Navigating Brain Injury Challenges Amid the COVID-19 Pandemic: Promoting self-care for clients and healthcare providers

By Kristine Kingsley, PsyD, ABPP-Rp; Founder and Director, Institute of Cognitive and Emotional Wellness

The time when COVID-19 was around brought lots of hard problems for everyone. The virus made a lot of people with disabilities really worried and scared. They were scared of getting sick, losing family, not hearing enough from leaders, not having enough money, or not being able to do things like they used to. Some people who needed help at home had to pick between staying safe or being independent, and that made them really upset.

“I needed to have physical and occupational therapy, but I have been mortified about allowing someone in my home. I cannot control what other patients they’ve treated that week. I cannot control whether they went to a family party and kissed all their relatives.” – Samuel, 50 years old, TBI

“At the initial stages of the pandemic, I was somewhat relieved. It has been a while since I allowed myself to attend events in my community, mainly because I feel shame about my brain injury. When no one was leaving their home, I felt ‘normal’ again. After a while though, the constant fear of contracting the virus and dying because of my frail health left me in a constant state of panic.” Anne, 67 years old, stroke

Likewise, extensive discussions have centered around the psychological toll of the COVID-19 pandemic on various demographics, such as frontline healthcare professionals and other occupational sectors. The pandemic has affected us universally, making it particularly challenging for many healthcare workers, especially those grappling with persistent long COVID symptoms, to sustain their roles while maintaining their well-being to support both their colleagues and individuals with brain injuries.

If you’re feeling these things below a lot, or see them getting worse, it’s good to get help. Here are some things to look out for:

• Trouble sleeping: If you can’t sleep well for a few days or more, it might be helpful to see a sleep specialist, especially if it keeps happening.
• Getting easily mad: If you’re getting angry or upset more than usual, especially with people you care about, it could be a sign of something like depression or anxiety.
• Changes in school or work: If you’re finding it hard to concentrate, feeling less interested in doing things, or avoiding tasks that need effort, it might be worth talking to someone about it. Sometimes, worrying a lot can make it tough to focus.
• Not wanting to do things you usually like: If you’re not enjoying the things, you normally love doing for a while, it might be good to talk to someone.
• Acting in unusual ways: Doing too much of something like watching TV, shopping a lot, or using substances more than usual might be a sign of feeling down. Sometimes, these things happen once in a while, but if it’s happening all the time, it might be helpful to talk to someone.
• Forgetting things or having trouble concentrating: If you’re forgetting important things or having a hard time focusing, it could be a sign to seek some help.

Strategies to Improve Mental Health

Managing emotions amid challenging times for brain injury professionals involves a multi-faceted approach. Here are some strategies to improve your emotional well-being and feel more in control of your life:

• Mindfulness and Relaxation Techniques: Breathing exercises, meditation, or guided imagery.
• Structured Routine: Practice a predictable routine.
• Physical Activity: Stretching, short walks or anything within your abilities.
• Cognitive Strategies: Break projects into smaller tasks; use calendars, checklists, alarms.
• Social Support: Connect with friends and family virtually or in-person.
• Limiting Media Exposure: Negative views increase stress.
• Healthy Lifestyle: Balanced diet, adequate sleep, avoid substances.
• Professional Support: Healthcare staff; therapists, counselors experienced with brain injury.
• Mind-Body Practices: Yoga, Tai-Chi
• Encouragement of self-care: Hobbies or other fulfilling activities

Moreover, discussing various therapy treatments with healthcare providers can offer valuable insights.

Distress Tolerance involves managing intense emotions without exacerbating them, essentially employing techniques to navigate distressing feelings without escalating their impact. This practice is akin to possessing a toolbox brimming with methods to calm oneself, such as redirecting focus, seeking comfort, or engaging in activities that divert attention from overwhelming emotions.

Cognitive Processing Therapy (CPT) tackles difficult circumstances, especially pertaining to emotions after trauma. It involves challenging the accuracy of these thoughts, understanding their influence on emotions, and transitioning negative thoughts to more constructive ones. The therapy emphasizes altering perceptions of events rather than just recollecting them and includes practice exercises to integrate these skills into daily life.

Acceptance and Commitment Therapy (ACT), on the other hand, centers on accepting difficult thoughts and emotions, employing mindfulness to heighten present awareness and control, identifying personal values, and aligning actions accordingly, despite challenges. It also emphasizes distancing from distressing thoughts and practicing self-compassion.

Therapy my offer valuable strategies for healthcare providers to prevent burnout, as it:

1.  Encourages mindful awareness involving the promotion of practices which help healthcare providers stay present in the moment, effectively managing stress, and preventing overwhelming thoughts and emotions.
2.  Assists professionals in identifying core values and aligning their work with these values to foster a sense of purpose and stave off burnout.
3.  Teaches defusion techniques allows clinicians to detach from distressing thoughts, preventing the onset of rumination and emotional exhaustion.
4.  Promotes a commitment to action, setting small, achievable goals that resonate with both personal and professional values.
5.  Emphasizes self-compassion and self-care practices as healthcare providers do often overlook their own well-being.

Lastly, highlighting the importance of seeking social support from colleagues, mentors, or support groups is crucial. Connecting with others not only offers emotional relief but also provides valuable perspectives and insights that can help manage stress and prevent burnout.

Recognizing the strength within those with brain injuries is key. Equipping them with stress management tools and innovative cognitive techniques boosts resilience and well-being. For healthcare providers, practicing self-care is vital; managing stress helps us support patients and families post-injury. Handling emotions during tough times involves accepting them without judgment, using mindfulness to stay grounded, seeking peer support, and reflecting on triggers. Stress-relief methods, setting boundaries, and personal well-being are crucial for emotional balance. Continuous learning enhances coping skills, and seeking professional guidance when needed ensures tailored support. This integrated approach empowers brain injury professionals to manage emotions, providing optimal care.

References

Ceban, Felicia, et al. (2021). Fatigue and Cognitive Impairment in Post-COVID-19 Syndrome: A

Systematic Review and Meta-Analysis. Brain, behavior, and immunity, 101: 93-135

World Health Organization (2021). A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021.

Shanbehzadeh, S., Tavahomi, M., Zanjari, N., Ebrahimi-Takamjani, I., & Amiri-Arimi, S. (2021).

Physical and mental health complications post-COVID-19: scoping review. Journal of psychosomatic research, 147, 110525.

Taquet, Maxime, et al. (2021). 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records. The Lancet Psychiatry 8.5: 416-427.