If I Look So Good, Why Do I Feel So Bad?

Jeffrey Kreutzer, PhD, Department of Physical Medicine and Rehabilitation Virginia Commonwealth University
If I Look So Good, Why Do I Feel So Bad?

Brain injury typically changes the way survivors think and the way they react to other people. Survivors sometimes feel really bad when another person gives them a compliment or tries to say something nice. How so?

Imagine yourself at church, at the mall, walking your dog in the street, or at a party — and a neighbor or friend says to you:

  • "You look great. When are you going back to work?" or
  • "You look so good. When are you moving out of your parents' house to live on your own?"

People who comment on how good you look are mostly trying to be nice. If others are trying to be nice, why do so many survivors feel so badwhen they hear these phrases?

Many problems left over from brain injury cannot be seen by others. Sometimes even professionals have a difficult time understanding or seeing the problems you have. Common hard-to-see problems after brain injury include:

  • Trouble following conversation
  • Headaches and other kinds of pain
  • Trouble thinking of the right word
  • Getting tired easily
  • Difficulty remembering people’s names and what has been said

Most likely, the reason you are not working or going to school, or living with your parents is because you have serious problems left over from your injury, problems that are hard to see or explain.

Others may ask about when your life will go back to normal. Their questions may be a painful reminder that your life is now different and difficult, and may never be the same. Most people have little understanding of brain injury. Sadly, their comments may leave you feeling misunderstood and alone. Others may also be confused about your injury because you are pretending that everything is OK and saying that you are perfectly fine.

You can explain to people in detail what your problems are. Most survivors prefer not to give a complete description of their injury and left over problems in public. Others don’t seem to care and won’t give you the time to listen.

What can you do if you are in public and someone says, "You look great, when are you going back to work (or school)?" Let’s consider multiple-choice options. You can tell them:

  1. "It’s none of your business when I’m going back."
  2. "Thank you for lying to me."
  3. "You don’t know it, but my life is a horrible mess and I have no idea when I’m going back."
  4. "Thank you. I’m doing okay."

If you wish to avoid an argument or making a bad impression, choice "#4" would seem like the best choice. When someone in public tells you that you look good, we suggest that you simply thank them for trying to be kind. You will feel better if you save detailed explanations of how you feel for private discussions with family members and friends, the people who you trust and care about you.

Posted on BrainLine October 27, 2011.

This article is adapted from the 2nd edition of “Getting Better After Brain Injury: A Guide for Survivors,” by Jeffrey Kreutzer, PhD,
a publication of the National Resource Center for Traumatic Brain Injury. Used with permission. For more information about the National Resource Center, please
go to www.nrc.pmr.vcu.edu or email jhmarwit@vcu.edu.

Comments (13)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

Multiple brain surgeries. Will never be normal. I look above average but struggle greatly daily. Isolating is much easier. The world sucks.

I just usually say thanks I'm trying or I'm getting there, I have to. and I try not to be rude in anyway and somehow find a way to change the topic

The hard part is that it doesn\'t improve, no matter how it looks. We are developing strategies every to deal with who we are now. Rather than say I\'m doing fine, I usually say, \"I\'m managing all right,\" or \"I\'m getting by,\" and quickly add, \"How are you?\" I read somewhere (don\'t know where anymore) that \"Brain injury shares some clear characteristics with otheer disabilities, but it requires its own, unique treatments and interventions.\" I keep it on a card, to look at to remind myself. I\'m usually o.k. in the afternoons. But unlike my pre-brain injury life, I cannot get myself underway for hours every morning.
You could say, "That's a good question. Wish I had a good answer." Then ask, "So how's work going for you?" Or change the subject completely. As another reader commented, people LOVE to talk about themselves -- and don't truly care how you are doing anyway or they would know not to ask such an ignorant question.
THANK YOU SO MUCH FOR THIS ARTICLE!! Knowing me, I probably would say 'thanks' and leave it at that. But, this morning, the thought came to me I am not what I was 22 years ago and never will be again, but I am what I am now, so be who that is...All these years, I've been comparing myself to what I used to be like and feeling sometimes low as a result. (By the way, for me, it was a brain aneurysm)
Thanks. You're looking great too. I don't know if or when I'll be able to go back to work. The physical and cognitive challenges of living with a Traumatic Brain Injury are really hard and often invisible to others. Please tell friends I said hi, and I would love to see them for short visits.
I always tell myself to suck it up. I have failed, post-brain A.V.M. resection, and I have succeeded, post-brain A.V.M. resection. The logical thing to do, following a failure, is the "scientific thing": go back to the drawing board and trouble-shot the method(s) that were used, determine where one went wrong, make amendments to the procedures that were used and try again. Always keep a record of what method(s) were used. In the short-term, one ought repeat bad procedures and, in the long term, if one has experienced success, yet can't remember how he or she got there, life can be arduous, slightly annoying and tedious. "I know I used to be able to do this, without a hitch; I can't figure out why, what used to come to me, second nature, is so amazingly difficult, now."
I suffer from tbi after falling 12.26.12 I got knocked backwards at a roller rink in front of my grandson, I had bleeding on the top of my brain so much so they told my family I wasnt going to survive, but through my will power I did. I have bad headaches and memory loss im only 49 years old I was in perfect health prior to my accident. I refuse to let this depress me. I loss the use of my left side but have since regained the use my left hand is still numb, and I have trouble with my hips, my thought process is strange, I studder now if I have to really think about something, I get upset easy and cry, I dont have patience like I use to. I cant concentrate on things like I use to.. I guess thats gonna be the way of life?
Over the years we've had many get togethers at our house. Often I introduce myself to people and they are like - I know, I have partied at your house. Ya, I don't really pay attention is usually my response. I've had people compliment my appearance and ask how I'm doing. Thank you. If I was a dog I would shoot me, is my response when it's applicable. Makes the other person reconsider their approach.
another strategy is to put the topic of comversation back to the other person. So add to #5....."Thanks. I'm doing ok. How are you?". Most people are happy to talk about themselves. People other than close friends and family don't REALLY want details of how you are doing. And it really feels like they are judging.
Hang in there .Don't let depression rule your life. Instead,let Christ work a miracle in your life.Amen
I suffer from a tbi that I obtained in a serious fall off a mountain in Colorado.I have been diagnosed with ptsd, Clinical depression, and I still suffer with anxiety and anger. I still feel out of place when I am around large groups of people so I avoid them whenever I can. What I hate is when people criticise me for things that are completely out of my control-I'm just doing the best I can.
you for got option 5 "who are you" which is how I felt when people I should have known came up to me in a public place and I couldn't remember who they where.