Diet & Nutrition

Diet & Nutrition

Following on from the last weeks and my posts Holistic Health and Exercise: Body vs. The Mind, I am continuing with my theme of trying to create a positive balance in all aspects of our bodies. I have spoken on exercise and the idea of Holism or Holistic health; how exercise contributes to Holism and the positive effects this approach of treating the whole person (not just symptoms and manifestations) can have for those of us with Acquired Brain Injury/Traumatic Brain Injury. I will continue in a similar vain today and talk about the part played by diet and nutrition. Specifically I will try to emphasise the ways certain vitamins, minerals and other nutritional benefits from certain foods can affect our state of mind and the way we feel generally. I am hoping I will be able to provide you all with come dietary information that can improve our circulation, our production of levels, our immune system generally as well as the ability to produce certain hormones, in particular, the feel good hormones.

Vitamins & Minerals – What Can They Do For You?

There are common misconceptions made about what we eat and how our diets can affect so many aspects of our wellbeing. I believe personally that there is not enough education regarding the potential nutritional value of certain foods during years of compulsory education. I release that due to the continual advances mad in science these days that to constantly adapt curriculum to incorporate everything would be nigh on impossible. That being said, I do believe that with a better understanding from a young age (the start of GCSE’s, say) of what vitamins and minerals actually do to the human body (not just lightly glossed over) that the current crisis regarding childhood obesity would not be as bad as it is where approx. 19% of UK children in the age group of ten to eleven years old are classed as obese according to recent UK public health surveys (http://www.noo.org.uk/NOO_about_obesity/child_obesity).
Of course diet and nutrition contribute to our physical wellbeing (Body Mass Index, Blood Pressure etc.) but few people are aware of the positive effect a varied healthy and nutritious diet can have on other aspects of the human body and mind. Our digestive system, muscle repairs, energy production, our immune and circulatory systems, sleep pattern and state of mind can all be positively affected by such a varied nutritious diet.
So many people will read that last paragraph and believe that I am full of hot air. However, I will be doing my best to provide you with some information on the type of foods that can provide these types of nutritional benefits. By the end of the post, you will be able to see a few particular foods that keep cropping up and can aid our physical, cognitive and mental health.
I cannot possibly hope to get through all vitamins and minerals required for a model diet post-ABI or TBI. However the one I have chosen is the one that contributes to most dietary needs for someone after brain injury to keep them healthy in body and mind.

Vitamin B

Vitamin B is a key part of any persons diet and provides so many benefits. The problem is that people trying to improve their diet can often get confused or mixed up due to the fact that Vitamin B has six sub categories, each with varying properties and each one providing the body with different benefits. So I will go through the different types of B vitamin and what each provides for the human body to provide some clarity and hopefully enable those that want to change their diets for the better to get the benefits they are after. Each paragraph on the different B vitamins will have a emboldened section which I believe provides particularly important information for ABI and TBI patients.

B1 – Foods that contain B1: Rice, Oats, Nuts and Butternut Squash.

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Otherwise known as Thiamine, is important for helping digestion in the human body, maintaining cellular and organ function and keeping energy levels at an even and suitable height. It also helps to create strong mucous membranes as well as helping to maintain the body’s nervous system. A deficiency of vitamin B1 can cause extreme fatigue as well as degeneration of the nervous and gastrointestinal system as well as degeneration of muscular systems.

B2 – Foods that contain B2: Quinoa, Oats, Spinach and Mangetout.

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B2 (Riboflavine) is important for maintaining muscle tissues as it plays a key role in repairing muscle tissue and mucous membranes. As well as playing an important part in converting food into energy. This would be an important vitamin to ingest for those who are regular exercisers, as foods high in B2 will help with repairing minor post-exercise damage done to any muscles.

B3 – Foods containing B3: Chicken, Turkey, Fresh Tuna and Crimini Mushrooms.

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Vitamin B3, to give it its technical name Niacin, is key to the production and storage of fats that can be used as a source of energy in the human body. As an added bonus B3 is also vital in detoxifying the body by eliminating free radicals and maximizing our energy potential (What are Free Radicals? To what extent are they dangerous as the body naturally produces them? Follow the link for an overview of Free Radical production and their purpose – https://draxe.com/fighting-free-radical-damage/). Once again, this B vitamin plays a part in maintaining nerves, the brain and digestive systems, protects the skin as well as maintaining healthy mucous membranes.

B5 – Foods containing B5: Cauliflower, Egg Yolks, Turkey and Avocado.

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Vitamin B5 or Pantothenic Acid is key to strengthening the body’s immune system. It acts as a stimulant for the production of antibodies helping us to fight off illness and infection. B5 also enables us to deal with stress better aiding the adrenal glands in producing the hormones to better produce red blood cells and the hormones related to both sex and stress. An increased presence of B5 included in the diets of people suffering with anxiety or nerves could provide some improvement for you, especially when combined with exercise.

B6 – Foods containing B6: Eggs, Soya Beans, Mackerel and Turkey.

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This is an important one for all of us with ABI or TBI. Not only does vitamin B6 or Pyridoxine, help to make and produce key amino acids for the immune system but also helps produce Phagocytic cells. Phagocytic cells ingest and destroy foreign bacteria and particles that find their way into our blood stream. Most importantly for ABI/TBI/Brain Injury readers out there, B6 helps the body produce several different neurotransmitters, the chemicals that carry signals from one brain cell to another. Finally it helps with the production of Serotonin, the hormone that contributes to mood as well as the hormone Norepinephrine that helps to regulate our body clock and sleep pattern.

B12 – Foods that contain B12: Beef Liver, Fresh Tuna, and Raw Milk.

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B12 is fundamental for the human body due to its requirement for the process of making DNA. It also helps to transport oxygen in the blood, playing a part in detoxifying the body, lowering blood pressure and levels of cholesterol. Most importantly for us struggling with brain injuries out there it also helps to maintain brain function while at the same time helping to reduce brain and neurological degeneration.

Folic Acid – Foods that contain Folic Acid: Lentils, Avocado, Broccoli and Citrus Fruit/Citrus Fruit Juices.

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Folic Acid is a B-vitamin that makes a significant contribution to our reproductive. Just as importantly it helps with maintain healthy blood cells as well as playing a part in the process of mitosis (cell division). The work that Folic acid does producing maintaining blood cells helps to reduce the risk of illnesses such as cancer

Minerals
Magnesium – Foods that contain Magnesium: Rice, Quinoa, Spinach and Mackerel.

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High levels of magnesium in our bodies mean that we can absorb more calcium. Maintaining a consistently high level of magnesium in the blood means our bodies have an easier time producing energy and helping with nerve transmission. This particular mineral also aids maintain muscle function and our metabolism.

Zinc – Foods that contain Zinc: Rice, Dark Chocolate (with high Cocoa solid percentage), Cashew Nuts and Seafood (generally).

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Zinc is predominantly an anti-oxidant, anti-viral mineral. Its main benefit really is that it boosts the body’s overall immunity as well as helping with the development and maturation of Lymphocytes commonly known as T-Cells (T-Cells are a type of cell that helps fight illness and infection. There are various types of T-Cells all with different roles and purposes in the immune system. Low levels of T-Cells weaken the immune system, making us more susceptible to illness, infection or disease). It is these Lymphocytes, T- Cells, that the HIV virus attacks when it is transmitted, lowering our immune system making us more prone to illness and unable to recover.

Others

EFA’s (Essential Fatty Acid’s including Omega 3 and Omega 6) – Foods containing EFA’s: Walnuts, Broccoli, Eggs and Olive Oil.

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The important role of EFA’s is that they are an anti-inflammatory as well as playing a vital part in maintaining healthy blood, skin and nerves. EFA’s are also believed to improve the responsiveness of the immune system. EFA’s can also be commonly found in oily fish such as fresh mackerel, tuna, salmon etc.

Serotonin Stimulators

Foods that can increase the production of serotonin: Eggs, Salmon, Nuts & Seeds, and Pineapple.

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As I stated earlier in the post, Serotonin is a hormone produced to help regulate our moods. As I mentioned in my post regarding exercise, the release of serotonin is the hormone behind the so-called “Runners High”, the feeling of happiness and ecstasy one get post-exercise. While exercise is certainly something that I would recommend for those looking for the uplifting feeling of higher levels of serotonin there are other methods such as the type of foods we eat that can induce higher levels of serotonin production.

Drinks

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I am certainly not an expert when it comes to dietary needs and exercise but if you want to find out some alternative drinks to try, have a look at my friend Chelsea’s blog on various teas and their benefits: specifically her post on teas more suitable for patients whttp://www.tastethetea.co.uk.

Common Appearances In Healthy Diet

It would seem as though there were a fair few foods that made repeat appearances through the various categories I have listed. It would stand to reason then that the foods that crop up in different categories I have mentioned should be incorporated as a key part of our diet. From the evidence and research I have provided it would seem fairly clear that a diet high in oily fish, poultry, rice, grains, nuts & seeds, as well as green leafy vegetables are the foundation of making us healthy and making us feel good physically, cognitively and mentally. While I did not do a section on this particular dietary supplement I would encourage the consumption of anything with Flavanoids, which helps with the maintenance and repair of blood vessels, muscle tissue and aids circulation. Flavanoids are commonly found in Seeds & Nuts, Berries, Tree Fruit (Plums, Cherries etc.) and Kidney beans.

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All I can suugest is that we try to continue to eat a varied and healthy diet. The issue nowadays is that so much food is processed, preserved or artificial that any goodness is cooked out of it. Many people believe that supplements and vitamins tablets can provide everything we need. However the more we try to cook ourselves, the more we are willing to experiment with our diet, the bigger the benefits we will receive. Even if you don’t consider yourself a dab hand in the kitchen just give it a go. Buy a cookery book. Here’s a link to get you started to Jamie Oliver’s Super Food cookbook.

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Holistic Health

Holistic Health

Scar

Brain injury, in all senses is an incredibly complex issue. There are numerous debates on different recovery methods; which works best? What’s the first step? What’s the best method of recovery? Finally, what I’m sure is the most common question, what is the cure? The truth is, as I and I’m sure you also have learned that there is no prescribed cure for ABI. In fact, I don’t think it can be cured; situations can improve but complete recovery? I’m very dubious. It is not the same as taking Ibuprofen to relieve a headache. The damage ABI does and the way it manifests itself can potentially affect everything from cognitive function to physical movement. Down the centre of my head is a huge scar that spirals round to the front of my right ear. And at the back of my head a large scar that slides down from just above the base of my skull to the upper parts of my neck; both visible mementos of my brush with death. The biggest scars, the ones that trouble me most today are the ones that can’t be seen.

Invisible Wounds & Injuries

I often feel that the things I am battling with most are issues such as anxiety, anger and depression, in essence factors connected to how I perceive myself and others perceive me. I will talk about the type of alternative choices and helpful lifestyle practices that can install a sense of calm and help achieve an inner-peace. These are methods of healing that are not just prescriptions to cure an ailment but to aid the healing of the whole, the mind, the body and the soul; in essence, holistic healing.

(Holistic – The belief that the parts of something are intimately connected and that you cannot separate one part without referring to the whole. For example when I was referring to a person’s health I used the term “mind, body and soul”, meaning that only when all are healthy and content at once can one be truly what you would call “healthy”.)

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Some of the things I am going to suggest are things that one can obtain by walking into a shop and buying, or looking up the methods online but those parts are just a small part of the overall recipe. Much of what I am going to advise is definitely not easy. Most of these things involve a lot of discipline and awareness of both yourself and what’s happening around you. If we master these techniques though, believe me when I say this, we can learn to carry and manage the burden that is ABI and obtain a sense of peace, something I lacked for three to four years until I made the effort to learn, change my lifestyle and accept myself for who I am now.

What Is Peace? How Do We Get It?

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The pursuit of peace, I believe stems from the every day stresses one endures: work, family life and commitments or, in our case, past traumas and the basic human need to escape from those stresses. I also believe that moments of peace where we are not in a state of constant mental conflict are essential for everyone’s day-to-day health. I am a great believer in holistic methods for creating periods of time where a person can be at peace and feel peaceful.

We all know that the ever-elusive pursuit of peace (a pursuit that on some level, all people whether they have suffered an ABI or not are on) revolves around our state of mind. It is a journey we try to go through each day so that we can arrive at a place, if only for half an hour each day, where we feel we have arrived at the desired destination; a place of comfort where none of the worries that we have been through during the hours before matter and they no longer concern us. What peace is depends purely on whom you are, the type of person you are, the intricacies and character traits that make you an individual. But I will explain to you what my place of peace is later on.

I also think that much of finding that feeling of peace within the self is being at peace with yourself and who you are. I think that accepting where your limitations are and finding alternative ways to overcome them or achieve the same end by a different means is how we can empower ourselves and feel that a brain injury does not rule our lives; that with hard work, the ability to accept certain defeats but not let them defeat you entirely and an open minded outlook and willingness to try new things we can be proud of who we are and be at peace with our injuries and the effects they have had on our lives. It’s a case of staring down the brain injury. The question is, who is going to blink first? I’ve found in the last seven years that I can stare for a long time.  

My Place Of Peace

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Near where I live (on the south coast) there are numerous cliff paths. I can walk up the cliff and onto a long coastal path. I have brought nothing with me except a bottle of water and my iPod. As I approach the uneven path up the steep cliff, I select my relaxation/mindfulness music album and press play.

As I set off I walk up the steepest part of the cliff walk up the steep green path until I come to a flat level where I can walk across the tops of the cliffs with ocean views as far out as you can see, I take that time to do some breathing exercises to get my already pumping blood full oxygenated. It is hear on these cliff tops that I can put aside the battles I have with myself in my own mind and stand and appreciate if only for half an hour, that there is so much beauty in the world. I can walk up and down that path for as long as possible. This is where I find my time of peace. A place where I can admire the beauty of the world, a world that seems much quieter, much more beautiful and relaxing that I enjoy far more than a world where I often see little to admire which only aggravates an internal struggle that I am battling with everyday.

Exercise

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There are many different ways to keep the body healthy and that can lead to a sense of happiness (a topic I covered in my previous post Exercise: Body vs. The Mind). Happiness is key to us finding a place of peace. Peace and relaxation is not what I would call happiness, more a sense of satisfaction or contentment. They are still though, in my opinion, branches of the same plant.

With regular aerobic exercise such as jogging, swimming or walking comes with it the release of endorphins into the blood, endorphins – the healthy person natural drug of choice. I think this is why my feelings of peace often come after a period of exercise. The oxygenation of blood, achieved by rhythmic steady breathing during exercise is also important during periods of relaxation. When oxygen passes through cell walls and attaches itself to red blood cells the oxygen is transported to the parts of the body that are most fatigued and need it most. The brain needs a steady supply of oxygen to operate at its maximum capacity. In other words, for people like us with brain injuries, providing the body with a supply of well oxygenated blood will ensure that our brains operate at a higher capacity that if we don’t do exercise.

Diet

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People say that dieting or eating healthily is a chore what they don’t know is that often the foods we eat can have a big impact on the way that we feel due to their content. Certain foods can help us cleanse and detox our body, even eliminating certain chemicals and molecules that can negatively affect our mood and yielding ones that produce a positive effect. I do not pretend to be in expert so I will link you to a couple of website that include far more information than I can give you. As I said, much of what disturbs my sense of peace is the ongoing battle in my mind and the effects that my emotions and mental health have. Changing ones diet can have a huge impact on the way that issues such as depression or anger can affect our day-to-day lives.

  1. http://www.webmd.boots.com/depression/guide/diet-depression
  2. http://www.everydayhealth.com/depression-pictures/8-foods-that-fight-depression.aspx

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I should also add that it is not just the things we EAT that can produce these positive effects within the body, but also within the things we DRINK. So here is a link to my friend and blogging colleague Chelsea Webster’s blog Taste the Tea particularly her post on the positive effects different types of tea blends can have in helping to relax the mind and the positive effects of Tisanes. http://tastethetea.co.uk/2016/05/10/abi/ You can also find out more about her and the writing she does on Twitter @TastetheTeaBlog.

Fulfilling The Soul

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One of the key parts to gaining peace within you is finding happiness and fulfillment in the things that you do. This is an extremely difficult thing to do after something like an ABI or TBI as it can seem that so much is against us. It can be difficult to find the right things for you personally due to the way your own individual injury has manifested itself and the things that you personally struggle with. These common feelings can often induce in us a certain fear, a fear of failure. Developing that kind of fear is the worst trap that we can set for ourselves. Instead, the approach that I take (and it’s not an easy mindset to get into) is that when we try new things, different things, there is always likely to be bumps in the road and difficulties the same as any other person. Those difficulties are emphasized by my injury and that is something that I cannot help. I hate and resent the idea that something that happened to me at the age of nineteen, seemingly at random, holds so much power over me but it does. That’s the way it is unfortunately and I can do nothing to change that.

What I can do however is use that as a motivation. Once we accept the fact that our injuries will affect certain aspects of performance, whether cognitive, physical or emotional and by proxy affect tour ability to do certain things I believe that we are in a much better position to try and do as many things as possible. When we do this, it is possible (and quite likely) you will find something that you do have a talent and passion for. I’m not saying we should try and do these things on a grand stage in front of a huge audience but why not try them on a small scale first. Why not (as I have mentioned it above in this post) try exercising and setting small goals to overcome, an example being losing a certain amount of weight in a certain amount of time. Or if you are struggling with issues such as depression then why not try experimenting with cooking recipes using the information I have provided with the links I have provided above to try and help improve your state of mind. Finally, an option that is my own preferred option that makes me happy; try expressing yourself in a creative way through writing (scripts, prose, poetry, songs). Why not try learning an instrument? Why not enroll in an arts class or maybe an amateur dramatics class? I am sure there will be plenty of information for local organisations online where these kinds of facilities will be available. If not then try speaking to specific charities and organizations’. Again I would suggest speaking to your local chapter of Headway UK who I am sure would be delighted to help you investigate where such local sports centre’s, organizations, clubs, societies and groups are and how to contact them to find out about different courses, lessons or meeting that take place.

The key thing is to find something that you can enjoy doing that gives you a feeling of accomplishment. Find where your talents are, embrace them and use them. The feeling you get when you are doing something you enjoy and it is yielding a positive result is an incredible one.

Peace & Relaxation

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Finally, I think that doing things that focus our minds, doing things that we enjoy and make us happy are a significant part of holistic healing. I believe that that lump in your throat and that feeling of heaviness in your heart that we feel so often after an ABI or TBI co-exist in the same part of you that explodes with happiness when England score a goal and the same part of you that brings a tear to your eye whenever you hear The Three Tenors –Turandot: Nessun dorma! They are just examples from my life, my point is that while there is sorrow that lives there, there is also passion, happiness and beauty in all of us. What we need to do is to find a constructive way to show our passion, our beauty and our happiness! When we can show that as well as absorb the beauty of the people and the world around us, while ignoring the slights of ignorant or unpleasant people and just continue living our life with good intentions and good morals and with gratitude. Then we shall be well on the way to being healed.I stress the importance of the wording, healed not recovered

Exercise: Body vs. The Mind

Exercise: Body vs. The Mind

Hi folks, this is a re-written post from over a month ago that immediately followed my post Post-ABI: Depression. However as I explained in earlier blog posts, I felt I had very much short-changed you in terms of the amount of information I had provided regarding what it is like to suffer with mental health issues. Over the last month though, I feel I have been very open with you when talking about my own experiences of mental health problems (which can be found via the following links: Go Back A Step – Depression, Identifying Triggers, Managing My Mental Health, Anxiety & Low Self Esteem, Socialisation & Emotional Instability). Within these posts I feel I have examined both the topics at hand and myself very deeply and hopefully provided you with some useful information. I feel as though I have agonised enough about the things that are pulling us back and it is now time to look at ways we can help ourselves and move forward. So this is where I should have posted about exercise, when it was the right time to do it. So here it is, in it’s rightful place as we examine how we can help ourselves.

One moment your life is mapped out, you know who you are, what you want and where you are going. We wanted to live the dream! But what if life is not a dream though, what if the dream that movies, news coverage, advertisements and politicians have described and tell you is imminent if you work hard enough turns out to be fake? What if it suddenly turns into a nightmare? The next moment you find yourself in a hospital bed with your life changed, as if someone has blindfolded you and dropped you in the middle of a rainforest and told you to find your way home. After many mishaps, mistakes and the feeling of injustice at the ridiculousness of the size of the challenge you have been set it is inevitable that feelings of anger, despair, futility and so many others will inevitably pile up to the extent that you don’t even want to get out of bed in the morning.

Depression & Exercise

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Now we all know that exercise is good for us in the conventional sense. We should all exercise daily according to our GP so as to keep blood pressure down, keep the blood pumping and oxygenated, to keep ourselves at the right weight and to generally make us look and FEEL better about ourselves. Depression is the parasite, a condition that is fed by our negative thoughts, our dark desires, our self-loathing, or stresses, traumatic experiences and our hatred. There are many ways to control that parasite though, not just medications (which, in my opinion, are handed out extremely frivolously these days), but by more natural methods that we can do ourselves with a little discipline and hard work. I personally believe that if you are susceptible and vulnerable to mental health issues that it is a case of getting those negative thought patterns well controlled, that with the right lifestyle we can ensure that they lie dormant for long periods. What I believe is that when it comes to depression, it is something that is linked to your own mind, the type of person you are and your own experiences. Therefore I believe that, as is the case with ABI, that you aren’t really ever cured. Because of the type of person you (or we, I also suffer from issues with depression anxiety and anger) are and all that you have been through will be prone to spells of depression or moments of anxiety for the rest of your days. This is also the reason I believe there are other ways to deal with them aside from just throwing pills and medications at the problem in the hope that it goes away.

The Science

There are two key parts to how exercise can keep us healthy not just physically but improve our state of mind as well. The first is the release of endorphins and the second contributory factor is ensuring that our blood remains oxygenated and circulating well. I will do my best to explain the processes, as I understand them but I will say this now; I am no expert scientist.

What Are Endorphins?

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Endorphins are a neurotransmitter (a chemical that continues the passage of signals from one neuron to the next) key to the central nervous system. They play an extremely important role in the nervous system as they can encourage or suppress the signaling of nearby neurons. They are also our brains response to certain stimulants, such as pain as well as emotional stimulation to the brain. Think of endorphins as the brains own drug and react mainly with the part of the brain responsible for blocking out pain and controlling our emotional state of mind.

While endorphins block pain and control our emotions, they also cause that great feeling of excitement and enjoyment from the things we are really passionate about, enjoy doing or are just something of a giddy thrill. So when we do an exercise that we are extremely passionate about, not only do endorphins block out or relieve us of issues such as pain but also emphasise the positive emotional state we are in when are enjoying our exercise. When you hear people talk about the “runners high” that is due to the rush of endorphins the runner is getting while their brain is active and their body is being pushed.

Oxygenated Blood

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Now, I’m not going to get too caught up in this. I’ll keep it brief, as I’m not sure exactly what the correct scientific explanation would be (Here is a good article on oxygenation of the body and body detoxification courtesy of Natural News.

To keep it simple, the oxygen from the air we breathe in diffuses through membranes into our red blood cells, the cells designed to carry oxygen around the body. The red blood cells then carry this oxygen to the places where it is needed most in the body.

The best way to ensure a good supply of oxygen in the blood and that your organs (particularly the brain), muscles and nervous system stay oxygenated is to focus hard on breathing patterns with slow and steady breathing.

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To help maintain both of these things, a steady supply of endorphins and a healthy supply of oxygen to the blood, those breathing patterns I spoke of earlier combined with regular aerobic exercise (hiking, running, cycling) or just breathing and stretching exercises such as yoga or tai-chi. The point is exercises.

I can guarantee that with the continued focus on breathing patterns and with regular daily exercise (it doesn’t have to be a big grand effort, just walking for half an hour a day) can have a really positive effect on the state of mind due to your body’s natural reaction, the release of endorphins; your body’s own natural high.

Confidence

One thing that exercise also provides that is a huge boost in the fight against depression is confidence in ourselves. During recovery and rehabilitation post-ABI I know that there are so many things that are foreign to us and that have changed, against our wishes. The situation escalated beyond our knowledge and control. However, when we find a particular type of exercise that we enjoy, we can implement an exercise regime that will enable us to set targets and, by achieving them, bring back an element of control.

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Depression can cause issues such as a lack of appetite, or a tendency to over eat, both of which cause issues with weight. Exercise can help to counteract both of those things wether it is exercising to build up an appetite or exercising to burn off excess calories you have consumed. Exercise can be used merely to keep your body in balance and ensure that you stay in good condition and that your health doesn’t suffer. It can also be used to set yourself goals such as adding muscle definition, increasing targets such as distance run or weight lost or gained. With regards to exercise, it can work as a way to motivate ourselves and as a tangible, visual incentive because it shows that the effort we are going to is worth it and the fitter we get the better we look, the better we look the better and more confident we feel.

NB. For more information on how exercise can act as a positive influence in life post-ABI check out the inspiring story of Nick Verron and how exercise changed his life after his brain injury. Follow the link to his blog: nickverron.com

Socialisation & Emotional Instability

Socialisation & Emotional Instability

 

Emotional balance and states of mind are a difficult thing to manage for me. I see many of my emotion precariously balanced on a knife-edge throughout my day-to-day life. There are small moments, events or incidents that may seem insignificant to other people of the non-disabled community, that they can brush off in a moment and see these incidents as merely small irritations in their day-to-day life. What I have found is that a moment, which could be interpreted as the smallest inconvenience for them, can turn out to be the blueprint that will reflect my mood and my attitude towards other people and the world at large for the remainder of the day (and in some cases a period of days).

We like to think (when I say “we” I mean all of us, people with a disability or anyone else) that we have these emotions under control from the start of our day to the end of our day. Much of what allows us to keep that kind of emotional control is (I believe) our cognitive abilities, in particular our social skills. For people who have not suffered an ABI/TBI, in essence the fully abled population of the UK, waking up in a bad mood is an inconvenience; they may be grumpy, have a slightly sharper tongue than usual and slightly less prone to socializing. What is more, when issues such as anger, mood and emotional instability become a problem they still have their cognitive abilities in tact to be able to deal with whatever the issue is. They can think around a problem, read a social situation and decide clearly what is the best way to respond and most importantly of all emotional reaction can be kept in check and (in the vast majority of cases) the person can put forward an appropriate emotional response.

Why Is That Different For Brain Injury Victims?

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I believe that there are many factors to consider in terms of the difficulties of determining an appropriate emotional response to situations for ABI patients and the potential emotional instability that we suffer from. But these I believe are the biggest contributing factors.

Firstly, I would argue that people such as myself and many reading this post who have suffered an ABI have a tendency to focus heavily on the abilities they now lack, the things they can’t do since they suffered their injury which causes a feeling of insecurity and a sense of fear that those (what we the patients) perceive to be “weaknesses” will be exposed (a point I highlighted in last week’s blog post Anxiety & Low Self Esteem and other posts in previous weeks Go Back A Step – Depression and Identifying Triggers). Fear and anxiety are states of mind that will contribute to any emotional social interaction and by-proxy emotional reaction an ABI patient has.

Secondly, something I believe to be strongly related to the first factor, people without ABI’s or TBI’s tend to be better in social situations. I am not necessarily being specific about a patient’s ability to perform, say verbal communication, tone of voice, articulation and body language but rather an their ability to read and interpret those aspects of language and communication accurately and correctly when they are delivered by other people. The skill of interpreting the codes and conventions of communication are vital to social interaction and it is common amongst recovering ABI and TBI patients that those skills can be lessened, damaged or lost post-brain injury.

Finally, something that I suffer from a great deal and that is the ability to cope with the unexpected or with incidents that can ruin a plan that a patient has arranged. I have tried to emphasize the importance of developing a routine, developing positive habits and processes that help you manage your day and living with your condition as well as trying to find things that you can enjoy each day. When these plans go astray due to outside influences, our emotional reaction can often turn out to be disproportionate to the event itself. It is a lack of ability to get to grips with disappointment, anger or whatever emotion takes hold, master ourselves and to not let the emotions that come from that event disrupt the rest of our day and the mindset we carry throughout the day.

My intention this week is to explore these particular topics in further detail and then, in the next few weeks, try and provide some helpful techniques as to how we handle the different emotional instabilities and mental health issues that can seemingly come from nowhere and ruin days, even weeks.

Social Engagement – Self Doubt

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In a society that is applying increasing pressure on people to conform, to meet a required standard in their abilities, their appearance, opinions and behavior, it is extremely difficult for people with ABI’s and TBI’s to feel comfortable with who they are, the way they act and to know if the way they are acting would be considered “normal”. This societal pressure (heavily influenced by the media) means that many ABI/TBI patients feel anxious about the idea of social engagement before it has even begun. If the activity is a pre-arranged event, I know that I myself have spent days leading up to an event fretting, worrying about how people will see me, perceive me and whether or not they are judging me. When we apply this kind of pressure to ourselves the likelihood that things can potentially go wrong in social situations increases dramatically.

Social Engagement – Communication

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I think it is safe to say, at least from my own perspective, that after a brain injury, we are fairly unsure about ourselves. For a certain period of time I would also add that we don’t understand ourselves. We have gradually recognized that there is something different about ourselves after our injury; there is something about us that is different to everyone else. I often think that our (or at least my) emotional reactions can have a tendency to ride roughshod over our cognitive abilities and for lack of a better term, “common sense”.

I have found that I will often blurt out a response in a conversation that is a statement composed entirely by my emotions can often be blurted out without any real thought of how people around me in the conversation will interpret it. The way a statement can be interpreted by people consists of many things, the statement itself, whether or not the timing of the statement is appropriate within the “flow” of the conversation (so timing, subject, the opinions of those taking part in the conversation on the subject at hand and finally the direction of the conversation), the tone of voice, the speed of the conversation, body language and so on. From my experience with an ABI all of these things can contribute to difficulties in social engagement. Mostly because of a patient’s inability to take in all of these contributing factors, decipher the meaning, think of an appropriate considered response and deliver that response with all of the contributing factors I mentioned previously applied so that other people in the conversation can interpret the correct meaning but also the fact that those people do not consider all of the intricacies of social conduct. Those intricacies have become so engrained that they do them almost automatically. Whereas for patients, many so called automatic bodily and cognitive functions have been damaged so that understanding, performing and interpreting those functions in a social setting is incredibly difficult.

What Is The Result? Emotional Instability

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Well when you consider the issues I have mentioned regarding self-doubt and the difficulties brain injury patients have when it comes to social interactions and the pressures those things ensure is that emotional knee jerk reactions can often overtake the processes of composing a measured and appropriate response.

For example, when we are involved in a conversation and (as so many of us experience) a statement we make is met with an awkward silence and the other people in the conversation staring at you, unsure how to respond, panic kicks in. The silence is deafening, we start to wonder what we have said and done, what the other people are thinking. We also feel the colour in our cheeks rise; we are embarrassed, humiliated, and angry at our inefficiency. The deafening silence continues so we try to make amends by filling the silence. We start talking again, not realizing that the things we are saying this time are just as awkward for the people listening as the last sentences were. We keep talking though like a man with a shovel who just keeps digging until finally the reaction, the looks on the faces of the other people (amusement, embarrassment, disapproval, confusion) and the overwhelming silence forces us to clam up.

Here is where the anger kicks in; we can react angrily to the people who we are talking to; “What the hell are you laughing at?” Or “Don’t you dare laugh at me!” Or we can be angry at ourselves, embarrassed and humiliated, attacking ourselves for our lack of skills, our inability to keep up with the conversation. These reactions to social engagement, ruled by emotion and reaction can be devastating to a re-integrating post-brain injury. There our many outcomes to a circumstance such as the one that is described above, each one detrimental to a patient and how they react to social engagement and how other people receive them.

The first, people can feel uncomfortable around you. These are the people I find that don’t really have the slightest clue about the type of battle we are fighting and have to fight day in day out (your true friends will understand and will know how hard this is for you and will make allowances for the social faux pas you make). The second is that you will become more resentful towards your condition, allow that anger, embarrassment and awkwardness to turn inwards so that you feel uncomfortable or even ashamed of who you are. The final one is that experiences such as the one I have described can make you unwilling to socialise and wake you more introverted. The last two issues for me are the most harmful. The ones where you start to despise yourself and your condition and become ashamed of who you are. NEVER BE EMBARRASSED OF WHO OR WHAT YOU ARE. None of us asked for this and the final two issues I have spoken about in this paragraph can lead you down a path towards isolation and loneliness which can then lead to deeper more troublesome psychological/mental health issues such as depression, anxiety or even a form of escapism through something like drugs or alcohol. All of those things are detrimental to our recovery.

Coping With The Unexpected

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I have spoken before about the importance of developing a routine and how a solid dependable one can have a really positive influence on the way we live our lives post- acquired brain injury. One thing I can say though is that too much dependence on a routine to make your life tolerable can have potentially damaging consequences. This is due to the fact (particularly when parts of your routine rely on things that are under the control of other people) that things beyond your control can disrupt your routine.

Take yesterday as an example. I woke up in the morning after having a dream. The dream was about a person (she broke my heart actually but that’s a story I wont go into) so I woke up angry, reflecting on all the ways she had hurt me and how those wounds were still sore. So I was angry before I even started the day. There are things I should have done in the morning to gather myself but I didn’t think properly, I was overwhelmed by a sadness and anger. Already, here was something I can’t control affecting me in a negative way.

After I had a cup of tea and had appropriately woken up, I decided to go into the local town where I would have breakfast and do some work in a local café (this is something I do often as the mile long walk to town gets me some exercise and gets me out of the house amongst people, both of which are important as being a writer can be a lonely profession and by its very nature is a sedentary one). I undertook the walk, with that haze of anger, frustration and sadness still hanging over me like a rain cloud. But I had my routine to look forward to; get a bacon sandwich at my favorite place (they do THE BEST BACON SANDWICHES EVER!) and a cup of tea, go to one of my favorite coffee shops where I have a cappuccino, use my E-Cigarette and listen to music for about half an hour before going to a different coffee shop to do my work.

I arrived in town, still feeling less than happy but the walk had done me some good. I went to get my bacon sarnie but as I approached the doors I saw that the blinds were down and there was a notice on the door that read: CLOSED FOR REFURBISHMENT – UNDER NEW OWNERSHIP. When reading this I couldn’t help but feel as though this might not be my day. I tried to continue as normal, I went to my café to try to enjoy my coffee, enjoy my E-Cig and listen to music. I tried to compensate for the absence of a bacon sandwich with a pastry in the café but it just wasn’t the same. I listened to my music, watching the other people sat outside drinking coffee and smoking REAL cigarettes (bastards! I gave up seven months ago).

My mood was moving further into decline, I was thinking about the girl, I was thinking about the lack of bacon sandwiches and cigarettes. So I moved on to my next café where I could work on my blogs, thinking I could take my mind off of things and concentrate on something else. However, when I started to write, I realized that the topic I was writing about (brain injury and emotional response) was making me think about all the other things in my life that I hate and resent. That hatred normally stays under the surface but today it was bubbling over. Then, the final nail in the coffin of the day; I received my coffee from the barista and received a luke-warm beverage. This was the climax of a day of complete crapiness. I closed my laptop left the cup of (now stone-cold) coffee on the table and walked home with thoughts of the girl that broke my heart, the effects and manifestations of my disability, the lack of bacon sandwiches, the fact that I wanted a REAL cigarette but couldn’t and the fact that someone who is paid to make coffee as a profession couldn’t make one to a suitable temperature, weighing heavily on my mind. I was so unbelievably angry at how the big things in life had all popped up at once to impact on my day combined with a series of little things aiding them in their sabotage of my emotional stability, state of mind and mental well being. This is actually the reason this blog comes to you a day later than anticipated.

That’s Life So…

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My point is that I had expected for things to go my way the other day and in many ways (nearly all the ways I can think of) they certainly did not. So from that experience I’ve had and the issues I spoke regarding socialisation earlier is that we cannot necessarily predict how life and events are going to work out for us. I think it is important that we don’t set too much store by whether or not things go well for us first time or indeed, all the time. I think that what we have to do is to try and do our best to handle situations the best that we can and not be too disheartened when things do not go our way. Equally important is our ability to overcome the disappointments, the times we do not succeed and develop an ability to come back and try again. We mustn’t allow the times where it seems as though the world is against us and we become angry, embarrassed or humiliated to dictate our actions in the future.

There are plenty of disciplines, thought processes and physical actions we can take that can improve our emotional stability as well as our state of mind and mental wellbeing that I will be exploring over the coming weeks. I hope that this has been beneficial to you all and that you will be back to read over the coming weeks. Meanwhile follow me on Twitter @ABIblogger to follow what I am up to. See you soon!Emotional Instability