After a patient suffers a head injury or a Traumatic Brain Injury from a car accident or some other kind of trauma, they may experience rapid changes in the person’s behavior, known commonly as mood swings. Many patients experience these emotions in intense, short instances, often only lasting for a short period of time. Other patients may also experience mood swings, however, the emotional change stays with them for longer amounts of time. Most of the time, this is described by people who have a TBI as being “an emotional roller coaster,” as they switch between feelings of sad thoughts, happy thoughts, and than anger, all within just a short period of time. Mood swings are common to people after incurring a TBI as head injuries often damage the part of the brain that is primarily responsible for controlling and governing the different emotions and behavior. If this area is altered or damaged due to an injury to the brain, it is easy to see how it may affect a person’s mood. People with traumatic brain injuries often have unpredictable behavior. For example, someone with a TBI may experience random periods of crying or laughing without the relating emotions if the areas of the brain that control these responses are damaged. Patients who experience mood swings after a severe head injury can often expect the symptoms to recede over time. As the brain heals, the affected areas of the brain will return to normal. If the problem remains the same, doctors can prescribe mood stabilizers and other psychotropic medications to help.
Hello, I am David A. Grant, writing for TBITalk.com .
While there are many people who have lived with lifelong disabilities, I am a relative newcomer to being disabled. For the first forty-nine years of my life, I was fully-abled. Everything changed in late 2010. I was cycling in southern New Hampshire when a sixteen-year-old driver t-boned me. In two ticks of a clock, I went from being fully abled to living the life I live today.
This was not the plan I had for myself.
Unlike many who are visibly disabled, I live with what is commonly called an “invisible disability.” Millions of us that live in today’s society face challenges that are not visible to the naked eye. The list of invisible disabilities is long: autism, fibromyalgia, PTSD, depression, multiple sclerosis, and many mental illnesses are all part of this family of unseen disabilities.
Though the Americans with Disabilities Act (ADA) recognize most hidden disabilities, most of us with invisible challenges fly just under the radar screen of society.
When you see someone in a wheelchair, or perhaps walking with a companion animal, it’s pretty clear that that person may be disabled. But not so with people like me. I can drive without assistance. I work on a part-time basis, spend time with my granddaughter, and go about my day as many others do.
However, looks are deceiving
My cycling accident left me with Post Traumatic Stress Disorder (PTSD). While a common misconception exists that PTSD is exclusive to the military community, many who experience different kinds of trauma also live with the daily challenges that come with PTSD.
My life today feels like an acronym soup, often defined by short bursts of letters that have indescribable effects on my life. In addition to PTSD, I live with PCS (Post Concussive Syndrome) as well as the lasting effects of a TBI (Traumatic Brain Injury).
Like many who have experienced trauma, my life is now split between “before and after.” My life before my accident was average. In fact, some might call it downright dull. I went to work as a self-employed, self-sufficient individual. I’d suit up and show up, pay my bills, spend time raising my children, and move forward toward a future that did not include trauma. In fact, I’d planned to remain busy, happily married, work for another fifteen years, and then retire, doing things that retirees do.
Years ago, I heard a saying that still makes me smile. “If you want to make God laugh, make plans.” If there is an element of truth to this, he must have enjoyed a belly laugh at my plans.
Accepting that I am a disabled adult has been a long and painful process. I have fought the disabled moniker since it was first presented to me in early 2012 when a well-respected doctor let me know that I was “permanently disabled” because of my injury.
How dare he call me disabled? For years, I hated him for that. I am not a big fan of the “H” word, but hate him I did. I fought his diagnosis for many years.
I had completed neuropsychological testing about a year after my injuries in a fact-finding effort to see where my deficiencies remained, and what I could do to speed my recovery. The test results were quite grim. In a couple of key categories, I scored in the bottom 5%.
I, once prideful about my perceived life successes, now sat at the bottom of my cognitive class.
Sure, my tests showed that I was in the lower 5% for complex problem solving and verbal recall. A speeding car had hit me a year earlier. Your scores would have crashed too if you met a teenage driver at 35 MPH with nothing but a plastic helmet to save your life. But disabled? No way. You have got me confused with someone else, someone who might actually be disabled.
I did all I could to prove him wrong. I moved on with my life, wrote a couple of books, started a new career and continued to stumble forward in this new second life.
I’ve since learned that it is easier to realize perspectives in the rearview mirror. With the passage of time comes a new clarity. Here is where it gets hard.
Humbled, I eventually had to admit that the doctor was right. I am disabled. This is perhaps the biggest single mea culpa of my life. I needed to come to terms with my disability in my own terms and in my own time.
For several years, I tried to live my life as I did before my accident, but there were challenges at every turn. Vertigo created the occasional appearance of drunkenness, though I’ve not had a drink for decades. Slow cognitive processing speeds meant that I lived in a perpetual state of time delay. Sure, you can ask me a question, but don’t hold your breath waiting for me to answer. It may take some time for me to understand what you just asked me. Memory issues mean that I might ask you a question, then ask it again, and perhaps a third time for good measure.
None of these challenges is blatant to the naked eye, but spend a bit of time with me, and you’ll learn soon enough that I’m not as normal as I look. Such is the nature of being invisibly disabled.
I fought my fate for close to seven years until I could not fight it any longer.
It has only been over the last few months that I have accepted what I had been most afraid of. By accepting that I am a disabled adult, something unexpected happened—I have gained freedom. I no longer need to struggle to be who I was before my accident.
I am more at peace with my life than I have been in years. I am slowly learning that even though I am disabled, there is still much that I can do. And quite unexpectedly, I feel relief. I no longer have to prove myself. The internal conflict about who I am and how I fit into today’s world has finally gone quiet.
It is in that newfound calm that I will continue to rebuild my new life.
Traumatic Brain Injury – What You Must Know
Traumatic Brain Injury is a serious medical condition that can extremely affect the life of a human being. It is also known as a traumatic head injury, closed head injury or head injury. It can be a confusing injury since it often produces a variety of symptoms that vary greatly from person to person. Symptoms can also vary in adults and children. The best way to learn about this injury is to look at the different symptoms for each type of traumatic head injury.
Causes of Brain Injury
An injury to the brain can be caused by any type of blow to the head. In many cases, it is obvious when a brain injury has occurred. A car accident, for example, may cause a traumatic head injury that is very apparent. However, some injuries are not as apparent. Someone who falls and then gets back up may not even realize they have injured their brain. It is not until later when symptoms present that a person realizes something is wrong.
When a person suffers from a traumatic injury to the head there may be visible swelling or bruising. In some cases, this swelling and bruising may only be inside the skull. When the brain starts to swell it presses against the skull and cause serious effects, even death.
Types of Traumatic Brain Injury and Symptoms
A mild traumatic head injury is one type of brain injury. The symptoms of this type of injury include unconsciousness, amnesia where the person forgets the events that led up to the injury and those following the injury, headache, confusion, dizziness, blurred vision and mood changes.
Moderate to severe traumatic brain injuries can produce persistent headaches, vomiting, seizures, and problems waking up from sleep, dilated pupils, and problems with speech, weakness in the body, and problems with coordination, confusion, and changes in temperament.
Mild, moderate and severe traumatic injuries to the head are the type of brain injuries specific to adults. These injuries in children are much different. Children may not be able to tell you how they feel and they may not have the skills developed yet to recognize when something is wrong.
Symptoms of an injury to the head in children include problems eating, cranky moods, problems sleeping, problems in school and loss of interest in favorite activities.
After an injury to the head or the surrounding area or other traumatic injury or fall, a person should be checked out by medical personnel. Any situation where the body is bumped roughly or otherwise injured could lead to a brain injury. The brain can easily bump against the skull and swelling can begin. It is better to be safe with any type of head injury and seek medical treatment as soon as possible. In most cases, the doctor will simply observe the patient for a short period of time to see if symptoms of an injury to the head are present.
An injury to the head should always be taken seriously. The brain is a complex organ that can easily be injured. It is important to always seek medical care if a traumatic head injury is suspected so that treatment can take place and further problems can be avoided.
Ordinary drugs have shown limited benefits for brain (serious physical or emotional harm) since they don’t address the main cause of what is driving (hard hit to the head that knocks you out) signs of sickness. Now, no neuro-(serving or acting to prevent harm) treatment options exist that improve signs of sickness after a TBI. Now many (people who work to find information) are starting to study a wide range of natural compounds and vitamins that have promising broad-spectrum, (related to protecting nerves from harm), and anti-swelling activity. Curcumin, green tea, extremely important fatty acids, resveratrol, and vitamin E are some of the compounds with potential medically helpful benefit in the treatment of TBI. The (event(s) or object(s) that prove something) for these substances is still very early (and subject to change) and there is much more research needed to confirm these effects in humans, but they offer possible options in a condition with no known treatment.
CURCUMIN – is an active compound found in the spice turmeric. It has attracted much interest as a possible treatment for many long-lasting sicknesses, including Brain disease (AD), cancer, and heart disease due to its powerful anti-swelling and body-protecting chemical properties. While results are still early (and subject to change), curcumin extracts are showing positive benefit in neuro-recovery, cell membrane (making steady/making firm and strong), and reduction of oxidative stress in animals.[8,9,19,11] Other potential medically helpful effects include increasing brain growth factors, chelating heavy metals, reducing cholesterol, and protecting mitochondria.
The problem with curcumin is that it doesn’t (mix with and become part of a liquid) well in water, making its (mental concentration/picking up of a liquid) through the (tube from the mouth to the anus) limited. It is important to point out that only free curcumin (not other curcumin molecules) can pass the blood brain (something that blocks or stops something). Newer, fat (able to be dissolved in something) creations, such as a curcumin extract called Longvida, appear to improve delivery into the bloodstream, past the blood brain (something that blocks or stops something) and into brain tissue.[12,13] Longvida curcumin was developed for nerve-based sicknesses/problems by (people who work to find information) at UCLA. Curcumin stands as one of the most promising (related to protecting nerves from harm) and medically helpful agents in TBI and PCS due its excellent safety profile and wide ranging (machine/method/way) of action.
(Editor’s note: Also, other brands of curcumin have been created for improved bioavailability, including NutriCure by NAKA. Or,/In a different way, (ancient medicine) doctors recommend cooking turmeric in oil, and combining it with black pepper, to improve bioavailability of its voters/parts.)
GREEN TEA – like curcumin, is a well-known and widely used/ate/drank/destroyed herb with broad-spectrum body-protecting chemical activity. Its (related to protecting nerves from harm) properties can be attributed mostly to the power body-protecting chemical molecule called epigallocatechin-3-gallate (EGCG), the amino acid L- theanine, and to a lesser degree (drug that gives you energy). EGCG has been shown to have body-protecting chemical and anti-swelling effects in animal models of brain injury.[15,16,17] One (like nothing else in the world) aspect of green tea is that the L-theanine content may offer protection from excitotoxic injury that happens immediately after a (hard hit to the head that knocks you out). There is a clear need for more research, but promising (event(s) or object(s) that prove something) hints that even regular dietary consumption of green tea may have a (related to protecting nerves from harm) effect if a (hard hit to the head that knocks you out) happens. Some other plant compounds such as resveratrol (found in red wine) and anthocyanidins (found in berries) have also shown (related to protecting nerves from harm) effects. Unlike (related to medical drugs) medicines, these plant extracts have many modes of action and work cooperatingally with each other. They also support the function of the body’s own body-protecting chemical systems and nerve repair systems. There have been some animal trials using plant compounds such as resveratrol, (showing or proving) an anti-swelling and (related to protecting nerves from harm) effect in TBI, but like green tea, there have been no human trials to date.[19,20] Since these molecules are found in many colourful fruits and vegetables, it would be a safe recommendation for people with TBI or PCS to include/combine them into their diets.
OMEGA-3 FATTY ACIDS – have long been thought about/believed extremely important for brain development and function. Docosahexaenoic acid (DHA), and to a lesser degree Eicosapentaenoic acid (EPA), is mostly found in nerve membranes; they influence cell signaling and anti-swelling pathways. Since the human body cannot (in a way that produces a lot with very little waste) convert plant-based extremely important fatty acids to EPA and DHA, fish oil adds to/helpful additions are the best source of the active parts/pieces. (It is important to note that, while using/eating/drinking fish high in omega 3 fatty acids is desirable, the heavy metals and polychlorinated biphenyls (PCBs) found in most fish is a concern, especially for brain function.) Some trials in animal models of TBI have found that DHA and omega-3 addition (to something else) improves thinking-related function, reduces nerve swelling, (makes steady/makes firm and strong) cellular energy production, and increases nerve repair.[23,24] One of these studies showed that pre-injury (something extra you eat or drink) with fish oil also had a (related to protecting nerves from harm) effect.
VITAMIN E – is a commonly studied natural compound for brain health since it has a powerful body-protecting chemical effect, specifically in fatty tissue (i.e. nerves). Some animal studies have found that vitamin E addition (to something else) reduces nerve damage and improves thinking-related performance following repeating, concussive brain injury.[25,26] Interestingly, addition (to something else) before the (hard hits to the head that knock people out) also had a (related to protecting nerves from harm) effect. A good creation should provide all eight molecules of vitamin E, with the highest proportion being the strong gamma-tocopherol, which is carefully thought about/believed the most anti-swelling part. Also, vitamin E works with other body-healing chemicals, such as vitamin C and coenzyme Q10 as part of a body-protecting chemical network. This highlights the need to consume body-healing chemicals together in order to support their proper (related to the body function of living things) function.
CREATINE, L-CARNITINE, ALA AND MORE – There are some other newly-visible (vitamins, minerals, protein, etc.) now being studied for TBI. Creatine, an amino acid found in muscles, has human (event(s) or object(s) that prove something) supporting its benefit in reducing signs of sickness after a (hard hit to the head that knocks you out). Benefits were found for addition (to something else) before and even after the injury, (event(s) or object(s) that prove something) that creatine can be used to prevent and treat nerve-based shortages after a (hard hit to the head that knocks you out). There are other promising adds to/helpful additions being studied, including acetyl L-carnitine, alpha lipoic acid, B12, ginkgo biloba, and magnesium.
HYPERBARIC OXYGEN THERAPY – Another (action that helps a bad situation) suggested to have helpful effects on TBI recovery is hyperbaric oxygen therapy (HBOT), although more research is needed to confirm its benefit.
When you get a traumatic brain injury (TBI), your life will probably never be the same. Although the time of healing depends on the area of your brain that was most affected, it can take up to several months to re-learn some of the most common things that you usually took for-granted; this tends to put TBI patients under a lot of stress.
Although it is normal to have stress, too much stress can cause other serious health problems, including heart problems. Stress can affect your ability to be focused, think clearly or be organized, as well as it can have a negative impact on relationships with your closest family members and/or friends. Learning how to manage your stress should be one of your paramount concerns. When you are under stress, you will likely start to feel anxious and frustrated.
4 ways to speed up your traumatic brain injury healing:
#1: Learn To Relax:
Learning to relax is never easy, and it may be more complicated in your situation. However, there are certain things you can easily do to train your mind and body to relax. You might want to try out breathing deeply while focusing on your breathing, do some visual imagery, or thinking positive. Although it may take you some time to be able to relax, it will help a lot.
#2: Learn To Reward Yourself:
Rewards can be good and rewards can be bad; it all depends on how you manage them. Say, something like therapy, occasionally going to something like therapy is the last thing we want to go and do. However, sometimes, we just need a push. Whenever you achieve one of your goals, reward yourself. It doesn’t need to be anything fancy or expensive. Just think about the things that give you more pleasure. It can be as simple as having that amazing cup of coffee you love, read a great book, or watch some specific TV show. Whatever works best for you.
#3: Keep A Regular Schedule:
One of the things that your brain is going to appreciate and that is going to speed up your TBI healing are routines. Just think about children, especially babies. They understand very little, if you manage to set them to eat and sleep at the same time, everyday, their bodies and mind will quickly adapt. No matter how old you are, your brain keeps working the same way and reacts a lot better when you have routines. Make sure that you have specific times for eating and sleeping.
#4: Regular Exercise:
Getting regular exercise is good for everyone, as you already know. When you’re looking to speed up your TBI healing process, make sure regular exercise is a part of your daily routine. You do not need to workout like a bodybuilder or anything like that. Simply take a walk, for about 30 minutes every day.
Although you don’t have complete control over your TBI healing, there are things that you can do that can make it quicker.
There is a link between the amount of sleep the patient gets and the rate at which their brain heals.
A study of 30 people that were hospitalized for moderate to severe traumatic brain injuries found that sleep quality and brain function improved in tandem, researchers reported in the journal Neurology.
“Patients who still had low levels of consciousness and cognitive functioning would “sleep for a couple of minutes and then wake up for a couple of minutes,” both day and night, says Nadia Gosselin.
The results increase the possibility that patients with brain injuries possibly recover even quicker if hospitals would take measures to restore normal sleep patterns, Gosselin says. Drugs are one option, she says. Another is making sure patients are exposed to sunlight or its equivalent during the day and at night rest in a dark, quiet environment.
“I think bad sleep can have bad consequences for brain recovery,” she concludes.
A new test using peripheral vision reaction time could lead to earlier diagnosis and more effective treatment of mild traumatic brain injury, often referred to as a concussion. Identify Brain Injury
A new test using peripheral vision reaction time could lead to earlier diagnosis and more effective treatment of mild traumatic brain injury, often referred to as a concussion, according to Peter J. Bergold, PhD, professor of physiology and pharmacology at SUNY Downstate Medical Center and corresponding author of a study newly published online by the Journal of Neurotrauma.
While most patients with mild traumatic brain injury or concussion fully recover, a significant number do not, and earlier diagnosis could lead to better management of patients at risk for developing persistent symptoms, according to Dr. Bergold and his co-authors.
Lingering symptoms may include loss of concentration and/or memory, confusion, anxiety, headaches, irritability, noise and light sensitivity, dizziness, and fatigue.
“Mild traumatic brain injury is currently diagnosed with subjective clinical assessments,” says Dr. Bergold. “The potential utility of the peripheral vision reaction test is clear because it is an objective, inexpensive, and rapid test that identifies mild traumatic brain injury patients who have a more severe underlying injury.”
Dr. Bergold’s co-authors include colleagues from the University of Texas Southwestern Medical Center; The University of Texas at Dallas; Washington University; the National Institute of Neurological Disorders and Stroke; the Uniformed Services University of the Health Sciences; and SUNY Downstate.
The article published by the Journal of Neurotrauma is titled “Measurement of Peripheral Vision Reaction Time Identifies White Matter Disruption in Patients with Mild Traumatic Brain Injury.”
- Kyle B. Womack, Christopher Paliotta, Jeremy F. Strain, Johnson S. Ho, Yosef Skolnick, William W. Lytton, L. Christine Turtzo, Roderick McColl, Ramon Diaz-Arrastia, Peter J. Bergold. Measurement of Peripheral Vision Reaction Time Identifies White Matter Disruption in Patients with Mild Traumatic Brain Injury. Journal of Neurotrauma, 2017; DOI:10.1089/neu.2016.4670
SUNY Downstate Medical Center. “New test may quickly identify mild traumatic brain injury with underlying brain damage.” ScienceDaily. ScienceDaily, 16 February 2017. <www.sciencedaily.com/releases/2017/02/170216120538.htm>.
– “Through my own experience dealing with a TBI, I found it beneficial to think positive, not only to me; but the world around me.” -Ryan
There may be no different choice around it, sorry…
you will enjoy negativity in your lifestyles–maybe on a day by day incidence.
There may be some of those days in which you want you stayed inside, laid on the mattress and played tag with the snooze button. There can be those days in which the people, locations, matters and events in your existence come collectively to shape one massive large mass of ‘suck’. As they are saying, things happen. For us in the ‘healing process’, the technique of navigating the bad that takes place to us can be an thrilling experience.
I am now not saying that the mere sliver of negativity will compel you to hurry without delay to the liquor store, corner tavern or your supplier, but in case you let the terrible things simmer and stew inside the crockpot of the soul chances are going to be almost exact that we are able to smell what we are cookin’ and it’ll not indicate properly for us.
The negative events that we encounter in our day-to-day doings are one of the most not unusual snares that we can fall into in regards to relapse. It’s sincerely crucial to stand what stresses, angers, and frustrates us head-on, but ‘cooking’ inside the juices of adversity and permitting it to run insurrection is ‘no bueno‘. How can we maintain the finger off the cause at the same time as shifting forward and keeping our sanity intact?
Understand the power of superb wondering in healing.
We ‘suppose’ a lot
have you ever ever thought approximately how many thoughts you’ve got in a single day?
Consistent with some estimates, we as people average between 40,000 to 60,000 different thoughts an afternoon. Isn’t that remarkable?? That may be a ton of information that passes thru our gray rely, and it’s miles a secure bet that a honest percent of those mind are the ones that motive us grief and problem to various tiers. Paying payments, elevated workload or college work, family issues, tickets, remembering to take the kids to soccer practice/dance class/lacrosse…the listing can go on and on…
It’s no wonder why there are days when we lay down and experience like we have been hit with the aid of a truck. Bad electricity drains us and breaks us down, and if we permit ourselves to stay stuck within the doom and gloom the manner we view ourselves, others and the world round us starts to bitter. While we live in Debbie Downer mode, we are extra prone to feeling prolonged periods of depression and anxiety because we stay caught in emotions of anger, frustration and hopelessness–and that is horrific in we’re looking to maintain our sobriety.
While we stay stuck in negativity, we’re at greater danger for growing high blood pressure, elevated times of infections, cardiovascular ailment and digestive problems. Moreover, research has shown that continual pressure and negativity can genuinely lower our lifespan with the aid of shortening our telomeres (the “end caps” of our DNA strands, which play a massive role in getting older).
It’s miles truly essential that we include advantageous wondering in recuperation if you want to stay on the level. As with the whole lot that we do in recuperation, staying wonderful in sobriety takes realize how.
Embracing Positivity In recovery
whilst you are careworn with the grind of existence and are weighed down via the negative, you’ll be amazed to analyze that some of the things that we agonize and dread in reality flip out for the pleasant. How many instances has that happened to you? Our pals at Happify daily proportion the following:
85 percent of the stuff we fear about end up having a tremendous or neutral final results.
Inside the occasion that what we fear about becomes reality, eighty percent of humans say they treated the outcome higher than they thought they could.
In our recuperation, it is important to maintain this in mind. We regularly pay attention around the tables of 12-step meetings the phrase this too shall pass, and at the same time as this pronouncing is properly-worn (and dare we say cliche) it’s miles absolutely the fact. Whether or not we believe it or no longer, we have an enormous power in reserve and we can persevere and pull via matters regardless of what the chances.
Easy recommendations to growth Positivity in your recovery
when we talk of positivity in recuperation, you already possess a number of the tools you want. When you have are in a drug remedy application or have already efficiently finished a treatment program, you had been taught the simple but essential life skills needed to keep your recuperation game on point at the same time as efficaciously navigating the molehills and mountains of daily existence.
You can additionally have picked up some of those abilities on your homegroup, via operating along with your sponsor or through a member of the family or pal. The subsequent are easy ways that you may incorporate and enhance tremendous questioning for your healing.
One manner to increase your tremendous questioning in recuperation is through the usage of meditation. Meditation is a powerful device which you have at your disposal, and if you may carve out 15 mins an afternoon you may advantage first-rate advantage. Whether it is simple aware meditation practices or greater formal meditation practices, focusing on your breathing is enjoyable and allows you attention on the here and now and the way you can impact the present. Whilst you exercise meditation frequently, any mind of the past or future fall to the sides and you can place your energies on what you may do right now to be happier.
Take duty in your existence
you know this, but you on my own are liable for your life, and also you on my own have the power to convert your life. This simple truth can be difficult to border in our minds due to the fact we often pinned the blame on others when we had been lively in our dependancy. As stated in advance, we’ve limitless electricity that resides inside us and while the chips are down we may be amazed at how we are able to pull through. Now could be the time to position the capabilities and realize how to proper use.
Stick with the Winners
if you need to come to be greater nice, you want fantastic role models. Another one of the commonplace announcing heard in 12-Step meetings is stay with the winners and the that means is simple. You want to dangle with folks that meet adversity of their existence with energy and fortitude. Whether or not is it your peers in restoration, circle of relatives participants, friends or whomever, discover the ones people in your lifestyles who recognise how to deal with negativity in a wholesome, constructive and sensible way and soak their know-how in like a sponge.
Be of provider to a person
in order to tug out of a tailspin, it is good to get out of your self and be of carrier to someone else. Volunteer your time at a drop-in middle, senior citizen home, or nearby sanatorium. Be a mentor or a sponsor to someone who’s new in recovery.
To generate positive mind for your healing, every now and then you simply ought to faux it that allows you to make it. You can not sense like it or up to it, however the easy act of placing a grin in your face may additionally help you get out of the doldrums. It’s miles often said that it takes extra muscle tissue and strength to frown than it’s far to grin. Simply the simple act of a grin could make you feel lighter. Provide it a attempt.
Like almost everything else in life, recovering from a TBI is a process. This article will make you aware of the different stages of that process.
In the first few weeks after a brain injury, swelling, bleeding or changes in brain chemistry often affect the function of healthy brain tissue. The injured person’s eyes may remain closed, and the person may not show signs of awareness. As swelling decreases and blood flow and brain chemistry improve, brain function usually improves. With time, the person’s eyes may open, sleep-wake cycles may begin, and the injured person may follow commands, respond to family members, and speak. Some terms that might be used in these early stages of recovery are:
- Coma: The person is unconscious, does not respond to visual stimulation or sounds, and is unable to communicate or show emotional responses.
- Vegetative State: The person has sleep-wake cycles, and startles or briefly orients to visual stimulation and sounds.
- Minimally Conscious State: The person is partially conscious, knows where sounds and visual stimulation are coming from, reaches for objects, responds to commands now and then, can vocalize at times, and shows emotion.
A period of confusion and disorientation often follows a TBI. A person’s ability to pay attention, agitation, nervousness, restlessness or frustration may appear. Sleeping patterns may be disrupted. The person may overreact to stimulation and become physically aggressive. This stage can be disturbing for family because the person behaves so uncharacteristically.
Inconsistent behavior is also common. Some days are better than others. For example, a person may begin to follow a command (lift your leg, squeeze my finger) and then not do so again for a time. This stage of recovery may last days or even weeks for some. In this stage of recovery, try not to become anxious about inconsistent signs of progress. Ups and downs are normal.
Later stages of recovery can bring increased brain and physical function. The person’s ability to respond may improve gradually.
Length of Recovery:
The fastest improvement happens in about the first six months after injury. During this time, the injured person will likely show many improvements and may seem to be steadily getting better. The person continues to improve between six months and two years after injury, but this varies for different people and may not happen as fast as the first six months. Improvements slow down substantially after two years but may still occur many years after injury. Most people continue to have some problems, although they may not be as bad as they were early after injury. Rate of improvement varies from person to person.
It is common and understandable for family members to have many questions about the long-term effects of the brain injury on the injured person’s ability to function in the future. Unfortunately, it is difficult to determine the long-term effects for many reasons.
- First, brain injury is a relatively new area of treatment and research. We have only begun to understand the long-term effects in patients one, five, and ten years after injury.
- Brain scans and other tests are not always able to show the extent of the injury, so it is sometimes difficult early on to fully understand how serious the injury is.
- The type of brain injury and extent of secondary problems such as brain swelling varies a great deal from person to person.
- Age and pre-injury abilities also affect how well a person will recover.
We do know that the more severe the injury the less likely the person will fully recover. The length of time a person remains in a coma and duration of loss of memory (amnesia) following the coma are useful in predicting how well a person will recover.
The Rancho Los Amigos Levels of Cognitive Functioning (RLCF) is one of the best and most widely used ways of describing recovery from brain injury. The RLCF describes ten levels of cognitive (thinking) recovery. Research has shown that the speed at which a person progresses through the levels of the RLCF can predict how fully a person will recover.
The Rancho Los Amigos Levels of Cognitive Functioning:
Level 1– No Response: Person appears to be in a deep sleep.
Level 2– Generalized Response: Person reacts inconsistently and not directly in response to stimuli.
Level 3– Localized Response: Person reacts inconsistently and directly to stimuli.
Level 4– Confused/Agitated: Person is extremely agitated and confused.
Level 5– Confused-Inappropriate/Non-agitated: Person is confused and responses to commands are inaccurate.
Level 6– Confused-Appropriate: Person is confused and responds accurately to commands.
Level 7– Automatic-Appropriate: Person can go through daily routine with minimal to no confusion.
Level 8– Purposeful-Appropriate: Person has functioning memory, and is aware of and responsive to their environment.
Level 9– Purposeful-Appropriate: Person can go through daily routine while aware of need for stand by assistance.
Level 10– Purposeful-Appropriate/Modified Independent: Person can go through daily routine but may require more time or compensatory strategies.
Recovery two years after brain injury
Based on information of people with moderate to severe TBI who received acute medical care and inpatient rehabilitation services at a TBI Model System, two years post-injury:
- Most people continue to show decreases in disability.
- 34% of people required some level of supervision during the day and/or night.
- 93% of people are living in a private residence.
- 34% are living with their spouse or significant other; 29% are living with their parents.
- 33% are employed; 29% are unemployed; 26% are retired due to any reason; and 3% are students.
This information is not meant to replace the advice from a medical professional. You should consult your health care provider regarding specific medical concerns or treatment.
Our health information content is based on research evidence whenever available and represents the consensus of expert opinion of the TBI Model Systems directors.
Our health information content is based on research evidence and/or professional consensus and has been reviewed and approved by an editorial team of experts from the TBI Model Systems.
Understanding TBI was developed by Thomas Novack, PhD and Tamara Bushnik, PhD in collaboration with the Model System Knowledge Translation Center. Portions of this document were adapted from materials developed by the Mayo Clinic TBIMS, Baylor Institute for Rehabilitation, and from Picking up the pieces after TBI: A guide for Family Members, by Angelle M. Sander, PhD, Baylor College of Medicine (2002).
Understanding TBI: Part 3 – The Recovery Process. (n.d.). Retrieved February 14, 2017, from http://www.msktc.org/tbi/factsheets/Understanding-TBI/The-Recovery-Process-For-Traumatic-Brain-Injury
Brain Injury Association of America
Centers for Disease Control and Prevention
Defense and Veterans Brain Injury Center
Health Resources and Services Administration
National Association of State Head Injury Administrators
National Brain Injury Research Treatment and Training Foundation
National Center for Medical Rehabilitation Research, NICHD, NIH
National Institute on Disability and Rehabilitation Research
National Institute of Neurological Disorders and Stroke, NIH
North American Brain Injury Society
Social Security Administration