7 Executive dysfunction challenges after brain injury

We all have that friend who is really indecisive and just goes along with your suggestion, but you are never really sure it that’s what they want.  Yes, that’s right, it’s me with my executive dysfunction.

Before my brain injury I would have described myself as opinionated. However I would be open minded enough to consider others views, and still tactful even if I didn’t completely agree. Well that person is still in there, just took a wrong turning. (I always did have issues with my left and right.)

The frontal lobe, which is directly behind the forehead, is responsible  for the brains executive function. Due to it’s position, casualties of falls, road traffic accidents and sports injuries, commonly sustain a brain injury in this region as it impacts with the skull.

Brain injury dysfuction

Some of you might have come to realise that supermarkets have become my nemesis for a variety of reasons. But being bombarded with choices is definitely one of them. Executive dysfunction makes those choices feel more like a trick question. The supermarket visit has become a very regular activity of modern life. But it challenges those with brain injuries in ways other people wouldn’t expect.

  • Low motivation/ability for completing tasks 

    Sometimes it can be hard to even write the shopping list because you have to decide what you need. If it’s not in front of me, I might not remember it’s missing! So I just don’t want to do it.

  • Disorganised

    In some UK supermarkets their trolleys are chained together and can only be released by putting in a pound coin (you get it back when you return the trolley). But so many times I have spent my last pound coin without thinking, and not realised until I’m at the Supermarket.

  • Rigid ideas 

    I always think I’m in the way and trying to get out of the way. But actually maybe the other shoppers are just busy in their own world. They haven’t even noticed me, let alone be bothered about where I’m standing.

  • Impulsive behaviour 

    Supermarkets are designed to harness the power of the impulse buyer. When you have a brain injury it can be torture. I’ve never used it before, but what if I’ll need it soon for something? Even though I don’t know how to use it I better buy it, just in case!

  • Controlling emotions 

    I think most people at some point have got frustrated during a Supermarket visit. However when you have a brain injury it can feel like the world is ending. So many times I have had to just abandon ship, and get out!

  • Struggle to socialise 

    Usually the staff try to engage in some polite conversation as is customary. But a brain injury can mean you can’t read the situation properly. What to you mean, “Do I want any cash back? I haven’t given you any yet to give back to me?”

  • Short attention span 

    You struggle to concentrate, and there are so many things in one space demanding your attention. Making you miss things all the time. I have walked marathons looking for things as I just never saw them!

Decision fatigue from 7 Executive dysfunction challenges after brain injury

 

All of this can lead to decision fatigue. This makes your brain is so overwhelmed you are more likely to make a bad decision.

So try not to be too frustrated with that indecisive friend who has a brain injury. Sometimes you have to choose your battles in life, and for us that can mean trusting someone else to decide. It’s a compliment really that we chose to leave it with you.

But it can get better. You can read why sometimes it is better to try in Avoiding problems: I must stop burying my head (inc injured brain) in the sand

Do you struggle with executive dysfunction? What other “normal” activities do you find a strain?

My blog on living with brain injury: This is why everyday activities such as shopping can be so difficult for brain injury survivors.

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21 Replies to “7 Executive dysfunction challenges after brain injury”

  1. Almost 16 years to the day now, my life changed. It was not recognized at the time as a serious problem. A concussion could take a few months, perhaps a year or so to recover was the line I heard. I kept saying I was not ok, but lacked any sort of way to define how different my life had become. To this day I have no answers and simply try to cope. Thanks for your story.

    1. Douglas it must be so hard having so many unanswered questions. I can’t say I was formally told very much and I have learned a lot from the online survivors community. We are all learning together.

      1. I feel most of the things said I suffered a brain anerysium in 2013 I use art therapy to get me through everything it’s been a hard time .I am so lucky that I am a artist in fine art and design .because doing art all my life from a very young age has helped both me an my daughter in our time of need in helping us recover from brain anursyium hers in 2009 .mine in 2013 . I am glad that I was able to help her with her recovery first useing art therapy .we had a mother and daughter art exibition in march 2013 .then only 3 months later I too suffered a brain anerysium. Things do come to test us .but we both do ok .I will never give up doing art and know how much it can help in ones recovery .so never give up ..

        1. Thanks Sharon, I love art too and don’t do it enough. I will put more effort into finding time for it. 🙂

    2. It hasn’t been a year for me, and when you say ” It was not recognized at the time as a serious problem,” I am think in my own timeline. I thought I was improving after a few months, I know this because I wrote about it, I don’t actually remember feeling improvement.

      Now I am worried my eloquence will suggest I AM better, while I know I am worse.

  2. I have a brain injury as a result of brain cancer. It’s been 11 years, but I still struggle with the supermarket, especially if I go there just to get a couple of things. I went there yesterday with the idea that I’d get some dried soup mix to make vegetable soup. I walked in the door and immediately forgot why I was there. “What am I doing here? I wanted something, what was it? Ohhh, come on! F-word, I can’t remember! I’m here for a reason, what can it be!” I said to myself as I clenched and unclenched my jaw. I worked it out eventually, but then I had to find the soup mix. It took around 15 minutes to get in and out when it should have taken under 5. Then, I had to find the car in the carpark. Luckily I found it after only 3 passes of the area I knew it must be in. “Why didn’t I pay more attention?” I berated myself as I wandered around looking for it. As if that would have made any difference!

    I’ve worked out that it’s the over-stimulation in shopping centres that does it to me. The bigger the shop, the worse I am. Everything is too much – the lights, the stock, the people, the music, the smells, all of it. It freaks me out. I used to get half way through a big grocery shop and have to leave in tears. I don’t do that anymore because I shop at a smaller supermarket with much less stimulation and I can cope with that. I always park in the same spot too, plus I bought a token for the trolley so I don’t have to worry about having a coin. I am lucky in Australia, customer service is so bad that no one ever talks to you at the checkout, so that’s one less distraction to deal with.

    1. You’re the first person I’ve ever heard that they are lucky that customer service is bad where they live 😂
      Thanks for sharing your experience and I agree smaller shops are better.

    2. I am so glad you addressed this. I have executive dysfunction from a brain injury. One of the things I have had to adjust and deal with has been shopping. Big stores, like Wal Mart definitely don’t work for me. It also found it helps me to go to small stores on days I’m doing well. I found that when I first discussed my difficulty people assumed I was having panic attacks. This really frustrated me. I finally found a neuropsychologist who understood. It’s helpful to hear from others going through it.

  3. The book, “The Ghost in My Brain” addresses all these symptoms in a man who couldn’t find help for eight years after his injury. Then he found two doctors in Chicago who rerouted brain signals and he had a full recovery! Check out the reviews on Amazon!

    1. Wow that sounds amazing, all the “experts” told me that there isn’t anything that can be done, it’s just got to heal itself as much as it can.

  4. Wow! So many good ‘sharing experiences ‘ here. Thanks everyone, it’s good to know that there are others that understand your situation with over stimulating places. Good advice too.

  5. One thing I noticed, and it still bugs me now, are the simple decisions for example, when making myself a coffee, putting the sugar in is that the correct amount on my spoon, no it’s too much, knock a bit off, too little, add some more, too much, take some off, add some, screw it give up with the sugar. I know it’s only a trivial annoyance, but I’m trying to not get into this type of decision making and forcing myself to go with my first choice and deal with the consequence, most of the time it’s not important.

    When shopping, for me usually at the DIY store, if I want something specific, I head directly to that department, get what I want, and then wander around the rest of the shop hoping that there is nothing similar to what I just picked up, so that I don’t have to choose between the two of them.

  6. Great article, Michelle. So often I get overwhelmed by decision fatigue while shopping, and wind up leaving empty handed. I do most of my shopping online now, so I can look at things for hours (or days) before I make my decision to buy, and no one is the wiser. Except grocery shopping, which my husband does. I had to pick up a few things at the supermarket yesterday. I made a list on my cell phone, and bought all the things I needed…plus a few more that seemed like a good idea. It took nearly an hour, and there were only 7 items on my list. Before TBI, that would have been a 10 minute task. Oh well.

    1. Reeds you sound so much like me! 90% of my shopping I do online and food shopping I sometimes do, but only when James is with me. Or he goes on his own.

  7. Today I was scrolling through Pinterest, desperately attempting to find ways to help me cope with my new life, the new me, someone I absolutely feel like I don’t even know any more & I found this article which soundedso much like some of the struggles I have. I’m thankful to have found this and this website. I’ve worked in the medical field for 5 years, I’m 25 years old, yet I never truly understood the after affect a TBI could have on someone’s life until 4.5 months ago, I was sitting at a stop sign and a boy came speeding down a hill came off the road and TBoned me in my door, pushing the door in on me and resulting in my head hitting the car door window and shattering the window. Since that day, my life has changed drastically. Concussion, Post Concussion Syndrome, Severe PTSD, Adjustment disorder resultinf in severe depression and anxiety, Neurocignitive Disorder, My ability to lear new things is impaired, I have to keep a planner to know each day what I have to do, the horrible headaches. Every week there’s appointments nonstop that I have to depend on others to take me to Vestibular Therapy, Nuero, Family Dr, Pyschatrist. My life has changed so much and I’ve lost friends but I have also gained so many I didn’t realize I had, it’s brought my family together in way I never would have imagined. I know things will get better, I just have to continue to learn to accept it, stop denying I’m not sick, learn to live each day to the fullest. Thank you so much for sharing this article!

    1. Megan I’m sorry you were in such a horrible accident. But it’s good for hear you are getting support for your recovery. I know having so many appointments can be daunting and inconvenient. But it’s going to help you in the long run.
      I wish you all the best for your recovery.

  8. I’ve done my BEST with my wounded brain as I can. My “executive director” aka husband died in April because I wasn’t fast enough to do CPR on him. I’ve had people that once pretended to “care” for me (because they never cared about me just cared about my husband) their backs because I wasn’t the better half; they tried calling CPS on me to take my child away but injured their relationship with him; all kinds of cluster f nightmares because my husband was told by several people, “don’t get involved with a girl with a brain tumor” which was about 14 years ago.

    DESPITE their painful malarkey I had all the support needed. His shoulder took a lot of responsibility but never the full brunt of what it was like being given the cold shoulder because you said something inappropriate or did something unpleasant.

    We started “the arachnoid cyst foundation” in 2003 trying to help people proactively. I would answer a few emails and calls then tons of emails and calls. I didn’t or couldn’t have much more capacity for understanding complex social situations. My CSF was so high I couldn’t think out of a paper bag and had a PM Dr Jack me up so high on meds so he could do the unthinkable.

    I have had my TBI since birth. Was ALWAYS different than the other kids and couldn’t “get it.” I always excelled in school and my mother would keep telling me tge people more hateful would suffer far worse in life and im just waiting for kharma to be a b****. I love kharma in action.

    When we found my plum sized arachnoid cyst in 1989 there wasn’t ANY info. I slapped my mom on the back laughing saying, “I TOLD YOU SOMETHING WAS WRONG!!!” as she looked at me with the most horrified reaction I’ve ever seen. It took her 9 neurosurgeons before she found one to do the surgery because as an artist she could read negatives and see it poking out my nose. So she found one to do the surgery the way she wanted.

    In 1992 I started looking through medical texts trying to understand what they meant. Now I can look at a MRI and read it. .

    I’m sorry this is all over the place but the one thing I’ve learnt in all these YEARS as an advocate for myself, as well as millions of others through various forms of caring, is A. You don’t have friends. You have people you walk with and sometimes carry, but they will never care for you as your same sex parent, or your chillin’, B. People use you C. Trust nobody because that’s letting people in to hurt you. Trust your close family but friends aren’t your friends and won’t see you through everything.

    Concentrate on yourself. Quit giving away your power to people that don’t care for you. I’m sorry I’ve come to believe these things at 45 but I do. People will always look for an “in” to hurt you and use TBI as an excuse. F them.

    I have issues with brain healthy people. They want to label you all kinds of diseases without looking at the core cause. They just can’t accept fundamental truths of TBI and that is healing from this is a lifelong process, you will ALWAYS be flustered in complex social situations and forget everything unless you keep your lists. People don’t MEAN to be MEAN they just have no framework for working in a professional capacity with you because you are above their paygrade. Don’t let that discourage you but teach you a lesson that you belong in an atrium of your own. Don’t give people an in.

    I loved your article.

    Goddess bless!!!

    1. Catherine it sounds like you have been on a difficult journey for a number of reasons. I totally understand how “once bitten, twice shy” makes you cautious of others intentions. And you are right to protect yourself. I just hope that you do get to meet some of the worlds genuine people who really do want to help others and will show you the love and respect that you deserve. All the best for the future x

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