Thought spirals after brain injury are common. Learn why they happen and 3 simple tools to calm your mind and think clearly.
I feel overwhelmed.
My thoughts keep spiraling.
I can’t think straight.
These thought spirals after brain injury are more common than you might think — and there’s a real reason they happen.
Certainly, we all experience these things at one time or another. For individuals who are living with brain injury, it can be a daily struggle. And not just for the reasons you may expect.
After brain injury, you would likely expect someone to experience some anxiety, some difficulty focusing, some fuzzy thinking, simply due to the circumstances surrounding the injury itself. But it goes beyond that.
During brain injury, changes in the brain’s communication pathways occur that can impact the mechanisms we depend on to regulate attention, emotional response, and self-monitoring.
How Do Thought Spirals After Brain Injury Happen?
CEO On Lunch Break
The prefrontal cortex, located behind the forehead area, acts somewhat as our CEO —an executive administrator that helps make wise decisions about its company (in this case…US). Is this a good idea or a bad idea? Should I buy this piece of property in Greenland (an actual example from a brain injury survivor I spoke with) or not? It can also be likened to a gate that keeps the cattle in the pasture.
If damage occurs to the prefrontal cortex (the area of the brain behind the forehead), and most brain injuries do involve some impact to this area, it’s like the gate is broken. The cows (in this case, our thoughts) are free to roam about unfettered. Without our CEO (or gate if you prefer), we can experience an inability to reign in that intrusive thought that is not serving us well. Instead, it spirals and picks up momentum the longer we entertain it.
The Smoke Alarm is Stuck
If you’ve ever tried to disconnect an ear-piercing smoke alarm doing its job despite no smoke or fire in sight, you have witnessed what can happen in the brain’s limbic system after brain injury. The limbic system of the brain processes emotions and threat detection. After brain injury, it can kick into overdrive, notifying its owner of emergencies that do not exist. Even minor stresses or brain fatigue can register as real immediate threats and fuel those thought loops that seem impossible to disconnect. Couple this with the prefrontal cortex on lunch break and you’re left dealing with those thought loops that seem impossible to disconnect. This is experienced as increased worry, racing thoughts, irritability, and trouble with thought regulation.
Low Battery
I wish I had a dime for every time I’ve heard someone living with brain injury say, “I feel so tired all the time and I don’t understand why.” And I wish those people would have been told early on, “It’s not you…it is cognitive fatigue and it is REAL.”
Much like a phone lacks the battery power to run continuously without recharging, the brain also has limited capacity and needs recharging. After injury, the brain has to work much harder to manage everyday tasks. With the prefrontal cortex not sufficiently pumping the brakes on thought loops and the limbic system sending out constant alerts, it’s no wonder cognitive fatigue is one of the most common experiences after brain injury. We all need brain breaks…sleep is at the top of the brain breaks list! After injury, the brain has fewer resources available to regulate emotions and filter out stressors. So even normal everyday challenges can feel overwhelming, increase anxiety, and make it harder to stop that spiral of unwanted thoughts.
Tools in the Toolbox
I often say, “There is no magic potion.” This applies to any problem or challenge we face. However, just because there’s no 3-step foolproof formula for solving the spiraling-thoughts problem, there are tools we can use. Tools that have been tried and tested in real life. They may not work for everyone every time. But you never know which tools fit best in your tool belt until you give them a try.
Dump them out – One tool to help take some of the load off the prefrontal cortex (aka CEO or cattle gate) is called externalizing. This is a practice that allows you to acknowledge the thoughts, give them a space to live outside your head. Often the simple act of writing down your thoughts can disrupt the thought spiral. Writing feels too much like a chore? Record your thoughts as a Voice Memo on your phone. Maybe you have a friend or a professional counselor you process things with? Another great option for externalizing those thought loops that are not serving you.
Just breathe – Breathing is the simplest and most accessible thought relief practice available to us. And it is the quickest way to disconnect that clanging alarm which, in turn, supports the brain’s ability to filter out unhelpful thoughts and even disrupt a spiraling thought loop. How often do you catch yourself holding your breath? A telltale sign of this is shoulders that are tense and lifted toward your ears. We know from studies that when our exhale is longer than our inhale, it calms the nervous system, thereby supporting calmer thoughts. Try it right now. Take a breath, letting your belly rise, and count to three. Hold for three counts. Then slowly exhale to a count of 5. Feel free to adjust the numbers to fit your own breath capacity. Just make sure your exhale is longer than your inhale.
Brain breaks – The best approach to addressing cognitive fatigue is prevention. Plan on regular breaks during the day when you step away from work or screens or anything that requires focused attention. Take a walk. Listen to calming music. Pick up a brush and some watercolors with no particular goal except noticing the colors on the paper. Maybe there are unavoidable chunks of time when you must be “on” for work or parenting or some other endeavor. Write in some pre-rest and some post-rest — avoid burning the candle at both ends as much as possible.
The next time you feel overwhelmed, thoughts spiraling, unable to think straight, remember — this is not a character flaw. Your CEO may be taking a lunch break. Your smoke alarm may be stuck. And your battery might be running low. These are all very real experiences following brain injury.
Give yourself space and grace. And reach into your toolbox to calm your thought spirals after a brain injury. You never know which tool might just hit the nail on the head on any given day.