Keep Going: Post Concussion Syndrome What to do Next Complementary and Alternative Therapy Strategies for Cognition
Post Concussion Syndrome: Ten reasons why symptoms persist
A concussion can happen to anyone. People who were perfectly healthy before their concussion and those who were already managing a chronic illness. People who used reminders and other memory strategies before their head injury and those who didn’t. People who find resilience a little easier and those who take awhile to adjust to something new. All of these factors impact someone’s concussion recovery.
Post Concussion Syndrome
Post concussion syndrome (PCS) is a complex disorder that is characterized by physical, cognitive, visual, sleep, and/or emotional symptoms that persist for weeks or more after a concussion injury. The medical community is still learning about post concussion syndrome. While the disorder is not fully understood, there are known risk factors that increase someone’s likelihood that concussion symptoms will persist.
People with post concussion syndrome should participate in a rehabilitation program directed by their healthcare provider. Thinking skills and other symptoms will improve with treatment. However, due to the complexities of health and life not everyone feels “back to normal” after their treatment program. If you or someone you know is frustrated by persistent changes in thinking skills after a concussion, consider these reasons why symptoms persist:
1. Medical conditions
People with persistent brain fog, difficulty concentrating, etc. may have other medical conditions contributing to the problem. Hormone imbalance, autoimmune disease, B-vitamin deficiency, mental health disorder, etc. all impact thinking skills. Ask your doctor if you should get tested for other medical conditions.
2. Physical symptoms
Thinking skills are complex processes involving different types of sensory input. Changes in brain functions such as balance and vision may be causing your difficulty with thinking skills. Migraines and other types of chronic pain also impact your concentration and energy levels. Some people do not see cognitive improvement until these problems are addressed. Ask your doctor if you should see a physical therapist, occupational therapist, or other healthcare provider.
3. Coping skills
Changes in cognition, work/school ability, physical symptoms, etc. after concussion are a type of loss. Any time something in life changes unexpectedly it takes time to adjust. It may take some time to understand your injury and adapt. It’s helpful to simplify other areas in your life to give yourself time to process what’s happened.
4. Stress levels
Following a concussion, some people experience stress from the injury itself, or from sudden changes in their health and activities. Some already had high levels of stress in their life before the injury. Stress has a negative impact on thinking skills, sleep, and physical symptoms like headaches. High levels of stress may also prolong recovery. Talk to your doctor about stress management if this is impacting your recovery.
5. Executive function
Executive functioning skills are strategic thinking skills that help you focus on a task, know what you need to do, and get it done. You need these skills to use and apply strategies. If life feels disorganized and unpredictable, you may need a refresher on executive functioning skills so you can strategically plan your day to get the important things done.
6. Error sensitivity
Memory mistakes, distractibility, etc. are normal. After a head injury however, you may be hyper-aware of difficulties with thinking skills. It can be hard to know what’s “normal” and what is from the injury. Even normal mistakes seem like a big deal. Try to reframe your thinking. Instead of saying, “I hate it when I’m late. This isn’t me.” you can say “Today I was late because I lost track of time. Next time I will set alarms to help me stay on track.”
7. Return to activity
The goal of therapy is to help you understand your condition, current strengths/challenges, and strategies to help bridge the gap between challenge and success. You may not be 100% when you discharge from therapy. It’s important to work towards a systematic return to activity instead of doing everything at once. Moving too fast can leave you feeling fatigued and scattered.
8. Waiting to feel 100%
Some people wait to challenge their thinking skills until they feel 100%. This actually hinders recovery. You may not be able to return to full-time work, school, volunteering, etc. right away, but you should “test the waters” as your physical symptoms allow. The brain grows through challenge, variety, and movement towards meaningful activities.
9. Treatment history
Not all healthcare providers have experience with the best approaches to treat mild head injuries. If you have not seen a therapist trained in mild head injury, ask your doctor for a recommendation to a multi-disciplinary concussion treatment team. Some people also benefit from seeing the same healthcare providers for multiple rounds of therapy.
10. Recovery speed
It does take time for the brain to heal. Injury severity, other underlying conditions, how many skills/systems were impacted, how soon you started treatment, etc. all impact recovery speed. Keep applying your strategies and challenging your brain. Progress over time is not only possible but expected.
Many people are surprised by how many factors impact thinking skills. This may seem overwhelming, but it should also give you hope. If some of these factors might be impacting your recovery, read about Next Steps.
Disclaimer: This content is for informational purposes only and does not substitute personalized medical advice, diagnosis, or treatment. Always consult your doctor or other qualified healthcare provider with questions, and before starting any nutrition, diet, exercise, fitness, medical, or wellness program.