Answer transcribed from the <a rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/11%3A-recreational-therapy-for-cognition-with-clinical-specialist-marlene-rivera" target="_blank">Brightway Answers interview with clinical specialist Marlene Rivera</a>: Yes, recreational therapists do address cognitive issues. When we think about free time management, what we're doing is evaluating an individual's cognitive capacity to effectively manage their free time.&nbsp; We may be looking at their ability to effectively engage in a specific recreation and leisure pursuit, as your cognition may be impacted in how you're able to successfully participate in these activities.&nbsp; There are also individuals who have a difficult time generating ideas about what they want to do. We look at what kind of compensatory strategies we can introduce to help with these things. It may be presenting individuals with written information, it may be communicating in a different way.&nbsp; Initially we will conduct an assessment and based on the outcome of that assessment, a recreation therapist will test and implement maybe some adaptive equipment or compensatory strategies that match an individual's current interests and their current abilities.

Answer transcribed from <a style="color: rgb(17, 85, 204);" rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/7%3A-susan-little-pt%2C-ms%2C-cbis" target="_blank">Brightway's interview with physical therapist Susan Little</a>: ﻿It's definitely not the bread and butter of my practice as a physical therapist. When I lecture to students, I always laugh that I need books of cognition for dummies because it's not the main part of my therapy. The main part of my education with brain injury covers recovery cognition rules. If you can imagine somebody at a very low level of responsiveness, as a physical therapist, I sure as heck am working in the context of my therapy on their ability to follow verbal commands and their ability to respond to commands as that individual progresses through their recovery. This includes challenging them from a memory point of view in the context of my mobility tasks, such as having them go on a scavenger hunt where they have to remember the items in the list. Just like how as you're going into the grocery store, you might have to remember that you need peanut butter, bread, and milk, they need to work on their memory while they're working on their mobility.&nbsp;In a brain injury team, we cross disciplines often. I don't pretend to be an expert on cognition, that's the rest of my buddies in my “village”. I'll ask the occupational therapist how our client is doing with their vision and if I give them this challenge with their walking, is that a difficult but doable thing to do. I'll ask the speech therapist if it’s reasonable for me to ask them to work on a certain memory or language task in the context of my mobility tasks. My point being is we work together. None of us are experts in all of the areas required for recovery from brain injury. We all have our area of expertise but we lean on each other and incorporate all of those challenges because it takes a village to encourage recovery and to maximize recovery from brain injury.&nbsp;&nbsp;I would say that the speech therapist or the neuropsychologist are the two that do most of the cognitive rehab. I have to say occupational therapy as well will work an awful lot on incorporating those skills with activities of daily living. Again, we cross the lines, but if I had to name the expert, I would say the speech therapist and the neuropsychologist. The second place would be the occupational therapist. Way down in tenth place would be the physical therapist but we do our best.

Physical Therapist

Absolutely. As a speech-language pathologist, one of the questions I answer during an initial assessment is if the person's ready for cognitive therapy. Neuroplasticity lets us view our brain as a muscle, so to work on cognition we want to exercise our cognitive abilities and challenge ourselves - it should be difficult. I use a lot of puzzles like deductive reasoning puzzles, which targets many cognitive processes.&nbsp;It looks sort of like a sudoku.&nbsp;Process of elimination is used to solve the puzzle, and there are some views that are presented that are straightforward, and some that are more difficult.&nbsp;So we're looking for the brain to make connections and eliminate something that's unnecessary and get to the answer. I also do mental manipulation.&nbsp;For example, alphabetizing random words.&nbsp;So I would give you apple, cat, banana, and would ask you to put them in alphabetical order.&nbsp;Or if I give you three numbers, you would put them in the correct order.&nbsp;Mental manipulation or mental flexibility is computation of a problem. You could do numeric computations or work with words to tap into the memory and processing. We also work on abstract reasoning and inferencing, deductive reasoning, divergent reasoning, and convergent reasoning.&nbsp;For example, I might be asking a patient to name as many items belonging to a specific category given one minute, like as any as many animals as you could think of in one minute.&nbsp;And we always start from simple and concrete and move to more complex and abstract. Problem solving and cause and effect are needed for daily living, so these get incorporated into all of our exercises.

speech language pathologist

Clinical Specialist

Answer transcribed from the <a rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/10%3A-symptoms-%26-approaches-to-care-after-brain-injury-with-speech-language-pathologist-amber-kloess" target="_blank">Brightway Answers interview with speech-language pathologist Amber Kloess</a>: Yes, as a speech-language pathologist, I work with patients on cognition. What I work on depends on where you are in your recovery.&nbsp; If you’re newly injured after a brain injury, speech-language pathologists will take a rehabilitative approach - that's where we target skills directly through more structured tasks. For attention, for example, there's attention process training - a whole system to follow to order to build up attention.&nbsp; There are short term and working memory exercises, direct coaching, direct feedback, errorless learning - where that feedback is almost instantaneous so they can correct the actions. Later on in recovery, we tend to move toward the compensatory approach to treatment.&nbsp; That means finding the strategies that will improve functioning in daily life.&nbsp; There are two sets of those strategies.&nbsp; The first is external - like implementing a calendar or a planner to help to recall appointments, charts to manage bills, writing notes, to-do lists, sticky notes, memory journals, things like that.&nbsp; Then there are the internal strategies which happen inside of you. That can be associations you can make to help recall people's names. For instance, if you met someone at a friend's house whose name is Tony and he was tall, that's “Tall Tony”.&nbsp; These strategies can help you to remember their name later. Many things center around a goal-plan-do-review model.&nbsp; That is for patients that I help to set reasonable goals with their input.&nbsp; They will plan how to accomplish that goal, reflect on it, execute it, and follow through with the task.&nbsp; I feel that's really helpful to improve awareness and also self-esteem, knowing that you're able to accomplish a goal after you planned it out. Family involvement is also key for that, especially with working on functional skills.&nbsp; The therapist can't be in the home 24 hours a day, so I coach families through some things and provide homework or activities that they can do within the home. I’ll also help patients to establish systems like timers on the stove so you don't burn your food or introduce the planner and make sure that they fill it out. I also recommend just engaging in cognitively stimulating tasks at home, but know your limits so you don't overdo it, take breaks to prevent overload and cognitive fatigue.

Speech-Language Pathologist

Do you address cognitive issues as a therapist? If so, what do you do?

Answer transcribed from the <a rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/11%3A-recreational-therapy-for-cognition-with-clinical-specialist-marlene-rivera" target="_blank">Brightway Answers interview with clinical specialist Marlene Rivera</a>: The American Music Therapy Association has an online directory of music therapists across the nation - that directory can be found at <a rel="noopener noreferrer" href="www.musictherapy.org" target="_blank">www.musictherapy.org</a>.

Hey @laughingsprings, you may want to look into recreation therapy - a lot of recreation therapists also do music therapy, and there may be a program near you.
 
I saw you live in Michigan - here is a sites I found for Michigan Music Therapists: <a href="https://www.mmtonline.org/" target="_blank">https://www.mmtonline.org/</a> - hope this helps!

Looking fr music therapy online. Know of any sites??

music therapy

Answer transcribed from the <a rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/11%3A-recreational-therapy-for-cognition-with-clinical-specialist-marlene-rivera" target="_blank">Brightway Answers interview with clinical specialist Marlene Rivera</a>: Practice, practice, practice. Repetition, repetition, repetition.&nbsp; I'm sure many brain injury survivors have heard this.&nbsp; The best way for you to build focus and increase your attention span really depends on you and what your lifestyle looks like. Setting a specific time each day to engage in activities that target your focus and attention can help you improve these skills over time. There are many cognitive programs out there that are pretty mainstream, like Luminosity is widely accessible to the public and can help you keep track of your progress.&nbsp; I know some individuals receive outpatient therapy or may receive other services that help them work on these skills. But even if you're not in a therapy program, you still have access to these programs that help you track your progress. Mindfulness activities also help with improving concentration and attention. With meditation for example, it makes you focus on the present and it takes practice.&nbsp; It's not something that you can just do and be well versed in. It takes repetition and practice. Being aware of your cognitive endurance level is also very useful before engaging in any of these activities, because that'll help you set limits for yourself.&nbsp; Sticking to those limits is very important, because if you engage in any task for too long you are at risk for decreased cognitive performance because of cognitive fatigue and other residual effects that you may be experiencing from your brain injury. To determine your cognitive endurance, think about physical endurance. After your workout you are probably tired.&nbsp; Depending on the physical demand, our body is basically telling us we're tired and need to rest. The same thing happens with cognition, even if we don't recognize it as easily. So if you're engaging in a cognitive task - and let's be clear - just managing your environment day-to-day can be cognitively overwhelming at times. An individual with a brain injury has a more difficult time processing information, which can really impact how you engage in any cognitive task. So if you feel like you are becoming a little bit disoriented or you're having more trouble comprehending what you're reading, what someone's saying to you, that may be a sign of cognitive fatigue. So when you think about your cognitive endurance, think about at what point that starts to occur for when you begin a task.&nbsp; If you're feeling fine, but then some time later you're noticing that you're just not as productive as you were when you first started, it may mean that you need to take a break because you don't have the cognitive endurance at this point to proceed. You definitely can improve your cognitive endurance, but it's good to get a baseline of where you are now so that you can begin to set those limits before you put yourself at risk of doing some unsafe things when you're not thinking as clearly as you could if you were to take a break.

This is actually really important.&nbsp;We can't really expect someone to sustain focus for 30 minutes.&nbsp;Someone uninjured is able to be on task for seven minutes without interruption.&nbsp;What that means is if I'm writing a letter, I have seven minutes on that letter without picking up my head, turning to see if everything's okay in the living room, looking at my phone. Sometimes clinicians shoot too high - 30 minutes isn't feasible.&nbsp;So what I do is time attention so you can see how long the patient is able to sort colors or cross out letters or fold towels, whatever the exercise is.&nbsp;Doing these common tasks is how we start to build focus, that actual sustaining of attention. Auditory attention is determined by reading two-three sentences and asking “did you hear what I said?”.&nbsp;That goes into the working memory as well.&nbsp;So auditory attention would be their working memory, going into short-term memory, going into retainment. So that all goes hand in hand and are important preliminary tasks to target.﻿

How can I build focus and increase my attention span?

Answer transcribed from the <a rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/11%3A-recreational-therapy-for-cognition-with-clinical-specialist-marlene-rivera" target="_blank">Brightway Answers interview with clinical specialist Marlene Rivera</a>: I think of brain fog as one of those things that you may experience when you are experiencing cognitive fatigue. This might not always happen - there might be, in some instances, where you experience brain fog and you haven't really been engaged in anything yet so it might feel like you're experiencing it on a more frequent level. But what I recommend is to assess the pace of your current lifestyle. Doing this will help you to determine what causes your brain fog. For example, is your sleep inadequate? Are there high levels of physical or cognitive demand that are causing your brain fog?&nbsp; Are you getting inadequate nutrition or hydration? Assessing those areas of your life and then discussing with your your primary care physician, then they may be able to make some recommendations or identify interventions that you can try to help your brain fog.

Answer transcribed from <a style="background-color: rgb(255, 255, 255);" rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/2%3A-dr.-thomas-franz-pt-2" target="_blank">Brightway's interview with Dr. Thomas Franz</a>: If you mean brain connections–learning, memorizing, reading, cognitive tasks–we know the memory works by establishing new connections and pruning others. Going back to school and going about those types of interactions are the way that you establish new connections.&nbsp; As for the brain fog, that sense that one is out of it and not quite fully present, there are tasks that can be practiced to help with it. Sometimes it does require medications, we talked about those a little bit during the first interview–what's available and particularly things that increase the naturally occurring neuro-stimulants, which are things in the dopamine norepinephrine system. That can be a sign of medications needing to be reviewed. Things that might be sedating and make the person foggy should also be looked at to see if anything can be eliminated. Again, as I mentioned last time, there can be pituitary and hormonal abnormalities from brain injury and those need to be reassessed. If somebody is profoundly low cortisol or low in hormones like thyroid or testosterone because the pituitary is not signaling the body correctly and what to release, those need to be revisited. If the person's not had a good medical evaluation for the cause of their brain fog, that really should be the place to start. As for behavioral things that this person may be able to do, it depends on the level at which they're already functioning. If they're talking about going back to school, this must be a fairly high-functioning individual. I think things that you would think are very popular right now is what is called mindfulness, but there are also other tasks that one can work on to improve attention and concentration.&nbsp; There are techniques that can be taught if a person is very easily distracted: focus on a page when reading or change the computer and other devices to highlight certain areas and bring them more front and center. Also, doing simple things like using earbuds and reviewing information to strengthen those connections could be helpful. Work with a therapist to understand how you can approach written material so that you can organize it in a way that's easier. A speech therapist or again a cognitive therapist psychologist can work with an individual on these types of tasks.

Division Director PM&R

My TBI is from 2011, and I’ve never been the same. I’m forcing myself to reconnect by going back to school. I struggle with motivation as well as brain fog. It seems like everything is in the way.

I’d like advice about brain fog: how can I force new connections?

Answer transcribed from the <a rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/11%3A-recreational-therapy-for-cognition-with-clinical-specialist-marlene-rivera" target="_blank">Brightway Answers interview with clinical specialist Marlene Rivera</a>: Absolutely. Whether you sustain a brain injury or not there are some sleep hygiene practices that we all can engage in. Being aware of what those are can help you improve the quantity and quality of your sleep. Assessing your daily schedule, and planning and preparing so that you're proceeding at a pace that meets your current level of cognitive and physical endurance is important. Maybe you're someone who can function with eight hours of sleep, maybe you're someone who can function with six hours of sleep. You really need to figure out what's most productive for you.&nbsp; If you need to, you can seek out recommendations from a medical professional to see what would best suit you based on your current needs. Rest breaks are also important.&nbsp; If I could, I would take a siesta every single day, because resting your mind is really important.&nbsp; And that again looks different for everyone - some people can take 10-minute power naps, while some people need to be in bed for an entire hour to feel refreshed.&nbsp; But the most important part of this is to figure out what sleep cycle works best for your lifestyle, then to make that rest time non-negotiable.&nbsp; You want to create a sleep wake cycle that works for you. A few other sleep hygiene practices to try are minimizing screen time before you go to bed, setting a specific bedtime for yourself and sticking to it.&nbsp; I know that's hard especially when we have our Monday to Friday and then different weekends. But for an individual with a brain injury, it might be harder to have those differences in bedtimes and wake times because the routine gets thrown off. If you can set a specific time and stick to it, then you'll have the greatest level of success. You should consult with a physician as well. There are sleep disorders that might be preventing you from getting better sleep. There are individuals who may have sleep apnea, but you might not even realize you have sleep apnea unless someone has told you. Unless you have someone who can recognize that, you might not even know. So it's important to reach out to a health professional to see if you can get a sleep study done. There are also mood factors for individuals who have sustained a brain injury. Mood changes can definitely affect sleep as well. The chemistry of your brain has changed and that can impact so many different things, so sometimes that might mean pharmacological intervention.&nbsp; You may need to take some medications that you didn't have to before. Sleep issues could also be from before your injury, but it's exacerbated after the injury. So again it's definitely something you want to get addressed because it impacts how you function throughout the rest of your day. To get a sleep study or potentially medication, I recommend starting with your primary care physician. Let your primary care doctor know what's going on and they can make referrals out to whoever you need to go to. They may recommend a sleep center or they may recommend a neuropsychiatrist who can help identify what type of medications to address mood and sleep.

Answer transcribed from <a style="background-color: rgb(255, 255, 255);" rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/1%3A-dr.-thomas-franz-pt-1" target="_blank">Brightway's interview with Dr. Thomas Franz</a>: Certainly, I think that it starts with a visit to a doctor who is familiar with brain injury or or to a sleep disorder specialist, depending on what kind of problems you're encountering. You want to start with some simple basic lab work to make sure there aren't those abnormalities for hormone levels in the blood. It may be important to do a sleep study. Sometimes the respiratory drive is off or perhaps because of physical inactivity from paralysis or in coordination after the head injury the person's put on a lot of weight and then they have obstructive sleep apnea. So assessing for those common things first, and making sure those aren't the issue are important. And then looking at the medicines that are prescribed to see if any of the medications that are prescribed are known for causing fatigue as a side effect? Particularly people who are on seizure medication may find that fatigue is a big side effect of the medicines they're already taking, and it may be possible to change the dosing or change the medicine itself, and so there are a number of ways to address that. If the person has more of the problems with the racing thoughts, then sometimes training the person in relaxation techniques and mindfulness techniques and meditation may help. Sometimes medications need to be prescribed if the problem is severe. If there's some underlying issues related to anxiety and coping with the brain injury, where counseling is required, then that may need to be ordered, but starting with somebody who really understands sleep and preferably somebody else who understands brain injury is a good place to to get started with those problems.

Are there ways that that survivors can get better sleep and and deal with that fatigue?

Answer transcribed from the <a rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/11%3A-recreational-therapy-for-cognition-with-clinical-specialist-marlene-rivera" target="_blank">Brightway Answers interview with clinical specialist Marlene Rivera</a>: RediscoverU, through the Council on Brain Injury, is one of those programs that initially started meeting in person and then as COVID-19 hit we started meeting virtually.&nbsp; Everyone's welcome to join us - we meet every Monday night from 6 to 7:30pm. I also know the Brain Injury Association of America has a list of support groups and many of those have gone virtual as well. There are also many groups on social media - there are facebook groups. The Council on Brain Injury, for example, has the Strive and Thrive group - it's a group where individuals are able to connect outside of the support group setting. I also recommend identifying other recreation and leisure interest groups, service project opportunities, even those that might not be tailored specifically to brain injury.&nbsp; I know your goal is to meet other survivors but you never know where you're going to meet another brain injury survivor. I think the goal is to be able to relate to someone who has similar interests to yours. I know churches have groups and other community organizations have activity-based interest groups, libraries have groups like book clubs that can definitely empower brain injury survivors. All of these groups empower survivors to raise awareness about their injury - it provides an opportunity to talk about their experience as a brain injury survivor and share it with people who may not be as educated in what they are dealing with every day.&nbsp; So those are resources I highly recommend. There are also apps you can try.&nbsp; Interestingly enough, a couple people have introduced me to the NextDoor app, which allows you to connect with your local community. So that's a resource you can use to get out from isolation. You’d also be surprised - some of the dating apps like Bumble are not just for dating - they actually have additional platforms like Bumble BFF and Bumble Bizz to connect individuals to make friends and make social network connections.&nbsp; Many of these resources are are built to empower individuals to have as many options as they can to connect outside of their immediate circle.

Hi! The BIAA of Texas puts out a directory that includes regional support groups. You can find that if you scroll down a bit here: <a href="https://www.biausa.org/find-bia/texas" target="_blank">https://www.biausa.org/find-bia/texas</a>. DFW starts on page 10.
 
I found this option on Meetup <a href="https://www.meetup.com/Chronic-Invisible-Illness-Warriors/" target="_blank">https://www.meetup.com/Chronic-Invisible-Illness-Warriors/</a>. It's not Brain Injury specific, but may be a way for your sister to make friends who would understand her challenges. More broadly, Meetup is a great place to find groups that she can engage with that cater to her interests. I've used it in the past to find friends in new places.
 
There's also paralympic and special olympic chapters in Dallas that she can volunteer with. There may also be opportunities to volunteer at brain injury clinics in the area.

Hello - my sister is suffering from isolation even with a local TBI group.  Any ideas for ways she can meet other suvivors? She is in the North Dallas, TX suburbs

Social Networking 

Answer transcribed from the <a rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/11%3A-recreational-therapy-for-cognition-with-clinical-specialist-marlene-rivera" target="_blank">Brightway Answers interview with clinical specialist Marlene Rivera</a>: There are so many brain injury movies out there.&nbsp; There are some mainstream ones like Concussion with Will Smith, and there are some documentaries out there - so it really depends on what type of brain injury movie you're looking for. When you think of some of the more mainstream ones they're built for entertainment purposes, and so the accuracy of the information in there you want to take with a grain of salt. But when you see any of these movies, whether it’s a documentary or a mainstream movie, you want to remember that every injury is different and the treatment of each injury, as well as each person’s progress and recovery period is therefore also different.&nbsp; You can put a search in your internet browser for movies about brain injury and a ton of things will come up. One of the movies that came to my mind when I saw this question was Crash Reel. In this movie, snowboarder Kevin Pearce suffered a traumatic brain injury while training for the 2010 Winter Olympics. He shares his traumatic brain injury journey, so you get to see how he struggled through rehab and some of the barriers he faced while trying to return to snowboarding after his injury. As you can imagine, and many brain injury survivors can probably relate, his family wasn't really a big fan of the idea that he would go back to the thing that caused his brain injury. So the movie shares that experience with its viewers. What I like about how Kevin shared this story was he didn't just stop there with that movie. He channelled his experience and influence through the Love Your Brain Foundation, which is a non-profit organization whose mission is to improve the quality of life of individuals who've been affected by a traumatic brain injury. They do that by providing programs that build community and foster resilience. They do yoga classes for brain injury survivors and I think it's a great thing they even help to certify instructors so that they know how to conduct a yoga session for individuals who may have sustained a traumatic brain injury. They're a great resource for the brain injury community - I highly recommend them. Watch Kevin's movie and then check out his non-profit organization.

50 First Dates! also Concussion with Will Smith is a good movie

Regarding Henry is a good onealso Brain on Fire

Any good brain injury movies to watch?

Answer transcribed from the <a rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/11%3A-recreational-therapy-for-cognition-with-clinical-specialist-marlene-rivera" target="_blank">Brightway Answers interview with clinical specialist Marlene Rivera</a>: Practice, practice, practice!&nbsp; Repetition, repetition, repetition! I cannot emphasize enough the importance of creating a healthy, balanced, daily routine that incorporates everything you need to do to remain medically stable, and that gives you purpose. We talk about doing things that are meaningful and I think that gets lost sometimes. If you can't identify what's meaningful to you, then I suggest starting there. Think about what's important to you in life, what are your goals in life, what do you want to do to reach those goals. Just because you've sustained an injury doesn't mean you can't continue to serve a role in this world where you can serve other people. We may get used to just having everyone serve us after sustaining a brain injury.&nbsp; You might feel like everyone's doing things for you but you can't do anything for them, and that's not true.&nbsp; There is a lot that you can still do for other people, but again, it's identifying what those things are. What's your personal mission? We did a session with RediscoverU recently where we talked about what's your personal mission statement. What are your life goals? What do you want? What kind of legacy do you want to leave behind? Start with identifying your personal mission, and then move to how you put that mission into practice. What does it look like in your everyday life? What does it look like on your schedule? How are you dedicating time to that while also taking into account all the medical recommendations you’ve been given to keep you healthy. Once you've created that blueprint for your lifestyle, once you find something that works for you, stick to it for a few months. It’s common knowledge that it takes 21 days to form a habit, but what doesn't always get communicated is that it takes 21 days to form the habit but it takes longer to maintain it.&nbsp; So you want to give yourself a few months to follow the same schedule over and over again. That will allow your brain to get used to the routine and it'll eventually help you to conserve energy for newer things. Think of when your brain is on autopilot because you do something so often. It doesn't require as much brain power to complete that task any longer because it's something that your mind is used to.&nbsp; So if you can follow your routines long enough, you’ll be able to manage novel situations better.

1). Aerobic exercise 30 minutes /day2) Exercise your mind : Puzzles, classes,3) brain health diet.happy healing!

Things that require mental and physical focus are said to really help. Sports, dance, yoga, etc.

What are things you can do to encourage neuroplasticity?

Answer transcribed from the <a rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/11%3A-recreational-therapy-for-cognition-with-clinical-specialist-marlene-rivera" target="_blank">Brightway Answers interview with clinical specialist Marlene Rivera</a>: Yes, one of the things that we do at ReMed (where I work) is we look to create the type of structure and support that will help with managing overstimulation. That structure and support is your schedule - we help to create a schedule that works best for you. When you think about what causes overstimulation - it might be the pace of your day, because you do have a choice to say this is what I’m willing to do in my day to maintain my mental health and medical stability. Whether it's physical, mental, spiritual, social, or emotional, there's a stability factor that we take into account. The way you stabilize yourself is by setting a pace for yourself that fits your current needs: your medical needs and the needs of a lifestyle that you find meaningful. So it's a combination of the two: identify what activities in your life are considered high-stimulation for you and what are considered low-stimulation. Meditation might be relaxing and a low-stimulation activity for most people, but for some people, meditating might be too overwhelming and would be considered a high-stimulation activity.&nbsp; Or maybe meditation itself is a calming experience, but the planning process to meditate may be considered overstimulating. Identifying high- and low-stimulation activities for yourself is an important first step. Figuring out what other environmental factors you can avoid or change is also going key to managing overstimulation. You want to set a time limit for yourself for activities. I've heard individuals talk about overstimulation when they're going out in crowds, for example, or a card game, or a dinner reservation with six other people. You don't do that every day, but you want to go and participate.&nbsp; You should do things that are meaningful for you. But take into account that if you have a history of overstimulation for these activities, then maybe that's the only thing you do that day. Maybe the next day is a low-key kind of day. Managing overstimulation is about making these compromises and identifying what's the pace that works best for you.

<a style="background-color: rgb(240, 242, 245); color: var(--blue-link);" rel="noopener noreferrer" href="https://www.youtube.com/watch?v=-2qoocmyD84&amp;t=34s&amp;fbclid=IwAR3vlkQsWFlaT-E32-S-4dblbbI8QpHNG08yVkaea5pLNGwiidLLoc_dRac" target="_blank">https://www.youtube.com/watch?v=-2qoocmyD84&amp;t=34s</a> Noise sensitivity desensitization

You must try Bose quiet comfort noise canceling earbuds. I went to a nhl hockey game with them! ALSO great for riding in the car! Or restaurants.

After a day in crowds or with a lot of noise, colors or even too much reading I'm so sick. I'm confused, disoriented, feel "drunk" and exhausted. It takes days to weeks sometimes to feel better.

Does anyone have tips on dealing with overstimulation?

Answer transcribed from the <a rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/11%3A-recreational-therapy-for-cognition-with-clinical-specialist-marlene-rivera" target="_blank">Brightway Answers interview with clinical specialist Marlene Rivera</a>: I like this question because it really brings home what mindfulness is intended to do. When you learn to use meditation, it's the same way you learn to do anything: you get exposed to it, and you figure out which ones works best for you, because there's a lot of meditation practices out there. Regardless of what your barriers are, even though your hearing is impaired and you're legally blind, what mindfulness activities like meditation allow you to do is to help you pause and focus on the present using all of your senses. So even if some of your senses aren't functioning at their optimal level, you still can focus on all the other senses to help calm you and bring you back down to earth and ground you - this is the intention of these activities.&nbsp; This is especially helpful when you may be feeling overwhelmed or overstimulated. Brain fog is a factor of cognitive fatigue for some individuals, so engaging in meditation might help to calm them. However, keep in mind that for some individuals, it might actually cause increased anxiety. So it's very important to understand which ones work for you. But by participating in in a mindfulness meditation that best suits you, if you are forcing yourself to pause, that's a very powerful step when when you're trying to help your brain function better and to recover. It's the same concept of rest. When you're resting, you're pausing in your day to take the time to reset before you continue. So if you pause and you focus on what's going on around you with your other senses - what do you hear? what do you see? what do you taste? what do you feel? - that's meditation.&nbsp;&nbsp; You can find guided meditations online that help you go through some of these exercises that will help you focus on those different senses, but again, even if you can't access one, you can engage in meditation independently by pausing and focusing on the senses you have available and taking deep breaths when you're going through those exercises. There are so many resources out there for meditation that you can use. We have a couple that we share on our resource page for the RediscoveryU group that I help to run: <a rel="noopener noreferrer" href="https://www.councilonbraininjury.com/resource-page" target="_blank">https://www.councilonbraininjury.com/resource-page</a>

Answer transcribed from<a style="color: rgb(34, 34, 34);" rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/7%3A-susan-little-pt%2C-ms%2C-cbis" target="_blank"> </a><a style="color: rgb(17, 85, 204);" rel="noopener noreferrer" href="https://www.brightwayhealth.org/podcast-episodes/4%3A-allison-huck%2C-ctrs%2C-rrt" target="_blank">Brightway's interview with recreational therapist Allison Huck</a>:&nbsp;For those not familiar with meditation, it's really just a process of learning how to pay attention. This is paying attention to the present moment with a certain amount of curiosity and not necessarily just quieting the mind, which a lot of people think meditation is about. You should be allowing yourself to be more mindful: notice what's happening, what's going on, and practice being less reactive to what's going on. There's a lot of research out there that shows that meditation can help improve brain functioning. It can change some of the structures of the brain. For example, it could change the amygdala, which is our fight and flight response. It can also help change the prefrontal cortex, which is a lot of our executive functioning, so decision making, planning, and problem-solving. Additionally, it can help change the parts of the brain that play a role in learning, memory, and emotional regulation. Focus meditation can do so much for people. It can definitely help decrease stress and anxiety. The greatest thing about meditation is that it's free and you can do it anywhere with very little things, you can do it at any time.&nbsp;&nbsp;There are a lot of apps available such as Headspace, Calm, and Insight Timer. They all have guided meditations at lots of different lengths for people of any skill level. I also love that there's a lot of resources on Love Your Brain, and they're specifically tailored to individuals with brain injury. This comes at different lengths, where you’d be starting out short and working towards longer ones targeting specific areas like stress, anxiety, pain, and sleep. You can filter them in a lot of different ways. Those are some great resources for anyone with traumatic brain injury to engage in meditation. Specifically for someone with visual or hearing impairments, there are a lot of things like amplification devices. That might be helpful for some, but for others, this might not be the solution depending on the level of hearing impairment. For instance, some people engage in meditation by just using white noise, so finding that one noise that you might be able to hear or focusing on just your own breath. Something as simple as counting your breath, so inhaling to a count of one and exhaling to a count of one, or inhaling to a count of two and exhaling to a count of two and so on. There's a lot of really simple ways that you can engage in meditation. There are more complicated ways that you can engage depending on your level of readiness and your skill level, but I think it's important for everyone to remember that meditation is called a practice for a reason. There's no expert in meditation and there's really no way to do it wrong, it's just the act of trying that matters.

I am hearing impaired, legally blind, and suffered a mild/moderate TBI 3 years ago 3/21/18. I do use art and poetry as therapeutic hobbies.&nbsp;

177arl317's Answers