TBI – Survivors, Caregivers, Family, and Friends

Archive for the ‘Another Fork in the Road’ Category

Another Fork in the Road Behavioral and Emotional Changes After Brain Injury

Fork in the Road copy“Another Fork in the Road”

This category is an extension of my radio show, “Another Fork in the Road,” which airs at 5:30 pm (Pacific Time) on the 1st and 3rd Sundays of each month on the Brain Injury Radio Network. (See the “On The Air Show Menu” category for a list – with links – of all my shows, which are archived and thus always available.)

On the 1st Sunday of each month, I host a panel of brain injury survivors, caregivers, and/or professionals in the field. On these shows, my panelists and I examine topics pertaining to brain injury.

On the 3rd Sunday of each month, I host guests – brain-injury survivors, caregivers, or professionals in the field.

Since I spend countless hours in preparation for each show, I decided to share the knowledge that I gather with my readers.

 

Behavioral and Emotional Changes After Brain Injury

by

Donna O’Donnell Figurski

 

BrainAs many of us know, all brain injuries are different. When an injury has happened to any part of the brain, there is going to be a change. The part of the brain that was damaged will determine the kind of symptoms that will be experienced. Because the brain is a complex organ in which different areas communicate, some damage may cause unexpected behaviors or emotional changes.

There are several sections of the brain, and each is responsible for many different aspects of daily life. Here I will discuss some of the behavioral and emotional changes that can result from damage to the cerebellum and to the cerebrum, which consists of the temporal lobe, the occipital lobe, the parietal lobe, and the frontal lobe, a major part of which is the prefrontal cortex.

The cerebellum, which is at the base of the skull, controls coordination, balance, equilibrium, and motor-skill memory. Some of the problems that result from damage to this area are compromised balance or the inability to walk, problems with fine-motor skills, and slurring of speech.

Damage to the temporal lobe can cause problems with hearing, memory, and motor-skill memory. Injury in the temporal lobe may also result in aggressive behavior.

The occipital lobe has to do with vision and vision-related activities. Reading and writing will be affected by damage to this area of the brain. Vision impairment can occur, which includes blurry, tilted, and double vision.

The parietal lobe is responsible for touch perception and the interpretation of visual information. Problems that may occur with damage to this lobe include difficulty in naming objects, difficulty with reading and/or writing, and spatial perception problems that can affect coordination.

Emotional responses and expressive language are housed in the frontal lobe. Emotions and the skills for problem-solving are dealt with there. The frontal lobe helps folks make sense of the world around them. It’s needed to understand others and be empathetic to them. Essentially, the frontal lobe is the emotional and social control area. It also determines and steers personality.

The prefrontal cortex of the frontal lobe controls analytical thinking, thought analysis, and behavior regulation. Executive functions are controlled here too. The prefrontal cortex is the gateway for making good decisions. When this area is injured, the thinking process is affected in such a way that inappropriate behavior is often the result.

 

I asked the following three questions of brain-injury survivors on the brain-injury support-group sites on Facebook to which I belong:

How have your emotions or your behaviors changed after your brain injury?

How do you cope with the change?

How do family members and/or friends cope with the change in your personality?

Several site members answered. The answers below are typical of the comments I received. (I used first names to protect the privacy of the contributors.)

 

Sherrie (survivor)

Happy SadIt’s been a long time since my brain injury. My emotions can be extreme or opposite to what they should be. Change is hard, and I don’t like change. Friends left, and family has never accepted my brain injury.

I have been known to laugh when someone gets hurt, like mashing a finger, and my emotions can be so overwhelming that I cry no matter the feeling. Happy, sad, proud, mad, love. It doesn’t matter.

 

Toby (survivor)

Toby told me that it’s hard to cope with his migraines with brain injury because a lot of meds don’t work very well.

He has been put on many meds for depression and anxiety disorder.

MemoryHe also says his memory is damaged, and he can’t remember a lot of things.

Toby’s family has a hard time with him and his brain injury because it changes many things in their lives too. A lot of people don’t know what to say, so they hold back, or they do not talk with Toby anymore.

Toby tries to cope by getting his head in a better place, but when the anxiety kicks in hard, he has no idea what to do. He tries to get some things set up in advance, so he can take the Migraineright meds before another migraine comes on. (He usually experiences over twenty migraines a month.)

When I asked Toby how his family and friends cope with him and his brain injury, he said, “They stay away from me. If I make a mistake on the computer or the Internet, they will call my wife and give her a heads-up on my condition. I don’t really have any friends after what happened to me.”

 

Jason (survivor)

k0184684In a nutshell, Jason said, “Lack of love.”

 

 

I thought an article by Janet Cromer in “Psychology Today” was very informative, especially for caregivers, who often struggle with emotional and/or behavioral changes in the survivor. The article can be found online (see below).

Janet Cromer, who is a Registered Nurse, has written the “Dark Side of Personality Change.” She tells of how her husband’s personality changed after his brain injury. Before his brain injury, Janet recalls her husband (Alan) as being kind and loving with a keen sense of curiosity and humor. Calm ManAfter his injury, Alan experienced intense anger and confusion. His bizarre behavior and sudden change from calm to fiery led Janet to believe her post-injury husband had two personalities. She likened Alan’s behavior to that of Dr. Jekyll and Mr. Hyde, which she found very frightening. (I’m sure Janet is not alone in her fears. I have heard comments such as these in my brain-injury support-groups too many times to count.)

As I mentioned above, injuries to the frontal lobe, especially to the prefrontal cortex, often result in emotional and behavioral changes in survivors. Survivors of any brain injury may find themselves in states of agitation and in unstable emotional chaos. These states can cause outbursts of unintended verbal aggression and raging attacks on family or friends, which can be very hurtful. Though family and friends may try to understand and to be empathetic and helpful, dealing with an unexpected outburst can be an overwhelming task because it is so hard to comprehend.

Violent outbursts and aggression by the survivor can result in the lack of trust and possibly fear of personal injury by the caregiver, family, or friends. But I think it’s the lack of trust – knowing that the survivor can become volatile at any time – that is the scariest and most hurtful. That loss of the sense of security is likely to be the most devastating.

 

How can caregivers, family, and friends help? I guess understanding would be at the top of the list. I know that’s not easy, especially if one feels that he or she has been unjustly attacked. Even knowing that the survivor is not responsible, would not act this way pre-brain injury, and will probably feel really bad after the incident, it will still be difficult to accept the aberrant behavior. It’s human nature.

empathyThe caregiver, family, and friends need to understand that the survivor’s outburst may occur because of his or her frustration with the reality of the new life – lacking the ability to do the things he or she once did easily and/or experiencing loss of independence and/or the realization of a futile situation. Also, an outburst might be triggered by uncontrolled pain, depression, or any number of ailments. So, showing compassion or empathy, providing comfort, support, and encouragement will go a long way to helping your survivor.

 

What can one do when faced with irrational behavior by the survivor? It often helps to leave the area when an outburst begins. Don’t try to reason with the survivor – your efforts will probably not be fruitful. Remember, the survivor’s brain is injured, and he or she can’t help the aberrant behavior. It might help to talk about the behavior in a calm manner after the incident has subsided, or … maybe let it go.

Try to determine if there is a specific trigger for the outburst. If one is identified, try to avoid those situations that provide it. At the very least, knowing the trigger can help the caregiver, family member, or friend understand a little more. As time goes by, the caregiver and the survivor may each recognize the triggers and be able to eliminate them or lessen their impact.gg60887323

 

Identify the survivor’s actions immediately prior to an outburst. Does the survivor show signs of agitation, tense his or her muscles, or become distracted? If so, take note and maybe remove the survivor from the area. Large groups of people (as in malls, family gatherings, or parties) can often cause agitation in a survivor, which in turn may cause an outburst.

Any overwhelming situation can bring about an outburst. Having to be ready to leave the house at a certain time can cause stress. So allow more time. Don’t rush.

Give plenty of notice for planned events. Make sure there are no surprises. If a survivor knows in advance that there is a family gathering to go to on Friday night, then he or she can plan for it. Surprises and unexpected events often cause anxiety and confusion, which can easily bring on an outburst. So plan ahead.

 

ClipArt-AfterTheFire7Get counseling. Counseling for both the survivor and the caregiver (or family member) can be helpful. Visiting a neuropsychologist or a behavioral therapist can help (see below). They are able to teach compensatory tactics to avoid or lessen the effects of an angry outburst. The survivor may employ deep breathing, alter thoughts to a more pleasant topic, leave the area to regroup in a quiet place, let friends know the trigger points, and ask for help. Periodic reminders can help those who struggle with memory. These are all simple and effective ways to compensate.

There are a lot of little tricks that can be incorporated into the lives of survivors and their caregivers, family, or friends that can make life easier for all.

 

Helpful Links

What Does a Neuropsychologist Do, Exactly?

Who Are the Rehab Specialists?

Cerebellum

Frontal Lobes

Parietal Lobes

Temporal Lobes

Occipital Lobes

What Are the Functions of the Prefrontal Cortex?

After Brain Injury: The Dark Side of Personality Change Part I by Janet M. Cromer RN, LMHC

 

Click here to listen to my show

“Behavioral and Emotional Changes After Brain Injury” on “Another Fork in the Road,” on the Brain Injury Radio Network.”

 

(Clip Art compliments of Bing.)

As I say after each post: Please leave a comment by clicking the blue words “Leave a Commentanim0014-1_e0-1 below this post.

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Another Fork in the Road Reasonable, Responsible, & Realistic Resolutions

“Another Fork in the Road”

Fork in the Road copyThis category is an extension of my radio show, “Another Fork in the Road,” which airs at 5:30 pm (Pacific Time) on the 1st and 3rd Sundays of each month on the Brain Injury Radio Network. (See the “On The Air Show Menu” category for a list – with links – of all my shows, which are archived and thus always available.)

On the 1st Sunday of each month, I host a panel of brain injury survivors, caregivers, and/or professionals in the field. On these shows, my panelists and I examine topics pertaining to brain injury.

On the 3rd Sunday of each month, I host guests – brain-injury survivors, caregivers, or professionals in the field.

Since I spend countless hours in preparation for each show, I decided to share the knowledge that I gather with my readers.

 

Reasonable, Responsible, & Realistic Resolutions

by

Donna O’Donnell Figurski

 

blank list of resolutions on blackboard

New Year’s Day has passed. A new year is always a time of renewal – a time to look back on the past year and make positive commitments for the upcoming year. As humans, we seem to strive to improve, to make life better. The new year is a good time to correct old mistakes and to look to the future and make new plans.

I think this topic is appropriate now, as we look back on the past two months to determine if we are honoring our New Year’s resolutions. Did we, in fact, make reasonable, responsible, and realistic resolutions?

 It feels like the whirlwind of the holidays happened eons ago, and yet it’s just been two months. If you are like most of the population, you probably made resolutions on New Year’s Day – promises to yourselves that you would do something in your life to better it. In the days after the New Year’s celebration, you will see more people in the gym or running through the streets – maybe decked out in new running clothes to increase their motivation. You might hear folks talking about the new diet they are going to try to lose those unwanted pounds. Some folks vow to stop smoking or drinking, or at least they intend to cut down. Folks promise to take more time for family or friends, save money, travel more. new-years-resolutionsThe list goes on and on. Usually these resolutions are good intentions for the year that last maybe a week or two – perhaps even a month – but for whatever reason or reasons – time, lack of interest or motivation – many of these good intentions fall by the wayside.

Each new year, I usually make the resolution to exercise more. I start off okay, but not long after New Year’s Day is past, the motivation walking_girlstarts to wane. Lack of time, or more like “inability to properly manage time,” is a big factor for me. I seem to be always too busy with tons of projects, most of them involving writing. I work daily on my blog. I spend hours preparing my radio show. I’m writing articles for publication, and, of course, I have to write a lot of query letters to agents and publishers as I try to sell my book, “Prisoners Without Bars: A Caregiver’s Story.” It seems that the only things that ever get any exercise are my brain … and my fingers as they fly over the keyboard. Uh, did I say “fly”? I meant more like “stumble.” Most of my projects have deadlines – if not actual ones, then at least self-imposed ones. So, due to my over-commitments, this year I chose not to make any resolutions that I know I will not keep. Not keeping my resolutions only makes me feel like a failure, and that is not productive. I bet a lot of people fall into this category.

Folks with a brain injury are continually working to improve their lives, and New Year’s resolutions may seem even more important. Brain-injured people are used to taking small steps, but the temptation for New Year’s resolutions may be to try to do too much.

I’m going to discuss how to keep interest up and to make it possible to reach the goal of a reasonable, responsible, and realistic resolution.

DO YOU ENJOY YOUR GOAL?

Don’t have a goal you will never want to do. That’s a recipe for disaster. Is your resolution such a chore that you can easily find any excuse to NOT do it? If you’d rather clean toilets than complete your resolution, then perhaps you should reassess your resolution. toilet1I can pretty much guarantee that you will not be successful and that lack of success is certainly going to instill feelings of failure. I think a big part of being successful in keeping a resolution is to give the goal some thought first.

DECIDE HOW YOU WILL IMPLEMENT YOUR GOAL

If you want to get more sleep and go to bed earlier, then set an alarm for 30 minutes before your desired bedtime so you can start your sleep in bedbedtime preparations. If you want to always remember where your keys are, put a hook on the wall and ALWAYS hang your keys there. You will never have to search your home again for keys. Following a routine makes life easier. That goes for anything. Also, use available tools (calendar, Post-It notes, smart phone, etc.) to help you keep organized.

KEEP A TRACK RECORD

By keeping a record of your accomplishments, you are setting yourself up for success. You could keep a record in a journal-like notebook. journalSimply write the date at the top of the page, and write what you accomplished that day (e.g., Sit-ups – 5 minutes; Meditated – 10 minutes). You could also simply use a calendar dedicated just to your resolution and write your activity under each day that you do it. If you are computer savvy, you could keep a spreadsheet. Place the days in the left column; list the activities across the top. Then just put a checkmark in the box corresponding to day and activity. That would be the way I would do it.

I like to see my progress. It motivates me. I enjoy seeing how well I am doing – or NOT doing, so that I can readjust and improve. It may work for you too.

BE PATIENT – YOUR GOAL WILL NOT BE ACCOMPLISHED OVERNIGHT

Your success will not happen overnight. It will take time. You may even become lax at times, but don’t worry. The record keeping that we spoke of above will help to get you back on track.

Before his brain injury in 2005, my husband, David, used to do a half hour of his version of Tai Chi every morning. He’d run twenty miles each week, and he’d regularly lift small weights to strengthen weight_lifting_13his arms. He was fit and healthy. He exercised not only for his health, but also to leave the stress of his laboratory behind. David’s disabilities are all physical, including severely compromised balance, which makes him unable to run. He regrets this, but he has turned his attention to the treadmill – with its handrails – for exercise. He has also recently acquired a recumbent trike, which allows him to pedal away on his own with no danger of falling. None of this was possible when David first arrived home from the hospital. He was confined to wheelchair and bed. He could not even stand unassisted. It was a slow process – one that he has worked on over the past eleven years, but with small steps and small increments of exercise, he is gaining his strength and his independence.

So, no matter what your goal is, BE PATIENT. Reach for the stars, but remember, it will take time.

BE FLEXIBLE

If you choose a goal that you find is not appropriate – it’s too hard, it’s too easy, or you are not enjoying it – QUIT IT!

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It’s your life, and you can make the choices. Because you are a brain-injury survivor, I am sure there are many goals you would like to accomplish. Make new resolutions. (It doesn’t have to be a new year.) And, mix it up.

If you are not seeing the progress you want – for whatever reason, choose something else to work on. You can always come back and try again later. That’s why I encourage you to make reasonable and realistic resolutions. You want success to be imminent.

Once David tried a form of therapy on the recommendation of a friend who insisted that it helped her greatly, and, in fact, it did help her. David tried it for quite a long time and dedicated himself to it, but found it tedious and boring. He soon quit and set his sights on something more enjoyable that was not going to make him miserable. That’s where the flexibility comes in. Do what works for you.

TRY SOMETHING NEW

I mentioned earlier to “mix it up.” That’s not a bad idea for anyone. If boredom sets in, your chance of success will fall greatly. You won’t reach your proposed goal, and you will become disenchanted with the activity. The feelings of failure are right behind. So, don’t put yourself in that position. Make a new resolution, and try something different. It can be something different that is still familiar, or it can be something so different that you have never done it before.David on Recumbent Trike

I want to go back to the story of David’s recumbent trike. In his adult life, he never rode a bicycle. As I mentioned, his preferred method of exercise was to run. When that was no longer a viable exercise mode, he turned to a recumbent trike. That has changed his post-brain-injury life. Before the trike, David was unable to leave the house alone. Now he can leave whenever he wants to. He is able to go to the garage, get on his trike, ride for several hours, and return. (The only thing he cannot do is get off the trike anywhere else because his balance issues do not allow him to walk freely outdoors.) So, try something you have never done before. Maybe you always wanted to draw or paint. Do it.

HAVE A BUDDY FOR SUPPORT

You may want to exercise with a buddy. Exercise can be much easier with a friend. I much prefer walking and talking or treading water in the deep end of a pool and talking or rotating through the machines in the gym and talking. Are you seeing a pattern here? I find exercising with a friend much more enjoyable than exercising alone. No matter what your goal is, if you can do it with someone else, it makes the exercise easier. It also adds an element of accountability. If you have made plans with a friend, you are more likely to meet your goal.swimming

For most survivors with brain injury, life has drastically changed. The kinds of resolutions that you may have made before your brain injury are now more than likely impossible to attain. But, that doesn’t mean that you can’t set goals that you can successfully achieve. The gym may be out of the question, but you can set aside some moments at home for leg lifts, small weights, push-ups, stepping-in-place, etc. You can do anything to keep your body fit.

Each brain injury is different. The disabilities that accompany each brain injury are wide and varied. For some folks, the injury entails only cognitive/learning disabilities or emotional issues. For others, the brain injury might include physical disabilities.

So basically, you want to assess what you can do to improve your life while not being miserable. You want to make resolutions that can fit into your lifestyle. You don’t want to set your goals so high that they cannot be achieved. But, if you set your goals too high, change them. Make your resolutions reasonable, responsible, and realistic. Most of all, make them FUN.

have_fun

 

Click here to listen to my show:

“Responsible Resolutions” on “Another Fork in the Road,” on the Brain Injury Radio Network.”

(Clip Art compliments of Bing.)

As I say after each post: Please leave a comment by clicking the blue words “Leave a Commentanim0014-1_e0-1 below this post.

Feel free to follow my blog. Click on “Follow” on the upper right sidebar.

If you like my blog, share intact it with your friends. It’s easy! Click the “Share” buttons below.

If you don’t like my blog, “Share” it intact with your enemies. I don’t care!

Feel free to “Like” my post

 

Another Fork in the Road Holiday Stressors

Fork in the Road copy“Another Fork in the Road”

This category is an extension of my radio show, “Another Fork in the Road,” which airs at 5:30 pm (Pacific Time) on the 1st and 3rd Sundays of each month on the Brain Injury Radio Network. (See the “On The Air Show Menu” category for a list – with links – of all my shows, which are archived and thus always available.)

On the 1st Sunday of each month, I host a panel of brain injury survivors, caregivers, and/or professionals in the field. On these shows, my panelists and I examine topics pertaining to brain injury.

On the 3rd Sunday of each month, I host guests – brain-injury survivors, caregivers, or professionals in the field.

Since I spend countless hours in preparation for each show, I decided to share the knowledge that I gather with my readers.

Another Fork in the Road

Holiday Stressors

by

Donna O’Donnell Figurski

The turkey and stuffing are gone, and the winter holidays are around the corner. For most folks, the holidays bring happiness and cheer. Extra gaiety is seen in office parties and large family-gatherings. Secret Santas are chosen and Hanukkah candles are lit, Menorahbut for many survivors of brain injury, the holidays are a stressful time, leaving them anxiety-ridden, exhausted, and distressed.

Survivors of brain injury may become melancholy as they remember their lost lives – lives in which they weren’t impaired, lives in which their freedom was at their fingertips, lives in which they were independent and didn’t need to rely on others for their every need. This supposedly joyous time may not be so happy for many folks. The holiday stress can be exaggerated for those living with a brain injury, compounding a survivor’s unhappiness and sometimes causing severe depression. The hustle and bustle of the holidays can definitely add disorganization and chaos to anyone’s life, but for those who live on a Sad GIrl 2daily basis with the confusion that often accompanies brain injury, the holiday season can be an utter nightmare.

The holidays bring many additional activities, like baking dozens and dozens of holiday cookies to give as gifts to family and friends. Entertaining friends might be fun, but decorating the house and preparing food and drinks for guests can be a daunting task. Entertaining out-of-town guests complicates that undertaking even further – arranging sleeping areas with sheets and pillows and extra blankets and towels. Then shopping – ah, shopping – braving the malls with their Women Shoppingwide-eyed, crazed shoppers and their cacophonous noise is not for the faint of heart. The uncertainty of whether Great Aunt Sally will love the little pink unicorn that you found in the bargain basement of Marky’s is tying up your brain in knots. For those who live in colder climes, weather may play a role, as blizzards and freezing rain make it difficult to leave the house and add the pressure of when to get the shopping done. The cold, gray skies can make life seem dreary, altering even the best of temperaments. But the holidays can be conquered, and a survivor can have fun if he or she tones it down a little and takes the holidays in itty-bitty steps.

To help ease their holiday doldrums, survivors of brain injury should try staying in the present or looking to the future. Survivors shouldn’t compare themselves and the current holiday to holidays from the past. It’s normal to feel the loss of one’s “old” self. It’s normal for a survivor to feel sadness at what once was and now is no longer. But if this is the “new normal,” then the survivor needs to make the new normal a better place to be.

Little Christmas TreePerhaps the six-foot tree that a survivor trekked out into the woods to cut down can be replaced by a three-foot artificial tree – something that can beFamily Eating assembled in less than an hour, instead of enduring the stress of an all-afternoon trip. Maybe the family-gathering to eat latkes must be limited to the immediate family to minimize the chaos that a large gathering might cause.

The holiday season is a good time for a survivor of brain injury to pull back. The survivor can make the holidays simpler and avoid their commercialism. So how does a survivor of brain injury still accomplish these goals? Here are some suggestions.

 Plan and Organize

ListMake a list of the things you want to do, and prioritize. Choose to do only one activity or job each day. Decide when you are best able to do the job. Are you better in the early morning hours – when you have more energy? Or are you like me – alive at night? That’s when I get more done. Everyone’s different, and only you will know what works best for you.

Pace Yourself

Baking Cookies-819562Don’t set your expectations too high. That is a guarantee for failure. Instead of baking ten dozen cookies in one afternoon, spread out the job by allowing several afternoons to accomplish the task. Or better still, make a smaller portion of the cookies. Set your sights lower. By planning and pacing yourself, you can avoid becoming overwhelmed, depressed, or simply exhausted.

Keep It Simple

Gift Bags 2Instead of wrapping a present the traditional way with giftwrap and ribbons, pop the gift into a pre-decorated box or a gift bag and stuff some colored tissue paper around it. It will be lovely, and it is so much easier! Do you really need to have a twenty-three-pound turkey with stuffing and all the trimmings? Probably not! A simpler meal will taste just as good and will be enjoyed by all simply because you are spending precious time together.

Accept Help

Wrapping Gifts

Usually family and friends like to offer help, especially during the holidays. Let them! Let them help shop for or wrap presents. Let them help cook dinner or bake cookies. It will be a lot more fun and actually make the holiday a more joyous occasion.

 

Make a change

Try something different. Plan a new routine or create a new ritual.

With some small steps, life during the holidays can be tolerable – maybe even fun. You just have to open your mind, look at life differently, and begin to make “new” traditions.Stress Free Holiday

Click here to listen to my show:

“Holidays – Less Stress – More Fun,” on “Another Fork in the Road,” on the Brain Injury Radio Network.

 

This article was also published on the following onli magazines and journals.

Holiday Stress and Brain Injury” on Lash & Associates Publishing

Brain Injury – Surviving Holiday Stress” on Disabled Magazine

“Holiday Stressors” on TBI – Hope and Inspiration (coming soon – in press)

 

(Clip Art compliments of Bing.)

As I say after each post: Please leave a comment by clicking the blue words “Leave a Commentanim0014-1_e0-1 below this post.

Feel free to follow my blog. Click on “Follow” on the upper right sidebar.

If you like my blog, share intact it with your friends. It’s easy! Click the “Share” buttons below.

If you don’t like my blog, “Share” it intact with your enemies. I don’t care!

Feel free to “Like” my post

 

Another Fork in the Road: Depression, Suicidal Thoughts, & Brain Injury

Fork in the Road copy

“Another Fork in the Road”

This category is an extension of my radio show, “Another Fork in the Road,” which airs at 5:30 pm (Pacific Time) on the 1st and 3rd Sundays of each month on the Brain Injury Radio Network. (See the “On The Air Show Menu” category for a list – with links – of all my shows, which are archived and thus always available.)

On the 1st Sunday of each month, I host a panel of brain injury survivors, caregivers, and/or professionals in the field. On these shows, my panelists and I examine topics pertaining to brain injury.

On the 3rd Sunday of each month, I host guests – brain-injury survivors, caregivers, or professionals in the field.

Since I spend countless hours in preparation for each show, I decided to share the knowledge that I gather with my readers.

Another Fork in the Road

Depression, Suicidal Thoughts, & Brain Injury

by

Donna O’Donnell Figurski

canstock16714646Depression is a state of mind that can cause long-term mental mood disorders. Everyone experiences sadness and unhappiness at times. That’s normal. Those feelings happen when something sad enters people’s lives or they experience grave disappointments. Normal life-events, like a pet dying, being passed over for a promotion, going through a divorce, or experiencing money problems, can trigger feelings of sadness. Usually with time, those feelings pass, and people move on.

But when there are unrelenting feelings of despair, usually coupled to at least one of the many telltale signs and symptoms of depression, then drastic measures need to be taken. Depression is devastating and can affect every aspect of daily living. Depression is pure agony resulting from desperation and the need to escape. It is constant; there is no relief. Unlike sadness or unhappiness, depression settles in to stay. It can last weeks, months, or even years. If not treated, depression can be deadly. But if a person seeks treatment, there are ways to diminish, and possibly even cure, depression.

I have never been diagnosed with clinical depression. Technically, I have never been depressed. But I have occasionally complained that I am “depressed” – using that word. I think everybody does. It’s a term we throw around too easily. When I’m feeling blue or down, I might say, “I’m depressed.” But I’m only experiencing a feeling of unrest or unhappiness for a short time. I have learned that there are ways for me to alleviate these uncomfortable and unwanted feelings with a few easy activities. I find if I remove myself from the environment that I am in, I can change my emotions. For example, if I am home when these feelings overwhelm me, I often will go to the store or run errands. Sometimes I will turn on uplifting music or talk to a friend. Exercise can usually jar me out of my doldrums. While I can change my mood when I’m sad, a truly depressed person can do so only with great difficulty.

Depressed GirlSome signs and symptoms of depression are very intense feelings of unhappiness, anxiety, worthlessness, helplessness, lack of self-esteem, and/or lack of self-confidence. Depression can seriously impact sleep and eating habits. It can lead to a significant loss of energy, focus, or attention. A prolonged feeling of panic is also a sign of depression. A lack of interest in taking care of health needs may be indicative of depression. A person may start to withdraw from his or her family or friends or from the things he or she once enjoyed – essentially quitting the world. Defying fate (for example, doing things that are risky or death-defying, such as swimming too far out into the ocean or walking too close to the edge of a cliff) is a relatively obvious symptom, but what about overeating,Depressed Man overuse of alcohol, or drug use? If a person is talking about suicide or is making statements, such as “Everyone would be better off, if I weren’t here,” “I can’t take this anymore,” or even more blatantly, “I wish I were dead,” that person may be sending up a red flag. It may be the person’s way of begging for help.

Depression is not discriminating. It can happen to anyone. Actress Winona Ryder, Princess Diana, former Pittsburgh Steelers quarterback and four-time Super Bowl winner, Terry Bradshaw, and Barbara Bush, wife of a former United States President all suffered from depression. And the list goes on and on. Sometimes, people hide their depression, as with actor and comedian Robin Williams. I think we were all broadsided when Robin committed suicide in August 2014. Though Robin’s close friends saw signs of his depression, the rest of the world saw only a very accomplished actor who always had a smile on his face. His great acting skills spilled over into his personal life, and his greatest role was “the great deceiver.” I can’t imagine the pain his smile must have been covering up. Robin sought help and willingly admitted himself to treatment centers, but unfortunately that was not his salvation.th

Former San Diego Chargers linebacker and Hall of Fame member, Junior Seau, was deeply affected by depression after years of collisions with other players. Years of playing football ultimately damaged Seau’s brain and led to his suicide in 2012. Chronic traumatic encephalopathy (CTE) was the unequivocal diagnosis by the National Visger, GeorgeInstitutes of Health (NIH) from the study of Seau’s brain. Former San Francisco 49er, George Visger, lives daily with the complications of brain injury. (You can hear George’s story on my August 16, 2015 show. You can also read more about George on this blog.) Another former football player, Kyle Turley, who played for the New Orleans Saints, the St. Louis Rams, and the Kansas City Chiefs is Kyle Turleysuffering the ravages of brain injury and depression. (Kyle will be a guest on my show on October 18, 2015. He will discuss his life with brain injury and how he is redefining his new world.)

Depression is not an unfamiliar state for those who live with brain injury. And it’s not surprising. Brain injury turns lives completely upside down. Usually it’s difficult, sometimes impossible, for survivors to realize the extent of the damage done to their brains. Many times they are not the same person they were before the injury, and they have to face their limitations – cognitive, behavioral, emotional, and/or physical. Thinking back on a pre-brain-injury life and being aware of what was stripped away can easily lead someone to depression – and even to suicidal thoughts.

One way to help deal with depression after brain injury is to accept the “new” person who a brain-injured person has become. I have noticed in the Survivor SPEAK OUT! interviews on this blog that many survivors have stated that, once they accept their “new” persona, they have found more happiness. That isn’t to say that everything is okay. That isn’t to say that the brain-injured persons have given up. It’s just that the survivors have become more accepting of the persons they have become, and they will take those new persons to the limit.

With her permission, I want to share the story of a friend of mine who used an additional method to help with her depression. Cat Brubaker was enjoying life as a young woman. She had completed college, and she was working in a position that she enjoyed. Then she became the victim of two brain injuries. These injuries left Cat feeling helpless and hopeless. With Cat confined to her home, the walls closed in on her, and she felt desperate. Cat’s loss of independence, the decline of her longtime relationships, and finally the death of her mother were too much, and she fell deeply into depression. She eventually entertained thoughts of suicide. But Cat found a way out of her trapped box when she discovered the joys of her recumbent cat-triketrike and met a new friend, Dan Zimmerman, a stroke survivor and also a recumbent trike rider. Cat and Dan set off last summer to cross the USA on their trikes. They rode their trikes from Anacortes, Washington, diagonally across the country to Key West, Florida – a trip that took them five months and was 5,400 miles. I’m not saying that everyone needs to get a trike and travel across the country, but I am pointing out that perhaps finding a new purpose in life can help shove depression into the background. The recumbent trike was the answer for Cat. Zimmerman, Dan Survivor 071015Riding her recumbent trike is something that Cat thoroughly enjoys and relies on for her mental health. Cat has made many new friends by riding her trike. She has even created a foundation, called “Hope for Trauma,” to help other brain-injury survivors. Cat’s story shows that, though people may feel the total helplessness and hopelessness that accompanies depression, it is sometimes possible to find a way to redirect their lives to find happiness.

There are other methods that may help alleviate the feelings of depression. Art Therapy also helps some folks connect with their inner selves. It usually also requires complete concentration, which can take the focus off the unwanted depressive feelings. Animal Therapy guarantees that one is never alone. Pets usually provide unconditional love, which a person suffering from depression could certainly use.

Technically depression is a chemical imbalance in the brain. It is not easy to turn off. So what can be done about depression? Two different types of health-care workers can help immensely: psychologists and psychiatrists.

PsychologistBoth psychologists and psychiatrists use psychotherapy, often referred to as “talk therapy” or “counseling.” Psychotherapy helps patients with mental health issues sort through their feelings, moods, and emotions. Through talk, a mental-health-care provider can guide or retrain a person’s mind to approach existing problems differently. The brain can actually change physically by talking about a problem. Psychotherapy can be effective with many different types of mental-health challenges, including anxiety, personality or mood disorders, problems with eating or sleeping, and various addictions. It can also address coping with life-altering situations, such as the ones that many brain-injury survivors live with daily. Realizing that they are not the persons they were before their brain injury is a major problem for many survivors. Not being able to return to the former life-style and having to redefine oneself can be devastating to a person who survives a brain injury. Often a brain-injured person wonders why he or she was saved. These kinds of thoughts can easily lead to depression.

Psychotherapy does not use medication. Both a psychologist (usually a Ph.D.) and a psychiatrist (an M.D.) use psychotherapy. A psychiatrist has been trained in the biology of the body and in neurochemistry, while psychologists focus more on the behavioral aspects of the person. Some patients may need stronger medical Doctor Womanassistance. Because a psychiatrist is a medical doctor, he or she can prescribe medication. Medications are getting better. The best ones are more targeted and thus have fewer side effects.

Research is very active and is greatly advancing our knowledge of depression. A recent NewsBit on this blog (“Depression Reversed in Mice”) reported that basic research has resulted in the curing of depression in mice. Memories are tagged with positive or negative feelings. Scientists have been able to activate specific neurons to induce a memory with its associated positive feeling to overcome depression. It will probably be a couple of decades before this kind of therapy will be ready for humans.

If you want to learn more about depression, the Internet is a marvelous tool for gathering information. There are countless sites, many very reputable, that examine this topic. Simply Google “brain injury” and “depression.” I can guarantee you will learn more than you could imagine.

Of course, if you or someone you know needs immediate help, don’t waste time on the web. Call 9-1-1 immediately.

There are also many depression and suicide hotlines. Here I name a few in the US that I found on the web. I really do not know anything about them, so I cannot endorse them. But I suggest that, if you have concerns about depression or suicide, you look into them in advance of any crisis.

Hotline-ICON-XS_optiHotlines

National Suicide Prevention Lifeline
800-273-8255
(suggested by the Mayo Clinic)

The Samaritans 24-Hour Crisis Hotline
212-673-3000

Crisis Call Center
775-784-8090

Most states in the US have mental health hotlines. Here is a site that has links to most state hotlines.

Suicide Hotlines

Depression is a common affliction of brain-injured survivors. It needs to be recognized as a serious and devastating illness, not as something one can “work through” himself or herself. The good news is that help is available. If you are suffering from depression or if you know someone showing signs of depression, I urge you to use it.

Listen to the October 4th show on depression.

(Clip Art compliments of Bing.)

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My name is Michelle Munt and this is my story about surviving a brain injury and what I continue to learn about it. This is for other survivors and their loved ones, but also to raise awareness of what can happen to those in an accident. This invisible injury too often goes undiagnosed and it can be difficult to find information about it. I will talk about things that have helped me as I continue to recover and invite others to see if it works for them too.

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