How long does fifteen minutes take?

 

One of the lesser known invisible consequences of brain injury is a time perception disorder. Often this consequence is not yet recognized by the person with brain injury her or himself.

 

A time perception disorder is not like in a Hollywood movie where someone does not know what year he or she is in. It is not the same as someone who is seriously disoriented, where he or she does not know whether it is day or night. It does indeed happen that someone is so seriously disturbed in time, but in most situations a time perception disorder is more subtle: "How much time do I have in a quarter and how much in an hour?" How long has it been since..?? How much time do I have left?

 

Time perception and time awareness are about various time-related tasks. For example:

• Estimating the time between two events (estimating time intervals). For example: "When did you last visit your neurologist?" How long have you had these complaints?
  
• Estimating the duration of time. For example: "How long did you wait at the doctor's?"
  
• Judging whether something happens at the same time (simultaneity). For example, researchers discovered that
  sound stimuli (auditory stimuli) seem to last longer than visual stimuli (visual stimuli).

 

A sense of time is essential for people who have to live in this fast-paced society. Our days are full of appointments, even the days off are planned and fully scheduled. Those who have a sense of time disorder miss the anchor points of our daily schedule and therefore lose control of the day.

It can even lead to cognitive overstimulation.

 

Unexpected events can increase the difficulty that people already have.

An agenda, daily structure or daily planning and making good agreements is then indispensable, with or without the help of modern tools. The moments of rest should also be planned well.

 

Busy

People who suffer from a time perception disorder ...

• usually experience great pressure to be on time,
  
• to finish something on time,
  
• or they plan very spaciously,
  
• almost always feeling that there is not enough time to do something,
  
• or that they have to do something in a hurry.
  

Unexpected events can upset these people. Then a person can 'lose' time or can no longer handle the schedule.

 

It turns out that people with this disorder often want to finish something because they don't know if there will be time for it later. Making an appointment with someone can feel like 'being under time pressure'.

Long in advance, pressure can be experienced about an appointment. Someone has been sitting ready with their coat on for an hour, so to speak, without being able to think of anything other than leaving.

It does happen that a person has been waiting for the evening nurse for an hour, without daring to go to the toilet. It is often caused by someone already being busy with that thing in their head and not wanting to forget it. All attention continues to focus on... for example the taxi. There is then no room in their head for another activity.

 

It often comes across as stressful to the bystanders. That does not always mean that there is stress, there is mainly a misty fact about the abstract concept of time.

 

Examples

• How long does something take me?
  
• What time do I have to go to my appointment to be on time?
  
• What time do I have to put the vegetables on to make sure they are done at the same time as the potatoes? I have a separate kitchen timer for each pan.
  
• What time do I have to walk the dogs if I have to leave afterwards?
  
• Can I still do this or that if I have an appointment afterwards?
  
• All my appointments are in the phone both a day and an hour in advance so that I don't forget them. My memory is fine but my sense of time is broken.
  
• I have made a whole booklet about how long it takes me to do a certain route, such as a visit to the supermarket, a trip to the hospital, taking the children to school, so that I can plan it better next time and not arrive an hour too early.
  
• For example, I don't know what you can do with fifteen minutes or an hour. What can you do in fifteen minutes? What can you do in an hour or what can't you do?
  
• I am always too early or too late.
  
• Because I don't dare to be late, I am always really too early. If I have an appointment somewhere, it seems to create a kind of blockage in my thoughts. Because of that restlessness, it gets stuck,
• I forget to take medication, or to get keys, for example.
  
• Whenever something happens that I don't expect, I lose track of time.
• When the person I have an appointment with says she has fifteen minutes, I get stressed because I feel like I have to leave right away. Because fifteen minutes sounds very short.

 

Where in the brain?

Different types of sensory information (hearing, seeing, touching, etc.) are processed at different speeds, by different neural networks.

• The lateral entorhinal cortex (LEC) on the side of the temporal lobe
  provides information about the experience of time.
  
• The medial entorhinal cortex (MEC) on the side of the temporal lobe
  provides information about spatial input (where it happened).
  
  • LEC and MEC together process 'episodic time'. So time and place, such as the memory of the moment and place where you got your first kiss.
    
• The hippocampus stores what, where and when.
  
• The cerebral cortex for planning time.
  
• The cerebellum regulates control over thinking.
  
• The basal ganglia:
  
  • in particular the suprachiasmatic nucleus (SCN) just behind the optic nerve regulates the day-night rhythm (the circadian rhythm). The SCN gives a signal to produce melatonin in the pineal gland.
• pineal gland day night rhythm

 

Tips

• Time certain routines. Note the times to and from, where you often go.
  
• Also note the extra times, such as how long it takes to find a parking space.
  
• Entrust the time planning to someone who is not careless with time themselves.
  
• Ask the people around you to be on time and to keep a close eye on the time as support for you.
  
• As a bystander, do not say that someone has 'fifteen minutes left'. Because of the time perception disorder, that no longer means anything. It has become an abstract concept. It can give a feeling of being rushed.
  
• If someone does not have a short-term memory disorder or dementia, you can time various habits together. Visualize it. Then you can safely say: "You have to be ready at a quarter past three". State: You will then have plenty of time if you go to the toilet at 'five minutes past three', 'ten minutes past three' you put on your coat. Then you'll be ready in plenty of time at a quarter past three". That gives peace.
  It removes the rush/time stress from the lack of time.
  
• Appoint to the person without a sense of time "You have plenty of time if you do this or that or if we do this or that together ...."
  
• An old-fashioned kitchen timer can be of great service in addition to the smartphone with alarm function.
  
• Use the Daylio App. That teaches you to recognize habits better and to remember them.
  
• Buy a calendar clock that shows both the date and the time, such as https://dayclocks.com/
  
• Buy a time timer. That ensures a better sense of time!
  The time timer is the ideal support for anyone who could use some extra help with timekeeping. Understanding the regular clock and concentrating on the hands is not necessary with the time timer. You see and "feel" the passing of time, while the red The disk clearly indicates the remaining time. A subtle but clear signal can be set to indicate when the time is up.

 

Additional problems

• People with planning problems are more likely to get into trouble if they also have a time perception disorder. They will more often continue with activities to feel like they have finished something. They may ignore their own signals of fatigue.
  
• People with serious fatigue due to brain damage can even become somewhat lonely because they do not schedule enough contact moments for fear that they will not have enough recovery time. They often schedule the recovery times, just like the other times, more generously.
  
• People with understimulation (who need a clear structure and reasonable filling of the day) may regularly experience a feeling of 'emptiness' due to planning too broad.

 

image: pixaby

Not feeling what time it is and how much time is left. It feels uncertain.