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Happiness and Wellbeing

Happiness and Wellbeing - Departments & Programs, UW Medical Foundation, Patient Resources, Social Work Services Quick Guide, Social Work Manual, Population Specific, Brain Injury


Challenges and Transformative Possibilities after Mild Brain Injury And Their Effect on Happiness and Well-Being

Ellyn Kroupa, Ph.D. (2010) 

The current popular literature on happiness suggests that everyone, no matter what their circumstances can improve their general level of happiness by changing how they think, living healthier, exercising, simplifying life, savoring pleasures but spacing them out, fully engaging in purposeful activities which use personal traits, skills and abilities, finding meaning by giving of self to others, looking for goodness and beauty, and identifying with something larger than oneself. To be motivated to do these things, it is important to take time each day to be quiet in order to meditate, pray or reflect. 

Although mild brain injury creates many unwanted changes which dramatically affect every aspect of survivors’ lives and that of their family members, improving happiness is an important and realistic goal. Initially, many survivors feel that the only route to well-being and happiness is to return to their pre-injury abilities and responsibilities. It is only after many unsuccessful attempts to regain lost abilities that survivors come to a crossroads. Some continue their valiant attempts to return to “normal” while others begin to change how they think about what is important in life. 

This transformation of consciousness evolves as a result of survivors’ unwanted, post-injury, life circumstances and the suffering it brings, and it is facilitated by the need to simplify their lives, their inability to keep up with society’s fast pace, their bone-deep fatigue, the time they now have to reflect and seek out life’s gifts, their isolation and the quiet it affords them and the humbling experiences that disability brings. As a result, survivors gradually begin to question what they previously valued and assumed about the good life. They experience a transformation of personal goals and expectations, increased awareness of the suffering of others and a new sense-of-self that can be defined as the growth of wisdom. And with this movement toward wisdom, their lives become happier and more meaningful, even though their actual life circumstances may not have changed significantly. 

Such a transformation occurs only if basic needs are being met, and it cannot be forced upon survivors in the hopes that they will enjoy life more. They must be ready to be able to see the limitations of their pre-injury values and world views and the advantages found in a more gentle and enlightened way of being-in-the-world. This is the same transformation that often occurs in advanced old age as the elderly attempt to make sense of their losses and increasing debilitation. Survivors of mild brain injury are nudged to choose this path much earlier in their lives due to the consequences of their brain injuries. 

The following chart summarizes the changes that may occur after mild brain injury, the consequences that negatively affect happiness and well-being and the transformative possibilities that survivors can experience as a result of their suffering. 

Possible Changes Caused by Brain Injury

Negative Consequences Affecting Happiness and Well-Being Based on Pre-Injury Values

Transformative Possibilities That May Improve Happiness and Well-Being

Loss of short term memory

Dependence on lists, dealing with others’ impatience, being constantly reminded of forgetfulness; becoming less dependable

Begin to live more in the present and not dwell in the past or worry about the future; learn to notice and appreciate the gifts of the present moment; create habits

Oversensitivity to environmental stimuli

Desire to stay at home, easily distracted and irritated in stores and restaurants, while driving in traffic and by chatter

Become more aware of pleasurable stimuli and learn to prevent unwanted sensory stimulation by simplifying life so that environment is more pleasing and better meets needs and accommodates limitations

Less able to learn from the past

Frustration, others’ impatience, social life declines, fear of mistakes, vigilance which creates more fatigue

Learn to forgive self and others and see the value of finding the humor in one’s foibles and mistakes

Fatigue and sleep problems

Lack of energy for fun and to do what needs to be done, difficulty planning for the future, less control of emotions

Learn to see the importance of resting throughout the day; setting realistic goals for each day, using down time to sleep, meditate, rest and reflect

Physical pain

Nothing else matters while it is present; less energy and ability to concentrate

Learn about both western and alternative methods to prevent pain and become healthier; use own experience of suffering to become sensitized to the suffering of others and act with compassion and educate others

Inability to plan, set priorities and compete tasks

Desire to begin and accomplish things is slowly eroded, small tasks seem too complicated, loss of a sense of control over life, less able to advocate for self and family, decreased sense of moving forward in life

Increase social interaction and the effectiveness and pleasure found in recreation and tasks by working and playing with others who can remind, transport, share responsibilities and offer feedback and reassurance

Possible Changes Caused by Brain Injury

Negative Consequences Affecting Happiness and Well-Being Based on Pre-Injury Values

Transformative Possibilities That May Improve Happiness and Well-Being

Depression, apathy, anxiety

Long days and sleepless nights, one’s world become smaller, life lacks meaning and joy, TV watching, too tired to exercise or get out in nature, boredom, staying at home everyday

Plan day around exercise, accept emotions as natural; find meaning by giving of self to others; use down times to meditate, rest and reflect; use own experience of suffering to become sensitized to the suffering of others and to act with compassion and educate others; talk with confidants

Distractibility and short attention span

Things never get completed, feeling scattered, less able to feel Flow

Learn to prevent distraction by keeping tasks small, removing clutter and unwanted stimuli, having a place for everything; feeling good about accomplishing small things each day,

Loss of former occupation, income & health insurance

Loss of the “American Dream”, basic needs may not be met, dependency on family and social service systems, waiting lists and many requirements to receive services, lack of purposeful activity and pastimes, boredom, loss of self-esteem, less sense of having value in society

Use free time to become healthier, change assumptions about the past, present and future; understand that material things are overvalued and what is most valuable and meaningful are authentic relationships, growing in awareness and wisdom and using strengths to participate in purposeful activities to help others

Slower cognition and response time

World seems to hurry by, others’ impatience, less willing to interact in the community, isolation

Come to realize that slowing down can increase awareness of the present, allow time for reflection on ways to interpret and respond to life, and savoring of the moment

Possible Changes Caused by Brain Injury

Negative Consequences Affecting Happiness and Well-Being Based on Pre-Injury Values

Transformative Possibilities That May Improve Happiness and Well-Being

More impulsive

Emotions close to the surface, can’t trust ones social abilities and behavior, others not sure what to expect which erodes trust

Learn to understand the mistakes, emotions and trespasses of self and others; gain peace and perspective by being quiet for a part of each day and by engaging in activities which unite mind, body and soul through being in nature, exercising and enjoying the arts

Impaired awareness of self and others

Isolation and loss of social interaction, less able to put self in others’ shoes, more misunderstandings; less able to see the big picture or catch subtleties

Find people who understand and appreciate your good essential self and learn to forgive those people who don’t; realize that our core goodness or essential self never changes; increase awareness by using reflection, prayer or meditation to put things in perspective, better see the big picture and identify with something larger than self

Inability to multi-task

Things take longer to do, less gets done

Learn to find the pleasure of focusing on one thing at a time (Flow)

Unpredictability and inconsistency of above symptoms

Less able and willing to make plans when it is impossible to know how you will feel that day, can’t have a job that expects consistent attendance and performance

Come to realize that no one really has total control over his or her life; take one day at a time knowing that nothing remains the same; acceptance of bad days knowing that there will be better days in the future