Stress and Stress Management Post-TBI


Why does stress bring back my TBI symptoms with a vengeance? It feels like a knife reopening a wound. What goes wrong in the brain after injury that makes this happen?


Stress occurs when there is a gap between the current task demands and the resources you have to meet those demands. Your brain interprets this as a threat. Acute stress — as in immediate physical danger — produces a physical reaction (the fight-or-flight response) that includes increased pupil dilation, perspiration, increased heart rate and blood pressure, rapid breathing, muscle tension, and increased mental alertness. However, less immediately threatening or prolonged stressors, such as ongoing money problems, too many things to get done in one day, even something like unexpected company, will produce these reactions. They may occur to a lessor degree, but ongoing stress reactions, even mild ones, will result in your body preparing for a long-term protective response.

Fatigue, concentration lapses, irritability, and lethargy result as the stress continues without relief. You probably recognize these as some of the TBI symptoms you feel coming back with a vengeance. Having experienced a TBI makes you both more susceptible to these symptoms, and these symptoms make it more difficult for you to effectively use whatever coping or compensatory strategies you may have developed to manage your TBI symptoms.

Learning to manage stress is important for all of us, and of particular importance to the recovery process after TBI. Techniques such as relaxation, time management, goal-setting, organization, cognitive-behavioral techniques, and lifestyle modifications can all be helpful in managing stress. It is recommended that you get some help and support in figuring out which of these techniques will be most useful for you from a mental health provider, a case manager, a life coach, a support group, or even a good friend if the stress levels are not overwhelming or seriously affecting your life. There are plenty of resources available for stress management, and a lot of information online, but sifting through it and tailoring it for your particular needs may be challenging without some support.

Posted on BrainLine August 14, 2013.

Comments (16)


Thanks! As you have shared this information with us. Learning to manage stress is important for all of us. Techniques such as relaxation, time management can help you to manage stress.

Has anyone had TBI from ECT? So much of what others have posted is just like what I go through. Was an Executive Assistant for more than 30 years. Loved being the "go to" person to find answers for people. Battled major depression and PTSD so they did 16 treatments and I have not been able to work in 7 years. Never drank or took illegal drugs (nor abused prescription meds). Since childhood work was my "drug of choice". Cant figure how to organize, cannot finish most of what I start. Husband and best friend of 23 years divorced me 4 years ago because he grew to resent the "shell" that stole his precious MJF. Before ECT CT scan showed more dark space than should have been there for a woman in 40's. IQ and psych eval showed me at high to superior even though was in depression. They stopped ECT and never followed up with another eval because I think they knew I was a babbling idiot then. They wouldnt return calls because i wasnt a positive statistic. Memory has no rhyme or reason, cannot control emotions, nightmares every night, and get so stressed over little things at which point I get totally frazzled and have a "fall apart". It destroyed my life. I try to accept my limitations. Doctors dont think ECT was cause but no one wants to find out reason. Medicare is helpful but doctors definately treat you different. I know there is something wrong with my brain but no one believes me.

What is ETC ?

I have hydrocephalus and had a shunt put in when I was 13yo.
That same year in ‘86, I had heamatomas due to a few accidents.
I then went 18yrs without incident but in ‘04 my shunt stopped working and I had a ventricular drain put in.
I ended up getting ventriculitis & meningitis- ended up in a coma for 5 days and took 6mths to get back to work full time.
I have a very short temper and I struggle with short term memory loss.
I am married and have 4yo twins and sometimes I scare them due to my outbursts.
What can I do & where can I go to get help?
Regular counseling is a short term fix!
I live in Brisbane Australia.
Can you help me?

My TBI was not properly diagnosed for 12 years after the accident. I have dealt with, been inflicted by just about every known condition caused by TBI. Ever since the accident I experience migraines with visual disturbances. These disturbances started off small a blue and white barber pool in the middle of my vision. With the added stress the visual anomalies increased to the point of total loss of vision. First Dr. response you are just stressed because your shop has been closed down and now you have to get a new job and move move, ect.. bla bla.
I get a job with the same company in a different state. Make the move get settled in. Pressures at the job mount. Visual disturbances return. Have to take multiple days off due to headache induced vision anomalies.
Over the last year I could feel my self slipping away, math, reasoning, name recall, self control and fighting the impulse just to knock someone's teeth down their throat because once again I am being told "But your alright now RIGHT?" when you try to explain to someone about the pain, sense of lose or the fragging side effects of the medicines you have to take just to start you day with.

My own PCP does not understand why I am not willing to make conditional calls for jet engine parts for commercial operators. Or understand why I believe the industrial manufacturing environment is not safe for me to be walking around in and on elevated surfaces. Even though the QEEG report identified 20% loss of gray matter located between the left and right hemispheres, roughly about the size of my fist. This doc believes take these pills and get back to work
The pills help but they do not take the pain, confusion and low frustration level. The root cause has not been addressed. Another band aid will not work. Waiting is what I am worried about. From the original MRI in 2005 compared to the QEEG results in 2017 the damage may grow. The wife believes the dead area is about one half to two thirds complete to what she remembers. Will the damaged area continue to grow even this many years after the accident

I agree with what the Dr said but there's more to it than that. I'm not sure just teaching coping skills can work. I also disagree with the other poster it's not about emploment..I've come to grips with the fact my TBI has left me unemployable but there are things that are harder to how I get lost in a town the size of a thimble that I've lived in for more than 20 yrs...and when I do panic sets in like a child left at the mall..I can't stand certain people who I love yet they bring gossip or drama.. anything to upset freaks me out...I was never this way..raised kids alone..had a career..was in the if anything changes anything it brings on tremors and a migraine and that's after I regain myself from a panic...I don't know's life changing

Dr Celeste sets out the case for stress resulting from TBI. As she says, it's too complex to explore thoroughly.
In my case, the gravity of my injury was not known because the hospital did CT scans instead of MRIs.
I was told I had a right frontal lobe bleed & I could go back to work & forget all about it. No rehab., little follow-up.
I taught for 15 years, with insomnia, depression, colitis, appendicitis and finally a seizure. My brain was telling my body "STOP!".
Finally an MRI revealed diffuse axonal injury; my brain had been thrown around, neurons torn plus damage to both frontal lobes.
The crazy stress I was suffering made it impossible to work.

I was not diagnosed with my TBI until a year and three months after the date of injury, during that year and three months my life was destroyed...The first sign was the day after my industrial accident and it was about three months before I really brought up the serious issues with my doctor but she had no response then shortly after that the Workman's compensation rescinded her approval to be my doctor of note so I had to go see another doctor, when I tried to talk to him about it he thought it was depression and stress from not working so he discounted it, when he told SAIF that I was permanently physically disabled they used a loophole to force me to see a doctor that was under contract with SAIF and was not there to treat me just to give SAIF information that they did not have to reveal to me or my lawyer for a length of time, the doctor refused to tell me anything so I refused his assessment and rescinded his rights to my medical records...but he still consulted with SAIF and due to how unstable I was as a result of the TBI I was unable to accomplish the requirements for litigation and they were able to boot me off of coverage as well as financial services... My life is a nightmare and until recently everyone in my life treated me like a horrible person due to my brain injury...I have been to the ER so many times and refused treatment for my TBI now for over 4 years. I have to leave my state to escape the black hole called a health care system here because even though I have documentation of my condition but due to their refusal to look through all the records to find it nor will they acknowledge documentation from out of state world class specialists... TBI is to gentle a name for what this injury does to your life, you say AIDS, CANCER or heart attack and people are horrified but when you sat acute toxic encephalopathy or TBI they all say well you look fine, you just have to try harder...until you are near dead from trying to not kill yourself because the hallucinations and paranoia and seizures and anxiety are so overwhelming that you can't even express yourself without screaming by the end of trying to tell them that the TBI is causing they just get offended and refuse to even listen to what you couple it all off My memory is so messed up that I can not remember to follow up with the advocating for myself let alone do normal things like bathe or eat or pay bills...TBI should be called THE DESTROYER OF LIFE so that people even doctors will give it the credit it is due... Chris

I hear you. I support you. I understand every word you say. I believe you. I applaud you for having to cope with this life changing injury.

You are not alone. From Sydney, Australia.

People are blind. No body knows.

In response to the first comment: I am so so sorry you are going through this. You captured so many points. People thinking you look fine, the medical and insurance nightmare.

As a caregiver, I just guided my husband through this for the past 7 years. I am exhausted and I am not the one with the TBI, I just don't know how people do it on thier own.

The systems need to change, the education and advocacy in this area needs to get ramped up.

Why racetam nuerotransmittes banned by the fda in 2009. Despite presidental authority to permit marijunia! Oxyigen is more important butt fda banned piracetam? What the dr lawyers and accountants in dc up too! Icd and dsm diseases based in stress. Oxyigen prevents cortisol release ( my opinion). Green tea alters potentially dna structure ( starting reasearch).

I agree with everything Dr. Celeste said but its all stuff one could get from reading a few books. People in authority to make changes (all these doctors) have never experienced TBI themselves. They all give good advice, and all of them say pretty much the same things, but they DO NOT know any of the nuances associated with TBI intimately. I appreciate Dr. Celeste's insights into TBI but she doesn't answer one of the most obvious answers to why TBI victims are stressed out. It's because the majority of us are all plagued with the issue of finding meaningful employment after the devastation of TBI.

And we cannot function well enough to do so. I recommend HBOT and Functional Neurology for those who can get these treatments. HBOT definitely reduced my reaction to stressors. Stress used to shut me down but after HBOT I can still keep going though not quite normally yet. Need more healing.