TBI & Moving through Grief: Part II

In Part I we explored the first two stages of grief, which include shock, denial, pain and guilt. Now we move into the second, third and fourth stages, starting with anger.

Anger

I admit it: I am angry.

In fact, I’m fucking pissed. I’m mad that this happened. I’m mad that every aspect of my life has been affected due to this brain injury. I’m angry that I’ve missed out on weddings, family and social gatherings, that can’t work as much as I would like to, have incurred so many medical bills and medical-related expenses, can’t do all the things I want to do, and am reminded of these things every single day, year after year.

Even though I know this rage is within me, I’ve not wanted to let it out completely. Like pain, I wanted to ignore it and pretend it doesn’t exist. There have been times when I’ve smashed broken household items with a baseball bat out in our garage, or punched pillows on our bed while yelling and screaming obscenities. But those have been rare occasions, and I feel like a volcano that is preparing to explode.

Part of me wants to remain the proper, professional, “good girl,” and not get angry, even though I know that is bullshit. In order to fully discharge emotion and trauma, we must talk about it and release it through our physical body. Hitting pillows and smashing things is very therapeutic. Thankfully there is a local business in Seattle that provides the perfect set-up for healthy anger discharge. For a small fee, they provide the safety- and smashing equipment so that you get to be the metaphorical bull in a china shop (plus, you don’t have to clean up your mess). I recently visited this business, called Rage Industry, albeit a little reluctantly, because I was a afraid of what might come out of me.

The question I asked myself was, “Why not get angry so that you can finally let it out? What are you afraid of?”

I’m afraid of the power of my anger. Anger and rage are aspects of our “shadow” Self: the dark parts of ourselves that we often repress or suppress. The “shadow” is a term coined by Swiss psychiatrist Carl Jung, and there are tons of books and articles available to learn more about it. When it comes to my own shadow, I guess I’m afraid that it will take over. But then again, I’ve already been a prisoner of my own anger and rage, so what do I have to lose by letting it out in a healthy and safe way?

Logically, I know letting my anger out will release me from its hold so I can keep moving forward, but it is scary for me to feel this amount of rage, just as it has been a bit scary to feel the intensity of the emotional pain. Not letting it go is toxic to my emotional and physical health. If I imagine anger like a thorn in my foot, it hurts to leave it in, but pulling it out will only make it hurt worse for a minute, and then healing will begin.

I survived the short round of smashing and bashing at Rage Industry, and it actually felt good. No scary monster came out of me, and the experience did help to begin to discharge my anger. There is certainly more to go, and I know I’ll be back again for further demolition.

With anger and every other phase of grief, each piece will last as long as you need or want it to. Only when you’re truly ready to address it will you move onto the next phase. No one can tell you when this “should” or will happen. Only you will know.

Bargaining

According to an article on Livestrong.com:

The bargaining stage is characterized by attempting to negotiate with a higher power or someone or something you feel, whether realistically or not, that has some control over the situation. You may make promises to God in return for the painful situation not to occur or for things to go back to how they were before the loss or change, according to Kubler-Ross and David Kessler.

In the bargaining stage you may find yourself intensely focused on what you or others could have done differently in order to prevent the loss or change. You may also think about all the things that could have been and how wonderful life would have been if not for this unpleasant situation. While these thoughts may help you begin to accept the loss or change by revealing the impact of the situation, North Carolina A&T State University warns that these feelings can also lead to remorse and guilt that interfere with healing.

This phase of grief seems to intertwine with Pain and Guilt. I have often, over the last five years, imagined how my life would be if my TBI hadn’t occurred: how it was “supposed” to be. I don’t just ask, I tell God to please not give me any more trauma for a long time. I’m not strong enough to take any more now or in the near future.

Going back to the way things were is neither an option, nor a possibility, I know. Accepting my reality without trying to see my life as needing to be anything different (while making the most of it) is one of my next steps and biggest challenges.

Depression

Let’s face it, living with a TBI or any chronic illness can be really depressing in general. Clinical depression is very common among TBI survivors. In fact, a 2010 research study done by the University of Washington and published in The Journal of the American Medical Association, reported that TBI survivors have a 53% occurrence of clinical depression within the first year of injury. This is, per the research, eight times higher than the rate of depression in the general population. The authors of the study admit that because of incomplete data, the depression rate of TBI survivors is likely higher than the study indicated.

Brain damage causes changes in neurochemistry, affecting neurotransmitters like serotonin and dopamine that impact mood and other physiology. For us TBI survivors, it’s not just “feeling sad” at what happened, it’s a physiological condition like any other illness or disease (watch my #tbidiaries video on depression here.)

When it comes to the grieving process, depression is a place of deep sadness and emptiness. Depression includes lack of energy or motivation. Your body feels heavy, as if filled with sand. It’s difficult or even impossible to get out of bed in the morning. Depression is isolating and lonely. You might even ask yourself, “Is life worth living anymore?” or “What’s the point?”

Understand that this is considered “normal,” even though it may not be anywhere close to “normal” for you. It certainly wasn’t for me. Living with depression on top of my other TBI-related challenges is very difficult at times. You and I, both, are not alone.

Ask for help. Seek a qualified counselor you can trust. Begin supplements, medication and/or self-care practices that can help (learn more about these and my experience with depression in my book). Simply trying to think positively or wanting to “snap out of it” aren’t the answers, and don’t listen anyone if they tell you to “get over it.”

When my depression got really bad again near my fifth anniversary of my TBI, I resisted getting help because I wanted to be “strong enough” to overcome it. Ha! I laugh at myself now, because being strong has nothing to do with depression. I had to check my ego and ask for help. Once I did, my depression came under better control and I experienced a really positive shift in my energy and all areas my life.

There is no reason to be ashamed of depression, just as you wouldn’t be ashamed of having a head cold. It happens and there are ways to work with it, but you have to take the first step by asking for help. It’s not about being “strong enough” to overcome it. It’s about balancing your neurochemistry and moving forward with your life with purpose.

Seek help from a licensed mental health counselor and talk with your doctor about treatment options. There is much more on this topic in Head of Hope, so if you want more, order your copy here.

In our conclusion on TBI and grief we’ll begin to move into reconstruction, acceptance and hope. See you for the post soon.