Living with an ABI
After a brain injury, it is common for people to have problems with attention, concentration, speech and language, learning and memory, reasoning, planning and problem-solving.
What is an ABI?
An acquired brain injury is an injury to the brain that has occurred after birth. Brian injury commonly results in life-long challenges, including a range of physical, cognitive, emotional and behavioural changes. The term ABI includes traumatic and non-traumatic brain injuries, such as those caused by:
- Road traffic accidents
- Stroke Trip/fall Assault
- Viral infection ( e.g. encephalitis, meningitis)
- Brain haemorrhage
- Anoxia /Lack of Oxygen to the brain (e.g. drowning)
An ABI may result in mild, moderate or severe impairments in one or more of the following areas:
- Sensory and Motor functions – e.g. seeing, hearing, movement, balancing, sitting, walking
- Cognition - e.g. attention (concentration) memory, reasoning, concrete and abstract thinking
- Communication – e.g. voice, speech, comprehension and expression of spoken and written language, pragmatics and non-verbal communication
- Psychosocial and Executive Skills – e.g. social skills, planning, initiating, censoring, monitoring and managing appropriate behaviours, controlling emotions and behaviours
Any of these impairments can affect your ability to control your own life and live independently.
Here are some ways in which you could be affected by your acquired brain injury:
You may not be as strong and you may tire more easily Sight - May have been affected since the injury. Hearing -May have also been affected since the injury.
Talking in a group
Where there is more than one person speaking at the same time and managing to keep up and stay in the conversation could be harder for you.
Organising your life
Could be harder because your abilities to plan and problem solve in many different areas may not be as good as they were.
Perhaps you may have problems learning new information or remembering details of recent events or recalling day to day things to do. You may have no difficulty remembering events that happened long ago.
Weighing up information and working out the best decision may be harder. You may find yourself more rigid or more impulsive or you may be unable to make decisions especially under pressure.
Speech and language
You may have problems speaking as fast as before. You may find it difficult to say what you are thinking or you might not be able to put the words in order. It may be harder to start or join in a conversation or understand what others are saying. You may find yourself rambling or getting off topic easily. Understanding what’s going on could be harder for you. You might need to ask questions to understand a situation that before would have been clear to you.
May be affected and you may find it hard to pay attention to more than one thing or for long periods of time. You may find yourself being easily distracted which can also lead to feeling restless. Poor concentration can result in difficulty finishing a project or working on more than one thing at a time; give you problems with long conversations.
Thinking, listening and talking may tire you much more easily.
Every brain is different so every brain injury is unique to each individual affected. For this reason your brain injury and how it affects you will be different to another person who has also acquired a brain injury.
Every brain is different so every brain injury is unique to each individual affected
For this reason your brain injury and how it affects you will be different to another person who has also acquired a brain injury.
How long will my symptoms last?
Factors that affect your recovery include type of injury, age, pre-work history, social support network and outlook on your life. The most rapid recovery occurs in the first six months after brain injury, and in milder cases, many persons with ABI will be back to normal by three months. The length of time the symptoms are present has a lot to do with the severity of the injury or how severe the brain injury was.
If you still have some symptoms after six months, these will most likely disappear altogether or be greatly improved within a year after the injury. If you suffered a severe injury, recovery can take several years. As time progresses, improvements will be more gradual.
Not everyone recovers at the same rate. People who are under 40 recover faster and have fewer symptoms during the time they are recovering.
If you are over 40, your recovery may be a slower process and you may have more symptoms at first. If you are older or you have been hospitalised for head injuries before, you should expect recovery to take 6 to 12 months even after a mild brain injury. The establishment of a meaningful everyday routine is crucial to recovery.
Most doctors who treat head injuries agree that recovery is faster when the person with ABI gets enough rest during the weeks after they leave the hospital. In addition to this work, exercise, social activities and family responsibilities should be gradually introduced, not all at once.
More about Specific Symptoms
The main cause of poor concentration is fatigue. When it becomes difficult to concentrate on what you are doing, take a break and relax (15 to 30 minutes should be enough). If you still continue to have problems, your work day, class schedule or daily routine should be temporarily shortened.
Trying to “stick to it” won’t help and usually makes things worse. Reducing distractions can help. Turn down the radio or try to work where it’s quiet. Don’t try to do too many things at once. It may be difficult to concentrate on more than one thing at first. You will be able to concentrate better when you have had enough rest, and are in an environment that is comfortable to you.
One of the most frequent causes of irritability is fatigue. People lose their tempers more easily when they are tired or overworked. Adjust your schedule and get more rest if you notice yourself becoming irritable. Everyone gets angry from time to time, often with good reason. Being irritable only becomes a problem when it interferes with your ability to get along with people from day to day. If you find yourself getting into arguments that cause trouble at home or at work, try to change the way you think about things.
Thinking about an event can often upset us more than the event itself. You can see this for yourself by imagining an irritating situation and why it would make you angry. The steps you need to take to solve a problem will be the same when you are calm as they would be if you were irritated. Try to remind yourself of this when you find yourself becoming irritable.
You can usually come up with several ways to solve a problem. Try to think of at least five different ways, and then decide on which is best, or ask for help to figure it out. Just realising that there are several things you can do to solve a problem will make it a lot less irritating.
Many times, removing yourself from a situation in which you become irritable can be helpful, especially until you become calm.
Counting to 5 in your head before responding often helps.
It is normal to be more tired after a brain injury. The only sensible treatment for being tired is rest. Avoid wearing yourself out. Gradually increase your activity level. Most persons with ABI have more energy in the morning than later in the day. You may benefit from scheduled daytime naps. If your symptoms get worse, this may mean that you are pushing yourself too hard, and you need to restructure the amount you are doing each day.
Depression after brain injury is common. It can be related to the change in the way the brain works or to your emotional reaction to your new situation, or both.
You should discuss your depression with your GP or Health Care Professional. There are many types of treatment that may help.
Memory difficulties have several causes. The part of our brain that records memories is called the temporal lobe. This is the part of the brain that is most often bruised in a brain injury. Some memory difficulties can be caused by the bruising on the brain, which is why you may not remember the accident very well. Like a black and blue mark on your arm or leg, these bruises will recover with time. Your memory will most likely improve as this happens.
If you can remember your accident, it is an indication that your brain was not bruised. Most of the memory problems that persons with ABI notice after a brain injury are not caused by bruising. They usually come from poor concentration and being tired.
For you to remember something, you have to pay attention to it first. If you don’t concentrate long enough the information is never stored in your memory.
Concentration problems are a normal part of recovering from a brain injury and some memory trouble is a normal side effect of this. You will probably be able to concentrate and remember better when you get enough rest. Memory problems can be a sign that you are pushing yourself too hard. Writing things down or using a calendar on your mobile phone, personal digital assistant (PDA) or a diary are other excellent ways of coping with temporary memory difficulties. They will help your recovery and not slow it down.
Worrying about remembering things that you would normally forget can make your memory seem worse to you. If you can remember your memory problems, you probably don’t have much of a memory problem! People with serious memory difficulties are usually not upset by their symptoms. They don’t remember that they have any memory trouble.
If you are concerned about your memory, have it tested. Your doctor can send you for these tests if you need them.
Headaches are part of the normal recovery process. Headaches are another cause of irritability and concentration problems after a brain injury.
Headaches can have many causes, and your doctor will want to diagnose the problem and may prescribe medication that can help, if you need it.
One of the most common causes of headaches after a brain injury is stress or tension. This is usually the cause when the headaches start for the first time several weeks after the injury. These headaches mean that you are trying to do too much. They will probably disappear if you take a break and relax. Your work day, class schedule, or daily routine should be temporarily shortened if you continue to have headaches.
Stress or worry causes tension headaches by increasing muscle tension in your neck or forehead. These muscles become tense and can stay tight without you realising it, out of habit. They can become even tighter once a headache starts, because muscles automatically tense in reaction to pain. This muscle tension makes the headaches worse.
Worry about symptoms or problems in other areas of your life after brain injury can be due to physical changes in the brain. Anxiety can also be a normal emotional response to life changes after the injury. Understanding this often helps. Be sure you are getting enough rest and gradually increase your responsibilities.
If you find yourself thinking anxious thoughts, stop. Simply stopping an anxious thought can make you feel better. See if what you are telling yourself is really true. Talk with your Health Care Professional for more ways to manage anxiety.
This problem is usually a side effect of other symptoms. Concentration problems, being tired, headaches and anxiety can all make it hard to think clearly. Other changes in thinking can include lack of awareness of deficits, confusion, distractibility, poor insight, and difficulty in changes in routine. It may be a sign that you are doing too much too soon.
Dizziness, Visual Difficulties and Light Sensitivity
Dizziness and visual difficulties should be checked by your doctor. These symptoms usually go away by themselves in three to six months or less in most persons with ABI. If you find these symptoms troublesome, your doctor may refer you to a specialist for further visual or balance testing. Some motion sickness medications are very effective for dizziness, but can make you drowsy or reduce your attention span as side effects.
You may notice some increased sensitivity to bright light or loud noise, particularly if you have headaches. Some increased sensitivity is normal after a brain injury.
If light and sound continue to bother you, talk to your Health Care Professional.
You are not alone
Approximately 13,000 people in Ireland every year suffer from a head injury. ABI a growing concern with more and more people looking for services and supports each year
ABI Ireland is a not-for-profit organisation dedicated to helping rebuild lives that have been shattered by the trauma of brain injury. We understand this is a difficult time for both you and your family so we are here to empower and support you on your road to recovery.