Posts Tagged TBI

[Infographic] How to Support Someone Impacted by Trauma

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[QUOTATION] Traumatic Brain Injury Doesn’t Come with a MANUAL…

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[Infographic] Changes Observed After Brain Injury

Changes Observed After Brain Injury

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[WEB PAGE] Growth Hormone Therapy Can Ease Symptoms in Brain Injury Patients

Growth Hormone Therapy Can Ease Symptoms in Brain Injury Patients

More than 2.5 million people in the United States experience a traumatic brain injury, or TBI, each year. Many deal with health issues for years after their head injury, such as fatigue, depressionanxiety, memory issues and sleep disturbances.

Now, a new study has found that TBI triggers a reduction in growth hormone. With growth hormone replacement treatment, many of these health issues improve, according to researchers at The University of Texas Medical Branch at Galveston.

A 20-year study from a team of researchers led by Dr. Randall Urban, The University of Texas Medical Branch at Galveston’s Chief Research Officer and a professor of endocrinology, led the team to name the syndrome “brain injury associated fatigue and altered cognition” or BIAFAC.

The research team’s work on brain injuries began in the late 1990s when Galveston philanthropist Robert Moody asked the researchers whether TBI caused dysfunction of the hormones made by the brain’s pituitary gland and funded research for the study. His son, Russell, had suffered a serious TBI during a car accident, so he was looking for ways to improve the life of his son and others living with brain injuries.

The researchers have been building on the discovery that TBI triggers a long-term reduction in growth hormone (GH). Most TBI patients experience “dramatic symptom relief” with GH replacement therapy, but the symptoms return if the treatment stops, the researchers noted.

“We already knew that even mild TBI triggers both short- and long-term changes to functional connections in the brain,” said Urban. “GH administration has been extensively linked with both protection and repair of the brain following damage or disease, however we didn’t know much about the particular mechanisms and pathways involved.”

The researchers examined 18 people with a history of mild TBI and inadequate GH secretion. The patients received GH replacement in a year-long, double-blind, placebo-controlled study. They were assessed for changes in physical performance, resting metabolic rate, fatigue, sleep quality, and mood. Functional magnetic resonance imaging was also used throughout the year to assess changes in brain structure and functional connections, researchers said.

The study found that GH replacement was linked with increased lean body mass and decreased fat mass, as well as reduced fatigue, anxiety, depression, and sleep disturbance.

It was also found, for the first time, that these improvements were associated with better communications among brain networks that have been previously associated with GH deficiency, according to the researchers.

The researchers also noted increases in both grey and white matter in frontal brain regions, the “core communications center of the brain,” that could be related to cognitive improvements.

In another study, researchers said they noticed TBI patients had altered amino acid and hormonal profiles suggesting chronic intestinal inflammation.

“We recently completed a trial to investigate the role of the gut-brain axis in the long-lasting effects of TBI,” said Urban. “We compared the fecal microbes of 22 moderate/severe TBI patients residing in a long-term care facility with 18 healthy age-matched control subjects, identifying disruptions of intestinal metabolism and changes in nutrient utilization in TBI patients that could explain the reduced growth hormone function.”

The results suggest that people with TBI-related fatigue and altered cognition also have different fecal bacterial communities than the control group. Urban said that the findings suggest that supplementing or replacing the microbial imbalanced intestinal communities may help to ease the symptoms experienced after TBI.

“These two studies further characterize BIAFAC and act as a springboard for new treatment options,” said Urban. “We hope that the publications will focus the collective wisdom of the research community to better understand and treat this syndrome, providing hope for many.

“Because these symptoms can manifest months to years after the initial injury and as this cluster of symptoms hasn’t been previously grouped together, it often goes unidentified in the medical community.”

The studies were published in the Journal of Neurotrauma.

Source: The University of Texas Medical Branch at Galveston

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[WEB SITE] Traumatic Brain Injury Basics – BrainLine

By Michael Paul Mason, Brain Injury Case Manager
TBI Basics

Overview

Doctors say that traumatic brain injury (TBI) is a catastrophic condition, like burns, amputations, and spinal cord injuries. But TBI is different. It upsets life on multiple levels: physical, psychological, social, and even spiritual. TBI affects the roots of who we are — our ability to think, to communicate, and to connect with other people. For approximately 85 percent of people with TBI, those problems eventually resolve, but the remaining 15 percent have lasting difficulties. If you’re dealing with lingering symptoms of a TBI, or if you’re caring for a loved one, it can help to understand more about the wide range of challenges that TBI can pose.

A tap on the head, and anything can go wrong. Anything usually does go wrong. Light taps — mild TBI — can result in daily headaches, agitated moods, or periods of sleeplessness. Stronger jolts may cause you to forget your name, or make you think you’re someone different. When you tell someone you’re sad, you may unintentionally yell. A TBI can introduce a frustrating amount of confusion and uncertainty into your life

TBI by the Numbers

TBI has a way of affecting everything and everyone in your life. It can make family life tough, and it can seriously impede your ability to work. It can affect the relationships you have and make it harder to make new friends. In the United States, TBI is a quiet crisis. As many as 5.3 million Americans are living with a permanent disability resulting from a brain injury. The Centers for Disease Control and Prevention report that 2.8 million Americans report a traumatic brain injury each year. Fifty-six thousand people die from it. Over a two hundred eighty-two thousand people are hospitalized. Some of them go home only to discover they no longer have a sense of smell or taste, or that their sleeping habits have changed, or that they can’t seem to do their job anymore.

If you look at the numbers a little differently, they’re even more upsetting. So many Americans become disabled from a brain injury that each decade they could fill a city the size of Detroit. Seven of these cities are filled already. A third of their citizens are under fourteen years of age. Currently, there are at least 125,000 people with a brain injury so severe that it requires extended hospital care — a service difficult to find and even harder to access. Fortunately, the majority of people who experience TBI will be able to return to a productive life once they receive appropriate treatment

A Closer Look at the Brain

Even though the numbers are large, it’s important to remember that TBI is a human injury. It has a way of showing us that life is fragile and precious. Because the brain is a complicated network of cells, each injury is as distinctive as the person it affects. Our skulls are only a quarter inch thick, although male skulls are a little thicker, which is lucky considering the fact that men tend to get TBI more often than women. The skull is both protective and restricting; it is the brain’s best defense but also its greatest risk in times of trauma.

Surrounding the brain is an almost rubbery, clear layer of tissue called the dura mater. It helps protect the brain from moving around too much. Beneath the dura mater is another layer called the arachnoid layer, which looks and feels like wet cotton candy. The dura mater, the arachnoid layer, and another layer — the pia mater — all form what is known as the meninges, which keeps the brain floating inside the skull. If these layers get infected, ripped, or torn, it can cause serious damage to the brain

Types of TBI

Every brain injury is different, but there are two basic types: open head injuries and closed head injuries. Open head TBIs are a frightening mess. Whether the injury comes from a bullet, a baseball bat, or a high-speed collision, the result is always chaotic and distressing. The scalp bleeds a lot when it is cut, and when the skull is cracked or penetrated, pieces of it can get lodged in the brain. Because the brain is such a complicated tangle of tissue, it’s extremely tricky to remove objects lodged inside a brain. That’s why we put brain surgery right up there with rocket science in our everyday language.

In a closed head injury, nothing penetrates your skull, but a closed head injury can be just as complicated and vicious as an open head injury, sometimes more so. During a closed head injury, the brain may slam against one portion of the skull, then bounce against the opposite side of the wall. Doctors call that a “coup-contracoup” injury, where two injuries occur from a single blow. One of the most common types of closed head injury is a concussion — a strong blow from an external force. If a person’s head is whipped around, a small tearing effect called shearing occurs throughout the brain, resulting in a diffuse axonal injury. Axons are the hairlike extensions of nerve cells that transmit messages, so in a diffuse axonal injury, the messages either get mixed up, or they don’t come through at all

Treating and Living With TBI

An injured brain also has a tendency to swell, so if there is no room in the skull to expand, the swollen brain may start pushing against the eye sockets. The optic nerve eventually gets pinched, and eyesight is affected. A surgeon might drill holes into a skull to test cranial pressure. If the swelling is too extreme, the only option is to create an escape hatch by sawing away a portion of the skull.

The neurosurgeon is in charge of protecting the brain through medical procedures, but the survivor has to manage life with the effects of the TBI. Everyone reacts differently, depending in part on the severity of the injury, the quality of their care, and the strength of the social network around them. Many survivors feel pulled in different directions, feeling at times that the injury has made them less than what they were, and at other times that they can integrate TBI into their lives in a positive way. People with TBI are forced to confront a whole series of personal questions: How does my injury really affect me? Can I regain the things I’ve lost? What am I other than my brain? How can I make the most of my life?

Looking Ahead

Our understanding of TBI is changing in front of our eyes. As organizations such as the Brain Trauma Foundation continue to define the best practices in treating brain injury, medical care is slowly improving — at least for those patients able to gain access to early trauma care. The war in Iraq has already changed the way we treat TBI in America. Military surgeons who learned life-saving techniques like early cranioplasty are able to employ similar protocols in American trauma centers

In the years to come, we may increasingly see brain trauma as a chronic but manageable condition similar to diabetes or cardio-pulmonary disease. That perspective might also help in reducing the negative stereotypes of TBI. For now, though, TBI survivors and those who care for them continue to face serious challenges in finding help and finding acceptance.

TBI is a much more manageable injury today than it has been in the past, but it remains a major health problem. As people with TBI continue to live longer and face the challenges of aging with TBI, it will be our duty to provide better education and long-term programs and services. We all have brains; let’s continue to use them — injured or not — to support TBI prevention, research, and treatment.

Posted on BrainLine February 13, 2018. Reviewed March 27, 2019.

About the Author

Michael Paul Mason is the founding editor of This Land, a monthly magazine based in Tulsa. Mason’s first book, Head Cases: Stories of Brain Injury and Its Aftermath, is an exploration into the harsh realities endured by people with brain injury. Mason’s first book, Head Cases: Stories of Brain Injury and Its Aftermath, is an exploration into the harsh realities endured by brain injury survivors. While currently a brain injury projects manager at the Neurologic Rehabilitation Institute at Brookhaven Hospital, Mason continues to advocate on behalf of Americans with brain injury and is involved with several national legislative initiatives. Learn more about Michael Paul Mason >

via Traumatic Brain Injury Basics | BrainLine

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[BLOG POST] Tackling Brain Injury as a Team – A Brain Injury Life

Tackling Brain Injury as a Team

Brain injury is an existential condition. What’s at stake is life itself. Survivors and families turn to experts for help—specialists with knowledge and experience. But it should be reciprocated. Our expertise is what they don’t know—family history, relationships, and world view. Somehow we must be partners in a necessarily empathic, holistic process. How? Build a team.

Central is the Survivor, then their family, friends and aides (Caregivers) and doctors and therapists (Professionals). Good communication and collaboration are prerequisites, and ideally the partnership grows with mutual respect. It’s hard, but better than going it alone as too many survivors must do.

At the start I didn’t know I had a team or that I was part of it. As I slowly got involved in my own care, my sense of independence grew. That is a team’s potential—a powerful source of strength for all of us living with brain injury, as long as we keep these 5 precepts in mind:

Trust • Listen • Respect • Patience •
Ask For and Accept Help

TRUST

  Survivor: Trust that your best “self” is still there and that the fog will start to lift. But don’t try to go it alone. Find someone who understands you, has earned your trust, and remember they’re on your side.

CaregiversCaregivers: Trust your loved one, even when he or she appears to be a stranger. What you’re seeing is the aftermath of brain injury. Good doctors and therapists are key so choose carefully, then trust them. If you don’t, change.

  Professionals: Trust your patients and families enough to be honest and open about what’s ahead, but with compassion and hope.

LISTEN

Survivor: Keep an open mind by listening to feedback from your family and doctors. Self-awareness takes a hit after brain injury and others may see things you can’t.

Caregivers Caregivers: Stop, look, and listen to what’s behind the words—your family member’s frame of mind and your own. Before replying, pause. Take a slow, deep breath and try to stay calm (you can always scream into your pillow later).

Professionals: Focus on your patients to show you’re listening. Put aside your agenda and directly address their concerns. To improve communication, model the strategies you want them to learn—verify, use stems, delay and chunk.

RESPECT

  Survivor: Respect the person you are now—a brain injury survivor, your life upended, trying to put it right. Respect those around you too. They are your partners working towards the same goal.

Caregivers Caregivers: Don’t beat yourself up when your best efforts don’t seem to be enough. Respect yourself and your team as equals even when you disagree. There is no right or wrong way to cope with brain injury.

Professionals: You’re not the only expert in the room; your patient’s living it and knows things you cannot see. Show respect by talking with them (not to them). Hospital professionals often address the caregiver not the patient. Their questions go unanswered, a spectator to their own care.

PATIENCE

  Survivor: This journey is slow and confusing, but don’t give up. It’s hard to be patient when you don’t see progress so put it in writing. Record and review your successes and celebrate each step no matter how small.

Caregivers  Caregivers You’re learning to live with brain injury as well as advocating for your loved one. The work is exhausting, frustrating; you’re bound to lose patience. Give yourself a break each day—music, meditation, or even a “power nap” may help.

Professionals: Even if time is short patiently add “wait time” to each interaction. Ask a question, then wait. Be alert but quiet for as long as the survivor needs to process your words, their thoughts, and find the words to answer. This gives them a sense of agency.

ASK FOR and ACCEPT HELP

  Survivor: Knowing what you don’t know is a quality not a weakness. Seeking advice is how we learn and take charge of our lives. Turn to your team—they are there to help. Don’t be embarrassed to ask “what?” or “why?” It puts you in the driver’s seat.

Caregivers Caregivers: When someone offers help say, “Yes, thank you,” instead of “I can do it myself,” And don’t feel guilty. Without taking care of yourself, you can’t care for someone else. Reach out to family, friends, a house of worship or support groups to help. Respite is not a luxury. It’s a necessity.

Professionals: Learn from your patient. Ask what they think, what’s working or not, how they’re coping and, if not, what would help. Brain injury makes it hard to express oneself calmly and clearly so be sure you fully understand what they’re trying to say. Follow their lead, be flexible, and willing to change gears.

For a long time I refused (fought) offers of help. Before brain injury I’d always followed my instincts, stubbornly sure I was right, so it was so hard to admit I could be wrong. When I realized how often I misheard or misspoke, I grudgingly accepted the advice of my team and learned to ask for help—gracefully and without shame. It’s funny. The more I did it the easier my life became. I now understand how important the team has been, hearing me out with trust, respect and as a fully supported partner.


To my team and friends, who’ have stuck with me through thick and thin:

I owe a you a tremendous debt of gratitude. I don’t know where I’d be today if you hadn’t taught me what I needed to know and offered your enduring support and empathy. Thank you, thank you.    –Laurie

 

via Tackling Brain Injury as a Team – A Brain Injury Life

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[WEB SITE] What Disabilities Can Result From a TBI? – BrainLine

What Disabilities Can Result From a TBI?

National Institute of Neurological Disorders and Stroke
¿Qué discapacidades pueden resultar de un traumatismo cerebral?

 

Disabilities resulting from a TBI depend upon the severity of the injury, the location of the injury, and the age and general health of the patient. Some common disabilities include problems with cognition (thinking, memory, and reasoning), sensory processing (sight, hearing, touch, taste, and smell), communication (expression and understanding), and behavior or mental health (depression, anxiety, personality changes, aggression, acting out, and social inappropriateness).

Within days to weeks of the head injury approximately 40 percent of TBI patients develop a host of troubling symptoms collectively called postconcussion syndrome (PCS). A patient need not have suffered a concussion or loss of consciousness to develop the syndrome and many patients with mild TBI suffer from PCS. Symptoms include headache, dizziness, vertigo (a sensation of spinning around or of objects spinning around the patient), memory problems, trouble concentrating, sleeping problems, restlessness, irritability, apathy, depression, and anxiety. These symptoms may last for a few weeks after the head injury. The syndrome is more prevalent in patients who had psychiatric symptoms, such as depression or anxiety, before the injury. Treatment for PCS may include medicines for pain and psychiatric conditions, and psychotherapy and occupational therapy todevelop coping skills.

Cognition is a term used to describe the processes of thinking, reasoning, problem solving, information processing, and memory. Most patients with severe TBI, if they recover consciousness, suffer from cognitive disabilities, including the loss of many higher level mental skills. The most common cognitive impairment among severely head-injured patients is memory loss, characterized by some loss of specific memories and the partial inability to form or store new ones. Some of these patients may experience post-traumatic amnesia (PTA), either anterograde or retrograde. Anterograde PTA is impaired memory of events that happened after the TBI, while retrograde PTA is impaired memory of events that happened before the TBI.

Many patients with mild to moderate head injuries who experience cognitive deficits become easily confused or distracted and have problems with concentration and attention. They also have problems with higher level, so-called executive functions, such as planning, organizing, abstract reasoning, problem solving, and making judgments, which may make it difficult to resume pre-injury work-related activities. Recovery from cognitive deficits is greatest within the first 6 months after the injury and more gradual after that.

Patients with moderate to severe TBI have more problems with cognitive deficits than patients with mild TBI, but a history of several mild TBIs may have an additive effect, causing cognitive deficits equal to a moderate or severe injury.

Many TBI patients have sensory problems, especially problems with vision. Patients may not be able to register what they are seeing or may be slow to recognize objects. Also, TBI patients often have difficulty with hand-eye coordination. Because of this, TBI patients may be prone to bumping into or dropping objects, or may seem generally unsteady. TBI patients may have difficulty driving a car, working complex machinery, or playing sports. Other sensory deficits may include problems with hearing, smell, taste, or touch. Some TBI patients develop tinnitus, a ringing or roaring in the ears. A person with damage to the part of the brain that processes taste or smell may develop a persistent bitter taste in the mouth or perceive a persistent noxious smell. Damage to the part of the brain that controls the sense of touch may cause a TBI patient to develop persistent skin tingling, itching, or pain. Although rare, these conditions are hard to treat.

Language and communication problems are common disabilities in TBI patients. Some may experience aphasia, defined as difficulty with understanding and producing spoken and written language; others may have difficulty with the more subtle aspects of communication, such as body language and emotional, non-verbal signals.

In non-fluent aphasia, also called Broca’s aphasia or motor aphasia, TBI patients often have trouble recalling words and speaking in complete sentences. They may speak in broken phrases and pause frequently. Most patients are aware of these deficits and may become extremely frustrated. Patients with fluent aphasia, also called Wernicke’s aphasia or sensory aphasia, display little meaning in their speech, even though they speak in complete sentences and use correct grammar. Instead, they speak in flowing gibberish, drawing out their sentences with non-essential and invented words. Many patients with fluent aphasia are unaware that they make little sense and become angry with others for not understanding them. Patients with global aphasia have extensive damage to the portions of the brain responsible for language and often suffer severe communication disabilities.

TBI patients may have problems with spoken language if the part of the brain that controls speech muscles is damaged. In this disorder, called dysarthria, the patient can think of the appropriate language, but cannot easily speak the words because they are unable to use the muscles needed to form the words and produce the sounds. Speech is often slow, slurred, and garbled. Some may have problems with intonation or inflection, called prosodic dysfunction. An important aspect of speech, inflection conveys emotional meaning and is necessary for certain aspects of language, such as irony. These language deficits can lead to miscommunication, confusion, and frustration for the patient as well as those interacting with him or her.

Most TBI patients have emotional or behavioral problems that fit under the broad category of psychiatric health. Family members of TBI patients often find that personality changes and behavioral problems are the most difficult disabilities to handle. Psychiatric problems that may surface include depression, apathy, anxiety, irritability, anger, paranoia, confusion, frustration, agitation, insomnia or other sleep problems, and mood swings. Problem behaviors may include aggression and violence, impulsivity, disinhibition, acting out, noncompliance, social inappropriateness, emotional outbursts, childish behavior, impaired self-control, impaired self awareness, inability to take responsibility or accept criticism, egocentrism, inappropriate sexual activity, and alcohol or drug abuse/addiction. Some patients’ personality problems may be so severe that they are diagnosed with borderline personality disorder, a psychiatric condition characterized by many of the problems mentioned above. Sometimes TBI patients suffer from developmental stagnation, meaning that they fail to mature emotionally, socially, or psychologically after the trauma. This is a serious problem for children and young adults who suffer from a TBI. Attitudes and behaviors that are appropriate for a child or teenager become inappropriate in adulthood. Many TBI patients who show psychiatric or behavioral problems can be helped with medication and psychotherapy.

 

via What Disabilities Can Result From a TBI? | BrainLine

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[BLOG] PROMOTING A BRAIN HEALING LIFESTYLE

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[WEB SITE] Understanding & Communicating Your Emotions After Brain Injury – BrainLine

Part I

After injury, survivors and their family members often experience a variety of strong emotions. Many people describe feeling frustrated, angry, or sad about changes following the injury. Others talk about feeling worried or scared about what will happen in the future. Some people notice that their emotions change quickly, “like a roller coaster.” Feeling misunderstood is also common. Strong emotions can weaken your ability to solve problems, handle challenges effectively, and get along with others. Recognizing, understanding, and controlling your feelings can be very difficult.

This is part of a series of articles focusing on intense feelings and how to manage them effectively. In this article, we’ll present Parts I and II. Part I covers understanding and identifying your emotions. Part II covers barriers to communicating about your feelings.  Part III, a separate article, will focus on ways to manage intense emotions effectively.

The first step in controlling your emotions is recognizing how you feel and noticing when your emotions get in the way. If you can figure out how you’re feeling early on, you can get your feelings under control faster and more easily. Then you’ll be able to feel better and reach your goals more efficiently.

Take a moment to think about how you feel. Below, check off the sentences that describe you:

  • I often feel frustrated.
  • I get angry easily.
  • I can’t do much to make things better.
  • I don’t like much about myself.
  • I worry a lot.
  • I have made many mistakes.
  • I worry about the future.
  • I’m lonely.
  • I believe I am at fault for many of my family’s problems.
  • I feel sad.
  • I cry over the least little thing.
  • People don’t understand me.
  • I feel overwhelmed.
  • My feelings change from minute to minute.
  • I get upset easily.
  • Very few people care about me.
  • I have many fears.
  • I feel like I should be doing more.
  • I’m disappointed in myself.
  • I wish my life could be the way it was before.
  • I am often grouchy.
  • Sometimes I feel I’m on top of the world.

Review the items you’ve checked and the ones you haven’t to better understand your feelings. The more items you’ve checked, the more likely it is that you are experiencing many different and strong emotions. Is there a pattern to the items you’ve checked? Show your checklist to someone you know and trust. Do you agree on the items that should be checked?

Once you recognize how you feel, you can take steps to help yourself cope with the emotions effectively. Talking about your feelings is an important first step to feeling better. But, many people have trouble talking about their feelings.

In Part II (below), we’ll talk about common barriers that keep people from talking with others about their feelings.

Part II

Talking about your feelings may be difficult. People often say they worry about what others will think of them. Others say they don’t know who to turn to or who they can trust. Think about what gets in the way of talking to others about your feelings. The following questionnaire will help you figure out the answer. Circle T (True) or F (False) to figure out the challenges you face in talking about your emotions.

T  F        1. My feelings change from day to day.

T  F        2. Nobody understands what I am going through.

T  F        3. I feel uncomfortable around other people.

T  F        4. I’m worried about what others think of me.

T  F        5. Nobody cares about me.

T  F        6. I have a hard time describing my feelings.

T  F        7. I don’t want to burden people with my feelings.

T  F        8. I feel uncomfortable talking about my feelings.

T  F        9. I don’t know where to turn for help.

T  F        10. I can’t hide my feelings like I used to.

T  F        11. I’m afraid to show my true feelings.

T  F        12. I don’t want to upset people by talking about my feelings.

T  F        13. I’m afraid to let my guard down.

T  F        14. I keep my feelings bottled up.

T  F        15. I don’t know how I’m feeling.

T  F        16. I don’t feel anything anymore.

Look over your answers with family, friends, or trusted professionals. Think about the main issues that are getting in the way of talking about your feelings.

  • Is it that you feel like other people don’t understand you or don’t care?
  • Do you feel uncomfortable around other people or uncomfortable talking about feelings?
  • Do you have trouble recognizing how you feel or describing your feelings to other people?
  • Do you worry about being able to trust others with personal information?

Each of these issues may get in the way of you talking to others about your feelings. Remember that talking to others about your feelings is a big step toward feeling better. Often, you need support from others to be able to deal with difficult emotions, so you can handle your responsibilities effectively.

Asking for help lets people know that you value their support and involvement and offers chances to build relationships. Talk to trusted family, friends, and professionals about your feelings and about ways to cope with strong emotions. They may be able to give you some good ideas about ways to cope with your feelings.

We’ve talked to lots of survivors and their families to find out ways they cope with strong feelings. Here are a few strategies that have worked for other people. Look over this list and pick out which ones you think will work for you and your family:

  • Remember that ups and downs are normal parts of life. Realize that your feelings are a common, normal response to your experience. Try to look forward to the ups!
  • Stop the cycle before your emotions get too intense. Watch out for early warning signs of intense emotions. It’s harder to calm down once they get out of control.
  • Intense emotions often come in response to stress. Monitor your stress level and take steps to control your stress. Some stress management strategies actually work well for dealing with intense emotions too.
  • Be hopeful and positive. Say positive things to yourself and others (e.g., “I will make it through this,” “I’m trying my hardest,” “I’m a good person”). Try to keep a good sense of humor.
  • Recognize the difficulties and challenges you face, and how hard you are working to make things better. Give yourself credit when you control your emotions and express your feelings in positive ways.

Emotional Adjustment Project

Virginia Commonwealth University’s TBI Model System includes a research project to better understand how to look at emotional adjustment after brain injury. Participants for this study need to have had a traumatic brain injury and be at least 18 years old. If you have questions about the project or would like to be involved, please call Jenny Marwitz at: (804) 828-3704 or toll free (866) 296-6904, or email her at jhmarwit@vcu.edu.

Part III

Managing Intense Feelings

After injury, survivors and their family members often experience a variety of strong emotions. Many people describe feeling frustrated, angry, or sad about changes following the injury. Others talk about feeling worried or scared about what will happen in the future. Some people notice that their emotions change quickly, “like a roller coaster.” Feeling misunderstood is also common. Strong emotions can weaken your ability to solve problems, handle challenges effectively, and get along with others.

Recognizing, understanding, and controlling your feelings can be very difficult. The first step in controlling your emotions is recognizing how you feel and noticing when your emotions get in the way. If you can figure out how you’re feeling early on, you can get your feelings under control faster and more easily. Then you’ll be able to feel better and reach your goals more efficiently.

Take a moment to think about how you feel. On the list below, mark the sentences that describe you:

  •  I often feel frustrated.
  •  I get angry easily.
  •  I can’t do much to make things better.
  •  I don’t like much about myself.
  •  I worry a lot.
  •  I have made many mistakes.
  •  I worry about the future.
  •  I’m lonely.
  •  I believe I am at fault for many of our problems.
  •  I feel sad.
  •  People don’t understand me.
  •  I feel overwhelmed.
  •  My feelings change from minute to minute.
  •  I get upset easily.
  •  Very few people care about me.
  •  I have many fears.
  •  I feel like I should be doing more.
  •  I’m disappointed in myself.
  •  I wish my life could be the way it was before.
  •  I am often grouchy.

Review the items you’ve checked and the ones you haven’t to better understand your feelings. The more items you’ve checked, the more likely it is that you are experiencing many different and strong emotions. Is there a pattern to the items you’ve checked? Show your checklist to someone you know and trust. Do you agree on the items that should be checked?

Once you recognize how you feel, you can take steps to help yourself cope with the emotions effectively. We’ve talked to lots of survivors and their families to find out ways they cope with strong feelings. Here are a few strategies that have worked for other people. Look over this list with trusted family, friends, or professionals and pick out which ones you think will work for you and your family:

  •  Remember that ups and downs are normal parts of life. Realize that your feelings are a common, normal response to your experience. Try to look forward to the ups!
  •  Remember that you have the power to control your emotions. You can choose to change the way you feel and the way you react. Your ability to control strong emotions will get better with practice.
  •  Stop the cycle before your emotions get too intense. Watch out for early warning signs of intense emotions. It’s harder to calm down once they get out of control.
  •  Be hopeful and positive. Say positive things to yourself and others (e.g., “I will make it through this,” “I’m trying my hardest,” “I’m a good person”). Remember that persistence is the best way to solve your problems and avoid failure. Try to keep a good sense of humor.
  •  Count your blessings. Think about things you are thankful for. Recognize positive feelings, good things about yourself, and changes for the better.
  •  If you can’t do something to make the situation better, don’t make it worse. Sometimes you may feel like there’s nothing you can do to make the situation better. Try to avoid doing silly things that may make the situation worse. Doing nothing may be better.
  •  Intense emotions often come in response to stress. Monitor your stress level and take steps to control your stress. Some stress management strategies actually work well for dealing with intense emotions too.
  •  Avoid thinking too much about your feelings. Instead, focus on positive steps you can take to feel better.
  •  Put yourself in the other person’s shoes. Try to understand other people’s points of view. Think about how they will feel in response to your actions or words. Remember that hurting others won’t make your life better, make people like you, or help you get what you want.
  •  Don’t say or do the first thing that comes to mind. Take a deep breath. Count to ten. Get into the habit of thinking about what you want to say or do before you say or do it.
  •  Wait and deal with problems when you are calm. Strong emotions will keep you from thinking clearly. Calm yourself down first — count to 10, take a break, or do something relaxing and fun. Then, think about the consequences and possible ways to solve your problems.
  •  Remember that nobody can solve all their problems by themselves. Talk to trusted family, friends, and professionals about your feelings and about how they cope with strong emotions. Ask for help when you need it. Doing so will let people know you value their support and offers chances to build relationships.
  •  Recognize the difficulties and challenges you face, and how hard you are working to make things better. Give yourself credit when you control your emotions and express your feelings in positive ways.

Sometimes people have trouble helping themselves feel better. Often, you can benefit from support and guidance from others. Talk with trusted family, friends, or professionals about your feelings. Also, consider joining a support group, so you can learn from others about how they’ve dealt successfully with similar emotions.

This column was written by Laura Taylor and Jeff Kreutzer from the VCU TBI Model System Family Support Research Program. The program teaches families how to deal with stress and intense emotions. For more information about the program, please contact Laura at 804-828-3703, toll free at 866-286-6904, or by email at taylorla@vcu.edu.

via Understanding & Communicating Your Emotions After Brain Injury | BrainLine

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[Brochure] Understanding TBI Part 4: The impact of a recent TBI on family members and what they can do to help with recovery

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.[…]

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