My Life in Brain Injuries

It is not uncommon for TBI survivors – and, indirectly, their loved ones – to suffer a variety of consequences. And this isn’t even an exhaustive list.

Anhedonia: Loss of sense of pleasure; inability to be moved by beauty.

Adynamia: Apathy; dull or flat affect. Activity is difficult to self-initiate and the individual may appear unmotivated or lazy.

Aphasia: Inability or difficulty expressing thoughts and understanding others. This may include problems identifying objects and their function as well as problems with reading, writing, and ability to work with numbers. Problems with pragmatic language, decreased vocabulary and word substitution may occur. Speech therapy may be necessary to work with language problems.

Apraxia: The person may have normal mobility and comprehension yet is unable to perform basic tasks such as answering the phone or coordinating the use of a knife and fork. This can appear as a consistent problem or it can be intermittent.

Chronic pain: Head and neck pain are most common, but the entire body can become engulfed in chronic pain.

Depression: There are many contributing factors, especially a profound sense of loss of self.

Disinhibition: Increased impulsivity. Conversations may be disjointed and erratic with tangential interruptions – often speech volume as well as content is poorly regulated. People who once were known for their circumspect, sober behavior may, after the TBI, act in such as way as to be absolutely unacceptable in social situations.

Yes, a person can be both adynamic and disinhibited. 

Disrupted sexual functioning: Loss of libido or – due to disinhibition – inappropriate displays of sexual behaviors.

Disrupted sleep patterns: “Pattern” may be a misnomer when it comes to TBI and sleep because there often seems to be no rhyme or reason to how people experience sleep. For days on end they may be unable to sleep more than a few minutes at a time while at other times they can sleep for what may seem like too many hours. They may be difficult to rouse or unable to sleep through even the most mild disturbance.

Disrupted appetite: Over and under eating can become issues. It often seems to have something to do with memory. The over eater forgetting he ate and the under eater forgetting to eat.

Distractibility: Even for people who do not appear disinhibited, it can be very hard to sustain attention to track conversations or logical thought sequences.

 Emotional lability: Extreme mood swings may become predictable – generally to everyone other than the survivor.

Flooding: Being overwhelmed by one’s emotions – even in situations that appear emotionally neutral. It can happen anywhere, any time, caused by perceived pressure or inexplicably popping up. Many TBI survivors describe it as “freezing.”

Memory deficits: TBI survivors usually suffer from what one of my clients called “blank spots” and another called “empty rooms.” One of the more intriguing memory problems TBI survivors have is remembering that they have had a head injury. People, after telling me repeatedly they have had no head trauma, frequently suddenly remember some devastating incident when they were either knocked unconscious or seriously injured but did not lose consciousness.

Motor deficits: Paralysis, poor balance, lower endurance, reduction in the ability to plan motor movements, delays in initiation, tremors, swallowing problems, and poor coordination.

Problems tracking time: Time can swell and expand or constrict dramatically. It usually means that survivors have difficulty maintaining a schedule or keeping appointments.

Oppositional/defiant behavior – frequently characterized as stubbornness: Families and friends complain about this often. I find it logical that a person will dig in when faced with the unknown. Without the capacity to track conversation; draw on memory or logic, one is unable to predict outcome which increases anxiety. It becomes seemingly safer to just say no.   

Sensory distortions: There may be a loss of sense of taste and/or smell or these senses may become extremely exaggerated, causing nausea or other discomfort. Vision may become permanently or sporadically compromised. Tinnitus may set in. There may also be tactile interference – either with increased sensitivity, such as being unable to tolerate certain fabrics, or numbness.

Speech Deficits: Speech that is not clear as a result of poor control of the speech muscles (lips, tongue, etc.) and poor breathing patterns.

According to the National Institute of Neurological Disorders and Stroke, TBI can cause a wide range of functional changes affecting thinking, sensation, language, and/or emotions. It can also cause epilepsy and increase the risk for conditions such as Alzheimer’s disease, Parkinson’s disease, and other brain disorders that become more prevalent with age. [i]