Long-forgotten concussions may cause current problems
Concussions are like ghosts from the past. The symptoms of old concussions and brain injuries may be the manifestations in the present. Often the person has forgotten about their concussions, or in some cases, their many concussions, but they continue to struggle with the lingering effects of concussion. Usually the symptoms associated with concussion resolve over the weeks following the injury. However, when symptoms persist for months and interfere with the person’s life and cause changes in mood, temperament and behavior it is time to address the changes through treatment and intervention.
Today one in three Americans report that they have experienced a concussion. Yet, in spite of the frequency, people who have had a concussion may not remember it or see the connection between concussion and problems they may be having. A concussion is a disturbance in brain function caused by a direct or indirect force to the head. Most often, a concussion does not result in a loss of consciousness as are seen with more severe brain injuries. The common symptoms are: headache, “feeling a pressure in the head”, neck pain, balance problems, dizziness, fatigue, blurred vision, sensitivity to light or noise, feeling like they’re “in a fog”, difficulty with concentration and/or memory, excessive drowsiness, trouble falling or staying asleep, irritability, sadness or depression and anxiety. Other people may notice changes in personality and behavior, which are inconsistent with their experience of the individual. The individual may start using drugs or alcohol to self-medicate. They may have problems in relationships at home, school, and work and with friends.
We know that concussions are common from sports injuries, falls and motor vehicle accidents. In the military over 30% of soldiers, returning from Iraq and Afghanistan reported symptoms of concussion. Military concussions can be caused by direct blows to the head as well as by exposure to blasts and explosions. Domestic violence is a cause of concussions that can go unreported, as the victim may be unable to access medical care or appropriate social supports. As the head is a frequent target in domestic violence, individuals living in these situations may have had multiple concussions throughout the years of abuse. Other groups exhibit high rates of concussion and brain injury. People living with the long-term effects of concussion and brain injuries are found in mental health settings, prisons and jails and among the homeless.
In mental health and substance abuse treatment settings, we are likely to see individuals with changes in mood, temperament, behavior and problems with substance use. Many of these individuals have forgotten about their concussion or the relationship of their current problems to their past concussion. It is important for the treating physicians and clinicians to screen individuals for concussion and brain injury effects and to tailor treatment to optimize outcome.
If you or a loved one is seeking mental health or substance abuse treatment consider if concussion or a past brain injury is part of problem and seek out a treatment provider who understands how long-forgotten concussions can be the cause of today’s problems.