Next month (March) is Brain Injury Awareness Month, which aims to increase public perception of brain injury as a chronic condition and reduce the stigma associated with the neurological disorder. One in every 60 people live with a permanent brain injury-related disability in the United States. According to the Brain Injury Association of America, that’s more than 5.3 million children and adults.
What is a TBI?
Traumatic brain injury (TBI), also called craniocerebral trauma, is defined by the Centers for Disease Control and Prevention as a disruption in the normal function of the brain that can result from a blow or jolt to the head. TBI is caused by outside force such as a severe car accident or sports injury, resulting in immediate or delayed symptoms of confusion, blurred vision, difficulty concentrating, sleeplessness, and more. TBI can lead to long-term cognitive and behavioral problems and other health conditions. The CDC reports that as many as 150 Americans die from TBI-related injuries each day and that everyone is considered at-risk.
Long-term symptoms of repeated mild traumatic brain injury, also known as chronic concussion, are difficult to treat. These can occur long after the concussive event and include depression, anxiety, headaches, and fatigue, and, in some cases, seizures. But recent research published in Applied Psychology: Health and Well-Being, offers hope to those with chronic concussion. The meta-analysis was the first of its kind to show the potential benefits of yoga, meditation and mindfulness-based interventions for treating symptoms of chronic concussion.
Lead researcher Rebecca Acabchuk, PhD, a yoga teacher for 17 years and adjunct professor of psychology at the University of Connecticut, utilized her background in competitive sports combined with her passion for yoga and personal connection to chronic concussion to inform her research. “Many athletes who play contact or adventure sports have experienced concussions—including myself, my mom, and two of my daughters,” Acabchuk says. “ I appreciate the athlete mentality, the willingness to take risks and push oneself physically and mentally.”
Acabchuk says she was working toward her PhD in physiology and neurobiology during the mid-2010’s as concussion awareness was emerging in the mainstream. She was studying the structural changes that occur in the brain from Alzheimer’s disease, and was struck by the parallels that were also occurring in the brains of football players who were half the age of Alzheimer’s patients. This observation was the impetus for Acabchuk to examine the changes in the brain that occur from concussion.
Using Mindfulness to Treat TBI
“As I was studying concussions, I started meeting people who suffered from persistent symptoms and they told me that the treatment they were receiving from their doctors wasn’t helping to resolve their symptoms,” she says. As a yoga teacher, Acabchuk became curious whether the practice could be beneficial. She started working informally with those who’d confided in her, employing gentle techniques including breathwork and mindfulness. The initial results, she says, were encouraging. “What I noticed they appreciated most was that the yoga and mindfulness tools gave them an opportunity to actively participate in their own healing process,” she says.
Until Acabchuk’s research, studies detailing the effects of mindfulness practices on chronic concussion were small and limited. So she analyzed 20 different studies of more than 500 subjects with mild traumatic brain injury (mTBI), each of which contained meditation, yoga, or mindfulness-based interventions to evaluate the potential benefits.
The large analysis observed the effects of mind-body interventions on mental and physical health, cognitive performance, social and/or occupational performance, and quality of life as well as specific symptoms of depression, attention, anxiety, and fatigue in subjects with mTBI. Acabchuk says the most statistically significant results indicated a reduction in depression and fatigue, noting fatigue as a common symptom that patients struggle to cope with.
Sarah Cohen, 19, a student at Lafayette College in Easton, PA, began practicing yoga in Hebron, CT following her first concussion in 2017 as part of her vision therapy. She says her post-concussive symptoms endured for more than six months when she experienced a second concussion in early 2018 when a high school classmate accidentally elbowed the back of her head. Then, another six months later, she was still recovering when she was accidentally kicked in the head by a student while she was teaching a swimming lesson, resulting in a third concussion. Despite being a seasoned lacrosse player, Cohen’s concussions were a series of isolated incidents unrelated to sports.
Now, Cohen’s post-concussive syndrome persists, and she continues to struggle with symptoms such as anxiety and headaches almost daily. During the early days of her treatment, she describes being “stuck in the sympathetic nervous system,” which made certain aspects of mindfulness difficult to learn. But in 2019, she met Acabchuk, who introduced some basic tips such as it’s OK to have thoughts while you meditate and that you can acknowledge a thought without it controlling you. She says working with Acabchuk helped her develop a regular yoga practice, which has been a valuable tool for relieving post-concussive symptoms throughout her recovery.
“I found that Rebecca’s advice about meditation really helped me to stay present during my practice,” says Cohen. “I have never been a person who has enjoyed sitting still, but yoga has allowed me to practice mindfulness through motion—it reminds me of my strength and makes me feel grateful for what my body can do.” she says.
See also Yoga for Migraines
While Acabchuk’s research shows promise it also highlights the need for more rigorous, large-scale studies on the effects of mindfulness-based interventions as a treatment for chronic concussion. “I am working to help disseminate these findings with the hope that it encourages more clinicians to recommend mind-body practices to patients suffering from brain injuries, and that those who are suffering from concussion give these practices a try,” she says. “I like to remind people that the results come from doing the practices regularly, and it may take time.”
Follow the Brain Injury Association of America’s 2021 #MoreThanMyBrainInjury campaign to learn more and help spread awareness about what it’s like to live with a brain injury.