actual stimulus because it has triggered a much more significant emotional threat.[2] From the thalamus, a part of the stimulus goes directly to the amygdala while another part is sent to the neocortex or “thinking brain”. If the amygdala perceives a match to the stimulus, i.e., if the record of experiences in the hippocampus tells the amygdala that it is a fight, flight or freeze situation, then the amygdala triggers the HPA (hypothalamic-pituitary-adrenal) axis and hijacks the rational brain. This emotional brain activity processes information milliseconds earlier than the rational brain, so in case of a match, the amygdala acts before any possible direction from the neocortex can be received. If, however, the amygdala does not find any match to the stimulus received with its recorded threatening situations, then it acts according to the directions received from the neo-cortex. When the amygdala perceives a threat, it can lead that person to react irrationally and destructively.[3]

Goleman states that “[e]motions make us pay attention right now — this is urgent – and gives us an immediate action plan without having to think twice. The emotional component evolved very early: Do I eat it, or does it eat me?” The emotional response “can take over the rest of the brain in a millisecond if threatened.”[4]HYPERLINK “http://en.wikipedia.org/wiki/Amygdala_hijack”%5B5%5D An amygdala hijack exhibits three signs: strong emotional reaction, sudden onset, and post-episode realization if the reaction was inappropriate.[4]

Goleman later emphasized that “self-control is crucial …when facing someone who is in the throes of an amygdala hijack”[6] so as to avoid a complementary hijacking – whether in work situations, or in private life. Thus for example ‘one key marital competence is for partners to learn to soothe their own distressed feelings…nothing gets resolved positively when husband or wife is in the midst of an emotional hijacking.'[7] The danger is that “when our partner becomes, in effect, our enemy, we are in the grip of an ‘amygdala hijack’ in which our emotional memory, lodged in the limbic center of our brain, rules our reactions without the benefit of logic or reason…which causes our bodies to go into a ‘fight or flight’ response.”[8].

Understanding the role stress plays on triggering the limbic system fight or flight response is critical for people to learn about after our brain injuries. Brain injuries are often described as either traumatic or acquired based on the cause of the injury.

Traumatic brain injury (TBI) is an insult to the brain, not of a degenerative or congenital nature, which is caused by an external physical force that may produce a diminished or altered state of consciousness, and results in an impairment of cognitive abilities or physical functioning. It can also result in the disturbance of behavioral or emotional functioning.

A TBI can affect our ability to, think and solve problems, move our body and speak, and control our behavior, emotions, and reactions.
Acquired brain injuries are caused by many medical conditions, including strokes, encephalitis, aneurysms, anoxia (lack of oxygen during surgery, drug overdose, or near drowning), metabolic disorders, meningitis, and brain tumors.

Although the causes of brain injury differs, the effects of these injuries on a person’s life are quite similar.

This is why understanding about the consequences of stress on the limbic system after a brain injury is so important.

Understanding the Sympathetic Nervous System in the brain injury recovery process is seldom talked about to us after our brain injuries by doctors or health care professionals because they only treat the symptoms.

The following information is critical to understand and has great value for people with brain injuries and their families to understand.
The Sympathetic Nervous System – “limbic system is autonomic” and creates many problems people with brain injuries face during our recovery process. If people with brain injuries don’t understand the Sympathetic Nervous System and how it works – our family members and friends react to our emotions and unwittingly create more stress for us for us to deal with.

This stress triggers the “limbic system’s fight or flight response” into action.

We do not have any control over what we are reacting to because of the stress that is being generated by our emotions shuts down the thinking part of our brain – pre-frontal cortex.

What happens next is – we react and they react, the stress builds and we lose control, get angry and have emotional meltdowns or worse.
During any stressful situation our loved ones react to our “actions” and we react to theirs – which increases our stress during those hard and difficult times.

We (family members/ people with brain injuries and friends) get caught up in a reactionary mode instead of being proactive to keep the limbic system in check.

If we set up daily routines, have structure and find purpose and meaning in our lives we have a better chance of controlling stress and the situations that trigger the limbic system fight or flight response.

If we do not control the stress, our families and friends will constantly be reacting to issues we have little control over. Learning relaxation techniques like mindfulness-based stress reduction can help to stay calm so the limbic system is managed.

Mindfulness-based stress reduction can help with this and I encourage you to look this up on the internet because there is a lot to learn about this tool that can help us rebuild or lives after a brain injury.

After our brain injuries “emotional outbursts, anger, and memory issues” are an expression of the problems caused by our limbic system fight or flight response under stress. By understanding how our emotions can get out of control we will have a better understanding of why we react to things that don’t make any sense to us.

There is a reason for all this madness and by learning the role the sympathetic nervous system plays in our recovery, the better chance we have to live full and rewarding lives again – after our brain injuries!

Using bad for good

I want to do more than keep my head above water.
I want to do more than keep my head above water.

It’s been a rough couple of weeks. No – wait – three weeks, actually. Ever since the middle of September, things have been… exciting.

And I’ve been getting emotionally overwrought over little things that shouldn’t even be “moving the needle”. It’s costing me sleep. And it’s very intrusive. I’ll be going along, going about my business, just living my life… then all of a sudden, this rush of thoughts and emotions over stuff I have no control over (and don’t really understand) wash over me, and I’m hijacked by all that.

I’ve tried tamping it down, but that’s not working very well. It’s really bothering me, too. So, I have to do something different.

And I’m using that rush of emotion, the intrusive thoughts, the “riled” state I get into as motivation and propulsion to do good things. There’s a lot I want to do with my life, and there’s a lot I can do. So I’m using that unwelcome energy in welcome ways.

Getting my act together — cleaning up my work spaces… doing fall cleaning around the house… working out… really kicking it at work… being incredibly productive — far more than in the past… and finding ways that I can elevate myself. Somehow. Some way.

And also doing my mindfulness meditation, my zazen, just sitting and breathing, slowing down my racing mind and focusing on the in-breath and out-breath.

I can’t always control my thoughts. I can’t change what’s happened to me. But I can control what to do with it, and I can use the energy to accomplish things that I’ve been wanting to do. There are a bunch of things I’ve been wanting to do, so now I can use this rush that I get for something productive.

It’s all a learning process, of course.

This isn’t my favorite thing, but at least there’s something I can do with it all.

Balancing my system, taking better care of myself

rocks piled in a balanced arrangement on a beach with the sea behind them
All the pieces fit together. Steady… steady…

I had a good session with my new neuropsych on Monday. They’re a little concerned about all the stress going on in my life. Between job craziness and the challenges my spouse is having, and the ever-present danger of me actually injuring myself… sheesh, I’ve got a few things to manage.

And they’re not alone – I’m worried, too. Not so much worried… no, actually worried. I have to stay steady, I have to keep my act together. This is no time to fall apart. The thing is, life isn’t going to get any less exciting anytime soon. Everything feels like it’s ramping up, and I’m being forced to learn a lot. I’m not adverse to learning. I just get very rigid and brittle when I am under pressure, digging in my heels, walking away from challenges, and being generally difficult with others — who are relying on me to step up and play my part. On the outside, I seem fine, but inside, I’m freaking out, going through all kinds of mental “gyrations” over how unfair everything is, how much trouble I’m having, and how nothing ever works out in my favor. It’s a pity-party extraordinaire.

And that makes it difficult to change and adapt to the extent I — and others — need me to. I need to be there for people. I need to step up. But I get tired, and that rigidity kicks in. I push back. That’s not helpful. I need to just go with it.

That rigidity and brittleness is such a problem. But I know what can help assuage it… take the edge off… relieve the pressure. It’s called extreme self-care.

As in — doing my stretches each night before I go to bed. Doing some modified yoga stretches for my back and stretching my legs and arms and shoulders. If I don’t stretch, I wake up in the wee hours in all kinds of contorted pain.

As in — doing my intentional breathing after I’m done stretching. I sit on the edge of my bed and focus my attention on a spot on the wall across from me, and I do slow breathing — 5 seconds in, 5 seconds out — for a little while, till I feel my system relax and my breathing becomes easier. When I first start out, my system is all tight and tense, and I have a hard time just breathing regularly. But after about 10 in-and-out breaths, my system starts to relax, and I can actually do it without forcing myself. It doesn’t come automatically. It takes a while to get going. But it happens. And then I can relax.

I have also started doing measured breathing in the morning when I wake up. I don’t want to get out of bed, anyway, so I might as well work on my breathing and also relaxing. I lie there and relax my body and breathe. And after a while, I’m not as stressed out, and I actually want to get up. Then I go downstairs, get my exercise (cardio every day, weight lifting every other day), have my breakfast, and get into my day.

So, I have my ways of dealing with my situation — regulate my fight-flight response and keep my heart rate in a healthy range. Strengthen both my body and my mind, and keep making continuous progress.

One thing that is throwing me off, is that I have to do this at all. Most of the people I know don’t have to go to great lengths to rise to the occasion and deal with these crisis situations. They just do it. And they adapt without a lot of apparent pain and suffering. It seems like everyone else in my group is able to adjust and “jump on it”, while I’m still struggling to just get out of bed in a proper frame of mind.

It’s a little discouraging, but I’ve got “stuff” going on with me that nobody can see, and I know how much it affects me. So, I can’t lose sight of that — of my own issues, as well as my spouse’s issues. I’ve got a lot on my plate, even when everything isn’t falling to bits around me. And when everything gets that much more “exciting”, I have to take extra steps that others seem to not have to bother with. They can skip their exercise. They can eat anything they want. They can go without more than 4 hours of sleep, night after night, and it never seems to block them. They keep on.

Of course, it only goes for so long… No matter what, the human body can only take so much abuse. But in the meantime, they’re quite unaffected and love to wax eloquent about how much abuse they’re taking, and how much they’re getting done, regardless.

It’s all a smoke-screen in many cases, of course. At least I know my limits and I know how to work around them. It’s just a little demoralizing that I have to, while others can sail along without problems — getting the favorable attention of everyone who makes decisions about promotions.

In the end, though, all I really want is to lie down in peace at the end of the day. And that’s something I can control and manage on my own. The fact that nobody else really knows I have as many problems as I do, is testament to how well I’m doing.

And I want to keep it that way.

Because letting everyone around me know how much I’m struggling isn’t good for my career prospects, position on my team, or my life in general.

Just keep on… keep on…

Onward.

Taking care of what needs taking care of

fairground ride spinning wildly
The ride’s getting rough – when can I get off?

Life is pretty crazy for me, right now. And it’s not going to get less crazy, anytime soon.

So, I need to create systems for myself… and stick with them.

I’ve got a pretty good system down for getting to bed at a decent hour. I just need to work on my ability to get as much sleep as I need.

Last weekend, I lost a day to socializing — a day I usually spend catching up with myself, my chores, my sleep. I spent the afternoon with some friends, instead of taking care of myself and catching up on my sleep. I really feel it now. They want to get together this coming Saturday, but I just can’t do it. Frankly, we spent the whole time discussing one person’s dysfunctional life — which has been caused by poor decision-making. It was very stressful to listen to, because they just weren’t all that coherent — and they were constantly apologizing for it, rather than doing something about it.

Plus, we were meeting in a Starbucks in a busy part of town, so there was constant noise, constant foot traffic, constant interruption, which made it hard for me to hear and also concentrate. It was exhausting to be honest. And there was an hour drive to and from – both directions.

That sort of activity doesn’t work for me. If I’m going to spend time on anything, it needs to be productive and beneficial for me, not just everyone else. I didn’t enjoy myself that much, to be honest. It was fine to be social, but then again, I get that at work, each day — way too much, each day, to be honest. When the weekend comes, I just want to drop.

Literally.

So, this coming weekend, I’m doing just that — dropping. I’ve told them I can’t make it, and I need to stick with that. I have so little time to myself, I can’t spend what little I have on people who offer me nothing in return.

Anyway, I need to sort out my systems. Get myself on a better schedule with work. Take things a bit at a time, and plan things better in advance. I have a bunch of stuff I need to do with my house — fall cleaning, getting ready for winter — and most of all, I have to take care of myself.

It’s no good pushing myself, especially over other people’s self-created problems. I’m sorry they are going through all that, but I have no patience for folks who wallow. Especially when I’m having so much trouble, myself, and am just dealing with it all.

I have been having trouble, lately. I’ve not been sleeping well. I’ve been waking up in pain from my legs and back, and then I can’t get back to sleep. I’ve been having terrible dreams about traveling and missing flights, forgetting my passport, losing track of time, feeling like I’m dying, being told I’m going to die, having people threatening to kill me. It just hasn’t been fun, lately, in my dreams. And that takes a toll on my days.

Of course, this will pass. I will figure it out. I will sort through things and find out what’s next… what’s coming down the pike. To get there, I just need to keep steady, keep focused on what’s important — and what’s not. Get my exercise — I rode my exercise bike for nearly an hour, this morning, and I lifted heavier weights, and later today I plan to swim. Eat properly — I’m eating big salads for lunch, I eat fresh fruit and a bowl of raisin bran instead of junk food to keep my energy up, and I drink about half a gallon of distilled water each day. Take care of my body, so I have the strength and stamina to make it through.

And I will make it through. I have my dark moments, with pauses of silent tears when no one is around and I can let down my defenses. But that’s all part of it, I suppose. There’s so much going on, I’m overwhelmed and terribly uncertain about my spouse’s and my future. I don’t know if I’m up to the challenge of caring for them, as they age in the coming years. I don’t know if I’m up to the challenge of interacting with all the doctors and various providers we deal with. Plus, my spouse’s PCP died last weekend, and he was the one who really kept them going, kept them motivated, and believed in them. Now we have to find another doctor … and that’s a big source of concern with me.

We just need to take things one at a time and figure it out as we go. Some things you can’t plan for. So, I need to keep strong and flexible, for those times when an emergency comes up, or I get hit by the unexpected.

That means sleeping. It means eating right. It means exercising religiously. Treating my body like my best friend, which it is, really.

One thing at a time, one day at a time… it’ll happen.

Onward.

From Ken Collins – What is a Brain Injury –or- What 40 years living with a brain injury has taught me.

injured_brainWhen we injure our brain, we injure an important part of our body.

Our brains control our ability to think, talk, move, and breathe. In addition to being responsible for our senses, emotions, memory, and personality, our brain allows every part of our body to function even when we’re sleeping.

The brain can be hijacked by the limbic system after our brain injuries as outlined in this source:

Wikipedia: Amygdala hiijacking – Amygdala hijack is a term coined by Daniel Goleman in his 1996 book Emotional Intelligence: Why It Can Matter More Than IQ.[1] Drawing on the work of Joseph E. LeDoux, Goleman uses the term to describe emotional responses from people which are immediate and overwhelming, and out of measure with the actual stimulus because it has triggered a much more significant emotional threat.[2]

From the thalamus, a part of the stimulus goes directly to the amygdala while another part is sent to the neocortex or “thinking brain”. If the amygdala perceives a match to the stimulus, i.e., if the record of experiences in the hippocampus tells the amygdala that it is a fight, flight or freeze situation, then the amygdala triggers the HPA (hypothalamic-pituitary-adrenal) axis and hijacks the rational brain. This emotional brain activity processes information milliseconds earlier than the rational brain, so in case of a match, the amygdala acts before any possible direction from the neocortex can be received. If, however, the amygdala does not find any match to the stimulus received with its recorded threatening situations, then it acts according to the directions received from the neo-cortex. When the amygdala perceives a threat, it can lead that person to react irrationally and destructively.[3]

Goleman states that “[e]motions make us pay attention right now — this is urgent – and gives us an immediate action plan without having to think twice. The emotional component evolved very early: Do I eat it, or does it eat me?” The emotional response “can take over the rest of the brain in a millisecond if threatened.”[4]HYPERLINK “http://en.wikipedia.org/wiki/Amygdala_hijack”[5] An amygdala hijack exhibits three signs: strong emotional reaction, sudden onset, and post-episode realization if the reaction was inappropriate.[4]

Goleman later emphasized that “self-control is crucial …when facing someone who is in the throes of an amygdala hijack”[6] so as to avoid a complementary hijacking – whether in work situations, or in private life. Thus for example ‘one key marital competence is for partners to learn to soothe their own distressed feelings…nothing gets resolved positively when husband or wife is in the midst of an emotional hijacking.'[7] The danger is that “when our partner becomes, in effect, our enemy, we are in the grip of an ‘amygdala hijack’ in which our emotional memory, lodged in the limbic center of our brain, rules our reactions without the benefit of logic or reason…which causes our bodies to go into a ‘fight or flight’ response.”[8].

Understanding the role stress plays on triggering the limbic system fight or flight response is critical for people to learn about after our brain injuries.

Brain injuries are often described as either traumatic or acquired based on the cause of the injury.

Traumatic brain injury (TBI) is an insult to the brain, not of a degenerative or congenital nature, which is caused by an external physical force that may produce a diminished or altered state of consciousness, and results in an impairment of cognitive abilities or physical functioning. It can also result in the disturbance of behavioral or emotional functioning.

A TBI can affect our ability to, think and solve problems, move our body and speak, and control our behavior, emotions, and reactions.
Acquired brain injuries are caused by many medical conditions, including strokes, encephalitis, aneurysms, anoxia (lack of oxygen during surgery, drug overdose, or near drowning), metabolic disorders, meningitis, and brain tumors.

Although the causes of brain injury differs, the effects of these injuries on a person’s life are quite similar.
This is why understanding “what’s going on between our ears” is important after a brain injury to improve our quality of life and wellbeing.

Information about the role the Sympathetic Nervous System plays in the brain injury recovery process is seldom talked to us about by doctors or professionals because they only treat the symptoms.

The following information is critical to understand and has great value for people with brain injuries and their families to understand.

The Sympathetic Nervous System – “limbic system and autonomic nervous system” creates many problems people with brain injuries face during our recovery process. If people with brain injuries don’t understand the Sympathetic Nervous System and how it works – our family members and friends react to our emotions and unwittingly create more stress for us for us to deal with.

This stress triggers the “limbic system’s fight or flight response” into action.

We do not have any control over what we are reacting to because of the stress that is being generated by our emotions shuts down the thinking part of our brain – pre-frontal cortex. The stress The prefrontal cortex al

What happens next is – we react and they react, the stress builds and we lose control, get angry and have emotional meltdowns or worse.

The “limbic system” is autonomic. The fight or flight response in the limbic system has been triggered and is in control because the limbic system is in “survival mode”.

During any stressful situation our loved ones react to our “actions” and we react to theirs – which increases our stress during those hard and difficult times.

We (family members/ people with brain injuries and friends) get caught up in a reactionary mode instead of being proactive to keep the limbic system in check.

If we set up daily routines, have structure and find purpose and meaning in our lives we have a better chance of controlling stress and the situations that trigger the limbic system fight or flight response.

If we do not control the stress, our families and friends will constantly be reacting to issues we have little control over. Learning relaxation techniques like mindfulness-based stress reduction can help to stay calm so the limbic system is managed.

Mindfulness-based stress reduction can help with this and I encourage you to look this up on the internet because there is a lot to learn about this tool that can help us rebuild or lives after a brain injury.

After our brain injuries “emotional outbursts, anger, and memory issues” are an expression of the problems caused by our limbic system fight or flight response under stress. By understanding how our emotions can get out of control we will have a better understanding of why we react to things that don’t make any sense to us.

There is a reason for all this madness and by learning the role the sympathetic nervous system plays in our recovery, the better chance we have to live full and rewarding lives again – after our brain injuries! Amygdala hijack – Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Amygdala_hijack

Amygdala hijack is a term coined by Daniel Goleman in his 1996 book Emotional Intelligence: Why It Can Matter More Than IQ.

The prison of your mind | Sean Stephenson

Depression is a disease of civilization: Stephen Ilardi at TED x Emory

Turning off the Fight or Flight