One of the major issues we address when treating someone with a brain injury is the issue of arousal.  Arousal refers to “a state of responsiveness to sensory stimulation or excitability”.  We fluctuate through various states of arousal throughout a 24 hour period.  A low state of arousal would be deep sleep or meditation and a high state of arousal is the fight or flight response. 

When an individual has had a brain injury, the most basic of deficits is the ability to regulate their level of arousal.  There is heightened and prolonged response to influences on their level of arousal.

Some examples of over-arousal are: agitation, irritability, disorganization, poor / impulsive decision making, anxiety / panic attacks, inattention, confusion, poor eye contact, sensory overload and mental shutdown.  These symptoms can eventually lead to secondary problems such as: headaches, stomachaches, joint / muscle pain, social isolation and depression.

It is extremely important to address the issue of arousal throughout the life span of someone who has had a brain injury.  Over-arousal is extremely disruptive and frustrating if not adequately understood and treated.