Posts Tagged Suicide

[WEB PAGE] True or False? Seven Common Myths About Brain Injury

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By Kellie Pokrifka, Member, Brain Injury Association of America Advisory Council

There is so much misinformation regarding brain injury floating around on the internet. Research in this field is progressing every day, and we frequently disprove old theories. It can be difficult to keep up with the latest research, so let’s take a few minutes to dispel some of the most common myths regarding brain injury.

Myth: You can always see brain injury on CT and MRI scans.

CT and MRI scans are looking for brain bleeds, skull fractures, and other acute trauma. Not all brain injuries, and especially not concussions, will appear on these scans. A clear CT or MRI does not eliminate the possibility that you have a brain injury.

Myth: Two years after brain injury, no further recovery can be made.

Many people assert that recovery from brain injury is only possible within the first year or two. We now know that is incorrect. Following the first nine months of recovery, time is no longer an indicator of recovery. What matters after this point is finding the proper therapies for your symptoms. Doing the right activities 50 years post-injury has the same chance of recovery as receiving proper treatment nine months out. Improvements in your recovery are always possible.

Myth: Concussions are not serious.

Concussion is a form of mild traumatic brain injury (TBI). “Getting your bell rung” or “seeing stars” are never things to ignore – they are signs of brain injury. Concussions are described as “mild” brain injury because they not usually life-threatening, but this does not mean they are not serious. While many people will fully recover after two weeks, a percentage of patients will have lifelong symptoms following a concussion.

Myth: Individuals with brain injury don’t think about suicide.

Unfortunately, suicide is not an uncommon occurrence after brain injury. Nearly one in five brain injury survivors admit to suicidal ideation, plans, or attempts in the five-year period following injury. In the general population, that statistic goes down to one in twenty-five. Extreme life changes and organic changes in the brain after TBI can increase the chances of suicide. Because of this increased risk, it is important for medical teams and loved ones to address this subject. Being open and honest about this tough conversation can save a life and help connect your loved one with proper resources. If you need help, you can call the suicide hotline at 1-800-273-8255.

Myth: Only athletes get concussions.

Concussions are not only a problem for athletes; concussions, like other TBIs, can happen anywhere, at any time, and to anyone. TBI is a common result of motor vehicle accidents, falls (particularly in elderly and child populations), military action or blast exposure, intimate partner violence, abuse, gunshot wounds, and other physical trauma.

Myth: If someone has sustained a concussion, you should wake them up every hour for the next day.

There is no need to keep someone awake for 24 hours after a concussion. Sleep is critical for brain injury recovery. If the person has been cleared by a professional for brain bleeds and acute trauma, restful sleep is safe and is crucial for recovery.

Myth: You should not be exposed to any stimulation that may trigger symptoms until you are completely recovered.

It used to be common practice to protect patients with brain injury by placing them in silent, dark rooms for weeks or months until symptoms subsided. However, the “rest and wait” approach is no longer an appropriate recovery plan and can actually worsen symptoms. Many experts even suggest light, controlled exercise within 72 hours of sustaining a concussion. As always, consult your doctor before making any changes to your recovery plan.

References

  1. “Brain Scans for Head Injuries.” Choosing Wisely, American Medical Society for Sports Medicine, 2018, www.choosingwisely.org/patient-resources/brain-scans-for-head-injuries/.
  2. Horn, Gordon & Lewis, Frank. (2013). Analysis of Post-Hospital Neurological Rehabilitation Outcomes. Journal of Head Trauma Rehabilitation. 28. E53-E54.
  3. Leddy, John J et al. “Exercise is Medicine for Concussion.” Current sports medicine reports vol. 17,8 (2018): 262-270. doi:10.1249/JSR.0000000000000505
  4. “Misconceptions about Sleep and Concussions.” ReThink Concussions, UPMC Life Changing Medicine, 2015, rethinkconcussions.upmc.com/concussion-sleep-myth.
  5. Schwartz-Lifshitz, Maya et al. “Can we really prevent suicide?” Current psychiatry reports vol. 14,6 (2012): 624-33. doi:10.1007/s11920-012-0318-3.
  6. Sports Medicine. “Concussion and Loss of Consciousness.” UPMC HealthBeat, 29 Aug. 2018, share.upmc.com/2015/04/concussion-and-loss-of-consciousness/.

This article originally appeared in Volume 14, Issue 1 of THE Challenge! published in 2020.

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[WEB SITE] Depression Overview: Emotional Symptoms, Physical Signs, and More – WebMD

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[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.

 

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[WEB PAGE] Chemical imbalance in the brain: Myths and facts

Everything you need to know about chemical imbalances in the brain

Last reviewed 

A chemical imbalance in the brain occurs when a person has either too little or too much of certain neurotransmitters.

Neurotransmitters are the chemical messengers that pass information between nerve cells. Examples of neurotransmitters include serotonin, dopamine, and norepinephrine.

People sometimes call serotonin and dopamine the “happy hormones” because of the roles that they play in regulating mood and emotions.

A popular hypothesis is that mental health disorders, such as depression and anxiety, develop as a result of chemical imbalances in the brain.

While this theory may hold some truth, it runs the risk of oversimplifying mental illnesses. In reality, mood disorders and mental health illnesses are highly complex conditions that affect 46.6 million adults living in the United States alone.

In this article, we discuss conditions with links to chemical imbalances in the brain, myths surrounding this theory, possible treatment options, and when to see a doctor.

Myths

a man looking sad because he is experiencing a Chemical imbalance in the brain

Many factors may contribute to a person’s risk of mental illness.

Although chemical imbalances in the brain seem to have an association with mood disorders and mental health conditions, researchers have not proven that chemical imbalances are the initial cause of these conditions.

Other factors that contribute to mental health conditions include:

  • genetics and family history
  • life experiences, such as a history of physical, psychological, or emotional abuse
  • having a history of alcohol or illicit drug use
  • taking certain medications
  • psychosocial factors, such as external circumstances that lead to feelings of isolation and loneliness

While some studies have identified links between distinct chemical imbalances and specific mental health conditions, researchers do not know how people develop chemical imbalances in the first place.

Current biological testing also cannot reliably verify a mental health condition. Doctors do not, therefore, diagnose mental health conditions by testing for chemical imbalances in the brain. Instead, they make a diagnosis based on a person’s symptoms and the findings of a physical examination.

What conditions are linked to chemical imbalances?

Research has linked chemical imbalances to some mental health conditions, including:

Depression

Depression, also called clinical depression, is a mood disorder that affects many aspects of a person’s life, from their thoughts and feelings to their sleeping and eating habits.

Although some research links chemical imbalances in the brain to depression symptoms, scientists argue that this is not the whole picture.

For example, researchers point out that if depression were solely due to chemical imbalances, treatments that target neurotransmitters, such as selective serotonin reuptake inhibitors (SSRIs), should work faster.

The symptoms of depression vary widely among individuals, but they can include:

  • persistent feelings of sadness, hopelessness, anxiety, or apathy
  • persistent feelings of guilt, worthlessness, or pessimism
  • loss of interest in formerly enjoyable activities or hobbies
  • difficulty concentrating, making decisions, or remembering things
  • irritability
  • restlessness or hyperactivity
  • insomnia or sleeping too much
  • changes in appetite and weight
  • physical aches, cramps, or digestive problems
  • thoughts of suicide

It is possible to develop depression at any age, but symptoms usually begin when a person is in their teenage years or early 20s and 30s. Women are more likely than men to experience depression.

Many different types of depression exist. These include:

The dramatic hormonal changes that take place after giving birth are among the factors that can increase a woman’s risk of developing postpartum depression. According to the National Institute of Mental Health, 10–15% of women experience postpartum depression.

Bipolar disorder

Bipolar disorder is a mood disorder that causes alternating periods of mania and depression. These periods can last anywhere from a few days to a few years.

Mania refers to a state of having abnormally high energy. A person experiencing a manic episode may exhibit the following characteristics:

  • feeling elated or euphoric
  • having unusually high levels of energy
  • participating in several activities at once
  • leaving tasks unfinished
  • talking extremely fast
  • being agitated or irritable
  • frequently coming into conflict with others
  • engaging in risky behavior, such as gambling or drinking excessive quantities of alcohol
  • a tendency to experience physical injuries

Severe episodes of mania or depression can cause psychotic symptoms, such as delusions and hallucinations.

People who have bipolar disorder can experience distinct changes in their mood and energy levels. They may have an increased risk of substance abuse and a higher incidence of certain medical conditions, such as:

The exact cause of bipolar disorder remains unknown. Researchers believe that changes in the dopamine receptors — resulting in altered dopamine levels in the brain — may contribute to the symptoms of bipolar disorder.

Anxiety

pensive woman

A person with an anxiety disorder may experience excessive worry.

However, people who have an anxiety disorder often experience persistent anxiety or excessive worry that worsens in response to stressful situations.

According to the authors of a 2015 review article, evidence from neuroscience research suggests that the gamma aminobutyric acid (GABA) neurotransmitter may play a crucial role in anxiety disorders.

The GABA neurotransmitter reduces neuronal activity in the amygdala, which is the part of the brain that stores and processes emotional information.

GABA is not the only neurotransmitter that anxiety disorders involve. Other neurotransmitters that may contribute to these disorders include:

  • serotonin
  • endocannabinoids
  • oxytocin
  • corticotropin-releasing hormone
  • opioid peptides
  • neuropeptide Y

Treatment

Doctors can prescribe a class of medications called psychotropics to rebalance the concentration of particular neurochemicals in the brain.

Doctors use these medications to treat a range of mental health conditions, including depression, anxiety, and bipolar disorder.

Examples of psychotropics include:

  • Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft).
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs), including venlafaxine (Effexor XR), duloxetine (Cymbalta), and desvenlafaxine (Pristiq).
  • Tricyclic antidepressants (TCAs), such as amitriptyline (Elavil), desipramine (Norpramin), and nortriptyline (Pamelor).
  • Benzodiazepines, including clonazepam (Klonopin) and lorazepam (Ativan).

According to 2017 researchantidepressants improved symptoms in an estimated 40–60% of individuals with moderate-to-severe depression within 6–8 weeks.

While some people experience reduced symptoms within a few weeks, it can sometimes take months for others to feel the effects.

Different psychotropics have varying side effects. People can discuss the benefits and risks of these medications with their doctor.

The side effects of psychotropic medications can include:

Suicide prevention

  • If you know someone at immediate risk of self-harm, suicide, or hurting another person:
  • Call 911 or the local emergency number.
  • Stay with the person until professional help arrives.
  • Remove any weapons, medications, or other potentially harmful objects.
  • Listen to the person without judgment.
  • If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 1-800-273-8255.

When to see a doctor

man talking to doctor in her office both smiling

If a person experiences anxiety and mood changes every day for longer than 2 weeks, they should consider speaking to their doctor.

These symptoms should not cause alarm if they are mild and resolve within a few days.

However, people may wish to consider speaking with a doctor or trained mental health professional if they experience emotional, cognitive, or physical symptoms every day for more than 2 weeks.

Summary

Mental health is complex and multifaceted, and numerous factors can affect a person’s mental well-being.

Although chemical imbalances in the brain may not directly cause mental health disorders, medications that influence the concentration of neurotransmitters can sometimes provide symptom relief.

People who experience signs and symptoms of a mental health problem for more than 2 weeks may wish to speak to a doctor.

 

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[WEB SITE] Keppra – The Law Offices of Gregory Krasovsky

 

Keppra

The dangerous drug attorneys at the Law Offices of Gregory Krasovsky can provide legal advice and representation to individuals and families considering pursuing a Keppra lawsuit. In order for a plaintiff to secure a maximum settlement in litigation of a Keppra claim, regardless of whether in an individual lawsuit or in a class action lawsuit, it is crucial that the law firm representing you have a competent and experienced team of Keppra lawyers to guide you through all of the legal hurdles as well as direct you to sufficient funding (litigation funding or legal finance) to cover pharmaceutical litigation costs. Contact  a Keppra attorney today to schedule a free consultation and take your first step to obtaining compensation for losses caused by Keppra side effects.

Keppra, which is generically known as Levetiracetam, is an anticonvulsant drug used to treat epilepsy. Keppra was originally manufactured and marketed by UCB Pharmaceuticals Inc., but now it is available as a generic and is manufactured by a number of firms. Unfortunately, Keppra has a number of serious side effects that can, at times, outweigh its benefits for people who are suffering from epilepsy. Some of the most serious Keppra adverse effects include suicidal tendencies and birth defects.

There are many Levetiracetam side effects. These include, but are not limited to, the following:

  • Suicidal Ideation
  • Suicidal Tendencies
  • Suicide
  • Headache
  • Unsteady Walk
  • Depression
  • Hallucinations
  • Fever
  • Sore Throat
  • Mood Changes
  • Changes in Skin Color
  • Anxiety
  • Birth Defects

A 2005 Food and Drug Administration (FDA) study of suicidal ideation in relation to epilepsy drugs has indicated that people taking those drugs, such as Keppra, are twice as likely to suffer from suicidal thoughts as are those who have not been taking these drugs.

Unlike many other drugs, such as Wellbutrin, people taking Keppra are likely to experience suicidal ideation regardless of what age group they might happen to fall into. The aforementioned study tracked almost 30,000 people, and the rick of suicide was spread fairly evenly across the population. Of the 28,000 people who had taken Keppra in this study, four of them had actually committed suicide. These unfortunate incidents serve to confirm the danger of this unsafe drug.

Although Keppra’s ability to cause birth defects is still under investigation, there is some amount of evidence that seems to confirm that Keppra is more harmful to unborn babies than was previously thought. Currently, the FDA has placed Keppra in the Category C for pregnancy, which indicates that there is little human risk. However, AdverseEvents, Inc. believes that Keppra should perhapd be in Category D, which indicates that a significant enough risk to pregnancy exists.

Keppra is similar to another prototypical nootropic drug called piracetam. Keppra is also thought to be a possible treatment for Tourette syndrome, autism, bipolar disorder, and anxiety disorder.

The attorneys at this Keppra law firm believe that drugs should not cause the same ailments that they are meant to cure. If you or your loved one has been injured as a result of taking Keppra, you might be entitled to compensation. Contact our attorneys today to schedule a free consultation.

Source: Keppra – The Law Offices of Gregory Krasovsky

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[Abstract] Traumatic Brain Injury and Behavior: A Practical Approach

Source: Traumatic Brain Injury and Behavior: A Practical Approach

  • Traumatic brain injury,
  • Psychosis,
  • Suicide,
  • Behavioral abnormalities,
  • Seizures,
  • Mania,
  • Depression,
  • Sleep-wake disorder

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