Is my personality delaying my concussion recovery?

After a sports related brain injury (concussion) academic work should be put on hold until symptoms begin to improve.  The brain uses energy to send signals in the form of electrical and chemical messages.  In addition to the energy needs of cognition (thinking) and autonomic brain functions, healing requires energy and adds to the metabolic demands of normal brain function.  Studying and taking tests often exacerbates symptoms during the recovery period after sports related concussion.

Among the greatest concerns is lack of sleep in this patient population.  Without sleep the brain does not get adequate opportunity to heal.  Not only is this a concern for Post-concussion syndrome, but is a real societal concern in the modern world.  Students with high expectation for top grades often study late into the night and end up sleep deprived.  It is important to rest appropriately during the recovery from brain injury.  Recommendations are for 8 hours of sleep per night.

Academic all stars often have a difficult time putting their school work on hold.  It is this “type A” mentality that leads to continued stress on the injured brain that can slow healing.  The analogy that best matches this scenario is that of an injured bicep.  One would not go to the gym and do bicep curls after a strain of their arm.  Why would someone stress their mind with difficult school work after a brain injury? The fear of falling hopelessly behind creates the sense that there is no room for rest from homework and testing.  It is this group of patients that remains a challenge in my practice, as the increased stress of engaging with cognitive demands of school increases metabolic demand in the brain and slows healing.  This often leads to post-concussion syndrome.

Fortunately there is a law that protects students with injuries of the brain.  It is the Americans with disabilities act, section 504.  A temporary “504 plan” will be written at the time of your concussion evaluation, and your school is required to help accommodate you during your recovery.  There are times where home education and home services are employed to help aid in recovery as well.  Should symptoms persist for several months an individualized learning plan (IEP) might need to be considered for longer term accommodations.  The point here is that systems have been developed to help get you back up to speed when you injury your brain.  Following the program can often help achieve relative brain rest, reduce stress, and allow for recovery.

While it can be several weeks before some students recover, relative cognitive rest with a systematic titration of activity starting with short bursts of reading from a printed page, then some writing when tolerating reading, and finally computer work when tolerating reading and writing is the progression we follow.  It is important to follow this recommendation noting symptoms and titrating accordingly to avoid a prolonged recovery, but many students are too afraid to follow the guidelines despite good scientific evidence for this approach.  To give your brain a chance to heal get to bed on time, stay off of the computer, limit phone use drastically, and work with your guidance counselor and teacher to implement the recommended strategies your doctor provides.

One response to “Is my personality delaying my concussion recovery?”

  1. […] One less commonly described phenomena that can lead to PCS is that of the high stress learner or “type A” personality.  In addition the severity of the initial injury and prior history of concussions (especially > […]

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