Have you ever felt like time was slipping away, or that minutes stretched into hours during a mundane task? For most people, these are fleeting experiences. I remember when that used to be the case. But for those recovering from a traumatic brain injury (TBI), such distortions in time perception can become a daily reality, intertwined with memory challenges that make even simple routines feel overwhelming.

Today is Daylight Savings Time where we artificially adjust time. An “hour” of time just elapsed in less than a second. While not the same as these experiences of time within brain injury recovery, the reality experienced is often quite similar. How is it now an hour later without feeling like any time has passed and no idea how I got here in this new room or what I am doing? Weren’t we just eating? Imagine Daylight Savings Time adjustments occurring all of the time and unpredictably without warning. For caregivers repeating the same conversation with the patient, like the “Fall Back” hour, wasn’t it already this time of day??! This conversation again?!
For me, pondering the difficulties experienced from this phenomenon leads to the question of why this is happening? Why can’t I just experience time like normal again?

Traumatic brain injury occurs when a sudden blow or jolt to the head disrupts normal brain function. It can range from mild concussions to severe cases requiring extended rehabilitation. Yet the severity of the mechanism of injury does not appear to indicate the symptoms experienced by survivors with cognitive impairments. I have met survivors who have had what would be called a “simple fall” or "routine bump on the head” that have suffered life-altering and debilitating effects for decades. While physical recovery often takes center stage, and rightly so. in those initial rehabilitation efforts to stabilize and repair physically altered effects of the injury, cognitive impairments—like those affecting memory and time perception—are equally profound.

Research shows that TBI frequently damages areas of the brain responsible for processing time, such as the frontal lobes. This isn't about just having a broken internal clock. Instead, studies indicate that distortions arise from secondary issues in attention, working memory, and executive functions.

For instance, in experiments using time reproduction tasks (where participants replicate a given duration), TBI patients often show greater errors and variability, especially for intervals longer than a few seconds. They might underestimate how much time has passed during longer activities, leading to feelings of time "flying by" or compressing. The TBI survivor doesn’t need to be in one of these experiments to experience this quite often. I have had many times where I recognize the activity must have been two hours but it felt like seconds and with no memory of what has occurred. Sort of like your “loss” of an hour today in Daylight Savings Time. Perhaps it is not being able to remember it that makes the jump in time. Perhaps it is just the brain damage.

Our family recently watched the first season of Beast Games where one of the challenges involved contestants holding a ball blindfolded for 10 minutes attempting to keep track of the minutes and seconds on their own without a clock. The show reminded me this skill is difficult enough without a brain injury. In the episode, one of the contestants starts counting out loud to throw off everyone else. The TBI is almost like that. So much misfiring all around and being overwhelmed, combined with fatigue, memory issues, and the like - and no wonder time doesn’t pass the same anymore. A task that would have been difficult enough, becomes impossible or nearly impossible.

Memory issues compound this. TBI disproportionately affects the formation of new memories, making recent events harder to recall than distant ones. This can manifest as losing track of time—forgetting what day it is or how long ago something happened—because without solid memory anchors, time feels fluid and unreliable. Initially, my recovery included remembering only the previous minutes at best, and being told I was repeating conversations that had just occurred 15 minutes prior. Eating breakfast multiple times forgetting it had already been digested. For the next two years, waking up I would wonder why my head hurt so much, and be surprised to learn what had happened with my injury and how much time had elapsed in the months and years I did not remember since the injury.

At the heart of these changes is the brain's reliance on cognitive resources for tracking time. Time perception isn't a standalone sense; it draws on working memory to hold durations in mind and attention to monitor their passage. In TBI patients, deficits in these areas lead to distorted perceptions. For example, one study found that while short durations (under 1 second) might be judged somewhat accurately, longer ones result in underestimation or high variability, correlated with poorer working memory and processing speed.

Memory problems exacerbate this. Prospective memory—the ability to remember to do something in the future—is often impaired, leading to missed appointments or forgotten tasks. Imagine planning to cook dinner but misjudging how long prep will take; without reliable time sense, you might start too late or abandon the task midway. Combine this issue of planning time with the inability to understand basic steps and keeping track of where on the recipe progress is and the recipe may as well be a recipe for disaster. Needless to say there are many kitchen mistakes I have made in these last three years. Episodic memory deficits mean the brain might "fill in" gaps with false details, further warping the timeline of events. We all have our brains fill in those gaps. But for the brain injured patient - how do you tell the difference and prevent that from warping time even further in your understanding? Ever wake up from a dream and for a while you are not sure what was real and what wasn’t?

Interestingly, not all timing tasks are equally affected after a brain injury. Time production (verbally producing a specified duration) often remains intact, suggesting the core "pacemaker" of the brain's clock is preserved, while tasks requiring memory retention falter. These alterations aren't abstract—they disrupt life profoundly. Patients may experience slowness in tasks, trouble following schedules, or misjudging activity durations, leading to chronic lateness or incomplete routines. Simple tasks become marathons. Being unable to gauge time accurately results in frustration and inefficiency. Tasks that may have been short can become lengthened substantially.

This can affect work, school, and relationships. Forgetting conversations or repeating questions strains social interactions, while disorientation with relation to time and space hampers independence and ability to accomplish tasks. Studies on neurocognitive impairments, including TBI, confirm distorted time perception compared to healthy individuals, linking it to broader brain network changes beyond just the hippocampus. This science all goes beyond my understanding of the brain. As a brain injury patient with memory difficulties, one of the hardest portions of recovery is just simply understanding what I am up against and how the brain really works. Something I wish I had learned before my injury. But there is hope.

Strategies for Reclaiming Control Over Time and Memory

The good news? While TBI changes may persist, adaptations can help. Recovery often involves leveraging external aids to bypass internal deficits. When we hurt a knee, we use a brace and crutches to help protect and improve strength. So what do we use for our hurt brain as those external aids for regaining control over time and memory? Among many others:

Build Routines and Use Tools: Establish consistent daily schedules with timers, alarms, and apps for reminders. Pill boxes, calendars, and checklists can anchor prospective memory.
Simplify and Practice: Break tasks into smaller steps, start with simpler versions, and practice with prompts. Over time, reduce reliance on cues, for example setting timers initially and working to reduce them.
Lifestyle Supports: Prioritize sleep, exercise, and nutrition to bolster cognitive function. Minimize distractions during tasks to aid focus. Give yourself extra time to practice, repeat, and rehearse information that you need to remember.
Encourage Support from Others: Ask people to talk slower or repeat back what they have said to make sure you understood correctly. Write it down.
Seek Professional Help: Cognitive rehabilitation therapy tailors strategies, while vocational support can provide job coaching.

Encouragingly, some timing abilities improve with recovery, even if memory issues linger, highlighting the brain's plasticity. The brain’s plasticity refers to the ability for the brain to create new pathways and heal itself. The brain directs the healing of the rest of our body, and is tasked with also healing itself.

Living with altered time perception and memory after TBI is like navigating a warped clock—challenging, but not insurmountable. By understanding the cognitive underpinnings and embracing practical tools, individuals can regain a sense of control. If you or a loved one are dealing with TBI, I have found resources like the Model Systems Knowledge Translation Center (MSKTC) offer valuable guidance. I’m no expert and can’t give great advice as I’m still figuring this out myself, but there is hope. This information is not meant to replace the advice of a medical professional. You should consult your health care provider regarding specific medical concerns or treatment.

Remember, every step forward, no matter how timed, is progress. Share your experiences in the comments—how has TBI affected your relationship with time?

Sources:

pubmed.ncbi.nlm.nih.gov