How TBI Affects Decision Making

I’m not going to sit here and pretend that I was ever the most decisive person in the World. After all, it’s a ladies privilege to change her mind! However, after my accident, my ability to

  1. Make ‘easy’ decisions, and
  2. Make ‘the right’ decisions, became much more challenging.

Making Easy Decisions

I’ll start with the ‘easy’ decisions. When I say ‘easy’, that doesn’t mean that they are simple to make. It means that they don’t have a right or wrong answer. They’re not life or death. And they’re not in anyway threatening to your health. These decisions are as simple as ordering off of a menu in a restaurant, arranging where to meet a friend, or picking out a new coat.

Full disclosure; I have NEVER been good at choosing what to have at a restaurant (I love food and I usually want multiple items from a menu), but this became painfully difficult after my accident. There were so many other distractions when eating out – crowds, noise, conversations amongst friends, reading, remembering what the waiter had said were the specials. There is so much going on around me for my brain to process. And on top of that I’m supposed to decide what I want to order?? Are you serious?

I would sit there and look at the menu, not necessarily reading it or processing it, and I literally wouldn’t be able to decide what to order. To the point where I would get worked up, the pain in my head would get worse and I would start getting emotional. It’s really difficult for somebody who hasn’t had a TBI or concussion to understand that this isn’t just me being difficult or indecisive. It is quite simply that I can’t mentally process the information in front of me in order to make a decision. So therefore, I can’t decide what to get.

In the same way as above, I found it difficult to make up my mind as to where to meet someone. This was often made worse by the fact that I was scared of going to new places where my brain would have to work even harder to process the additional information of new surroundings.

The same applied for deciding on any other purchases; which new coat do I want? Which runners should I buy? Will I buy chicken or beef?

Top Tips for Making Easy Decisions

  1. I started looking at menus online before I went to the restaurant. Therefore I had time at home, in a relaxed environment with no distractions, to decide what it was that I was going to order when I went out.
  2. I identified certain restaurants and cafes that were quieter and suited me better in terms of size, noise, and shorter menus and tried to go to them when possible.
  3. I would explain to friends that I couldn’t decide where to go, but if we could please go somewhere I was familiar with and within walking distance that would make things easier for me.
  4. Instead of meeting for lunch, I would suggest meeting for a coffee (decaf tea for me!), as this would eliminate the stress of deciding what to order.
  5. I would make a shopping list at home to ensure I didn’t have to be deciding (and remembering) what I wanted when in the middle of a busy grocery store.
  6. If I saw multiple items that I liked when shopping and couldn’t decide what to get I would take pictures and send them to my friends or my mum to help me decide. (To be fair, this isn’t too uncommon for us ladies at the best of times anyway!).

Making Right Decisions

There are ‘good’ decisions and there are ‘bad’ decisions. But there are also ‘right’ decisions and ‘wrong’ decisions. You’re probably thinking ‘Who are you to say what’s good or bad, right or wrong for ME?’ And you’d be right. Everyone is so different. What’s one person’s good decision, could be somebody else’s bad decision and vice versa.

However, there are some decisions that are just WRONG.

For example: Walking into a busy road or street without looking both ways for traffic. Or taking a hot tray out of the oven without putting oven gloves on. Or pushing yourself physically or mentally to the point of exhaustion.

I’m not saying everyone will make ‘wrong’ decisions, but I certainly made a lot of them in the early days! I’ve lost count of the number of times that I went to cross the road without looking for oncoming traffic! Sometimes I only took one step off of the path, other times I made it halfway across the road before I noticed. Other times I only managed a couple of steps before being beeped off of the road by a car, or screamed at by a cyclist.

I was lucky enough to have never been injured, or to have caused an injury. But that didn’t stop the panic from rising inside of my body, the pain pounding in my head and the dizziness spiralling in front of my eyes each time I did it. “How could I have been so stupid to do that AGAIN?”

When it came to taking hot trays out of the oven I would often forget to use an oven glove or tea towel to protect my hands from the heat. Luckily, I never felt pain when I did it (my brain was pre-occupied with the pain in my head). And I would never hold it for long enough to cause any serious damage or scars. I always realised what I had done after a few seconds and would instinctively go and hold my hand(s) under cold water. At least those instincts were still in place!

Struggling to Make Right Decisions

One of the biggest ‘wrong’ decisions that I continuously made was deciding when to leave work. I was repeatedly told to not push myself, to take it easy, to take a break or go home if I didn’t feel well. Doctors, family, friends and colleagues; they all told me “It’s not worth it”. I knew myself it wasn’t worth it. I knew that if I felt unwell and continued to work that I would experience an ‘episode’.

Yet, there I’d be, sitting at my desk, staring at my computer trying to remember why I had this file open and what I had been doing for the last 20 minutes. The sense of nausea would begin to rise inside of me. A feeling of dizziness would come over me. And I’d sit there, continuing to try to work. Continuing to try to work through the pain. Continuing to make the ‘wrong’ decision.

I needed to leave. I needed to go home. That was the ‘right’ decision. Why couldn’t I see that? Eventually, I would go home. Usually as a result of an Episode, or a colleague telling me I looked awful and to go home. Sometimes, I got there on my own. It would just take me a while to arrive at that decision. Soon, I became better at making this decision. I became more confident that my decision to leave would be the ‘right’ one. But I learned the hard way. And I suffered many set backs as a result.

How I Started Making Right Decisions

In all honesty, I’m not sure how to avoid making these ‘wrong’ decisions. I can tell you to always look both ways when crossing the road, I can tell you to use oven gloves and I can tell you to leave work when you don’t feel well. But I knew all of those things too and I still couldn’t make the ‘right’ decision.

In terms of traffic, when taking routes that I travelled regularly I began crossing the road at the same traffic lights on my route every single time. However, it’s inevitable that you will be walking unfamiliar streets at times, or on streets or roads with no traffic lights, so this won’t always work. However, you will begin to notice improvements in your decision-making as your brain begins to heal.

I noticed that these ‘wrong’ decisions were made most often when I was tired or showing multiple other symptoms of my brain injury. So instead, focus on keeping those other symptoms under control. Ensure you are getting enough rest, avoiding noise where possible, practice your mindfulness, talk about how you are feeling and do whatever else helps you to manage your various symptoms. Eventually, these ‘wrong’ decisions will become fewer and further between. Remember you just need to be patient!