Posts Tagged post traumatic stress disorder
“Social engagements became opportunities for embarrassment and ridicule, causing Melissa terrible personal conflicts. She wanted to be out among the crowds, but simultaneously felt vulnerable and frightened by them. Melissa sank into long sulks and quiet withdrawals. The invitations stopped coming and the phone rarely rang,” writes author and TBI case manager Michael Paul Mason about Melissa Felteau who sustained a brain injury in a car crash.
Anxiety can come in many colors and textures following a brain injury. It can bubble up in crowded, noisy places. It can surface when there is too much quiet — when worries seem to snowball and there is no place to hide.
What exactly are anxiety and stress?
Following a life-changing event like a brain injury, it’s normal to feel intense stress. But sometimes stress can build up and lead to anxiety. The main symptoms of anxiety are fear and worry. In turn, anxiety can cause or go hand-in-hand with other problems including:
- Difficulty concentrating
- Difficulty completing tasks
- Difficulty getting along with others
People can express anxiety in both emotional and physical ways — from being inordinately irritable to experiencing shortness of breath or feelings of panic. Anxiety becomes a significant concern when these feelings intensify to a point where they interfere with the tasks of life. Anxiety can also be a symptom or effect of post-traumatic stress disorder.
Like depression, chronic anxiety can cause low self-esteem and poor quality of life, and without treatment, symptoms can last longer or return. Anxiety is usually treated with medication and/or psychotherapy (counseling) by a trained professional. Treatment is usually quite successful, so there is little reason to delay seeking help. Here are a few strategies that people with anxiety after TBI have suggested:
- Share things that worry you with others.
- Set up a routine for your day and try to stick with it.
- Stay involved in life. Find activities that give you pleasure — ones you used to enjoy, or new ones.
- Be open to the support of others. Healthy relationships with family and friends are healing.
- Acknowledge your feelings, and then find ways to accept them. There is no shame in feeling anxious or depressed after a life-changing event like brain injury.
Learning from anxiety
Sometimes facing your darkest emotions, like anxiety and depression, can help you better understand yourself. Melissa Felteau started meditating to help combat her own anxiety and depression; she found a new clarity. “That was my biggest problem,” she says. “I realized that I was always comparing myself to my pre-injury self. I was trapped in a vicious cycle of rumination and depression.”
Six years after her injury, through meditation and mindfulness, Melissa was able to shed her anxiety and use what she had learned to help herself — and others.
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Post-Traumatic Stress Disorder (PTSD) is a condition that runs its victims down emotionally and physically. Though most frequently linked to combat veterans and sexual-assault survivors, PTSD can present itself following any traumatic experience, and that includes medical emergencies. Following a stroke and its resulting medical treatment, it is common for patients to feel overwhelmed.
According to a study published in the journal PLoS ONE in June of 2013, almost one quarter of patients who survive a stroke will suffer from PTSD. Unfortunately, it is common for the symptoms of PTSD following a stroke to go unnoticed; due to the intense nature of physical recovery, the psychological hardship associated with it can lead to increased risk for heart disease or another stroke.
What is PTSD?
After experiencing or witnessing a traumatic event, such as a medical emergency, natural disaster, or an assault, it is difficult to adjust to everyday life again. Some people may struggle with relaxing or sleeping, have flashbacks or unsettling memories, or feel constant anxiety.
This psychological reaction is common and very frustrating. The good news is that it typically diminishes, and life returns to normal over the course of weeks or months, depending on the severity of the event. If a patient is experiencing these mental health symptoms for longer than a few weeks or months, whether constant or in waves, it is possible that they may have PTSD.
Symptoms of PTSD After Stroke
It is important to know the signs and symptoms of PTSD so that you can recognize them in a patient or loved one you are caring for after a stroke. Common symptoms of PTSD include experiencing a traumatic event over and over again, having nightmares, or being unable to stop thinking about it. To add to these extremely uncomfortable experiences, victims can also feel general, unyielding anxiety and try to avoid reminders of the event that started their suffering. They can also be tortured with feelings of self-doubt or misplaced guilt after a stroke or other traumatic event, a state of hyperarousal, or feeling overly alert.
If you are worried that a patient or family member is suffering from PTSD, ask them questions such as:
- Are you having nightmares?
- How are you coping?
- How does this make you feel?
These questions can help the patient discuss their symptoms and improve the likelihood of psychological recovery.
TIA and PTSD
Transient Ischemic Attack (TIA), also known as a mini stroke, can increase the likelihood of developing PTSD because the fear of having a stroke may become overwhelming. According to a study published in the American Heart Association journal Stroke, about one third of TIA patients develop signs of PTSD. Approximately 14 percent of TIA patients also experience a drop in physical quality of life, with 6.5 percent of patients experiencing a drop in mental quality of life.
There are ways to relieve the strain of PTSD. Treatment for PTSD may include medication, psychotherapy, or both. Patients experiencing signs of PTSD should see a trained and qualified mental health professional as treatments may vary from patient to patient.
A mental health provider or psychiatrist may prescribe antidepressants to patients struggling with PTSD. Antidepressants have been shown to relieve the symptoms of anger, sadness, and overwhelming worry better than other available medications.
Sometimes referred to as “talk therapy,” psychotherapy can take place in a one-on-one capacity or in a group setting. Talk therapy is the process of speaking with a mental health professional and can encompass the discussion of PTSD symptoms alone or the effect such symptoms may be having on a patient’s life.
PTSD can sometimes wreak havoc on a person’s social, family, or professional life. To help heal the damage, a mental health professional may combine multiple forms of psychotherapy to address any and all issues a patient may be having with the aftermath of a stroke or TIA. Most often, psychotherapy lasts six to twelve weeks, but it is not unusual for it to take longer to address each patient’s symptoms and struggles. Patients are encouraged to involve family and friends in their recovery because having the extra support can improve the speed and efficiency of mental recovery from a stroke.
PTSD can plague individuals who experience or witness a traumatic event. Medical emergencies are often traumatic, so it is common for survivors of stroke to suffer from PTSD; survivors of TIA can develop PTSD because they may be scared of suffering another mini stroke or of having a full-fledged stroke.
Symptoms can be very taxing on survivors and heartbreaking for their families to see. Fortunately, there are effective treatments for PTSD, including antidepressants and talk therapy with a mental health professional. If you are experiencing PTSD, it is important that you communicate how you feel with your doctor, family, and friends, as a strong support system can help you find the relief from psychological pain that you deserve.
Brain injury and emotions
A brain injury can change the way people feel or express emotions. An individual with TBI can have several types of emotional problems.
Difficulty controlling emotions or “mood swings”
Some people may experience emotions very quickly and intensely but with very little lasting effect. For example, they may get angry easily but get over it quickly. Or they may seem to be “on an emotional roller coaster” in which they are happy one moment, sad the next and then angry. This is called emotional lability.
What causes this problem?
- Mood swings and emotional lability are often caused by damage to the part of the brain that controls emotions and behavior.
- Often there is no specific event that triggers a sudden emotional response. This may be confusing for family members who may think they accidently did something that upset the injured person.
- In some cases the brain injury can cause sudden episodes of crying or laughing. These emotional expressions or outbursts may not have any relationship to the way the persons feels (in other words, they may cry without feeling sad or laugh without feeling happy). In some cases the emotional expression may not match the situation (such as laughing at a sad story). Usually the person cannot control these expressions of emotion.
What can be done about it?
- Fortunately, this situation often improves in the first few months after injury, and people often return to a more normal emotional balance and expression.
- If you are having problems controlling your emotions, it is important to talk to a physician or psychologist to find out the cause and get help with treatment.
- Counseling for the family can be reassuring and allow them to cope better on a daily basis.
- Several medications may help improve or stabilize mood. You should consult a physician familiar with the emotional problems caused by brain injury.
What family members and others can do:
- Remain calm if an emotional outburst occurs, and avoid reacting emotionally yourself.
- Take the person to a quiet area to help him or her calm down and regain control.
- Acknowledge feelings and give the person a chance to talk about feelings.
- Provide feedback gently and supportively after the person gains control.
- Gently redirect attention to a different topic or activity.