The Cyclical Nature of Brain Injury

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Last week I came home to an urgent message from the mother of a person who has had multiple “mild” brain injuries. I’ve known the mother for nearly forty years and had become reacquainted with her son over the last several years. When I returned the mother’s call she told me that her son had become despondent and threatened suicide and that a friend had taken him to the local hospital where he was committed for a period of stabilization.

“Sean” had just started a new job, and his mother couldn’t understand his sudden reversal of mood. She related to me that she hoped that the depressive episodes which her son experienced and his seizure control problems would be addressed through this hospitalization. When we spoke again she reported that the physician’s were not addressing the seizure issues, but rather were focusing on his depression and the related suicide attempt.

Her son had become angry with her and other family members and had isolated himself from her phone calls. She was feeling extremely frustrated with the healthcare system, her son, his brain injury and the problems of the last ten years. She was expressing concerns over her inability to get him the help he needed.

Several days later she called back. Her son had been discharged, his mood brighter and he hadn’t lost his new job. Once again we spoke about addressing his seizure disorder with a comprehensive work-up, but that option moved towards the distance as he was once again functioning in a job and back into his life.

What continues to strike me in situations like this is the cyclical nature of the problems, the emergency response, the stabilization and resolution phase followed by the return to “life as before the crisis”. Often the crisis cycles deepen and the periods of time between crises shorten. Ultimately the problem does not get resolved, sometimes due to a lack of available resources, and often due to the need of the person and their family to get on with life and to forget about the crisis until the next time.

For the person with a brain injury, the passage of time may mean fewer resources and supports which are available to them. Caregivers become older, families move away and life creates time and distance barriers. Yet each crisis brings us together, albeit for a short time to solve the problems we can, and to defer on those which we cannot solve.

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