Feb 082012
 

People don’t perceive traumatic brain injury (TBI) as a mental illness but neither do they see it as a physical injury. So it gets less attention than even mental illness, which is not exactly visible and the reason why Bell is sponsoring Let’s Talk day today.

But TBI is often accompanied by depression or can create a mental illness if the injury affects that part of function of the brain, which is not surprising really. After all, if your life was squished, crushed, kicked into the gutter, wouldn’t you get depressed? Wouldn’t you be deeply grieved? And having to resurrect yourself while still physically alive is weird and extremely difficult.

So it’s remarkable that I did not tumble into a depression after my TBI. It was mostly because I was consumed with achieving a long-held goal — to finish writing my first book Lifeliner — and with getting back my life. Well, the former happened once I stopped believing my rehab team who asserted that because I could write words and sentences for a page length, I could write a book, and after I found real treatment — you know, the sort of thing docs do with physical injuries — fix them — and after I received remarkable help from a stranger. As for the latter … I’ve finally discovered it is impossible. Not going to happen. It’s dead, deader than a plague rat after London’s Great Fire.

Another big reason I didn’t fall into a depression or deal with my grief because I was fighting three — yes, THREE!! — lawsuits. After a few years, I gave up on one, knowing I was consigning myself to poverty despite the law being on my side. But as the lawyer said: I had too much on my plate, and it would not end the way it should. A little later, the second lawsuit was settled. But the third one went on and on like the friggin’ Energizer Bunny. Lawsuits are a hurry-up-and-wait-a-year type thing. I had inured myself to the way it works, but it does affect your life one way or the other, even if it’s only in how you manage your money.

When that lawsuit finally ended with a whimper, I joined Twitter and fell into a pool of weariness so deep, I didn’t think I’d rise to the surface again.

Was that depression? Or was it more likely what happens when you keep yourself going, push yourself hard to fight a big fight or endure a tough challenge, and then when it’s over, fall over in sheer exhaustion?

But soon I started to look anew for a neuropsychiatrist to help me with the emotional and mental fallout and the grief from my TBI, and with all the betrayal and abandonment that most people with a TBI suffer. At this point, I feel like ranting about all the despicable things I’ve had the misfortune to experience. But I’ll spare you.

It took me two years — yes, YEARS — to get an appointment with a qualified neurodoc. Psychiatrists who treat TBI are rarer than hen’s teeth or maybe the demand is too great for what the government of Ontario and hospitals are prepared to supply. During that time, I received help from CCAC, but there are some issues only a neurodoc had the skill to treat. I had to wait. And I had to continue to figure out my own treatment for the life-long problems the TBI had caused. It’s a lonely place having to rely on your broken brain to piece together solutions.

So you’d think I’d be depressed, eh? Certainly the dumb docs in the early post-TBI years who knew diddly squat about brain injury mistook the fatigue and initiation deficit and cognitive deficits and lack of affect as depression, something my rehab team had warned me about. Needless to say none of these docs wanted to educate themselves. I soon realised they would not only make my situation worse, but also throw me into a depression, and so I stopped seeing them and any new ones as soon as I saw signs of that kind of ignorant thinking. My affect was a problem, but treatment for my brain injury began to fix it. I suppose taking pills for depression may’ve seemed to have done the same thing, but they would’ve masked the cause instead of addressing it. My situation was certainly worthy of being depressed about. But I believe that situational depression is best treated with something like cognitive behaviour therapy wherein you learn how to cope with the situation, to perceive it in a manageable light, to avoid people or events that would make it worse, to learn to control that which could make it better, to find alternatives, all skills a pill will not teach you and you need regardless.

Anyway, unbelievably, I’m still not depressed. The neurodoc doesn’t even think I am. What I am is angry, frustrated, disappointed, angry, impatient, disbelieving — and grieved. Deeply, deeply grieved. I not only didn’t get a chance in the first eight years or so to grieve my own death (not physical but who I was) but also the death of my relationships, of my life, of my dreams. Tis time.

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