Concussion symptoms: Managing cognitive overload
After my concussion, leaving the house usually meant my brain would soon shut down. I’d hold a family member’s arm when carpet colors were so over-stimulating I couldn’t walk. Or I’d leave a wedding reception to lay down in the backseat of a car because stimulation from the music made my body crawl. Noise, bright colors, or a conversation with too many details all made my brain feel like it was spiraling into a dark and painful fog.
This kind of episode is called cognitive overload and is all too common after brain injury. It may feel like the brain is constantly bombarded by stimuli. It can also cause headaches, nausea, dizziness, and/or intense brain fog. The healthcare community can’t say exactly what causes this but some factors include an energy crisis in the brain and overall slowed processing speed.
In my experience the cognitive overload got better (and it should!) but it was messy and debilitating for a long time. Even after I could tolerate more lights and sounds I still got overwhelmed by everyday tasks.
If you experience cognitive overload after a brain injury, there are many things you can do so it feels easier. The next few posts focus on the best ideas from healthcare providers and other people with Post-Concussion Syndrome (PCS).
Strategies for managing cognitive overwhelm
Cognitive overload happens for a couple of reasons. First, an injured brain is like a broken filter. A healthy brain filters all of the stimulation coming in and decides what’s important and what to do with it. An injured brain can’t filter stimulation in the same way.
Processing speed is also slow so it takes longer to process all kinds of information. With a broken filter and slowed processing speed it’s no wonder that injured brains get overwhelmed!
There are different types of stimulation that cause the brain to feel like it’s shutting down. People experience overstimulation from lights, sounds, conversations, reading material, multi-step tasks, and the list goes on. Upcoming posts will focus on strategies for specific types of stimulation. Today we’re going to talk about the two most important strategies for any type of cognitive overload: self-awareness and self-regulation.
Self-awareness
Self-awareness helps you understand your strengths and limitations. It also helps you know how they impact your everyday life. You already use self-awareness at work, school, or in social settings to understand your tendencies, and predict how successful you will be in a situation. You can use self-awareness after a concussion in a slightly different way. Here are some tools to get started:
Keep a log
A log is one of the best strategies to gain control of your symptoms. It helps you understand how different activities and environmental factors impact your symptoms. Then, you can predict when things will get challenging.
First, record the tasks you complete throughout the day. Write down your symptoms after you finish the task. Use a number scale to rate the severity of symptoms in addition to describing them.
Record outside factors such as what medications you took, the weather, how much sleep and exercise you got, and what you ate and drank. These outside factors can impact you without you realizing it.
Analyze your log to help you understand patterns before and after different activities.
Look at factors like how long you spent doing a task, the environment you were in, and how hard the activity was.
Keep the log for at least 4 weeks. Use your increased awareness to predict which activities and situations are going to be difficult.
Make adjustments. You can change the environment, how long you spend on an activity, and the strategies you use while doing the activity so your symptoms don’t escalate too much.
Hint: If this sounds overwhelming, start by simply recording daily activities and your headache and fatigue levels after those activities.
Ask for feedback
If you have trouble filling out or analyzing your log, ask for help.
You may also need help remembering the different symptoms you had during the day. Friends, family members, and therapists can help you understand how different activities impact your symptoms.
Remember that this won’t last forever
An activity log and other self-awareness activities are meant to empower you. But, you may also feel discouraged. Cognitive overload can have a big impact on your life. These activities may show you just how much. It’s important to remember that cognitive overload will not last forever. Take care of your body now. You will be able to increase how much you do and get back to life soon.
Self-Regulation
Self-awareness helps you understand your tendencies and limitations in general. Self-regulation helps you recognize what’s happening in the moment and make changes to be successful. Self-regulation is key to symptom management. Here are two ideas to get started:
Monitor symptoms in the moment
An activity log is helpful, but you have to monitor your symptoms in the moment to manage them. Some people refer to this as mindfulness. Here are some tips to get started:
Leave a note by your workspace or set alarms to remind you to analyze how you feel at regular times throughout the day.
Try mindfulness exercises to increase attention in this area. Apps like Headspace and Calm are free to use. Love Your Brain, a brain injury organization, also has mindfulness videos.
Recruit help from friends or family. If they notice signs that you aren’t feeling well, ask them to help you recognize them.
Have a symptom management plan
A symptom management plan helps you know what to do to bring symptoms down once you’ve noticed them.
It’s important that you don’t stop an activity as soon as you experience increased symptoms. This will slow your progress. But, you also don’t want to let symptoms increase to a moderate-severe level. Everyone is different so it’s very important to work with a skilled healthcare provider to find a system that works for you.
In the meantime, here are some general ideas that help calm the body once it gets over-stimulated:
Make sure your needs are met. Dehydration, hunger, and fatigue can make symptoms worse. Before heading into a situation that might aggravate your symptoms, try to take care of these needs.
Decrease sensory input. Cover your face or ears with your hands, wear noise cancelling headphones, etc.
Get sensory input from something else. Give yourself a hug, squeeze a stress ball, or take a cold drink of water.
Take a break. If an activity or environment is causing symptoms, stop the activity or leave the area for a while until your brain calms down.
Use relaxation techniques. Breathe deeply and slowly. Use a visual like the Calm app’s Breathe Bubble if that helps. If you don’t have access to an app, practice sniff breathing (sniff in slowly through your nose, make a “shh” sound as you breathe out).
Celebrate Success
Even with the best plan in place you will still have good days and bad days. This is part of the healing process. Do the best you can to make a plan to avoid symptoms, but know that it won’t be perfect. Celebrate the times when you are able to manage symptoms to avoid and/or decrease them. Also leave room for plan B, C, D… and be patient with your healing body.
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Disclaimer: This content is for informational purposes only and does not substitute personalized medical advice, diagnosis, or treatment. Always consult your doctor or other qualified healthcare provider with questions, and before starting any nutrition, diet, exercise, fitness, medical, or wellness program.