Are you struggling with depression as a result of a traumatic brain injury (TBI)? Do you feel as if you are emotionally drowning, as if your existence is meaningless? Or maybe you don’t have a TBI, but also feel saturated with hopelessness. Depression is as real as a broken bone, a slipped disc, a migraine. It is more than feeling blue. Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. It can impact every day life: work, sleep, relationships.

About fifty percent of those who have sustained a TBI suffer from depression within the first year of injury, and two-thirds are affected within seven years. More than half of all TBI survivors who are depressed also experience significant symptoms of anxiety. In the general population, the rate of depression is much lower, affecting one in ten people.

TBI survivors may suffer from depression as a result of changes in the level of chemicals in the brain, and injury to the area of the brain that regulates emotions. Depression also stems from an emotional response to the struggles of adjusting to life after a TBI. Some people have a family history of depression, placing them at greater risk.

On October 4, I joined Donna O’Donnell Figurski, the host of “Another Fork in the Road,” and Juliet Madsen, a TBI survivor, on the Brain Injury Radio Network for a discussion about TBIs and depression. If you missed the show, here’s your chance to listen to the archived version.

*If you, or someone you know is having suicidal thoughts, here are a few resources.

Suicide prevention

Crisis text line

Vermont Department of Health

If you are suffering from depression, please know: You are not alone.

* The information provided in this post is intended as a suggestion, and not my endorsement of any or all of the resources listed.  Nor am I providing medical or professional advice of any kind.

Since October is Domestic Violence Awareness Month, I thought this would be a perfect time to share with you a societal problem that has been largely ignored. Not only do war veterans, football players, and accident survivors sustain traumatic brain injuries, but women who are victims of domestic violence sustain TBIs too. Here’s the tragic truth: Close to five million women in the United States experience domestic-related assaults every year, and the injuries they suffer are mostly to the head, neck, and face. Men experience approximately three million domestic-related assaults each year. The CDC estimates that nearly one hundred sixty thousand TBI-related deaths, hospitalizations, and emergency room visits in the U.S. every year are a result of physical assaults. But the actual numbers are unknown. Why?

Many victims don’t report the abuse to family, friends, or the police because they worry others will not believe them. And victims are often dependent on their abusers, financial and physically. Also, a TBI can make it difficult to communicate clearly, preventing victims from reporting the abuse. The perpetrator may convince others that the victim shouldn’t be taken seriously because of her TBI-related cognitive problems, and victims may be unwilling to admit that they have a TBI out of fear of the fallout: losing custody of children for instance.

An obvious trauma does not have to occur for a TBI to exist. Women who suffer a blow to the head in a domestic violence incident may not lose consciousness, and, therefore, they may not seek medical attention. Symptoms may not be easily recognized and women are often misdiagnosed with a mental health illness. In an article from the Huffington Post, a woman who was interviewed about her experience subjected to a two-and-a-half year abusive relationship says, “When you are in a relationship with that much trauma and violence, you don’t know what’s physical or what’s emotional or mental.”

In a past study conducted by the American Psychological Association, trained staff surveyed one hundred sixty nine women who visited three different emergency rooms with injuries sustained over a period of seven to nine months. Of the forty-six women who answered all the survey questions, seventy-one assaults were reported. Thirty-five percent of the women were identified as possibly having sustained a mild traumatic brain injury.

Women with traumatic brain injuries caused by domestic violence have below average recoveries and are more likely to develop post-concussive syndrome. Researchers don’t know the reasons for this, but suspect it’s due to the nature of the injury to the head, that female hormones may affect recovery, or that female victims of domestic violence have sustained multiple injuries.

Overall, researchers found that sixty-seven percent of the women who participated in the survey exhibited symptoms of a TBI.

What is being done about this dire reality? Researchers have advocated for further exploration into the nature and consequences of domestic violence and TBIs. They are also proponents of early screening for TBIs, so women have access to treatment, thus preventing further injuries.

The New York State Office for the Prevention of Domestic Violence has made available to those likely to encounter victims of domestic violence a list of statistics, TBI symptoms, and questions to ask when assessing for abuse. Though the document is geared toward professionals, I encourage all of us to read it, to be better aware of the connection between domestic violence and TBIs.

How often do you view social media sites? Two, three, five times a day? Do you have nightmares after viewing clips of school shootings or movie theatre bombings? Do you feel chronically uneasy, irritable, hyper-vigilant after watching unfettered displays of violence?

If this is the case, you might be suffering from post-traumatic stress disorder. Yes, viewing violent news events on social media can cause PTSD. In a recent study conducted by Dr. Ramsden, a researcher at the University of Bradford in the UK, 189 individuals completed questionnaires regarding personality and violent news events such as 9/11 and suicide bombings. They also participated in clinical assessments concerning PTSD and vicarious traumatization, a term typically assigned to those who repeatedly witness trauma such as therapists, rescue workers, crisis clinicians, police officers, and nurses.

Out of the 189 participants, nearly one quarter of them scored high on clinical assessments of PTSD, showing that they were significantly affected by watching violent news events on social media. The more individuals who viewed violent events, the greater they were affected. Extroverts were also found to be at greater risk for developing PTSD.

Now that I’ve added a layer of worry to your day, (sorry), how do we protect ourselves from unrestrained acts of violence? Though, in June of this year, the Supreme Court ruled in favor of protecting free speech on social media and the Internet, we, as viewers, possess a similar freedom of choice, namely the freedom to make choices that protect our emotional well being. We can choose to walk away from our computers, iPhones, iPads, e-readers, and tablets. The challenge I pose to you is this: Can you shift your eyes from the screen, even for a day, and onto something else like a walk in the woods, a fantasy novel, or a crossword puzzle?

I’m over-the-moon excited to announce that my essay, “Reaching for the Keys,” has been published in Saranac Review  It’s about my emotional struggle to take the car keys away from my father, who was diagnosed with Alzheimer’s disease in 2012. I spent a year and a half working on it – typing, deleting, reflecting, pacing, tearing up drafts and starting over, pulling my hair out, waking up in the night to scratch down notes. Why all the fretting? Though any piece of creative work takes time to craft into a piece of salient art, writing this essay challenged me more than most other essays I have written. How so? While I know I made the right choice by taking the keys away from my father, the act of writing the essay brought me uncomfortably close to particular emotions and a long list of complexities that speak to the human condition (at it’s core, what this essay is really about): fear, anger, remorse, guilt, truth, loyalty, mortality, illness, aging, independence. I suppose that’s partly what creative writing should do – push us a little too close to the edge of the metaphorical embankment.

There’s also an ironic element to the piece, but I don’t want to give too much away here (apologies for the teaser). To quench your curiosity, relieve your hunger, I encourage you to read the essay. The Journal is available for purchase at: Saranac Review.

The Saranac Review was born in 2004 out of four writers’ vision to open a space for the celebration of many voices including those from Canada. Attempting to act as a source of connection, the journal publishes the work of emerging and established writers from both countries. As our mission states, “The Saranac Review is committed to dissolving boundaries of all kinds, seeking to publish a diverse array of emerging and established writers from Canada and the United States. The Saranac Review aims to be a textual clearing in which a space is opened for cross-pollination between American and Canadian writers. In that way, we aim to be a textual river reflecting diverse voices, a literal “cluster of stars,” an illumination of the Iroquois roots of our namesake, the word, Saranac. We believe in a vision of shared governance, of connection, and in the power of art.

~ Saranac Review

Vermont College of Fine Arts will be holding its inaugural Hi-Residency conference – a cross-disciplinary alumni reunion – from September 24 through September 27.  The themes is “Art as Advocacy.” As part of a panel titled “The Personal is the Political,” I will discuss how writers advocate for those who are disabled.

Hope you can join me for an intellectually stimulating and fall-fun weekend!