Tag: Support

Mobility

Many physical effects impact a person’s mobility, or the ability to move. Examples of this include, but are not limited to:

  • Being unable to walk (limps, poor posture, poor endurance, not able to walk and complete activities at the same time, poor balance, needing to use a walking aid like a cane or rollator).
  • Being unable to work, play or drive
  • Being unable to sit or get dressed
  • Pressure sores from staying in the same position for too long
  • Contractures (permanently stiff joints and/or tight muscles)
  • Loss of muscle mass from disuse
  • Experiencing impaired movement control
  • Increased dependency on others
  • Increased risk of falls
  • Poor bed and wheelchair positioning

When a person experiences changes in their mobility after a brain injury, it can be difficult to adjust to their new reality. This can lead to increased risks of mental health challenges, such as anxiety and depression.

It’s important to work with medical professionals, including physiotherapists, occupational therapists and kinesiologists, to address mobility issues and create a goal-oriented rehabilitation plan.

Topics in this section include:

How the brain perceives the environment & controls mobility

Our brain controls our ability to move, our physical responses and our ability to use and move objects.  While the location and size of the brain injury doesn’t always mean there will be mobility challenges, certain areas of the brain do control specific aspects of mobility, such as:

  • Basic body functions such as heart rate, blood pressure, respiration, sweating, consciousness, and alertness.
  • Coordination and balance, including smoothness of movement.
  • Information related to sight, touch, and spatial awareness. If the brain is having trouble determining where and what things are, it can make it difficult to perform movements like reaching for and picking up objects and moving in the environment.
  • Planning movements and putting them in order, and strength and coordination of muscles. This means that a person may be able to walk but have difficulty planning their movements or may move impulsively.
  • The vestibular system. Everyone has a vestibular system which is made up of organs in the inner ear and the vestibular nerve. The vestibular system provides the brain with information about motion, head position, and where you are in a space. It also helps with balance by stabilizing the head and body during movement and maintaining good posture.
  • Vision. Movements can become more difficult if there are visual deficits that make it more difficult to see.

Many survivors with traumatic brain injury will not have significant visible physical limitations because of the brain injury (although they may have additional temporary injuries like broken bones which will impact mobility). In many cases, physical deficits are ‘invisible’ to others. This is true of cognitive and behavioural effects as well. This is why brain injury is often referred to as an invisible injury.

Effects on mobility after brain injury

Balance
Balance is the ability to keep yourself centered as you walk, sit, and engage in other movements. It allows you to control and adjust your body before, during and after movement to keep from falling. Balance problems after a brain injury are common: 30-65% of survivors have reported some sort of issue with balance [1].

Balance requires functional muscle strength, vision, vestibular function (inner ear), sensation in the skin, muscles, tendons and joints (known as proprioception). It also requires cognitive function and movement planning. When you are keeping your balance, your brain is continually processing inputs and information from multiple senses and body parts. The brain then sends directions out to the body’s motor and sensory system (muscles in the arms, legs, core, and eyes) to keep you centered.

Common causes of balance problems after an acquired brain injury include:

  • Changes in blood pressure
  • The actual injury to the brain
  • Medications
  • Mental health issues like depression, anxiety, fear of falling, or fear of moving
  • Sensory impairments
  • Impairments in motor control
  • Dizziness, which is a sensation of light-headedness, spinning, or nausea.

Balance is important not only for walking but for doing all daily activities. Poor balance can keep you from taking part in activities such as sports, driving and work. Issues with balance and dizziness can increase the risk of falls and injuries, including another head injury. It can have an impact on your abilities and your mental health and well-being.

How can I improve my balance?

Balance problems will usually improve over time with activity and exercises. The more you move, the more you improve. You may be referred to a physiotherapist or other specialist who can help you with your balance. While many people with an acquired brain injury can walk or move independently within a few months of their injury, many will have problems with quick movements, running, sports and high-level balance activities. Some people will recover completely while others may have lasting deficits that change their daily lives.

If one or more of your balance systems is not working well, you can try to improve your balance by focusing on areas that are working. For example, if you have poor vision, make sure you have good shoes, optimal lighting, and vision aids

Other ways to cope with balance problems include:

  • Use mobility aids such as canes and walkers, if recommended by a healthcare professional.
  • Hold onto a family member or caregiver’s arm if you feel unsteady
  • Wear proper footwear (closed toe and heel, well fitting, flat-heeled)
  • Work with an occupational therapist to make changes to your home environment such as railings on stairs, installing railings and safety chairs in the bathroom, and removing rugs or other tripping hazards.
  • Clear high-traffic areas in your home
  • Use adequate lighting and nightlights (for example, smart lights that can be controlled by voice or by phone).
  • Avoid alcohol or other substances that can impair your sense of balance
Endurance
Endurance is having the strength, energy and ability to perform an action over an extended period of time. It can be measured by how well you perform an activity or how much you can increase the intensity or duration of the activity. For example, first you walk further, then you walk faster.

How to improve my endurance

It takes time, patience, and practice to build up your endurance. This will be regulated by your physiotherapist and occupational therapists, healthcare providers, and caregivers. Your therapist may give you strengthening exercises like using small weights or resistance bands. They may also recommend focusing on form and repetition to help your endurance and other aspects of mobility such as posture and gait.

One of the ways you can keep track of your progress is by keeping a record of the activities you are doing. For example, if your goal is to walk 100 metres on the treadmill in a set time, track that progress. Then set your next goal. Goal-setting is something your therapists can help with, and it can help you see how much progress you’re making.

Gross & fine motor skills
Mobility refers to the ability to move your limbs. This includes gross motor skills such as walking and larger movements and fine motor skills such as picking things up and writing. These skills are incredibly altered by brain injury. If you lose parts of your mobility, you have to cope with major lifestyle changes. Physiotherapy and occupational therapy can help with strengthening or re-gaining mobility as well as learning new ways to accomplish tasks. This could include activities such as:

  • Working with your fingers on small, detailed tasks such as writing or crafting
  • Range of motion and strengthening exercises

Certain exercises and activities will be recommended based on your needs.

Muscle tone, strength, and coordination
Muscle tone is the amount of tension in a muscle when it’s in the resting position (not being actively used). When muscle tone is normal, the limbs and body feel easy to move. A brain injury may damage your normal control of muscle tone. This may cause decreased muscle tone – your limbs feel floppy and heavy (also called hypotonicity or flaccid). It could also cause an increase in muscle tone – your limbs feel stiff and tight (also called hypertonicity or spasticity). Both affect the ability to control movement.

After a brain injury, muscles may show different degrees of weakness. Some muscles may be stronger in one limb than another. Damage to certain parts of the brain may result in slow, jerky, or uncontrolled movements. You may hear the terms:

  • Hemiparesis: muscle weakness on one side of the body only
  • Hemiplegia: muscle paralysis (no movement) on one side of the body only

Physiotherapy and occupational therapy can assist with working on muscle tone. This is a process that requires patience as it can take a long time. Your treatment plan will need to be adapted as your mobility changes, and you may never fully regain the mobility that you had before the injury.

How to improve muscle tone and strength

Ways to improve muscle tone depend on whether you are experiencing spasticity or flaccid muscles. If you are experiencing spasticity, your doctor may recommend medication along with stretching and range of motion (ROM) exercises overseen by a therapist. If you are experiencing flaccid muscle tone, treatment can include working on proper positioning, exercises, and joint-positioning devices [2]. Improving muscle tone requires time and patience.

Improving strength involves focusing on which muscle areas need the most help. Exercises such as resistance training can help increase strength over time and with a lot of practice and patience.

How to improve coordination

You need coordination for every movement you make. Improving coordination involves a lot of time and patience, like improving muscle tone and strength. While exercises will vary, they will contain several key components, including but not limited to:

  • Repetition
  • Goal of increasing speed and accuracy
  • Proper form
  • Inclusion of sensory cues
Posture
The head and neck give the eyes, mouth, and tongue a stable base. The trunk (the area of your body between the shoulders and hips) gives us a stable base so we can use our arms and legs. To move normally, the head, neck, and trunk need to be properly positioned when standing and sitting.

A brain injury can affect the muscles that control head, neck, and trunk positions. It can also affect the sense of what is upright and what is straight. For example, you may be leaning left or right because the muscles that hold your posture are affected. This may be caused by wrong information coming from the senses about position, limited range of motion, abnormal muscle tone or pain. If posture is poor, you can create a list of visual checks to make when you are sitting or standing. You can also ask for a caregiver to help.

Physiotherapy can be useful in helping you work on your posture when sitting and standing. Therapists will use specific exercises and gait training to help make improvements. Along with these exercises, you can work on your posture by:

  • Rolling your shoulders back
  • Use a wall to help straighten your posture. Your ears should line up with the middle of your shoulders
  • Sit all the way back in your chairs, and choose chairs with high backs
  • Wear shoes that provide proper support
  • Use a mattress that properly supports the spine

There are also some simple yoga stretches and positions to help with your posture and your flexibility. You should first consult with your therapists and doctors about whether you should perform yoga. If you are coping with balance issues, there are some forms of chair yoga that can be done from a seated position.

Sensations
Sensations tell us how we are moving, what we are feeling, and what’s going on around us. Forms of sensation include light touch, pain, temperature, moving joints and muscles, vision and hearing.

Changes to the way you experience sensation can affect your ability to sense movement or position, to feel changes in temperature, or to feel touch to the affected part of the body. It can also make it harder to re-learn movement since movement information must be sensed by thinking about the movement first. Loss of sensation can also make walking and balance more difficult.

Losing sensation can be a very serious safety issue because you may not be able to feel an injury or be aware of that part of your body anymore. It is important to know what types of sensations have changed to help keep yourself safe. For example, if you cannot feel hot or cold temperatures in a part of your body, use an unaffected body part to check the water temperature before a shower.

Managing changes in sensations can be challenging, but your healthcare team can help you learn ways to cope. Your treatment plan will depend on the sensation changes you are experiencing.

Assistance from caregivers

If you require mobility assistance, it is important that your caregivers are trained to provide it. Mobility assistance can include transferring you from a bed to a chair, helping you use the facilities, and walking. Caregivers need to know how to safely lift, position, and move you. This is important for everyone’s safety – proper training reduces the risk of injury for both of you. Caregivers will commonly receive this training from healthcare professionals involved in your care.

Physical rehabilitation

When a brain injury causes damage that affects mobility and movement, a physiotherapist will assess your physical status and abilities. After the assessment, a treatment program is created that fits your needs. Rehabilitation programs are goal-oriented, meaning the therapists work with you to develop a treatment plan that not only addresses areas of need, but will help you reach your goals. These goals and plans require ongoing re-assessment and modification as the treatment progresses and your goals change. Physical rehabilitation may consist of activities such as:

  • Strengthening exercises focused on building endurance and muscle
  • Range of motion (ROM) stretches, which often focus on specific joints
  • Balance exercises which will target areas of deficit
  • Gait training to improve walking
  • Dizziness/vestibular retraining
  • Visual/perception re-training

Physiotherapy can be short or long term and requires active participation. You may be given activities or exercises to do between appointments. Doctors may also recommend that you work with an occupational therapist to help meet goals surrounding activities of daily living (ADLs) and work. This could include cooking, typing, using public transportation independently, and more.

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Tips to manage fatigue

There are some actions you can take to help manage your fatigue.

Ask for help

Fatigue can make it difficult to complete daily tasks, travel, or go to appointments. A caregiver, family member or personal support worker can assist with tasks that may leave you fatigued, and work with you as you build up your endurance.

Cognitive behaviour therapy (CBT) and occupational therapy (OT)

One of the leading causes of fatigue is the extra mental and physical efforts it takes a person with a brain injury to complete tasks.

Cognitive behaviour therapy is designed to help survivors coping with mental and cognitive changes. For fatigue stemming from cognitive changes, cognitive behaviour therapy can be helpful in building endurance and understanding what’s causing fatigue and how to manage it.

Occupational therapy is available to help people living with brain injury relearn skills or find new ways to complete activities of daily living (ADLs). When you practice these skills consistently, it will take less and less energy for you to complete them – this leads to less instances of fatigue.

Remember: the effects of rehabilitation happen over time and recovery is based on several factors. You won’t notice significant changes right away but that doesn’t mean the rehabilitation isn’t helping you. It’s like tracking fitness goals: you notice changes and improvements week to week, not day to day.

These therapies are available both privately and publicly. Private therapy is paid for by you. Publicly funded therapy is available at no additional cost: however, availability of public therapy is limited and differs from province to province based on the services available. Your doctor will be able to provide you with more accurate local information or recommendations.

Depending on your private or work insurance plan, occupational therapy and cognitive behaviour therapy may be partially or fully covered under psychotherapy services. It is always best to check directly with your insurance provider about your coverage.

Communicate your experience with fatigue

Your loved ones and friends may not understand how deeply fatigue can impact your daily life.  They may see you at a family gathering or event and make comments like “glad to see you are feeling better” or “great to see you back to normal”. They don’t know that you have had to sleep leading up to the event and will have to sleep for hours after it, just so you could have the energy to attend.

It’s okay to tell them you struggle with fatigue and you are always recovering. Openness and honesty will help educate others on the experience of living with a brain injury.

Create schedules to manage your day and your fatigue

Set out a schedule and plan your activities, appointments, and tasks for each day. You only have so much time and energy, and you want to make sure it will get you through the day. Chances are your energy levels before your injury were a lot different than your energy levels now. This means you will have to practice pacing – taking a bit more time and spreading out your schedule.

When building your schedule, try to do it the night before or in the morning after you wake up. When making a schedule, make sure to do the following things:

  • Build in rest periods. One of the best ways to manage fatigue is to give yourself time to rest. Listen to your body and don’t “push through” if you’re feeling fatigued. If you know you need multiple rest periods a day, schedule them before you schedule anything else. Having a schedule with time set aside to rest will help ensure you take the time you need.
  • Schedule activities when you have the most energy. Depending on when you experience fatigue, there will be periods of time during the day that make the most sense to schedule activities. For example, many individuals have the most energy after they wake up in the morning and much less energy in the evenings. By scheduling activities and appointments during the times you have the most energy, you will minimize the risk that fatigue will interfere.

Exercise and physical activity

This should be undertaken on doctor recommendations. Exercise and physical activity have all-over health benefits but should be reintroduced slowly and under supervision. Overtime you will build up your skills and endurance, meaning you can do more and feel less fatigued.

Have plans in place for unexpected fatigue

Fatigue can be debilitating and leave a person unable to complete tasks. It can also occur unexpectedly, especially immediately following your injury. For example, you could become fatigued in a public place, at a social event, or at work.

When this happens, having coping strategies can help manage the situation. This could include having hand signals with your caregivers or having an emergency contact come get you. If you’re worried about fatigue catching you off guard, try the following aids:

  • Keep a journal to track when you commonly feel fatigued
  • Speak with your rehabilitation therapists about strategies for coping with fatigue and public outings
  • Share your feelings with caregivers or employers – they can help you come up with a plan

Manage stress

Elevated stress levels can increase fatigue, particularly for individuals with brain injury who have cognitive and problem-solving challenges. When you identify what causes you stress, you can either remove those stressors or start dealing with them on a gradual basis. Giving yourself this time to process and respond to stressors will help manage feelings of fatigue.

Manage your expectations

A brain injury is a major life change, and that means abilities have changed. It’s important during recovery to manage your expectations and focus on what you can do. Don’t always compare where you are today with where you were before the injury. That will lead to negative feelings and fatigue because you’re trying to push yourself too hard. Instead, focus on setting weekly or monthly goals and prioritizing your health and well-being.

Track your fatigue

What causes fatigue for you may not cause fatigue in someone else. It is dependent on the person, their injury, and the environment. While it can be difficult to identify triggers, it’s important that you and your caregivers learn what makes you feel fatigued: if you don’t, you may experience extended periods of fatigue or feel like you have no control over your energy levels.

It can be difficult to track your fatigue through the course of a day, especially if you’re experiencing memory issues. By keeping a journal of your activities and your feelings, you can more accurately identify periods of time where you feel fatigued.

Record all medications you’re taking

Some medications can have increased feelings of fatigue as a side effect. Keep a list of what medications you’re taking, when you’re taking them, and their side effects. This will help you identify when you may feel more tired.

Create a rating system

One way to check in with yourself and how fatigued you’re feeling is to create a rating system. Make a scale from 1-10 and measure your fatigue on that scale. For example, a 1 is not fatigued at all while a 7 or 8 is strong feelings of fatigue.

You should rate your fatigue levels before and after you complete an activity – for example, doing the dishes. If you find that doing the dishes takes you from a 1 to a 5 on your fatigue scale, perhaps take breaks or ask for help with dishes.

This rating system will not only help you identify what makes you feel fatigued; it will help you identify when to take breaks and improvements you make over time [1].

Understand what environments work for you

Some environments can increase a person’s fatigue. This includes places with loud noises, bright lights, overcrowding or that require a lot of travel. By understanding what environments cause fatigue and what environments work best for you, you can more easily participate in activities. Over time, you can reintroduce yourself to other environments for short periods of time. Wear sunglasses if it will help you deal with bright lights and ear plugs to deal with noise if it does not jeopardize your safety. Look for places that offer sensory-friendly settings – for example, some grocery stores have specific sensory-friendly shopping days.

Remember: take breaks as often as you need. You don’t have to stay out for a full day if you’re experiencing fatigue or other symptoms. It’s important to listen to your body.

Use assistive technology and tools

Assistive technology and tools help individuals with acquired brain injury manage their symptoms and complete activities of daily living [2]. There are ways to use assistive devices to cope with fatigue. For example:

  • Wheelchairs during walking rehabilitation
  • Checklists to help manage tasks and minimize stress
  • A sleep journal to track sleep disturbances

Occupational therapists and cognitive behavioural therapists can assist in developing coping methods or introduce you to tools that manage fatigue.

If you need financial support to obtain assistive devices you can explore this assistive devices program. This program assists adults with physical disabilities who are in financial need to purchase assistive devices that increase their mobility and functional independence.

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Emotional effects

When the brain is injured, a person’s emotional processing and responses can change. Major life changes and stressors associated with brain injury can add to emotional difficulties. You may experience less emotion or more intense emotions. You may feel and act in ways that are out of character for you. For example, a person who was mostly calm and cheerful before an injury may get angry more easily after the injury.

Like with all parts of brain injury recovery, it takes time to learn how your emotions are affected and what you can do to manage them.

Topics in this section include:

 Changes in emotions

Anger/irritability
It is common for people living with brain injury to get frustrated, angry or irritated more often or more quickly. They may even become aggressive. This can lead to yelling, cursing, and physical outbursts. This is often distressing both for the survivor and their loved ones.

These episodes of anger or an increase in irritability can be triggered by:

  • Confusion
  • Frustration with a task that is harder than it used to be
  • Fatigue
  • Misunderstanding another person’s intentions
  • People telling you what to do or pointing out mistakes
  • Too much stimulation (e.g., light, noise, and movement)

If you’re experiencing periods of anger or irritability, try some of the following coping methods.

  • Engage in calming activities – listening to music or reading are some examples
  • Practice deep breathing
  • Remove yourself from the situation and go to a more calming location
  • Work with a doctor who is familiar with acquired brain injury and emotions on some self-calming methods and communication strategies – being able to communicate what you’re feeling to others can be extremely helpful when it comes to emotional situations. Cognitive behaviour therapy can provide support and tools to help manage anger/aggression and understand why you have these reactions.
Anxiety
Anxiety is a common emotion related to your mental health. It stems from feelings of worry and fear. After a brain injury, people commonly worry about recovery being too slow, getting back to school or work, not having enough money, and relationship difficulties.

Depression
Depression is common after a brain injury. Adjusting to your new self and your experiences is difficult and can result in decreased motivation and feelings of sadness, loneliness, and even despair. When these feelings last for weeks or longer, a person may be diagnosed as having Major Depressive disorder, a health condition that requires treatment.

Emotional control
A lack of emotional control means you speak or do something before thinking it through, reacting solely based on your emotions. You don’t consider the outcome/consequences of what you say or do. You may also do risky or dangerous things. Emotional control and behavioural (or impulse) control are closely linked because they are both managed by the same brain systems.

If you have a decision to make, even a simple one, give yourself a reminder to stop, think, and ask if you really want to do or say something. You can also ask someone to be your safety net – ask them about what you want to do and listen to their advice.

Mood swings
Mood swings – also called emotional lability – are when you go from one emotion to another quickly, often for short periods of time. It can also mean you experience emotional outbursts – for example, laughing or crying a lot even if you don’t feel very happy or sad.

Mood swings are common when the parts of the brain that control emotion are injured. Sometimes there is an obvious reason why your emotions suddenly change. At other times there is no specific event that causes a change in mood: it appears random to other people. Mood swings can also be unrelated to a situation or the way you feel. This can be confusing.

In general, these mood swings are outside a person’s control. It’s important not to be hard on yourself. Mood swings happen. Instead, celebrate the times you feel calm and in control. Other ways to cope with mood swings include:

  • Calming activities
  • Deep breathing
  • Distract yourself from the thing that is making you laugh or cry more than you want to
  • Speaking with your doctor – they may be able to help with mood stabilizing medications and tools. If you do take medication, remember that it may not work right away and you will need to work closely with your doctor to find the right medication and dosage

You can ask a caregiver or family member to help you with calming strategies like deep breathing, exercises or calming activities. Over time, many people find that their mood swings happen less and less as their emotions balance out and they use coping methods to help.

Personality changes
Personality changes can come from both emotional and behavioural changes. Personality traits may become exaggerated or more intense after a brain injury. For example, a quiet person may become even quieter; an assertive, active person may become aggressive and outspoken. The opposite can happen too, where a normally quiet person becomes very outgoing or outspoken.

These changes can happen with all brain injuries. While some people find that their emotions and personality changes fade as they recover, some changes may be permanent.

I’m feeling upset over my brain injury – how do I cope with my new reality?

It’s normal to feel upset, angry, and sad about your brain injury. It’s also easy to get swept up in your grief over what has changed. It’s important to let yourself feel grief – but don’t dwell on it. Instead, do your best to focus on the improvements you’re making, things you’re looking forward to, and things that make you happy. Try breaking your goals down into smaller pieces – you’ll more easily be able to see your progress.

It’s going to take a long time, and some days will be better than others. If you are having difficulties, make sure to share them with your family, caregivers, and doctors.

Identifying and managing emotional changes

Working with a cognitive behavioural therapist (CBT)
One of the most effective ways to manage the emotional effects of brain injury is to work with your healthcare team. Cognitive behavioural therapists develop a personalized program that will address your areas of need. This includes coping with emotional challenges. Cognitive behavioural therapy is goal-oriented, meaning you have specific things you want to achieve, and you actively participate to reach those goals. These plans can adapt over time as new goals are set, but in general cognitive behavioural therapy is meant to be a short-term treatment that teaches you the skills you need to cope with cognitive, emotional, and behavioural changes.

If not available at your local rehabilitation hospital or mental health clinic, this kind of service may have a fee. While cognitive behavioural therapy may be covered under some insurance plans, this can be an out-of-pocket expense.

Psychiatrists and psychologists specialize in talk therapy and mental health, which can have a huge impact on emotions. The main difference between them is that psychiatrists have medical degrees rather than primarily academic degrees and can prescribe medication. Working with either a psychiatrist or a psychologist can help you share your feelings, access feedback, and understand the relationship between mental state and emotions.

Deep breathing
If you’re feeling overwhelmed, pausing and taking deep breaths is a good tool to help you focus. This is something your caregiver or family member can help you with by talking you through it. Deep breathing sounds relatively simple but there’s a lot more to it than just “in and out.” There are additional steps you can take to bring more mindfulness to the exercise.

Take a rest break
When we’re tired, we tend to get more emotional. After a brain injury, many people experience fatigue. Make sure you take all the time you need to rest or have some alone time.
Remove stressors
Are there things in your house or in your life that are stressing you out? If so, try to find ways to remove them. Depending on what your stressors are, you’ll need to come up with different ways to handle it. One example: if you get stressed because you can’t remember what house cleaning needs to be done, a checklist can help manage that stress.
Visit support groups
Many communities have local brain injury associations or support groups with activities and resources. Participating in support groups is a great way to build up your community; it also gives you a place where you can feel safe and welcome, which will have a huge impact on your mental health. Support groups are also a great place to hear about other experiences and learn new tips/strategies that have helped others in recovery.

Disclaimer: There is no shortage of web-based online medical diagnostic tools, self-help or support groups, or sites that make unsubstantiated claims around diagnosis, treatment and recovery. Please note these sources may not be evidence-based, regulated or moderated properly and it is encouraged individuals seek advice and recommendations regarding diagnosis, treatment and symptom management from a regulated healthcare professional such as a physician or nurse practitioner. Individuals should be cautioned about sites that make any of the following statements or claims that:

  • The product or service promises a quick fix
  • Sound too good to be true
  • Are dramatic or sweeping and are not supported by reputable medical and scientific organizations.
  • Use of terminology such as “research is currently underway” or “preliminary research results” which indicate there is no current research.
  • The results or recommendations of product or treatment are based on a single or small number of case studies and has not been peer-reviewed by external experts
  • Use of testimonials from celebrities or previous clients/patients that are anecdotal and not evidence-based 

Always proceed with caution and with the advice of your medical team. 

Create a routine
Since you’ve experienced a lot of changes, creating a schedule for each day or each activity you have to do can take a lot of stress away. When you know exactly what’s happening and what to expect, you can mentally and emotionally prepare yourself.
Exercise
Exercise can have a positive effect on both the body and the mind. Even if it’s just a few arm circles, a walk, or leg stretches. It’s a great way to occupy yourself and focus your energy.

Please note: You should only do exercises that have been doctor-recommended.

Spend time outside (if possible)
Fresh air is a great way to boost your mood. Even if you’re only outside for a few minutes at a time, this change of venue and activity can be incredibly stimulating.
Medication
In some cases, it might make sense to take medication to help with depression or anxiety. Please note: only your doctor can recommend and prescribe you with medication.

See sources