Managing Stress Effectively After TBI, Part I
Anxiety & Stress
Following a life-changing event like a brain injury, it's normal to feel intense stress. But sometimes stress can build up and lead to anxiety. The main symptoms of anxiety are fear and worry.
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The Emotional Consequences of Concussion
[Jeffrey Barth, PhD, ABPP-CN - Director, Brain Injury and Sports Concussion Institute University of Virginia School of Medicine] There are oftentimes emotional sequelae related to or consequences of mild head injury and concussion. In sports we don't see it as often, immediately following a blow if it's one single concussion. However, it still can occur there, and actually after multiple concussions, it's very common. What are those consequences? Well, they are irritability that can relate to depression and often fatigue that's associated with that as well. Some people would say you can have the same types of emotional reactions to a concussion that you see in post-traumatic stress disorder. At the high school and college level, again, what we mostly find is the irritability and so on. These people become kind of grouchy and stressed. Of course, the way to treat that is reduce the stress, so we of course don't recommend that people go right back to exercise again. We titrate that in or bring it in slowly. We also try to work with school systems, for example, to reduce the curricular load a little bit, and make people aware that this person has had an injury, even though they look perfectly normal and are acting perfectly normally, and give them time to recover. If we talk about those recovery curves of 5 to 10 days typically, they should be over it relatively quickly. Sometimes though, that irritability lasts for awhile. Again, with our younger players, as I said, this can go for 6 to 10 times longer. That should be just watched by the parents and, again, reduce stress, get plenty of rest. Sleep is really good for those sorts of things.
Mental Illness and Brain Injury Are Not a Dual Diagnosis
One of the most common misconceptions about mental illness and traumatic brain injury is that it's a dual diagnosis, that it's something separate from the traumatic brain injury rather than the mental illness actually stemming from the actual injury to the brain. When we talk about problems after brain injury, some things seem to be intuitive. So for example, if a patient has cognitive difficulties after a brain injury, everyone knows that's from the brain injury. If somebody has problems with their sensory system or their motor system, everybody knows that's from the brain injury. But people don't appreciate that if you have an injury to the brain it will actually produce problems in your behavior and problems in your emotions, such as being irritable, being depressed, being anxious, as a result of the actual injury to the brain.
TBI and PTSD Often Go Hand-in-Hand
When people have a traumatic brain injury, they usually get a TBI during a car accident or some other traumatic event: assault, fall. And if it's caused by something traumatic that was caused by a natural disaster or an assault, then this is often psychologically traumatic as well. So sometimes you have PTSD and TBI and they're comorbid, meaning you have both at the same time.
