Boom and Bust – The all or nothing phenomenon

Any other friends out there who have had concussions? This is not a club I ever thought I would join. I don’t play contact sports. I don’t put myself in situations where I am likely to get smoked in the head. In fact, I actively avoid these situations! Ha! And yet I still have found myself suffering from back to back concussions in 2022. Two freak accidents that have resulted in 3 months and counting off of work and a new normal that consists of constant appointments, rehab, and a lot of naps.

In concussion treatment, they use the phrase “Boom and Bust”. Maybe you are familiar with this term in relation to the economy, but in terms of concussion recovery it refers to pushing yourself way past where you should instead of finding your baseline and gradually increasing your tolerance for that activity. The result is significant regressions and set backs. Back in June, I had a big “Boom and Bust” the first week after my initial concussion. I woke up after 5 days and felt great. I instantly went from laying around doing nothing to deciding it would be a good day to mow my lawn. If you are not familiar with concussion symptoms and triggers, lawn mowing basically hits the trifecta… Bright light (sun), loud noise, and an elevated heart rate. The next day, I could hardly sit up without feeling like I was going to be sick. This was when my physio and my friend Stacy introduced me to the boom and bust.

After that first time, I did really well for the duration of that recovery and the first 4-6 weeks of my second concussion. I was careful to keep up some form of normal life and activity every day. But if I became symptomatic, I would stop and rest. Seemed simple enough. Enter phase two: when you feel so much better that you no longer feel symptomatic from the small things. All of a sudden it is a lot harder to determine your baseline and when enough is enough. This past weekend I had a major boom and bust. I spent all day Saturday decluttering my living room. This is both a physical and cognitive task. I was SHOCKED when I woke up on Sunday and I felt good still. I figured that was a sign that I would be totally fine to keep going on Sunday and do the bedrooms….. Spoiler alert: I was not fine.

When I woke up Monday, I felt awful. All day… headache, more sensitive to light, noise and screens. Tired, nauseas and dizzy. A much less intense version of initial concussion symptoms from right after an injury. And it continued the same and worse on Tuesday as well. My OT used this as a reminder that recovery needs to be consistent. It shouldn’t be all or nothing. And man, if that didn’t feel like a shot to the heart.

If you know me, you know that All or Nothing is how I live my life. If I decide it is time to declutter, I will do the whole house in one go. If it is time to do yard work, I want to do everything that needs doing in one day. When I am faced with a new task, I take it on with my full concentration. I start a workout program and I can’t miss a day. If I do, I give up. I throw myself into work, life, tasks, etc so completely that burn out. And then I stop. Like totally stop. I watch TV or read and I just don’t move. I do nothing until am rested and then I get back on the horse giving life 110%.

Don’t use all-or-nothing thinking. Take each day as its own day, and don’t worry about it if you mess up one day. The most important thing you can do it get back up on the horse.

Henry Cloud

I am going to jump around a bit but bear with me. In the fall of 2018, I had a significant set back with my mental health. I had struggled for years with anxiety and depression. I treated it with exercise and counselling and meditation but I was still not coping well. That fall, I went to my doctor and begged for help. This was the beginning of my journey with medication. At the time, my family doctor, and the rehab consultant I was assigned through work both wanted me to take a full time leave. I said no. I knew my history of all or nothing thinking. I wanted to find balance. So I took a partial leave, working 3 days a week, staying in grad school, but using 2 days a week to rest and go to counselling while I adjusted to my medication. And it was exactly what I needed. Moving away from all or nothing thinking has been something I have been cognizant of ever since.

Over the last little while, I have found myself back in those old patterns. My concussion recovery is serving as the most recent reminder of the importance of slowing down. I bet many of us have stories of starting a new routine and giving up once we miss a day or two. I mean, this is why “new year, new me” is such a popular trend on social media in January. It is the perfect time to start fresh on these new ideas and new resolutions that most of us will have abandoned before February 1st.

So I say, maybe it is time that we start to celebrate doing less. I mean, if you are giving 100% to your job, your family, your friends, your hobbies…. that’s a much higher percentage of output than humans were created to do. And damn, if it isn’t exhausting to give that much. So what if we do our job well, but we don’t let it drain us. What if we balance supporting our partner/kids/parents with supporting ourselves by making time for things that fill our cups. What if we start a new hobby without feeling like we need to make it into our whole identity. What if we decluttered one drawer at a time instead of taking the whole damn house apart in one fell swoop.

What if we never find that elusive “balance” thing, but we let ourselves off the hook a bit and start to recognize that the same pacing recommended for concussion recovery is the pacing we should be applying to our lives. Maybe we move away from the “motivational quotes” that push us into a boom and bust pattern in our lives and we lean towards ones that help us keep the pace in a sustainable way. Maybe we all get ok with giving percentages of our effort to our jobs, family, hobbies, etc that total 100 combined. . And maybe that’s enough.

Post script: It is not lost on me that I was supposed to spend 20 min on my computer starting this post but instead have been working on it for 90min and my head is killing me. Time to start taking my own advice. But what can I say? I am a work in progress.