By Karen Tang, General Member
Disclaimer: The insights shared in this blog are not medical advice and thus, should not be taken as such. Please consult a licensed medical professional if you are unsure.
Dealing with a concussion, or traumatic brain injury (TBI) can be anxiety-provoking, painful, and an all-around bad experience. The recovery after a concussion can be complex and unpredictable, and coupled with one’s intolerance with uncertainty, it can make predicting when you are ready to return back to school/regular life to be quite challenging and ambiguous.
I sustained a TBI from a motor vehicle accident in my third year in graduate school. It was a devastating experience that took months to recover both physical and mentally, that involved multiple health appointments, dealing with memory and cognitive challenges, taking three months of medical leave from school, and sitting with the uncertainty of a TBI recovery journey. Reflecting back on my experience now, I am grateful that this experience taught me the power of resiliency and hope, and that I was able to employ some clinical skills on myself (as a clinical psychologist trainee). Here are a number of ways I coped with a TBI/concussion as a student:
Build your health team
It is crucial to build a health team with qualified professionals familiar with working with individuals with a TBI. Working with my physician, they were able to diagnose my constant headaches and cognitive challenges as a concussion, and spurred my journey to recovery.
I found a physiotherapist who specializes in concussions, and they were able to do a comprehensive concussion assessment. A month into my healing journey, my physiotherapist deemed it was safe for me to incorporate light physical activity into my treatment and so using a stationary bike was my main form of movement. From a psychology standpoint, this draws on principles of behavioral activation, which is scheduling time in your day for pleasurable activities, particularly activities that move your body. I found doing physical activity was incredibly helpful for my recovery as it prevented me from being sedentary, which also helped my mood and anxiety symptoms.
My physiotherapist also referred me to an occupational therapist (OT) and massage therapist. Working together with my OT, we developed a “gradual return to normal plan” which included several helpful recommendations such as using time-based pacing for pain, which I found to be especially helpful when it came to screen time/doing cognitively challenging work like trying to read an article or write a paper. Furthermore, the OT was able to upgrade my ergonomic set-up, including a new computer monitor that was anti-flicker as well as a custom desk chair.
I also worked consistently with a massage therapist that specialized in working with clients with concussions, and found that to be a key aspect in my recovery (especially with the headaches).
Taking a pause at school
I ended up taking a full month of medical leave from my coursework, and a total of three months off from clinical placements (with a doctor’s note).
I highly recommend connecting with your school’s Student Accessibility Centre. Working with my student accessibility advisor, we were able to set up temporary (short-term) academic accommodations during that time (particularly as I had to pause my attendance in courses + renegotiate coursework deadlines). My advisor was able to reach out to my course instructors and negotiate deadlines for me, or suggest other ways of completing assignments (e.g., instead of a presentation in class, I could do an essay).
I would also connect with your program coordinator or similar to see if they can do anything to accommodate you and your needs! And if you are a graduate student, it would be imperative to reach out to your thesis supervisor as well. From my experience, everyone was very accommodating and understanding of my challenges and they were able to work with me to ensure I was able to make a full recovery while also mitigating the impacts of the leave on my progress in the program.
Coping with the uncertainty
In my opinion, one of the worst parts of my concussion recovery journey was dealing with the uncertainty with the healing process. I found that channeling some of my clinical skills gleaned in my training was helpful with dealing with this.
Firstly, I aimed to be gentle with myself. I recognized that my brain is doing my best, and that the passage of time really helps with healing. I practiced plenty of self-compassion exercises during this time, and really strived to treat myself with kindness and warmth.
Secondly, I really pulled on a technique called “Sphere of Control”, which is a concept that helps individuals focus on aspects that they can control, instead of ruminating on areas that are outside of their control. For example, during the healing process, I focused on what I could control (e.g., doing physical therapy exercises, engaging in movement), instead of fixating on aspects that were outside of my control (e.g., worrying about how long I have to take medical leave).
Summary
To summarize, recovering from a concussion or TBI can be a painful experience rife with uncertainty. Hopefully this blog sheds some light into how a student can manage and cope with a concussion (although hopefully, you are never put in this position)!
Resources and further reading:
Time-Based Pacing: https://www.va.gov/PAINMANAGEMENT/Veteran_Public/Veteran_docs/Pacing-formula.pdf
Self-Compassion exercises: https://self-compassion.org/category/exercises/#exercises
Managing chronic pain: A cognitive-behavioral therapy approach. Workbook (2007) by John D. Otis
Brain Injury Canada: https://braininjurycanada.ca/en/concussion/