Wise Young
05-14-2002, 05:58 PM
Hurley RA and Taber KH (2002). Emotional Disturbances Following Traumatic Brain Injury. Curr Treat Options Neurol. 4 (1): 59-75. Summary: Mood disturbances are common sequelae of traumatic brain injury (TBI), but the scientific database for such disorders is very limited in descriptive, prognostic, and treatment data. Post-TBI symptoms often cross diagnostic boundaries and include cognitive loss, amotivation, psychosis, mood, changes, or other domains. The treating physician must be mindful that clear diagnostic boundaries may not exist. Premorbid level of functioning commonly affects post-TBI level of functioning. When setting treatment goals, this must be considered. Patients who had lower levels of psychosocial functioning before the injury may not fare as well afterwards. Treatment of post-TBI mood symptoms should proceed after a full diagnostic work-up including imaging and electroencephalographic (EEG) studies, neuropsychologic testing, and physical and laboratory examinations. Once the diagnostic picture is established, treatment should then proceed with a multidisciplinary team (physician, social worker, neuropsychologist, and others). For the medications, consider both target symptoms and side effects; start medications with low doses and raise slowly, give full therapeutic trials before switching or adding second agents, avoid benzodiazepines if possible, limit anticholinergic or antidopaminergic agents, and avoid providing large quantities of lethal medications. When starting medications for the treatment of mood disorders following TBI, several general principles of treatment in this population should be considered, including: balancing treatment of target symptoms with the potential for adverse effects; making use of side effects to treat comorbid problems when present (ie, relatively antidepressant for depression and marked insomnia); using a "start low, go slow" approach; continuing dose escalation to full therapeutic levels (ie, completing therapeutic trials) before switching or adding augmenting agents; avoiding agents with predictable and functionally important adverse effects (ie, benzodiazepines, strongly anticholinergic or antidopaminergic agents); and avoiding prescription of large and potentially lethal quantities of medications. *Departments of Psychiatry and Behavioral Sciences and Radiology, The Herbert J. Frensley Center for Imaging Research, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA. taber@bcm.tmc.edu
After the concussion there was a time where mood stuff seemed to be secondary, and primary rest and systems "repair".
Later a bit difficult for me to adapt to was feeling to an extent like a differing person.
I could regard it logically if I wished, doing some systems transcalculations,
like front got zoinked, therefore my limic stuff could do less parallel,
with that I could process even less than before as MBD stuff from other systems,
and with that correlations between us alter,
blabla.
But it did not change a frustration about the loss of previous capacities,
and feeling to an extent like a differing person.
"cognitive loss" If frontal cortex got damaged, for example, that's normal, that then it can't do some stuff as before.
Difficult I found, that I started to sort of meander between topics, could not as clear and compact as before "stack out data",
and I got the complaint, that I start topics, do not finish them, and meander to someting else, to do the same maybe there.
Also I forgot really important stuff, which can be trouble if one should have been some place at a certain time.
Also I took ages to get jokes, if getting them at all, there seemed lower on connective (and maybe also abstract) capacities,
and I lost against people in chess, where before I usually won. (And then stopped playing a long time, because even more bothering I found the capacities differences indication not just for such.)
"amotivation" For a damaged brain too much action can be bad, and rest better for recovery.
"The treating physician must be mindful that clear diagnostic boundaries may not exist."
Hm, if someone got hit on the melon in a certain place, it stands to suspect the damages are extending in from there.
Damaged regions diagnostics might be possible to an extent. With some also effects on other systems to an extent (I made a limited example with front damages).
"Patients" I find that very Westie
and negative.
Of the Lakota a healer has himself called "grandfather" and the attitudes to others seeking aid seems more as to grandchildren.
That I find better.
"who had lower levels of psychosocial functioning"
Sounds like emotional systems and own I are some sorts of robots.
"before the injury may not fare as well afterwards."
Might be less friends are there and care for someone not liked as much.
Also if not in well balances and having unwise attitudes, it might hit harder.
"electroencephalographic (EEG) studies,"
Messing a bit into own energy balances,
is not going to fix a damaged system.
Even if messing in there otherwise, and knowing where it is.
Some stuff just takes its time.
"For the medications" Are brain systems some bacteria attack?
Even me old druggie quit taking stuff I liked before, to not mess additionally chemically into healing systems.
They are enough busy there with that
and other stuff,
without a chemical attack on their natural balances.
"consider both target symptoms"
And next a brain system is a "symptom"?
Or a "target"?
Gee, good not one messed into mine with such attitudes.
I doubt it would ever have healed that well, if someone had started chemical attacks on top.
"and side effects;" Interesting, how possible serious main effects of drug attacks are shoved off as "side" effects.
(In our language such attitudes are found, too.)
"limit anticholinergic" Grand, messing up cholinergic systems. I am sure, that was just what was missing after the concussion.
"or antidopaminergic agents," Or dopamin levels.
Best one forces the receptor molecules balances to wrong settings to make up for the messing up into the transmitter balances,
ignores that aspect entirely,
and forces that on top of damaged systems,
so a whole caleidoscope of problems is added.
"and avoid providing large quantities of lethal medications."
Lol ... The more I read of that, the more glad I am that my brain healed rather naturally back then, without someone messing into my sleep, attacking my chemical balances,
and messing into systems he seems hardly to understand.
"When starting medications for the treatment of mood disorders" So, how do you know they are not orders. Did you ask the basolateral part of the amygdala about that in a unique genetic individual,
or just any order outside how someone without brain damages and being genetically differing is declared a "disorder".
And interesting how chemical attacks into emotion generators or whatever are put there.
((Among the most remarkable among the psycho-branchers I found one, who insisted om something like one can not say certain brain systems are to do with certain "functions".
He did not even seemed to have bothered with neuro books decades old there yet,
apart from probably not even finding the center of his own I on a brain map.
If I look for someone not understanding half, if even a tenth as much about emotional systems, I might turn to psycho-branchers.
Here some say, that after psychiatrists force drugs into unconsenting people, the suicide rates of them afterwards are higher than they would have been without that, and that they basically commit murder in a way.
I do not exclude it, as I read a book where they treated their shit on an anorectic young woman, and when I read what they did, I thought are they utterly mad? She is good as dead now.
... I skipped to the end, from about page 30 or so, because I knew she would not survive that, to read how she died then.
And later read the middle, where also her mother said, that after she had been to psychiatry, she was never again as before (in a negative way).
Of course not. They had just been destroying there what she needed to get out,
in their stupid, brutal attempts to force her to eat.
I knew she was dead, in their brutal ways they had killed her by destroying her ticket out,
but of course society politely looks away, and it is put like it was just her fault,
and not that they murdered her that way.
Another point for psyjunkytry.
... Someone I met in the past seemed to consider to rather kill himself before ever being abused in psychiatry again.
For me they are sense censored, headblind, and maybe the biggest drug shovers of this land.
Differing from the average black market drug dealer by forcing drugs into people and even children.
I could probably get less making drugs sounding harmful from a black market drug dealer than a psycho-brancher.
I once was curious what USies mean with all that Prozac talk there on the net, and tried parts of the contents of a capsula. I thought, that dangerous warper is suited as a drug if I should ever wish to kill someone and suffer from inhibitions.
Later I read, over a thousand death cases on Prozac, killing others or themselves.
Yep. And they still give it to people. One forced that dangerous warper into a child of about 5 years, brain-raping the girl chemically with that shitstuff.
I said before, it would not stop what she tried to stop there with the girl. Of course it did not. The brutality and stupidity of some people might remain beyond my understanding.))
This text here remotely read to me like,
after brain damages, start chemical attacks into your kidneys, with the advice of a headblind psycho-brancher (who might not find half of the systems where he attacks receptor molecule balances on a brain map),
and make sure you mess against systems requirements for special sleep-wake times within the recovery phase.
Having read this, I am really glad no headblind nutter messed into the healing of my systems after the concussion with chemical attacks and trying to dictate me when I am to sleep, maybe even at the costs of my kidneys and receptor molecule balances.