Traumatic brain injury (TBI) refers to damage to the brain as a result of an accident such as a blow to the head. Not all bumps to the head result in TBI – only those that disrupt the normal function of the brain. TBIs can range from mild, such as a concussion, to life-altering or even fatal, and can affect anyone of any age. In fact, in 2014, the deaths of 56,800 Americans were linked to a traumatic brain injury. An estimated 5.3 million more are living with a TBI-related disability. TBI is one of the leading causes of death worldwide for under-45s and is the most common cause of epilepsy in adults.
Diagnosing and Treating TBI
Despite the prevalence of TBIs in America, treatment options are limited and usually focus only on treating symptoms, rather than mitigating the actual damage to the brain.
What’s more, just getting a TBI diagnosis can be very difficult, especially for people who weren’t in a serious accident. This is partly due to the fact that many of the symptoms of traumatic brain injuries vary greatly. Some can be vague or difficult to measure, like brain fog, while others relate to other conditions, like trouble sleeping, which can often be misattributed to anxiety.
We spoke to Amanda Burrill, an athlete, journalist, and veteran, who suffered two traumatic brain injuries: one in 2003 during her time in the Navy, and one in an accident in 2014. After a lengthy recovery process, which included a long struggle to get the correct diagnosis, Amanda is now an outspoken advocate for greater research and understanding of TBIs.
Many of the symptoms that Amanda was experiencing in the wake of her first accident – such as difficulty concentrating and memory loss – were misattributed to post-traumatic stress disorder. And yet, Amanda knew that something else was wrong, not least because she was experiencing vision problems, headaches, and more. In fact, she maintains that the stress of not getting the correct diagnosis was actually as damaging as the injury itself:
“The bulk of my issues really stemmed from not getting help or a proper diagnosis right away, not from the actual injury or injuries themselves. I have heard many times, ‘How are you not completely crazy?’ Not even on the mental health side, but from doctors who couldn’t believe how long I couldn’t see straight!”
Amanda was given a cocktail of prescription drugs to manage her symptoms, but she didn’t respond well to them. It was not until after Amanda’s second accident in 2014 that she was able to get a TBI diagnosis, which helped her to recognize that many of the difficulties she had been facing could be traced directly back to her first head injury. Finally getting a diagnosis allowed her to seek alternative routes to recovery, starting with rehabilitation to target her vision, speech, and balance.
Words of Wisdom
“On a recovery path geared towards my real underlying issue, TBI, I saw how well I was responding to rehab, speech, vision, and balance, and just knew in my heart that all the medications I’d been on hadn’t helped at all. They most likely hindered my condition as no medication rewires neurons for us! I’d trusted modern medicine when I was at my most vulnerable, desperate to get better. In 2017, I started to realize that medications are a big bandaid, and decided to start down the holistic road.”
Her advice to other people who are struggling to get their brain injuries diagnosed is to listen to their bodies and keep pushing for answers:
“Pain of any kind, whether physical or emotional, is the body’s way of letting us know that something is wrong, and I am glad I’ve honored that in my approach to recovery, especially once I started to understand what I was dealing with medically. If I’d given up, I’d never have found my answers, so my advice is to keep looking and surround yourself with those who will help you find those answers.”
The Mechanics of TBI
But before we look at recovery, let’s look at what a traumatic brain injury actually does to the brain and the body. TBIs actually share many mechanisms with strokes, as in both situations cerebral blood flow is disrupted. In the case of an injury, this is due to inflammation, whereas, with a stroke, a clot is to blame. Disrupted blood flow in the brain, if not quickly treated, causes damage to brain tissue. In response, the brain releases huge quantities of glutamate (a neurotransmitter that can lead to cell damage), free radicals, and inflammatory compounds.
That combination can cause what is known as a “secondary injury cascade” that can lead to swelling, damage to cells and blood vessels, and a breakdown of the blood-brain barrier. This is what causes many of the symptoms of TBI – dizziness, headaches, fatigue, brain fog, and so on.
The Road to Recovery
In addition to rehabilitation, Amanda focused on getting her overall health back, starting with exercise, diet, and sleep. These are the very same things that PurePower’s co-founder, Sean McCabe, attributes to his full recovery from a TBI he suffered in 2015. Says Amanda,
“I have always been an athlete, and though I am a different sort of athlete now, it’s how I’ll always see myself. Movement is life! It makes perfect sense: The brain craves oxygen and lots of it. After a head injury, the brain wants even more oxygen and nutrients, and what better way to get it there than through exercise, pumping blood through the body. Because I’ve had some serious surgeries, I know a thing or two about exercise-deprived recovery and that it’s not good for the body or the soul. Even today, I know I have kicked more ass today because I exercised this morning. It’s part of my self-care.”
“After my first head injury, my sleep was a mess for a very long time. As time went on, I started learning little tricks to improve my sleep quality. It was years later that I started to realize sleep isn’t in its own category, but part of a big lifestyle dynamic that must be tended to from every angle! My sleep is very good these days, and I am sure that is directly proportional to my continued progress.”
TBI and Cannabinoids: A Ray of Hope?
Now, new studies suggest that cannabinoids could help not only help mitigate against the symptoms of TBI but also to potentially help protect the brain against serious damage in the immediate aftermath of an accident. Could this be another piece in the puzzle of holistic treatments for traumatic brain injury?
In case you need a brief recap, cannabinoids are naturally-occurring compounds that every living creature produces – including plants and animals. Humans produce some cannabinoids themselves, known as endocannabinoids. We can also get plant-derived cannabinoids as supplements, such as CBD (cannabidiol), which is found in hemp (CBD is non-psychoactive: it doesn’t get you high). Cannabinoids interact with the endocannabinoid system (ECS), a complex system that works throughout the body to regulate a number of vital processes, from digestion to the central nervous system.
A 2017 study looking at how the body uses cannabinoids to heal after a brain injury found that levels of endocannabinoids in the brain spiked significantly immediately after an injury, which seems to show that the ECS plays an important role in the healing process.
Could CBD Provide Hope?
A number of studies have looked at the application of CBD in relation to brain injuries, including following concussions. Many of these studies cited the potential application of CBD as a neuroprotectant, thanks to its antioxidant properties and its potential to mitigate glutamate toxicity, as well as its ability to interact with many other systems that can be disrupted by a TBI, such as the blood-brain barrier.
Another potential benefit of CBD and other cannabis-derived therapeutics is their polypharmaceutical properties – that is, they target multiple areas at once, rather than focusing on one symptom only. Indeed, a 2018 study concluded that cannabis botanicals have the potential to “revolutionize neurological treatment into a new reality of effective interventional and even preventative treatment.”
The U.S. Department of Health and Human Services even holds a patent entitled “Cannabinoids as antioxidants and neuroprotectants,” which claims, among other things, that “cannabinoids are found to have particular application as neuroprotectants, for example in limiting neurological damage following ischemic insults [brain injuries], such as stroke and trauma” and “Non-psychoactive cannabinoids, such as cannabidiol, are particularly advantageous.”
The Need for More Research
However, while these studies all seem promising, much more research is needed to fully establish the link between CBD and traumatic brain injuries, including dosage, how it should be taken, and for how long. Indeed, more research into traumatic brain injury and holistic treatments in general is needed, especially with regards to better recognition and diagnosis.
Amanda sums it up by describing her experience of the stigma attached to invisible injuries:
“Having been through rehab several times AND having had a number of surgeries, I am still astounded by the way the waters parted when I was in a cast, especially the neck brace after spine surgery. Yet talk of TBI and persistent concussive symptoms often earns me eye rolls. Invisible wounds can be just as debilitating, if not more so, than visible ones.”