resilient, resiliency, brain injury

Building Resilience After a Brain Injury 

Resilience is the ability to adapt positively to changes and build yourself back up after experiencing obstacles in our lives (e.g., adversity, trauma, unexpected problems and tragedies). To be resilient means that even though you cannot always change your current circumstance, you try your best to cope, modify, or change the aspects that you can control. To be resilient does not mean you will not experience pain or stress, it is how you deal with the challenges you have been faced with and consists of a combination of thoughts, behaviors, and actions that are important to develop and continuously work on throughout our lives. It is an active process. After a brain injury (BI), individuals deal with a new reality and can be faced with limitations and changes in their personal relationships, employment status, leisure activities, and education. Participation deficits in everyday activities can significantly affect individuals’ mental health, self-esteem, and their overall sense of self.  

Studied have found that resilient individuals demonstrate certain characteristics such as being more socially competent and present better physical health and emotional wellness than individuals that do not exhibit resilient characteristics. They also exhibit proactive behaviors rather than reactive behaviors, have better mental flexibility, find more solutions to deal with challenges (resourcefulness), and value positive emotions. Furthermore, studies found higher resilience in individuals with a BI was correlated with better emotional adjustments, increased participation (e.g., social relationships, leisure, and productivity) and their ability to reintegrate into the community. Resilience was also found as a protective factor against experiencing depression as well. Strategies to improve resilience will depend on evaluating a combination of static (unmodifiable) factors such as age, sex, intellectual abilities, and their psychiatric history and dynamic (modifiable) factors which includes can include social support, nutrition, exercise and even socioeconomic status. It is also important to note that resilience requires certain skills such as having good judgment, problem-solve skills, emotional stability. Factors and strategies are listed in the template below. 

Dynamic (modifiable) Protective Factors / Strategies 
Support system 

 

Studies have found the following:  

  • Having stronger social support was related to decreased depression and increased well-being in adult TBI survivors.  
  • Increased neurobehavioral impairments such as depression was closely related to family issues in adults following a TBI 
  • Parental warmth and a low-stress family environment in children had fewer behavioral problems.  
  • In conclusion: having a good support system can serve as a protective factor after sustaining a TBI 

Benefits of having a good support system which can include family system can help increase feelings of self-worth and help view your problems in perspective. Finding a mentor, role model, or support who have endured similar experiences or demonstrate resilient traits will be beneficial to learn from them and vent about your feelings as well. 

Spirituality or Religion 
  • Can provide a moral compass for individuals and help build their emotional resilience 
  • Can help you provide a more positive outlook from having faith and hope 
Exercise  
  • Exercising releases chemicals that boosts our mood such as endorphins and a can possibly increase our brain’s ability to learn from and adapt from stressful events 
  • Feeling in a better mood rather than feeling depressed can help us think into a more positive mindset and view the challenges we are faced with as temporary rather than fixed. This way of thinking helps you become more emotionally resilient. 
  • Short periods of exercise can improve your sleep-wake cycle and improve your sleep (see benefits of sleep) 
  • Moderate and regular exercise can help decrease your stress hormone (cortisol) and  
  • A short walk can help decrease anxiety and improve your energy 
Nutrition 
  • Eating healthier such as Mediterranean diets that contain large amounts of omega3 fatty acids. Omega 3 fatty acids have been mentioned on the benefits.  
  • One study that looked at TBIs and animals and nutrition, found that animals that were deficient in omega3 fatty acids demonstrated more anxious behaviors. Another study looked at micronutrients and TBIs and found that animals that had an adequate amount of zinc compared to being deficient in zinc, demonstrated less anxious and depressive behaviors, had better spatial learning and memory skills. 
  • Keeping your diet and nutritional elements in mind can help improve your health and immune system and can give you a sense of control when it is difficult to control other aspects of your life. Lastly, it can help you feel better physically and mentally. 
Sleep 
  • Sleep is one of the most important and essential areas that are often overlooked. The amount of sleep you receive can impact how to experience and manage your stress, thus decreasing your resilience 
Coping strategies include a combination of small efforts such as: 

 

  • Breathing exercises: Our breathing is not as efficient when stressed, thus reduces our oxygen. Taking deep breathes can help us manage stressors better in the moment. 
  • There are multiple breathing exercises to engage in – Common ones include diaphragmatic breathing and pursed lip breathing 
  • Taking mental breaks as needed, this includes saying “no” when overwhelmed to improve your emotional stability 
  • Journaling – journaling can help you track and monitor thoughts and feelings. Journaling 3-5 things you are grateful each day will help you see the positive things around you. 
  • Practicing to view “failures” as necessary experiences and lessons you can learn from. You can only make improvements from learning from your “mistakes.” 
  • Focus on the aspects you CAN change instead of dwelling on what you cannot. Know that you are doing your best. 
  • Develop small realistic and achievable goals, create a plan, and track your progress. 
  • Celebrate all the small accomplishments 
  • Setting your daily intensions each day (e.g., creating an affirmation such as “I am strong enough to get through this” and repeating it to yourself daily or posting notes around your house with positive messages 
  • Taking care of yourself (e.g., sleeping well, monitoring your diet, and engaging in exercise) 
  • Additional beneficial strategies include mindfulness techniques (e.g., mediation and guided imagery), engaging in yoga, and cognitive behavioral therapy  

References:

Wardlaw, C., Hicks, A. J., Sherer, M., & Ponsford, J. L. (2018). Psychological Resilience Is Associated With Participation Outcomes Following Mild to Severe Traumatic Brain Injury. Frontiers in neurology9, 563. https://doi.org/10.3389/fneur.2018.00563         

Holland, J. N., & Schmidt, A. T. (2015). Static and Dynamic Factors Promoting Resilience following Traumatic Brain Injury: A Brief Review. Neural plasticity2015, 902802. https://doi.org/10.1155/2015/902802 

Elliott, T. R., Hsiao, Y. Y., Kimbrel, N. A., Meyer, E., DeBeer, B. B., Gulliver, S. B., Kwok, O. M., & Morissette, S. B. (2017). Resilience and Traumatic Brain Injury Among Iraq/Afghanistan War Veterans: Differential Patterns of Adjustment and Quality of Life. Journal of clinical psychology73(9), 1160–1178. https://doi.org/10.1002/jclp.22414 

The Best Brain Possible. (2018). The Neuroscience of Building a Resilient Brain. https://thebestbrainpossible.com/neuroscience-resilient-brain-stress/ 

Evie. (2018). Building mental resilience after brain injury. Redefining Normal. http://refindingnormal.com/en/2018/04/04/mental-resilience-brain-injury/ 

Wilkens. (n.d.). Building Resilience Part III: Sleep, Exercise, and Health. Center for Motivation and Change.  https://motivationandchange.com/building-resilience-part-iii-sleep-exercise-health/ 

American Psychological Association. (2012). Building your resilience. American Psychological Association. https://www.apa.org/topics/resilience 

Naval Center for Combat & Operational Stress Control. (2013). Resilience: The Bounce Back Factor. BrainLine. https://www.brainline.org/article/resilience-bounce-back-factor 

“Trajectories of Affective Balance 1 Year After Traumatic Injury: Associations with Resilience, Social Support, and Mild Traumatic Brain Injury” 

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