My Life in Brain Injuries

Continuing the discussion

A common complaint among TBI survivors is a sense of loss. Not your simple “I lost my keys” or “I lost my train of thought”, although these can be enough to drive one bonkers. Most survivors of TBIs express a loss of some aspect of “self”. They no longer recognize themselves and their partners and loved ones live with familiar strangers.

Easily confused or gets lost often.

Marvin’s wife was often frantic because Marvin insisted on doing errands by himself but couldn’t remember how to return home once he left their neighborhood. In the days before GPS or smartphones, he would call her from a phone booth, sometimes many miles from home. As a veteran with a couple of tours in Afghanistan, he was easily triggered by roadside debris, someone standing by the side of the road, or simply a car passing him on the highway. His wife told me she was frightened for him when he drove, but his behavior behind the wheel was so erratic, she couldn’t tolerate riding with him.

Beth made three appointments with me before staying focused enough to find my office. She arrived two hours late.

Georgia had to pull over and call the office several times en route to her first neurofeedback appointment. Even though she had written instructions, making turns was consistently confusing because she could not easily tell left from right.

Loss of energy/motivation

Berta rarely left her studio apartment after her injury. Her days and nights were spent on the couch, staring at the television. She had no interest in any of the many hobbies and sports she had participated in during her younger years and career as an educator, before the car crash that disabled her brain. Her daughter, who took responsibility for getting her mother to medical appointments, eventually gave up asking her out for social activities.  Instead she developed the pattern of shopping for her mother and stopping by to fix a meal for her once per week. During that visit she would clean the apartment but she could not engage her mother in conversation. “It is as though she is locked away. There isn’t anyone left in her eyes. My mama is gone.”

“Chuck hasn’t worked in over two years. The doctor says there’s nothing wrong with him physically. They put him on antidepressants but that didn’t work. Nothing helps and he just sits on the couch. I’ve had to take a second job, do all the housework, and pay all the bills.”

Loss of libido

Dennis told me he loved his wife but simply could not feign an interest in sex. His wife said, “We used to have a great sex life. Now we can’t even cuddle because he gets antsy. Every time I touch him, he jumps.”

Jane still participated in sex with her partner but said, “There’s nothing to enjoy.” She resented having sex because she felt nothing but she believed it was her duty and, more importantly, she was afraid of being abandoned. Much of her body was numb due to her injuries. “Sex is boring and messy but it’s my job and I have to do it.”

Loss of inhibitions

Bryan is a brawny former football player with multiple head injuries. Known to his family and friends as a good-natured fellow with a great sense of humor before his most recent injury, he became what he called “…a faucet I can’t turn off. I cry all the time.” Ashamed of his lack of control, he isolated himself. “I can’t have people see me like this. When I’m happy, I cry. When I’m confused, I cry. Any emotion at all – I’m sobbing. It’s so humiliating.”

Tom’s head injury caused a hyper-sexuality. He struggled to control his drive to masturbate but was not successful on his own. His wife required him to move out of their home and away from their children. “I know he’s a good man and this is because of his head injury, but I can’t let the children be around him while he’s like this. He doesn’t understand and is so angry at me, but I have to protect the kids.”

Wendy lost friends because her capacity to filter her thoughts and modulate her voice disappeared after her brain injury. Not only did she offend people; she did it in a very loud, abrasive voice. She knew she was angering others but she justified her behavior by saying, “I have to be honest and tell it like it is. I can’t lie. Besides, I have a brain injury. I can’t help it.” She reported several people had told her to never come back to their homes and she’s been “86d” of shops, banks, restaurants and two churches. 

“Andy hasn’t hurt anyone yet that I know of, but he’s broken a lot of dishes and furniture,” his elderly mother explained to me.  “We had to replace the telephone twice and plaster over a few holes he punched in the walls. His wife kicked him out after he  broke their wedding china. She thought it meant he didn’t love her anymore but I don’t think he could help it.”

Jesse, a young bodybuilder who had enjoyed sparring in the boxing ring, had developed a very short fuse. It was easier for him to punch people than to discuss situations. “Yeah. If I get arrested one more time, they’ll lock me up for good.”

Loss of Sense of Humor

After two significant blows to the head within a year, Carol, a bright and accomplished 66-year-old woman, had plenty of problems with balance, attention and confusion, but the problem that bothered her the most was the loss of “receptive humor”. She could still crack jokes, seeing the incongruity in her situation and making light of it, but she could not receive humor. “You have no idea how offended people are when you ask, ‘Was that supposed to be funny?’ I’ve lost all the friends I really enjoyed.”

Next time: Changes in sleep habits, appetite & proprioception.