Lost & Found: Caps, Sunglasses, and Earplugs

Barbara J. Webster, Lash & Associates

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  I had a concussion about three months ago and now my food doesn’t taste as good. My sense of smell seems different, too. Are these changes related to my brain injury and, if so, is there anything I can do about it?
   
  Click here to go to About Ask the Expert. Changes in Taste and Smell After Brain Injury

Strategies for Coping with Sensory Hypersensitivity

If it seems like your sense of touch, taste, smell, hearing, or vision is extra sensitive or heightened after your brain injury, it’s not your imagination. Sensory hypersensitivities are another major, yet not as obvious, contributor to fatigue and overload after brain injury. What we experience with our senses is essentially more information for our injured brains to try to process and organize. You can have difficulties processing sensory information just like any other information in your brain. Some examples of sensory hypersensitivities are:

• Sounds that you barely noticed before are alarming and startle you.
• It feels like you have megaphones in your ears.
• Background sounds and stimulating environments become overwhelming.
• Fluorescent and bright lights give you headaches.
• Clothing that was comfortable before feels irritating now.
• Large gatherings of people feel overwhelming.

Pain and fatigue can intensify sensory hypersensitivities, putting you in a hyper-sensitive or hyper-vigilant state. When you are in a hyper-sensitive or hyper-vigilant state, even subtle stimulants feel overwhelming. Especially sights and sounds that didn’t bother you before, may now trigger anxiety and the fight-or-flight response where your whole being feels threatened and out of control. You may shut down and not be able to do any more or you may feel compelled to escape from the situation. It can be very taxing, physically and mentally.

Stress management, movement and using all of your senses can help your brain organize and integrate the senses. This is similar to what children do. Consider how physically active children are as they grow and develop!

See Brain Recharging Breaks at the end of this chapter for some basic meditation techniques. Meanwhile, following are suggestions for coping with sensory hypersensitivities.

General Coping Suggestions

Limit exposure to avoid sensory overload.

• Avoid crowds and chaotic places where there are a lot of stimuli, like shopping malls.
• Do shopping and errands early in the week and early in the day, when stores are less crowded and quieter.
• Shop in smaller, quieter stores when possible.
• Eat out in restaurants when they are quieter, in between regular meal times.
• Hold conversations in a quiet place.
• Ask people to please speak one at a time. Explain that you’d really like to hear what everyone has to say but you can only hear one person at a time.
• Sleep during car trips.
• If you want to attend a function that you expect will be taxing, plan to stay only a short while. Take your cap, sunglasses and earplugs. Sit towards the back to minimize the sound and where you can easily exit to a quieter place or the car.

Monitor your pain, stress and fatigue levels.

Lights and sounds will bother you the most when you are stressed or fatigued. If you are feeling especially sensitive, use it as a cue that you need to take a break and use some relaxation techniques.

Try avoiding nicotine, caffeine and alcohol.

They may make the symptoms worse. If you have vertigo, try limiting your salt intake, which can cause fluid retention. Consider strengthening exercises for your neck with the guidance of a physical therapist.

When you are starting to feel stressed or anxious, try incorporating another sense.

• Put something in your mouth to chew or suck on. Strong flavors like peppermint or cinnamon are especially effective.
• Put on some soothing music.
• Apply some deep pressure. Give yourself a hug or press your palms firmly together or on the table. Squeeze the steering wheel if you are driving the car.

Experiment with activities and alternative therapies that involve your senses.

Listen to music, experiment with movement, dance, yoga, water, art, aromatherapy, etc.

Challenge your sensitivities.

Gradually increase your exposure and tolerance when using earplugs, sunglasses, etc.
Don’t eliminate the senses completely or you set yourself up for super-sensitivity.

Specific Coping Strategies

Sensitivities to sound

• Limit your exposure to noisy stores and loud situations like sporting events, the movie theatre and children’s school activities. Don’t participate or plan to stay for a limited amount of time. Sit on the outskirts so you can gracefully escape to a quieter place if needed.
• Use earplugs, try different kinds, and carry them with you.
• Use headphones for TV and music:
  • For others, when you don’t want to hear it.
  • For yourself, when you want to hear it better.
• Minimize distractions from snacking while doing things like working in groups or playing games. Use bowls for food instead of eating directly from noisy bags.
• Add some background sound – a fan, white noise machine, soothing music.
• Remove yourself from the situation and go to a quieter place as soon as possible, even the bathroom, when you feel overwhelmed or anxious. Then try:
  • Closing your eyes
  • Taking slow deep stomach breaths
  • Putting an ice pack on your forehead and eyes
• Gradually expose yourself to different sounds and louder sounds to increase your tolerances.

Sensitivities to light

• Avoid bright light and fluorescent lights.
• Use sunglasses or a cap with a brim, even indoors.
• Try yellow tinted glasses if florescent lights are a problem.
• Try polarized sunglasses if driving glare is a problem.
• Try yellow tinted glasses if night driving is a problem.
• Make sure you are getting plenty of vitamin A (but not too much!).