The difference between having a concussion and also having
problems from the concussion like depressed mood or depression
or having chronic pain and having a condition
that is, in fact, the full barrage of both of those
or all three of those conditions linked together is that if the concussion itself
or the PTSD itself is just causing symptoms, it's just causing you to have
a somewhat depressed mood but not have full-blown depression,
or the concussion is causing you to have a little bit of anxiety, or the PTSD is causing you
to have a little bit of anxiety, those--that single diagnosis with just symptoms
that kind of look similar will respond exquisitely well to the known treatments.
From, again, my experience and what limited things we know from the
science, the research that's been done is the human brain, the human body
does extremely well when it has a mission or a problem that it understands,
that it can deal with. When people understand what the goal is,
what their problem is, even if, to be fair, we don't understand it 100 percent--
maybe we're at 91 percent or 86 percent--but the patient feels,
"I've got a care provider and a team that understands this. They've seen this before.
It's got a name." All this-- People actually want to understand or to have something
to call what they're working on and, more importantly, not just a name,
but to know what to expect, even if the expecting thing isn't good.
You know--if you've had a more severe injury or you've got cancer,
and you know it's going to be rough, but someone paints the picture for you
and says, "Here is your chemo. Here are the symptoms. Here is your
chance of doing well, etc. That's much better than the unknown.
And we really get the unknown when one care provider says, "You've got
generalized anxiety disorder."
Another care provider says, "It's related to medications that you're taking
that are interacting and making you feel weird."
Another care provider says, "I think it was that blast you had 2 years ago,
and you got your bell rung."
Even though each of those might have a piece in this, to present it like that
is very challenging. It's challenging for the healthcare provider
to present six diseases at once and how do they interact.
But it really does help the entire--the system. The care provider. The patient.
The family. The therapists who are providing the services.
So, again, from my experience, it's been a very useful tool.
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Not knowing the root of medical and psychological problems often exacerbates the issues; a clear diagnosis is important for successful recovery.
Produced by Victoria Tilney McDonough and Brian King, BrainLine.
David Cifu, MD is chairman of the Department of Physical Medicine and Rehabilitation at the Virginia Commonwealth University (VCU) School of Medicine in Richmond, Virginia, and national director of the PM&R program office for the Veterans Health Administration.
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