Lost & Found: Dealing with Sensory Overload After Brain Injury

Barbara J. Webster, Lash & Associates
Lost & Found: Caps, Sunglasses, and Earplugs

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!).
  • Eat orange colored fruits and vegetables like carrots, sweet potatoes, squash, and cantaloupe.
  • Take a moment to just close your eyes for a few minutes when you are starting to feel stressed or anxious. This blocks out the visual stimuli.

Sensitivities to touch, taste, and smell

  • Experiment! Cultivate an awareness of how things feel, taste and smell.
  • Rub different textures on your arms, increasing the intensity to gradually decrease sensitivities.
  • Add texture, contrasting temperatures and flavors to your food, like ice cream with crunchy nuts or chips with spicy taco sauce.
  • Notice the textures.
  • Pay attention to smells.
  • How do different aromas make you feel?

If your sense of smell is altered, make sure to have functioning smoke and gas detectors in your home.

Doing cognitive work

  • Plan to do cognitive work when your environment is quiet. Eliminate as many distractions and interruptions as possible.
  • Screen out distractions by using earplugs or headphones, playing soothing music, or using a fan or white noise machine if you have sensitivities to sound.
  • Turn down the volume on the phone and let the machine get it.
  • Work in an uncluttered space or use a three sided table screen, to help screen out visual distractions.
  • Give children headphones for the TV if you are having trouble screening it out.
  • Do your “thinking” work while children are in school or asleep.
  • Still having trouble concentrating? Try bringing in another sense.
    • Put on some soothing nature or instrumental music, something without words at a low volume.
    • Try chewing or sucking on something while you are working. Coffee stirrers can substitute for fingernails. Strong flavored or fizzy candies and gum can aid alertness.
    • Try using some deep pressure by giving yourself a hug, pressing your palms strongly against each other or on the table.
    • Try sitting on a large therapy ball while you work. A great strategy if you have trouble sitting still!
  • Take a physical break, every 15 min. at first. Resist the urge to push through. I know it feels counter-intuitive but taking breaks will actually help you work longer! Gradually you will find you can increase the time between breaks.
    • Use a timer - without a ticking sound!
    • Pause and stretch, drink some water or make a cup of tea, walk around the house or the yard, rock in a chair, walk the dog, pat the cat.

Visual Processing Problems

Vision is an extremely important and complex source of sensory information. What you see with your eyes travels through your brain to the back area of your brain, where it is processed in the occipital lobe. There is a lot of territory between the eyes and the back of the brain where an injury can occur. The occipital lobe may be damaged directly from impact to the back of the head or it may be damaged indirectly from the ricochet of the brain inside the skull when the front of the brain is impacted. Damage to the occipital lobe frequently occurs in car accidents, falls and sports injuries. Even subtle visual problems following a brain injury can have a significant impact on cognition and functioning.

I wish I had known about visual problems and visual therapy when I had my car accident. I thought I was really going crazy! Fortunately for me, my issues improved with time but not without mishaps, like falling off a curb!

Some common problems after a brain injury related to vision include:

  • Double vision
  • Trouble tracking words on a page
  • Impaired depth perception
  • Hypersensitivities to light
  • Difficulties remembering and recalling information that is seen
  • Difficulties “filling in the gaps” or completing a picture based on seeing only some of the parts
  • Trouble seeing objects to the side
  • Low tolerances to changing light or clutter
  • Impaired balance, bumping into objects
  • Feeling overwhelmed when there is a lot of visual stimuli

If you notice problems in areas related to visual processing, please consult a visual therapist or a neuroopthalmologist, they can help!

Tips:

  • Don’t eliminate any sense completely or you set yourself up for a super-sensitivity.
  • Gradually expose yourself to more light, sound, touch, smell, and taste.
  • Be patient, in many cases your sensory hypersensitivities will decrease in time!
  • Ask for physical therapy or occupational therapy with a therapist with a background in sensory integration for help with sensory sensitivities.

Some good news about sensory hypersensitivity is that it is also associated with a heightened sense of awareness and intuition. You may find that you feel more aware of your intuition and more creative since your brain injury. This is not uncommon. Enjoy!

Brain Recharging Breaks

If I had to choose one strategy that helped me the most after my brain injury, it would be learning to meditate. Meditation is especially helpful when you are experiencing sensory overload. It can help you calm yourself down from that hyper-sensitive state. It was also the only way I have found to give my brain a rest, to put it temporarily in a “cast”, like you would a broken limb. Often, after meditating for 15-20 minutes, the “logjam” in my brain clears up and I am somehow able to think again!

I recommend using some stress management or meditation techniques at least once a day. Plan it, schedule it in your planner, make it part of your daily routine. Meditation is not as mysterious as you might think. Try these basic steps:

  • Get in a comfortable position on the bed, in a recliner or even in the car; uncross your arms and legs. Cover yourself with a blanket if you are cool.
  • Close your eyes and do some slow deep breathing.
  • Slowly inhale, expanding your stomach and counting to 7.
  • Exhale gradually, contracting your stomach towards your spine, counting to 7.

Repeat. Repeat. Repeat.

When you are feeling more relaxed, as you continue your slow deep breathing, experiment with the following suggestions to increase the effectiveness of the experience.

Do a body scan checking for areas of pain or stress.

  • Eyes closed, inhale deeply, picture your forehead and notice any stress or pain.
  • Exhale and imagine the pain floating away with your exhale.
  • Inhale, picture your eyebrows and notice any stress or pain. Exhale and release it, imagining the stress floating away.
  • Repeat for your eyes, ears, jaw, throat, back of neck, shoulders … down to your toes. Breathe in relaxation, breathe out stress and pain.

Notice how you feel after you get to your toes!

  • Visualize or imagine yourself in a warm, secure, relaxing, happy, peaceful place; floating on a cloud, floating in the water, or recalling a happy memory.
    • Continue slow deep breathing.
  • Focus on a picture or artwork that you like, noticing each detail.
    • Continue slow deep breathing.
  • Listen to music, any music that is soothing to you. Nature sounds or instrumental music is a good place to start experimenting.
    • Continue slow deep breathing.
  • Use aromatherapy – any scent that smells good to you. Favorite scents are often from childhood memories!
    • Continue slow deep breathing. 

Strive to let go of that never-ending tape of worries and “shoulds” that plays in your head. Focus on your senses – your breath, the music, a relaxing place, a comforting aroma. If thoughts drift in, gently push them away. It gets easier with practice, you’ll find what works best for you and you’ll be amazed at how much it helps you!

Posted on BrainLine July 28, 2011.

Excerpted from Lost & Found: A Survivor's Guide for Reconstructing Life After a Brain Injury by Barbara J. Webster. © 20ll by Lash & Associates Publishing/Training Inc. Used with permission. Click here for more information about the book.

Comments (37)

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.

I'm sure 95% of the people here deal with this on top of dealing with the people who say we are liars, exaggerating and are weak/fragile; My success is because of you! Now let me go use my extreme sense of intuition to plan (yes plan) my next amazing journey! Plotting my revenge was an aspect of my recovery but then I saw what the world really looked like after months and months of HARD A$$ WORK (which included looking at a pencil and a string. Yes. They changed my life. Thank you pencil and string. ) and thought everything was worth it. They will never see the beauty I see and like we all know explaining it does no justice.
Be well and become the person you dreamed of during recovery!

Had nerve injury sense then ,do seem to lost sense of, how to sat on the floor, when I am on the floor I cant stand , need a door or anything sold.,

Thank you! This is the best I’ve read to date!! I’ve been trying to work out what’s going on, sensory overload!!! It was so nice to read here that it does settle down. This is the most relatable article for me. Time to meditate!!!

I still have to function at work, and it's getting harder.

I had a concussion 15 years ago . It seemed to leave me with the condition of multiple chemical sensitivities ..at least that is what I had been diagnosed with . I am super sensitive to smells , all clothes or materials make my skin pain even when I am asleep . ..I also have all over body pain . Could I possibly have this sensory overload .?

I had a tbi 4 years ago, It has taken this long to see a lot of the symptoms.But I recommend the book The Ghost In My Brain, Clark Elliott it has shown myself how I have been using work arounds without knowing such as asking a person in a store to help me find something because I forgot my glasses when that’s not the case.
People try to give you coping skills but they are not helpful when you’re frozen or as I call it glitching, the book really gets the message across for families trying to help tbi patients. My family now realizes I can’t help being stuck sometimes.

Same here but its getting hard to survive

Ive had the same problem so I had to make my world and surroundings very small

Hello. I am not sure how often this forum is checked but I figured I’d give it a shot. I am a case manager for a Brian injury program in Massachusetts. I found this article very informative and plan to use it in our weekly discussion group. I would love to hear feedback from others about what they find helpful when receiving support or what they wish they had more support with.

Tbi 1994 getting vertigo ,seizures ,memory loss.But my surgeon said this would happen,saved my life and im grateful! Im 52 now and he was write.

I am on the 6th day of 12 day light sensory therapy.
I am seeing ball shapes instead of flat circle, these ball shapes start out one color but then can change color, or become 2 balls rotating like planets. I'm looking for someone else that has experienced these same type of effects.

I received a concussion I s rear end accident. This was my 3rd concussion. I have been I physical and speech therapy for 3.5 months and making little to no progress. Today my PT told me that she just realized that she thinks I'm not improving because they have approached my therapy wrong. Granted, three isn't a ton of information on treatingmy specific symptoms so they are really trying hard to get me better. Instead of the constant failed attempts at habitation that they have been trying, she thinks we need to combine that with sensory intigration. So, we started from scratch today. What we have learned so far is that the more contact I have with another object, like sitting in a chair, laying down, or even holding onto something as I walk, the fewer symptoms I have. So today, instead of making me walk through the gym at the physical therapy place unassisted, she let me hold her arm and close my eyes as she let me to the back room. I then laid on the table (my entire back side was in contact with the table), and when I had no symptoms, with the lights off, she had me do a visually complex task. When I got symptoms, I stopped and waited for them to resolve before we started the task again. Each time, I was able to engage in the task a little longer. This was the first time in 3.5 months I had been able to accomplish this. She attributed it to the fact that I had so much off my body in contact with the table I was laying on. I think she is on to something and am anxious to see if this works to help improve my symptoms as we slowly go from full contact during visually complex tasks to less and less contact. Hopefully this comment can help others in their recovery.

The similarities between brain injury and autism are striking.

Perhaps the recent literature showing the link between autism and blocked CSF flow are correct.

Thank you! I acquired a pharmacological brain injury last year from anti-depressant withdrawal. A lot of my issues are visual and cognitive e.g tracking words on a page, thinking when there is background noise.

Hi Jackie, I suffer with the same.I am so truly sorry

My wife suffered a TBI twelve years ago. As her husband and companion, I am getting quite adept at noticing the onset of sensory overload. We call it “unravelling”. Most times I see it before she realises it. If I see it, I do my best to bring it to her attention and we decide the best course of action. It is usually to remove ourselves and take her to a place she feels comfortable and cam decompress. That usually means home.

My daughter had a concussion in April of 2018. She had some of the sensory things fade for a bit, but they are now back. Is this normal? Does it happen to other people?

Even I had concussion before 2 years and symptoms of hyper sensitivity to sound and vision went off for an year and came back.. plse someone tell us wat to be done?

It's like I wrote this myself (and I've been disabled by TBI for over a year), this is so spot on. Thank you for this!

Thank you for posting this, as I to often have many of these difficulties.

I love all this information. I got my TBI in May of 1976. I had to learn about my disability by my mistakes. Back in that day, my parents focused on the fact that I survived a motorcycle accident, they didn't SAY anything about the TBI. I was in a coma for 4 weeks. A seniors in High School, I was 18 but had the reactions of a baby.
I am so pleased that there is information for people who need it. I am now post 42+ years TBI.
Thanks for letting me share, Bobbie Bares

Love this sure hits home!

Being a very logical person, it took me a long time to finally admit that I was dealing with a TBI and chronic fatigue issues before that. In the past doctors couldn't find anything wrong in tests - other than sensitivity to light, sounds, smells, etc. I finally agreed to try a naturepath, which really went against my rational personality, and was given some vitamins to take - E manganese and a B cataplex, though needs vary from one person to another. I very skeptically took them but have been a changed person since then. I still have issues when I've overdone it, but they aren't nearly as extreme as they used to be.

Yes the after effects of TBI with the heightened sensory to light and sound is very frustrating. I too just take it one day at a time. Noise cancelling headphones along with yellow tinted prism glasses have been an effective strategy to be able to be more integrated back into society. Taking it slow and appreciating the small accomplishments I have achieved thus far. Keep working to be the best I can and knowing when to take a step back. Good Luck to all this is possible to work through and accept and love you again!

Lots of Omega's and try something called Alpha Stim with a doctors approval and prescription. It has worked for my husband and given him about 90% improvement with sensory overload.  His hat, earplugs and glasses are almost never used these days except when he is fatigued. It has been almost 3 years since his bike accident that gave him a TBI and changed his life forever.  Best wishes to all!

Hi there, Thank you for your comment. My sister had an car accident 5 yeas ago resulting in some brain trauma. The result is that she suffers from acute sensitivity to light and sound often wearing earplugs and sunglasses, and gets headaches easily. Her scar from surgery gets starts to hurt with “too much” stimulation of light, sound, concentration.

May I ask whether your husband had similar issues and if Alpha Stim provided relief and how?

Thank you
Adam

I had one major and one very minor concussion b/c of being sensitive after the first one over a yr and a half. Just as I was getting better. My one word of advice is to go to a Neuropsychologist and also a behavioral optometrist. In addition to what's here, take LOTS OF OMEGAS, Magnesium (for mood) and serotonin, B Vit's and get your hormones and endocrine levels checked. They all play into your brain's recivedy and become altered after a concussion or TBI.

Anger seems to grab hold of me. I almost throw a tantrum, unreal! I have changed here, and hate it. I am trying to see a psychologist, but car insurance wants information released or they refuse to pay. And I thought it was just one on one knowing, unless suicidal. I am trying to figure out a way to control anger. Some of me it's being able to be flexible... that's so hard. I have to get that working again. Does anyone have some ways to calm down or run or What before I explode? Thank you

I have a friend who had a motorbike accident and had anger management problems. He used a boxing bag to release and control his anger. basically directing it into something he could control is what he was doing. Its all about getting control back. After my car accident I got control back from ninjitsu, a marshal art I learned 20 years earlier. that got me out of a wheelchair, now I can walk again. So I suggest boxing or some other marshal art, it will give your control back.

I have a problem with anger if I am tired. I can't cope when my brain wants to rest. It's hard but take note when the anger gets to you most. Self talk through the worst part helps. Ask yourself if the problem is life threatening. That is really the only issue that should get a response like anger. The rest just take your hands and go through the act of dumping the problem over your shoulder. It helps to get ride of the anger. My husband will say cranky cranky to me when I don't notice I am short tempered. That's his way of telling me without me really get angry. I then take a few minutes of relaxation and it usually passes. This article has excellent suggestions for relaxation. Good luck to you and you're not alone.

My grief/anger had me so wound up I didn't know if I was coming or going. My psychiatrist upped my anxiety & depression meds until I could get though dealing with insurance, doctors, etc. Now that I've come through it I want you to know that anger burns a lot of energy that could have been invested in my recovery.

I also have noise cancelling headphones....expensive but well worth it.  They have allowed me to attend some sporting events and tolerate stores for longer periods. I always try to carry them with me when I go out.  Some days I am fine at home but as soon as I am out in public places I become overwhelmed, confused and anxious from all the input(people, conversations, overhead lights, fans, CONSTANT MUSIC everywhere, millions of buying choices, etc.)

Who did you see for these symptoms? My neuro of 8 years, just stopped seeing me, he stated he is only going to see MS patients! I was seeing him because I went to a chiropractor who adjusted my neck and dissected my artery and caused 4 strokes! Since then I have been experiencing all of the same symptoms and work won’t give me any accommodations so I can’t do my job! But my neuro was the person I was counting on to write something to get me out of my job, so I can do something that doesn’t tax my system!! Help I feel deserted!!

I have these problems and wondered if it was creating the fatigue...though it has been slow and I do most of these tricks..at least I'm on the right path..baby steps.
I have experienced 5 brain surgeries and 4 severe falls to my head. I look completely normal, but people just don't understand when I need to remove myself from a situation. People don't understand brain injury. Most folks only understand the disabled who are visibly affected. I live in a town that has absolutely no support for this silent disability. Thank You for posting this article.
Very helpful hints. we are getting ready to atttend a large gathering in KC so I will be looking forward to using these tips
Thank you to Barbara Webster for this extremely helpful book/excerpt and to brainline.org for posting it! I developed these sensitivities about 10 years after brain tumor surgery (I am a 16 yr. survivor). These helpful strategies include some of the ones I had developed as well, and I really appreciate the others. I have also used noise-reduction headphones which have felt life-saving at times!