whats the difference between a concussion and actual brain damage?

Why you should wear a helmet!
Why you should wear a helmet!

This question was asked recently in a search engine, and the person who asked it ended up here on this blog. A lot of people have been searching for concussion information, some worried about brain damage…. and worried about becoming stupid as a result of their concussion.

Concussion, while technically a brain injury, can vary in its severity, as well as the outcome. You just can’t say, from one person to the next, whether or not a person sustains lasting and significant brain damage as a result of a concussion. Some people heal relatively quickly and show no signs of injury after the fact. Others heal more slowly and experience some changes, but get back to their lives without huge impact. Still others struggle for a long time after their injury and have considerable difficulties well into their future.

It’s very individual, and it’s also very unpredictable. That’s what makes concussion and brain injury so frustrating — and interesting at the same time.

The thing is, you have to factor in neuroplasticity — the ability of the brain to shift and change and “remap” itself. Contrary to what we’ve been told for many, many years, the brain actually does change, and damage can be overcome. There are numerous stories about people who overcome serious neurological problems to live incredible lives. The book The Brain that Changes Itself (click here to buy it) is a great example of how the fact of neuroplasticity can trump the impact of neurological problems — some of them acquired.

See, here’s the thing for me — even in the face of concussion, even in the face of brain damage, the fact of the matter is that you can overcome a huge amount of difficulty by proper management of outcomes. Over at The Concussion Blog, they talk about that a lot — the problem isn’t concussion (it happens), the problem is managing it when it happens. It’s the same with any brain injury, I think. Brain injuries happen. TBI happens. Sh*t happens. We often have no control whatever over that.

What we DO have control over, is how we respond to it. And when we respond with educating ourselves and coming up with smart and common-sense responses to the issues, rather than running in circles, or running in fear, we improve our chances of a positive outcome dramatically.

Think about it, folks — concussions and traumatic brain injuries have been happening since the beginning of time. And yes, we’re still here. We’re still pluggin’ right along. We don’t have to curl up in a ball and give up. We don’t have to say, “Oh, I’m brain damaged – that’s it, then. I’ll just have to give up on ever having a normal life.” … or “Oh, you’ve had a TBI, and that’s it – you’re f’ed up and you’ll never change.”  Both of these statements are based on fear and ignorance, and a real lack of knowledge about what the human spirit is capable of doing.

The human spirit is capable of so much, and so long as we have that — and an earnest desire to improve and work towards something positive — we still have hope.

Ultimately, the difference between concussion and brain damage might not matter so terribly much. Of course, severity plays a role. But attitude has a lot to do with it, too. Both of them (regardless of severity) can be sidelining, if you decide that they mean you’ve got problems that will never go away, and the challenges are more than you can take. If you decide that all hope is lost, and it’s pointless to pursue any sort of recovery, that you need to just accept your “new self” as you are and not reach for something bigger and better, and you refuse to adopt different ways of reaching the goals that matter so much to you, then ultimately there probably isn’t that much difference between concussion and brain damage. The effects can be similar, if not the same. A lot of it depends on how you approach it.

Now, I’m not saying that concussion and brain injury are laughing matters, or you can just shine them on and pretend they never happened. Brain injury introduces permanent structural changes to your brain… and concussion can, too. The thing is, the brain is an awfully big place with a whole lot of potential for change. And if we just give up, we never give ourselves (and our loved ones) the opportunity to learn and grow and adapt and have all the life that is possible for us and them.

Brain injury changes a lot. Concussion can change a lot, too (see The Biography of a Teenage Concussion for more discussion of that – it’s a new blog I just discovered recently). But if we stay flexible and focused, we can do a tremendous amount to overcome whatever new challenges stand in our way.

whats the difference between a concussion and actual brain damage? Sometimes, it’s all about the attitude.

Author: brokenbrilliant

I am a long-term multiple (mild) Traumatic Brain Injury (mTBI or TBI) survivor who experienced assaults, falls, car accidents, sports-related injuries in the 1960s, '70s, '80s, and '90s. My last mild TBI was in 2004, but it was definitely the worst of the lot. I never received medical treatment for my injuries, some of which were sports injuries (and you have to get back in the game!), but I have been living very successfully with cognitive/behavioral (social, emotional, functional) symptoms and complications since I was a young kid. I’ve done it so well, in fact, that virtually nobody knows that I sustained those injuries… and the folks who do know, haven’t fully realized just how it’s impacted my life. It has impacted my life, however. In serious and debilitating ways. I’m coming out from behind the shields I’ve put up, in hopes of successfully addressing my own (invisible) challenges and helping others to see that sustaining a TBI is not the end of the world, and they can, in fact, live happy, fulfilled, productive lives in spite of it all.

6 thoughts on “whats the difference between a concussion and actual brain damage?”

  1. BB –

    Let me start by making clear that I agree with you that no one should be told to ‘give up’ on their life or see themselves as less than. I also believe that many (but not all) rehab programs for people with BI do not empower people to rebuild satisfying, productive and effective lives. I also believe however that the range of BI is vast; I know hundreds of folks with BI and their levels of challenge range greatly. This depends on their pre-injury functioning, their psychological status, their supports – AND their injury. Most of them (but not all) do work hard at having a life that brings them satisfaction and happiness.

    What I think is critical to understand (and where I differ from your post) is that I DO NOT think it is a question of attitude. In fact I think putting a notion of ‘attitude’ on BI is what hurts it – these folks cannot positive thinking will themselves into functioning the way they want. There are three ways to deal with BI – compensate, rebuild, or alter your lifestyle. ALL THREE ARE LEGITIMATE OPTIONS and no one should be made to feel less than or a quitter because they chose one or the other. Sometimes it does make sense to rebuild – which often requires a TREMENDOUS effort, a lot of failure and a long long time (years). It can be painful and humiliating, it may be costly. But sometimes it is the right thing; sometimes that persons injury is such that they can make new connections or other pathways can do double duty and they can partake in things they once did – though almost never at the level they once did. The brain is a system and if you put a load on one aspect of the system another aspect will have to give a little. It is important to understand this because almost everyone with a mild BI has a hard time seeing themselves and understanding where and what their issues were – they often make leaps in thinking, get lost in the weeds, are at the finish line before they started and are oblivious to the circumstances – broken feedback loops are endemic. Recognizing that you have to make adjustments doesn’t mean you are quitting or giving up or having half a life – it means you are dealing realistically with the situation.

    Most people could become pretty decent singers if they worked at it for years and years and years – but to what avail? To say they are good singers? For a shot on America’s Got Talent? To prove a point? You can want to be a great singer but if you recognize that your voice is limited then you think about other ways to enjoy the world of music.

    Compensation for deficits can be done but again, awareness is key. Most people with BI tend to go too fast, jump to conclusions, over-react etc so that they don’t see the disasters they make till they are knee deep. Often the biggest compensation tool is for them to take a deep breath and pause. So there is a lot of relearning and conscious effort required to use compensatory techniques. By the way MOST people do use some sort of compensatory techniques in this world – we have smart phones ,we make lists, we use organizers, calendars and many many other tools – in fact there are industries dedicated to helping people address the various skill challenges they may face in trying to manage their way through the world. It IS difficult at times to use these approaches if you are not used to them and again, it takes lots and lots of practice.
    I have also known folks who just changed their lifestyles. Again this isn’t such a bad thing – for many it was a way to re-assess their lives. I think that the economy is not great for most folks and that there isn’t much support for people to do this which makes it harder but if one can it’s not a bad thing to do. Again, these folks weight the cost and stress and burden of trying to recapture something versus pursuing another path that is less painful and they choose the latter. In truth if I could have I would NOT have gone back to my previous career.

    Most of all is recognizing that there are changes – that one must take better care of ones health, the sleep is a NECESSITY and that even when we think we are doing fine with less we are not, that stress is a cognitive drain, that there are small ways to make things better but no miracles.

    When you were writing about your financial straits you mentioned that you thought you needed to take on some side work for extra money – this is a good example of the kind of dilemma that many BI people get themselves into. You are currently exhausted, you are fighting hard to maintain your position and your productivity at work –and are already overworked, you do not have enough time to relax or do things around your house that would make your life simpler and easier, and you KNOW that fatigue makes you more likely to blow up and be impulsive – so why would you think that taking ANOTHER job is a good solution? I would humbly suggest that you reconsider.

    Yes, there are some folks who don’t want to push themselves at all and yet I can also understand that. The effort to do things is sometimes so hard that it is overwhelming. The world, especially the business world, doesn’t give a hoot about my struggles or my effort – it’s do or die. People who are teachers or doctors often simply cannot return to their previous environment – and unfortunately they will lost the only forms of support they have (SSI) is they make an attempt to slowly re-integrate themselves back. Plus if you are 45, 50, 55 and you are trying to re-integrate yourself back at this time it will take you 10 years to get close to where you were (for many people) – and it may cost you in terms of happiness, enjoying family and life in general.

    Rebuilding your life after a BI is not a contest and not about proving anything. Some people (and I would probably count myself among these) do work doggedly to return to a life that is similar to pre-injury (but no matter what it IS different, I am different). But many people (and oddly I would ALSO include myself in this category) find other aspects of themselves – their circumstances encourage them to rethink their life styles and choices. This is also try of people with a BI who face a significant event – that’s just life.

    A concussion is a brain injury that has healed with no lasting effect; post concussion syndrome is a series of residual symptoms that remains for a prolonged period; this may be lasting to some degree where in it is more commonly referred to as a traumatic brain injury. A tbi is a physiological experience and NOT a character issue, not an attitude issue, not a personality or psychological issue. The circumstances of a person’s life, health, situation may dictate the best way to address this physiological injury and it may require a degree of determination and tenacity but it is not just an issue of attitude. Indeed much of the educational effort that various groups do is to make people understand that a person is not choosing to be unmotivated, disorganized, forgetful, impulsive etc. – these are symptoms of injury – an injury that can be addressed in some ways but it not simply willed away.

    I think I understand your point –and I agree that one has to recognize and embrace challenge – but I also hope it is clear to people that BI is injury and that it is not simply a matter of effort.


  2. m –

    I probably agree with you on many counts, here. I think my main point probably got lost in the shuffle — effort and attitude are only part of the overall picture. There’s a lot to be done, which can include making necessary changes and accommodations. At the same time, however, I do think we sometimes sell ourselves short or don’t realize how much more we are capable of. I think, in particular, of Paul Bach y Rita’s father, who sustained a stroke that killed something like 75% of the part of his brain that controls movement. He had to learn to walk again by being urged to crawl, being prompted, being pushed. And he ended his days on earth about a decade later while he was mountain climbing. I think there is a real temptation in BI to not plan for the best, but to hope for it a little, but not get your hopes up too much… and inadvertently create conditions that undermine the possible progress.

    Remember, I was once walking the streets of an inner city in February, looking for a doorway to sleep in… and I’m so far from that world now, nobody would believe me, if I told them where I came from. I once lost the use of my hands for several days, thanks to “irreversible” carpal tunnel… and yet here I sit, typing away without pain. I am walking, talking living proof that miracles are possible, and I do believe that attitude has a huge amount to do with motivation and action. It’s the fuel behind everything else. Certainly, you may need to make adjustments and accommodations. Nothing would give me greater pleasure than to leave this 9-to-5 world behind and ditch the career path I have been on for the past 20 years. But bills have to be paid, and somehow I’ve got to stick with it. So, I do. And it actually is working out well – as far as everyone else is concerned 😉

    Certainly, Brain Injury is an injury. And it changes everything. We just don’t go back to how we were before. But how much else is possible for us? Yes, there really is serious loss at times, and that loss needs to be acknowledged and appreciated. But there’s so much more to life. And that, I think, is what a lot of people, brain injured or not, lose sight of.

    In times of despair, I look around and think, “Lots of people who really are not that bright or principled or even talented, do very well for themselves in life – why shouldn’t I?” And so I keep plugging away. Because like Jacob wrestling with that angel, I say again and again to life and all it puts in front of me, “I will not loose thee, except thou bless me.”


  3. BB –

    I understand – this is such a difficult path to walk at times – on one hand amazing things do occur – on the other hand people can bang their heads against the wall in search of something that doesn’t really mean anything in the long run. For me it’s not just that I would ditch my career – it’s that it robs me of life – literally – I am so drained and it is so consuming and it takes such effort to keep on track that I feel like I have nothing but a job in my life. It is not the way I want to live and I have put a time limit on it (if I can sustain it). It might be different if the business world valued me for my contribution but they value me for my assimilation and that is much harder to do.

    Knowing this and knowing that I am one of the more ‘functional’ and able folks makes me realize how hard this is for others who have even greater cognitive battles.

    I don’t want anyone to ‘quit’ or to think that they cannot achieve things, I simply believe that folks need to understand as much as they can – and not to feel shame, guilt, stupid, or anything like that – and I know that that is what you seek as well.




  4. m –

    I hear you loud and clear.

    My life at present consists of — M-F get up, exercise, eat breakfast, write a little bit if I have time, go to work and stay there late, allowing myself enough time to actually work through everything I need to work through without going into a panic over the lack of all the time I need to do my job to my own satisfaction… going home, eating something, watching some television, reading or catching up with friends on Facebook, checking in with my Asia colleagues who are emailing me, going to bed (usually later than I should), and doing it all over again. Saturday and Sunday, I usually stake out for myself — writing and reading and maybe going for a walk or a drive, sleeping a few hours in the afternoon (if I’m lucky), then checking in with work again on Sunday, so I don’t get to the office on Monday with a sh*tstorm waiting for me.

    That whole conformity thing… it’s just crazy. I can’t do it, and I’ve recently come to accept the fact that I cannot — and will not — remake my life and my person to suit the desires (oh, let’s be honest – rank cowardice and refusal to speak/hear/live truth about what it means to be truly alive) of the status quo. It’s interesting, coming at it from a position of someone who used to be quite capable of balancing between the political requirements and my own personal expression. Now it just doesn’t work, and when I try to talk to people about the fact that we’re all human and we don’t need to punish each other for being fallible (not only me, but others as well), I get blank stares. Crickets. It is so profoundly stupid and arrogant and idiotic. Small wonder these companies depend on corporate welfare to live to see another day. They are chock full of people who check their humanity at the door and blame and attack everyone else who doesn’t.

    Interestingly, I recently came across the Heroic Imagination Project — http://heroicimagination.org/ — found it mentioned in a Twitter feed. It looks promising, for me anyway. If I can conceive of my constant struggle with the inequities and unrealities of life on the job as part of a larger dynamic that plays out in countless lives (and which I can actively engage in as a conscious participant), it helps. What I’ve found to be true — at work as well as elsewhere in my life — is that some people are really hungry to find others who are willing to stand up and step out and model a different way of being and interacting. The problem is, I can’t always tell who and where they are, so I always take my chances, being who I am and how I am, and there’s always the chance I could be wrong about someone being a kindred spirit. But that can’t keep me from standing up for what I believe to be right and good. I have to trust that in innermost myself, regardless of what my neurological state may be.

    I hear you about the understanding piece. I am pretty isolated in my own life, not having much to do with people outside work, so I am not as in touch with the myriad people who are struggling each day with brain injury. I am in touch with my own experience, but that often includes an eagerness to see and move beyond the challenges I have, and focus on the possibilities beyond them. The challenges do tend to get short shrift in my writing, of late. I’ll have to do something about that.

    Thanks for your thoughts. It really helps.

    All the best


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