Topic: Miscellaneous - Coping with the Holidays

Question:

Dear Kathy M.,

The holidays are always such a rough time for me. Besides getting into my accident on the way to my mom's house on Christmas Eve six years ago (we were hit by a drunk driver), everything about the holidays seems to be completely overwhelming to me. Every year it gets worse and all I want to do is cancel everything. I don't shop any more. I hate the mall. I don't send cards. Basically, I try to stay to myself as much as I can (I don't decorate or anything like that any more either). Everyone in my family seems to think I should get out and do all the "Christmas stuff." The more I try to stay to myself the more they seem to harass me (I recently overheard my mother telling my sister-in-law, "She used to enjoy the holidays; she's never been the same after the accident.") How can I politely tell people to leave me alone and that I don't want to be the same as before (besides turning off my phone or not answering the door). I do NOT want to go to any Christmas dinners or gift exchanges. Certainly no Christmas morning stuff. Please help!

Beth in New York

Kathy's Response:

Dear Beth,

Christmas can be a "loaded" time for lots of people. But if your accident was around then too, I can see how the normal stressors lots of people have this time of year are worse for you. Then there are all possible effects from a brain injury to also make things around this time of year worse than they were before…

Over-stimulation
What may even be more important than the fact that the anniversary of your injury is around this time of year, is the way a brain injury can affect the way we process all the extra noise, flashing lights, crowds and other things in the category of "external stimulation."

I'll never forget the first Christmas I had after my injury. I was only three months post-injury and I had left rehab. the afternoon of Christmas Eve to visit my parents. They had flashing lights on their tree and I could not stay in the room when the tree was lit. I became agitated to the point of anger, and the whole evening was disastrous. Turns out, I could tolerate a lighted tree, as long as the lights were not flashing. I learned later, from both the professionals on my rehab. team and from my peers in the rehab. center, that many persons with brain injury can become "over-stimulated" and "overloaded" by things like lights (especially flashing lights), background noise, motion, and even "busy-ness" (like knick knacks). It's called "visual and auditory overload" and it's a real problem this time of year.

Changes in routines
This is another "biggie" for many of us! If we have memorized our routines, it can be very disturbing to have big changes in them during the holidays. Extra shopping, special get-togethers, dinners, parties, gift exchanges - all the things that we used to enjoy - can be too difficult to cope with following a brain injury. Not coping well with change may make us look inflexible (rigid), and to some degree we may be. It's a survival mechanism.

Now, there are strategies we can learn to make managing routines less stressful (especially managing changes in them), but this is only an option if we want to become more flexible. It sounds to me like you have made up your mind that you want to be left alone during the holidays. If I'm wrong, and you would like to learn about coping more effectively (with changes, noise, light, etc.), please e-mail back and I'll focuses on responding to that.

Becoming a Recluse
Many persons with brain injury become reclusive. There are many reasons for this. Avoiding over-stimulation is one of them. Difficulty with initiation and follow-through is another. Difficulty making new friends and maintaining old relationships is yet another. Then there's loss of one's work or school life, loss of self-esteem, losses of other kinds. The list is long and varied.

I mention this simply to point out that it sounds like you may be heading in this direction. If becoming more reclusive works for you (and it does for some), it may be the way you are best able to cope with the changes your brain injury has caused. On the other hand, if your preference is to be less reclusive, you may want to reach out to others who have brain injury and have successfully overcome some of the problems associated with living "in the world" again. This means dealing with changes, noise, light, family, social contacts, meaningful activities, etc. There are strategies one can learn to deal with these things again.

Support Groups
Support groups can be a great way to network with others who share your experience. You will find people who support the approach you have selected, and if or when you are ready to do things differently, you will probably find others to help with that too. If you are unable to get out to go to a support group (or if there are no groups in your area), you can join an Internet support group (chat rooms and e-mail support group lists). I facilitate an e-mail discussion and support list called TBI-WORKING. There are others. You can find out more about my support group and others by going the TBIMO.ORG web page where different groups are described. See: http://www.tbimo.org/groups.asp#internet

Assertiveness
I know it's "easier said than done," (especially with family), but you may need to practice "pleasant assertiveness" with your family and friends. If they cannot get anyone to answer the phone, or no one responds to a knock on the door, they are likely to worry and intensify their efforts to get you out of the house. On the other hand, perhaps simply telling them that you do not wish to participate in the holidays will work (mention that you have learned that many persons with brain injury find that excessive noise, light and motion are not comfortable). I do not know what you have tried, but being direct and to-the-point may be effective. And if you feel that some of the things I've mentioned in here (especially with respect to noise, light or changes in routine) are on target, it might be very productive to let the people around you know that you experience things differently now, and are simply doing what you need to do to feel comfortable. Like I said, it may sound easier to do than it is, but it may be worth a try. Asking them to join the ASSIST-TBI support group (for families) could help them become more enlightened, as well.

Seeking medical or counseling help
I understand that the holidays are particularly troubling time for lots of people. If you find yourself more depressed than usual (or if you are drinking or using drugs or other things to self-medicate), I would encourage you to talk to your doctor and seek counseling support. Being on one's own has it's benefits, but if you need someone to talk to, things can get out of perspective and talking to your doctor or a counselor may be a good thing to do.

Hope this helps. And I hope you have a pleasant holiday.

Kathy M.

University of Missouri - Columbia
School of Health Professions
Great Plains RCEP