Every time you turn on the television or read the paper there seems to be a story about how tens of thousands of service members have suffered a traumatic brain injury during combat.
There is no doubt that tens if not hundreds of thousands of men and women are dealing with the after effects of this cruel and devastating consequence of war. Indeed, traumatic brain injury is considered a signature injury of the Iraq and Afghanistan wars and has changed the way we look at head injuries.
The most common brain injury experienced by combat troops is called a concussion. Although definitions vary a bit, a concussion is simply a mild brain injury. For purposes of this article, it is defined as either an alteration of consciousness (feeling dazed or confused – you don’t have to be knocked out) or a loss of consciousness that lasts less than 30 minutes. More severe brain injuries are often labeled as moderate and severe.
The days, weeks, and months following a concussion, people may experience a variety of symptoms. Some of the more common ones include memory loss, headaches, sensitivity to light and noise, nausea, reduced concentration, fatigue, irritability, and insomnia.
It is also common for people to not remember the explosion (one does not have to get hit in the head to experience a concussion) or direct blow to the head that caused the problems. This is referred to as posttraumatic amnesia. Knowing how long the amnesia lasted can be help identify the severity of the head injury.
Healing from a concussion is mostly a natural process that occurs within our bodies and minds over time. Just like any other injury, the healthier you are and the better lifestyle you lead, the better off you will be.
Also, understanding that full recovery from a concussion is the norm goes a long way in keeping anxiety and depression in check, which helps the healing process. These are all things that need to be explained to your veteran client who has suffered a brain injury.
For some, just the simple tool of psychoeducation can be very effective.
In addition to reminding your clients to give themselves time, there are some other things they can do in the short-term to speed up their recovery and reduce the negative long-term effects of a concussion. These are by no means all-inclusive. Recovery from traumatic brain injury takes times, patience, and understanding. Your clients will need to work closely with rehabilitation professionals. But, research shows that the following are important and can help.
Do not Drink. Alcohol interrupts recovery in a number of ways. It disrupts healthy sleep cycles. This situation can lead to worsening of mood related symptoms, concentration problems and fatigue. It leads to poor judgment, which can lead to further injuries (see below for more). Alcohol is also believed to slow brain recovery. And keep in mind, people who have experienced a brain injury are more susceptible to the effects of alcohol.
Take it Easy. During the critical days and weeks following a concussion, physical exertion only serves to make the symptoms worse, particularly headaches and dizziness. In fact, one of the ways some doctors make sure concussive symptoms are gone is to make patients physically exert themselves after it looks like their symptoms are gone.
If they do not come back after physical exertion, the person is usually considered recovered. Encourage your veteran client recovering from a head injury to rest. This advice is a must, and if it is not done, your client can expect a worsening of symptoms or delay in recovery.
Do Not Hurt Yourself Again. This recommendation is probably the most important one. After a person has had a concussion, they are more likely to have another one. Having more than one makes recovery take longer. In young adults, a second concussion within a few days of the first one can result in serious damage and lead to lifelong problems.
And in some cases, repeated injuries in a short period of time can lead to death. So, encourage your client to wear his seatbelt, stay off the sports field and fight the impulse to do a back flip off the tailgate of their buddy’s truck until their brain is fully operational.
Remember, the expected outcome after a concussion is full recovery. But, your client has to be smart. Instruct them not to drink, get plenty of rest, and avoid high risk activities. And if their symptoms persist or worsen, make sure they talk with their healthcare provider.
*This article is adapted from Dr. Moore’s column Kevlar for the Mind published in Military Times.