New member, had TBI from woodland cycling accident in 2017 with subarachnoid haemorrhage to right frontoparietal region.
Hospital for two weeks until amnesia subsided, then off work for three months with gradual return and mostly working as I was before, but from home and generally try to keep to one thing at a time. I've admittedly been very lucky, but still have my issues, the usual suspects really - memory, fatigue, frustration, etc.
Aside from that, I feel like I have a fringe case and have been struggling to find any information, so thought I'd finally get around to signing up here to ask the wonderful community for advice.
I work as a senior telephone engineer for an insurance company and am kept very busy. Whilst I can work effectively and almost as well as I did before, the analytical work I do that heavily relies on the frontal lobes' functions. If I've had a busy day, I tend to be a bit of zombie in the evening. I'm I'm separated from the real world as I'm thinking through a badly tuned telly.
I can auto-pilot just fine on tasks that rely on other parts of the brain - cooking, walking, driving, etc but as soon as someone else is involved it's hard to tune in.
I've tried exercise, meditation, but what really helps is alcohol. Just a couple of units seems to do the trick.
After some research I believe the alcohol-triggered GABA relaxation release quickly relaxes the frontal lobe and I then feel human again.
Whilst this is effective, I'm trying to find an alternative - especially as mild (undiagnosed) ADHD makes me not want to stop drinking.
Diazepam may be useful, but it has its' own addictive issues and it's a short-term solution so I don't want to start on that.
Any suggestion or advice on a medication that I can use to trigger the frontal lobe relaxation and replace the alcohol?
Many thanks!
Adam
Written by
AdskiM
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I've taken Diazepam for 40 years with no addiction issues ; in fact I chose to reduce them systematically from 25ml daily to 1ml twice daily.
I too had a frontal lobe SAH (spontaneous) 11 years ago and I really get your point about auto pilot vs social interaction. I'm used to being a loner now since various shortcomings get in the way, and my poor short term memory & slow word recall aren't conducive to meaningful conversation anyway.
But for sanity's sake I take an SSRi antidepressant ; now officially considered beneficial for aiding progress after brain injury.
I haven't had alcohol since the coiling procedure to stem the bleed 11 years ago, except from a small sherry one Christmas just to 'fit in' at a family gathering and it knocked me out !
My addiction was tobacco 'til the Bi but not one ciggy has touched my lips since then. All these years later I still feel the loss but have now gained weight from substituting with chocolate 😵.
Hope you find your own personal substitute for alcohol Adski. It's never easy ! Best wishes, x
Thank you for the informative reply!I'll (try to) get a GP appointment and see what they are able to provide.
I'd not previously thought I needed antidepressants, but you comment had made me think twice - which SSRi has worked for you/is available in the UK?
It may be that the low dose Diazepam and SSRi are a good combination to try for me.
My chocolate/sugar consumption is also way up from before. I found early on that an elevated blood sugar level helped avoid the typical fatigue and daytime naps. It's tapered off now from the regular consumption of brewing sugar (dextrose) which was vastly cheaper than the typical glucose tablets. I have a "tool" box in my office with a selection of treats. Lol
Hi AdskiM, An SNRI called duloxetine worked for me, put a damper on my chronic headache - low dose , because with a BI, the prescribing rule should always be 'start low and go slow' (and incidentally, it didn't deserve the bad rap it has on the web - I eventually weaned off it, with no problems at all.)
While it's good that you have analysed your situation and worked out some fixes (and welcome to the forum by the way). It worries me a bit that you're using sugar to skip breaks. This is alright for an occasional unavoidable fix, to help you to perhaps have enough energy to sort out your evening meal when you've had a 'strenuous for BI' day, for example. But it sounds from your post as if you're pushing yourself to that limit regularly/ daily? That does run the risk of building up to a large crash/ bust on the fatigue front - and my neuropsychiatrist (MTBI / chronic fatigue specialist) warned me very seriously that we do run a very real risk of burnout. The sugar doesn't get rid of the fatigue, it just postpones it for a larger bust later on (in the typical boom bust pattern of fatigue) I know that I can self-medicate with caffeine and sugar to lift me through a social event I want / have to do, but it always catches up with me later. I think possibly you could be reinforcing your fatigue on a downward spiral this way. On the other hand, managing your fatigue to avoid a boom/bust cycle and gradually increasing your activity level, is more likely to get you back to a stable level of activity, I can do loads more in a day/ week than I could do a few years ago. Try and turn your analytical skills onto workarounds that give you lasting improvement, and identifying what else in your environment might be overloading you ( type of screen /background noise levels, for example) and how you can adjust those factors without using sugar (and alcohol tbh) Neuropsychologists that specialise in brain injury rehab are great for this. Plus there some useful stuff written by people in the ME/ chronic fatigue community about living with your 'fatigue envelope'. Perhaps you might find the book written by Jody Mardula and her neuropsychologist Frances Vaughan also has some useful insights. Despite the title, it isn't a mindfulness book as such, it's actually a very clear diary by Mardula of her experience of stroke, with a useful commentary by Vaughan on each chapter, and she also writes the second half of the book - which section I found particularly good. The book is called 'Mindfulness and Stroke - a personal story of managing brain injury'.
I think while you might cope in the short term, loading yourself with sugar regularly could also lead to other health problems like diabetes? I try and snack on stuff like nuts and fruit now, rather than cereal bars.
Thank you for taking the time to write such an informative response.You're quite right, I do push myself and probably more than I should.
I'm quite senior in my role and relied upon to get things done. I'm also keen to perform as I did pre-TBI as I don't want to be seen as someone who work from home and this can be lazy. That's a pre-covid way of thinking though so is definitely out of date these days!
I hopefully have another four years before my mortgage is paid off and am planning to then go part time, but perhaps need to take it easy before then to avoid causing other issues.
Thanks for the book recommendation - I'll check it out.
Hi Adam, I used to do the highly pressured thing, so do understand where you're coming from. But I ended up having to bail out at 60 when I had the BI, as I couldn't function at the level I needed to (luckily for me, with savings and no mortgage) but it certainly wasn't part of my planned career path at that point ( quite annoying - things were going sooo well at the time!) It's very difficult when these accidents strike when you still need to earn, that's really hard. Though as you're in that higher earning bracket, possibly have a long conversation with a chartered financial adviser who is willing to offer a planning service ( rather than just sales) about what your options might be - as you may possibly have more room to manoeuvre than you realise. Worth finding a neuropsychologist privately that you get on with, but importantly is strong enough to challenge you, who works in brain injury rehab though - mine was really worthwhile, really valuable insight and a great provider of helpful strategies. (On the plus side, I find I actually don't mind living simply now, and my blood pressure is actually spectacularly good these days, much lower than it used to be).
Finding a compatible SSRi can be straightforward for those folk who hit lucky first time.
I was prescribed them as an upgrade on tricyclic antidepressants for clinical depression. It took almost a year of trial & error with 7 different types (had to trial each one for 4-6 weeks to test out their suitability) but every time the side effects were intolerable).
My neighbour saw I was struggling and told me how Paroxetine had turned her life around and, at my wit's end, I asked my GP if I could try it. I had no side effects and it took only a fortnight to lift my sprits and, from then on, to start giving me my life back.
So it isn't a one-size-fits-all and many people give up after one trial. My daughter was prescribed Paroxetine after a marriage breakdown ; it made her ill. The second one suited her well and helped her through divorce, house buying and a new career ....... it was Citalopram ---one of those I couldn't tolerate.
So mine won't necessarily work for you AdskiM. Not trying to put you off ; just think you should be aware of the facts. SSRis can be lifechanging for those who find 'The One'.. x
I am in Canada so can't really recommend a shop, a quick search shows you can get GABA there in powder, chewable, and capsules. The brand N O W has chewable, for instance. I use the N a t u r al F a c t o r s chewable which is 100 MG. I think the chewable work faster but your mileage may vary - the powder is likely the most cost effective.
For those who don't know GABA is an amino acid that acts as a neurotransmitter.
Of course always check with your pharmacist for drug interactions .
That's another think they tend not to tell you re medications - is how hard some of the medications are on our organs (kidney/liver), or that they make your mouth dry giving you dental issues.
I think GABA is pretty safe, however your pharmacist is your expert about such things.
You're doing well. A third of the population don't metabolise diazapam that well. SSRIs are usually substituted for diazapam, but some people can become over-emotional according to a possible study. When I was prescribed an SSRI, I became wound up and was then prescribed diazapam.
Hi Adam .. welcome to the group , I’m sure you will get some good info from here . I’ve never heard of Gama and must admit it all sounds very interesting as im emotionally not the same person as I was .. I think the emotional dead bit is improving slowly ..
I didn’t drink for over a year as I was always sick if I’d had a drink but have improved and can now enjoy a glass or two .. definitely more relaxed but I would say that was the same as pre TBI ..
not sure I have anything else to say except this group had been the only place I’ve had to actually understand the new me ..
good luck on your journey and yes I also have SSRI antidepressants which are reduced right down as there was a thought that the emotional dead bit was from them but over several months of reducing them the o ly thug that changed was my anxiety went up including racing heart . Back on low does feel emotional more level and the deadness is improving very slowly
I would think long and hard before taking an SSRI. Though a decade of more before my brain injury, the doctor thought it would be a good idea to treat my anxiety disorder with citalopram. Counselling wasn't available and the drug was cheap and effective. It made me think about suicide. Alcohol is an absolute no no if you take it as it amplifies the drug effects. My brain felt on fire! I think it should be banned for the suicide risk it presents.
I think all SSRIs and SNRIs carry that risk in the early stages Skulls, I was fine on duloxetine though - whereas some of the migraine meds I was put on originally ( by the non TBI specialist neurologist for the 24/7 headache) actually did make me suicidal - which stopped when I stopped taking them - just being on pizitofen was particularly bad for me, I only lasted a week on that!
As a population we are apparently more prone to recurrent depression, so antidepressants are among the available options. But it is important to get to discuss all the pros and cons in advance, and weigh everything up ( I was willing to try anything to get back to work though at the time.) Neuropsychiatrists are the specialists in the effects of drugs on the brain. In my case it was clear in hindsight that the non TBI specialist neurologist was going straight to full strength drugs for me, whereas the 'start low and go slow' maxim is really important where brain injury is concerned.
Hi Adam, lovely to hear from you on here. I am so pleased to hear that you have decided to reach out. Interestingly, I have done a lot of research about alcohol after a SAH, and from what I have been able to find, we should actually stay away from it, it’s different for people with a different type of brain injury. For example, drinking red wine after the removal of a rumour for a cancer patient may help their recovery and healing.
I am surprised also that you have already gone back to work - to a job which sounds cognitively demanding. Saying that it is probably good ‘exercise’ for your brain.
I have tried several medications to help me relax and sleep so I can function the next day. The winner got me is Amitriptyline. It puts me to sleep, helps reset my brain and I sleep without any headache…although as soon as I open my eyes, the headache creeps back.
I used to be on 75mg but now only take 25mg and this is 5 years post SAH. I am sure your consultant can arrange a trial for different medications and my only advice would be, medication may be better for all alcohol. I hope this helps somewhat.
Thank you for the info and your experience.I've been very lucky, I was back at work in 3 months and working relatively normally - as long as people leave me alone to get the work done as I see fit..!
I have a holiday coming up so don't want any medication changes before then, but will get my GP appointment asap after that.
I signed up to the Calm App / website It’s less than a £1 a week and I love it …
I especially like the Sleep Stories …Famous People and all sorts of other Relaxing voiced people Tell stories …random subjects …not relaxation tapes but interesting stories
Every night I get all cosy and comfy in bed and choose a story most last about 30 -40 minutes and I am always asleep before the end…and the iPad switches off at the end
There’s loads of other stuff like Music White noise Waterfalls Whale sounds
And obviously relaxation sessions etc etc
I got myself convinced that a drink before bed would help me sleep ..a drink or two or three when all it did was get me up several times to go to the bathroom…
Most effective thing I do before bed is to eat some carbs …a small bowl of cereal..a banana or a couple of crackers
Hi all. Just thought I'd provide an update on case it helps someone else.Took a while to see a GP, of course, and then get on a proper prescription but I'm now on minimum dose of Amitriptyline and it's working amazingly well for me.
Given I wasn't depressed, antidepressants clearly have a lot more uses that I can't begin to comprehend!
I take it in the evening and to start with was drowsy, but that's mostly gone now.
Even before I've taken it, the urge/need to drink has vanished.
I'm down from the 30+ units per week and am more than happy to have a single glass of wine with my wife a couple of nights a week with no 'sneaky' extra units from the cupboard.
Your collective wisdom has probably extended my life and I am very grateful!
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