Mild Traumatic Brain Injury: A Silent Epidemic Brain injury is a silent epidemic.

On the surface, you may look fine and things seem great. But beneath the surface, there is a vast network of symptoms that no one sees. These symptoms, or effects, are very difficult to deal with and almost impossible for others to understand.

This is why I liken the effects of a brain injury to an iceberg.

The symptoms a TBI survivor must live with, often on a daily basis and usually coming on without warning, are not visible to others. This is what makes brain injuries a silent epidemic. 

Anyone who has had a concussion or traumatic brain injury (TBI) understands what this means. Hopefully those who live with a TBI survivor understand this, as well. But those who have not lived through it, have a hard time relating.

June is Traumatic Injury Awareness Month.

As the wife of a TBI survivor, I understand what it means to live with a TBI and how challenging it can be for everyone involved, including care-givers and loved ones.

As an educator, it’s my mission to teach others about this silent epidemic with the hope of helping the general population become aware of the issues faced by a TBI survivor and make them more tolerant when dealing with the sufferer.

Suffering Silently after a TBI

A mild traumatic brain injury is no laughing matter. Rather the injured often suffers in silence because many of them do not have visible physical symptoms. They often express such thoughts as:

This is because patients often experience cognitive, psychological, and behavioural impairments that can be debilitating. What makes matters worse is that in many cases, mild TBIs often remain undiagnosed. 

Those who seek medical attention generally receive a standard exam and may be pushed through the system with little regard. 

Those fortunate enough to be taken seriously may be given a CT scan or MRI, especially if they experienced a loss of consciousness. 

Unfortunately, these diagnostic tests are not sensitive enough or specific enough to identify a mild TBI. So if the injured does not receive a proper diagnosis, managing their care appropriately becomes a challenge. 

The patient often has to muddle through their symptoms alone. They can feel isolated and think no one is listening to them or understanding what they are going through, especially if their symptoms persist. 

The impact of an invisible injury

The effects of a brain injury run deep and reach far. Every aspect of your life and the lives of those around you can be affected. Some effects will be visible right away while others will increase or decrease over time. 

Every individual will experience a different combination of challenges and changes, as no two injuries are the same. Moreover, many factors work together to influence how each person’s physiology will react to the injury.

What becomes even more challenging is the fact that healing is not linear. Not only is there no clear cut time frame for healing, but medical professionals cannot even offer an estimated time for recovery. 

Then come the ups and downs. 

You may take 1 step forward in your progress then be struck by three steps back for no apparent reason. This repetitive cycle can be even worse than dealing with the symptoms themselves. It can also cause the injured to feel like they are in a perpetual downward spiral, with no way out. The resulting depression and anxiety further compound symptoms and make the injured feel even worse.

In addition to the neuro-fatigue and chronic pain one has to deal with, there are often challenges walking, sitting for too long, moving too quickly, and feelings of restlessness. With a heightened sense of anxiety yet overwhelming feelings of fatigue, it can feel as though you have internal energy to burn but are physically unable to do so.

These compounding and conflicting symptoms make it very difficult to explain or describe what you are going through.

Some other invisible symptoms of a brain injury include:

• Difficulty understanding: Cognitive effects can leave you needing more time to understand and parse information. You may need to hear something several times before being able to finally understand it. To make matters worse, the ringing in your ears may be so loud at times that you miss words in a conversation - or entire conversations all together.

• Poor memory: You may have difficulty concentrating and feel easily distracted. Your memory will likely keep failing you, as you cannot remember instructions, follow directions, or lean new things easily. If this happens for you, please take my advise and ensure that you have a trusted friend or loved one accompany you to all of your doctor appointments or meetings so they can translate what was discussed after you leave. They can also help become your advocate, asking questions on your behalf and relaying doctor’s instructions after the fact that you most likely missed, didn’t understand, or forgot.

• Getting stuck on a thought: Another consequence of a brain injury is that you may get stuck - stuck on a single thought, idea, emotion, or action, unable to break free from this single-line of thinking. This is called “perseveration” or “hyperfocus”, and is quite common after a TBI. It’s also seen in autism, ADHD or OCD with repetitive actions, obsessions, or an inability to shift focus when engaged in certain activities. It occurs when there is a dysfunction in the front part of the brain, making it difficult to shift attention or shift gears.

• Reduced processing speed: Your processing speed also slows down. It takes longer to form the words you want to say and the thoughts you’d like to convey. Sometimes, excruciatingly slow - for both you and the person you are trying to talk to. This is one area where you have to allow yourself some grace. Understand that it is not your fault and be gentle with yourself. 

• Emotional outbursts: The emotional effects of a brain injury are often worse than the physical ones. Feelings of irritability, depression, anxiety, fear, and anger can take over without notice. You can be prone to sudden outbursts of emotion like crying one minute to laughing the next, then blowing a short fuse moments later. 

• Emotional blunting: Alternatively, you may not be able to show any emotion at all and seem distant or emotionally “flat” to others. Either emotional extreme can be confusing and hard to understand.

• A loss of identity: It’s also common to feel like you have lost your identity. Many people sustain a brain injury while they are engaged in some kind of sport - football, soccer, cycling, skiing, motorbiking, etc. People who participate in these kinds of activities are generally active and have been so their whole lives. This makes it even harder to accept the reality of having to slow down or to not be able to do everything they used to be able to do.

• Other behavioural effects: Other behavioural changes can take place as a result of a brain injury. They can include isolating themselves, engaging in risky behaviours, impulsivity, saying inappropriate things, or lacking a “filter.” As a result, maintaining positive relationships at home, at work, or at school can become a challenge. In fact, many families breakdown after one partner suffers a brain injury. 

Studies show post-injury divorce rates are alarmingly high at 48% to 78% - leaving no question that brain injuries strain marriages.

Part of this may be due to a lack of understanding, behavioural changes often seen in the injured, the added duties and stress placed on everyone else in the household, or the newfound feelings of inadequacy that the injured often feels. Getting used to the switch from being independent to having to rely on others for care and support can be very hard to overcome.

How to Deal with an Invisible Injury

Unlike a broken leg or other physical impairment, damage to the brain is not visible from the outside. Because we cannot “see” a brain injury, most people don’t understand the impact it has on the life of the sufferer.

As as result, others can be ignorant. Despite their best intentions, they may say or do things that may actually make matters worse.

When there is a physical or visible injury, others often say things like:

• Oh no! Are you okay?

• How can I help?

• Instead of going for a walk, let’s stay in and watch a movie.

• Let me park close to the door, so you don’t have to walk as far.

• Take it easy! Let me do that for you.

When someone has a TBI or post-concussive syndrome, no one knows how to react or what to say, especially if the person looks “normal.” Often comments include:

• You look great!

• Let’s get you out of the house and go see a movie.

• Why don’t you just try?

• But it’s just a small gathering of friends.

• Really? You still can’t do that? But you look so good.

Concussion recovery is often not what we expect or anticipate.

Many people who suffer from a brain injury become hypersensitive to sound, bright lights, large spaces, and external stimulation. They can be irritated by the feeling of a clothing tag rubbing against their skin. They can get dizzy when walking through a large store or warehouse, unable to process the multitude of stimuli bombarding them from all directions. They can get irritable, angry, and short-tempered, often for no apparent reason. They can become impulsive or uncharacteristically anxious. Plus, they can feel physically and mentally exhausted from the moment they crawl out of bed in the morning. 

This neuro-fatigue is often the hardest symptom to deal with, as it makes even small daily tasks seem insurmountable.

So what is one to do?

How can you deal with the multitude of invisible symptoms that are irritating you and making you miserable? How can you cope with the unusual effects of a TBI that you can’t put into words, let alone understand yourself? 

First, please realize that you are not alone. It is not all in your head. You are not making things up or going crazy.

And better yet - there is hope!

Certain foods and lifestyle changes can make a huge positive difference! 

Start with proper neuronutrition and a brain-healthy diet. If you’re not sure what this looks like for you, as an Amen Clinic Certified Brain Health Coach, I’d be happy to help you devise a program that suits your needs.

In the mean time, understanding how to deal with a TBI can be helpful. 

Living with Post-Concussive Syndrome

Other than some of the initial physical symptoms immediately following a brain injury, the main challenge one faces after a brain injury is that others cannot see the invisible effects or ramifications of the injury.

If we were to become disabled or debilitated, we would expect to have support. We would expect the people closest to us would band together and help in any way they could. We would also expect the medical professionals around us to work hard to figure out what was wrong, then work to fix it.

After all, this is usually what would happen if we broke a bone or received a cancer diagnosis. People would rally around, provide support, bring over meals, and take over duties we physically could not. 

Why do neurological injuries have to be any different?

Telling an injured person they are “lucky” to not have to work, makes an already daunting recovery even more unbearable.

When we know better, we do better.

A better understanding of concussion recovery will allow us to support our loved ones and friends with the integrity they deserve. [quote]

We need to be patient, positive, encouraging, and understanding as our loved one acclimates to his or her new normal. 

There’s no doubt that brain injuries can be hard for outsiders to understand - adding to the trauma of recovery. Learning that there is more to an invisible injury isn’t always easy, but it makes a significant difference and we owe it to the injured to try.

So if your friends get angry because you don’t want to attend their party, they lack an understanding of what you are going through. They don’t get that too many people, too much noise, and too much stimulation will create an even worse headache or greater neuro-fatigue for you. They don’t understand that one evening out will equate to three days of recovery time. 

It’s easy for others to forget how disabled a person can be. As a TBI survivor, you must become your own advocate. 

Don’t follow what others want or expect from you. Know your body and listen to it. Know your limitations. And don’t be afraid to tell someone you are unable do something. 

If you’d like more help recovering from a brain injury, optimizing your brain function, or improving your memory through natural means, consider working with me. I will help you create a realistic plan that works with your lifestyle, needs, and individual goals.

As always, I welcome your thoughts and value your feedback. Let me know what you think by dropping me a line or commenting below. Please share and subscribe to us on Facebook and YouTube.