Coping Strategies for Day-to-Day Life
Many participants talked about strategies that they could draw upon to help them navigate life and manage ongoing symptoms of their TBI. As one Veteran said, “what I found out is being able to talk about so much of this stuff is good, it’s therapy to me.” Although he was initially ashamed of his memory loss and tried to hide it, Theo has now come to the point that “anyone I deal with on a semi-regular basis I share with them very quickly up front, ‘I had a brain injury in the service, I have short term memory loss, forgive me if I forget or if I see you outside of here just remind me.’”
Sam is very upfront with his family about his injury and how it has changed him.
Sam is very upfront with his family about his injury and how it has changed him.
I come from such a huge loving, supportive family. So, when I came back – I’m very open about it, and a lot of veterans aren’t open about what’s happened to them because there’s a stigma that says if you’re open about it you’re a wuss. No, what you’re doing is you’re trying to help, what you’re doing is trying to bring these problems that veterans deal with to the forefront. If instead of doing it on TV where you’re telling millions of people, you’re doing it one person at a time, until another person. And it works just the same; it’s just slower. With them I, I, I was pretty upfront about it. It was like, “So did you get hurt?” And be like, “Well I got blown up a few times and knocked me silly.” It’s - yeah, remember when I got back there wasn’t any talk about TBIs. Like, so like yeah I got a concussion, [laughs] that’s what it was called. Contusion of the brain, quite a few times. And I would tell them that, I would tell them funny stories. I never really told them war stories, just funny stories that happened in war, you know and all this other stuff. And they’ve supported me like one hundred percent. Like my mom, my dad, my stepdad, my wife, all this other stuff; they, they – because I’m very forthcoming with it. Like I tell them, be like, “This is me. Physically, there’s certain things that I can’t do, or can’t remember to do,” or something like that. Like it has nothing – I’m not being disrespectful, you just have to know.
Theo has found that if he is upfront about his memory issues, people they are much more understanding.
Theo has found that if he is upfront about his memory issues, people they are much more understanding.
Part of it for me is that I’ve had to adapt and adjust in my memory issues so much so that I no longer hide it. Initially I was ashamed of it, I thought it would get better and I’ve worked at not allowing people to see it. That created more problems. When I’d go back in to like a hardware store or an automotive place they’d be like “Don’t you remember me, we just talked about this.” So, it’s come to the point now that anyone I deal with on a semi-regular basis I share with them very quickly up front, I had a brain injury in the service, I have short term memory loss, forgive me if I forget or if I see you outside of here just remind me - it’s all in my head, it’s just not always accessible. And once you tell people that and they see you, they’re much more understanding. They’re more happy about the amount that you do remember than they are upset by the amount that you forgot.
Accepting and learning to work around limitations
Over time, many of the Veterans we talked to have learned to anticipate their symptoms and avoid triggers or situations that might make things worse. Some people spoke of staying away from large crowds and busy places - like malls or fireworks on the 4th of July. Others have navigated their limitations by minimizing stressors in their lives and putting themselves in environments that are more comfortable. For example, one Veteran said that he “moved back to where I was familiar, where there is less stress and anxiety of being lost.” Max told us that he still struggles with lots of symptoms – especially related to his memory. His injury happened over 10 years ago and he doesn’t know “if there’s ever going to be a treatment for it,” but says that he has learned “to deal with it, I believe I’ve learned to mask it better.”
Although he isn’t sure if his TBI has gotten better, Max says that he has learned to mask it better and adapt.
Although he isn’t sure if his TBI has gotten better, Max says that he has learned to mask it better and adapt.
I have, I don’t believe it’s gotten better. The VA has decided to state it is not TBI so I have learned to deal with it. I believe I’ve learned to mask it better, and, I don’t know if it, maybe it has gotten better. It’s, you find ways to adapt. You find ways to, to get to know, to get to know the answer more. See this is a guy who wrote dissertations - and he can’t even talk - that’s one, so this is exactly it. I’ve written dissertations, hundreds of research papers, and putting the sentences together becomes difficult, and you know there’s no, it’s, that’s one of the things. And sometimes you, you know what you want to say but you can’t. So, and that’s one of the things that I’ve also seen. So, you sort of adapt to it. So, it’s gotten better, but I don’t, I don’t know if there’s ever going to be a - I don’t know if there’s ever going to be a treatment for it. I mean it’s been a decade for me. I’ve been sort of left on - 2004 left on your own kind of thing, you know. I got activated as an individual, and I was sent back home as an individual, so I had no support of a unit. No support of any bases here. They, you know they, all the picket parades, I didn’t have any of that. I was basically told to go. And I went and came back to this, and there was no support. I went to the VA and the VA wasn’t ready at 2004. So, there’s a lot of guys in 2004 that are affected, I believe, have these issues that might not, that might be masked.
Sam has learned to live with his injury by finding ways to work around it instead of getting frustrated.
Sam has learned to live with his injury by finding ways to work around it instead of getting frustrated.
I feel really good. I feel, I feel really, really good. And it’s just been lately. Like over the last two years, life’s been getting really better. Like school’s coming easier to me, like I – that’s because I just stuck – I put my nose to the grindstone and just charged hard into it. I was like, “I have to do this.” And so, I forced myself over and over and over again to do certain things. I don’t think I’ve cracked a textbook, because I would go to tutoring and stuff like that. I don’t think I’ve really cracked a textbook in like two years, other than like the online class that I’m taking today where I’m going to crack the textbook and read it probably six or seven times to try and get it. Look up a video; look up some sort of article, maybe it’s better explained to me. But that’s about it.
I: Yeah. Do you feel like there’s any amount, like some of the things that you’ve experienced, are there any things that you feel like are getting better over time? Like are there healing or is the brain repairing itself?
I don’t think it’s getting better, I think it – I think what’s getting better is my ability to live with it, my ability not to get frustrated at it, my ability to work around it. But it’s still there. Like when I couldn’t think of the word ‘organize.’ It took me thirty seconds to like finally figure it out. Like and I’ve probably used that word already four or five times today. It doesn’t matter. And so, I know it’s there, but I don’t get frustrated with myself when I can’t think of it. And that’s the big thing, you guys.
On the other hand, almost everyone we talked to recognized that there may be days when you need to accept your limitations, take care of yourself, and not push yourself too far.
Matt has learned to accept his limitations, but not let them stop him from doing the things he needs to do.
Matt has learned to accept his limitations, but not let them stop him from doing the things he needs to do.
A lot of them I just learned to deal with and just accept it and not let it stop me from doing stuff. It’s like if I get headaches but I need to go with my son to some scouting event or something with him, I’ll just deal with the headache and go do whatever I need to do. Unless I can absolutely not have to do it, I’ll find a way to commit myself to be able to do it. Whether it’s walking around late afternoon with dark sunglasses on or -
I: Yeah. Does that get hard?
It does, it does get hard after a while the, it’s not really that hard on me but it’s really hard on my wife and kids, because we go places, they always have to make sure where I’m at, that I’m comfortable before they can do anything. It’s like, so, it’s more tough on the family then it is on me because I’ve learned to deal with it and accepted it. And it’s just, it’s always something constantly that changes it. One day I could go into Walmart and it could be crowded and it wouldn’t bother me at all with Bella [his dog] next to me and the next day I could go in and, just the way people are acting could put me on edge. So I really don’t know what to expect each day when I get up. It’s like I could be in a good mood when I get up, or I could be in one of my bad moods when I get up.
I: And do you know, can you know what to expect, like from the moment your feet hit the floor, can you kind of tell what the day’s going to be like or does it take a while to unfold?
I can usually tell by once I get up and start moving around how the day is going to be. Then it’s like - I’ll let my wife know - “OK, don’t expect a lot from me today because I’m just not there.”
Karen often reschedules appointments and may not even get out of bed on the days when her “brain isn’t braining.”
Karen often reschedules appointments and may not even get out of bed on the days when her “brain isn’t braining.”
So, sometimes, I've had to like cancel an appointment or cancel going to an event because just lack of interest. When I do things, I'm very good at them. I'm not going to half-ass them. So, if I can't - if my brain isn't braining today, I'm going to call you - my dog, my car, can we reschedule, thank you. Sometimes I just won't get out of bed, and that’s wonderful because I don’t have to.
Managing stress and finding equilibrium
Veterans talked about their experiences with mindfulness, self-discovery, and using techniques such as deep breathing to combat stress. One person described learning “to reduce stress, walk away from a lot of situations where I would have confronted before. I learned to lay on my back, put my knees in the air and breathe through my nose.” Brian said that when he gets overwhelmed he uses strategies like “deep breathing, sitting down, laying down and writing things down, just writing down the problem itself so you can—what’s the word—sort of deconstruct it, and it isn’t as big.”
When his thoughts start to snowball, Brian tries to distract himself.
When his thoughts start to snowball, Brian tries to distract himself.
Usually what happens is my thoughts snowball, and one small problem I think about the problem escalating six months into the future and then, like I said, it snowballs and I start pacing around and talking very fast to myself and getting worked up. I’ve found either distractions have been good, deep breathing, sitting down, laying down and writing things down, just writing down the problem itself so you can - what’s the word - sort of deconstruct because it’s big.
I don’t always do it. Sometimes I get ramped up or down whichever before I can implement those strategies, but those are some of the things I’ve used - or another thing, forcing myself out of the house. Usually once I’m out of the house, or apartment I should say, I’m good.
When Steven gets keyed up and anxious, it helps to step outside and go for a walk or close his eyes and take a deep breath.
When Steven gets keyed up and anxious, it helps to step outside and go for a walk or close his eyes and take a deep breath.
But they helped with, you know – would do these things like – it’s like I can’t even, it’s been a while since I’ve seen or talked with them. But mindfulness and all that kind of stuff. And I find that when I, you know, when I get really keyed up now, and I’ve noticed that when I get really keyed up or I get anxious, that I’ll just step outside, I’ll go for a walk. And I said, “I’ll be back.” And or I’ll go outside and I’ll grab a cigar and, and just go outside a smoke a cigar and just sit there, close my eyes, take in some deep breaths, you know? Well, I didn’t inhale my cigar because you never inhale a cigar. But just taking some deep breaths, close my eyes, and just kind of like you know find a place where I can just calm my inner self. Which is something that I took away from those classes and stuff and everything. But I do feel that I need a lot more work and stuff, you know. And – because I don’t want to get to this point, I don’t want to get to a point where I become explosive because I’ve seen how I’ve, I’ve seen how I can be and it not only scared the people around me, but it scared me.
A few people said they found relief from listening to music, playing guitar, telling jokes, or reading. Other Vets talked about keeping a journal, exercising, and giving to others through volunteer work.
(See also: Coping with Impacts on Memory & Cognitive Function; Positive Changes, Moving Forward & Finding New Meaning; Seeking Professional Help for Emotional & Mental Health)