You are more than a mere blob of flesh. Part of the mystery of being human is that we know we are more than the sum of our parts. Our biomolecules don’t think, don’t feel, but we do. As human persons, we possess dynamic psychological lives that are inextricably united with our bodily life, and, as such, when we suffer bodily injury, there is always an inner mental experience that accompanies it.
Mental health is always a crucial consideration during concussion recovery. Indeed, psychological complications present some of the most common causes of prolonged concussion symptoms.
Now, it is essential to note at the outset that to feel emotions like sadness, frustration, anger, and fear after suffering an injury is a normal human response. For one thing, injuries hurt. But they can also (temporarily, at least) disable, if only for a short time. Injuries have emotional and practical consequences for our lives, giving us good cause to feel an emotional impact.
What is most important is that we keep the intensity, duration, and life impact of these natural human emotions within a “normal” range.
The best approach to concussion recovery from a mental health perspective, therefore, is a proactive one. Even if you’re late implementing the following strategies in this blog post, please know there is still time. The cliché is true in this case: better late than never.
Up to 1 in 5 concussion sufferers may experience mental health complications up to six months after their injury. As such, it is paramount that measures are put in place immediately by you, in partnership with your clinician, to mitigate the potential mental health consequences that may arise after suffering a mild traumatic brain injury.
What are some of the concussion-related psychological factors that may complicate your recovery?
First, there is the raw and obvious fact that concussion symptoms are unpleasant. The longer these symptoms persist, the more likely they will have a negative psychological impact. Compared to musculoskeletal injuries like strains, sprains, and even fractures, concussions are unique because they often result in a complex web of symptoms simultaneously.
This leads to a second factor that may affect mental health after a concussion. Despite the number and complexity of symptoms one may suffer, much remains “invisible” to the public eye. Your peers may not recognize that you are suffering. In this sense, pain, fatigue, dizziness, and nausea are unlike scars or bruises.
Thus, your concussion’s “invisibility” may leave you feeling alienated and misunderstood. You may find that people do not sympathize with your condition unless you outwardly complain or show signs of your suffering. This can have a significant effect on your emotional state.
Third, there is the impact your concussion may have on your ability to play sports, drive, work, and/or study. As you recover, your clinician will guide you through specific protocols designed to help you safely return to all these ordinary daily activities. But human nature dictates (especially true of athletes and parents) that we often want to jump back into these things sooner than is best for us. The sudden decrease or delay in doing the things we love, desire, or are required of us may understandably harm our psychological well-being.
Fourth, suffering a concussion often affects your social life. Your loved ones can play an essential part in your recovery, but after suffering a head injury, you may feel tired, listless, irritable, and averse to social interaction. But even if this is how you’re feeling, it is nonetheless critical that you find trusted individuals to share your post-concussion struggles with. Social accompaniment through the recovery process is critical for every person who suffers a head injury.
The fifth factor I want to consider is the fact that a concussive blow to the head may have physiological effects that predispose you to heightened anxiety and depression-like symptoms. When a concussion occurs, your brain cells (i.e., neurons) are stretched, and as a result, they “fire” in irregular ways. When your brain is healthy, the chemicals that flow in and out of your neurons are highly regulated. But after a concussion, the chemical inflow and outflow become dysfunctional.
The temporary “chemical imbalance” in the brain that results from a concussion can instigate changes in your mood and energy levels.
These are some of the common factors that can create mental health barriers during concussion recovery, but the good news is that it is all very treatable. Before we get into our discussion of prevention and treatment, however, let’s consider just a few more factors that may have consequences for your mental health following your injury.
Researchers looking into the effects of concussion on mental health have also identified the following as potential complicating factors:
This is the tendency to overestimate or underestimate your symptoms and their severity. A well-known example of the former is the “good old days” bias. We all know what it is like to walk into a room and forget our reason for going there in the first place. This is an ordinary human fault and happens to the healthiest among us. But after a concussion, you may attribute this to the head injury itself, though, in fact, it has nothing to do with it. Consistent with the “good old days” bias, patients with concussion appear to misperceive their pre-injury functioning as better than the average person. “Ahh… it was better in the good ol’ days.”
If you have a pre-existing history of anxiety or depression, for example, it can make concussion recovery more challenging. It may be difficult to discern whether your mental health struggles are related to your pre-existing condition(s) or the concussion itself. This even appears to apply to individuals with a family history of mental health disorders.
Sometimes, concussion symptoms (such as headache, fatigue, brain fog, or irritability) can be attributed to other causes. This may lead to a delay in seeking proper treatment and prolong the recovery process. It might also lead you to believe that your recovery, despite receiving care from a trained professional, is delayed when, in fact, it is not. A surprisingly common example of this can include medication-overuse-headache (MOH), where the medication used for your headaches is actually what is worsening your headaches.
With all of these complicating factors, the bottom line is your clinician is there to help you determine when such factors are in play and to provide reassurance throughout the recovery process.
Now, I think we could all—concussed or not—benefit from implementing the following strategies. Most (if not all) of us could use better gut health, less anxiety, more silence, and even some counseling to deal with the traumas (micro- or macro-) every human person faces in this topsy-turvy world.
Given the physiological, emotional, social, and potentially even financial challenges that a concussion may pose, those who have suffered from a head injury should certainly implement some or all of the following strategies immediately. The urgency is the same, whether for purposes of prevention or treatment.
Here, then, are some reliable strategies that together provide a potent recipe for good, robust mental health following concussion. Ask your clinician how these strategies should be implemented into your personal treatment plan.
The link between brain health and gut health is one of the most rapidly developing and fascinating areas of concussion research today. Fatigue, low energy, cognitive problems, headaches, anxiety, low mood, and other symptoms can be traced back to poor gut health.
Did you know that in the first three hours after a concussion is suffered, the gut lining begins to change significantly, making the gut-brain connection less efficient than it was only a few hours earlier?
https://pubmed.ncbi.nlm.nih.gov/28526435/
How can you optimize your gut health? Eat various fruits and vegetables (“Eat the rainbow!” as they say). Regularly consume fermented foods like sauerkraut, kimchi, and kefir. Avoid inflammatory substances like alcohol, tobacco, sugar, and ultra-processed foods.
These are deceivingly simple but proven effective strategies for improving and maintaining the health of your digestive system.
Numerous studies have consistently shown exercise to decrease stress and anxiety, improve mood, and increase energy levels. It also promotes better sleep, which is essential for proper brain function.
https://pubmed.ncbi.nlm.nih.gov/38355154/
But wait to hit the gym for rigorous workouts. After a concussion, you will require a graded exercise program beginning at a light intensity and increasing over time. Remember to consult with your clinician before starting any new exercise routine.
“If I were a physician and I were allowed to prescribe one remedy for all the ills of the world, I would prescribe silence.”
These are the words of the great nineteenth-century Danish philosopher Søren Kierkegaard. They have been repeated many times by commentators about our modern culture. Why?
We live in a society polluted by literal and metaphorical noise (and Kierkegaard thought it was terrible two hundred years ago!). Many of us have become slaves to our smartphones’ incessant pings, bells, and whistles. The lights and sounds of our digital age constantly compete for our attention, and the harm to our brains from the undisciplined use of our devices has become apparent.
If you have suffered a concussion, it is all the more true that special measures are taken to decrease or eliminate the constant stimulation of digital devices. Put another way, you must find moments of silence to recollect yourself and give your nervous system a chance to wind down.
Many studies have confirmed the value of practices like breathwork, meditation, and prayer for reducing anxiety and symptoms of mental illness like depression. Your clinician may be able to recommend specific techniques that would be the best fit for you.
It’s essential to have a support system, whether it’s family, friends, or a professional therapist (all of the above is best!), who can help you navigate the psychological challenges associated with your injury.
Counseling has been shown to improve mental health outcomes for those suffering from concussions by providing coping strategies, addressing any underlying concerns or fears, and promoting overall well-being. Don’t hesitate to seek counseling if you need additional support during your recovery process.
Cognitive-behavioral therapy (CBT) has been specifically shown to be helpful for those who suffer from conditions like depression and anxiety. CBT focuses on changing negative thought patterns and behaviors to improve overall mental health. This may be a good option for some concussion patients, especially when experiencing persistent symptoms.
In conclusion, the road to a full recovery after a concussion can be challenging, but many strategies can help optimize your mental health. Maintaining a social support system, optimizing your diet, increasing physical activity, and implementing other proven anxiety-reducing strategies can support your brain’s healing process and promote overall mental and physical well-being. Always consult your healthcare professional for personalized advice and treatment plans. And most importantly, don’t delay in taking care of yourself during this time – both physically and mentally. Your journey towards recovery is unique and deserves all the attention required!
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