Brain injuries are tricky little devils. Most of the time they hide so well that no one is able to see them no less note that anything is wrong. Sometimes they show up after the most unlikely events  like surgery or treatment for a disease, or as part of the progression of a disease not necessarily localized in the brain.  They are not just the result of a traumatic physical incident or an accident or a fall or a stroke. Brain injuries and all the stuff that goes along with them sometimes simply pop up without warning.

Medical professionals give them names that sound so harmless, like post-concussive syndrome or chemo brain or brain fog, that they don't even feel worthy of a deeper look. But they are.

Here is the big question: How do you help someone with something you can't see? Even the well intended will miss the signs if they are not looking for them and, to be fair, how would they know to look?

The biggest indicator is change in behavior, attitude, level of involvement in life, personality, and routine. If you see a change, take a deeper look.

If you believe you are living with someone who has had some kind of brain change, here are some tips:

  • Listen, watch closely, and adapt to changes as they happen.
  • Drop assumptions and preconceived notions about how that person “should be”.
  • Slow down and think through your questions, especially when you get unexpected answers.  Perspective, among so many other things, changes so it may take a while to find the right question.
  • Find those things that are difficult and create ways to practice those skills in a safe place.   Games – board games, word games, car games, online games, apps – are ideal.
  • Think about how frustrating the changes are for you and now imagine having those same frustrations with no way to control your emotions or think your way out of them….
  • Find the experts as you need and support groups when you need.
  • Know that, if this is a brain injury, that person will change, not just during recovery but also might be different in the end. Make the most of that new person and celebrate what you can.

Let's take a look at some real examples.

SYMPTOM: Sensory problems, such as blurred vision, ringing in the ears or a bad taste in the mouth
EXAMPLE:
• “What is that smell?” when there is nothing unusual.
• Favorite foods don’t taste good or are no quite right. You might hear “Did you try a different recipe?”.
• Children might have “crawly” feeling (skin sensations) or hear mosquitoes or bees.
• Limbs “fall asleep” more than usual and for not identifiable reason.
• Repeatedly cleaning glasses, moving closer to the TV, changing the position (closer and farther away) of reading material.
• Does not turn on the lights or sits in silence.

SYMPTOM: Change in ability to pay attention
EXAMPLE: 
• You have to repeat instructions more than usual and maybe things still don’t get done.
• Everything gets started (projects, tasks, chores, thoughts, games, puzzles, books, preparing dinner, laundry, etc.) but nothing is finished when that is normally not the case or at least to a lesser extent.
• Can’t sit still for personal normal periods of time.

SYMPTOM: Mood changes or mood swings
EXAMPLES:
• Unusual emotional outbursts or periods of long silence.
• A lack of patience (resulting in agitation) in situations that would not normally be a source of anxiety as seen in little things like waiting for toast to finish or clothes to finish drying.
• Not interested in favorite things or routine things. In children, this could be things like not interested in favorite toys or activities.
• Does not want to be around people.

The key to all of this is look for change! Keep a list and report all of this to the person or group managing care. They may be breadcrumbs that will help form better treatment but at the very least all of these things are indicators that help build the best plan for recovery.

What other practical, everyday signs and symptoms have you seen?