Posts Tagged Stress

[Factsheet] Understanding TBI: Part 4 – The Impact of a Recent TBI on Family Members and What They Can Do To Help With Recovery – Model Systems Knowledge Translation Center (MSKTC)

Written by Thomas Novack, PhD and Tamara Bushnik, PhD in collaboration with the MSKTC

How does brain injury affect family members?

For most family members, life is not the same after TBI. We want you to know that you are not alone in what you are feeling. While everyone’s situation is a bit different, there are some common problems that many family members experience such as less time for yourself, financial difficulties, role changes of family members, problems with communication, and lack of support from other family members and friends. These are just some of the problems that family members may face after injury. Sometimes these problems can seem too much and you may become overwhelmed, not seeing any way out. Family members have commonly reported feeling sad, anxious, angry, guilty, and frustrated.

Ways to reduce stress

Since the injury, you have likely been under a great deal of stress. A little stress is part of life, but stress that goes on for a long time can have a negative effect on the mind and body.

Stress is related to medical problems such as heart disease, cancer, and stroke.

  • Stress can make you do things less well because it affects your ability to concentrate, to be organized, and to think clearly.
  • Stress also has a negative effect on your relationships with other people because it makes you irritable, less patient, and more likely to lash out at others.
  • Stress can lead to depression and/or anxiety.

If you are under constant stress, you are not going to be as helpful to your injured family member or anyone else. If you do not take the time to rest and care for yourself, you will get fewer things done, which will lead to more stress. If you won’t do this for yourself, do it for your injured family member. They will be better off if you are healthy and rested. Here are some suggestions for ways to reduce stress and stay healthy. These things have worked for many people, but not all of them may work for you. The important thing is that you begin thinking about ways to improve your life.

Learn to relax

Taking a few moments to relax can help you be more ready for the things you need to do. Learning to relax is not easy, especially in your current situation. There are relaxation techniques that can help you such as breathing deeply and focusing on your breathing, stating a word or phrase that has positive meaning (e.g. peace), or visual imagery. In order to train your body and mind to relax, you need to practice often. Don’t give up if it doesn’t work right away. If you keep practicing these techniques, you will feel more relaxed in the long run, and you will find that you’re able to function better in all areas of your life.

Learn which coping strategies work for you

No matter what was going on in your life before, the injury has caused changes. You may never have experienced anything similar to the injury, and some of your usual coping strategies may not work in your current situation. The best thing that you can do for yourself is to be open to trying new ways of coping and find out what works for you.

Some coping strategies that others have found helpful:

  • Taking time for yourself
  • Keeping a regular schedule for yourself
  • Getting regular exercise such as taking a 20-30 minute walk each day
  • Participating in support groups
  • Maintaining a sense of humor
  • Being more assertive about getting the support you need
  • Changing roles and responsibilities within the family

Learn how to reward yourself

Everyone needs something to look forward to. You’ll probably say, “I have no time; it’s impossible.” Just remember that you will be more ready to do the things you have to do if you take some time to do some things that you want to do. Even if you have very limited time, you can find some small way to reward yourself. Promise yourself a cup of your favorite coffee or an opportunity to watch a good TV show or read something you enjoy.

Problem-solving for caregivers

Sometimes you may feel overwhelmed by problems. There may be so many problems that you’re not sure which one to tackle first. You can only solve one problem at a time, so pick one. Use the problem solving steps below to find a good solution. Try to choose a smaller problem to solve first. This will give you practice and make you more confident about solving bigger problems. If you deal with problems in this way, they may seem easier to handle.

Steps in Problem Solving

  1. Identify the problem: What is the problem? Define it as clearly and specifically as possible. Remember that you can only solve one problem at a time.
  2. Brainstorm solutions: What can be done? Think of as many things as you can. Don’t worry about whether they sound silly or realistic. This is the time to think about all possibilities, even the ones that you don’t think will happen. Be creative.
  3. Evaluate the alternatives: Now you will start thinking about the consequences of the ideas you came up with in Step 2. For each idea, make a list of positives on one side of the page and a list of negatives on the other side.
  4. Choose a solution: Pick the solution with the best consequences based on your list of positives and negatives. Keep in mind that more positives than negatives is not always the best rule. Sometimes you will have one negative that outweighs many positives.
  5. Try the solution: Try out the idea you have chosen. Give it more than one chance to work. If it doesn’t work right away, try to figure out why. Was there some consequence you didn’t think of? Is there another problem in the way that could be easily solved?
  6. If your first solution doesn’t work, try another one: Don’t give up. Everything doesn’t always work out the first time. You can learn from your mistakes; they may help you to choose a better solution next time.

Ways family members can help the injured person

The treatment team can provide you with guidance in how to help the person while not giving them too much or too little assistance. Attending therapy when possible and working with the therapists and nurses are the best ways to learn to help the person before discharge from the hospital.

The following recommendations are intended to help families and caregivers care for their loved one once they have returned home. Not all of the following recommendation may apply to your situation.

Provide structure and normalcy to daily life

  • Establish and maintain a daily routine – this helps the person feel more secure in their environment.
  • Place objects the person needs within easy reach.
  • Have the person rest frequently. Don’t let the person get fatigued.
  • Be natural with the person and help them to maintain their former status in the family.
    Communication is important to the person’s recovery. Although they may not be able to speak, they should continue to be involved in as normal a social world as possible.
  • Include the person in family activities and conversations.
  • Keep a calendar of activities visible on the wall. Cross off days as they pass.
  • Maintain a photo album with labeled pictures
    of family members, friends, and familiar places.

Provide support in a respectful way

  • Try not to overwhelm the person with false optimism by saying statements like “You will be alright” or “You will be back to work in no time.
  • Point out every gain the person has made since the onset of the injury. Avoid comparing speech, language or physical abilities prior to the injury with how they are now. Look ahead and help the person to do the same.
  • Treat the person as an adult by not talking down to them.
  • Respect the person’s likes and dislikes regarding food, dress, entertainment, music, etc.
  • Avoid making the person feel guilty for mistakes and accidents such as spilling something.
  • If the person has memory problems, explain an activity as simply as possible before you begin. Then as you do the activity, review with the person each step in more detail.

Avoid over-stimulation –

Agitation can be heightened by too much activity and stimulation.

  • Restrict the number of visitors (1 or 2 at a time).
  • Not more than one person should speak at a time.
  • Use short sentences and simple words.
  • Present only one thought or command at a time and provide extra response time.
  • Use a calm, soft voice when speaking with the person.
  • Keep stimulation to one sense (hearing, visual or touch) at a time.
  • Avoid crowded places such as shopping malls and stadiums.

Safety Tips

The person who has confusion or impaired judgment may be unable to remember where dangers lie or to judge what is dangerous (stairs, stoves, medications). Fatigue and inability to make the body do what one wants can lead to injury. Therefore it is very important that a brain injured person live in an environment that has been made as safe as possible. The following are some safety guidelines to use in the home:

  • Keep clutter out of the hallway and off stairs or anywhere the person is likely to walk. Remove small rugs that could cause tripping or falls.
  • Remove breakables and dangerous objects (matches, knives, and guns).
  • Keep medications in a locked cabinet or drawer.
  • Get the doctor’s consent before giving the person over-the-counter medication.
  • Limit access to potentially dangerous areas (bathrooms, basement) by locking doors if the person tends to wander. Have the person wear an identification bracelet in case he or she wanders outside.
  • Keep the person’s bed low. If they fall out of the bed, you may want to place the mattress
    on the floor or install side rails.
  • Make sure rooms are well lit, especially in the evening. Night-lights can help prevent falls.
  • Have someone stay with the person who is severely confused or agitated.
  • Keep exit doors locked. Consider some type of exit alarm, such as a bell attached to the door.
  • Consider a mat alarm under a bedside rug to alert others if the person gets up during the night.

Things that can be more dangerous after a TBI and should be resumed only after consulting a health care professional: contact sports, horseback riding, swimming, hunting or access to firearms, power tools or sharp objects, riding recreational vehicles, and cooking without supervision.

Individuals with brain injury should receive permission from a health care professional prior to using alcohol or other substances at any point after their injury. Also, NO DRIVING until approved by your doctor.

Disclaimer

This information is not meant to replace the advice from a medical professional. You should consult your health care provider regarding specific medical concerns or treatment.

Source

Our health information content is based on research evidence whenever available and represents the consensus of expert opinion of the TBI Model Systems directors.

Our health information content is based on research evidence and/or professional consensus and has been reviewed and approved by an editorial team of experts from the TBI Model Systems.

Authorship

Understanding TBI was developed by Thomas Novack, PhD and Tamara Bushnik, PhD in collaboration with the Model System Knowledge Translation Center. Portions of this document were adapted from materials developed by the Mayo Clinic TBIMS, Baylor Institute for Rehabilitation, and from Picking up the pieces after TBI: A guide for Family Members, by Angelle M. Sander, PhD, Baylor College of Medicine (2002).

via Understanding TBI: Part 4 – The Impact of a Recent TBI on Family Members and What They Can Do To Help With Recovery | Model Systems Knowledge Translation Center (MSKTC)

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[BLOG POST] Basic Survival Guide For Caregivers – H.O.P.E TBI

Before you take your loved one home from the hospital or care facility, there are things you can do in advance to help prepare them for their transition home, and prepare YOU for one of the most important roles in your life.   Absolutely, if at all possible, spend a full few days and nights following your loved one through their routines so you can see what they are actually capable of, what their routines are, and what may be expected of you as their caregiver at home. Know that you will be burning your candle at both ends for an undetermined amount of time.

It will be important to create a notebook, binder, or file with important information that will be available to you without a lot of stress and searching.  It may even be helpful to purchase a Planner that includes daily and monthly pages to include everything on. Make a typed or written list of the following:

  • Medications needed and schedule of medications (what gets taken when)
  • Names and numbers of providers to call with questions, appointment scheduling, or emergencies
  • If your loved one has a traumatic brain injury, the name and number of the Brain Injury Association for your area, support groups available, their hours and location.
  • Write down ALL questions as you think of them.  You may have every intention of remembering them.  However, I promise you – you will remember these questions at the most inopportune times if you don’t have them written down.
  • Purchase one or more “white boards” with dry erase markers to hang up at home.  These are very handy for keeping track of all kinds of things.
  • Have a documented list of all medical equipment, supplies, toiletries, and assistive devices you may need at home for your loved one, BEFORE you bring your loved one home.  Keep in mind there will ALWAYS be something you didn’t think of at the time, learn about after the fact, or discover in your advocacy for your loved one. That’s okay, don’t be hard on yourself.
  • Have a support system in place for yourself.  Counselor, social worker, therapist, other family members willing to help, home health agency, medical case manager, etc.   Keeping yourself healthy first, will allow you to do your very best for your loved one.

So your loved one is ready to come home from the hospital.  You may feel excited, nervous, impatient, and mostly prepared.  Nothing can prepare you for all the dynamics and changes you are about to take on, other than first hand experience.  Structure is imperative.  Especially if your loved one has a traumatic brain injury. The first two weeks home will most likely be the toughest to adjust to.  Don’t get caught up in the idea that they need a “break” and no routines, schedules, or therapies.  Recovery is enhanced with structure and consistency.

You may have realized by the end of the first week that you are feeling exhausted and scattered. You may feel like maybe you weren’t ready to take this on at all.  Who is this person you brought home?  They are so different. They may be painful, irritable, demanding, and impatient. It may be hard not to take this personally.  Your time is no longer your own and you are now responsible for every aspect of this person’s safety, health, and recovery process. You may become so focused on what you should be doing next to help with all the things that need to be done that you cannot sleep or slow down your thoughts. You may be feeling like you cannot do anything right….or perhaps you realize you are doing everything right, yet your loved one is not responding in the way you were anticipating they would.  You may find yourself tiptoeing around them, being cautious of everything as each hurdle presents itself.

caregiverstrain

By the end of the second week, you are fully aware of the time commitment that is involved now.  You may be losing track of time as your days now seem to run together. You may now be thinking of a thousand things you should have asked, learned about, or prepared for BEFORE your loved one came home. You may be feeling a bit overwhelmed and may even realize that you are not able to do EVERYTHING on your own.   It’s okay, you are not alone in this realization.  You also may actually be getting a better grasp of the schedule that is going to work the best for you to survive being a caregiver, while helping your loved one progress through their recovery at this point. You will most likely be beyond exhausted and unsure how you are going to be available to your loved one and still meet the demands, responsibilities, and obligations in your own life – that exist outside of your new caregiver role.

Your loved one has gotten used to certain schedules, expectations, routines,  push to be independent and compelled to focus on their recovery  in the hospital or rehab facility and will come home expecting those same things to be in place at home.  They may feel distant, resistant, challenging, and develop unrealistic expectations about what you are able to accomplish for them both directly and indirectly.   caregiverandworkstress

Sometimes your loved one, if they have a traumatic brain injury, may have a skewed view of reality.  They may have mood changes you are not used to dealing with, have difficulty adjusting to their “new normal”, and may have difficulty accepting the changes they are now facing every moment of every day.  You may be having difficulty adjusting to the expansive and growing list of needs and accommodations they now require.

You may have become overprotective at this point. You may be able to anticipate your loved one’s needs before they even ask for it.  You may micromanage every aspect of their day.  You may also be doing things for them, that they are able to do for themselves with a little supervision or prodding. This is not not good for your loved one in the long term to have you doing EVERYTHING for them.  It is imperative that you encourage independence as much as possible.  Help them with what they need help with, of course.  However, encourage them to do as much on their own as possible.  This will take them out of their newfound “comfort zone” and will not always be successful in the first attempt. HH_SEO_Graphics_CBDon’t get angry if they attempt something and do not succeed, or if they are unable to complete something they have attempted. This effort may takes weeks, months, and in some cases years of consistent attempts for this to happen succesfully.  For some caregivers, there is no mastering this aspect of the caregiving process.  You may have a loved one who is incapable of independence.  In that situation, set small goals for yourself, for them, and partner with providers to celebrate even the littlest victories or accomplishments.  Sometimes just getting up for the day, getting bathed and dressed for the day is the best that can be accomplished that day.

It is imperative to eventually include your loved one in as many life activities as is possible.  They may not be ready for this in the first few weeks home. Consider trying to take them on very brief, small outings with you a little at a time.  Even if just to a convenience store and then back home, the library and back home.  Perhaps even just a ride around the block after getting dressed for the day can be a huge accomplishment.  You can build to other places, longer times, and more challenging things as time progresses and they are ready.  Some things to consider when leaving the house with your loved one:

  • Have a “travel bag” ready to go with you on each trip that includes their medications,  a change of clothing (maybe two changes of clothing), items that help them cope, and notebook (with pen or pencils and higlighters in different colors)
  • Have something for them to drink with you (bottled water, thermos, juice box, etc)
  • Carry ear plugs, headphones, sunglasses, lap blanket, and any other things that may help your loved one when they are away from home based on their personal needs.
  • Allow tons of extra time for getting ready to leave the house with your loved one.  Allow extra time to make it to appointments on time.  I would suggest at least an hour wiggle room. Folks with traumatic brain injuries have a real challenge with being rushed, given too many tasks at once, or last minute changes.  Even though they may make many last minute changes in their level of participation, effort, and coping ability.
  • Be prepared to turn around and go home.  You loved one may have a meltdown, panic attack, behavioral outburst you are unable to manage safely away from home, or they may feel “flooded”or voice their desire to be home NOW.  Sometimes, when they have a medical appointment, going home is not a possibility until after the appointment.  Often times, going to a medical appointment will be the only outing they can do that day.

compassionfatigueThe largest part of recovery will take place within the first two years.  However, this is not where recovery ends. Research continues to show that healing, strength, behavior, body changes, and rerouting of the brain continues – even years later.

It is common to feel sad, depressed, or disappointed if your loved one has not reached the recovery level you anticipated at the one or two year mark in their recovery.  Your loved one also may be having some struggles around this time as well.  They may have expected to be further along in their own recovery, or reliving the time of year their accident happened and comparing it to their life before their injuries.  Families often misjudge the amount of time it will take for their loved one to recover or plateau ; especially if their obvious physical injuries/fractures have healed by this time and you are unable to “see” the traumatic brain injury.

tbisurvivorcaregiver

 

[Potential Providers may include the following:  physicians, physiatrist, nurses, physical therapists, occupational therapists, speech therapists, recreational therapists, respiratory therapists, counselors, psychologists, neuropsychologist, social worker, specialists, nurse’s aids, home health aids, medical case manager, family caregivers, volunteers, and/or clergy.]

~Compiled By: Caren Robinson

 

via Basic Survival Guide For Caregivers | H.O.P.E TBI

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[WEB SITE] Researchers develop new prediction method for epileptic seizures

Epileptic seizures strike with little warning and nearly one third of people living with epilepsy are resistant to treatment that controls these attacks. More than 65 million people worldwide are living with epilepsy.

Now researchers at the University of Sydney have used advanced artificial intelligence and machine learning to develop a generalized method to predict when seizures will strike that will not require surgical implants.

Dr Omid Kavehei from the Faculty of Engineering and IT and the University of Sydney Nano Institute said: “We are on track to develop an affordable, portable and non-surgical device that will give reliable prediction of seizures for people living with treatment-resistant epilepsy.”

In a paper published this month in Neural Networks, Dr Kavehei and his team have proposed a generalized, patient-specific, seizure-prediction method that can alert epilepsy sufferers within 30 minutes of the likelihood of a seizure.

Dr Kavehei said there had been remarkable advances in artificial intelligence as well as micro- and nano-electronics that have allowed the development of such systems.

“Just four years ago, you couldn’t process sophisticated AI through small electronic chips. Now it is completely accessible. In five years, the possibilities will be enormous,” Dr Kavehei said.

The study uses three data sets from Europe and the United States. Using that data, the team has developed a predictive algorithm with sensitivity of up to 81.4 percent and false prediction rate as low as 0.06 an hour.

“While this still leaves some uncertainty, we expect that as our access to seizure data increases, our sensitivity rates will improve,” Dr Kavehei said.

Carol Ireland, chief executive of Epilepsy Action Australia, said: “Living with constant uncertainty significantly contributes to increased anxiety in people with epilepsy and their families, never knowing when the next seizure may occur.

“Even people with well controlled epilepsy have expressed their constant concern, not knowing if or when they will experience a seizure at work, school, traveling or out with friends.

“Any progress toward reliable seizure prediction will significantly impact the quality of life and freedom of choice for people living with epilepsy.”

Dr Kavehei and lead author of the study, Nhan Duy Truong, used deep machine learning and data-mining techniques to develop a dynamic analytical tool that can read a patient’s electroencephalogram, or EEG, data from a wearable cap or other portable device to gather EEG data.

Wearable technology could be attached to an affordable device based on the readily available Raspberry Pi technology that could give a patient a 30-minute warning and percentage likelihood of a seizure.

An alarm would be triggered between 30 and five minutes before a seizure onset, giving patients time to find a safe place, reduce stress or initiate an intervention strategy to prevent or control the seizure.

Dr Kavehei said an advantage of their system is that is unlikely to require regulatory approval, and could easily work with existing implanted systems or medical treatments.

The algorithm that Dr Kavehei and team have developed can generate optimized features for each patient. They do this using what is known as a ‘convolutional neural network’, that is highly attuned to noticing changes in brain activity based on EEG readings.

Other technologies being developed typically require surgical implants or rely on high levels of feature engineering for each patient. Such engineering requires an expert to develop optimized features for each prediction task.

An advantage of Dr Kavehei’s methodology is that the system learns as brain patterns change, requiring minimum feature engineering. This allows for faster and more frequent updates of the information, giving patients maximum benefit from the seizure prediction algorithm.

The next step for the team is to apply the neural networks across much larger data sets of seizure information, improving sensitivity. They are also planning to develop a physical prototype to test the system clinically with partners at the University of Sydney’s Westmead medical campus.

 

via Researchers develop new prediction method for epileptic seizures

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[WEB SITE] Learning stress-reducing techniques may benefit people with epilepsy

Learning techniques to help manage stress may help people with epilepsy reduce how often they have seizures, according to a study published in the February 14, 2018, online issue of Neurology®, the medical journal of the American Academy of Neurology.

“Despite all the advances we have made with new drugs for epilepsy, at least one-third of people continue to have seizures, so new options are greatly needed,” said study author Sheryl R. Haut, MD, of Montefiore Medical Center and the Albert Einstein College of Medicine in the Bronx, NY, and member of the American Academy of Neurology. “Since stress is the most common seizure trigger reported by patients, research into reducing stress could be valuable.”

The study involved people with seizures that did not respond well to medication. While all of the 66 participants were taking drugs for seizures, all continued to have at least four seizures during about two months before the study started.

During the three-month treatment period all of the participants met with a psychologist for training on a behavioral technique that they were then asked to practice twice a day, following an audio recording. If they had a day where they had signs that they were likely to have a seizure soon, they were asked to practice the technique another time that day. The participants filled out daily electronic diaries on any seizures, their stress level, and other factors such as sleep and mood.

Half of the participants learned the progressive muscle relaxation technique, a stress reduction method where each muscle set is tensed and relaxed, along with breathing techniques. The other participants were the control group-;they took part in a technique called focused attention. They did similar movements as the other group, but without the muscle relaxation, plus other tasks focusing on attention, such as writing down their activities from the day before. The study was conducted in a blinded fashion so that participants and evaluators were not aware of treatment group assignment.

Before the study, the researchers had hypothesized that the people doing the muscle relaxing exercises would show more benefits from the study than the people doing the focused attention exercises, but instead they found that both groups showed a benefit-;and the amount of benefit was the same.

The group doing the muscle relaxing exercises had 29 percent fewer seizures during the study than they did before it started, while the focused attention group had 25 percent fewer seizures, which is not a significant difference, Haut said. She added that study participants were highly motivated as was shown by the nearly 85 percent diary completion rate over a five-month period.

“It’s possible that the control group received some of the benefits of treatment in the same way as the ‘active’ group, since they both met with a psychologist and every day monitored their mood, stress levels and other factors, so they may have been better able to recognize symptoms and respond to stress,” said Haut. “Either way, the study showed that using stress-reducing techniques can be beneficial for people with difficult-to-treat epilepsy, which is good news.”

Haut said more research is needed with larger numbers of people and testing other stress reducing techniques like mindfulness based cognitive therapy to determine how these techniques could help improve quality of life for people with epilepsy.

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[WEB SITE] Monitor stress, seizures, activity, sleep

Embrace it’s wearable device designed to improve the lives of the people with epilepsy.

 

“Embrace is glorious in design, very sleek and attractive. Living in a world of seizure helmets and wheelchairs it is nice to have such an unobtrusive and attractive device.

 

A gorgeous smart watch for you

The case is made of strong, polished metal with either an elegant leather or an elastic fabric band. Embrace is the thinnest smart watch of this kind ever made. It snaps on, then tightens with a magnet for perfect fit. […]

Source: Monitor stress, seizures, activity, sleep

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[WEB SITE] Stress and Stress Management Post-TBI – BrainLine

Stress and Stress Management Post-TBI

Question: 

Why does stress bring back my TBI symptoms with a vengeance? It feels like a knife reopening a wound. What goes wrong in the brain after injury that makes this happen?

Answer: 

Stress occurs when there is a gap between the current task demands and the resources you have to meet those demands. Your brain interprets this as a threat. Acute stress — as in immediate physical danger — produces a physical reaction (the fight-or-flight response) that includes increased pupil dilation, perspiration, increased heart rate and blood pressure, rapid breathing, muscle tension, and increased mental alertness. However, less immediately threatening or prolonged stressors, such as ongoing money problems, too many things to get done in one day, even something like unexpected company, will produce these reactions. They may occur to a lessor degree, but ongoing stress reactions, even mild ones, will result in your body preparing for a long-term protective response.

Fatigue, concentration lapses, irritability, and lethargy result as the stress continues without relief. You probably recognize these as some of the TBI symptoms you feel coming back with a vengeance. Having experienced a TBI makes you both more susceptible to these symptoms, and these symptoms make it more difficult for you to effectively use whatever coping or compensatory strategies you may have developed to manage your TBI symptoms.

Learning to manage stress is important for all of us, and of particular importance to the recovery process after TBI. Techniques such as relaxation, time management, goal-setting, organization, cognitive-behavioral techniques, and lifestyle modifications can all be helpful in managing stress. It is recommended that you get some help and support in figuring out which of these techniques will be most useful for you from a mental health provider, a case manager, a life coach, a support group, or even a good friend if the stress levels are not overwhelming or seriously affecting your life. There are plenty of resources available for stress management, and a lot of information online, but sifting through it and tailoring it for your particular needs may be challenging without some support.

For more information on stress and stress management, click here.

Source: Stress and Stress Management Post-TBI | BrainLine

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[BLOG POST] Common Epilepsy Triggers – Epilepsy Talk

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[WEB PAGE] Stressed out? Try talking to yourself in the third person

New research shows that talking to yourself in the third person may help to relieve stress and anxiety.

From meditation to physical activity, there are various things that we can do to regain control over our emotions during stressful times. But what if there was an easier way of doing that? New research investigates the effect of talking to yourself in third person on emotion management.

A team of researchers, led by scientists from Michigan State University in East Lansing and the University of Michigan in Ann Arbor, set out to examine the neuropsychological effect of talking to oneself in the third person on controlling one’s emotions.

The researchers’ hypothesis was that talking to oneself in the same way that one would about others would provide some much-needed psychological distance, which may help to control emotions.

The new study – which is published in the journal Scientific Reports – consists of two neuroscientific experiments that tested this hypothesis.

Using an electroencephalograph

In the first experiment – which was conducted at the Clinical Psychophysiology Lab and led by Prof. Jason Moser, of Michigan State University – participants were asked to look at emotionally aversive images (for example, a man pointing a gun at their heads) and neutral images.

They were asked to view these images in both conditions: the first-person condition, and the third-person condition.

In the former, the participants asked themselves, “What am I feeling right now?” But in the latter condition, they asked themselves, “What is [participant’s name] feeling right now?”

The participants’ brain activity was monitored using an electroencephalograph.

Referring to themselves in the third person reduced the participants’ brain activity across the neural mechanisms that are known to be involved in emotional regulation – and it did so almost immediately, within 1 second.

Interestingly, the brain activity – as recorded by the electroencephalograph – did not show an increase in cognitive control markers, which suggests that the strategy is effective at managing stress in a cognitively effortless way.

Talking to oneself inside an fMRI machine

In the second experiment, participants were asked to recall emotionally distressing experiences from their past in both first-person and third-person conditions.

This time, however, their brain activity was monitored using a functional MRI (fMRI) machine.

The second experiment revealed decreased activity in the medial prefrontal cortex, an area known to be a marker for self-referential emotional processing.

So, the third-person technique decreased activity in the brain area involved in processing painful autobiographical emotional memories.

However, reinforcing the findings of the first experiment, the second experiment did not reveal increased activity in the brain network involved in the cognitive control of emotions, the frontoparietal network.

This suggested, once again, that talking to oneself in the third person may be a simple and cognitively inexpensive way of reducing negative emotions on the spot.

Essentially, we think referring to yourself in the third person leads people to think about themselves more similar to how they think about others, and you can see evidence for this in the brain. That helps people gain a tiny bit of psychological distance from their experiences, which can often be useful for regulating emotions.”

Prof. Jason Moser

“What’s really exciting here,” says the leader of the second study, Ethan Kross, of the University of Michigan, “is that the brain data from these two complementary experiments suggest that third-person self-talk may constitute a relatively effortless form of emotion regulation.”

“If this ends up being true – we won’t know until more research is done – there are lots of important implications these findings have for our basic understanding of how self-control works, and for how to help people control their emotions in daily life,” concludes Kross.

Source: Stressed out? Try talking to yourself in the third person

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[WEB SITE] Stress and Epilepsy – Epilepsy Foundation

 

  • Seizures and epilepsy affect all ages. While they tend to occur for the first time in young children or older adults, each age group has unique concerns and problems.
  • We aren’t sure just why stress may trigger a seizure.
  • While there is no definite evidence that reducing stress help seizures, a recent study showed that nearly 9 in 10 people who actively managed their stress believed it reduced their risk of seizures.
  • Try to avoid stressful situations if it makes sense to do so, and if you can avoid it.

Stress is one of the most common seizure triggers for people with epilepsy.

 

How often does stress trigger seizures?

It’s hard to know exactly how often stress triggers seizures, since stress means something different to everyone. It’s also hard to judge how much of an effect stress has on a person.

Stress comes in different forms and has a different meaning for everyone. It can come from a major life event or from more everyday activities that can potentially put us in a bad mood. Some studies have found that major life stressors, either good or bad, could affect seizures. Others have found that a build up of ‘daily hassles’ or stress seems to be more important. Since people are very different, it’s likely that stress can affect people in different ways at different times of their life.

VIDEO: Dr. Michael Privitera, MD talks about the relationship of stress and epilepsy, and an innovative new study to explore how stress reduction may also reduce seizures. 

How does stress trigger seizures?

We aren’t sure just why stress may trigger a seizure. Stress is an expected and unavoidable part of life. It is our body’s reaction to any change that requires a physical and emotional response. Stress is known to cause worry, depression, frustration and even anger. Stress may affect people in many ways. Consider the following:

  • Stress makes or releases certain hormones related to the nervous system that can impact the brain.
  • Areas of the brain important for some types of seizures, for example partial seizures, are the same areas of the brain involved in emotions and responding to stress.
  • Stress can cause problems sleeping which is also a seizure trigger.
  • Chronic stress can lead to anxiety or depression. Sleep problems are symptoms of these mood problems. Being anxious and depressed can also worsen stress, causing a vicious cycle with more seizures and mood problems.

What can I do to manage stress and prevent seizures?

While there is no definite evidence that reducing stress help seizures, a recent study showed that nearly 9 in 10 people who actively managed their stress believed it reduced their risk of seizures. Common sense tells us that if something is bothering you, see what you can do to avoid it or make it better.

Managing stress is very personal and specific to your situation; however, there are some universal activities and recommendations.

  • Use a diary and write down what’s likely to cause stress for you.
  • Try to avoid stressful situations if it makes sense to do so, and if you can avoid it! If you can’t avoid it, can you let go of the worry it’s causing you?
  • When a stressful situation is unavoidable, make sure you are doing your best to get enough sleep and take your seizure medications on time.
  • Find ways to diffuse a situation. Avoid people who cause anger and anxiety if you can. Try to approach them differently – it may help calm down the stressful situation.
  • Exercise regularly. Lots of research has shown the exercise helps lower stress.
  • Do your best to relax. Try exercise, yoga, tai chi, Pilates, a massage, cat naps, or relaxation and controlled breathing techniques.
  • Limit long naps during the day. Sleeping during the day will cause sleep problems at night and make people feel worse.
  • Keep to a daily routine. Pace yourself and take frequent breaks.
  • Set priorities for what is important in your life and let the rest go.
  • Seek help. Talk to your doctor, nurse, or counselor. Let them know what’s bothering you.
    • Make sure the epilepsy team knows that stress is affecting your seizures.
    • Seek counseling or psychotherapy. If you think you may have anxiety or depression, talk to you doctor about treatment options.
    • Join a support group or online support community. Reach out to the Epilepsy Foundation affiliate near you.
Authored by: Michael Privitera, MD | Sheryl Haut, MD | Patricia O. Shafer, RN, MN | Joseph I. Sirven, MD on 7/2013
Reviewed by: Joseph I. Sirven, MD | Patricia O. Shafer, RN, MN on 3/2014

Source: Stress and Epilepsy | Epilepsy Foundation

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[WEB SITE] UC study explores how low risk stress reduction treatments may benefit epilepsy patients

Patients with epilepsy face many challenges, but perhaps the most difficult of all is the unpredictability of seizure occurrence. One of the most commonly reported triggers for seizures is stress.

A recent review article in the European journal Seizure, by researchers at University of Cincinnati Epilepsy Center at the UC Gardner Neuroscience Institute, looks at the stress-seizure relationship and how adopting stress reduction techniques may provide benefit as a low risk form of treatment.

The relationship between stress and seizures has been well documented over the last 50 years. It has been noted that stress can not only increase seizure susceptibility and in rare cases a form of reflex epilepsy, but also increase the risk of the development of epilepsy, especially when stressors are severe, prolonged, or experienced early in life.

“Studies to date have looked at the relationship from many angles,” says Michael Privitera, MD, director of the UC Epilepsy Center and professor in the Department of Neurology and Rehabilitation Medicine at the UC College of Medicine. “The earliest studies from the 1980s were primarily diaries of patients who described experiencing more seizures on ‘high-stress days’ than on ‘low-stress days.'”

Privitera and Heather McKee, MD, an assistant professor in the Department of Neurology and Rehabilitation Medicine, looked at 21 studies from the 1980s to present–from patients who kept diaries of stress levels and correlation of seizure frequency, to tracking seizures after major life events, to fMRI studies that looked at responses to stressful verbal/auditory stimuli.

“Most all [of these studies] show increases in seizure frequency after high-stress events. Studies have also followed populations who have collectively experienced stressful events, such as the effects of war, trauma or natural disaster, or the death of a loved one,” says Privitera. All of which found increased seizure risk during such a time of stress.

For example, a 2002 study evaluated the occurrence of epileptic seizures during the war in Croatia in the early 1990s. Children from war-affected areas had epileptic seizures more often than children not affected by the war. Additionally, the 10-year follow up showed that patients who had their first epileptic seizure during a time of stress were more likely to have controlled epilepsy or even be off medication years later.

“Stress is a subjective and highly individualized state of mental or emotional strain. Although it’s quite clear that stress is an important and common seizure precipitant, it remains difficult to obtain objective conclusions about a direct causal factor for individual epilepsy patients,” says McKee.

Another aspect of the stress-seizure relationship is the finding by UC researchers that there were higher anxiety levels in patients with epilepsy who report stress as a seizure precipitant. The researchers suggest patients who believe stress is a seizure trigger may want to talk with their health care provider about screening for anxiety.

“Any patient reporting stress as a seizure trigger should be screened for a treatable mood disorder, especially considering that mood disorders are so common within this population,” adds McKee.

The researchers report that while some small prospective trials using general stress reduction methods have shown promise in improving outcomes in people with epilepsy, large-scale, randomized, controlled trials are needed to convince both patients and providers that stress reduction methods should be standard adjunctive treatments for people with epilepsy.

“What I think some of these studies point to is that efforts toward stress reduction techniques, though somewhat inconsistent, have shown promise in reducing seizure frequency. We need future research to establish evidence-based treatments and clarify biological mechanisms of the stress-seizure relationship,” says Privitera.

Overall, he says, recommending stress reduction methods to patients with epilepsy “could improve overall quality of life and reduce seizure frequency at little to no risk.”

Some low risk stress reduction techniques may include controlled deep breathing, relaxation or mindfulness therapy, as well as exercise, or establishing routines.

Source: UC study explores how low risk stress reduction treatments may benefit epilepsy patients

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