Mental Health

I felt a lot of shame for the mental health struggles I have after my brain injury. I have learned to be kinder to myself and have created and/or posted some information and posters that might help you:

What if things are ok the way they are?

What if I trust the way things were meant to be?

What if I am more resilient than I give myself credit for?

What if I gave myself permission and space to have my big feelings?

What if life is not as complex as I think it is or needs to be or as I make it?

What if I am already fulfilling and creating goals for my life through everyday activities?

What if I was confident in the efforts that I am making in the face of uncertainty?

What if I am already handling my big feelings through resilience and gratitude?

What if I let control out and let chaos in, and let chaos initiate the exchange?

What if I were to just let life happen rather than forcing certain outcomes?

What if I consider my time for appointments and other things as gold?

What if it is ok that not every feeling I have is a great one?

What if I let my guard down?

What if I let go?

You will be dealing with some or a combination of these after your accident:

Anxiety:

Difficulty with cognitive processes, reasoning and decision making make it harder to solve problems and see them with a healthy/accurate perspective. Some people then perseverate on problems making them seem larger and more unwieldy than they really are. Then we try to protect ourselves by being on the lookout for anything bad, so we don’t get overwhelmed and have to perseverate more. Then we find ourselves in a state of over vigilance like in a state of continually being chased by wild animals…(it’s got big fangs and moving faster but I have to stay ahead of it!!). We feel we have to keep vigilant and be ahead of it, or it will get us (leaving me in more shock, pain, or something that needs to be processed).

Depression:

Depression can happen when people try to adjust to a new life that includes disability and loss/change. Sometimes it is the result of unhelpful thinking habits, or changes in biochemistry, especially areas of the brain that control emotions. Sometimes it is the result of not meeting a set of expectations you have for yourself. Changing the way you think can be facilitated through Cognitive Behavioural Therapy.

Emotional outbursts:

These are caused because the parts of the brain that control emotions have been injured. People may just spontaneously cry for no reason or have a strong emotional response to something that may be out of proportion. It might also be reacting to feeling isolated, overwhelmed, depressed or misunderstood. Difficulty concentrating, remembering, expressing oneself or following conversations, all can lead to frustration and emotional lability. Difficulty with identifying and expressing emotions is common after brain injury.

Emotions are exaggerated after an MVA. If you had anxiety before, it will be exaggerated after. If you were depressed before, that will be exaggerated after too. Same with irritability, anger, impulsivity, emotionality, etc.…
Handling life and other tragedies after MVA can be harder and is a skill to develop and practice
Processing a pandemic is much harder for those with brain injury because the demands of inflexible thinking, assessing risk, and further isolation affects mental health
It is important to learn how to manage: self- care, gratitude, positivity, meditation, reducing stimuli, simplifying your life, expecting less, self-love and patience, mindfulness, and possibly psychological treatment (CBT).

PTSD, Trauma and intrusive imagery

Post-accident: Its common to be triggered by watching news or reading newspapers because you can’t unsee images that pop up without notice. These images then stay like you and pop up in your brain like you are seeing them flash for the first time and then experience the shock each time anew. Brains do this to protect from further loss, the resulting anxiety, or the perseveration of the image/thought. Perseveration about the thought can then turn into a judgement/panic cycle. "Why am I thinking that? Seeing that? Remembering that?"Catastrophizing about life events, trying to anticipate them (outrun them) is the brain trying to protect itself from being shocked, pained or caught off guard.

How to manage intrusive thoughts/imagery

Think about containing the thought outside of your body…like under a glass so you can see it and look at it non-judgmentally like a pet. Have I had this kind of thought/image before? What happened after some time went by? What happened if I don’t feed it? What happens if I do?
Thoughts/images are wild on purpose. They are designed to get your attention on a second’s notice and divert it from whatever you were in the middle of doing
People who have intrusive thoughts about hurting others, themselves, sexual or religious depravity can sometimes get the thought action fusion happening where they panic about a thought because they think once you have a thought like that you will definitely act on it. Thoughts and actions originate completely differently in our brains. People who actually do the things that are in your thoughts have likely had a lifetime of problematic behaviour or “clues” to what led up to it. People don’t just snap.
Accept or understand these symptoms as overstimulation or a signal that you are taxing yourself and remember they will eventually die down. Time for a nap.
Mindfulness: Your mind will go to the brightest sparkliest thing which is the intrusive thought. Keep bringing it back to the present, or what you are doing right now. What is in front of your face. Keep doing things that remind us that all is well, or a distraction activity. Remember we might get distressed, but we are safe. Have extra self- compassion and give yourself credit for recognizing: ’whoop there I go again”. Time will go by, and you can bring your mind back from distress with kind and loving thoughts “I’m ok” “I am not alone” “other people experience this” “I have gotten through this before”

Great book on the subject: Sally M Winston and Martin Seif (2017). Overcoming Unwanted Intrusive Thoughts. New Harbinger Publications

This book helped me understand that most intrusive thoughts often start with "what if...??"

What if???

What if I am no longer relevant●What if I don’t matter●What if I lose control●What if I make a fool our of myself●What if I don’t live up to others expectations of me●What if I am no longer like the person I have always been●BULLSHIT●What if I lose the ability to demonstrate intelligence●What if I’m not productive●What if I let others define my worth●What if I hurt●What if there is pain●What if I have big feelings●What if I can no longer hide my disability●What if people cant accept who I am●What if I don’t know how to feel●What if I’m not normal●What if I cant find something to do with the rest of my life●What if what I do isn’t important●What if I lose those I rely on most●What if I can’t●What if????●

Understanding your own mental health

Sometimes you just have to stop making lemonade out of lemons. Sometimes life is crappy. Its ok to just wallow in the fact that everything is not great. That’s OK. Your goal is to understand your process, not always being happy.

'I'm out of the freakin' lemonade business. I can't put a shiny face on this. This sucks, and who am I to tell people to be optimistic?'- Michael J. Fox

How to help yourself understand your process

We need to develop an internal locus of control to build confidence in our own process. Don’t be a fool to your emotions and let them cart you off to places you don’t want to go. Where are they on this scale?

Manageable….………………………………………. Unmanageable

Meaningless……………………………………….… Meaningful

Structured……………………………………………….Unstructured

Easy to influence………………………………..……. Impossible to influence

Significant……………………………………………….Insignificant

Clear……………………………………………………...Unclear

Controllable……………………………………………. Uncontrollable

Rewarding………………………………………………. Unrewarding

Predictable……………………………………………… Unpredictable

Being in control…………………………………………Letting go

Ability to plan my life…………………………………...Life that happens without planning

Within my control………………………………………. Outside of my control

Personalization of events……………………………... Things I have nothing to do with

Catastrophizing………………………………………….Remaining in the present

My personality……………………………………………How I choose to define myself

My Time…………………………………………………..How I choose to spend my time

Grounding

Grounding is the act of connecting a conductor, or exposed conductive parts of an installation, to the earth. Grounding, also called earthing, is a therapeutic technique that involves doing activities that “ground” or electrically reconnect you to the earth. Grounding is also a way to help you get your mind into the present, to stop thinking too much and connect with the environment outside yourself.

How do I ground Myself? A phone call with parents, family, friends, a psychologist appt, yoga, meditation, distraction to another activity, journaling (pen to paper), paying bills, cleaning

Physical techniques

Pick up/touch items near you
Breathe deeply
Eat or drink something
Take a short walk
Hold a piece of ice, or put your hands in water/do dishes
Smell something good-candle, flower,
Move your body
Listen to your surroundings
Meditate
Do yoga

Mental techniques

Play a memory game
Do a crossword, sudoku
Use math and numbers-pay bills
Use an anchoring phrase
work on a small project
Do a task or chore you enjoy or don’t mind doing
Do something for someone else. Anything.

Soothing techniques

Practice self-kindness Repeat “You’re having a rough time, but you’ll make it through”” you’ve been here before and were able to manage”, “you’re doing your best.”
Sit with your pet
meditate
Plan an activity
List positive things, gratitude
Listen to music
Watch ASMR videos on YouTube
https://www.braininjurycanada.ca/guide-mental-health-covid-19/
https://msktc.org/tbi/factsheets/emotional-problems-after-traumatic-brain-injury