Flooding of the Senses: Sensory Overload After Brain Injury

 

Finding out about sensory overload after brain injury has been tricky.

Many months, (maybe over a year ago), I received a letter asking for information about sensory overload in adults after brain injury.

While I did not have a lot of first-hand experience, I figured when researching all things ‘brain’ – information is usually plentiful.

I was surprised that I could not find a whole lot of information on sensory overload for adults after brain injury. Consequently this article has been a long time in the making.

Please feel free to help out with additional information and references.

 

Sensory Overload – Sensory Flooding

Sensory Overload Flooding

“Sensory Flooding” is another term I discovered. I like the clear picture that the term “flooding” gives.

Brain injury can reduce or remove filters. This enables sensory information to ‘flood’ the brain. Overwhelming it. Creating surges just as flood waters do.

 

What is Sensory Overload?

One important function of the brain is to filter incoming information from every part of the body:

What needs to be paid attended to?

What needs to be acted upon.

What can be ignored?

Damage to the brain can mean that sometimes this filter function is reduced, or removed. The brain no longer has clear ideas on what to pay attention to.

This can include the filtering of messages coming in from each of the sensory organs to the brain creating chaos and sensory overloading.

How Does Sensory Overload Happen?

Sensory-Overload-Busyshops_thumb.jpgTake me into a busy shopping centre with lights, music, bright displays, excesses of colour and movement.

Within a very short time I feel irritable, a little panicked, I make poor decisions, and I want to escape.

Like many people with, or without, brain injury my senses become overloaded.

Unlike a person living with brain injury, my experience is momentary.

For a person with sensory overload after brain injury this can be a debilitating and ongoing outcome. It does not go away with a simple strategy.

 

Which Senses Can Be Affected?

One, or more, or all, of the senses can be affected.

It can change a person’s ability to tolerate sensory input – such as sound, sight, touch, movement, taste, smell. It may be altered or absent.

This sensory overload can occur –  with excessive levels of sensory input. With normal levels of input. When it’s sensory input we like. And in one or more of the senses.

Depending on your reading you will find differing numbers of senses listed. I will talk about 6 senses. Sometimes it might be only 4.  The Body is Not an Apology lists 8 senses. Here they are – some with their fancy titles:

· Visual System (sight)

· Gustatory System (taste)

· Olfactory System (smell)

· Auditory System (sound)

· Tactile/Somatosensory System (touch)

· Proprioceptive System (muscle/joint movement, where body is in space)

· Vestibular System (balance)

· Interoceptive System (state of internal organs)

 

What Might Cause Sensory Overload?

Here are just a few examples of what might cause sensory overload.

Sensory overload for some people can be caused even when the sensory experience is something they enjoy.

Sound

Music and announcements playing in shopping centres and other public venues.

Groups of people talking or shouting.

Sounds of a city: traffic, sirens, trains

For some even the sound of your own voice can be difficult to tolerate.

Sight

Busy, multicoloured venues

Classrooms with a lot of display and decoration

Visiting places where one is taking in a lot of visual information – art galleries, sightseeing, museums.

Bright flashing lights

Taste

New and/or exotic tastes

Tastes that are unpleasant

Strong tasting things

Touch

Being patted, poked, stroked

Touching new or unusual things – craft, petting animals.

Having items such as clothing next to skin that irritate e.g. rough clothing, sharp objects.

Sometimes the lack of filtering can mean even normal touch sensations – sitting on a chair, wearing shoes – can be distressing.

Smell

Scent or perfume

Household and Hardware Chemical substances – cleaning materials, paint, glues.

Multiple and new smells such as food markets, visiting new cultures and places

Strong food smells – good and bad

Movement

Being bumped and moved in a crowd of people

Unusual movement; rolling, rocking, tipping – such as on a boat, ride at a fair.

More about overload in each of the senses can be found  here: Sensory Processing Disorder Australia

 Enjoyable Sensory Activity:

We often think sensory overload comes from too much of what we don’t like. Being in a loud train station, or a busy shopping centre.

Unfortunately even enjoyable sensory input – events, places, and people providing sensory input we enjoy – can cause overland and distress:

Sensory Overload. Photo of man and 3 boys with coloured buckets throwing water

 

  • A group of friends together
  • Going to cafes, restaurants, pubs. Gathering places you once enjoyed
  • Your own or other children playing
  • Venues you were OK with before brain injury: classroom, music concert, race track.
  • Venues you might have to pass through: airports, supermarkets,
  • Holiday and Sightseeing

 

 

Possible Outcomes of Sensory Overload

Spend a Day on Planet TBI from Mind Your Head gives a vivid first-hand account of living with sensory overload. The Comments after the article give further first-hand experiences.

Being easily distracted by sensory input: taking notice of every sensory input.

Seemingly “over-reacting’ to sensory stimulation

Paying attention to sensory input others do not seem to notice – a smell or touch others accept creates irritation

Fight and Flight symptoms – sweating, clammy skin, racing heart.

Becoming irritable, angry, behaviour changes

Withdrawing from activity – in the extreme there may be unwillingness to leave home

Increasing fatigue

Difficulty concentration and paying attention

Less able to make decisions

Distress / Stress – signs of anxiety and / or depression.

An extensive list of signs and symptoms in children can be found here. Some of these also relate to adults.

Please share other outcomes you have noticed in the Comments below.

 

Tips And Strategies for Sensory Overload

This is a beginners list only. It is not something I have a lot of experience with. Please share strategies you have used or heard about in Comments below or Email me HERE.

Before Starting Out and Throughout:

Recognise this is an issue resulting from damage to the brain. It is not deliberate. It will not just go away.

The tips and strategies below are not suitable for everyone. Take the ones that seem most useful and modify them to suit.

Not every strategy should be implemented. Begin with one, or a small manageable number.

Most often simple and quick fixes won’t work – “Don’t go to supermarkets” “Just leave the room”. This fails to see the impact of sensory overload and how it can affect a person’s life.

People who have not had experience with brain injury, or the invisible nature of the outcomes, may not understand.

You may need you to explain what sensory overload means for you and how to help.

Oh and you may need to do this more than once!

 

1) Do a Bit of Sensory Lifestyle Planning

Sensory overload Photo person wearing a hat sitting on rocks watching sunsetBorrowing a term from popular culture – why not do a bit of ‘lifestyle planning’ of the senses to manage sensory overload.  To begin with – a focuss on planning and preventing sensory overload:

Find out what sensory overload means to you:

  • The signs of becoming ‘overloaded’.  This will help in a plan to use strategies early.
  • What are the levels of sensory input that are OK before overload happens? Plan to work well within these levels.
  • Get to know what causes distress; and to know what is calming. Have a list of both as a reminder for you and to share with family, friends and supporters.

Develop a Calmer (and maybe Karma) Daily Life: think about routines that are calm AND reduce sensory overload – for you. This will be different for each person. Meditation, Shopping online, Studying in a quiet room instead of classroom.

You might need to make some changes to lifestyle. Look critically at the strategies you come up with: Are they

+ possible

+ necessary

+ of benefit.

Sorry that sounds a tad obvious – but sometimes we all make changes because it seemed like a good idea when someone else did it whether it works for us or not.

 

2) Live the Sensory Lifestyle

Live a ‘good life’ – a bit obvious but…  maintaining optimum health and fitness,

a healthy diet,

avoiding things that are stimulating such as coffee, alcohol,

reducing stress as much as possible.

a good and healthy life can be helpful.

 

We have Slow Food, Slow Music, you might find Slow Life is of benefit – find what works for you, take breaks, enjoy moments.

I was going to say slow down and smell the roses but that seems a bit inappropriate here. You know what I mean.

Manage and minimise fatigue. Cognitive fatigue can significantly affect the ability to manage difficulties such as cognitive outcomes and sensory overload.

If you have to be somewhere, or do something that you know will cause you to become overloaded – schedule in breaks around this event or activity. If going to a family function you might find a quiet place to go to for breaks before you become overloaded.

 

3) Take a sensory holiday or retreat

Sensory Overload ResortNo I don’t mean a resort in an exotic place – though if that helps, and it is possible – I am not saying No!

I mean create one where you are.

Think about times, places, people, activities that take you away from it all and give your senses a little holiday. Add these to your routine.

Take little mini breaks throughout your day, and life.

Think in an ‘off peak’ kind of way. ‘Off Peak’ usually means quieter times – look for these in daily life. Going to cafes between major meal times. Holidays when there are less crowds. Studying when less people attend the library.

It can be a balancing act between managing overload and building tolerance to the sensory input. Professional assistance might be helpful here.

4) Gain a Sense of the Senses

Do a Sense Audit – Oh this is just a fancy term for – have a think about each of the senses. Write down which senses are affected? In what way?

Don’t be alarmed if it doesn’t make sense. Remember outcomes of damage to the brain can seem hard to understand at times.

What support and strategies might be needed for each sense? Easy for me to say – think of it as a work in progress. Make a start and keep adding.

Look at what works for each sense – below are examples for Sight and Sound:

Sight:

Sensory Overload HibiscusProgram in time where you can rest with your eyes closed, it may be either at home or out and about.

Carrying a dark eye/sleep mask to further block out visual overload might also help.

Watch the times and places visual overload happens. Record this and work out a strategy for each. e.g. Large supermarkets cause distress – see if you can find small, quieter, local stores.

If severe – light sensitivity can cause distress including severe headaches. You might need to consider strategies such as wearing dark sunglasses – even indoors – when this is an issue.

Sound:

Sensory Overload. Drawing of a CD with musical notes around it

It may be helpful to have ear plugs or noise cancelling headphones to use for times when noise becomes an issue.

Consultation with people experienced in this issue may give more advanced strategies which may involve desensitizing hearing and the brain over time.

Strategies designed to block out unwanted noise such as relaxation music, the use of white noise.

Professional help may support the use of specific music to help the brain and ears adjust and increase tolerance to sound.

 

And Finally

It came as a shock to me that despite 27 plus years getting to understand brain injury and meeting many, many people with brain injury along the way – I had very little understanding of sensory changes.

Today’s article is a beginning for me, and I would appreciate any further comment, resources, experiences and information.

Finally here are a small number resources I found that relate to sensory overload and brain injury.  They appear to have some useful, easily understandable, information:

“Sensory Overstimulation”

Sensory and Perceptual Problems After Brain Injury

Lost and Found: Caps, Sunglasses and Ear Plugs  – this article focusses on strategies for managing sensory overload – termed sensory hypersensitivity here.

22 Responses to Flooding of the Senses: Sensory Overload After Brain Injury

  1. Sandra E Brown November 24, 2015 at 11:39 pm #

    Hi Mel, as you know I live in Paris as an expat. I don’t have a brain injury. The exact issue though occurs with expats regarding sensory overload (except I call it emotional overstimulation).

    Stepping outside is akin to your comment about shopping centres. Not only is the language new but so is what side of the street you walk on, how traffic works, how to both enter and exit a French shop … After even a brief sojourn to buy lunch, my brain is worn out from both the increased stimulation of differences and the constant guessing and anticipating.

    The outcomes you describe are very similar to what many expats experience. My methods of coping are to use relaxation music to sleep (with a timer to switch it off), choosing only one or two events to do each day, writing a daily diary, and talking to people in a similar situation. If I’m not in a great mood I don’t go out as I know the over stimulation will exacerbate the negative mood. I also have some favourite places to go to eg cafes, that I know that won’t produce new stimuli.

    • Melanie Atkins November 26, 2015 at 7:49 pm #

      Great example of sensory overload in daily life. Strategies that could also be useful to people with brain injury. Thankyou Melanie

  2. Matthew Gale November 26, 2015 at 6:46 pm #

    Melanie Atkins,
    I am so appreciative that I can finally read an article on the sensory overload topic. I am recovering from a ABI, I acquired in March and its a long road back. I must say when going in to stimulating areas like City, Art galleries and such it can be a overload on the cognitive powers to process so much we take for granted. I have a process in attempting to keep my glass over half full which takes a fair bit of planning. Fortunately with assistance from my OT and Neurophysiologist we have worked on tactics e.g. withdrawing for a while or buying time(silence), awareness of physical signs of fatigue, pressure at the back of my head , 10 minute breaks or tea breaks on the hour and half an hour at about 1.30pm to top up the cognitive glass.
    I know the consequence if I don’t respect my ABI and through loving friends and family making me aware of the tell tales signs . I can share my experiences freely and no shame attached because I know every ABI person or relative I have met in my recovery ,have been happy to pass on their valuable experiences . They are worth their weight in Gold because simply no one can understand the invisible injury once the physical ones have healed. Thank you Melanie and to my Neurophysiologist Dawn who recommended your beautiful Wed Site.

    • Melanie Atkins November 26, 2015 at 7:57 pm #

      Thankyou Matthew for your words of support and for sharing your experience. Your examples give people ideas for further strategies. Regards Melanie

  3. Damian January 25, 2016 at 12:22 am #

    Hi, my senses are hyper sensitive post accident- now two years on the 27th. My ‘startle reaction’ is earth shattering and flips me immediately into flight, fight or freeze. I can get scared very easily and it takes me a considerable time to self soothe. Sensory overload is probably my biggest deficit as it prevents me from going out, shopping, and interacting with more than two people at a time. I react when I would prefer to reflect and respond. I have done a lot of damage to the people I love and I’m no longer trusted by those close to me. Tough times indeed.

    • Melanie Atkins January 28, 2016 at 7:24 pm #

      Damian Thank you so much for sharing a little of your experience post accident – of changes to sensory responses and the impact of hyper-sensitivity. It helps us all to better understand the different ways difficulties can occur. This area is one people can struggle to understand yet it can have a significant impact on life, as you have briefly shared. I truly appreciate all the comments people contribute to build knowledge and understanding. Thanks again. Regards Melanie

  4. Gc January 25, 2016 at 2:29 am #

    Great article. Brimmed hats, sunglasses, and ear buds help when going to public places. I would add that making a plan helps, such as only planning to pick up one or two things at a store. As you continue research, consider the adrenaline affects of over stimulation. For example a sudden phone ring cannot be processed quickly, the unexpected noise causes an adrenaline rush like it was an explosion, the reaction causes anger, and long after the phone call ends (and teenager was chewed for having their volume on) the adrenaline still flows, raised heart rate, heavy breathing, tense muscles, racing mind, energy to burn, and increased senses. It ends with pain from muscle spasms and exhaustion to the point of being unable to control body temperature. Thanks for your research!

    • Melanie Atkins January 28, 2016 at 7:29 pm #

      Thankyou GC for sharing strategies that I hope others will find helpful. I have learned so much from the comments of people living with sensory flooding. I had not thought of the link to adrenaline and the after effects – I will look further into this. The impact is more far-reaching than most of us would think. Thanks so much for commenting. Regards Melanie

  5. Deb Brandon January 26, 2016 at 11:54 pm #

    After several brain bleeds and subsequent surgeries in 2007, I became extremely sensitive to sensory input. My usual reaction is tears, and when it’s particularly bad I have major meltdowns.
    It has improved over time, though it’s still very much there. Now irritability is the more frequent reaction.
    I can no longer eat apples. The sound of the crunch, the smell, the texture as my teeth sink into it… Just thinking about it makes me shiver and clench my teeth.
    The rustling of grocery bags completely overwhelms me. I have trouble hearing anything else while it’s going on. In general I often have trouble filtering out sounds. I can’t make it what one person is telling me when there’s too much other stuff going on.
    If a hairdresser uses shears on me, it can burn. Sometimes It seems like can feel the pain in every hair follicle.
    Bright colors can be difficult but nowhere near as bad as they used to.
    Often when I touch fabric that’s got a synthetic component, it feels harsh to me.
    Getting to the milk aisle in grocery stores (have you noticed it’s usually in the back?) is difficult. The only way I can do it is if I restrict myself to two, on good days three, aisles per shopping trip. If there are too many choices, I often have to give up and walk away.
    Shopping lists help a lot, but are not infallible. If my usual brand isn’t there, or if an item has been moved. If a store has been rearranged, I have to bring a friend with me the first few times and brave a couple of aisles per trip.
    Life is interesting.
    Thanks for the article. It helped me recognize some of the situations where I hadn’t yet made that connection.
    I’ve written a lot about my issues (blog pieces, essays, and in a memoir I’ve written).

    • Melanie Atkins January 28, 2016 at 7:35 pm #

      Hi Deb, Thankyou so much for sharing your own experience of sensitivity to sensory input. It helps me to better understand, so I am guessing it helps many others to better understand the many outcomes of damage to the brain and the potential impact on life. I am pleased you found some useful information in the article and I certainly have learned more about how sensory changes can happen from you. I would welcome you sharing your website or book title here if you would like to. Just send another comment if you are happy to do so. Regards Melanie

  6. Donna Culver January 29, 2016 at 2:36 pm #

    Finally, validation of how I feel! My family look at me like it was a brick that fell on my head instead of a very large brain tumor!
    Thank you!

    • Melanie Atkins February 2, 2016 at 11:20 am #

      Thankyou so much Donna for your comment. I am so pleased you have found articles useful. Your image of a brick rather than a brain tumour is powerful and speaks volumes. Thanks again. Regards Melanie

  7. Barbi Stephan February 21, 2016 at 10:18 pm #

    Great article. It’s been 24 months since my horse kicked me in the face/head. Blessed that I lived, but a long, hard 24 months. I thank God for my awesome husband of 25 years. We have learned a lot just from us working together and him paying close attention and wanting me to heal, however much that may be. I’ve used the phrase ” OVERLOAD ” quite often in this time! But adding ” sensory” makes much more sence to me, but mainly others! My new catch phrase! Lol. But I was never a half-empty thinker…or a depressed-down person…or have much anxiety issues. Well, now I have a new respect for those that are. I’ve always given people the benefit of the doubt, we are all different, but now I have 2 personalities. It sucks. But I’m finally getting more used to it. I’m finally also letting go of the ” old me” that is not here anymore. Part of me wants to still THINK I can do what I always did. I can’t ! But 2 years later, and with support from my husband and family, I’m ok with it. I’ve been an extremely driven, hard working woman. 59 years old, worked full time at physical jobs since 17, plus at home on our cattle/ grain farm ( which I love) , plus raise 2 wonderful grown daughters. It’s been sooo hard to think I can not do it now. My mouth says ” yes” , then it’s BRAIN OVERLOAD! I finally told my husband after 2 years , that HE has to help me. But only because I have FINALLY accepted it. Whew, poor guy. He’s gone thru as much hell as me. But there’s been months of noise too loud ( and I’ve been extremely hard of hearing my whole life) go figure?! And lights and sunlight( which I LOVE) , I can’t take at times at all. And if I am on the phone and anyone is within my hearing distance and they are talking, I CANNOT hear just one of them! So I don’t know what anyone is trying to tell me. It’s a learning process for both my husband and I , for sure. I can’t be with my grandsons near as much as I want. But a 5 and 2 year old boys is crazy lol. I love them, so fun, but I can overload in no time. But the first year and a half I couldn’t even do it. At all. So I take the over stimulation, the leave when I know I should, and rest the rest of the day…. If I’m smart enough to. Yesterday I wasn’t. Lol. I did leave, but then I went thru my in-laws attic , and one of my barns ( I’m a pack rat) for things I want to make things out of! But I was alone then, which I needed. But by late afternoon my husband knew I was beat. He said I had told him in the morning I was only going to visit my grandsons. But I was busy for hours after. I can’t help it. I still have hopes of doing things like I did before my TBI. I’m retired now , so I still think it was a normal retirement. It’s not. I’m still a driven woman, but I don’t think straight . We are still trying to rein me in. Lol. Good luck with that! Thanks for the article, and for listening.

    • Melanie Atkins February 25, 2016 at 10:53 am #

      Hi Barbi, Thankyou so much for sharing some of your story. So many experiences you raise will I’m sure resonate with others. The feeling of an old and new you. The fatigue. Not being able to do as much as you once could. I am so pleased you have written about this. I am not sure if you have read the article on cognitive fatigue http://www.changedlivesnewjourneys.com/cognitive-fatigue/ “I’m So Tired My Brain Hurts – just thought it might be useful. Thanks again. Regards Melanie

  8. Sydney June 16, 2016 at 5:57 am #

    Great article! I have been trying to find information on sensory overload in relation to TBI’s but I agree there is not much out there. I do feel that we can relate this in a way to Sensory Processing Disorder that has been a recent diagnosis for children. I would be very curious if some of the techniques used for Sensory processing such as Weighted blankets, proprioceptive input, etc would help individuals with a TBI.

    • Melanie Atkins June 20, 2016 at 10:16 pm #

      Hi Sydney, Thank you – your query matches mine – what can we learn and use from other areas such as children with Sensory Processing Disorder. I hope we hear from others with more experience. Regards Melanie

  9. Luanne August 29, 2016 at 8:19 am #

    When I was reading your article it became evident that you were talking about it from an outside perspective. Many of things you said are very relevant and I commend you for supporting the survivors. I too am a brain injury survivor. In 2010 I acquired Strep Toxic Shock Syndrome which left me with a brain injury. I have spent many years learning about my symptoms. I find the most helpful way to do this is by joining a local brain injury group. Face to face chat is the best way to compare notes. I belong to the local chapter of Brain Injury Association in Ontario. Their peer mentoring program saved my life. For most individuals with an injury, chronic fatigue is the biggest issue. If you are tired, all of your symptoms become more evident. Rest, and I mean total rest like a nap is the best way to lessen symptoms. I need to follow a schedule and when I don’t, my symptoms can be hell! Probably many of you have heard this analogy before, but for those of you who haven’t, here it is. When you have a brain injury, you have a limited amount of energy. For example, when I wake up I have ten chips or tokens for the day. Getting out of bed uses 1, making breakfast and getting dressed uses 1-2, driving to the store to get groceries 1, shopping at least 2, etc. You can see how one could easily use half their allotted amount of chips/tokens before noon! This is where your ability to gauge how much each activity will take becomes important. For me, I know from years of tweaking my schedule, I can only do one major thing a day. For certain days I may need to use more chips/tokens. I’m also aware that this will require me to get extra sleep and have a quieter day the next day. For every chip/token that I use beyond my 10, it will take twice as long to recover. When I have used all of my chips for the day, my symptoms start to become more evident. If I’m really exhausted, it gets ugly fast. My symptoms include: irritability, hypersensitivity, upset stomach, I get hot, my heart pounds, I get anxious and want to flee the situation etc. When I keep to a strict schedule, tracking how much I can do, eating healthy food and getting proper rest etc. I can manage my symptoms much more effectively. I learned how to do this from my Peer Mentor who received her rehab at Parkwood in London, ON. It is by far, one of the leaders in rehab treatment in Ontario. On a side note, heavy blankets are used to help individuals sleep who brain injuries. It’s similar to use of a compression vest when shopping. I hope this helps others in their journey.

    • Melanie Atkins August 29, 2016 at 8:51 am #

      Thank you so much this has so much information that others may find helpful. I really like the tokens for energy- a visual picture can be a great reminder. I really appreciate you taking time to share your experiences. Regards Melanie

  10. Dana Jaffe September 14, 2016 at 5:14 am #

    Yes, after hundreds of micro infarcts, I still suffer from sensory flooding., among other things. I use many of the coping strategies that are mentioned,however I still work and one of the hardest things to deal with are meetings where a lot of intensive planning
    is going on with multiple people. I start shutting down and experience nausea and the flight instinct as well as headache and feeling washed out. This is often interpreted differently than what it is. Very frustrating. My injury is 12 yrs old.

    • Melanie Atkins October 11, 2016 at 4:50 pm #

      Hi Dana, Thank you for sharing this information. Sensory flooding is so easily misintrepreted and the more examples we can use the more we can try and help people understand what it is like to live with it. I can imagine this must be very difficult in a work environment and trying to share your experience with work colleagues who may not fully understand. Regards Melanie

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