Overcompensation

Overcompensation in the brain and body happens all the time, most often unintentionally. Let’s use walking as an example. When one leg or one foot has an issue, the other side overcompensates in order to allow you to continue walking. The brain does this in a magical way, unbeknownst to us, so that we can continue to function as close to normal as possible. However, this comes at a cost, and over time this unbalanced walk and overcompensation will start to affect the good leg, and possibly the hip, etc. Now imagine all of this happening inside your skull, where the injured brain is trying to compensate for deficiencies, like a sensory structure, including vision, hearing, etc. This can be common with brain injury, where the brain is working harder, and overcompensating, in order to make things as close to normal as possible. Over time, headaches, migraines, dizziness, anxiety, and other symptoms will no doubt follow this overcompensation.

Overload vs overcompensation –

When it comes to senses and the brain, it is important to draw a distinction between overload and overcompensation. Sensory overload is either related to damaged sensory structures which prevent proper collection of sensory input, or the sensory information running into a bottleneck because the sensory processing part of the brain is damaged. On the other hand, overcompensation is the result of deficits where the brain is overworked trying to reconcile what it already knows against the sensory input received.

Our experience

When Sarah had her initial hemorrhagic stroke at age 12, she sustained some brain damage that included a Peripheral Vision deficit. In her case, she can no longer see out of the top right quadrant of both eyes. Since Sarah has been an advanced student, she has alway been looking at a book or a computer. Also, she watches TV frequently, which in her case has served as a stimulus. Now think about how hard the brain has to work all day trying to reconcile this missing void through her vision. Think also about the consequences of this on her hard working brain that was already troubled. Well, during the years that followed her hemorrhagic stroke, she started experiencing all kinds of additional symptoms, including more anxiety, dizziness, headaches, and finally aura migraines. It is difficult to decipher all those symptoms to determine which is related to overcompensation, or to other areas of the injured brain. She was prescribed Effexor to deal with the anxiety, dizziness, and headaches.

But here is what you need to know, and the lesson we have learned. Sarah started having these drastic episodes where she would lose her vision for a bit, then have a giant migraine. This led us to a whole host of testing, including brain scans, and a neuro-ophthalmology exam. After all the testing, this temporary loss of vision was diagnosed as aura migraine, and possibly the result of hormonal changes. Two things to note about hormones: first, it is a common issue for girls her age to have hormonal changes, which may lead to similar consequences. Second, some recent discoveries have shown that brain injuries result in additional hormonal changes, which may account for some of the symptoms experienced by brain injury survivors. But years later, and with Sarah’s advances in the study of neuropsychology, she discovered something different. At age 27, while deep in her PhD studies, and now fluent in neuropsychological assessments, she pulled out her old neuropsych assessment and came to a different conclusion. The overcompensation for her deficiencies in the field of vision triggers her migraine problems. She discovered that her mind is trying to reconcile what she sees with what the brain already knows. This also could explain her struggle in previously mastered skills, like reading comprehension, writing composition, and verbal expression. Please see “Verbal & Written Link” under “symptoms”.

Over the next 5 years, I started to hear less and less from Sarah about her aura migraines. Why? She now understood that she was having symptoms following overcompensation and started to find ways to minimize this. The trick was to understand overcompensation, and what event(s) led to it. For example, seeing a rotating fans, especially ceiling fans, is a major trigger for overcompensation in her case, which leads to aura migraines. So, she avoids places with fans and ceiling fans, and requests them to be turned off if she has to be in a place with a fan. Usually, people look at us weird, not understanding what this is all about. Obviously, this is one of many examples of things to do, but the idea here is reasonable. If you are having overcompensation issues, read and understand what you can do about it and look at your neuropsych report for possible clues. Then, take some steps toward eliminating or minimizing those activities that cause your brain to overcompensate. Walk your symptoms backward, and try to think of what you have done that leads to overcompensation, and your symptoms. You may not be able to totally eliminate overcompensating, or the symptoms that follow, but you can work towards minimizing it.