Avoiding Screen Time Following a Head Injury?

By Hannah Burgess

Once an individual sustains a head injury, one of the first questions that they often think about is whether screen time should be avoided.  Siding with caution, many health care providers will advise against it. We are just beginning to understand the importance, if any, of reducing screen time following a head injury. We are also working towards understanding how this may differ depending on the type of injury. Continue with us to learn more. However, before we get too far let’s define “screen time”. Screen time is an all-encompassing term for activities that are done in front of a screen such as (but not exclusive to): 

  • Working on a computer 
  • Watching tv
  • Playing video games 
  • Scrolling through social media on your phone 

Concussion patients should avoid screen time for first two days | Science  News for Students Photo sources from ScienceNews for Students 

A recent study found that those who limited their screen time for 48 hours right after they suffered a concussion, had a significantly shorter duration of symptoms compared to those who didn’t. These findings are clinical evidence suggesting that restricting screen time within the acute period after sustaining a concussion can lessen the length of symptoms. Shortening symptoms such as:  

  • Headaches 
  • Ringing in the ears 
  • Nausea 
  • Vomiting 
  • Blurry Vision 

If you knew of strategies that could reduce your recovery time, wouldn’t you consider trying them?  

We believe there is a collective “YES” to this answer. However, individuals most often do not realize that they have sustained a brain injury, and continue to live their everyday life, potentially causing a longer recovery for themselves.  Even if you do or do not know if you have a diagnosed head injury, we have all come to learn through the COVID-19 pandemic that our excessive screen time may be detrimental to our well-being. And there are ways to reduce screen time. Continue reading for 8 of the top strategies. 

8 Strategies to Reduce Your Screen Time

Following a few of these simple steps could help improve your health and possibly reduce TBI symptoms.    

  1. Track – Using the screen time daily and weekly usage tracking features that are available on most electronic devices can help you measure the amount of time you spend on your devices. 
  2. Avoid Screen Fatigue – Limiting the amount of time you spend on video calls can help you to avoid screen fatigue. You can do this by setting time limits within the technology itself. 
    1. Check out this article that can instruct you on how to set screen time limits. 


      Photo sourced from Meru International School 

      Photo sourced from Meru International School

  3. Leveraging Technology –You can turn off notifications to social media platforms to help you refrain from logging in as often.  
    1. Check out this article that can help you learn how to turn off notifications. 
  4. Regular Breaks – Set yourself breaks or timers within the day that can remind you to step away from the screen.  
    1. Following the 20-20-20 rule is a good way to adhere to this strategy. The 20-20-20 rule states that every 20 minutes you should look at something 20 feet away from your screen for a full 20 seconds. This could be looking out the window or looking at your dog, either one providing a break from looking at your screen.  
  5. Sit Less – Get up and get moving. Standing or walking around promotes health, so try to sit less. 
    1. Even stretching or going for a quick walk on your recommended breaks can help to promote health.  
  6. Paying attention to your Posture – An upright posture helps to support the head and reduces fatigue and aches. Keeping in mind the importance of maintaining a correct posture, could help reduce some of the strains of screen time. 
  7. Avoid eating in front of a screen – Having a separate mealtime rather than always enjoying your food in front of a screen, can help you to take a much-needed break away.  
  8. Avoid having screens in the bedroom – Screens emit a light that can interrupt your quality of sleep. Avoiding them right before bed is a good way to improve sleep and therefore health. 

Individual to Individual

Now what may work for you in limiting your screen time may not work for someone else. An individual’s job and lifestyle may influence their screen habits more than another’s. Individual head injuries are also completely unique from one another, altering the methods that may provide someone relief. Hear from Diamone Ricketts (pictured below in a picture she provided), a brain injury survivor on her experience with monitoring her screen time habits following her injury.  

A person wearing glasses

Description automatically generated with low confidence

“I am an active brain injury individual who currently suffers from sleep deprivation as an active side effect. I’ve read books and used Google as a search engine to know the factors about what is good for my body and what is bad. I used my own hypothesis to see which method will allow my brain to grow smarter with screen time.” – Diamone 

As you can see Diamone has taken initiative on ways, she can elevate herself through technology, without impacting her brain injury symptoms. She emphasized the importance of that being knowledgeable on your body and ways to care for it effectively, is one of the best ways to approach your recovery.   

“There’s no law against screen time. Just limit your time doing so. Cognitive activities such as puzzles, word cross-board games, card games, and physical exercise, can also help enable educational growth in problem-solving and enhance skill development.” – Diamone 

Diamone also clearly understands that technology and screen time can be used towards improving cognitive deficits as well. It is all about finding balance.  

Irritability and Anger: How TBI Affects Aggression

From: Power of Patients Spring Blog 

A traumatic brain injury affects more than just you and your brain. It affects everyone who comes in contact with a person suffering from a TBI. irritability and anger

It makes sense that an injury to the brain would affect brain processing as well as motor skills. But does TBI affect emotions?

Studies and anecdotal evidence together, indicate that TBI and anger go hand in hand, not just because of the injury to the emotional center of the brain, but because of the frustration that comes with recovering from a traumatic brain injury.

Over 70 percent of families of individuals with a TBI report the TBI victim demonstrating irritability and anger.

Keep reading for a full explanation of how a traumatic brain injury causes anger and irritability, and what both caregivers and victims can do when anger begins to bubble up.

What is a Traumatic Brain Injury?

A traumatic injury is more than just a general bump on the head. A TBI is the result of a violent blow to the head. It is a permanent injury to the brain.

Individuals can also suffer from a TBI if matter, such as a shattered piece of skull bone or a bullet, goes through the brain. Closeup young woman with worried stressed face expression eyes closed trying to concentrate with brain melting into lines question marks deep thinking. Obsessive compulsive, adhd, anxiety disorders

Major and mild traumatic brain injuries will affect the brain differently. A mild TBI may cause temporary damage. A serious TBI, on the other hand, can result in permanent damage to the brain and possibly death due to long-term complications.

Why does a TBI Cause Irritability and Anger?

The different reactions to a TBI stem from a variety of reasons. For example, men and women respond differently to a TBI. Women tend to respond to a TBI with depression, substance abuse, and memory problems, whereas men struggle with more irritability and depression.

Thus, first, you need to consider the gender of the individual suffering from a TBI. No two people will respond the same.

With that said, many individuals with a TBI demonstrate a shorter fuse than the average person. They have quick tempers and tend to fly off the handle frequently. They may use course language, slam their fists into things, threaten the people they love, slam doors, and throw objects.

The TBI causes irritability and anger when the injury affects the limbic system of the brain. This part of the brain is responsible for emotional responses as well as hormone release, sexual responses, and temperature regulation.

Thus, when your limbic syNeuronsstem sustains a traumatic injury, it only makes sense that you will have a difficult time controlling your emotions. You may find yourself irritated by small things or angry over things that would not have bothered you in the past, simply because your brain is not functioning as it did before your injury.

Other Potential Causes

When you suffer from a TBI, you may have a difficult time controlling your temper. This difficulty stems from more than just the actual brain injury.

It could also stem from simple frustration or dissatisfaction with the new life you have to live. Your traumatic brain injury could be causing motor deficiency and physical changes. You could feel frustrated with these changes.

Often, individuals with a TBI will feel isolated and misunderstood. No one other than other people with a TBI understands what they’re going through. As a result, they may feel depressed, as well as angry.

A TBI can affect attention span as well as memory. As a result, individuals with a TBI may experience difficulty concentrating and remembering things. This challenge can lead one to become frustrated and angry.

Individuals with a TBI will also tire more easily. When you tire easily, you miss out on important parts of life, and this can be frustrating, too.

What the Anger Looks Like

These mitigating factors can all lead to anger that will look the same, regardless of the factors that cause it. One thing is certain. The anger expressed by someone with a TBI often stems from several causes in combination and not just one single thing.

For example, when you suffer from a TBI, you may lose your job and financial stability. You may feel like you’ve completely lost control over your life. These losses will lead to both sadness and anger, especially since the TBI stems from something completely out of the victim’s control.

Some people already had an anger problem before their TBI. The TBI will just exacerbate an issue that existed before the injury.

However, some individuals will develop impulsive anger. They will just snap suddenly and seemingly without any cause. Angry Woman 1

There is a physiological cause, though. Often these individuals have suffered brain damage to the part of the brain that would normally inhibit angry feelings and the behavior that accompanies them. In a normal brain, when a person feels anger, a part of the brain will stop that individual from acting on the anger.

For an individual who has had a TBI, though, the brain will not stop the anger because it has sustained damage. As a result, they will respond quickly and severely in anger in a way that they normally would not have behaved before their injury.

Impulsive anger makes itself known through a few different symptoms:

  • The individual did not demonstrate the same type of anger before the injury
  • The angry feelings appear and leave suddenly
  • Minor events precede the angry episodes
  • The individual who demonstrates quick anger also feels embarrassed or surprised when it happens
  • Physiological stress such as pain, low blood sugar, or fatigue worsens the anger

These symptoms may indicate a type of anger that the TBI has caused.

Irritability and Anger Triggers

Once patients and caregivers determine that a traumatic brain injury has caused a problem with anger, they can begin to determine the triggers that lead to the angry outbursts.

While each brain injury survivor responds differently to their TBI, there are some common factors in most survivors.

The brain injury survivor is, in some ways, a different person. What makes them angry may be different. We need to learn what those things are. Here are some common factors that contribute to anger after a brain injury.

Factors that Lead to Angry Outbursts

Environmental factors, as well as personal factors, can stimulate an angry outburst. Here are a few of the most common factors that lead to a person snapping:

  • High activity level
  • High noise level
  • Unexpected changes in schedule
  • Lack of structure and unpredictability
  • Fear and anxiety
  • Embarrassment
  • Shame
  • Guilt
  • Frustration
  • Memory deficits
  • Communication deficits

Physiological factors can also lead to angry outbursts. For example, low blood sugar leads the average person to become “hangry.” Someone with a TBI will feel extreme levels of anger when their blood sugar dips.

Here are a few other physiological causes:

  • Physical pain
  • Wrong levels of medication
  • Fatigue
  • Drugs
  • Alcohol

These physiological factors would lead the average person to feel irritated. But the average brain can also stop the angry outburst. An individual with a TBI does not have that capacity.

Signs Before The Outburst

When you know what to look for, you can prevent an angry outburst. The impulsive anger demonstrated by someone with a TBI differs from the average person with a few different physiological, speech, and behavioral signs. Here are the most common signs:

  • Threatening speech including cursing and name-calling
  • Loud voice
  • Clenched fists
  • Increased fidgeting and movement
  • Throwing and breaking items
  • Physical violence
  • Racing heart
  • Sweating
  • Clenched muscles
  • Bulging eyes and flushed face
  • Increased breath rate

Additionally, providers that work with TBI patients will notice mental signs such as feelings of fear or anxiety, embarrassment, hurt, shame, guilt, and frustration.

While all of these symptoms are common with individuals that do not have a TBI, when a person encounters a situation that makes them angry, those with a TBI will demonstrate the signs at times that simply do not make sense.

Treating and Managing a TBI

Providers working with an individual that has suffered from a TBI can limit angry outbursts with the right preventative and management techniques. Consider the triggers that could lead to an angry outburst, and then avoid those triggers. Here are a few basic ideas.

Create a Safe Environment

You can create a safer environment by removing potential weapons as well as drugs and alcohol. Keep both dangerous tools and vehicles inaccessible as well.

Regulate Stimulation

Test and know the individuals you’re working with. Some people with a TBI need to avoid overstimulation, so have dimmer lights and calm colors. Other individuals will need distractions and busyness, so plan for them accordingly.

You will also want the right amount of supervision for that individual. Create the least restrictive environment while still creating a safe environment.

If that individual struggles with orientation, be prepared to redirect them regularly, reminding them of where they are and what is happening.

Give Space

It’s alright to withdraw from the individual to give them a chance to cool down. Sometimes the person in the middle of an angry outburst just needs space and time, so give it to them.

Re-Focus

Guide the individual to gather themselves by changing the subject and helping them focus away from whatever has made them angry.

Regulation Strategies

Once a brain-injury survivor has recovered physically, you can begin to teach them methods that will help them learn how to deal with the overwhelming feelings of anger that assault them. Here are a few common strategies.

Retreat

When the individual begins to feel the anger bubble up, they need to look for a physical way out. It’s okay to retreat. At the beginning of teaching this technique, caregivers will want to teach the individual a cute word or symbol that lets that person know they’re about to go over the edge.

At some point, the individual will learn to recognize their physiological symptoms and then self-regulate by removing themselves from the situation.

Mental Break

If a physical retreat isn’t an option, the individual should use mental techniques that allow them to calm down. You can teach them to take a deep breath, close their eyes, and then take another big breath.

Other factors will help with calming down, such as prayer, meditation, soft music, and even physical exercise.

Prepare, Then Come Back

Before the individual brings themselves back to the situation that has caused anger, they need to review some basic questions. Have the individual with a TBI practice and use these questions.

  • Should I apologize?
  • Should I explain my absence?
  • Should I share my feelings with anyone?
  • How can I avoid this problem in the future?

The answers to these questions will allow the individual with a TBI to return to the situation and build relationships despite their disability.

All of these techniques combined will help the individual with the TBI to recognize their problems, handle them, and maintain meaningful relationships in society.

Education and Action for TBI Victims

Anyone who experiences irritability and anger runs the risk of ostracizing their loved ones. There is a way to deal with a TBI, though, that allows one to have meaningful relationships.

First, the individual must note why they’re angry. Once they’ve recognized their triggers, they can either avoid them or learn how to manage them. By following some basic steps, they can move their way back into society and friendships that last a lifetime.

Have you suffered from a brain injury or know someone that has? Do you work with TBI survivors? If so, we can help you.

We have designed an app with an easy-to-use dashboard to help brain injury patients and their caregivers. By using Sallie, our FREE, customized app, you can track these symptoms and triggers that cause your irritability.

Tracking this information with our app lets you manage your brain injury better. Thus, you can show your data to any provider that can further help you manage your TBI.

We aim to empower patients and caregivers with data and drive change, to reshape and accelerate clinical trials which help people who suffer from brain injuries.

Check us out today. We have some personal connections that drive our passion to help individuals with brain injuries.

Works Cited:

https://www.cdc.gov/traumaticbraininjury/get_the_facts.html

https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557

https://msktc.org/tbi/factsheets/emotional-problems-after-traumatic-brain-injury

https://www.healthline.com/health/what-part-of-the-brain-controls-emotions

https://www.powerofpatients.com/blog/the-differences-between-males-and-females-with-brain-injuries

https://www.powerofpatients.com/about

https://www.powerofpatients.com/providers

https://www.powerofpatients.com/patients-caregivers

The Differences Between Males and Females with Brain Injuries

by Tayeb Benjaafar

What are the differences between males and females?

This is an age-old question that no person has ever been able to truly figure out. What makes a male and a female so different from one another? Genetically, males and females are 98.5% identical. In fact, we even share the same hormones and critical organs (brain, heart, lungs, stomach, etc.). Fundamentally, it seems males and females are more alike than we think?

Meet Odette Harris

Well Odette Harris, a professor of neurosurgery and brain trauma expert, began to explore that very question through her research. Harris never intended to bring sex differences into her line of work because it was believed that no matter the body, a brain is still fundamentally a brain. While analyzing data from the Department of Veteran Affairs she realized that there is in fact a huge sex difference in the aftermath of traumatic brain injuries, and nobody is exploring it.

The same type of injury in both males and females has a drastic difference in recovery based on a person’s sex.

Photo of Odette Harris

Through her studies, Harris, director of the Traumatic Brain Injury Center of Excellence at the VA Palo Alto Health Care System, found some insane trends. It was found that females with some form of brain injury trauma and other possible severe injuries saw vastly higher rates of substance abuse, depression, memory problems, and even homelessness along with a vast array of other troubles than males with the same type of brain trauma and injuries.

More…
Continue reading “The Differences Between Males and Females with Brain Injuries”

What Does it Mean to Have Expressive or Receptive Aphasia

By Dr. Lori Bartels (reprinted from SATBIL Magazine By Walter Kilcullen)

Expressive, receptive, and mixed aphasia are terms that get tossed around a lot in the hospital after a stroke or brain injury. Medical professionals tend to describe aphasia to the families as receptive aphasia, expressive aphasia, or mixed aphasia. This is a generic label families hear early in the recovery process.

Thinking of aphasia in this way can be confusing. I frequently see clients incorrectly diagnosed because the physician isn’t familiar with the predominant features of each type of aphasia. Their job is to say that aphasia is present, so they try to classify it very early in the recovery.

All aphasia is receptive and expressive. Each person with aphasia, no matter what part of the brain was damaged, has difficulty with ALL language skills – reading, writing speaking/language, and understanding – when compared to pre-stroke or pre-injury language skills. These skills are all affected by aphasia, but some of those skills are relatively better than others. The keyword here is “relatively.”

Aphasia affects language input, such as reading and understanding speech. “Input” is something that goes INTO your language system. Reading and understanding are two different forms of input (written words, photos, or speech) and they must be processed in your brain to understand them.

Aphasia also affects outputs, such as writing and speaking/language. These are skills that let you get things OUT of your brain. You think of what you want to say or write and you say or write it. Or you listen to what someone said and say something back to them.

If someone has expressive aphasia, it’s supposed to mean that they can’t speak or write well. In terms of input and outputs, the outputs are much more affected than the inputs. This is how we would describe something like Broca’s aphasia or Transcortical motor aphasia. Understanding in these aphasias is relatively better than speech. The predominant feature is that the person can’t speak effectively. Broca’s aphasia, for example, means that while the person doesn’t understand the same as before the stroke, their understanding appears to be much better than their talking.

If someone is described as having receptive aphasia, it’s supposed to mean the opposite – that the inputs are much more affected than the outputs. This is how we would think of Wernicke’s aphasia or Conduction aphasia. Understanding in these aphasias is relatively worse than speech. Although the first thing you may notice about Wernicke’s aphasia is that there is a lot of speaking but no real content, the speech is flowing. What is lacking is a real language, so it’s the opposite of expressive issues.

Mixed aphasia should mean that the client’s inputs and outputs are “equally” affected. This would be closer to a Global aphasia diagnosis in which the person has very little speech, say the same words over and over, or has no speech. Their comprehension has also been severely affected. The majority of people have this type of aphasia right after their injury while their brain heals.

Expressive aphasia, receptive aphasia, or mixed aphasia may be used incorrectly to help categorize your loved one’s aphasia. It can be very confusing to families to learn something completely different in the beginning. This affects the treatment progress of the person with aphasia. If you are starting off with incorrect information, you’re going to make treatment choices based on that information. If you have acid reflux but are diagnosed with heart problems, you’re treating the wrong problem. There is a distinct difference between treatment approaches for receptive, expressive, or mixed aphasias. Don’t be afraid to get more than one opinion – knowledge is power.
_________________________________________________________________
Dr. Bartels is a published aphasia researcher, presenter, author, and founder of The Aphasia Center Intensive Aphasia Program. She is an aphasia diagnostic expert and treatment expert with over 13 years of daily experience. She helps families with aphasia all over the world plan their recovery and exceed their goals

COVID-19 and PTSD: Assessing the Pandemic’s Toll on Mental Health

(Reprint from https://medicine.yale.edu/news-article/covid-19-and-ptsd-assessing-the-pandemics-toll-on-mental-health/)

Illness, grief, job loss, social isolation, uncertainty, and other pandemic-driven stressors have contributed to an increase in psychological distress on an unusually wide scale. As researchers and clinicians continue to grapple with the psychological fallout from COVID-19, a growing body of literature has examined the prevalence of post-traumatic stress disorder (PTSD) in the general public.

Women’s Health Research at Yale, in partnership with colleagues at the University of Bordeaux in France and the U.S. Department of Veterans Affairs National Center for PTSD, published a paper in the journal Chronic Stress identifying 36 studies assessing PTSD symptoms in the general population, and the occurrence of these symptoms ranged from 5 percent to 55 percent of those being studied, averaging 26 percent across the studies.

How can these estimates vary so greatly, and can such wide swaths of the public truly be suffering from pandemic-related PTSD? Before the pandemic, about 3.5 percent of American adults every year were diagnosed with PTSD, with women twice as likely as men to have the disorder.

The American Psychiatric Association defines PTSD as a disorder in which someone experiences “intense, disturbing thoughts and feelings” for long periods following a traumatic event. Such a diagnosis requires, in part, that the event involve “actual or threatened death, serious injury, or sexual violence” either directly; as a witness; or learning of a loved one’s serious injury, an encounter with sexual violence, or violent or accidental death.

Dr. Mathilde Husky, professor of clinical psychology at the University of Bordeaux and lead author of the paper, notes that a life-threatening medical condition does not qualify unless it involves sudden or catastrophic events, such as waking up during surgery or anaphylactic shock. Husky and her co-authors question whether the pandemic “as a disruptive global experience can be construed as direct exposure to a traumatic event in the general population.”

Dr. Mathilde Husky
Dr. Mathilde Husky
Dr. Mathilde Husky, previously a postdoctoral student with Dr. Mazure and now a professor at the University of Bordeaux, is the lead author of a study on classifying the pandemic’s effect on mental health.

“As clinicians, when we ask about symptoms of PTSD, it’s always in reference to a specific traumatic event, with a significant level of shock,” Husky said. “In the context of a pandemic that is nearing two years in length, if I ask someone if they are experiencing flashbacks, the question becomes: flashbacks of what? Are they avoiding cues in their environment or situations that would expose them to things that would remind them of the event? Some people report a singular traumatic event in the context of the pandemic, but many do not.”

These findings have led the authors to question whether the pandemic can be considered as a single entity when it can affect people in so many different ways over such a long period of time, depending on their jobs, exposure to the disease, preexisting stressors, and psychopathology, and many other factors. And, as important, whether other existing classifications adequately address the health needs of individuals who experience stress not as a single event but as an enduring experience with varying levels of severity or shock.

The authors, including Drs. Robert Pietrzak of Yale and the National Center for PTSD and Brian Marx at the National Center for PTSD, suggest that the next research step should be to ensure that PTSD criteria are met when evaluating PTSD or consider another, alternative way of classifying perceived stress that is related to a long, ongoing adverse experience. In addition, the authors suggest researchers should gather data on preexisting mental health disorders and prior exposure to traumatic events to better determine the source of more recent symptoms.

“We must also continue to focus on how preexisting and concurrent stressors may disproportionately affect women more than men,” said Dr. Carolyn M. Mazure, senior author on the paper and director of WHRY. “There is a growing body of evidence showing that lockdowns, school closures, and working from home to reduce the spread of COVID-19, for example, have had a greater effect on women. Is this because women have greater ongoing stressors?”

BIAG welcomes our new Executive Director, Cassandra Palmer

The Board of Directors for the Brain Injury Association of Georgia is thrilled to announce the promotion of long-time Executive Director Jane Jackson to Director of Resource Facilitation. She, along with Dr. Chantel Davis, will work to pilot the all-new Resource Facilitation program in conjunction with the Georgia Brain and Spinal Trust.

Caregiver and Forsyth County support group leader Cassandra Palmer has been hired to assume the role of BIAG’s Executive Director.

Caregiver Study Opportunity

CAREGIVERS’ VOICES NEEDED!
We are looking for volunteers for a research study. The study aims to explore the needs, concerns, and quality of life of working-age caregivers of stroke survivors. Working-age caregivers’ specific needs and concerns have not been included in the majority of stroke caregiver research. It is important that working-age stroke caregivers have a voice and the ability to share their needs and concerns. The goal of this research is to study how unmet needs and concerns as well as other factors affect the quality of life for working-age caregivers.
First, we ask that you complete a short screening questionnaire to see if you are eligible to participate in the study. The screening will take less than 5 minutes. If you are eligible and you would still like to participate, you will receive a link to a second survey and you will be asked to answer questions about your needs and concerns, caregiver situation, social support, and quality of life. The survey will take about 20-30 minutes to complete. You can complete the screening questionnaire and survey online through the link. You can complete the screening survey at https://redcap.link/9zt852zk
You will receive a $50 Amazon e-gift card as a token of appreciation for your participation in the study. After completing the survey, please provide your email so we know where to send your gift card.
Risks include experiencing emotional distress, boredom, or fatigue as you may have to reflect on past experiences or as you answer a specific survey question. But the study poses no physical, social, or legal risks. There is also a risk of loss of confidentiality. To minimize this risk, we will maintain the confidentiality of your information in accordance with all national and local regulations.
Thank you for allowing me the opportunity to share my research study with you. . If you have any questions or comments, please call, text, or email me. I would love to hear from you!
Sincerely,
Dixie Rose, MSN, RN, ACUE
Ph.D. Candidate, Medical University of South Carolina College of Nursing
(903) 922-3292

It’s OK If You Struggle to Accept Your Health Condition

You may feel pressure to accept yourself and your health condition every second of every day, especially if you’re open about how it affects you. But no matter how you approach life with your condition, you don’t need to live in a constant state of self-acceptance. It’s OK if you struggle to accept your health condition — and it happens to almost all of us.

It’s OK if you need time to grieve the life you lived before your diagnosis. It’s OK if you feel like making different health decisions wouldn’t have landed you with a new label to carry. It’s OK if you can’t seem to believe that you have a diagnosis or feel sad, frustrated or angry that your condition affects you along with many others. The grieving process may take weeks, months or even years, but no matter how long it takes, let yourself process your emotions. You deserve time and space to move through every stage of grief without your own judgment of your feelings.

It’s OK if you’re having a hard day and hating life with your health condition. It’s OK if you feel like you took 10 steps backward on the road to self-acceptance and feel stuck in a place of self-hatred. It’s OK if you feel sorry for yourself as your symptoms flare up, and you desperately want a life that doesn’t make you feel like a professional patient. Whether your hard time lasts for just a day or stretches longer, remember that it’s natural and won’t last forever. You will have bad days, but they don’t have to define your journey towards self-acceptance or the ways in which you advocate for others with health conditions.

It’s OK if you worry about others’ ability to accept you with your health condition, even if you’re surrounded by people who care.  It’s OK if you have moments when you doubt your ability to find love or friendship or fear that your loved ones will walk away when they learn the intricacies of your condition. It’s OK if you have moments of mistrust and self-hatred as you struggle to cope with changing relationships as your health shifts. You are surrounded by love and support, but those moments when you believe otherwise don’t make your fears any less valid. You won’t feel this way forever, and your health condition may eventually make your relationships feel deeper and more fulfilling than ever before.

Self-acceptance matters, but in life with a health condition, it isn’t everything. It’s OK if you struggle to accept your health condition — living with an illness or disability is hard, and acknowledging the struggle is perfectly fine.