"Keep stimulating your brain and you will eventually get better."
 

This is what the new neurologist said to me as I was walking out of the room.

Just before that, I was asking him what I should be doing to improve my recovery. He said rest and minimize stress.

So which one is it? Rest or stimulate?

The only time I feel somewhat "alright" is when I'm doing nothing at all. It seems like everything I do brings on the cognitive problems. Sometimes I could lay in bed all day and still have problems.

So I'm stuck between a rock and a hard place.

I think he's right. It's both things, not just one or the other. It's a balance between the two.

The accident that caused the head injury I acquired was about 18 months ago. I am doing much better now! I still have a while to go... And I recognize that stimulating my brain has helped some of those neural pathways to reconnect. But I also know that overdoing it (becoming overstimulated or overwhelmed cognitively) makes my functioning degrade.

I remember that my Primary Care Physician told me that when I feel like resting that I need to rest (unfortunately, I never really "feel like resting" but I know I need to) and to do stuff when I feel up to it.

Try to be grateful that you can recognize when you need to rest and know that it will get better over time. (I know it's very boring, just hang in there!) :D

I have found this to be true too. It's a fine balance, but gentle stimulation (through walking, reading, writing, conversation, second language, etc) when feeling somewhat better, in very moderate doses (especially at first), interspersed with large doses of rest, seems to help. My brain seems to need both. The challenge is figuring out how not to overdo it so that you stay "sub-threshold" of symptoms as much as possible. As others have said, it's a marathon, not a sprint - take it real slow.

Thanks for your responses.

I figured alternating between the two is what he meant. I do know you need to stimulate your brain occasionally so that the brain and create new pathways and what-not.

I'm still trying to figure out what "over-doing it" means for me. I noticed that some stimulation is great and I noticed after whatever I did I felt a little better.

Like I said just need to find out what my limits are. That can sometimes be hard since the brain can delay your symptoms...so if they show up the next day its hard to figure out what you did the day before that caused it.

I personally think it's difficult to figure out a balance between the two since my own limits are always changing and improving for the most part. I find I am happiest (function the best) when I err on the side of caution.

It sounds like he is mixing up the research in 'brain training' and recovery from PCS. None of the brain training research has yet demonstrated that brain training aids in recovery from PCS. But, vegging out will not cause recovery. You need to maintain a minimal level of stimulation. By this, I mean stimulating one sense at a time with a single stimulation. Multi-sensory stimulation may be too much for a recovering brain.

It is not difficult to determine what level of stimulation does not cause an increase in symptoms. We all have our own limits.

Well, it's really like physical exercise. It's not a question of either/or, it's doing both. You would not exercise all the time, nor would you rest all the time. They are the separate components of a complete cycle. You exercise, then rest, exercise, rest.

Exercise is the physical stimulation that drives the body to higher levels of performance. But you still very much need rest for the rebuild part. Catabolism + anabolism = the complete metabolic cycle.

There is a big difference between the exercise to condition muscles and the exercise to maintain an injured brain. Muscle exercise is designed to tear down the tissues so that they rebuild stronger. One does not want to tear down brain tissue as in over-stimulating it.

Mental exercise needs to be stopped before the subject reaches brain fatigue. Slowly, the mental exercise can be increased in duration. If mental fatigue is reached, the person should back off for an extended period.

Rebuilding brain 'endurance' can take a long time. The slow progression of building up the length of time can seem tedious. But, overdoing it can cause a relapse that takes even longer.

I see what you're saying, and did not mean to push the catabolism angle so far. My basic tenet was only a rough analogy with somatic regrowth, a cycle alternating between stimulation and rest. This is just an answer to the OP's question which seemed to infer an either/or situation.

It is a fine line, of course, between just a little over and too much, but then there's the art. You can push yourself too hard physically, too. You only do more if you push yourself to do more, and that applies mentally as well as physically.

I disagree with the statement <You only do more if you push yourself to do more, and that applies mentally as well as physically.>

This is true physically but not mentally in an injury situation. Stimulating the brain to a level that does not cause a return of symptoms IS therapeutic. You do not need to push the injured brain to help it improve. The uninjured brain can be pushed but not the injured brain. The uninjured brain has access to a wide bandwidth of processing. Not so with the injured brain, especially the diffuse axonal injured brain.

The important difference that needs to be understood with brain training is simple. The uninjured brain has a great capacity to establish new functional abilities. These can be a wider visual processing ability, better auditory processing, better memory and recall skills. The basic neuronal structure is sound and available to be developed to a higher level of function. Much of this improvement is just from overcoming a trained in laziness.

The injured brain has has a form of laziness that was caused by the injury. The bandwidth for processing has been decreased by the injury. Instead of an 8 lane highway, there may be just 4 lanes available but none of them with an adjacent functioning lane. So, each lane can be used to the limits of that lane. There is a very limited ability to change lanes while in motion.

The uninjured brain can easily change lanes while at a high speed. This is improperly called 'multi-tasking.' In reality, it is the brain switching processes quickly and maintaining a memory bank of data from each task.

The injured brain may be able to switch lanes but it often struggles to memorize and recollect the data needed when it switches back to the original lane of thought. So, in essence, there is no ability to multi-task. Any attempts to multi-task is seen by the brain as over-stimulation with the resulting crash and bio-chemical toxins from that crash being built up.

The simple act of stimulating an individual lane causes blood flow to the brain to increase. This increase of blood flow helps cleanse the brain of toxins and nourish the neighboring brain cells. As one uses a single lane over and over, that lane becomes cleaner with the near-by lanes getting some clean-up.

Then, when one stimulates another lane of thought, the same clean-up and nourish process happens. Rinse and repeat as often as possible and slowly the brain has cleared itself of toxins and nourished itself to accommodate a spontaneous improvement of LOST functions.

Keep in mind that the goal is to restore LOST functions. Those lost functions were injured due to cellular/tissue straining and chemical dysfunction.

The brain does not have physical regrowth. It has natural growth but not beyond the early development years that end by adulthood. There is research still trying to find a way to stimulate growth or regrowth. Even with such regrowth, the training of new neuronal cells takes a long time. The connection of axons and dendrites is a slow and haphazard process.

Muscle regrowth is simple. A muscle cell only has one binary function, contract and relax. There are only 3 kinds of muscle cells. There are 5000 kinds of neurons with a network of 100 to 10,000 axons and dendrites per neuron connecting each one to the others. It is this rebuilding of the axon network that takes sooooo long and that is if the neuron survives the concussion.