Mental Health

While it is normal to experience changes in our emotions, after a brain injury you may have difficulty controlling your emotions and behaviour. You may feel you have lost yourself, feel anxious, depressed or disoriented. These feelings are because of your injury. There are strategies to help you with your emotions, including meditation and mindfulness.

Approximately 18 to 37 per cent of people with a concussion develop depression in the first year after their injury. One to two years after the injury, this rate can double with up to 61 per cent of survivors reporting depression. If you are feeling depressed, speak to your family doctor.

Many brain injury survivors also develop anxiety after their injury.

Changes in personality and behaviour

Caring for Yourself After a Concussion Video Series

Watch Emotional Changes on YouTube

Emotional difficulties

After a concussion, you may also find you don’t have the same emotional responses as you did before your injury. You may have trouble expressing your feelings. You may find you don’t laugh at jokes or cry when you're sad. 

You may find it difficult to control your emotions and be quick to anger, have increased intensity in your emotions, be grumpy all the time, or “snap” at loved ones.

You or those close to you may notice changes in your personality. You may find you are unable to see things from another’s point of view. You may have difficulty predicting the needs of others and be more focused on yourself. 

Social difficulties

Many concussion survivors experience difficulties in social situations such as following a conversation, answering questions and even remembering names. One of the dreaded questions for concussion survivors is, “How are you doing?” Trying to figure out how to answer this question can cause survivors to feel anxiety and panic to the point where they decline invitations to go out. They also may withdraw from social situations and prefer to be alone. 

Low self esteem

Concussion survivors often face drastic changes to their level of ability to do their job, enjoy hobbies and their role in their family. This can leave them wondering who they are. 

How to take care of your mental health

There are many treatment options that can help depression and anxiety. If you are experiencing a mental health crisis go to the emergency department. You can also find treatment and resources through the Canadian Mental Health Association.  

Focus on preventing negative emotions and behaviours by setting yourself up for success.

Try to track and understand what triggers negative emotions or behaviours. If you are feeling angry or frustrated, ask yourself questions:

1. Am I hungry? – eat a snack, drink some water
2. Am I tired? – take a rest
3. Am I overwhelmed? – try meditating
4. Is it too noisy where I am? – move to a different room, wear your musicians ear plugs, take a break from the situation
5. Am I trying to push myself too hard? take a break

Mindfulness and meditation

Things to remember when first starting mindfulness meditation:

• start by doing mindfulness meditation in a quiet space where you are comfortable, in order to make the first experiences more likely to be a success
• it will not come naturally to you at first and that is okay, it will take some time getting use to paying attention to your thoughts, feelings, and body in a non-judgmental manner
•  use short-guided meditations to eventually be able to tolerate longer sessions
•  try and stick with it, you will notice the difference in the long run

Mindfulness Exercise - Mindful Breathing

The primary focus in Mindfulness Meditation is the breathing. However, the primary goal is a calm, non-judgemental awareness, allowing thoughts and feelings to come and go without getting caught up in them. This creates calmness and acceptance.

• sit comfortably, with your eyes closed and your spine reasonably straight
• direct your attention to your breathing.  When thoughts, emotions, physical feelings or external sounds occur, simply accept them, giving them the space to come and go without judging or getting involved with them
• when you notice that your attention has drifted off and is becoming caught up in thoughts or feelings, simply note that the attention has drifted, and then gently bring the attention back to your breathing

It's okay and natural for thoughts to arise, and for your attention to follow them.

No matter how many times this happens, just keep bringing your attention back to your breathing.

© Carol Vivyan 2009, permission to use for therapy purposes

Mindfulness Practice for Patients with Mild Traumatic Brain Injury

Resources – Many resources are available to facilitate the incorporation of mindfulness meditation into our daily lives. Below is a list of websites, videos, apps, and community resources that can help you be mindful.

• UCLA Mindfulness Awareness Research Centre
• Greater Good – The Science of a Meaningful Life
• Living Well – Mindfulness Exercises

Videos

• Dr. Jon Kabat-Zinn Explanation of Mindfulness
• Mindfulness Meditation with Dr. Jon Kabat-Zinn
• Andy Puddicombe -  All it takes is 10 mindful minutes
• TEDxSunsetPark presented by Diana Winston, The Practice of Mindfulness 
• Dr. Kasim Al-Mashat, How mindfulness meditation redefines pain, happiness, & satisfaction
• Shannon Paige, Mindfulness & Healing

Community Resources within London Area:

• The London Mindfulness Clinic
• Diane Yeo Meditation
• Forest City Mindfulness

Video resources:

• speak slowly with long pauses
• don’t rush, stay calm
• share your difficulties so that others can be aware and prepared
• try to use short sentences with familiar words
• when stuck for a word, try to think of an alternative or explain it
• try to plan what you’re going to say in advance where possible
• use gestures, pictures or other non-verbal communication. Getting the message across is what’s important, not having the words exactly right