Thinking Forward After A Traumatic Brain Injury

08/29/2026

This is the best explanation of what life is like after a traumatic brain injury. Capacity is not measured by the best hour someone can produce. It must include duration, recovery time, consistency, and the cost to every other part of life. I’m still trying to figure it all out six years later. 🧠

When the Brain Won’t Turn Back On

HIGH FUNCTION IN FLASHES

One of the most misleading sentences after brain injury is:

“But I saw you do it yesterday.”

People see me teach a group, conduct a screening, speak publicly, exercise, or carry a conversation.
They see real ability.
What they may not see is what it took to access that ability, what I stopped doing to preserve it, or what happened afterward.

High-level performance in one moment does not prove sustainable capacity.
I can be articulate for an hour and later struggle to answer a text. I can lead a room and then need silence. I can know what my brain requires and still be unable to pace.

The capable version of me is real.
So is the version that cannot process another conversation, make another decision, tolerate stimulation, or organize the next task.

Brain injury can be consistently inconsistent.

Once someone sees you function well, later limitations can sound like excuses, avoidance, laziness, or selective effort.

Many survivors try to explain. We describe neurofatigue. We ask for time, fewer demands, or permission to withdraw.

But the same question returns:

“If you could do that, why can’t you do this?”

After enough failed explanations, some people stop explaining.
They hide the crash. They isolate. They force performance because appearing unable can threaten employment, relationships, independence, and identity.

Some discover that a substance can temporarily increase energy, reduce anxiety, or make social performance possible.

The depleted brain becomes conditioned to override itself instead of resting.
Short-term performance conceals long-term cost.

That is one danger of being “high-functioning.” The better you compensate, the less support people believe you need. Success brings more responsibility while its neurological cost remains invisible.

Even you may wonder:

Was I really that impaired if I performed so well yesterday?

But capacity is not measured by the best hour someone can produce.
It must include duration, recovery time, consistency, and the cost to every other part of life.

I see this in the populations I work with. Many have no recognized brain-injury history. Their competence becomes evidence against impairment, while their crashes are labeled psychiatric, manipulative, or noncompliant.
Screening can change that story.

It does not excuse every behavior. It gives us context for better questions:

What can this person do?
For how long?
What happens afterward?
What support would make that ability sustainable?

The gap between visible performance and sustainable capacity can produce shame, isolation, self-medication, hopelessness, and dangerous thinking. Research associates brain injury with increased su***de risk. Hidden collapses must be recognized, not dismissed.

The goal is not to make life smaller.
It is to stop mistaking a flash of ability for an unlimited supply.

07/14/2026

Six years ago yesterday, my life changed. There are good and bad changes. I can be more present in life for myself and others. I cannot consistently function in a capacity that would allow me to successfully work. Each day is different even when it is the same. Some days I function like a rockstar for the first few hours of the day while others…not so much. One constant need for me every day? I need to lie down in a dark room with my eyes closed. How long…it depends.

I am thankful for those in my life who have loved and supported me and will continue to, no matter what. ❤️🧠

07/05/2026

Tid-bit: Every lobe of my brain was injured due to my concussion. Due to the damage, everyday activities are very taxing. Cue in the need for neuro/brain breaks even 6 years post-concussion. 🧠

We all need neuro/brain breaks to function at our best.

04/27/2026

Concussion care should never be approached as a one-size-fits-all. Sometimes symptoms are incorrectly tied to a diagnosis that is not brain injury related. Treatment for the symptoms may then not be beneficial.

I had no idea how much the injuries to my brain and neck after my concussion negatively affected my vision and balance (along with other things). Getting the right assessments and treatments significantly helped ease my symptoms (specifically neuro-glasses and chiropractic care).

I recently found a great post on LinkedIn by Sonia Vovan who is a Physiotherapist and Vestibular Therapist. I believe every person who suffers a concussion should have a vestibular consultation.

🧠 Sonia Vovan, Physiotherapist and Vestibular Therapist, Concussion Management and Vestibular Rehabilitation

A few patterns in concussion care that I wish we'd stop seeing.

After many years of clinical practice in vestibular rehabilitation and concussion management, and now as a PhD candidate researching s*x-specific differences in sensorimotor integration following concussion in working-aged adults, I continue to notice a persistent gap between what the evidence supports and what patients encounter in everyday care.

This outlines the specific patterns I see most often. What strikes me, collectively, is that closing these gaps doesn't require new science. It requires translating what we already know into consistent, individualized, multi-system care. It also requires recognizing that concussion recovery is shaped by factors we've historically underweighted in both research and practice, including s*x, hormonal status, the cervical spine, and the cognitive-motor demands of the environments people are returning to.

For clinicians, this means broadening assessment beyond symptom checklists and resting presentations. For researchers, it means continuing to build the evidence base around heterogeneity in recovery. For patients and those supporting them, it means feeling empowered to ask more specific questions about how their care plan reflects the complexity of their injury.

I'd welcome input from other clinicians, researchers, and those with lived experience. Which of these patterns resonates most with what you're seeing in practice?

https://www.linkedin.com/posts/soniavovan_concussion-vestibularrehabilitation-physiotherapy-activity-7452672561487998976-zXei?utm_medium=ios_app&rcm=ACoAAChz9rUB4CJ2jrGInBg6I3gwc-GSIRx4KZE&utm_source=social_share_send&utm_campaign=copy_link

04/08/2026

I felt the need to comment on this today. I’ll probably ramble. 😂 And it might sound funny or weird…

What if you woke up and you were no longer you is a powerful question. I think of obvious deficits or differences from my old self. Others might not notice, but they might after talking with me for a few minutes. I think of word finding, losing my train of thought, having a hard time following a conversation and needing things repeated, etc. Not a big deal, right? It is and it isn’t. It depends. It depends on the situation I’m in. I will tell you it is often embarrassing for me. I know what I am trying to say. I am listening to the person. I care. I know what I’m doing (You can have confidence in me, I promise! 😉).

There is almost always a question in the back of my mind: Was I like this before?

Am I that different than before my TBI?

Am I overthinking things? Of course I am…why wouldn’t I?! Now That I did before! 😂🙋🏻‍♀️

But, back to the question…am I really that different than before? Others who’ve known me for years before my TBI and now after my TBI tell me I’m a lot “different.” I’ve asked them to tell me what’s different. Telling me I’m “a lot different” makes me nervous. No one can really tell me or “put a finger on it.” Can you guess what happens next? You guessed it! I overthink! Sometimes I feel like a bad fraudulent check of my previous self! 😂 I think I said that right…feeling like a fraud. Does that make sense?

Imagine not knowing what is different about you now. Would you question how you’re perceived by others (like I said before)? I do. And it Sucks.

I want to feel like I “fit in,” that I’m perceived as “normal,” yet I want to still be me. Be whomever I was before the car accident (Whoever? Whomever? My little sister, Marley, the brainy sibling with a Masters in English, would know which to use…I don’t want to look it up right now 😂. My brain is tired.)? Who I still am? I forget who I was…or am.

Have I confused you yet? I confused myself 😂😉. Welcome to my world. Ha!

I want All of me to fit in, not just the pieces that fit into the “normal” puzzle (Boring…’The Office’ reference…PowerPoint is boring).

Just like everyone else, I want to feel like I fit in and belong. To be Accepted. Even better! We all want that. To be accepted.

Unfortunately trying to fit in and be perceived as normal is Exhausting, especially after a TBI. I already have zero battery reserve, so my effort to fit in drains me after a few hours (sometimes a few hours more, a lot of times less). What’s left after that? Meh…not much. Cue in a cat nap? 😴 I like naps…

Maybe my next step is to truly accept who I am right now and not worry or dwell about who I was or could be. Or maybe not worrying so much about how I am perceived by others…especially when that drains me, too! 😂🧠 If I achieve the potentially unachievable (ha)…does that mean I’ll need to find a hobby to tire me out instead?! In my opinion, I’m hilarious. 😆

Now that I’ve rambled…Can you relate? 🤔💭

Brain Injury changes everything...