According to the Centers for Disease Control and Prevention (CDC), in 2014, there were around 2.87 million TBI-related emergency department visits, hospitalizations, and deaths in the United States. More information about concussions, which are classified as mild traumatic brain injuries, can be found in the Everyday Health concussion guide. But mild is a misnomer — concussions can have big consequences if left unaddressed and untreated. Brain injuries are classified as either mild, moderate, or severe. The severity of the injury is determined using the Glasgow Coma Scale (GCS), an assessment tool that is used to measure a patient’s level of consciousness using the metrics of eye opening, motor response, and verbal response following a brain injury. People with a mild TBI have a GCS ranging from 13 to 15 whereas a moderate TBI leads to scores in the 9 to 13 range. Severe TBI is associated with a GCS score of 8 or less." Living with a traumatic brain injury can be difficult, but it is manageable. Whether you’re looking for medical professionals, emotional help, or advice for day-to-day living, this guide will help you manage life post-TBI. TBIs often come with an increased response to stimuli and a decrease in the ability to focus. It’s important to avoid distractions and manage your expectations during your recovery. Healing from a traumatic brain injury is a marathon, not a sprint, and can take a lifetime. Haley Neidich, a licensed mental health professional based in New Haven, Connecticut, says, “The biggest problem individuals suffering from TBIs encounter is that it is an invisible illness. People with TBIs can be struggling significantly with cognitive, behavioral, physical, and mental health issues while appearing as if all is well on the outside.”

Exercise

Exercise is an important part of recovery and can help your brain during the healing process. There are many different forms of exercise you can engage in to maintain health as you recover. Some ideas are below. Not all forms of exercise are right for everyone, so talk to your doctor before starting an exercise program. Yoga is one form of exercise that has been shown to help brain injury survivors with balance, flexibility, and muscle strength following an accident. Initiatives such as LoveYourBrain — started by snowboarder Kevin Pearce after his own TBI in 2009 while training for the Winter Olympics — foster a mind-body connection for TBI survivors through a free, adaptable yoga program. Moderate aerobic exercise has also been shown to help recovery from a TBI. A small study published in April 2015 in Archives of Physical Medicine and Rehabilitation found that patients with mild and moderate brain injuries who followed a vigorous aerobic exercise training program 3 times a week for 30 minutes, saw improvements in brain cognition. According to a 2019 study in Behavioural Neurology, semi-immersive virtual reality brain exercises “may be a useful approach for the rehabilitation of individuals with TBI, potentially leading to better cognitive and behavioral outcomes.” But digital applications advertised as brain training aren’t always a failsafe plan. Therese O’Neil-Pirozzi, ScD, an associate professor in the department of communication sciences and disorders at Northeastern University in Boston, cautions: “All brain training apps are not created equal. Some have evidence to support their use for individuals with particular cognitive-communicative challenges from acquired brain injury, and many do not.” For example, CT Speech and Cognitive Therapy was designed by speech-language pathologists to provide comprehensive exercises addressing speech, memory, and cognitive functions. But other apps were created without consulting specialists. “Some brain training apps are introduced to brain injury survivors during their cognitive rehabilitation sessions by clinicians with whom they are working,” Dr. O’Neil-Pirozzi explains, “and then survivors continue to use these on their own following therapy discharge.” Professional input is always advised to avoid patients from focusing on apps that haven’t been proven to show any benefits or have no evidence. If you’re interested in trying out a brain training app, talk to your cognitive rehab clinicians to determine which one is best for you.

Diet

The types of food you put into your body have a direct effect on the well-being and recovery of your brain post-injury. While some dietary suggestions have been proven to show benefits for brain health, there is no one specific diet that is beneficial for every person with a TBI. Brainline suggests eating small meals every three to four hours and setting a reminder alarm if your body is having problems providing signals. Those small meals should be composed of foods found in the Mediterranean diet, including:

Protein, like fish, lean meats, nuts, and eggsHealthy fats and oils from avocados, seeds, and nutsHealthy carbohydrates found in vegetables, fresh fruits, and grains

Fatty fish are strongly advised for brain recovery since they are a great source of omega-3 fatty acids. A study published in April 2017 in Cell Transplant found the consumption of omega-3 fatty acids led to improved spatial cognitive recovery and helped protect against cell death after brain injury. Other good sources of omega-3s include:

FlaxseedsChia seedsWalnutsSoy or kidney beans

Vitamin B12 is another important nutrient that is beneficial for people recovering from a TBI. According to a study published in April 2019 in Frontiers in Pharmacology, B12 is beneficial for improving functional recovery and repairing nerves after a TBI. The vitamin can be found in the following foods:

TunaSalmonBeefFortified cerealsMilk and dairy products

Gut health is an important and often overlooked factor when it comes to recovering from a traumatic brain injury. Research shows that a brain injury can lead to an imbalance of gut microbes and increase inflammation in the gut. You can help reduce inflammation and gut damage by paying attention to the food that you eat. Harvard Medical School’s Health Blog suggests cutting down consumption of processed and high-sugar foods as well as alcohol. Food sensitivities you may not realize you have can also cause inflammation. It’s worth exploring if your body is having adverse reactions to gluten, dairy, or other food groups. As always, consult your doctor about what dietary options would best serve your specific injury.

Work or School

Whether it’s returning to a job or resuming school, it’s important for TBI survivors to have realistic expectations of their abilities and limitations. All people with disabilities are entitled to reasonable accommodations, as defined by the 1990 Americans with Disabilities Act. For example, a TBI survivor may need to alter some of their work responsibilities or may require reasonable accommodations to perform functions or tasks. The same is true for people returning to school. You may need to ease back into work or school by starting out working shorter shifts, lowering your workload, or taking frequent breaks to rest throughout the day. To best prepare yourself for a return to work or school, talk with your doctor or therapist to find out about the types of accommodations you might need. RELATED: TBI Survivors Share Their Journey Back To Work

NeurologistSpeech and language pathologistPhysical therapistOccupational therapist

Here are some recommendations for finding a suitable provider to fit your needs for continuing and ongoing recovery.

Neurologist

The head of your care team will be a neurologist. This is the doctor who will order any magnetic resonance imaging (MRI) needed, analyze the results, and make decisions about your overall care plan. Different neurologists specialize in different brain conditions — try to find one with a background in traumatic brain injury. Depending on the areas of the brain affected, different medical interventions or measures to improve your condition will be necessary. For example, if your occipital lobe, which is located at the back of the brain and controls vision, is damaged, an ophthalmologist may be necessary. Your TBI-specialized neurologist will detect any deficits and know which specialists are needed to address them. Then, your neurologist will refer you to the appropriate doctors.

Speech and language Pathologist

Speech therapists help patients with everything above the neck, including cognitive function, communication, and swallowing. Aphasia, the loss of ability to understand or express speech, is a common deficit, to varying degrees, in TBI sufferers. Speech therapists will help you work through it or find alternative means of communicating your thoughts.

Physical Therapist

A TBI can cause a lack of communication between the mind and body, resulting in an array of movement deficits. Physical therapists help TBI sufferers relearn movement patterns and regain balance that may have been affected from damage to their vestibular system, which is located in the inner ear and enables equilibrium.

Occupational Therapist

While speech therapy focuses on your mind and physical therapy focuses on your body, occupational therapy bridges the physical and mental to help you effectively re-enter daily life and your previous routine. Depending on your interests and needs, an occupational therapist might help you find a process for managing your finances, create daily schedules, regain hand dexterity and the fine motor skills necessary to write by hand, practice cooking, or reacclimating to personal hygiene procedures. Some common mental health issues that arise after a TBI include:

AnxietyDepressionPost-traumatic stress disorder (PTSD)Anger issues

Psychologist Specializing in TBI

If you are suffering with mental health problems following a TBI, a psychologist or therapist will help you work through any emotional difficulties you’re having with your injury. Finding a psychologist with a background in traumatic brain injury is helpful. Your care team will have a medical social worker on hand to help you find a suitable psychologist.

Medication

Sometimes medication may be needed to help with addressing your mental health problems. Below are some drugs that may be prescribed by a doctor for common mental health issues following a TBI.

Selective serotonin reuptake inhibitors (SSRIs) to treat depression, anxiety, and PTSDCarbamazepine and valproate to treat agitation and aggression

Here are some more resources to help with managing mental health in conjunction with a TBI:

Blue Light Therapy May Help Improve Mood in People With Traumatic Brain InjuriesWhen PTSD Accompanies A ConcussionTraumatic Brain Injury Linked to Increased Risk of Suicide

Of course, specific types of relationships come with their own specific difficulties and ways of being handled.

Romantic Partnerships

While the benefit of therapy for the TBI survivor may seem inherent, therapy for the partner is important, too, to help promote understanding and compassion. It’s also important to be patient with yourself and communicate your specific needs to your partner as you recover, since they might have different expectations.

Parents or Children with a TBI

Family dynamics will likely be altered as a result of a TBI. Parents or children may not behave as they used to or maintain their former position in the family. To help all members of a family adjust to new personality traits of their parent or child with a brain injury, it might help for the whole family to meet with your loved ones treatment team to get a better idea of what to expect from your loved one and how best to adjust. Family counseling might also be helpful.

Anticonvulsants to prevent seizuresAnticoagulants to prevent blood clotsStimulants to increase attention and alertnessAntianxiety medication, antidepressants, or antipsychotics to help treat mental issuesMuscle relaxants to reduce muscle spasmsSedatives to help with sleep issuesAnalgesics to help with pain reliefOver-the-counter acetaminophen (Tylenol) or ibuprofen for headaches, or prescription medicines like Imitrex (sumatriptan) for migraines

Medication is prescribed by members of your treatment team so be sure to discuss any side effects you’re experiencing with any drugs. Some costs include:

Hospital billsContinued costs of rehabilitation after acute hospitalizationAny copaysPrescription medicationAny recommended medical devices, such as arm crutches or gait belt

The act of managing your money may also become difficult and require external help after a traumatic brain injury. One option is to apply for Social Security’s disability insurance (SSDI) while recovering. Insurance comes with Medicare if health insurance is also an issue. If you were working while injured, depending on the circumstances surrounding your TBI, you may be entitled to worker’s compensation. If this is the case, speak with your employer, a union for your industry, or a worker’s advocacy group associated with your line of work. Talking with your occupational therapist, the person on your care team who prepares you to manage finances, will help you address this and find the necessary resources for taking care of yours.

Amy Kraft: Managing Insomnia Post-TBI

According to research published in Neurologic Clinics, insomnia is a problem that affects 30 to 70 percent of TBI sufferers. In this story, Kraft discusses how she learned that her sleep issues were linked to her TBI — 17 years after the accident — and how these problems can be addressed. Counting Sheep: Traumatic Brain Injuries Including Concussions Can Cause Sleep Problems

Instagram Recoveries: Finding Community Post-TBI via Social Media

Traumatic brain injuries are an incredibly isolating experience. Patients often report feeling misunderstood or unable to communicate their experience. But some TBI survivors have found community and shared experience through their Instagram accounts. This article explores 10 inspiring brain injury Instagram accounts. The 10 Most Inspiring Instagram Accounts for Brain Injury Survivors

Back to Work: Challenges Reentering the Workplace after TBI

Many of the personal and social difficulties that stem from a traumatic brain injury factor into an individual ability to return to work. A study published in Brain Injury found that nearly 40 percent of people with TBI or a nontraumatic acquired brain injury are able to return to work after one to two years, but not all of these people are able to return to the same line of work or in the same capacity. In this article, TBI sufferers share the different routes their professional lives took as they reacclimated to the workplace. TBI Survivors Share Their Journey Back To Work

Mayo ClinicU.S. Library of Medicine Clinical Trials Database

When deciding whether or not to participate in a clinical trial, it’s important to assess the risks with your doctors and loved ones to determine if the benefits outweigh any risks. For news and updates, visit:

Brain Injury Association of AmericaPink ConcussionsBrainLineAmerican Academy of NeurologyCDC: Traumatic Brain Injury and Concussion — Publications, Reports, and Fact Sheets