Rosemarie Scolaro Moser, Ph.D., ABN, ABPP-RP, Director
Licensed Psychologist, NJ #SI 02148
Traumatic Brain Injury
Every year approximately 1.7 million Americans experience a Traumatic Brain Injury (TBI). TBI occurs when the head receives a jolt, hit, or force that results in dysregulation or damage to the brain cells. This dysregulation causes a cascade of neurochemical reactions in the brain that can occur over a period of days. Depending on the severity of the injury, it can take weeks, months, or years to recover or become stable. Furthermore, TBI often comes with long lasting residual symptoms that never fade.
TBI can range from mild to moderate to severe. For example, concussions are generally considered “mild” and usually resolve completely. However, with moderate to severe TBI, significant impairment persists. Depending on the nature of the injury, there can be impairment in speech, language, motor functions, sensory functions, executive functions, memory, attention, reasoning, processing speed, and problem solving. Since the brain is the Master Control of all body functions, individuals may experience changes in any body function such as vision, balance, smell, and hearing. Depression, anxiety, stress tolerance, impulsivity, and moodiness may also occur due to the neurochemical changes. But whether considered mild or not, brain injury should be taken seriously. TBI interferes with all aspects of one’s life: occupational, academic, personal, social, relational, recreational, and spiritual. It affects cognition, emotions, behavior, sleep, and physical functioning.
Many individuals with TBI look “normal” because you cannot see the brain injury. With a broken arm, you can see a cast; with a broken leg, you can see a change in gait. Since brain injury can be “invisible,” others may not understand why a person with a brain injury is experiencing difficulties. As a result, others may think that the person with the brain injury is “faking” or being “lazy.” When others don’t understand you, and you are not functioning as well as you used to function, it is easy to feel discouraged, demoralized, hopeless, angry, and depressed.
When TBI is diagnosed or suspected, the individual should be examined by a neuropsychologist, a doctor who specializes in brain-behavior relationships. The neuropsychologist can assess a vast array of brain functions and abilities. The neuropsychologist can create a specialized treatment plan to address any impairment in functioning. Such treatments may include cognitive rehabilitation or remediation to improve the weak areas of cognitive functioning, as well as biofeedback for stress or headaches, psychotherapy for the related emotional and social distress, and appropriate medical consultations, such as neurologic, psychiatric, vestibular, pain management, ophthalmologic.
Recovery is a slow process, and engaging in treatment as soon as possible can help shorten recovery time. Coordinating with the individual’s school or employer will be essential when planning a return to academics or work. Accommodations may need to be put in place. Along the way, aiming for self-acceptance and a new sense of self is essential for well-being. In addition, family support and education is necessary, as brain injury affects not only the survivor but all of the significant people around him or her.