Posts Tagged emotions

[WEB SITE] TBI and PTSD: Navigating the Perfect Storm – BrainLine

Marilyn Lash, MSW, Brain Injury Journey magazine
TBI and PTSD: Navigating the Perfect Storm

So often people talk about the effects of traumatic brain injury or the consequences of post-traumatic stress disorder as separate conditions — which they are. But for the person who is living with the dual diagnosis of TBI and PTSD, it can be hard to separate them.

Just as meteorologists predict “the perfect storm” when unusual and unprecedented conditions move in to create catastrophic atmospheric events, so can the combination of PTSD and TBI be overpowering and destructive for all in its path. The person with TBI and PTSD is living in a state unlike anything previously experienced. For the family, home is no longer the safe haven but an unfamiliar front with unpredictable and sometimes frightening currents and events.

While awareness of PTSD has greatly increased with recently returning service members and veterans, it is not new and nor limited to combat. Anyone — children, adolescents, adults, elderly — who is exposed to a life-threatening trauma can develop PTSD. Car crashes, shootings, floods, fires, assaults, or kidnapping can happen to anyone anywhere. But the rate of PTSD after brain injury is much higher in veterans than civilians due to their multiple and prolonged exposure to combat. According to O’Connor and Drebing, it is estimated that up to 35% of returning veterans with mild brain injury also have PTSD.

What’s unique about PTSD?

Symptoms of PTSD include:

  • Unwanted and repeated memories of the life-threatening event
  • Flashbacks where the event is relived and person temporarily loses touch with reality
  • Avoidance of people, places, sights, or sounds that are reminders
  • Feelings of detachment from people, even family, and emotional numbness
  • Shame about what happened and was done
  • Survivor guilt with loss of friends or comrades
  • Hypervigilance or constant alertness for threats.

Individuals with PTSD are at increased risk for depression, physical injuries, substance abuse, and sleep problems, which in turn can affect thoughts and actions. These risk factors also occur with brain injury.

PTSD is a mental disorder, but the associated stress can cause physical damage. TBI is a neurological disorder caused by trauma to the brain. It can cause a wide range of impairments and changes in physical abilities, thinking and learning, vision, hearing, smell, taste, social skills, behaviors, and communication. The brain is so complex, the possible effects of a traumatic injury are extensive and different for each person.

When PTSD and TBI coexist, it’s often difficult to sort out what’s going on. Changes in cognition such as memory and concentration, depression, anxiety, insomnia, and fatigue are common with both diagnoses. One basically feeds and reinforces the other, so it’s a complicated mix — it’s the perfect storm. It may help to consider and compare changes commonly seen with TBI and PTSD.

Memory

TBI: A period of amnesia for what went on just before (retrograde amnesia) or after (anterograde amnesia) the injury occurred is common. The length of time (minutes, hours, days, or weeks) of amnesia is an indicator of the severity of the brain injury. For example, the person may have no memory of what happened just before or after the car crash or IED explosion.

PTSD: In contrast, the person with PTSD is plagued and often haunted by unwanted and continuing intrusive thoughts and memories of what happened. The memories keep coming at any time of day or night in such excruciating detail that the person relives the trauma over and over again.

Sleep

TBI: Sleep disorders are very common after brain injury. Whether it is trouble falling asleep, staying asleep, or waking early, normal sleep patterns are disrupted, making it hard to get the restorative rest of sleep so badly needed.

PTSD: The mental state of hypervigilance interferes with slowing the body and mind down for sleep. Nightmares are so common with PTSD that many individuals dread going to bed and spend long nights watching TV or lying on the couch to avoid the night’s terrors. Waking up with night sweats so drenching that sheets and clothing are soaked. Flashbacks so powerful that bed partners have been struck or strangled while sleep battles waged.

Isolation

TBI: Many survivors of TBI recall the early support and visits of friends, relatives, and coworkers who gradually visited or called less often over time. Loss of friends and coworkers leads to social isolation, one of the most common long-term consequences of TBI.

PTSD: The isolation with PTSD is different as it is self-imposed. For many it is simply too hard to interact with people. The feeling of exposure outside the safe confines of the house is simply too great. The person may avoid leaving the house as a way of containing stimuli and limiting exposure to possible triggers of memories. As a result, the individual’s world becomes smaller and smaller.

Emotions

TBI: When the areas of the brain that control emotions are damaged, the survivor of a TBI may have what is called “emotional lability.” This means that emotions are unpredictable and swing from one extreme to the other. The person may unexpectedly burst into tears or laughter for no apparent reason. This can give the mistaken impression that the person is mentally ill or unstable.

PTSD: Emotional numbness and deadened feelings are a major symptom of PTSD. It’s hard for the person to feel emotions or to find any joy in life. This emotional shutdown creates distance and conflicts with spouses, partners and children. It is a major cause of loss of intimacy with spouses.

Fatigue

TBI: Cognitive fatigue is a hallmark of brain injury. Thinking and learning are simply harder. This cognitive fatigue feels “like hitting the wall,” and everything becomes more challenging. Building rest periods or naps into a daily routine helps prevent cognitive fatigue and restore alertness.

PTSD: The cascading effects of PTSD symptoms make it so difficult to get a decent night’s sleep that fatigue often becomes a constant companion spilling over into many areas. The fatigue is physical, cognitive, and emotional. Feeling wrung out, tempers shorten, frustration mounts, concentration lessens, and behaviors escalate.

Depression

TBI: Depression is the most common psychiatric diagnosis after brain injury; the rate is close to 50%. Depression can affect every aspect of life. While people with more severe brain injuries have higher rates of depression, those with mild brain injuries have higher rates of depression than persons without brain injuries.

PTSD: Depression is the second most common diagnosis after PTSD in OEF and OIF veterans. It is very treatable with mental health therapy and/or medication, but veterans in particular often avoid or delay treatment due to the stigma of mental health care.

Anxiety

TBI: Rather than appearing anxious, the person acts as if nothing matters. Passive behavior can look like laziness or “doing nothing all day,” but in fact it is an initiation problem, not an attitude. Brain injury can affect the ability to initiate or start an activity; the person needs cues, prompts, and structure to get started.

PTSD: Anxiety can rise to such levels that the person cannot contain it and becomes overwhelmed by feelings of panic and stress. It may be prompted by a specific event, such as being left alone, or it can occur for no apparent reason, but the enveloping wave of anxiety makes it difficult to think, reason or act clearly.

Talking about the Trauma

TBI: The person may retell an experience repetitively in excruciating detail to anyone who will listen. Such repetition may be symptomatic of a cognitive communication disorder, but it may also be due to a memory impairment. Events and stories are repeated endlessly to the frustration and exasperation of caregivers, friends, and families who have heard it all before.

PTSD: Avoidance and reluctance to talk about the trauma of what was seen and done is a classic symptom of PTSD, especially among combat veterans.

Anger

TBI: Damage to the frontal lobes of the brain can cause more volatile behavior. The person may be more irritable and anger more easily, especially when overloaded or frustrated. Arguments can escalate quickly, and attempts to reason or calm the person are often not effective.

PTSD: Domestic violence is a pattern of controlling abusive behavior. PTSD does not cause domestic violence, but it can increase physical aggression against partners. Weapons or guns in the home increase the risks for family members. Any spouse or partner who feels fearful or threatened should have an emergency safety plan for protection.

Substance Abuse

TBI: The effects of alcohol are magnified after a brain injury. Drinking alcohol increases the risks of seizures, slows reactions, affects cognition, alters judgment, interacts with medications, and increases the risk for another brain injury. The only safe amount of alcohol after a brain injury is none.

PTSD: Using alcohol and drugs to self-medicate is dangerous. Military veterans drink more heavily and binge drink more often than civilian peers. Alcohol and drugs are being used often by veterans to cope with and dull symptoms of PTSD and depression, but in fact create further problems with memory, thinking, and behavior.

Suicide

TBI: Suicide is unusual in civilians with TBI.

PTSD: Rates of suicide have risen among veterans of OEF and OIF. Contributing factors include difficult and dangerous nature of operations; long deployments and multiple redeployments; combat exposure; and diagnoses of traumatic brain injury, chronic pain, post-traumatic stress disorder, and depression; poor continuity of mental health care; and strain on marital and family relationships. Veterans use guns to commit suicide more frequently than civilians.

Summary

There is no easy “either/or” when it comes to describing the impact of TBI and PTSD. While each diagnosis has distinguishing characteristics, there is an enormous overlap and interplay among the symptoms. Navigating this “perfect storm” is challenging for the survivors, the family, the caregivers, and the treatment team. By pursuing the quest for effective treatment by experienced clinicians, gathering accurate information, and enlisting the support of peers and family, it is possible to chart a course through the troubled waters to a safe haven.

References:

O’Connor, M. & Drebing, C. (2011). Veterans and Brain Injury. In Living Life Fully after Brain Injury: A workbook for survivors, families and caregivers, Eds. Fraser, Johnson & Bell. Youngsville, NC: Lash & Associates Publishing/Training, Inc.

Ehde, D. & Fann, J. (2011). Managing Depression, Anxiety, and Emotional Challenges. In Living Life Fully after Brain Injury: A workbook for survivors, families and caregivers, Eds. Fraser, Johnson & Bell. Youngsville, NC: Lash & Associates Publishing/Training, Inc.

Posted on BrainLine March 7, 2013. Reviewed July 26, 2018.

 

via TBI and PTSD: Navigating the Perfect Storm | BrainLine

, , , , , , , , , , , ,

Leave a comment

[WEB PAGE] Dopamine vs. serotonin: Similarities, differences, and relationship

By Jamie Eske, Reviewed by 

Dopamine and serotonin are chemical messengers, or neurotransmitters, that help regulate many bodily functions. They have roles in sleep and memory, as well as metabolism and emotional well-being.

People sometimes refer to dopamine and serotonin as the “happy hormones” due to the roles they play in regulating mood and emotion.

They are also involved in several mental health conditions, including low mood and depression.

Dopamine and serotonin are involved in similar bodily processes, but they operate differently. Imbalances of these chemicals can cause different medical conditions that require different treatments.

In this article, we look at the differences between dopamine and serotonin, their relationship, and their links with medical conditions and overall health.

What is dopamine?

a young woman sat on her bed wondering if its dopamine or serotonin thats helping her feel so awake this morning.

Dopamine and serotonin play an important role in sleep and emotional well-being.

Neurons in the brain release dopamine, which carries signals between neurons.

The body uses dopamine to create chemicals called norepinephrine and epinephrine.

Dopamine plays an integral role in the reward system, a group of brain processes that control motivation, desire, and cravings.

Dopamine levels also influence the following bodily functions:

  • mood
  • sleep
  • learning
  • movement
  • alertness
  • blood flow
  • urine output

What is serotonin?

Serotonin is another neurotransmitter present in the brain.

However, more than 90% of the body’s total serotonin resides in the enterochromaffin cells in the gut, where it helps regulate the movement of the digestive system.

In addition to aiding digestion, serotonin is involved in regulating:

  • the sleep-wake cycle
  • mood and emotions
  • metabolism and appetite
  • cognition and concentration
  • hormonal activity
  • body temperature
  • blood clotting

Differences between dopamine and serotonin

Although both dopamine and serotonin relay messages between neurons and affect mood and concentration, they have some other distinct functions.

Dopamine, for example, relays signals between neurons that control body movements and coordination.

This neurotransmitter also plays a role in the brain’s pleasure and reward center, and it drives many behaviors. Eating certain foods, taking illicit drugs, and engaging in behaviors such as gambling can all cause dopamine levels in the brain to spike.

Higher levels of dopamine can lead to feelings of euphoria, bliss, and enhanced motivation and concentration. Therefore, exposure to substances and activities that increase dopamine can become addictive to some people.

Like dopamine, serotonin can also influence people’s moods and emotions, but it helps regulate digestive functions such as appetite, metabolism, and gut motility.

The relationship between dopamine and serotonin

nicotine withdrawal in stressed and tired man

Overproduction of dopamine may lead to impulsive behavior.

They interact with and affect each other to maintain a careful chemical balance within the body. There are strong links between the serotonin and dopamine systems, both structurally and in function.

In some cases, serotonin appears to inhibit dopamine production, which means that low levels of serotonin can lead to an overproduction of dopamine. This may lead to impulsive behavior, due to the role that dopamine plays in reward seeking behavior.

Serotonin inhibits impulsive behavior, while dopamine enhances impulsivity.

Dopamine and serotonin have opposite effects on appetite; whereas serotonin suppresses it, low levels of dopamine can stimulate hunger.

Which conditions have links to dopamine and serotonin?

Having abnormal levels of either dopamine or serotonin can lead to several different medical conditions.

Both neurotransmitters can affect mood disorders such as depression. Imbalances can also result in distinct conditions that affect different bodily functions.

In the sections below, we cover these conditions in more detail:

Dopamine

Having too much or too little dopamine can impair communication between neurons and lead to the development of physical and psychological health conditions.

Dopamine deficiency may play a significant role in the following conditions and symptoms:

Dopamine also plays a role in motivation and reward driven behaviors.

Although dopamine alone may not directly cause depression, having low levels of dopamine may cause specific symptoms associated with depression.

These symptoms can include:

  • lack of motivation
  • difficulty concentrating
  • feelings of hopelessness and helplessness
  • loss of interest in previously enjoyable activities

The SLC6A3 gene provides instructions for creating the dopamine transporter protein. This protein transports dopamine molecules across neuron membranes.

A medical condition known as dopamine transporter deficiency syndrome, or infantile parkinsonism-dystonia, occurs when mutations in the SLC6A3 gene affect how the dopamine transporter proteins function.

Dopamine transporter deficiency syndrome disrupts dopamine signaling, which impacts the body’s ability to regulate movement.

For this reason, dopamine transporter deficiency syndrome produces symptoms similar to those of Parkinson’s disease, including:

  • tremors, spasms, and cramps in the muscles
  • difficulty eating, swallowing, speaking, and moving
  • impaired coordination and dexterity
  • involuntary or abnormal eye movements
  • decreased facial expression, or hypomimia
  • difficulty sleeping
  • frequent pneumonia infections
  • digestive problems, such as acid reflux and constipation

Serotonin

a man smiling when his daughter greets him with a touch on the shoulder.

Genetics and family history may contribute to a person’s risk of developing a mood disorder.

Similar to dopamine, researchers have linked abnormal levels of serotonin with several medical conditions, especially mood disorders such as depression and anxiety.

Contrary to popular belief, it appears that low serotonin does not necessarily cause depression. Multiple factors beyond biochemistry contribute to depression, such as:

  • genetics and family history
  • lifestyle and stress levels
  • environment
  • additional medical conditions

That said, having low serotonin levels may increase a person’s risk of developing depression. Serotonin medications — such as selective serotonin reuptake inhibitors (SSRIs), which increase the availability of serotonin in the brain — may also help treat depression.

SSRI medications include:

On the other hand, having too much serotonin can lead to a potentially life threatening medical condition called serotonin syndrome.

Serotonin syndrome, or serotonin toxicity, can occur after taking too much of a serotonergic medication or taking multiple serotonergic medications at the same time.

The Food and Drug Administration (FDA) provided a list of serotonergic medications in 2016. Aside from SSRIs, some of these include:

  • serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor)
  • tricyclic antidepressants (TCAs), such as desipramine (Norpramin) and imipramine (Tofranil)
  • certain migraine medications, including almotriptan (Axert) and rizatriptan (Maxalt)

According to the FDA, opioid pain relievers can interact with serotonergic medications, which can lead to a buildup of serotonin or enhance its effects in the brain.

Summary

The neurotransmitters dopamine and serotonin regulate similar bodily functions but produce different effects.

Dopamine regulates mood and muscle movement and plays a vital role in the brain’s pleasure and reward systems.

Unlike dopamine, the body stores the majority of serotonin in the gut, instead of in the brain. Serotonin helps regulate mood, body temperature, and appetite.

Having too much or too little of either neurotransmitter can cause psychological and physical symptoms.

via Dopamine vs. serotonin: Similarities, differences, and relationship

, , , , , , , ,

Leave a comment

[BLOG POST] 7 Common Behavioral Effects of Brain Injury and How to Deal With Them – Jumbledbrain

A brain injury can have various physical, cognitive, medical, emotional, and behavioral effects on head injury survivors. Of these changes, behavioral changes can be one of the most challenging for survivors to overcome to live happier and more independently. To help survivors with traumatic brain injury (TBI), families and caregivers should learn to understand their behavior and develop practical ways to address those challenges.

Why Does Brain Injury Affect Emotions?

Behavioral problems following TBI are often the result of damage to the frontal lobe, the area of the brain that controls “executive functions.” Executive functions refer to the set of skills a person uses to plan, create, evaluate, organize, evaluate, reason, communicate, and solve problems. These impairments have a significant impact on how a person behaves.

Common Behavioral Changes Experienced by TBI Survivors

Human behavior is complex and multi-faceted. This means it can be difficult to isolate which behavior is a result of TBI. A TBI patient’s behavior is, after all, influenced by many different factors, like the nature of the injury, their pre- and post-injury experience, their cognitive abilities, or the behavior of other people. But some of the most common behavior changes encountered by TBI survivors include:

1. Memory Problems

Most people diagnosed with a brain disorder may experience memory problems, but they are more common among TBI survivors as a result of an injury from the bony protrusions inside the skull. Typical situations include forgetting a person’s name, losing a train of thought, and difficulty learning new things.

2. Temper Outbursts

Family members of people with TBI often describe their loved one as someone with a quick temper. They may use bad language, throw objects, or slam doors. Drastic changes like the loss of independence and inability to follow a conversation, in particular, can make a person with TBI more prone to these temper outbursts.

3. Depression

Depression among people with TBI can arise because of the struggle to adjust to disabilities and the changes to one’s role in the family and society. Symptoms of depression include feelings of worthlessness, suicidal thoughts, changes in sleep and appetite, and withdrawal from peers.

4. Poor Concentration

TBI affects a person’s attention and concentration abilities, posing a challenge to work, study, and everyday living. Poor concentration manifests itself in difficulty multitasking, following conversations, and processing information. This happens when the lateral intraparietal cortex—the region of the brain responsible for controlling attention—suffers damage.

5. Self-Centered Attitude

It’s common for TBI survivors to show signs of egocentrism. In turn, this could hamper their ability to see things from another person’s point of view which severely impact their relationship with family members, especially if they used to be a caring person. And although it is often taken for granted, the ability to understand another’s perspective is a complex cognitive skill.

6. Aggressive Behavior

Aggressive behavior following a TBI is often impulsive. A person with TBI can easily grow agitated over trivial disagreements. Experts explain that aggression that happens directly after the TBI is the result of delirium and other post-injury medications. Aggression up to three months after TBI, on the other hand, happens as a result of depression, chronic pain, and post-traumatic stress disorder.

7. Lower Sex Drive

A decreased desire or interest in sex is more common among TBI survivors than heightened libido. Disinhibited sexual behavior can be a possible effect of poor awareness and impulsivity. Changes in sexual functioning following TBI can be due to hormonal changes, medication side effects, fatigue, and movement problems.

Coping with a Loved One with Head Injury

People with TBI showing signs of these behavior problems should be evaluated by a doctor so they can receive proper treatment. On top of medical intervention, friends and family of survivors should also actively participate in rehabilitation, recovery, and advocacy.

1. Set Realistic Expectations

Brain injury has lifelong effects. It pays to understand that a person with TBI might already be trying his or her best. Every member of the family can have different abilities, skills, comfort levels, and limitations, so set small goals and acknowledge that every day is an achievement.

2. Get Involved

Behavioral problems are often hard to deal with. But try to resist the temptation of avoiding difficult situations. People with TBI could end up feeling more confused and isolated if left alone. Instead, get involved and familiarize yourself with their day-to-day routine.

3. Encourage Independence

Learning how to comfort a loved one with TBI is a must. But tread carefully: there is a fine line between caring for people and smothering them with affection. Try to instill independence and study their behavior to know the right time to provide comfort.

4. Reinforce Positive Behavior

What used to come easy to a TBI survivor may now feel extremely difficult. Reinforce positive behavior by focusing on the patient’s strengths, rather than pointing fingers or directing behavior.

5. Rediscover Preferences

Stay alert and pay attention to the wants and needs of a person with TBI. Discover new ways they can engage in activities and establish a balance between easy and difficult tasks. And always encourage them to participate, instead of assuming that their injury makes them unable to.

6. Confide with Loved Ones

Honesty is the best policy, and confiding in friends and family members can help alleviate the burden. Enlisting others for support can provide a fresh perspective and make it easier to identify triggers and how to avoid them.

7. Bounce Back Quickly

Accept that encountering behavioral problems is a part of life. Avoid getting stuck by teaching

new skills while a person is upset. Bounce back quickly from these obstacles then revisit them again later since people aren’t receptive to learning new things when they’re upset.

Other articles you may like:

Have you or a brain injury survivor you know struggled with these behavioural issues? What advice would you give to others?


Today’s article is written by Hazel Ann Westco.

Hazel Ann Westco is a start-up freelance writer. She is interested in writing blogs and articles related to legal cases mainly in personal injury and employment.  Whenever she has free time she rides her bicycle or motorcycle for a road trip. You can follow her on Twitter using her handle @AnnWestco.

via Guest post: 7 Common Behavioral Effects of Brain Injury and How to Deal With Them | Jumbledbrain

, , , , , , , , ,

Leave a comment

[WEB SITE] Epilepsy or Seizures & The Emotional Roller Coaster

My dad had his first seizure when I was 10 years old. I remember being confused by his reaction to his developing epilepsy, and my family members felt the same way. He seemed to want to ignore what had happened, and he seemed to be in a mixture of complete denial while also being aware of it and just not caring enough or wanting to be careful enough. I was terrified for him. He lived alone, and I knew that his risk of having a seizure without anyone realizing it was quite high. I hated that he wanted to blow off doctors appointments or to not follow-up on test results.

I had my first epileptic seizure last October, at age 23. You can read about my first seizure and my second seizure in my past blog posts if you’d like. Prior to my first seizure, if someone would have asked how I would respond if I were to have a seizure out of the blue, my answer would have been simple: PANIC. I’m prone to anxiety about small, trivial matters. I would have guessed that I would be terrified about my health, and that I would want to have as much testing as possible to get answers as quickly as possible. I would have guessed that I would be completely on top of my medication and avoiding risky behaviors such as drinking or not getting enough sleep (alcohol and sleep deprivation both lower the seizure threshold).  I would have guessed that I wouldn’t hesitate to accept the reality of my situation, and that if I found a medication that prevented my seizures, that I would be terrified to get off that medication even years later.

Yet, my real reaction to my seizures has been quite different. It’s now been about 8 months since I had the seizures and I’ve experienced a roller coaster of emotions, several of them I’ve experienced several times over. Fear or panic has not been my primary reaction like I would have expected. I think my friends and family members have probably been a bit surprised by my reaction. I realize that there are probably a lot of friends or family members of people with seizures and/or epilepsy who are struggling to understand why their seizure-prone loved one isn’t reacting the same way that they are. My goal for this blog post is to share the roller coaster of emotions that I have experienced and why. I’m going to run in the order that the emotions showed up for me.

After a seizure or after an epilepsy diagnosis, emotions may arise for the individual and their family that are outside of what you might expect. This explains the roller coaster of emotions that followed my post-seizure experience and what caused the emotions to come up.

 

Confusion. When I first “came to” after my seizure my first reaction was confusion. I felt like I had been sleeping for HOURS and was waking up mid-dream. So, it was confusion but not a logical, well thought out confusion but instead just a really surface level “hmm that seems odd” type confusion.

(emotional) numbness: Once I was at the hospital, I remember realizing that others (Ryan, my mom, etc) were quite worried about me. Everyone seemed serious and concerned. This was mildly confusing to me because I was still in a “foggy” mental state and the reality of what had happened hadn’t hit me yet.

Exhaustion: Despite having felt like I had been asleep for hours when I first “came to”, I was still exhausted afterwards. I did a LOT of sleeping and when I would wake up I still felt tired.

Frustration: I was hospitalized for five or six days after my second seizure and on about day three of being in the hospital I became frustrated. I was tired of being poked, prodded and of just being in the hospital in general. I was frustrated that I had so many people concerned about me because I just wanted to sleep and have time to myself to absorb what had happened and to wrap my mind around it.

Denial: After getting out of the hospital, I googled seizures and read that most of the time, doctors don’t medicate people after a single seizure because their odds of having a second seizure are fairly low (under 50%). If a person has 2 seizures within 2 year,s their odds of having a third seizure are more likely than not (over 50%) so after a second seizure medication usually is started. After being out of the hospital for a little bit I remember saying to my boyfriend “I guess I should try to accept that I ‘just’ have epilepsy. That maybe my brain just had a seizure for no apparent reason and we won’t find a cause and my brain just needs anti-epileptic medication to avoid seizing now.” I meant to suggest this as a ‘worst case scenario’ that I should try to mentally prepare for. Yet as soon as I said it, I realized by the look on his face that my boyfriend believed that to be true already. He had already accepted that my seizures weren’t just “random” and that something in my brain had changed. I was still assuming that we would find some weird answer such as an infection or illness (even though all of my testing came back normal and I had no symptoms of illness prior to, during or after the seizures). I was in denial.

Sadness. Once I realized that I didn’t have a seizure as a result of any illness, infection or other “random” cause, it started to sink in that we probably wouldn’t get answers to what had happened, and I was probably at a high risk of having more seizures if I weren’t on medication. This was hard for me to swallow and caused sadness.

Hopelessness. I was 23, childless and had been with my boyfriend for 7 years when I had my first seizure. After accepting that I was probably now dependent on seizure medication to avoid seizures, I realized that this was an important factor regarding getting pregnant, being pregnant and giving birth. Even the safest of seizure medications increase the risk of birth defects, even though the risk is fairly low (my neurologist said about 8% vs the general population being at about a 2% risk for birth defects). I also began to realize that with my father having epilepsy, and now me having seizures myself that perhaps this is somehow genetic and if I do have a healthy pregnancy and birth, I could pass the epilepsy on to my child. This is the hardest for me to handle because I love children and have always dreamed of being a mother someday. At first, I was fixated on the thought that if I have a baby while on seizure medication and then my baby has a birth defect, or I miscarry, or my child has epilepsy I would forever feel guilty. If any of those things happened, would I live in regret feeling selfish for having chosen to go ahead with having a baby knowing my risks? If that IS selfish, then isn’t the obvious unselfish thing to do be to not have children? Not having children has never really felt like an option for me. So for a while I became overwhelmed with helplessness.

Determination. After feeling hopeless for a while I realized how much I had to be thankful for. I was seizure-free since beginning medication. I have read stories of people who have completely uncontrolled seizures and I can’t even imagine how difficult that must be. I felt terrible for feeling all of these negative emotions regarding my situation when SO many others have it much, much worse. I realized that I needed to force myself to be determined to live with my seizures/epilepsy regardless of how many seizures I have or how it affects my life. Having children has been a dream of mine longer than anything else, and I realized I can’t let epilepsy take that from me no matter what.

Avoidance. It took me roughly 3 months to really wrap my mind around what had happened to me. I have always been a bit slow to accept change or big events. I have to repeat things in my mind over and over before I can find peace with them. Having seizures turned my world upside down and it took me a full three months to pick everything back up and put it back in place. During that three-month period, I was really up and down with my thoughts and feelings surrounding what had happened. I live in a small town so it’s hard to go into any store or business without seeing someone I know. My family members had posted on Facebook about my seizures (I did not) so it seemed like everyone knew what had happened. I ran into the grocery store and the bank and would be stopped by people who I only see a few times a year asking me details about what had happened. I was still trying to make sense of it myself, so I didn’t really have the ability to explain it all to other people. Sometimes I didn’t want to think about it at all, but even when I wasn’t avoiding thinking about it, I didn’t have an interest in re-hashing the details with people I am not emotionally close to. So I wanted to avoid most of the people I knew.

Loneliness. While I avoided going out in public too much to avoid having to talk about what happened, I found that this made me lonely. I needed more social interaction than I was getting, but I was afraid that venturing out into the world more would mean I had to address what happened, so I felt stuck between a rock and a hard place.

Anxiety. Both of my seizures happened at night, within an hour of falling asleep. For months (five or so?) I don’t think I laid down for bed a single time without the thought of “what if I have a seizure in 20 minutes?” crossing my mind. This made it really hard to fall asleep , and then I would start thinking about how NOT sleeping increased my odds of having a seizure (sleep deprivation) which increased my anxiety and the cycle just kept going. A few nights I would lay in bed for over 3 hours before finally falling asleep. I also experienced anxiety when going out with my mom or my sister when my boyfriend would stay home. I knew that he handled my seizures perfectly (calling 9-1-1) but I have never really seen most other people respond to a seizure so I’m not sure if they would freeze or panic or if they’d get me help. I was particularly anxious about going with my sister because her children were only 1 and 4 and I was afraid of having a seizure in front of them as that would be traumatic for them.

Panic. Every once in a while I’d have a new “symptom” that I had never experienced before and I would panic, thinking that it might be an aura. I had read that many people with epilepsy have auras that include things like “floaters” in their vision, the smell of burning rubber, a smell of gunpowder, a metallic taste in their mouth, sudden confusion/brain fog, etc. Our apartment had a radiator style electric heater that ran along the base of our living room wall. Once a pair of waterproof gloves fell onto the heater and started to melt, and my heart started beating so quickly and I blurted out “I smell something burning! Do you smell something burning?!” and to my horror my boyfriend said no, he didn’t smell anything. I felt like I could barely breathe and my chest was tight because I was so panicked. Thankfully, my boyfriend got up and walked around and then said “Oh yeah I do smell it over here” and then found the glove so I realized it was a ‘real’ smell and not an aura.

More denial and avoidance. The last few months (5-8 months post-seizures) my primary emotions have been denial and avoidance. I feel exactly like I did before having seizures. I’ve accepted that the odds of any kind of test showing a cause for my seizures is highly unlikely. So, when it comes to making appointments at my neurologists or scheduling testing that my doctor or neurologist wants me to have, I tend to just want to avoid going. I don’t feel like the odds of the test showing anything are very high, I hate how going through with the testing makes me recall what happened, and I just don’t enjoy being at the doctors or having testing done in general. Logically I know that it makes sense to do whatever testing and appointments my neurologist feels are worthwhile, but it’s emotionally easier for me to avoid appointments and tests and just avoid having to think about seizures or epilepsy at all.

If you have had seizures, please feel free to share what emotions you’ve dealt with in the comments. Or, if you love someone with epilepsy feel free to share your emotions about the situation as well. The goal of this blog post is to increase awareness of what emotions may come along with seizures and an epilepsy diagnosis, but I’m only one person so I’m sure others out there have different experiences and emotions.

I also want to apologize if this came across as whiny or ungrateful for how lucky I have been to have seizure control while on medication, and to have very few side effects from medication. I realize that my situation could be much worse than it is, and I’m somewhat ashamed of the emotions that I’ve felt in the past (primarily hopelessness and sadness because others have it so much worse) but I wanted to be as honest as possible about my experience. My goal isn’t to whine or complain or get sympathy at all, I just want others to realize they aren’t alone and their emotions post-seizure and/or epilepsy diagnosis are normal.

Source: Epilepsy or Seizures & The Emotional Roller Coaster

, ,

7 Comments

[Poster] The Influence of Personal Emotional Awareness on Aggression After Brain Injury

The primary objective of this research was to examine the influence of alexithymia (poor emotional awareness), depression, and anxiety on aggression after traumatic brain injury (TBI). A secondary objective was to determine differences in aggression severity and prevalence in people with TBI and healthy controls (HC).

Source: The Influence of Personal Emotional Awareness on Aggression After Brain Injury – Archives of Physical Medicine and Rehabilitation

, , , , , , , ,

Leave a comment

[WEB SITE] Traumatic Brain Injury: 6 Brain Functions That Suffer Most

Traumatic brain injury most often is the result of severe external force against the head. The force is violent enough to cause brain dysfunction and disrupt necessary brain and bodily functions.

When a traumatic brain injury occurs, according to the National Institutes of Health, several brain functions are disrupted causing various degrees of damage from mild to permanent.

Traumatic brain injury can be caused by blunt force trauma or by an object piercing the brain tissue.

Symptoms may be mild and temporary, moderate, or severe. Often, the injury requires brain surgery to remove ruptured blood vessels or bruised brain tissue.

Disabilities may arise depending on the extent of damage from the traumatic brain injury.

The following six brain functions suffer the most after a traumatic brain injury, according to the Mayo Clinic:

1. Nerves

When an injury occurs at the base of the skull and damages the cranial nerves, the following complications may result:

  • Facial muscle paralysis
  • Eye nerve damage resulting in double vision
  • Loss of sense of smell
  • Vision loss
  • Loss of facial sensation
  • Problems with swallowing

2. Intellect

A traumatic brain injury, depending on the severity of damage, can cause significant changes in cognitive and executive functioning abilities including the following:

  • Memory
  • Learning
  • Reasoning
  • Mental processing speed
  • Judgment
  • Attention or concentration
  • Problem-solving skills
  • Multitasking abilities
  • Organization
  • Decision-making
  • Task initiation or completion ability

3. Communication

Traumatic brain injuries can significantly disrupt and affect cognitive and communication skills and have lasting social implications. The following communication and social problems may result from a traumatic brain injury:

  • Difficulty understanding speech or writing
  • Difficulty with speech or writing
  • Disorganized thoughts
  • Conversational confusion and awkwardnes


4. Behavior

Behavioral changes may be seen after a traumatic brain injury and may include the following:

  • Lack of self-control
  • Risky behavior
  • Self-image issues
  • Social difficulties
  • Verbal or physical outbursts

5. Emotions

Emotional changes may include the following:

  • Depression
  • Anxiety
  • Mood swings
  • Irritability
  • Lack of empathy
  • Anger
  • Insomnia and other sleep-related problems
  • Self-esteem changes

6. Sensory

Damage from a traumatic brain injury may greatly affect a person’s senses including:

  • Ringing in the ears
  • Problems with hand-eye coordination
  • Blind spots or double vision
  • Issues with taste or smell
  • Tingling, pain, or itching of the skin
  • Dizziness or vertigo
  • Object-recognition difficulties

Source: Traumatic Brain Injury: 6 Brain Functions That Suffer Most

, , , , , , , ,

Leave a comment

[BLOG Post] How to be a good friend to a brain injury survivor

BY: ALISON

During my recovery process, I distanced myself from friends, avoided social situations, and became quite isolated. Every time I heard an insensitive comment (albeit without any malicious intent) or felt pressure to meet an unrealistic expectation, I felt more and more unheard, invalidated, and misunderstood. This caused me to feel emotionally unsafe to share honest and detailed accounts of my struggles and experience. The impact of social isolation was especially hard on me, considering my previously extroverted and lively social life.

two girls hugging
photo credit: Best Friends via photopin (license)

I went from craving high energy interactions and profound conversations to avoiding eye contact and all forms of communication. However, I was lucky enough to have a few people in my life that knew how to be supportive, what not to say, and how to adjust to the changing dynamics. These people were not only incredibly helpful during my most difficult times, but they made it possible for me to reassimilate to my social life when I felt better.

The following guidelines for how you can be a good friend are based on what my friends did well, what I found effective, and how I’ve supported others through the loss of loved ones, major life changes, and other serious health problems. Keep in mind that everyone needs different types of support and that those needs change circumstantially. So when you’re with someone who’s struggling, don’t hesitate to ask them directly what they want you to say and do

#1. Set your own emotions aside

Empathy allows us to understand and feel other peoples’ physical and emotional pain. Hearing about someone else’s struggles can make us feel uncomfortable, because we become reminded of our own fears and worries. So our initial reaction is to reduce our discomfort by disengaging from what we find upsetting. In conversation, we do this by fidgeting, looking away, or changing the subject. Even statements such as, ‘I’m sure everything will work out’ when used too early in the conversation sends the message, ‘Please stop talking about this.’  That person is then much less likely to speak openly about what’s really going on, even when asked down the line.

After my injury, one particular long term friend asked me about my symptoms, but when I started describing the severe issues, his eyes glazed over, he avoided eye contact, and he froze up. I immediately changed the subject and never answered that question in detail outside of a health professional’s office again.

Disappointingly, even my brief and sugar-coated progress updates triggered similar avoidance reactions in most people. For years, I avoided talking about my injury, feared rejection, felt alone in my suffering, and lost faith in the relationships that I had, all of which had detrimental effects to my confidence. So the next time you’re listening to someone’s problems, brush your own emotions aside and remind yourself that in that moment, it’s not about you

2. Listen actively

Two women having a conversation
photo credit: DSC 0459 via photopin (license)

To show that you care and that you’re willing to listen to someone’s problems, hear what they have to say, be patient by giving them enough time to finish their thoughts, and acknowledge and respond to what they’ve said using verbal or non-verbal cues (e.g. nodding your head). Then, ask some clarifying or thoughtful questions. Considering how unhappy topics make most people uncomfortable, I could always tell whether someone was genuinely concerned about me and/or interested in learning about brain injury by the number and types of questions that they asked. Finally, end the interaction by making plans for the next call or get together, or by asking the person to update you on any major changes (positive and negative) to their situation. This implies that they can reach out to you if they need to talk to someone and that you want to celebrate their wins with them.

#3. Don’t not do anything

When someone we care about is going through a difficult time, we might feel like we don’t know what to say or do. Out of fear that we might do something wrong, we can end up doing nothing or avoiding interaction with that person altogether.

However, doing nothing makes the person feel like you don’t care, which is probably the furthest thing from the truth. So when you don’t know what to say or do, don’t be afraid to admit that. Say, ‘I am so sorry that this is happening to you. I don’t know what to say, please tell me how I can help.’ I always tell my friends and family to be honest with me if something I’m saying or doing is not helpful, so that I can change my approach and try something else.

Everyone has different needs that change depending on the situation. So be sure to ask, ‘What would be helpful right now?’ and ‘Is this helping? If not, I can try something else.’ Remember, it’s never too late to reach out. A simple, ‘I was thinking about you. How are you doing?’ can mean the world to someone who feels alone in their sadness. Just don’t take it the wrong way if they don’t respond.

#4. Don’t take it personally

'Not Now' heart shape candy
photo credit: End-of-conversation heart via photopin (license)

Throughout my recovery process, I wanted to be alone but I didn’t want to feel lonely. When I didn’t have the energy or confidence to talk to or see my friends, it made all the difference when they tried to get in touch with me. I loved hearing from people, but I felt too much anxiety and grief to reply. My most helpful friends were the ones that didn’t make me feel guilty for hiding and didn’t give up on me. These special people left voicemails or sent text messages and emails every few weeks to see how I was doing, to offer to visit, or to invite me to their homes for a quiet dinner or get together. Despite my infrequent responses and frequent declined invitations, they never gave up on me and, more importantly, they never took it personally. This reduced my fear of being misunderstood, made me feel genuinely cared for, and let me know that I had good friends to return to when I was ready. Coming out of isolation was one of the most difficult, fear and anxiety-laden aspects of my recovery, but thanks to those friends and their maintained connections, it was easier for me to bounce back and rejoin society as my symptoms subsided. So the next time you check up on someone, don’t wait to hear from them before you get in touch again. Your efforts are more appreciated than you know.

#5. Be considerate

Sign that says 'be considerate'
photo credit: No loud noises via photopin (license)

One of my barriers to socializing after a concussion had to do with limitations that healthy people would never think twice about. For example, brightly lit, crowded or noisy places wore me out and made it difficult for me to focus on conversations. Also, driving or traveling by public transit was exhausting, so I had few workable meet-up locations and times. My most understanding friends didn’t always know or understand my barriers, but they always asked. For example, they would suggest an outing and then they would follow it up with, “Would that be okay for you?” They were also willing to offer other suggestions. While hanging out, they would check in and ask me how I was feeling. At their homes, they would say, ‘Let me know if you want to take a nap.’ Those questions sound so simple, yet so few people that I know ever thought to ask them. In social situations, I was hesitant to speak up when I was approaching my limits, but thanks to my friends’ pro-active thoughtfulness and willingness to accommodate, I had fun and I wasn’t made to feel embarrassed while vocalizing my needs.

# 6. Provide long-term support

Whether it’s the death of a loved one, a serious illness such as cancer, or a brain injury, all traumas have long-term, and occasionally, life-long, effects. The more time that passes after a tragedy or accident, the less support that the survivors receive and the less likely they are to ask for help. Just because someone appears to be fully recovered doesn’t mean they are. So, even years after the incident, be sure to check in with them to open a line of communication so that they can get the support that they need.


Alison suffered a concussion in 2013 that completely changed her lifestyle. She is finding her way back to her old self and still loves traveling, dogs, cooking, and helping others. She hopes to help other brain injury survivors and their caregivers by sharing her experience and by spreading awareness

Source: How to be a good friend to a brain injury survivor

, ,

Leave a comment

[WEB SITE] Neurofatigue

Fatigue fatigue fatigue, that is what people with brain injury often experience.

Everything takes effort. The energy for the whole day is often consumed completely within two hours. There are many brain injury victims who have insomnia ón top of this all. Another group of brain injury survivors have an increased need for sleep. But the similarity is FATIGUE.

Mental fatigue is different from physical fatigue. We can all get an idea when talking about physical fatigue. Being tired after an exercise, after a brisk walk, after strenuous physical labor, after housework and so on.

Mental fatigue comes in thinking processes, learning and information processing, watching television extensively, doing computer actvities, but also solving problems, interpreting the behavior of other people and thinking logically.

A healthy person can also be mentally tired of all such functions if it is intense and long enough. Healthy people can also come to a point that they become annoyed when the “energy” is low, and especially if that mental activity was filled with noise. It seems like you cannot endure radio or TV, or something like that, anymore.

For brain injury victims that is many times worse. The mental energy has already been exhausted after a short time. They use more parts of the brain, because the dead area must be passed by, in the communication between braincells.

Neuro-fatigue is one of the most debilitating consequences of a brain injury, as it influences everything the injured person does, both physically and mentally. A person’s emotions can also become raw when they are tired.

At the beginning, the ABI survivor is likely to find out that he or she will be tired easily after any activity, even chatting to friends or watching television, but particularly after tasks that require concentration or physical effort. This can be very depressing, particularly if the individual is aware of this change.

They will often try to push themselves to complete a task in the belief that they might overcome their fatigue. This is seldom the right thing to do as it can lead to increased fatigue in long-term. It takes time to build up energy. Taking rest periods both in between activities and when feeling tired is essential.

More brain activity in brain injury patients

Continue —> Neurofatigue / Invisible consequences / Consequences | Braininjury-explanation.com

, , , , , , , ,

Leave a comment

%d bloggers like this: