Finding happiness after brain injury

BY: SOPHIA VOUMVAKIS

How can we survive, and perhaps even find happiness after experiencing loss or trauma ?This is a question that has fascinated me ever since surviving my traumatic brain injury almost four years ago.

woman doing yoga
photo credit: via photopin (license)

I reviewed the writings of Martin Seligman, the leading authority in the fields of positive psychology, the scientific study of what makes life most worth living. [We also talked about positive psychology at our August community meeting.]  It is a call for psychological science and practice to be as concerned with strength as it is with weakness; as interested in building the best things in life as in repairing the worst; and as concerned with making the lives of normal people fulfilling as with healing pathology.

Seligman identifies three types of happiness: the pleasant life, the good life, and the meaningful life. The pleasant life is amassing as many pleasurable experiences as you can and learning to savour those moments by practicing mindfulness techniques. The way psychologists help people experience the pleasant life is to have them create their perfect day, and using the techniques of mindfulness, savour those activities.

What would your perfect day look like? Mine would include an early morning yoga session, followed by a breakfast of fresh fruit, yogurt, and granola, and a latte (prepared by someone else, of course!); an ocean, a beach, and a good book; a lunch of fresh fish and greens by the seaside; my requisite afternoon nap; followed by a hike; and, getting all dressed up for a dinner of pasta and a glass of red wine.

The good life is experienced when we experience flow, when we are fully engaged in some activity that so engrosses us that time stops. The way we can increase flow, or the good life, is to identify our signature strengths (you can take the test on at www.authentichappiness.org) and re-craft our life in the arenas of work, love, family, friends, and fun to make use of those signature strengths.

pasta and red wine
photo credit: Wine Spaghetti and Shrimps via photopin (license)

Prior to my TBI, I had managed to craft a professional life as a researcher where I made good use of one of my signature strengthes – the love of learning. Often, when I was in the midst of analyzing the data, time literally stood still for me, I would look up from my screen and the hours had flown by.

My second signature strength is a deep appreciation of beauty. When I look around at my home, in my closet, at my dinner table when I’m entertaining, that signature strength is in full display. When I reflect back on how I raised my two daughters I now see how I incorporated these two signature strengths in their upbringing, we were always discussing new ideas, new research, traveling, and visiting art galleries and museums. I derived great happiness from these activities and I think, in some small way, I cultivated those strengths in my children.

The meaningful life is achieved when we identify our signature strengths and use them for the betterment of others. When I’m reading books on psychology, neuroscience, and happiness, time literally stops for me – I’m so engaged in the activity. I have been extremely fortunate to have found a way to take this signature strength to increase the good life and hopefully to some small degree, the meaningful life post TBI. By sharing my learnings about TBI and how the advances in neuroscience may offer hope to survivors of TBI, I have found some meaning from my TBI, and this increases my happiness. For this I thank the Brain Injury Blog Toronto and its readers!

Other TBI survivors have used their signature strengths to become peer mentors, run workshops, organize social activities, volunteer on the Board of Directors, and so much more.

woman at sunset who is happy
PHOTO: HUFFINGTON POST

Do we achieve the same life satisfaction from all three happy lives? Martin Seligman and his team have conducted research in 15 replications involving thousands of people — to determine to what extent the pursuit of pleasure, the pursuit of positive emotion, the pleasant life, the pursuit of engagement, time stopping for you, and the pursuit of meaning contribute to life satisfaction.

It turns out the pursuit of pleasure on its own, has almost no contribution to life satisfaction. The pursuit of meaning has the strongest impact on life satisfaction, and the pursuit of engagement is also very strong. The pursuit of pleasure positively impacts life satisfaction when you have both engagement and you have meaning.

Which is to say, the full life is one in which we have all three. So, identify your signature strengths and then use them to enhance the engaged life and the meaningful life, and don’t forget a dose of pleasure! Wishing you much happiness!


 

Since her TBI in 2011, Sophia has educated herself about TBI. She is interested in making research into TBI accessible to other survivors.

Can physical exercise help ABI survivors?

BY: SOPHIA VOUMVAKIS

After sustaining a traumatic brain injury (TBI) in 2011 I was blessed to be referred to a wonderful cccupational therapist who helped me to firstly understand what had happened to me, secondly, helped me to develop strategies to deal with my deficits, and finally helped me to accept my new normal.

PEOPLE RUNINNG
PHOTO: DR ANN BLOG

We focused on three areas during my therapy: cognitive, emotional, and physical. Recently I read a scientific article published in Current Opinion in Behavioral Sciences which outlines the extensive neuroscience literature that supports the positive effects of physical activity for improved cognitive performance and brain health.

Experiments with animals have shown that increased physical exercise leads several benefits to the brain, including:

yoga class at rehab centre
Photo: MIAMI HERALD

These findings have been observed across the lifespan and in a multitude of species, including rodents, dogs, and monkeys. The findings in animal models provided the basis for human studies of physical activity, fitness, and exercise and its impact on brain function. In a
meta-analysis (a quantitative statistical analysis of several separate but similar experiments or studies in order to test the pooled data for statistical significance) of eighteen human randomized controlled trials published in 2013 by Colcombe and Kramer, a moderate effect size between exercise and cognition was reported.

Specifically, the meta-analysis revealed a clear and significant positive effect of aerobic exercise training on cognitive function. As discussed in an earlier post, TBI often leads to deficits in cognition – attention, memory, thought, behaviour and emotion.

Furthermore, exercise training had both general and selective effects on cognitive function. Although exercise effects were observed across a variety of cognitive tasks, the effects were largest for tasks that engage the central executive network, including planning, problem solving, cognitive flexibility, and working memory. Lastly, the meta-analysis revealed that aerobic exercise training combined with strength and flexibility training had a greater positive effect on cognition compared to exercise training programs that included only aerobic components.

More recently, human studies have begun to include measures of brain function and structure along with behavioural measures of cognition. These studies have reported that relatively brief fitness programs result in increased brain volume in the hippocampus, benefits in the striatum, and increases in the integrity of white matter tracts. Additionally, these fitness programs enhance patterns of brain activation, including measures of functional connectivity of frontal and parietal brain regions, suggesting more efficient activity within the central executive network.

While the majority of experiments have focused on older adults, more recent studies have reported similar cognitive and brain benefits of exercise and physical activity in children, and young adults. Collectively, these studies have demonstrated that physical activity and aerobic fitness benefit brain function and cognitive performance across a variety of aspects of cognitive control, including attention and inhibition, working memory, mental flexibility, and action monitoring/error detection, as well as hippocampaldependent memory.

Despite the global benefits of physical activity and the potential to improve cognitive performance and brain health, remarkably little research has evaluated the effects of physical activity on cognition following TBI.

Consistent with the literature in healthy adults, evidence indicates that physical activity in a four-week aerobic fitness intervention produced improvement in executive functions following TBI.

The physical fitness interventions for TBI can be personalized for the patient, selecting from a variety of fitness activities (e.g., aerobic, strength, and flexibility training) that accommodate the patient’s abilities and functional goals.

Mine include hiking, biking, yoga, swimming, snowshoeing, and strength training. Activities that I had always enjoyed and continue to enjoy which benefit both my body and my brain!


Since her TBI in 2011, Sophia has educated herself about TBI. She is interested in making research into TBI accessible to other survivors.

Will new research help treat excessive sleepiness post TBI?

BY: Sophia Voumvakis

In May 2011, I sustained a traumatic brain injury (TBI). My TBI left me with a number of physical,cognitive, and emotional deficits. Working with an occupational therapist, we were able to identify these deficits develop a number of strategies to help me compensate for them. I will be eternally grateful for the help I received from a compassionate and eminently capable occupational therapist.

photo credit: 3/365 - Self Portrait for 365X3 via photopin (license)
photo credit: 3/365 – Self Portrait for 365X3 via photopin (license)

The one deficit that I have found the most difficult to accept is my need for more sleep. My two-hour afternoon rest period, actually, a nap, is sacrosanct. I am unable to function without it. This nap is in addition to a good nine hours of sleep a night, much more than I needed before my injury. My need for more sleep has made a huge dent in the number of productive hours I have in a day.

Whether the TBI is mild or severe, at least 25 per cent of patients experience some disturbance in sleep and/or level of daytime arousal following their injury. These symptoms can impact recovery and contribute to disability.

Most doctors will tell you that increased need for sleep arises because it takes time for the brain to heal; even a mild concussion can disrupt neural fibres and that mental activity may take much more effort following such an injury.

photo credit: Cat Naps via photopin (license)
photo credit: Cat Naps via photopin (license)

I recently came across an article by Dr.Barbara Schildkrout where she discusses new research in pleiosomnia, the need for an unusual amount of sleep in a 24- hour period. This research may point to new treatment approaches for this common symptom of TBI.

Schildkrout discusses the findings of two research studies which draw attention to the fact that injury of the hypothalamus is common in TBI. The posterior nucleus of the hypothalamus which contains histaminergic neurons is most affected by injury. Histaminergic neurons are part of a the body’s system which control wakefulness. The researchers suggest that a consequence of shearing forces at the point where the hypothalamus and the midbrain meet during head trauma is the loss of histaminergic neurons.

The research also identifies a less substantial but still significant loss of hypocretin/orexin neurons and melanin-concentrating hormone (MCH) cells in the hypothalamus. Scientists know that these types of neurons and hormones are involved in regulating arousal and sleep. In individuals with narcolepsy (frequent and excessive sleepiness) the hypocretin/orexin neurons are deficient or absent. MCH neurons are involved in both REM and non-REM sleep and are thought to promote sleep

The authors suggest that their findings point to a new approach for treating post-TBI patients who experience the need for extra sleep. Drugs which increase histamine signalling to the brain may prove helpful in the management of excessive sleepiness in TBI survivors. One such drug, Pitolisant, is being tried with some success in patients with narcolepsy and might prove helpful to TBI survivors, who like me, suffer from excessive sleepiness.

In my life before my TBI, I was a researcher. I had a passion for conducting both primary and secondary research and then communicating the results of that research in an accessible way. I hope that this is what I’ve done here, and I hope to do more of it in the future. Now, it’s time for my nap!

Since her TBI in 2011 Sophia has educated herself about TBI. She is interested in making research into TBI accessible to other survivors.