Surviving Traumatic Brain Injury

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

“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 1^st and 3^rd 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 1^st 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 3^rd 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

Depression 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.

Some 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, 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.

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 Institutes 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 suffering 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 trike 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. Riding 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.

Both 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 assistance. 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.

Hotlines

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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