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“I wonder if I’ve been changed in the night,” says Alice in Alice’s Adventures in Wonderland. “Let me think: was I the same when I got up this morning? I almost think I can remember feeling a little different. But if I’m not the same, the next question is, who in the world am I?”

Sometimes a traumatic brain injury can feel like falling down a rabbit hole, or being trapped on the wrong side of a looking glass, especially in the first days or weeks of recovery. You feel different; you are not sure who you are — the most daunting aspect of all these changes is the fact that you are having trouble with your memory.

What is memory?
Memory is the brain taking in, keeping, recalling, and using information. A brain injury can affect any of these facets of memory. And it can also make it hard to learn and remember things.

How can TBI affect memory?
Confusion is very common for people in the early recovery phase of a brain injury. They may not remember events that happened immediately before the injury or events from their hospital stay. As they recover, people who have memory problems typically have more difficulty with remembering recent events or learning new information (recent memory), rather than forgetting their identity or events that occurred in the remote past (remote memory).

What can make memory problems worse?
Other symptoms from brain injury can exacerbate memory problems, including:

• Fatigue and lack of sleep
• Stress
• Illness, poor health
• Strong emotions like anxiety, depression, and anger

Memory problems are not only frustrating, but they can also be dangerous. They can impact people’s whole life — from interfering with their work or home life to affecting their ability to drive a car or take care of their children. It’s important for people to talk with their doctor about their memory, especially if the problems change or worsen.

Even after the “acute” recovery phase has passed, people with TBI can continue to have problems with their memory. They may forget details from conversations or have trouble remembering names, appointments, or basic procedures like doing the laundry. For some people after a TBI, their problems with memory never resolve; they may need to use tools or strategies to make up for the loss.

Strategies for remembering
Types of memory problems differ depending on each injury, but here are some general strategies to help:

• Write everything down — keep a notebook or a PDA with you at all times to remember what you have to do.
• Use signs, labels, or cue cards, or iPhone or Android smartphone apps to remind you where objects are located.
• Keep a “cheat sheet” of important information in your wallet.
• Buy appliances that turn off automatically.
• Use a pill organizer to organize your medicines.
• Get enough regular rest during the day.
• Set a routine: Have a plan for each day and each week so you remember important things like taking your pills and going grocery shopping.
• Have a family member take notes during meetings with your doctor or healthcare provider.
• Break down new information into small parts. Learn the small parts instead of trying to learn everything at one time.
• Focus on one thing at a time.
• Keep a journal to record your progress, your thoughts.

Don’t go it alone
Living with memory problems after a TBI can be challenging, but unlike Alice from the famous children’s book, you are not in a rabbit hole or on the wrong side of a looking glass. Work up the courage to tell your family, friends, and colleagues that you have issues with your memory. That way they won’t get frustrated and angry with you if you forget important information or miss meetings, and they’ll also be able to help you establish effective strategies to make your life easier.