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Brain Injury Awareness Month | Alaska

It Is Brain Injury Awareness Month!

March marks the month dedicated to Traumatic and Acquired Brain Injury (TABI) awareness. This awareness focuses on topics including what a brain injury is (hint: concussions count), how common TBI’s are, prevention, and recovery (recovery is possible!).

If you or someone you know has been impacted by a brain injury: you’re seen here. If you wish to learn more about brain injury, you are just as welcome here.

What is a Brain Injury?

Alaska defines a Traumatic and Acquired Brain Injury as: 

“Injury that occurs from physical force or internal damage to the brain or its coverings, not of a degenerative or congenital nature, that produces an altered mental state and that results in a decrease in cognitive, behavioral, or physical functioning.” (AS 47.80.529)

Have you ever paid attention to the approach to TBI’s in real life or in movies? I’ll share a personal pet peeve: the saying, “it’s just a little concussion”

NO!

Being told, “It’s just a little brain injury” is not helpful. At the end of the day, a mild brain injury is a brain injury.

Any external jolt to a person’s head which causes the 3lb jelly-like-mass in our noggins to bump around = traumatic brain injury. Common causes of TBI’s in Alaska include: motor vehicle accidents (ATV, snowmachine, or car), falls, assault, and unintentional injury to the head (State of Alaska Epidemiology, 2023).

Acquired brain injuries occur after birth via an internal mechanism rather than an external jolt to the head; such as strokes, aneurysm, tumor, insufficient oxygen supply to the brain, or infectious diseases (Brain Injury Association of America, 2022)

Other causes of brain injury may be intimate partner violence, assault, sport injury (common cause for youth), and pedestrian-motor vehicle collisions. Many people have heard about, “Shaken Baby Syndrome,” which is a brain injury. Active-duty military personnel may be at risk for sustaining a head injury from explosions or blasts (BIAA, 2022).

Brains don’t like to be disturbed, and they tend to make that known in uncomfortable ways.

The symptoms of brain injury vary: almost no two people have the exact same symptoms.

Keep scrolling to learn more

Here are a few brain injury facts:

Worldwide

Brain injuries are a leading cause of death and disability

In the United States

Men are more likely to sustain a brain injury

In 2021, nearly 70,000 people died from a brain injury

In Alaska

In 2023, TBI’s were a leading cause of death among Alaskans younger than 30 years-old

Suicide was the primary cause of TBI-related death in Alaska in 2023 (State of Alaska Epidemiology, 2023)

Common Symptoms Following a Brain Injury:

  • Headache, dizziness
  • Light sensitivity
  • Nausea
  • Changes in sleep pattern
  • Loss of consciousness
    • Note: someone can incur a brain injury without losing consciousness. This is one reason people may overlook a head injury
  • Changes in pupil dilation
  • Slurred or delayed speech
  • Less stable when standing or walking, tripping or falling more
  • Confusion

The human brain is a complex and delicate system made up of billions of nerve cells controlling all functions in the body. So, it’s a pretty big deal if any part of the brain gets damaged.

Since the brain is complex (and fantastic), it localizes functions in different regions of the brain. That is part of the reason why brain injuries are complicated: because the severity of injury is largely determined by two factors: (1) how severe was the injury, and (2) which region of the brain did the injury occur.

Brain Injury Awareness Month: Why?

TBI’s look different, which is part of the reason people do not receive a diagnosis for a brain injury. Lacking a diagnosis leads to lacking treatment, and lacking treatment means unnecessary difficulties in the recovery process. 

Brain injury survivors CAN and DO heal from brain injuries, and receiving treatment often makes a significant impact on recovering.

Brain Injury Awareness Month aims to increase the detection and diagnosis of TBI’s, along with increasing survivors’ access to treatment, and share resources for survivors (and their family members).

Many brain injuries still go undiagnosed, whether due to a person not seeking medical care, or medical providers failing to detect and diagnose brain injuries.

That creates layers of burdens: on the survivor, their family, relationships, and community. TBI’s change people. Several people I care about have experienced brain injuries, and the impact of a brain injury can be a lifelong change for some. While many survivors recover, healing takes time, patience, and support.

Brain Injuries & Mental Health

Brain injuries often impact mental and behavioral health. It is common for brain injury survivors to experience anxiety, depression, or other mental illnesses; changes in personality, changes in mood, decrease in energy levels, substance misuse, sleep impairment, or difficulty handling emotions, such as anger (Howlett, Nelson, & Stein, 2022).

Changes to life post head injury can be distressing and frustrating. Losing one’s sense of self, feeling out of control of one’s emotions, increase of migraines or headaches, difficulty maintaining skills or hobbies prior to the injury, are just some of the struggles which survivors experience.

As a mental healthcare provider in Alaska, I ask each new client if they have ever had a brain injury, jolt to the head, or concussion; and if they received any treatment. Many clients have had a brain injury, and many never received a diagnosis. 

Brains heal, and many people do heal from a TBI without treatment, but that doesn’t mean it is easy.

Many people don’t know that TBI’s cause various symptoms in the brain and body. Nor do many people know what kind of treatment they need (which is VALID because there are multiple: ophthalmology, medication management, mental/behavioral health, primary care, nutritionist, case management, neurology, etc), or: people do go to an ER or health clinic but a doctor dismisses the injury and does not provide a diagnosis. 

Worse, perhaps a person doesn’t have access to an ER or provider; as is the case with much of rural Alaska.(CDC, 2023)


An aside: one of the best supports I can imagine for a brain injury survivor is a great case manager. Case managers are some of the best people; they know EVERYTHING. As this post discusses brain injury awareness, case managers must be acknowledged and appreciated, because they hold it all together.
(Thank you, case managers!)

There are many reasons why TBI’s go undetected; none of those reasons include shaming or blaming survivors.

Having clinical and research experience with TBI’s; I enjoy providing psychotherapy to TBI survivors. When working with survivors, it is critical to pace psychotherapy appropriately. 

The traditional pace of counseling may be too overwhelming for survivors; it often fluctuates and requires understanding around the fluidity of abilities during recovery.

In my practice, I like to collaborate with survivors so we can find an optimal time for therapy. Brain injury survivors tend to have several different weekly healthcare appointments. It can be a lot for a survivor to attend multiple appointments in one day, and instead may be better to schedule therapy on a day without any other appointments.  

Prevention

Brain injuries are often preventable. Preventing serious illness, harm, or death promotes healthier lives, happier communities, to name a few.

According to the State of Alaska Epidemiology Health Report (2023), Alaska has the highest rates of TBI’s per population than any other state. 

Racial disparities are evident: Alaska Native and American Indian peoples disproportionally make up TBI-related deaths, at a rate more than double that of white Alaska residents (State of Alaska Epidemiology).

Rural location and the well-known shortage of health professionals in the state are contributing factors for these disparities.

Prevention saves lives; and informing people where they may be at risk can encourage folks to change their behaviors and implement safety precautions. There are not many ways to frame it but:


Preventing a head injury is COOL, actually


Wear a helmet on a bicycle, motorcycle, snowmachine/snowmobile, or ATV/four-wheeler.

I know, I know: helmets are not part of Alaska snowmachine culture. But, the sad reality is that traumatic brain injuries are very much a part of Alaska snowmachine culture. Accidents are not called “on-purposes,” so it is best practice to wear a helmet each time. Preventing death and disability is COOL.

Other activities where participants benefit from wearing a helmet: boxing, ice skating, skateboarding, horseback riding, and skiing or snowboarding.

Don't drink & drive

A classic: impaired judgement while operating a vehicle, snowmachine, ATV, or boat can lead to disability or death from a brain injury.

Wear a seat belt

Recall that our brains are precious, sensitive, gelatinous masses that are responsible for every single function in the body. A seat belt can go a long way to protect our brain in an accident.

Prevent falls

Older adults are most likely to incur a head injury due to accidental falls. In the winter, using removable ice cleats can provide more traction. 

It is common for older adults to add new supportive features, such as shower grasp bars, into their homes. Consult with a healthcare provider for more information specific to your situation.

Here are COOL ways to prevent or reduce your risk of brain injury:


TBI Recovery

The most important message about healing from a brain injury: it is POSSIBLE!

TBI survivors often recover. Receiving a timely diagnosis and treatment are crucial factors in recovery.

TBI symptoms may persist for years following the injury. The brain is equipped to recover, but survivors deserve treatment, healthcare to promote brain healing, and support in the areas unique to their injury.

Many TBI survivors become self-advocates; if you wish to learn more about self-advocacy check out the Brain Injury Association of America self-advocate toolkit

The more stories that come from brain injury survivors help generate awareness, research, and funding towards healthcare programs to promote those impacted by brain injury.

Resources

Here a few TBI specific recovery “tips” I’ve learned during my career:

  • Bright, fluorescent overhead lights are often uncomfortable for TBI survivors. Better alternatives include lamps and dim lighting
  • Rest, and grace to rest. Brains do a lot of work even when we are at our laziest. Resting is vital. It is important to challenge yourself, but avoid overextending, which can often lead to worsening of symptoms
  • Sleep disturbance is common among survivors, which can lead to feeling irritable
  • Survivors may notice increased sensitivity to noises that hadn’t bothered them prior to injury
  • Survivors are often surprised by how much they recovered: and some report feeling even more alive post brain injury recovery! Going through brain injury treatment often teaches people new insights about him/her/themself

This is not medical advice or treatment; but general information. The content shared may be used to educate readers about head injuries, and is not considered a valid diagnosis. Nor may this information be used to diagnose someone you know. If you suspect you have a brain injury, visit your primary care physician or local health clinic.

Any information here may be used for self-improvement purposes, not as healthcare advice or medical treatment. Consult with your healthcare providers about any changes to your lifestyle or health.

Reading this post does not imply Stellar Insight Counseling or any members of the clinical team are providing you healthcare, advice, or treatment.


References:

Brain Injury Association of America. Abi vs. TBI: What is the difference? Brain Injury Association of America. (2022). https://www.biausa.org/brain-injury/about-brain-injury/nbiic/what-is-the-difference-between-an-acquired-brain-injury-and-a-traumatic-brain-injury

Center for Diseases and Control. (2023). Traumatic brain injury & concussion. National Center for Injury Prevention & Control. https://www.cdc.gov/traumaticbraininjury/get_the_facts.html

Howlett, J. R., Nelson, L. D., & Stein, M. B. (2022). Mental health consequences of traumatic brain injury. Biological psychiatry, 91(5), 413–420. https://doi.org/10.1016/j.biopsych.2021.09.024

State of Alaska Epidemiology. (2023). Traumatic brain injury in Alaska (Section of Epidemiology Bulletin 23(2)). http://www.epi.alaska.gov/bulletins/docs/rr2023_02.pdf