14 Brain Injury Basics for Self-Care

I returned to work part-time just shy of 17 months after my traumatic brain injury, and I recently increased to full-time hours in a new position within my company. Gone are the days of long walks around the local reservoir, extended meditation sessions and regular journaling! I’m now spending much of my day in front of a computer screen, engaged in two-way conversations over the phone and learning the ropes of a brand new role. As my brain symptoms have amplified and my energy levels and stimulation tolerance have decreased, I’ve had to sacrifice a few of my favorite leisurely activities, let go of some personal responsibilities and go back to the basics of supporting my sub-optimal brain.

Below are some strategies for “better brained” self-care, what I consider “the basics,” that I’m using to support my brain after going back to work.

1. Set up a supportive work environment.

I use Iris software on my work computer to reduce blue light exposure, and luckily, I work from a home office where I can keep the overhead lights down low and completely avoid CFL bulbs and fluorescent lighting. If you work in an office or another public place with harmful bright lights, you can purchase blue light blocking glasses.

As much as possible, I schedule 45-minute meetings rather than 60 minutes so I have short breaks in between calls to recoup, grab a snack or water, or take a bio-break, and to write down notes from the previous meeting. I keep a healthy supply of sticky notes for reminders, and I use OneNote to write everything down during/after meetings since I’m more likely to forget the details post-brain injury. I have turned off all pop-up notifications from email and instant messenger to avoid bombarding my brain with little distractions.

I use Himalayan salt lamps to generate positive ions, and I diffuse Doterra’s “Balance” essential oil blend to create a calm workspace. Most importantly, I block off time in my calendar to take regular mini-breaks from work, time to get fresh air, walk the dogs, boost my heart rate, sit for a couple of quiet minutes, do breathing exercises, or have a cup of soothing tea.

2. Ask for help.

Near the end of my medical leave, I was able to run more errands and take my daughter to her dance classes. Now that I’ve gone back to work, I’ve had to ask my husband to take these family responsibilities back from me again. I’m also enlisting the help of my 8-year-old daughter with more household chores like vacuuming, washing dishes, folding laundry, making her own school lunches and feeding the dogs.

3. Accept less than perfect.

If you’ve ever seen the inside of an 8-year-old’s dresser drawers, you know where I’m going with this. The bottom line is that I need help, and every little bit counts.

4. Say no and set boundaries.

With work responsibilities, I’m no longer able to spend a day or two resting and recovering from an overstimulating event or series of events that will cause a spike in symptoms that linger. This means I have to pass on my kid’s all-day break dancing battles, evening time social events, volunteering in the classroom, and serving on FARE’s (Food Allergy Research and Education) Support Group Leadership Council. This also means instead of binge-watching “Breaking Bad” after my daughter goes to bed, I listen to an audiobook or stretch and roll or do some light reading before bedtime.

5. Re-prioritize.

My daughter’s elementary school teaches this technique for organizing a to-do list: determine what tasks you must do as a top priority and determine what tasks you may do (or just want to do) as a lower priority. There are many days I only get to the “must do’s” (and even some days I can’t even tackle that list!) So I keep a small notebook with my various pending projects in different categories, such as creative projects like designing a family photo album, housework projects like cleaning the fridge, and a list of books that I want to listen to or read. For me, writing these “may do’s” down in an organized fashion helps prevent my brain from ruminating on them when I can’t seem to find the time for them.

6. Simplify.

With lower energy levels and a reduced capacity for multitasking, I’ve had to find ways to simplify daily life and break down lengthy or complex tasks into simpler steps. If I try to prepare more than one dish at time in the kitchen, I will inevitably miss an important ingredient or burn something. So I make crock pot meals often or cut veggies and measure out spices for dinner in the morning. Instead of spending a whole day or two cleaning my entire house on a pre-determined schedule, I clean in batches and only after it’s unbearably dirty. I might clean the bathrooms one week and the floors the week after, or vacuum the main floor on one day and the upstairs floor the following day. I have also found it helpful to declutter our house as much as possible so I can find things easily and my brain has fewer junk items to process (ever heard of the KonMari method and Marie Kondo?)

7. Eat well. 

When I first went back to work, I found myself constantly raiding the pantry for crunchy snacks, usually something that would spike my blood sugar and cortisol. Now I make sure I have healthy brain-supporting snacks like olives, nuts and seeds, coconut milk yogurt, fermented beets and avocados on hand. On the weekends, I make paleo/keto muffins or bread so I have something quick to grab during the week. I also divide chopped veggies for breakfast smoothies into mason jars to save time and energy during busy weekday mornings.

8. Sleep well.

I have read volumes and volumes about sleeping well and how to beat the insomnia monster that has been haunting me for 13 years. The American Sleep Association recommends good sleep hygiene tips for behaviors that promote healthy sleep. I was recently able to completely wean off of all prescribed sleeping medications, and my top effective sleep hacks have been to:

• Practice good sleep hygiene.
• Train my brain to associate bed with sleep – no more reading in bed, no more lounging in bed at any time of day or night, no meditating in bed, and certainly no working on my to-do lists in bed.
• Use sleep restriction therapy to train my brain to consolidate sleep in fewer hours in bed based on my average total sleep time and my sleep efficiency score from the prior week. For more information, check out “End the Insomnia Struggle: A Step-by-Step Guide to Help You Get to Sleep and Stay Asleep” by Drs. Colleen Ehrnstrom and Alisha Brosse.
• Take steps to increase my sleep drive – unless my brain is extremely exhausted, I avoid naps. I’m usually fighting the urge to nod off between 8:45 and 9:15 p.m., but if I get in bed early, I will surely toss and turn that night. If I can stretch myself to get in bed at 9:45 or 10 p.m., I usually sleep more soundly. I’ve also learned that getting more intense exercise during the day or even in the evening helps improve my sleep drive so I sleep more soundly.
• Time and dose my supplements and medications appropriately for sleep – it took me quite some time to discern that my thyroid medication dose taken at 6 a.m. was contributing to insomnia, and I have finally adjusted the dose low enough to manage thyroid symptoms without affecting sleep. I also switched to a thyroid medication I tolerate better, and I don’t drink any caffeine within three hours of my morning thyroid dose in order to avoid an unpleasant spike in cortisol and anxiety. I have to take all adrenal stimulating and brain-boosting supplements early in the morning, and then take adrenal and brain calming supplements in the afternoon and evening. I’ve also started taking melatonin 90 minutes before bedtime rather than immediately before. Finally, I’ve learned that the following supplements can be stimulating for some people so are best avoided after noon: vitamins A, B (specifically B5, B6, B12), C, D and K.

9. Exercise.

Experts recommend getting 150 minutes per week of moderate exercise to lower your risk for cardiovascular disease and dementia. After going back to work and feeling more tired, it’s been challenging to fit exercise into my day and also make it a priority when I’d rather be resting. On days when I’m feeling a bit more energetic, I will meet a friend for warm power yoga or take hip hop dance class with my daughter after work hours. I find I am far more motivated to work out with a partner than alone. On medium energy days, I will do a Pilates or Tracy Anderson exercise video in my basement. On low energy days, I will take the dogs for a leisurely walk around the neighborhood and maybe do some light stretching or rolling. When I’m really pressed for time, I squeeze in 5-7 minutes of quick cardio-boosting exercises like jumping on the mini-trampoline (though I was not able to do any bouncing in my early brain injury days), squats, push-ups or the 7-minute scientific workout. I also try to get extra movement in my day by parking farther away and walking my daughter to school each day, and I aim for at least one day a week of myofascial release techniques such as yin yoga, eldoa or rolling.

10. Rest and de-stress.

Back to work means back to resting on the couch more often, more audiobooks and more evening time alone. While I’m not able to meditate as often or for as long as I did while on medical leave, I absolutely have to keep up with a semi-formal meditation practice to calm my nervous system and get rid of daily stress. I save the longer meditation sessions for weekend mornings and make sure I still adhere to a twice-daily (morning and mid-afternoon) schedule for short 10-30 minute meditation sessions during the week. On days when I am really pressed for time, I will at least sit for 5-10 minutes and take mindful breaths, or 2x breaths (breathe in for 2 counts then out for 4 counts, breathe in for 3 then out for 6, breathe in for 4 then out for 8), or 4-7-8 breathing, or even just some mindful listening to the sounds in my environment.

Aside from meditation, there are multiple other ways to stimulate your vagus nerve and activate your parasympathetic nervous system such as singing, gargling, cold showers and using a soft ball (like a deflated soccer ball) to roll your stomach. Dr. Izabella Wentz, author and thyroid expert, recommends scheduling four hours of personal management time each week when you only do something you feel like doing and nothing that you “have” to do. I’ve been working on scheduling two hours at a time to read, knit, journal, or snuggle with my family and watch a funny movie.

11. Connect with friends.

Positive social relationships not only help us feel happy, supported and connected, but they also boost cognitive performance and lower our risk for dementia. After going back to work full-time, I’ve discovered I no longer have the energy to invest in friendships that are mostly one-sided. If I’m going to put effort into creating meaningful social connections, I want to find friends who are physically and emotionally available, who are interested in supporting their health in the same way I am, and who have positive energy vibes. While I don’t have as much time and energy to invest in friendships after a busy work week, I know how important it is to my brain health, well-being and overall happiness, so I make time to schedule some social time every now and then. I find that brunch dates work best for my brain since I have more energy in the mornings.

12. Practice gratitude.

Whenever life feels challenging, I have to remind myself of all the blessings, big and small, that surround me. Most evenings over the dinner table, we discuss as a family what we appreciated most during our day, and I often fall asleep at night while running through a list of things I am grateful for in my head.

13. Let go of guilt. 

It certainly doesn’t serve me to waste energy feeling guilty about spending more time on the couch after work hours or doing fewer chores or even missing some family outings. My brain requires more tender, loving care, and that’s just the way it is.

14. Remember that this too shall pass.

My husband reminds me that I was overwhelmed and exhausted when I went back to work part-time, spending additional hours on the couch again or time alone in my room listening to audiobooks rather than engaging with my family. Over time, I was able to train my brain and build up resilience in the midst of a busy schedule and heavier workload. I may be struggling with full-time hours now, but my brain is becoming more resilient and healing every day. Soon enough, I’ll be able to say with confidence that I am able to work full-time, despite my brain injury!