Traumatic Brain Injury: Living With It

Staying Healthy After Traumatic Brain Injury

Living well after a traumatic brain injury 

Traumatic brain injury (TBI) is an injury to your brain that may change the way you feel, act, move, and think. For veterans who have been deployed in a war zone, a blast injury is often the cause of a TBI. They can also be caused by accidents, injuries, fights, or falls. If you have been diagnosed with a TBI, recovery may continue for a long time after you leave the hospital.

A TBI can change your life. Symptoms may include slowed thinking, headaches, clumsiness, memory loss, and mood swings. Learning how to deal with these symptoms can be hard and even make you feel depressed and angry. But the good news is that most TBI symptoms do and will improve with time. And even though some symptoms may last for years or even a lifetime, you can find ways to cope.

Recovery after a TBI

Everybody’s brain heals differently after a TBI. How quickly you will recover is unpredictable. It can be hard to be patient during recovery. You may look fine on the outside, but be struggling on the inside. You may have good days and bad days. The important thing to remember is that you will get better. Staying active, spending time with friends and family, and trying to live as normal a life as possible is the best way to cope.

Tips for living well 

Continue working with your TBI team. They can help you with your physical and mental recovery. Make sure to keep all your appointments and be honest with your health care providers about your symptoms. The recovery steps that you take on your own are also important, and many are good habits that you should continue for a lifetime. Try to:

A TBI can change your life in ways that are hard to deal with. The biggest mistake is to give up and drift away from caregivers, friends, and loved ones. It takes some courage and willpower, but you need to stay active and involved. And you don’t have to do this alone.

Improving sleep after traumatic brain injury

A traumatic brain injury (TBI) is a sudden jolt to your head that causes your brain to change the way it works. This could be the result of a blow to your head, a blast, a sudden movement of your head that bounces your brain inside your skull, or a bullet or fragment entering your brain.  For people in the military who are deployed, blast injuries are a common cause of TBIs. Falls, fights, sports, and motor vehicle accidents are other common causes before, during, and after deployment.

TBI can cause many brain changes. Because everybody’s brain is different, your symptoms may be different from those of other people. Symptoms can include changes in the way you feel, act, think, and move. Having trouble sleeping is one symptom that affects many people with TBI. Studies show that about 60 percent of people with TBI have this problem.

Why TBI causes sleep problems 

Having a TBI may cause a sleep problem because it can disrupt your “internal clock.” This is the part of your brain that tells you when to sleep and when to wake up. Other problems and some common TBI symptoms also can make sleep more difficult. These include:

Types of sleep problems with TBI

If you are recovering from TBI, you may:

Why sleep is important for TBI recovery

Your brain needs sleep to recover from a TBI. Not getting enough sleep can make many other TBI symptoms worse. These symptoms include:

Help for TBI sleep problems

Medications that help you sleep are rarely the answer for sleep problems that a TBI causes. Many sleep medications, including over-the-counter drugs, can make TBI worse. Do not take any sleep medications or aids before checking with your TBI team.

The best way to treat TBI-related sleep problems is with what is called good sleep hygiene. That means:

Sleep problems are common after a TBI. If good sleep hygiene is not solving your sleep problems, talk with your doctor. You may need to learn some relaxation techniques or try talk therapy to help you through a mental health problem like depression or anxiety.

Sleeping well is one of the best ways to help your brain recover. Do everything you can to get the rest you need.

Preventing traumatic brain injury

Traumatic brain injury (TBI) is an injury to your brain that changes the way your brain works. A TBI can change the way you think, feel, act, and move. For military people deployed in combat zones, the most common type of TBI is a blast injury.

A TBI can result from anything that jolts your brain. Some causes are a bullet or fragment that enters your brain, a fall, a motor vehicle accident, a fight, or a sports injury. About half of all TBIs outside combat are caused by motor vehicle accidents. Violence causes about 20 percent, and sports injuries cause about 3 percent.

Preventing a second TBI 

If you were diagnosed with a TBI in the past, you should know that recovery may be slower if you have another TBI. If you still have symptoms of a TBI, they can increase your risk for a second TBI. These symptoms include:

Make sure you are aware of these symptoms and work closely with your rehabilitation caregivers to manage them. Don’t try to drive or participate in any dangerous activity if your symptoms put you at risk for an accident.

Preventing a first TBI

Substance abuse is using a substance like alcohol or drugs in a way that is dangerous to you and others. Some service members or veterans have trouble with alcohol or drugs after returning from combat. Abuse of alcohol or drugs can lead to a first or even a second TBI.

Alcohol is the most commonly abused substance in people who have a TBI. Studies show that 75 percent of people who are admitted to the hospital for a TBI have been drinking alcohol.

Risky behavior is another danger that can lead to a TBI. Mental health issues like depression and posttraumatic stress disorder can lead to poor decision-making and high-risk behavior, including problems with drugs and alcohol. All of these factors can increase your risk for a TBI.

Tips for preventing TBI

The first tip is to recognize the dangers of a TBI and avoid risky behavior. Let someone know if you are having trouble adjusting to work or family life. Here are some other tips:

A TBI is a risk for people while in combat and after returning home. If you’ve been diagnosed with a TBI, work closely with your TBI team until your brain heals. And be aware that your symptoms could put you at risk for another TBI. If you’ve never had a TBI, you can prevent one by avoiding risky behaviors and asking for help if you are struggling to cope.

Depression and traumatic brain injury

Traumatic brain injury (TBI) is an injury to your brain that can change the way you think, act, and feel. It is easy to understand how a brain injury can change your thinking. It may be harder to understand how it changes your feelings. In fact, dealing with changes in feelings and emotions may be the hardest part of a TBI.

A TBI is caused by a jolt or a blow to the brain. A TBI is more common in military life than in civilian life. It can be caused by a blast injury or by a fall, motor vehicle accident, fight, or sports injury. One of the changes that can occur after a TBI is depression. Studies show that depression affects anywhere from 15 to more than 50 percent of people with a TBI.

A TBI may change your brain in a way that increases your risk for depression. The stress of recovering from a TBI can also increase your depression risk. It is important to recognize and treat depression because it can slow your TBI recovery. The combination of a TBI and depression is also dangerous. It may increase your risk for substance abuse and even suicide.

Symptoms of depression after a TBI

Many of the symptoms of depression and TBI are similar. Having a TBI can get you down. It is normal to have “the blues” sometimes. But depression symptoms tend to be worse and last longer than the blues. Let your TBI team know if you have symptoms of depression, such as:

Treating depression after a TBI

If you have a TBI and depression, you should be treated for depression in addition to the steps you’re taking to recover from the TBI. Know that depression is a medical problem, not a sign of weakness. You can’t just snap out of it using willpower. Untreated depression can lead to problems at work and at home. The good news is that you are not alone and that there is treatment for depression that works. Here are some types of effective treatment:

Symptoms of depression and a TBI can be very similar. Let your doctor know about any TBI symptoms that are getting worse and about any new symptoms. If you have feelings of sadness, hopelessness, or grief that are interfering with your life and your TBI recovery, it could be depression.

Don’t try to treat your symptoms with alcohol or drugs. These substances make both depression and the TBI worse. Always let someone know right away if you have any thoughts of suicide. Thoughts of suicide are a medical emergency.

Here are some resources you can use for more information and support:

Adjustment disorder and traumatic brain injury

A traumatic brain injury (TBI) is an injury to your brain that can change the way you think, act, and feel. For people in the military who are deployed, blast injuries are a common cause of mild TBIs. Falls, fights, sports, and motor vehicle accidents are other common causes.

Experiencing a TBI and recovering after a TBI are life-changing and stressful events. One problem that some people develop after a trauma like a TBI is a group of symptoms called adjustment disorder.

Diagnosing adjustment disorder along with a TBI is important. Adjustment disorder may make it harder for you to participate in your TBI recovery program. It may also increase your risk for abuse of alcohol and drugs. If it is not treated, adjustment disorder may even lead to thoughts of suicide.

Symptoms of adjustment disorder

Adjustment disorder symptoms usually start within three months of a traumatic event. The traumatic event could be your TBI or your combat experience. It could also be a divorce, death of a loved one, worries about money, or other major changes taking place in your life. Symptoms of adjustment disorder can be bad enough to affect your ability to function normally at home or at work. They may include:

What to do for adjustment disorder

Many symptoms of adjustment disorder are similar to TBI symptoms. It is important to let your TBI team know about all your symptoms. They are aware of the dangers of adjustment disorder and can connect you with a mental health professional who can help you.

Treatment for adjustment disorder is very effective. It may include a type of counseling called cognitive behavioral therapy (CBT). CBT is a form of talk therapy. It teaches you to replace negative thinking and behaviors with healthier thoughts and behaviors. You may benefit from individual sessions or group therapy.

Family therapy sessions and self-help support groups may also help. Joining a support group is a good way to share your feelings and get support from others with similar problems. Medications may be used for symptoms like trouble sleeping or anxiety, but talk therapy is the main treatment.

Adjusting to recovery

Having a TBI changes your life in many ways. In addition to sticking with your treatment and rehabilitation, there are some steps you can take to make your adjustment easier:

Adjusting to life after TBI is hard, but it does get better. Remember that you are not alone; work with your TBI team and get support from friends and family. Be sure to let your TBI team know about any symptoms of adjustment disorder because treatment is available, and it works.

Anxiety and traumatic brain injury 

A traumatic brain injury (TBI) is a brain injury that can change the way you think, act, and feel. A TBI could be caused by a blow to your head, a blast, or a sudden and severe movement of your head that bounces your brain inside your skull. For people in the military who are deployed, blast injuries are a common cause of TBI. Other causes include falls, fights, sports, and motor vehicle accidents.

Anxiety is fear and worry. Dealing with a TBI is stressful, so it’s not surprising that anxiety is a common symptom of a TBI. But when fear and worry become so strong that they interfere with your ability to live your life, you could have an anxiety disorder.

Recognizing an anxiety disorder with a TBI is important because an anxiety disorder can make it hard to do the things you need to do to recover. An anxiety disorder may also increase your risk for substance abuse and depression.

Symptoms of anxiety disorder

Like a TBI, an anxiety disorder can change the way you think, act, and feel. It can also cause physical symptoms. In extreme cases, it can even cause a seizure. Here are some common symptoms to watch for:

Types of anxiety disorders 

If you have common symptoms of anxiety that interfere with your ability to function normally, it is called generalized anxiety disorder.

There are also these specific types of anxiety disorders:

What to do for an anxiety disorder 

The most important thing to do is to let your TBI team know about your anxiety symptoms. You are not alone, and your TBI team is aware of the risks of anxiety disorder and can help you. A mental health professional can treat an anxiety disorder with a type of counseling called cognitive behavioral therapy (CBT).

During CBT you learn to identify sources of anxiety and manage your symptoms. CBT teaches you to change the thoughts that lead to anxiety and deal with symptoms in healthy ways. Relaxation techniques and deep-breathing exercises may be part of the treatment. Antianxiety medications are sometimes used along with CBT.

You can also take steps on your own to cope with anxiety:

It helps to know that TBI symptoms get better with time. Everybody’s brain heals at a different pace. Be patient and give yourself the time you need. Don’t let anxiety get in the way of your recovery.

Post-traumatic stress disorder and traumatic brain injury

A traumatic brain injury (TBI) is a jolt or blow to your head that changes the way your brain works. It can cause changes in the way you think, act, and feel. Post-traumatic stress disorder (PTSD) develops after a scary experience in your life that also changes the way you think, act, and feel. TBI and PTSD are both common in veterans who have had combat exposure. They can also occur in civilian life after events like accidents and assaults.

Veterans Affairs and the Department of Defense screen all service members for TBI as they are commonly reported following combat. The TBIs may be caused by blasts, motor vehicle accidents, or gunshot wounds. Being diagnosed with a TBI also increases the chance that you will also have PTSD. This depends on many factors, including how severe your TBI is. However, about 25 percent of people with a TBI also have PTSD.

Symptoms of TBI and PTSD

Symptoms of TBI are different for everyone, and they don’t always depend on how severe your injury was. That’s because everybody’s brain is different. Common symptoms include headaches, dizziness, tiredness, memory loss, slowed thinking, and mood swings.

Traumatic events that can cause PTSD are events that cause fear and stress. TBI is just one example. Others include combat exposure, physical abuse, sexual assault, and serious accidents. Symptoms include reliving the event in flashbacks or nightmares, avoiding situations or people who trigger memories of the event, feeling numb, and feeling anxious and jittery.

TBI and PTSD can cause similar problems. These include:

Recovering from TBI and PTSD

One of the most important ways you can help yourself overcome both PTSD and TBI is to learn as much as you can about these health issues and work closely with your medical team. Knowing what to expect and what you can do reduces worry and stress.

The good news is that counseling for PTSD may help TBI as well. Two types of therapy that work well are cognitive processing therapy (CPT) and prolonged exposure therapy (PE). In CPT, you learn about how to deal with your thoughts and feelings in a healthier way. In PE, you talk about your experience until the memory is no longer painful.

Coping with TBI and PTSD

Many of the things you can do to help yourself recover from TBI will also help you recover from PTSD. Here are some of the self-care steps you can take:

Most people with TBI recover over time, but everybody’s brain heals differently. Go at your own pace. Don’t push yourself too hard. The same is true for PTSD. It takes time, and progress may come a little bit at a time.

Making bad decisions is a danger for people who are struggling with PTSD and TBI: Don’t try to treat your symptoms with drugs or alcohol. Call your TBI team if you are struggling or if your symptoms are getting worse.

Substance abuse and traumatic brain injury

A traumatic brain injury (TBI) is a shock or blow to your head that changes the way your brain works. A TBI can change the way you think, feel, and act. Substance abuse is using a substance, like alcohol or a drug, in an uncontrolled way that hurts you or those around you. Many people with a TBI also have problems with substance abuse.

Substance abuse can lead to a TBI. Studies show that at least 30 percent of people hospitalized for a TBI have a history of substance abuse. This relationship can work in the opposite way, as well. Having a TBI can lead to substance abuse, even if you haven’t had a problem with substance abuse in the past. Studies show that 10 to 20 percent of people develop a substance abuse problem after a TBI. Alcohol is the most common type of substance abuse problem seen in people with a TBI.

Why substance abuse leads to TBI 

Just like a TBI, substance abuse changes the way you think, act, and feel. Being intoxicated affects your vision, coordination, and judgment. This can lead to risky behavior and poor decisions that cause TBI accidents and injuries.

Why TBI leads to substance abuse

Symptoms of a TBI include slowed thinking, mood swings, depression, anxiety, and headaches. Living with these symptoms can be very frustrating, and some people try to ease their problems with alcohol or drugs. This is very dangerous because a TBI may make your brain more susceptible to the effects of alcohol and drugs.

The dangers of misusing alcohol or drugs after a TBI

If you have been diagnosed with a TBI, you need to know how dangerous it is to try to relieve your symptoms with alcohol or drugs. Mixing a TBI with misuse of alcohol or drugs raises your risk for:

What to do 

Knowing the dangers of substance abuse after TBI is the first step. Many people who have had a substance abuse problem in the past actually stop using drugs and alcohol after a TBI because they understand the dangers. Here are important steps to take:

Although it may be tempting to ease the symptoms and frustration of recovering from a TBI by drinking alcohol or taking drugs, this only makes things worse. Be patient with your brain. It takes time to heal and remember that most people do recover.

A good resource for more information on drug and alcohol abuse is located at the Department of Veterans Affairs.

Coping and living with traumatic brain injury

Managing pain after traumatic brain Injury 

A traumatic brain injury (TBI) is a sudden jolt to your head that changes the way your brain acts. A TBI can change the way you think, act, feel, and move. Because everybody’s brain is different, no two TBIs are the same. That means that your symptoms and recovery will be hard to predict. However, pain is one symptom that many people with TBI have.

Because a TBI is caused by a brain shock, there may be an injury to the brain that causes pain. There may also be an injury to your neck or other parts of your body. The most common types of pain after a TBI are headache and neck pain.

There is a chance that having a TBI will change your brain in a way that makes pain seem worse. Also, pain can make some other symptoms of a TBI worse. Studies show that about half of people being treated for a TBI complain of long-lasting pain, also called chronic pain.

Why managing pain is important

Work with your TBI team to get your pain under control. Here’s why:

How to manage TBI pain 

Strong pain medications, called opiates or narcotics, are usually not the answer for pain from a TBI. These pain medications can have unpredictable effects on your brain. In fact, these medications can make some TBI problems worse, like slowed thinking, memory loss, substance abuse, fatigue, and depression.

That’s why the first choice for pain medicine is what’s called a nonnarcotic medication. Examples include muscle relaxants, numbing medications applied to the skin, and over-the-counter pain relievers, like Tylenol or Advil.

Other important ways to manage pain include:

Living with pain affects you and everyone around you. It is important to talk about your pain and seek the support of friends and loved ones. Avoiding other people and suffering in silence is dangerous for you. It also will only make your pain feel worse. Learn as much as you can about your condition and work closely with your TBI team.

Pain and other symptoms of a TBI usually go away with time. How long it takes your brain to recover depends on the type of injury you had. Managing pain well can help you heal faster. Don’t take any medications for pain unless you check with your health care provider or TBI team, and call them if your pain is getting worse. Never try to treat pain on your own with drugs or alcohol.

Managing post-traumatic headaches after traumatic brain injury

A traumatic brain injury (TBI) is a sudden jolt to your head that changes the way your brain works. It’s not surprising that headache would be a common symptom after a brain injury. Because a jolt to your head also causes a jolt to your neck, headaches with neck pain are the most common types of pain after a TBI. About 50 percent of people with a TBI suffer from headaches.

The type of headache you get does not depend on how bad your TBI is. That’s because symptoms after a TBI are unpredictable. You could have a mild TBI but still have very painful headaches. Also, having headaches can make your other TBI symptoms worse, and other TBI symptoms can make your headaches worse. Because of this, it’s important to learn how to manage your headaches.

Types of headaches after a TBI

Your headaches may be mild or severe. They may come and go, or you may have them all the time. TBI symptoms, such as trouble sleeping, anxiety, fatigue, depression, slowed thinking, and memory loss, can all be made worse by headaches.

Here are some common types of TBI headaches:

Managing TBI headaches

Strong pain medications, called opiates or narcotics, are usually not the answer for TBI headaches. These medications can make other TBI symptoms worse. They also can have unpredictable side effects in a person with a TBI.

If pain medications are needed, the first choice is a nonnarcotic medication. Examples include over-the-counter pain relievers like acetaminophen or ibuprofen (Tylenol or Advil are examples). If you use pain relief medication for a headache more than three days a week, you need to watch if your headaches are getting worse. This is called rebound headache.

The best way to manage your headaches is with self-care, also called headache hygiene. Here are some self-care tips:

TBI headaches usually go away with time. How long it takes your brain to recover depends on the type of injury you had. Managing headache pain with self-care can help you heal faster. Call your doctor if your pain is getting worse. And remember, never try to treat headaches on your own with drugs or alcohol.

Improving cognition after traumatic brain injury 

A traumatic brain injury (TBI) is a jolt to your brain that changes the way your brain works. This type of injury can change the way you think, act, move, and feel. One of the most common symptoms of TBI is slowed thinking. After TBI, you may have trouble remembering things, getting organized, or finding the right words to use when speaking. These types of brain functions are called cognition.

TBI symptoms, such as anger, fear, stress, or trouble sleeping, can slow down your thinking even more. Some medications used after a TBI to reduce anxiety, pain, or depression can also slow down cognition. That’s why doctors are careful about giving medications for a TBI. For these reasons, it is very important to learn ways to improve cognition after a TBI.

Common TBI cognition problems

Changes in your brain after a TBI can affect the way your brain takes in and stores information. This can cause your thinking process to be slower and make it harder to stay focused. Here are some common problems you might have:

Improving cognition after TBI 

Specialists who work in TBI recovery programs are trained to look for and treat cognition problems. If you are in such a program, take advantage of their help. There are also many things you can do on your own to improve cognition:

Cognition problems can cause some people to make bad decisions. One of the worst decisions you can make is to treat your symptoms with drugs or alcohol. Also, medications are usually not the answer for cognition problems. Take only medication prescribed by your health care provider or TBI team. Take no other medicines, even over-the-counter ones, without checking with your TBI team first.

Cognition problems and other symptoms of a TBI usually get better over time. The time it will take your brain to recover is unpredictable, because every brain is a little different and no two TBIs are the same. Also, be sure to let your TBI team know if your symptoms are getting worse.

Your recovery team for traumatic brain injury

Traumatic brain injury (TBI) is a blow or jolt to your brain that can change the way your brain works. A TBI can change the way you think, feel, act, and move. It can cause different kinds of problems and symptoms. Because everybody’s brain is different, it is hard to predict how your brain will recover from a TBI. It takes a team of health care providers, also known as a TBI team, to help you develop the best plan for your recovery.

Teamwork is important, and one of the most important members of your recovery team is you. You need to be an active member of your TBI team and work closely with all the other team members. Let’s take a look at who might be on your TBI team:

The physiatrist

This team member is a medical doctor who specializes in rehabilitation. You could think of this health care provider as the quarterback, because he or she calls the plays for all the other members of your TBI team. While you are recovering from a TBI, your physiatrist may be your primary doctor.

The physical therapist  

TBI can change the way you walk and move. It can cause weakness and clumsiness. Your physical therapist can help you learn to move and walk well. In physical therapy, you can also work on painful or stiff muscles and joints.

The occupational therapist 

This professional helps you learn to handle your day-to-day activities after a TBI. For instance, you might have trouble performing tasks you need to do at work or at home. Your occupational therapist will help you find ways to adjust to any changes caused by the TBI.

The psychologist

Emotional problems like anxiety, depression, mood swings, and irritability are common after a TBI. Your psychologist is a mental health professional who can help. Psychologists may do testing to find out how much your TBI is affecting the way you think and feel. Psychologists also do counseling, or talk therapy, to help you deal with the emotional effects caused by TBI.

The neuropsychologist

A TBI can cause slowed thinking, which is called cognitive dysfunction. This may result in memory loss, trouble concentrating, and trouble organizing. This professional can do tests to find out where you need help. A neuropsychologist can teach you ways to improve memory, concentration, and organization.

The neurologist

This TBI team member is a medical doctor who specializes in brain and nerve problems. A TBI may cause symptoms like headaches, dizziness, and seizures. This doctor may be called in to treat these problems.

The psychiatrist

Like your psychologist, this team member deals with emotional and behavior symptoms caused by a TBI. In most cases, talk therapy works best for these problems. But if medications are needed to treat symptoms like depression or anxiety, a psychiatrist is the doctor who is called in.

The speech pathologist

Memory loss is not uncommon after a TBI. This can make it hard to find the right words or to put words together the right way. A speech pathologist can help you with speech and language problems. This professional may also be able to help you with memory issues or problems with attention or organization.

The vocational rehabilitation counselor

A TBI can change your brain in ways that may make it hard to go back to your old job and hard to find a new job. This counselor can help you find work and may provide special support as you adjust to a new job.

The social worker

Because a TBI changes your life in so many ways, you may need help with family matters and home care after you leave the hospital. A social worker can help figure out what type of help you need and the services that are available to assist you.

The recreational therapist

Recreation may not seem like a big priority while you are recovering from a TBI, but being active and having fun is important. Some people with a TBI spend too much time alone. Isolation is not good for a recovering brain. This therapist will help you stay active and involved in life. That will help your recovery.

Depending on how your TBI affects your brain, your TBI team may have other members, too. These could include the nurses who care for you in the hospital or at home, surgeons who repair areas of damage, or doctors who specialize in vision, breathing, or hearing.

It’s important to remember, though, that every brain recovers at its own speed, and most people do get better with time. Make sure to work closely with all your TBI team members. And don’t forget to let friends and family members become part of your recovery team. Their love and support is what makes all the teamwork worthwhile.

Source: Veterans Administration

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