The Psychological Effects of Concussion

One of the most challenging things about concussion is that you can’t see it; there are no scars, no broken bones, very few, if any, outward signs of injury. We hear a lot about common symptoms of concussion such as headaches, sensitivity to light and sound, balance or vision issues, and memory and attentional impairments, but we don’t often talk (openly) about the psychological symptoms.

When it comes to concussion, I’ll begin by emphasizing that everyone is different and each experience is unique. Psychological and emotional symptoms present differently in each person. That said, there are a few more common symptoms that we tend to see. Here’s a short list, along with a few strategies to help you work through them:

Anxiety:

There is no shortage of things to worry about post-concussion. How long will this last? When will I be able to go back to school/work/play? What will others think of me? Will I ever be the same again?

Excessive worry never seems to do much good for anyone, especially if you’re worrying about things that are beyond your control. When you’re injured, your physical, cognitive, and emotional resources are limited. Ask yourself this: is there anything you can do right now to help the situation? If the answer is yes, then do it. If the answer is no, then direct your energy toward more productive avenues. Focus on the 3 S’s: Strengths, Solutions, and Safety. 

Stress:

Getting back to “normal”, financial concerns, work or social commitments, physical and cognitive limitations, the list goes on. 

Test out some strategies to manage your stress.

Test out some strategies to manage your stress.

Being injured is stressful, no one should deny that, including you.  The first step is acknowledging your stress and, more importantly, identifying your “stressors”. What are your “yellow light” and “red light” things that signal stress? Know your triggers, acknowledge them and decide in advance how you’d like to deal with them. Test out some strategies to manage stress like deep breathing, meditation, light physical activity, or just spend time with a friend or loved one. Everyone deals with stress differently, the key is knowing what works for you and deciding in advance how you’re going to deal with it. 

Depression/Low mood:

You’ve been told you should rest, limit your screen time, limit your physical and cognitive strain, you can’t do your regular duties or activities, you’re missing out on other commitments, and you generally don’t feel all that good, physically or mentally. 

Optimism and hope matter. You will get through this.

Optimism and hope matter. You will get through this.

Concussions suck. Period. But they are not uncommon, and one has happened to you. While that can be pretty scary and overwhelming, it isn’t permanent. We hear all about the ‘worst case scenarios’ in the media, but we don’t often hear about all the people who successfully recover from concussion (the vast majority) in a reasonable amount of time (a few weeks to months). Again, everyone is different, but those with a positive outlook tend to experience positive outcomes (ref). Look for the good things, no matter how small they are, and choose to focus on those. What are you able to do? What are you learning from this experience? How is it making you stronger? Make a list and refer to it often.

PTSD:

Flashbacks, nightmares, negative thoughts, avoiding certain places or activities, avoiding thoughts/feelings, fear of re-injury.

You’ve been through something significant and when that happens your subconscious mind can sometimes take advantage of your vulnerability. Talk about it. Grab a close friend, family member, or a professional, and talk it out. Sometimes this can be scary and uncomfortable, but better out than in, as they say. Once you feel a little more comfortable talking about it, try to gradually reintroduce some of the things that make you uncomfortable. For example, if concussion is a result of a car accident, the idea of driving might be stressful for you. Start by simply spending a few minutes per day just sitting in the driver’s seat of a parked car. Put your hands on the wheel. Maybe even turn the car on and adjust some of the radio or mirror settings. Eventually, once you feel comfortable (and that might take days, weeks, or months), take a slow ride around your block or on quiet side street, and then build from there. By gradually reintroducing some of these things in a safe and controlled environment, you allow your body and mind to build some confidence to reengage in those activities or experiences.  

Anger/Blame:

He was driving too fast and not paying attention, the turf was too wet we shouldn’t have been playing on it, I should have been more careful, he back-checked me on purpose!

It happened, it was scary, but it’s over now and your energy is best spent in the here-and-now.

It’s human nature to want to understand why bad things happen and it can feel cathartic (at least temporarily, anyway) to assign blame. The problem with that is, when we assign blame to others, we remove our control over the situation; we become victims. In some cases, it can even be tempting to blame yourself. The problem is, the blame game can take a serious toll on your recovery. Blame requires a focus on the past (what happened, why did it happen, who was involved, etc.) but at the end of the day, how can you expect to move forward and recover if you’re spending your limited resources dwelling on the past? It happened, it was scary, but it’s over now and your energy is best spent in the here-and-now. What are you going to do today to help yourself move forward? What is your goal and what steps can you take to bring yourself closer to achieving it? 

To summarize, this is very much a simplified explanation of the psychological and emotional side-effects of concussion paired with a few tidbits of advice, but be well-aware that there really is a lot more to it. These symptoms can be difficult to acknowledge and challenging to work through – no one is saying it’s easy – but around here we like to operate guided by optimism, positivity and, of course, the evidence. What that tells us is that with the right attitude, a lot of hard work, and maybe a little guidance, you really can feel better, get back to school, work, sport, and life, and thrive once again.