Women and #concussion #TBI – do current treatments make things worse?

This is an important thought that came to me today. I looked around to see if I could find anyone who was talking about this. I couldn’t. Maybe I’m looking in the wrong place… but I don’t think so.

I think this is something that’s just gotten lost in the shuffle – women (and also men) who deal with stress by bonding with others (tend and befriend) are going to suffer more under the strict isolation of concussion treatment. And that stress could possibly contribute to exacerbating their symptoms.

Seems likely — and important — to me.

TBI Research Riffs

work-against-womenSomething absolutely critical occurred to me today, as I was scanning the tracking data for a technical website I optimize. Pardon me, if I’m behind the times on this — it just occurred to me, but after some admittedly cursory Googling of terms, I found no evidence that anyone else had made or published about the connection I’m about to discuss.

The Burning Question That Needs To Be Answered:

Do the ways we currently treat concussion / TBI actually work against the women who have been injured?

I’ve been influenced, of late, by a good deal of conversation about women and concussion, including my reading about the “miserable minority” of mild TBI survivors (mostly women) whose symptoms persist past the 3 months they’re expected to last. After decades, we still have double-digit percentages of PCS sufferers who continue to deal with sometimes debilitating symptoms. There is some compelling dialogue going…

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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.

2 thoughts on “Women and #concussion #TBI – do current treatments make things worse?”

  1. Hmm – I do think that there are gender differences in TBI– in how it occurs, is experienced and expressed and in what approaches with rehab work best but not sure we have much data on those differences. While women do tend to use social exchange more than men I don’t know that the post injury rest period is detrimental – women – just like men – actually don’t feel like socializing due to the sequelae that come from the injury, at least not for the early stage recovery. Once they improve there are plenty of socializing options – such as support groups, on-line groups, and various other options – which women do tend to utilize. Women are also more inclined to be expressive about their emotions which may make the psychotherapeutic process more effective. However there are many other factors – for example women tend to channel their anger towards self, men channel it towards others – yet women who are injured can experience great anger and have difficulty expressing it. This can also be in part due to perceptions of the health providers who are often male and may respond differently to a female’s anger than a man’s – accepting a man being angry where as shaming a woman for it (or making it be a disorder). Some anecdotal evidence also suggests that men are more likely to have diminished impulse control over sexuality than women – but that’s not tested in any way. There are also self-perception issues, women who have families may resist being in need of care when they are used to being the caregivers, or they may receive reduced vocational supports because they are assumed to have a spouse who can support them. These are of course all presumptions, based somewhat on gender issues that exist outside of TBI and which may be carried over in TBI. These factors can also cloud the recovery process – so for example women may be more inclined to be passive or feel victimized about their recovery where as men feel more of a need to do something, anything. In both cases this can create psychological overlays that make the recovery process more challenging – which is why it is important to understand the psychological response a person has to injury.

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  2. All true. All good points. I’d love to see some more data collected regarding this – it would make these kinds of discussions so much more productive. The point I’m making is that “there could be something useful there to consider that could help a lot of people”, in hopes that the qualified data-collecting folks will see some value in pursuing it. I do think that things are changing with regard to support after improvement. What I’m most concerned with is the acute period immediately after the injury, when you’re in that limbo of thinking WTF?! and not knowing where to turn. I think that stage offers a lot of opportunity to intervene with injured folks, and rather than just saying, “Oh, you’ll be fine, just go home and rest,” healthcare providers can (and should) offer more — and in ways that are more appropriate to the individual, than they are today.

    Yes, it’s nirvana, and it may never happen in our lifetime. But it’s a goal. And without those, we might as well just give up.

    I also totally agree that the psychological comes into play to a great extent. It is all connected, and it seems foolish to think otherwise. My issue is when it’s when psychology is used to explain everything, and the functional and physiological/neurological issues are overlooked. Psychology as a field is fraught with validity issues — a significant percentage of principles are based on findings that cannot be reproduced. And it’s wielded widely and with extreme variations of skill/ham-handedness. Considering how powerful it is, and how much power it’s been given over us (e.g., DSM-V) the people swinging that sword need to be held accountable for the damage that they can — and do — produce as a result of their care.

    All this is imperfect, of course, but we do need to move forward.

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