Mary contacted me because of the unabating symptoms of concussion. Her injury was not a serious one, and she had not suffered any loss of consciousness but certainly felt dazed and disoriented for some time after hitting her head. As these feelings dissipated, and Mary felt able to return to her normal daily activities and routine, she expected that everything was fine. But within a few days of the concussion, she began to experience other symptoms.
Fortunately, once Mary realized that she needed some help, she sought out a physiotherapist with experience in concussions. While her physiotherapist was able to help her with her vestibular symptoms such as dizziness and the difficulties she experienced with her vision, she continued to experience headaches and sensory sensitivity and felt consistently fatigued.
When she went shopping, her symptoms increased and she experienced difficulties finding the right product in a sea of similar products, remembering what she wanted to buy, or realizing later that she bought the wrong product, all of which left her feeling frustrated, anxious, and depressed because she could not figure out how to address the problem despite her best efforts, and it seemed to be getting worse rather than better. She began to isolate herself from others as she had difficulties with social interactions, especially when it involved more than two or three people talking. Going to a coffee shop was fatiguing, she couldn’t follow a conversation for too long before it became ‘white noise’, and she needed a break afterward.
Similarly, she worked hard to be able to complete all of her responsibilities during her 35-hour workweek. But try as she might, she could not overcome the fatigue and needed longer breaks much more frequently, feeling exhausted after a day of work, and began wondering whether she was just lazy. She explained to me that, as time went on, she also found herself making more errors on tasks she had done well prior to the concussion. She began to question whether her symptoms would ever go away and became anxious over her future prospects. Not only did she become despondent, she also began to believe that all her difficulties were due to the concussion, and she began to lose confidence in her abilities.
All of the difficulties that Mary recited were nothing new in the concussion world. The challenge that the brain experiences after a concussion include difficulties processing or dealing with the larger amounts of information that it usually can deal with easily.
After all, a concussion is a brain injury at the brain cell level. Brain cells don’t work at normal levels after a concussion: they get more easily tired and take longer to refuel. As a result, they cannot fulfill their function as consistently as before the injury.
While an initial period of rest is indicated after a concussion, returning to activity as soon as possible is important. However, how to implement such a return to activity is often a mystery to people. And so, people often do what Mary did, they attempt to return to a normal level of activity but have to exert more effort, notice symptoms that lead them to rest, and then go back to the normal level of activity to begin this cycle again. A more beneficial approach to concussion recovery is a gradual approach to returning to activity.
I provided Mary with guidance on how to approach her tasks such as shopping and driving in a gradual way. More generally, I taught Mary how to identify the right level of stimulation for her brain without too much overstimulation, how to rest, and what type of rest activities would be beneficial. At the same time, I taught her about the brain, concussion, and strategies while supporting her emotional well-being throughout the recovery process that we call rehabilitation. The philosophy behind my approach is to provide hope to people that returning to functionality is possible while moving them towards independence at their own pace.
If you would like to read about ‘how to get better after concussion’, you can continue here
Read here about a) the sources of emotional distress following brain injury and b) the gradual approach to activity to support your recovery, i.e. how to know when to take a break to avoid the “crash and burn” cycle:
More posts on acquired brain injury, concussion, and caregiver challenges can be found here