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How Minor Car Accidents Can Cause Brain Injury
Learn how traumatic brain injury can occur after minor car accidents, even without hitting your head, and what science says about healing.
Table of Contents
Can Minor Car Accidents Cause Traumatic Brain Injury?
Most people believe that if you didn’t hit your head, you didn’t injure your brain. But that assumption can do more harm than good. A traumatic brain injury from a car accident, even a so-called “fender bender,” can occur without your head ever striking the steering wheel or window.
In the days or weeks after a crash, you might notice brain fog, headaches, irritability, or unusual fatigue and brush it off at first. Some people may tell you it’s just stress or that you need more sleep. Yet research shows that rapid acceleration and deceleration alone, like what happens to your brain even in a low-speed collision, can disrupt normal brain function.
Unfortunately, when it comes to brain injuries, sometimes big problems really do come in small packages.
When a “Small” Accident Doesn’t Feel Small Later
According to the Centers for Disease Control and Prevention, millions of Americans sustain traumatic brain injuries (TBIs) each year, with motor vehicle crashes among the leading causes. But most people don’t know that even minor accidents and whiplash can compound your risk of brain damage.
Your brain is powerful and remarkably resilient, but it is also made up of soft tissue housed in a hard, rigid skull. That protective shell is mostly a guardian but can be a liability. This is why understanding head injuries is so important. Essentially, when forces move faster than the brain can adapt, even subtle injuries can occur and sometimes without immediate warning signs.
A traumatic brain injury from a car accident, even a so-called “fender bender,” can occur without your head ever striking the steering wheel or window.
What Is a Traumatic Brain Injury?
A traumatic brain injury is a disruption in normal brain function caused by an external force. This can range from a severe injury with internal bleeding or skull fracture to a mild traumatic brain injury (mTBI), which is often called a concussion.
Severe TBIs typically involve structural damage that’s visible on brain imaging scans and may include prolonged unconsciousness or neurological deficits. A 2022 study published in The Lancet Neurology highlights the long-term disability risks associated with moderate to severe TBI. Additional epidemiological studies in the Journal of Neurotrauma confirm increased mortality and cognitive decline in more serious cases.
Mild TBIs are more common but less understood when it comes to negative effects. Studies have found that even mTBI can lead to persistent cognitive issues that affect memory and concentration. Research also shows that an increase in anxiety and depression symptoms is associated with mTBI.
“Mild” does not mean the effects are insignificant. The term refers to the initial clinical presentation of the symptoms, not necessarily the potential impact on your daily life. For some people, symptoms resolve quickly. For others, they linger in a slower effect. The reality is that brain injuries, big or small, do not follow a predictable path of healing.
Related: Emotional Concussions The Silent Brain Injury You Might Have
Traumatic Brain Injury From a Car Accident Even Without a Head Impact
When we talk about a traumatic brain injury from car accidents, we’re often referring to forces known as rapid acceleration and deceleration. In the simplest terms, when your car stops and your brain keeps moving forward or backward, even for a fraction of a second, it can cause damage.
Inside the skull, which is a hard protective case, your brain is soft and malleable with a gelatinous texture. During a car crash, it can shift, rotate, or twist around. This movement may strain nerve fibers (called axons), leading to what research deems diffuse axonal injury. This type of injury can still happen, even when brain scans initially appear normal.
Whiplash adds another layer. Whiplash is a neck injury caused by a sudden, forceful back-and-forth movement of the head (like a snapping whip), common in car accidents. A 2020 study found that people with whiplash-associated disorders demonstrated measurable changes in brain connectivity and function. This suggests that neck injury and brain changes can and often do co-occur.
Standard safety measures such as helmets, airbags, and seatbelts can dramatically reduce the risk of severe or fatal brain injury. In fact, the National Highway Traffic Safety Administration reports that seatbelt use reduces serious injury and death risk by nearly 45 percent to 50 percent, respectively. However, while these measures can save lives, they cannot eliminate all the forces that transmit to the brain in a sudden collision.
How Whiplash and Sudden Jolt Can Affect Brain Function
Your neck and brain work in tandem to keep you in motion. The brainstem extends into the spinal cord through the neck, forming a communication highway between your brain and the rest of your body. When the neck snaps forward and back, that same force can transmit along this pathway.
This matters because your nervous system is highly interconnected. The force of whiplash and sudden strain it causes can influence your balance, coordination, and even mood regulation. The symptoms are often delayed to the following conditions:
- Inflammation can build gradually
- Stress hormones surge during trauma
- Subtle nerve strain may not cause immediate pain
A study published in Frontiers in Neurology found that in patients with whiplash injury, advanced imaging detected signs of white matter tract disruption, such as thinning or partial tearing. In the multiple documented whiplash cases studied, even standard CT and MRI scans sometimes appeared normal.
The Hidden Risk of Multiple Minor Car Accidents
The brain is powerful, but also incredibly fragile. One low-impact crash might seem manageable at first, but repeated minor collisions can create cumulative stress on the brain. Research on repetitive mild TBI shows that even sub-concussive events may contribute to long-term neurological changes.
The good news is that your brain adapts through neuroplasticity. The bad news is that repeated strain without adequate recovery can overwhelm that adaptive capacity to heal well.
Symptoms may worsen over time depending on age, genetics, previous injury history, stress levels, sleep quality, and overall health. A 2023 study found that mental health problems following mTBI is very common. An individual may experience issues with anxiety, depression, post-traumatic stress disorder, ADHD-like symptoms (impulsivity and attention issues), or chronic pain following a mTBI. But the root cause, the traumatic brain injury, can be missed. Without comprehensive evaluation that looks at the brain, the underlying patterns driving mental health conditions goes unnoticed, and your injury can go untreated.
Oftentimes, people don’t connect their current mental health symptoms to past accidents. The effects can appear weeks, months, or even years later and, with memory gaps added to the mix, that connection can become even harder to trace. That delay is precisely why early, comprehensive evaluation matters.
Common Symptoms of Brain Injury After a Car Accident
Any symptoms of a traumatic brain injury from a car accident should be addressed, even if they seem subtle or like they’ll heal with rest.
Here are common symptoms to be aware of:
- Brain fog
- Headaches
- Memory issues
- Sleep problems
- Light or noise sensitivity
- Irritability or mood changes
A 2025 review and meta-analysis found that headaches, trouble sleeping, and difficulty concentrating are among the most common and persistent symptoms after a concussion. Symptoms vary widely, but they can also overlap with stress, anxiety, or even burnout. That overlap is why careful evaluation is key.
Why Standard Tests May Miss Car-Accident-Related Brain Injuries
If you’ve ever been told “everything looks normal” following a car accident, you’re not alone. After experiencing an accident-related TBI, you might feel “off” while scans like CTs or MRIs come back with no clear signs of damage. That’s because standard imaging is designed to detect structural damage, not the subtle functional changes that can occur in your brain after a collision.
CT/MRI Focus on Structure, Not Function
CT scans and MRIs are designed to detect structural abnormalities like bleeding, swelling, and fractures. These are essential in emergency care, but mild TBIs often involve microscopic or functional changes that standard imaging cannot detect.
Why People Are Told “Everything Looks Normal”
When imaging is clear, clinicians may conclude there is no visible injury. That doesn’t invalidate your symptoms. Studies show about 15 to 30 percent of people with persistent post-concussion symptoms show normal CT or MRI scans, highlighting how standard imaging can miss subtle brain changes.
Validation Without Undermining Providers
It’s important to know that emergency providers and first responders focus on life-threatening injuries first. Their tools are not designed to measure subtle functional changes. Understanding this distinction can empower patients without creating distrust in the medical system.
Looking at Brain Function After a Car Accident
When talking about structural damage, we’re referring to visible injury. Functional change refers to how the brain works, including blood flow, nerve connectivity, and brain activity patterns. Imaging that looks at brain function, rather than structure, can clarify whether or not a brain function issue is driving your symptoms. Mild traumatic brain injury often affects function. Thus, the right kind of brain imaging can be helpful in identifying potential areas of the brain that are functionally impaired by injury.
Thankfully, issues with mTBI-related brain function can be improved.
Evidence suggests that individualized rehabilitation strategies targeting sleep, nutrition, stress regulation, and cognitive behavioral therapy improve potential outcomes in persistent post-concussive symptoms.
When to Consider a Brain Evaluation After a Fender Bender
It’s important not to dismiss the effects of a fender bender, even if you did not hit your head. The brain can still be affected by the rapid acceleration and deceleration forces that occur in a crash. After any accident, it’s wise to see a medical doctor and keep an eye on how you feel in the days and weeks that follow.
If symptoms persist, especially those affecting thinking, mood, or energy levels, a brain-focused evaluation can be helpful. Looking at the brain more closely can uncover issues that might otherwise go unnoticed and guide the right path toward recovery.
Symptoms That Don’t Resolve
A good rule of thumb is that symptoms lingering beyond several weeks deserve further attention. Research suggests that most concussion symptoms improve within about 10 to 14 days.
However, headaches, fatigue, brain fog, or cognitive problems that continue for three months or longer may indicate persistent post-concussive symptoms. These ongoing issues can affect concentration, learning, and executive function, making a thorough evaluation especially important.
Changes Others Notice Before You Do
Look to those you trust that are closest to you, like your family members and friends, as they may observe irritability, forgetfulness, or personality shifts. Behavioral and cognitive changes, such as mood swings, irritability, and increased symptom burden, are well documented in people with persistent post-concussion symptoms.
Impact on Work, Relationships, or Daily Life
Research shows that people with persistent post-concussive symptoms often experience a decreased quality of life. This especially includes challenges when returning to work or maintaining their previous workload and lifestyle standards, even months after injury.
If your concentration, productivity, or social interactions are suffering after a head injury, it’s a clear indication that your brain may need help.
Related: 10 Ways to Help Your Brain Heal After Head Trauma
Getting the Right Care After Repeated Minor Car Accidents
Finding clinicians experienced in TBIs is critical as brain injuries do not follow one predictable path to full healing. Research published in the Journal of Rehabilitation Medicine shows that effective options for TBI recovery may include cognitive rehabilitation, sleep optimization, anti-inflammatory nutrition, stress management, physical therapy for neck injury, and psychological support.
At Amen Clinics, we take a similar whole-body approach. That means we treat brain and mental health issues by addressing the whole person, mind, body, and spirit, rather than just masking symptoms.
Our comprehensive evaluation includes brain SPECT imaging that specifically measures brain function based on blood flow activity before and after treatment. The evaluation also includes a detailed personal history, clinical assessments, and diagnostic labs as needed. Collecting this critical data helps our clinicians practice precision medicine to create a highly effective, personalized treatment plan that addresses your unique issues.
Plans often include a combination of recommended lifestyle interventions (including nutritional guidance and supplementation, stress reduction, gentle movement, etc.), therapy, natural ways to treat mental health conditions related to your TBI, and medication if necessary. We call it holistic psychiatry.
Whatever care you seek, be sure to always ask questions as you listen to informed medical guidance. The great news is that evidence-based care exists for TBI.
Trust Your Symptoms, Even After a “Minor” Crash
The most important thing to remember is that even a minor car accident can disrupt critical parts of the brain. Rapid deceleration, whiplash, and repeated impacts can affect cognitive function, mood, emotional regulation, and sleep quality, even if your head never directly struck anything.
Brain injuries are complex and require nuanced treatment. If symptoms linger or interfere with your daily life, consider learning more about comprehensive brain assessments like those offered through Amen Clinics.
Traumatic brain injuries and other mental health conditions can’t wait. At Amen Clinics, we practice Precision Medicine—using brain SPECT imaging and comprehensive evaluations to understand what’s really happening in your brain, not just your symptoms.
Our whole-body approach to Holistic Psychiatry combines cutting-edge neuroscience with natural ways to treat mental health conditions, including targeted nutrition, supplements, lifestyle strategies, therapy, and medications (when necessary). Every treatment plan is personalized to address the root causes of your struggles and support the health of your brain, body, and mind.
Don’t settle for guesswork. You deserve answers—and a plan built specifically for you. Speak with a Brain Health Advisor today at 888-288-9834 or visit our contact page to get started.
FAQ About Intensive Outpatient Programs
Can a minor car accident cause traumatic brain injury?
Yes. Sudden acceleration and deceleration can disrupt your brain’s cognitive function even without direct head impact.
How can traumatic brain injury happen without hitting your head?
Whiplash and rapid stopping can cause the brain to shift within the skull, straining or even shredding critical neural connections. Additionally, issues come from neuroinflammation, internal bleeding, and a host of other issues that can affect your behavior and personality.
Can multiple minor car accidents cause brain injury?
Yes. Repeated low-impact collisions can have cumulative effects, especially without proper recovery and treatment plans. Take care to use preventative measures to reduce your risk, including seatbelts and airbags when driving as well as helmets during sporting activities.
What are symptoms of traumatic brain injury after a car accident?
Common symptoms include headaches, brain fog, irritability, memory problems, and sleep changes. It’s important to track any major and minor shifts in mood, emotions, and physical ability.
Why do CT scans or MRIs look normal after a car accident brain injury?
Standard scans detect structural damage, which can be helpful for certain ailments. However, many mild TBIs involve functional changes that are not always visible on routine imaging.
Amen Clinics
Founded in 1989 by double-board certified psychiatrist and neuroscientist Daniel G. Amen, MD, Amen Clinics Inc. (ACI) is known as the best brain and mental health company in the world. Our clinical staff includes over 50 healthcare specialists, including adult and child psychiatrists, integrative (functional) medicine physicians, naturopaths, addiction specialists, forensic psychiatrists, geriatric psychiatrists, nutritionists, licensed therapists, and more. Our clinicians have all been hand-selected and personally trained by Dr. Amen, whose mission is to end mental illness by creating a revolution in brain health. Over the last 35-plus years, ACI has built the world’s largest database of functional brain scans—over 250,000 SPECT scans on patients from 155 countries—related to how people think, feel, and behave.
References
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McCrea MA, Giacino JT, Barber J, et al. Functional Outcomes Over the First Year After Moderate to Severe Traumatic Brain Injury in the Prospective, Longitudinal TRACK-TBI Study. JAMA Neurol. 2021;78(8):982–992. doi: 10.1001/jamaneurol.2021.2043
Mesfin, F. B., Gupta, N., Hays Shapshak, A., & StatPearls. (2025, July 7). Diffuse axonal injury. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK448102/
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If you go to a psychiatrist for anxiety, depression, attention problems, anger issues, or another “mental illness,” you’re likely to be asked a number of questions about your symptoms, your feelings, and your family history.
But there’s one question most psychiatrists—and other healthcare professionals—never ask but should:
There’s one question most psychiatrists—and other healthcare professionals—never ask but should: “Have you ever had a head injury?”“Have you ever had a head injury?”
Why is this question so important? In years past, experts believed that mild head injuries were innocuous. However, emerging research confirms that mild head trauma—even if you don’t black out or aren’t diagnosed with a concussion—can impact brain function and lead to serious neuropsychological issues.
In this blog, you’ll learn how common head injuries are, how concussions and mild traumatic brain injuries impact mental health, why it’s common to forget about a past head injury, and how to heal the brain to help your mental wellness.
HOW COMMON ARE CONCUSSIONS?
According to statistics, about 1.7 million Americans are diagnosed with a traumatic brain injury (TBI) annually. Some 80% of them are categorized as mild traumatic brain injuries (mTBI) or concussions.
Millions more head injuries go unreported because the person doesn’t think the injury is severe enough to seek treatment.
Head injuries are common among patients at Amen Clinics, which has treated over 100,000 people over the past 30-plus years. In fact, its database of more than 300,000 brain SPECT scans shows that 40% of patients have experienced a significant brain injury before visiting one of the nationwide clinics.
COMMON CAUSES OF CONCUSSIONS
What are the most common causes of head injuries?
- Falls—falling out of bed, slipping in the bath or shower, falling down steps, or falling off ladders
- Motor vehicle-related collisions—accidents involving cars, motorcycles or bicycles, or pedestrians
- Violence—caused by gunshot wounds, assaults, domestic violence, or child abuse
- Sports injuries—football, soccer, boxing, baseball, lacrosse, skateboarding, hockey, cycling, basketball, skiing, and other high-impact or extreme sports
- Explosive blasts and other combat injuries
Note that sports injuries also include repetitive sub-concussive impacts to the head. These are mild impacts that don’t cause any immediate symptoms—no headache, no seeing stars, no feeling like you got your bell rung.
Think of a soccer player who repeatedly heads the ball or a football player who gets tackled several times per game. Research shows that these repeated head impacts can harm the brain and lead to problems later in life.
THE LINK BETWEEN HEAD INJURIES AND MENTAL ILLNESS
Did you know that head trauma is a major cause of mental health problems? If not, you aren’t the only one. In fact, very few people—including psychiatrists—know it.
This is because most mental health professionals never look at the brains of their patients. And this is a major oversight.
A growing body of scientific research shows that concussions and other types of traumatic brain injuries (TBIs) increase the risk of:
- Clinical depression
- Anxiety disorders and panic attack
- ADD/ADHD
- Psychosis
- Post-traumatic stress disorder (PTSD)
- Suicide
- Drug and alcohol abuse
- Borderline and antisocial personality disorders
- Alzheimer’s disease and other types of dementia
- Aggression
In some cases, mental health issues and cognitive problems occur soon after a head injury. In other instances, mental health symptoms don’t appear until months or even years after the incident.
Because of this, many people don’t make the connection between the head impact and their emotional symptoms, behavioral problems, or cognitive issues.
WHY PEOPLE FORGET PAST HEAD INJURIES
It’s astounding how many people forget they’ve had a significant head injury. At Amen Clinics, the mental health professionals routinely ask patients several times whether or not they have sustained any impacts to the head.
“Have you ever had a head injury?” is one of the many questions on patient intake paperwork. An historian, who gathers patients’ personal histories before they see the physician, asks them again about hurting their head. Sophisticated computer testing that patients complete asks a third time about impacts to the head.
Typically, when the patient meets with their physician, the question will come up yet again. If they respond no again, they’re generally asked if they’ve experienced any of the most common causes of head injuries, which were outlined above.
It’s surprising how many people think their head injuries were too insignificant to mention. For others, they simply do not remember the incident as amnesia is a common occurrence in head traumas.
When asked the question for the fifth time, one patient put his hand on his forehead and said, “Oh yeah! When I was 5 years old, I fell out of a second-story window.”
It’s hard to imagine forgetting such an incident, but many do. Some patients forget that they flew through a windshield in a car accident, smacked their head after slipping in the shower, or were knocked unconscious when they tumbled off their bicycle.
The vast majority of these people never realize the connection between their head injury and the signs and symptoms of mental health problems. And the traditional treatments they’re prescribed often don’t work because they don’t heal the underlying trauma to the brain.
You may be in the same situation. Anyone who is not responding to traditional treatment for major depressive disorder, anxiety attacks, or other mental health conditions should consider if a past head injury might be contributing to symptoms.
HEALING FROM POST-CONCUSSION SYNDROME
The good news is that the brain can heal, and this can help you overcome a wide range of psychological symptoms. Strategies to enhance the brain following a concussion or other head injury include:
Neurofeedback: Learning to control your brainwaves with this noninvasive treatment can reduce the symptoms of post-concussion syndrome, according to research.
- Hyperbaric oxygen therapy: HBOT utilizes pure oxygen to accelerate the healing process in the brain.
- Balance hormones: With head trauma, it’s common for the pituitary gland to get injured. This gland plays an important role in hormone production. When damaged, it can lead to imbalances in key hormones, such as thyroid, testosterone, and DHEA, which can lead to mental health symptoms. Testing your hormone levels and optimizing them if necessary can be beneficial in reducing symptoms.
- Brain scan: Getting a SPECT scan can help you see hidden brain injuries. This can also help your mental health professional develop a more personalized, effective treatment plan for your needs.
- Take nutraceuticals: Nutritional supplements that help support the brain’s healing process include a multivitamin/mineral complex, omega-3 fatty acids, gingko biloba (to support blood flow), acetyl-l-carnitine (to support mitochondrial energy), huperzine A (to support acetylcholine), N-acetyl-cysteine, alpha lipoic acid (antioxidant support), and phosphatidylserine (for nerve cell membrane support).
Implementing these strategies can help speed your recovery from a head injury, whether it happened recently or years earlier. When your brain is healthier, you’ll experience fewer mental illness symptoms and feel better overall.
Anxiety, depression, attention problems and other mental health issues related to head trauma can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.
Have you noticed that your child is struggling with learning certain skills in school, such as reading, writing, or math? Or maybe they have trouble staying focused, paying attention, or keeping organized. You might think that your child will simply “grow out of” these behaviors without treatment, but that’s not the case with learning disabilities. Ignoring the warning signs of learning disorders—which affect an estimated 1 in 5 children in the U.S.—can have lasting negative effects, far beyond school. From anxiety and troubled peer relationships to suicidal thoughts and substance abuse, the repercussions can last a lifetime. That’s why it’s crucial for parents to become more familiar with different types and symptoms of learning disorders, as well as where to seek help. Children with learning disabilities can be just as smart as their peers. They simply have neurologically based processing issues that make learning more challenging.WHAT ARE LEARNING DISABILITIES?
Learning disabilities negatively impact a child’s ability to learn. Amen Clinics’ brain-imaging work using SPECT scans has found that issues with learning are not single or simple disorders, and they can create attentional, emotional, or behavioral problems. Children with learning disorders can be just as smart as their peers. They simply have neurologically based processing issues that make learning more challenging. Brain-imaging research shows that learning disabilities are associated with abnormal function in brain regions involved with certain cognitive processes necessary for learning. Affected skills include reading, writing, language, math, memory, problem-solving, attention, and information processing. Left untreated, these issues can persist in adults, who may have issues with time management and organization. Those with learning disorders may also have difficulty with short-term memory or the ability to focus. A range of factors may influence the onset of a learning disability. This can include exposure to drugs (including alcohol) or illness to a fetus in utero, or brain damage caused at birth. Other children have a genetic predisposition or face an illness or psychological trauma in their early years. Traumatic brain injuries (TBI) and exposure to environmental toxins also may play a role.7 TYPES OF LEARNING DISORDERS
Let’s look more closely at 7 types of learning disorders that have been identified through extensive brain imaging work at Amen Clinics, and the symptoms and brain patterns associated with them.- Attention-Deficit Disorder, also called Attention-Deficit/Hyperactivity Disorder (ADD/ADHD)
- Autism Spectrum Disorder (ASD)
- Emotional Disturbances
- Behavioral Problems
- Traumatic Brain Injuries (TBI)
- Dyslexia
- Irlen Syndrome
SEEKING TREATMENT FOR LEARNING DISABILITIES
In years past, children with learning disorders too often went undiagnosed. Instead, they were branded as troublemakers, lazy, or less intelligent. Today, we know how harmful these assumptions can be to children whose brains are wired differently, so it’s important to screen your child as soon as learning issues arise. You could potentially prevent the years of frustration, shame, and low self-esteem that often accompany learning disabilities. However, bear in mind that learning disorders are complex, so a one-size-fits-all approach to treatment will never work. Treatment that’s beneficial for one child (or adult) might not be effective for another—or could even worsen their symptoms. Getting a personalized treatment plan for each individual, based on their brain type, is necessary to target the issue effectively. In addition, natural interventions such as lifestyle changes and alternative learning strategies can make a significant positive impact. A comprehensive approach to treatment is the best strategy to ensure that children with learning disorders overcome their difficulties and enjoy the successful lives they deserve. Learning disorders and the mental health issues that come with them can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 833-543-1401 or visit our contact page here. This post has been updated since its original publish date. If you sliced your finger while chopping carrots, sprained your ankle while hiking, or broke your wrist after falling on a slippery floor, you’d probably race into action to:- Assess the damage: such as a visit to the ER, an X-ray, or MRI
- Minimize the injury: such as getting stitches, bandages, or a cast
- Kickstart the healing process: such as taking anti-inflammatory medication, restricting activities, or using heat or ice
A SILENT EPIDEMIC OF HEAD TRAUMA
Over 2 million head injuries are diagnosed each year in the U.S., according to the Centers for Disease Control and Prevention (CDC). That’s not counting the hundreds of thousands, or perhaps millions, of unreported incidents of head trauma, including undiagnosed concussions. Why are there so many brain injuries? There are several reasons, including:- Many people think the brain is rubbery and fixed within the skull, but it isn’t. In reality, your brain is soft, about the consistency of soft butter, tofu, or custard—somewhere between egg whites and gelatin. It “floats” in cerebrospinal fluid and is housed in a very hard skull that has many sharp bony ridges. As such, it is easily damaged.
- Blows to the head can cause the brain to slosh around, slamming into the hard ridges in the skull. This can cause bruising, broken blood vessels and bleeding, increased pressure, lack of oxygen, damage to nerve cell connections, ripping open of brain cells that spill out proteins that cause inflammatory reactions.
- On top of that, your pituitary gland (which regulates hormones) sits in a vulnerable part of your skull, and it’s often hurt in head injuries, causing major hormonal imbalances.
- Often, brain injuries that don’t result in a loss of consciousness go undetected and are never treated.
- Sadly, most people don’t think about their brain or actively care for it. They are careless and engage in behaviors and activities that put their brain at risk of damage.
CONCUSSIONS AND MENTAL HEALTH ISSUES
Brain injuries are commonly associated with physical issues, such as dizziness, fatigue, headaches, visual disturbances, trouble sleeping, sensitivity to light and sound, and poor balance. But the impact goes much deeper. Research shows that brain injuries are also a major cause of mental health disorders, such as:- Anxiety disorders
- Panic disorders
- Clinical depression
- Post-traumatic stress disorder (PTSD)
- ADD/ADHD
- Substance abuse disorders
- Personality disorders
- Memory loss and dementia
- Suicidal thoughts and behaviors
CONCUSSION SYMPTOMS
Head injuries, including mild ones, can lead to a host of cognitive and psychosocial symptoms, such as:- Cognitive problems – poor concentration, brain fog, learning issues, poor judgment and impulsivity, and difficulty putting thoughts into words.
- Psychosocial problems – depression, anger outbursts, irritability, personality changes, and anxiety.
WHAT ROUTINE BRAIN IMAGING MISSES ABOUT HEAD INJURIES
If you seek medical treatment for a head injury, you may undergo certain types of brain imaging, such as MRI or CT. These neuroimaging technologies show the structure of the brain, but they don’t provide information on how it is functioning. For this reason, an MRI scan or CT scan can show “normal” results even if you’re struggling with symptoms. Brain SPECT imaging, on the other hand, shows how the brain functions. It measures blood flow and activity in the brain and shows 3 things:- Areas of the brain with healthy activity
- Areas with too much activity
- Areas with too little activity
PREVENTION IS THE BEST MEDICINE FOR BRAIN HEALTH
To help keep your brain safe and prevent brain injuries:- Wear a seat belt every time you drive or ride in a motor vehicle.
- Always buckle your child into a child safety seat, booster seat, or seat belt (according to the child’s height, weight, and age) in the car.
- Never drive under the influence of alcohol or drugs, including prescription medications that can impair the ability to drive.
- Avoid high-risk sports and activities where you can hit your head (no tackle football, hitting soccer balls with your head, or boxing).
- Always wear a helmet and make sure your children wear helmets while playing contact sports, bike riding, horseback riding, skateboarding, snowmobiling, skiing, or snowboarding.
- Do not dive in water less than 12 feet deep or in above-ground pools. Check the depth and check for debris in the water before diving.
- Always hold handrails when going down stairs.
HOW TO HELP YOUR BRAIN HEAL AFTER A CONCUSSION
Many people have a first-aid kit for life’s mishaps. It’s just as important to have a concussion first-aid kit that can minimize damage and accelerate the healing process. In addition, you should protect yourself from hurting your brain again as repeat injuries increase the risk of serious long-term problems. Other self-care techniques you can use to help your brain heal include:- Get plenty of sleep at night, and rest during the day.
- Increase your activity slowly.
- Write down the things that may be harder than usual for you to remember.
- Avoid alcohol, drugs, and caffeine.
- Eat brain-healthy foods.
- Stay hydrated by drinking plenty of water.
- Ask your doctor when it’s OK for you to drive a car, ride a bike, or operate machinery.
- Avoid activities that are physically demanding (sports, and housework, for example).
- Avoid activities that require a lot of thinking or concentration (like playing video games or balancing a checkbook).
- Be patient because healing takes time.
WHAT IS A CONCUSSION AND HOW DOES IT AFFECT THE BRAIN?
A concussion changes the way the brain functions and can result from bumps, jolts, shakes, or blows to the head or body that cause the brain to move back and forth within the skull. Brain cells can become damaged or stretched, and our fragile brains cannot support this type of trauma. Many of us are under the impression that concussions typically cause a person to blackout, similar to what we see in Hollywood action films when an actor is hit or falls down. In reality, however, more than 90% of concussions do not involve loss of consciousness. Yet, they can cause a host of problems.CONCUSSION SYMPTOMS
Concussions are rated mild, moderate, and severe. Be aware that mild TBIs and moderate concussions do not mean there are no long-term problems. Decades of scientific studies show that head injuries are a major cause of psychiatric issues, but few people know it. In addition, research shows that one or more mild or moderate head injuries can increase the likelihood of lasting memory impairment. Concussion symptoms include:- Brain fog
- Loss of memory
- Problems focusing
- Drug and alcohol abuse
- Aggressive behavior
- Fatigue
- Sleep issues, including insomnia
- Depressive symptoms
- Anxiety
HOW HEAD INJURIES CAUSE BRAIN TRAUMA
The wildly complex and fascinating human brain is seemingly well protected from harm by its hard skull. The problem is the skull is made up of facial, cranial, and hyoid bones along with ear ossicles, all of which are ridged. Any kind of trauma to the head can do damage to the soft, pliable brain that lives underneath the skull by pushing against the skull’s uneven surface. Whether it’s a hard shake, a strike from a fall, whiplash from a car accident, or “heading” in soccer, the fragile brain can easily sustain long-term damage. Traumatic brain injury (TBI) is common. A recent study noted that approximately 3 million Americans have some kind of mild traumatic brain injury every year, and 20% have symptoms that last more than a month. Brain trauma can present itself in a variety of ways including:- Broken blood vessels and bleeding
- Increased pressure in the brain
- Nerve cell damage (at the connection site)
- Brain cells open and leak proteins that cause inflammation
- Lack of oxygen
- Bruising of the brain
SOCCER HEADING AND BRAIN INJURIES
Heading a soccer ball is not the only sports activity that puts athletes at risk. Hockey, football, horseback riding, boxing, cycling, rugby, and other recreational activities that involve a fall risk or intense physical impact can potentially result in traumatic brain injury and subsequent neurodegenerative diseases. While most team sports that put athletes at risk of a head injury mandate the use of a helmet, soccer typically does not require helmets for kids, adolescents, or adults. “Heading” the ball is no longer allowed for children 10 and under in youth soccer, but teens can still use their heads to bump the ball. In all sports, a helmet can prevent more extreme traumatic brain injury, but it can’t prevent all damage.COMMON CAUSES OF HEAD INJURIES
It is common to hear about sports as the main cause of concussions, but there are many other causes. For example, the causes of head injuries also include destructive acts like domestic violence, child abuse, gunshot wounds, and combat injuries sustained by people in the military. According to a 2019 study, 90% of victims with a history of domestic violence have traumatic brain injuries associated with abuse. Research published in the Journal of Aggression, Maltreatment & Trauma shows that children and adults are at much higher risk of neurological issues as a result of domestic violence. These types of trauma are almost always coupled with post-traumatic stress disorder (PTSD), which also negatively affects the brain.PROTECT YOUR HEAD TO PROTECT YOUR MEMORY
To reduce your risk for head injuries and to safeguard your memory, be smart and follow these tips:- Don’t head soccer balls.
- Avoid contact sports.
- Avoid high-risk activities.
- Wear a helmet when needed.
- Don’t text while driving.
- Don’t climb ladders.
- Hold the handrail when going up or down stairs.
- Wear a seatbelt while driving.
HOW HEAD INJURIES DAMAGE THE BRAIN
After getting hit in the head, many people think they can just “shake it off” and don’t think too much about it even if they get a little headache or feel a bit queasy afterward. It’s not unusual for someone to believe that if they didn’t lose consciousness or crack open their skull, they’re OK. However, a mild traumatic brain injury (mTBI)—or concussion—can cause actual harm to the brain, including:- shearing of the axons—the fibers that allow brain cells to communicate with each other
- bruising of brain tissue
- disrupting the flow of oxygen to the injured areas in the brain
- broken blood vessels, bleeding, and blood clots
- cell damage that causes increased inflammation in the brain
COMMON SYMPTOMS IN PEOPLE WITH MILD TBIs
Symptoms that can emerge shortly after a “mild” head trauma include:- Feeling confused or disoriented
- Onset of a headache
- Dizziness and fatigue
- Nausea/vomiting
- Sensitivity to noise or light
- Problems with memory or difficulty concentrating
- Increased moodiness
- Irritability/anger
- Impulsive behavior
- Brain fog
- Anxiousness
- Difficulty with sleep
- Balance and/or vision problems
- Tinnitus (ringing in the ear)
- Lost sense of smell and/or taste
LONG-TERM RISKS AND SYMPTOMS RELATED TO TBIs
Although most people recover from mTBI events, approximately 25% will continue to struggle with symptoms that interfere with the quality of their lives, and sometimes in very serious ways. They could be affecting how you feel, perform at work or school, and how well you interact with others. Most people are unaware that even mild head injuries can cause a wide array of neuropsychological and behavioral problems. For example, research has shown that head injuries increase the risk for many mental health conditions, including:- Alcohol and substance abuse
- Depression
- Anxiety disorders
- ADD/ADHD
- Posttraumatic stress disorder
- Learning problems
HOW BRAIN IMAGING HELPS IDENTIFY DAMAGE FROM PAST TBIs
If you go to the doctor to get help for symptoms such as these, your physician may completely overlook the possibility that you have had head trauma, especially if you don’t bring it up. One of the reasons for this is that most doctors don’t look at the brain, and if they do, it is usually with a CT scan. Although this type of imaging is critical for identifying any bleeding or a potentially life-threatening blood clot, it does not provide much information about how the brain is working. Brain SPECT imaging—an advanced technology that measures blood flow and activity in the brain—offers more valuable information regarding how the brain is functioning. On SPECT scans, unhealed brain injuries show as areas of lower-than-normal blood flow. Depending on the parts of the brain that are affected, different kinds of symptoms can emerge. For example, injury to the prefrontal cortex can adversely affect mood, impulse control, and concentration, while damage to the temporal lobes can be linked to irritability and anger problems as well as memory issues. What’s even more alarming? SPECT scans have revealed a high prevalence of past brain injuries in people who don’t recall getting hurt or who think that their injury was too insignificant to cause any damage or symptoms. At Amen Clinics, which has accumulated a database with more than 300,000 SPECT scans on tens of thousands of patients, approximately 40% of those patients have experienced a brain injury.HAVE YOU EXPERIENCED ANY OF THESE COMMON CAUSES OF TBI?
Millions of people have bumped their heads at some point in their lifetime, yet many of us don’t remember the incident or believe it was insignificant. To determine if you might have had a head injury that could be contributing to lasting symptoms, ask yourself these questions. Have you ever:- fallen off a horse, a ladder, or a roof?
- slipped on an icy surface in winter or fallen backward on skates and bonked your head at the ice rink?
- been in a car accident, even a minor one, and hit your head on the dashboard, window, or steering wheel—or gotten whiplash?
- hit your head on the bottom of a swimming pool after diving into shallow water?
- been struck in the noggin by a baseball or bat while playing the game?
- suffered a physical assault that involved your head?
- tumbled out of the top bunk, a tree, or off the jungle gym at school when you were a child?
- had a concussion from playing contact sports?
- fallen on your head while cheerleading?
- or any of many other possible causes of head injuries?
WHAT ARE THE FRONTAL LOBES?
The human brain is a very delicate but vastly complex organ that is involved in everything we think, say, do, believe, and create. It is comprised of 200 billion neurons (a type of brain cell) and many distinct, but interconnected structures each of which provides a vital and necessary role in our human experience. The outermost portion of the brain is called the cerebral cortex—often referred to as grey matter. It is divided into four major sections: the frontal, temporal, parietal, and occipital lobes. Of these, the frontal lobe is the largest and is comprised of the prefrontal cortex and the motor cortices (plural for cortex). The frontal lobes are responsible for a wide range of higher-level functions, including:- Forethought, planning, and rational thinking
- Insight and empathy
- Judgment and impulse control
- Emotional and behavioral regulation
- Decision-making
- Analytical thinking and logic
- Speech and written language
- Sense of smell and taste
- Intentional body movements
- Creativity and imagination
- …And more
COMMON CAUSES OF FRONTAL LOBE SYNDROME
There are numerous ways the function of the frontal lobes can be disrupted. Some of the more common causes of this are:Traumatic Brain Injury:
The frontal lobes are one of the two brain areas most often damaged in head injuries. The more severe the injury, the greater the number of symptoms and problems a person will likely develop. The famous case of Phineas Gage, although a dramatic example, is a good illustration of what can happen to this part of the brain after a serious injury. In the mid-1800s, Mr. Gage was a popular and affable man who worked installing new railroad tracks. One day while using a long tamping iron to pack down explosive powder, the powder ignited and caused the tamping iron to shoot through his cheek, brain, and the top of his skull, exiting completely and landing on the ground. Although he lost one eye from the incident, he survived physically. His personality, however, was a different story. The accident transformed him from being a well-liked citizen into a rude, inconsiderate, irritable, profane, and poorly behaved man. The tamping rod had significantly damaged his frontal lobes.Cerebrovascular Disease and Stroke:
We have blood vessels—capillaries, veins, and arteries—throughout our body and brain. A disease called atherosclerosis (hardening of the arteries) is caused by the buildup of plaque and other substances in the arterial walls. This is often the result of high cholesterol, hypertension, insulin resistance, inflammation, or tobacco use, among other health problems. Over time, the arteries become stiff, brittle, and vulnerable to rupture, and plaques can obstruct the flow of blood in the brain. Both processes can cause a stroke, which can occur in many areas of the brain, including the frontal lobes. The resulting damage will depend on the severity and location of the stroke.Brain Tumors:
A cancerous or benign tumor growing inside the brain or under the skull can destroy or damage cells, put pressure on brain tissues, or cause a buildup of fluid inside the skull and/or brain. Frontal lobe tumors can interfere with the way this part of the brain works.Neurodegenerative Diseases and Other Conditions:
Although they are usually classified under their own disease category, many neurodegenerative processes can alter frontal lobe function. For instance, vascular dementia, which results from the aforementioned damage to blood vessels in the brain, is thought to be one of the more common causes of frontal lobe symptoms. Other forms of dementia as well as degenerative neurological conditions such as Huntington’s disease and Parkinson’s disease can deteriorate the frontal lobes. And, while not necessarily degenerative, brain infections and frontal lobe epilepsy can also affect behavior, movement, and thinking processes associated with this part of the brain.SYMPTOMS OF FRONTAL LOBE SYNDROME
Because of their diverse functions and critical connectivity to other parts of the brain, injury to the frontal lobes can cause significant changes in the way a person behaves, thinks, and is able to function. In any individual, the symptoms that emerge will reflect the damage to the specific frontal lobe structures that have been impacted by injury or disease, and can include any of these:- Personality changes
- Loss of motivation or inability to initiate self-directed activities
- Apathy
- Poor judgment
- Inappropriate or risky behavior
- Lack of impulse control
- Frequent and/or intense emotional outbursts
- Depressive symptoms
- Increased or decreased interest in sex
- Difficulty with problem solving and concentration
- Disorganization and distractibility
- Loss of sense of smell and/or taste
- Problems speaking or writing
- Falling down or difficulty with motor movements, such as walking or picking up objects
- Weakness on one side of the face or body
TREATMENT FOR FRONTAL LOBE SYNDROME
In addition to any medications or surgical procedures necessary for addressing the underlying cause of symptoms, treatment strategies for frontal lobe syndrome vary depending on the type and degree of damage to the brain. For example, when the motor areas are affected, physical rehabilitation can help someone build strength and function to the extent possible or learn alternative ways of moving. Other types of treatment may include:- Speech and language therapy to improve an individual’s ability to communicate, if those functions have been damaged
- Occupational therapy to help a person develop or improve their ability to engage in everyday activities, such as getting dressed and cleaning their teeth
- Cognitive behavioral therapy to identify negative thinking patterns, reduce impulsivity, and manage appropriate social behavior
INSIDE THE CTE BRAIN
Tau protein is essential as it provides the lattice-like structure of brain cells. However, when the brain is damaged from repeated concussions, common in football and soccer players, tau breaks down and pierces through cell membranes, causing an inflammatory response that damages the brain. I was blessed to be a consultant on the Concussion. Since CTE can only be diagnosed with certainty on autopsied slices of brain tissue, it can only be diagnosed after death. I am friends with Dr. Omalu, and we have published scientific papers together. I tell him, his patients are the dead, but I am interested in the living and doing everything I can to delay their journey to his autopsy table.WHY HEAD TRAUMA ISN’T HOPELESS
Yet, the lore in medical circles is that CTE is permanent, progressive, and untreatable. I think that is nonsense and there is virtually no scientific evidence to support the lack of hope. Yet, because many people believe it, former football players and other professional athletes avoid getting help because they do not believe there’s anything they can do to stem the inevitable destruction of their brains. Some in the media have accused me of giving people with CTE false hope. Let me be clear, the scans we do at Amen Clinics do not diagnose CTE (you need a pathology slide for that). However, there is large body of peer-reviewed scientific research demonstrating that brain SPECT imaging can diagnose the current impact of past concussions, and whether or not with proper help, the brain can improve. The media tends to be purveyors of doom and despair, because that sells papers or gets more eyeballs for advertisers, but my 40-year career has shown that there is reason to be optimistic about the brain’s ability to heal. Here’s an example. In July 2007, College Football Hall of Fame running back from USC and former professional football player Anthony Davis (AD), came to see me at Amen Clinics because of problems with memory, periods of confusion, and irritability. A professor at USC told him about our work, and he thought we could help him. He was also concerned about the cognitive problems he saw in other retired football players and was hoping to find a way to help them too. At 54, Anthony’s brain looked like he was 85. It showed clear evidence of brain trauma to the prefrontal cortex and left temporal lobe. I put AD on a brain rehabilitation program described below, and within several months he told me that he felt better, was more focused, and had better energy and a sharper memory. Through my relationship with AD, in 2009 I partnered with the Los Angeles Chapter of the Retired NFL Players Association, which co-sponsored the largest brain imaging and rehabilitation study on active and retired NFL players. At the time, the NFL was still saying they did not know if playing football caused long-term brain damage, but they had never done any brain-imaging studies on players to prove it or not. My colleagues and I decided to tackle the issue. To date, we have scanned and treated more than 300 active and retired players using SPECT, a functional brain-imaging technique that measures blood flow and activity in the brain. The pre-treatment brain scans showed high levels of damage in almost all of the players. Damage was seen most commonly in the following regions:- Prefrontal cortex—involved with judgment, planning, forethought, and impulse control
- Temporal lobes—involved with learning, memory, and mood stability
- Cerebellum—involved with mental agility and processing speed
AD’s Brain Before and After 10 Years
In brain SPECT images, a healthy scan shows full, even, symmetrical blood flow. The “holes” in AD’s pre-treatment scan represent areas of low blood flow. His follow-up brain scan shows healthier overall blood flow.
HOPE FOR A BETTER BRAIN AND A BETTER LIFE AFTER HEAD TRAUMA
To not do anything to ameliorate the chronic effects of concussions, as some medical professionals and some in the media suggest, is unconscionable. Let’s not wait until people are dead to uncover that something is wrong. Let’s have a bias for action to make sure it takes longer to get on Dr. Omalu’s autopsy table. Concussions and other head injuries can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Helmet-to-helmet tackles in football. Knockouts in boxing. Explosive blasts in combat. These are the types of incidents most people associate with concussions and traumatic brain injuries (TBIs). But you don’t have to be involved in a skull-crushing incident, and you don’t have to lose consciousness to cause damage to your brain. In fact, many people have what the medical field calls a “mild TBI” and in these cases, you may not even realize that you’ve suffered a brain injury. This is bad news because suffering a mild TBI can cause a host of lasting psychiatric, behavioral, and cognitive consequences. Suffering a mild TBI can cause a host of lasting psychiatric, behavioral, and cognitive consequences.Why Does Mild TBI Go Undetected So Often?
Statistics on head injuries don’t tell the whole story. According to the CDC, there are over 2.8 million TBIs in the U.S. each year. But that’s only counting the people who visit the emergency department, are hospitalized, or die from their injuries. There are millions of others who experience a blow, bash, or bonk to the head but never seek medical help because they don’t think their injury is serious enough. And there are countless more who endure repetitive bangs to the head, such as hitting a soccer ball with your head, who don’t think they require treatment. These people are never diagnosed with a concussion or mild TBI. Surprisingly, many people forget they’ve had a significant head injury in childhood or as an adult. That’s why at Amen Clinics, patients are asked multiple times if they have suffered any type of head trauma. Even if patients initially answer “no,” their physicians at Amen Clinics will keep digging, asking a series of probing questions: Have you ever fallen out of a tree, fallen off a fence, or dove into a shallow pool? Did you play contact sports? Have you ever been in a car accident? It’s shocking how many people think their head injuries were too insignificant to mention. For others, they simply do not remember the incident, as amnesia in head trauma is a common occurrence. For example, one Amen Clinics patient had insisted multiple times that he had not suffered a concussion, but after being asked a fifth time, he put his hand on his forehead and said, “Oh yeah! When I was 5 years old, I fell out of a second-story window.” He isn’t the only one. Many other people forget they went through windshields, fell out of moving vehicles, or were knocked unconscious when they fell off their bicycles. Have you suffered a head injury? Think back in your own history to see if you recall experiencing any of these common causes of mild TBIs:- Falls—falling out of bed, slipping in the bath or shower, falling down steps, falling off ladders
- Motor vehicle-related collisions—involving cars, motorcycles or bicycles; also, pedestrians involved in accidents
- Violence—caused by gunshot wounds, assaults, domestic violence, or child abuse
- Sports injuries—besides football, they are common in soccer, boxing, baseball, lacrosse, skateboarding, hockey, cycling, basketball, and other high-impact or extreme sports
- Explosive blasts and other combat injuries
What Happens to the Brain in a Mild TBI?
Suffering a concussion or mild TBI can impact the brain in many harmful ways. Here’s why. Many people think the brain is rubbery and fixed within the skull, but it isn’t. Your brain is soft, about the consistency of soft butter, tofu, or custard—somewhere between egg whites and gelatin. It floats in cerebrospinal fluid and is housed in a very hard skull that has many sharp bony ridges. As such, it is easily damaged. Whiplash, jarring motions (think Shaken Baby Syndrome), blast injuries, and blows to the head can cause the brain to slosh around, slamming into the hard ridges inside the skull. Here is what happens in the brain after physical trauma:- Bruising
- Broken blood vessels and bleeding
- Increased pressure
- Lack of oxygen
- Damage to nerve cell connections
- Ripping open brain cells that spill out proteins like “tau” that cause inflammatory reactions
TBI, Mental Health Problems, and Cognitive Dysfunction
What makes undiagnosed and untreated head injuries so troublesome is that they are associated with a wide range of psychiatric illnesses and cognitive problems. Research shows that head injuries increase the risk of depression, anxiety, panic disorders, psychosis, post-traumatic stress disorder (PTSD), substance abuse, ADD/ADHD, personality disorders, aggression, learning problems, and suicide. It also raises the odds of dementia. In the database of tens of thousands of patients at Amen Clinics, SPECT imaging reveals that 40% had a significant brain injury before they sought treatment for psychiatric, behavioral, or cognitive issues. Most of them had no idea that an underlying brain injury was contributing to their issues. In the database of tens of thousands of patients at Amen Clinics, SPECT imaging reveals that 40% had a significant brain injury before they sought treatment for psychiatric, behavioral, or cognitive issues. Anyone who is experiencing psychological or cognitive symptoms that aren’t getting better with standard treatment may want to investigate if a hidden mild TBI may be contributing to those issues. For these people, following a concussion rescue protocol to heal the brain can make a significant improvement in symptoms. Undetected, untreated, or misdiagnosed head injuries can’t wait. During these uncertain times, your mental well-being is more important than ever and waiting until life gets back to “normal” is likely to make your symptoms worsen over time. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Many people think of mental health disorders as isolated conditions. When we hear someone say, “I have depression,” or “My husband has anxiety” it leads us to think that there’s a specific solution for each of these problems that would help people feel better. But it’s not quite that simple. For instance, if someone had only depression, you might think antidepressants would be the simple solution to reduce symptoms and boost their mood and energy. But more than half of depressed patients don’t get the relief they want from taking antidepressants, according to a large study. Similarly, if someone has ADD/ADHD, you might think that prescription stimulants are the easy answer to their issues. But they often aren’t. Why are the standard treatment models ineffective for so many people? Increasingly, physicians and other clinicians recognize that most patients with psychiatric conditions have complex conditions that don’t fit into the tidy categorical boxes described in the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM)—and for a good reason. Many people with mental health issues have an array of symptoms that can occur in a variety of disorders and confound the diagnostic process. Here’s an example of the same symptoms which can be seen in different mental health issues:| Depression | Anxiety | ADHD | Bipolar Disorder | TBI | |
| Irritability | x | x | x | x | |
| Insomnia | x | x | x | x | |
| Poor concentration | x | x | x | x | x |
| Impulsivity | x | x | x | ||
| Restlessness | x | x | x | x | x |
| Behavioral problems | x | x | x | ||
Having More Than One Psychiatric Diagnosis is Common
While there are other symptoms that cross diagnostic categories too, recognizing that most mental health problems are not single or simple disorders is helpful in understanding why so many people struggle to get adequate relief of their symptoms. A 2019 research study published in the journal, JAMA Psychiatry, reviewed the mental health history data of more than 5 million people and found that having one mental health disorder increased the risk of having another. This means that comorbidity (having two or more conditions) may actually be more common than having just one. Comorbidity (having two or more mental health conditions) may actually be more common than having just one. This means it’s common for people to have multiple conditions at the same time, such as depression and anxiety, ADD/ADHD and depression, panic disorder and bipolar disorder, addiction and anxiety or depression, obsessive compulsive disorder (OCD), and an eating disorder, and so on. Having multiple psychiatric disorders is referred to as dual diagnosis, co-occurring conditions, or co-existing disorders. Treating only one of the conditions will never be adequate. All of the issues need to be treated in order to get well. While it is still not yet known why mental health problems are more complex than originally believed, there are likely some genetic influences and environmental experiences that make some people more vulnerable to them.Mental Health Disorders Have Multiple Causes
However, what we do know, is that a person’s mental health is directly linked to what’s going on in their brain. During the past 30 years, many people have sought treatment at Amen Clinics after they’ve had several failed attempts to feel better elsewhere. This is largely because of traditional psychiatry’s reliance on the limited DSM symptom-cluster approach to diagnosing their patients. Plus, most psychiatrists don’t use advanced imaging technology, such as SPECT (single-photon-emission-computed-tomography) to actually look at their patients’ brains to assess for the biological underpinnings of their symptoms. Consequently, many people are misdiagnosed and/or inadequately treated because underlying brain problems are missed altogether. Using the example of depression again, to accurately treat a patient, it’s necessary to identify what could be driving a person’s symptoms, since there are several potential causes, including these:- Heritability
- Concussion
- Toxic exposure
- Infection
- Trauma
- Grief and loss
A Game-Changing Discovery
Another discovery that helps to explain the problems with treatment response also comes from the extensive brain SPECT imaging work done at Amen Clinics, which now has a database of more than 183,000 patient scans. One of the most important findings is that some of the more common mental health conditions have several identifiable subtypes, which are based on specific brain patterns. The doctors and researchers at Amen Clinics have identified:- 7 types of ADD
- 7 types of anxiety and depression
- 6 types of addiction
- 5 types of overeaters