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-   -   startle response (https://www.neurotalk.org/traumatic-brain-injury-and-post-concussion-syndrome/246948-startle-response.html)

injuredbutrecoverin 05-07-2017 06:33 PM

startle response
 
i have been having an issue lately where things that startle me will cause symptoms. for example walking down the street, something sudden and unexpected happens causing me to stop abruptly and this will cause symptoms. any thoughts on what's going on or what can be done to help ease this? it's a real problem as it causes pretty severe disruptions in my life.

Mark in Idaho 05-07-2017 09:21 PM

There are two issues to deal with.

First, Treating the anxiety that causes startle to have such a hair trigger. This may benefit from some profession guidance to desensitize this response. Training such that you are walking down the street and know somebody is going to attempt to startle to and you are using relaxation techniques to be ready for it. Some get startled by touch, especially to the head. Having people in your house walk by and lightly touch you. You first might want to practice sitting with your eyes closed and waiting for people to quietly do it.

There are counselors/therapist who know how to do such exposure therapies.

Second, When you are startled, you need to have your rescue technique to settle your body and mind. The same therapist may be able to help you develop them.

The goal is to prevent a simple surprise from turning into a bodily response.

Having a rescue med available can help, especially in the early stages of developing strategies. Propranolol (a beta blocker that settles blood pressure and similar issues) or clonazepam ( a benzo anti-anxiety med) can work. They only need to take the edge off. Occasional use of either should not be a problem for most. Often, a very small dose is all that is needed.

It can help to address the startle trigger directly and discount it as just a surprise. "Ohhh. You surprised me. Don't do that." It acknowledges the surprise and puts it in context and redirects the issue.

It may take some time but it can be done.

injuredbutrecoverin 05-07-2017 10:13 PM

thanks mark, this is very helpful. would this type of training be done by psychologists?

part of the issue i have (as i'm sure all of us do) is my first thought is: "did i just suffer a concussion?" for me logic goes a long way to settle things down, however, i have actually experienced prolonged concussion symptoms from things that were really mild and shouldn't have caused anything while not experiencing them from things that might have caused something. how do i convince myself that what happened didn't actually cause a concussion? any thoughts on that would be helpful. i realize the sensitization therapy could help as well as the meds. what i'm thinking of is maybe some sort of way to delineate what is a strong vs weak impulse to my brain.. not sure if some rule of thumb can be created here.

Mark in Idaho 05-08-2017 02:02 AM

Many different therapists can help you. You need to find the one with the right experience and skill sets. A neuro rehab hospital may have a referral for you.

From all of the times you have related a contact that manifested as concussion symptoms, it appears to me that none were of a level to cause a concussion. The mind can do strange things. All you need is to start the response to the contact with the wrong thought and your mind will react like it is a concussion. A minor vestibular challenge or emotional surprise can be that trigger. I have posted before that the brain can memorize symptoms and play them back with a simple suggestion.

Maybe you just need to surrender to the idea that hits will happen and that you will move on past them, regardless of severity.

There are many concepts to consider. When the going gets tough, the tough get going. Another version is "If you're going through hell, keep going."

None of these hits will stop you unless you let them. Many of us have had serious injuries and eventually moved on. My first was in 1965. I was hospitalized for 4 days with slurred speech. Bud was much worse.

Sure, we have struggles, some daily, some infrequently. But, we keep moving forward. Some of us have Christian faith that tells us to keep moving forward trusting God to hold the pieces together.

When you first started on NT, you were much stronger. But, as you learned about others struggles, you appear to have taken them on as your own. The power of negative suggestions has burdened you. You need to find a way to break free of those burdensome thoughts. The key thought to overcome is, "Did I just cause damage to my brain ?" You suggest the idea of damage with that thought. Replace it with "Ouch, I need to be more careful with my movements." or something else that does not suggest a negative outcome.

It sounds to me like the startle caused you to jump or jerk. Then, you let your mind throw out the idea, "Did I just cause brain damage with that movement ?" Do you see how bad that simple thought became ?

I wear a hat due to sensitivity to bright light so I hit my head on things frequently. My response it to remind myself that I need to be more careful.

Head hits happen. They always have. They always will. And, it will be a very rare situation where they will cause damage. Even then there is nothing one can do to change the outcome other than to not obsess about it.

So, work on a new response to replace the "Did I just cause brain damage? irrational thought.

davOD 05-08-2017 08:28 AM

I have this very bad......I have a service dog now to help me cross the street.....as most people have "fight or flight" when startled usually by loud noise(not exclusively) I freeze....

I did not catch if your using any hearing protection?...I use noise cancelling ear buds 100% of the time in public and if by traffic the buds are switched on to lower all the outside noises....

Mine has never improved but my over the top reaction has lessened...

I also found out my startle reaction is cumulative.....I get edgier and edgier and takes less and less to make me feel worse...This took me years to figure out!


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