Parenting after traumatic brain injury

Most parents will tell you that raising children is the hardest job they’ve ever had. New parents lament sleepless nights, managing fussy infants, and a general uncertainty about their parenting abilities. Parents of older children typically juggle work, multiple schedules, homework, sports practice, and household chores. Certainly, parenting is a tough job for anyone, but the demands of parenting can feel particularly unmanageable for people living with the long-term symptoms of traumatic brain injury (TBI).

TBI is one of the most common causes of injury in the United States. The majority of TBIs are mild, commonly referred to as concussion. Concussion is typically not associated with major medical impairments, but it can result in long-term diminished memory and cognition, and long-term psychological effects such as anxiety and depression, headaches, poor sleep quality. These long-term symptoms following concussion are collectively referred to as post-concussion syndrome (PCS). When a parent sustains a mild TBI, they often face the seemingly impossible task of managing their PCS in addition to caring for their children and other family members. Below, we discuss the challenges associated with becoming a new parent while managing PCS, and some coping mechanisms that may help with coping in daily life.

Cognitive challenges of new parents with PCS

Parenting an infant brings unique challenges. In the first few months of your child’s life, you are likely sleep deprived, and if you’re a first-time parent, there’s a good chance you’re spending most of your energy trying to figure out how to keep your baby safe and healthy. If you’re a nursing mom, you’re also managing a demanding feeding schedule. These are all tasks that are made much more complicated if you’re also living with PCS. People with PCS often feel overwhelmed and frustrated, have trouble remembering responsibilities and schedules, and can find it hard to learn new things.1

Modern technology can significantly improve daily life for a parent with PCS. Phone apps can help you manage a schedule, provide alerts and reminders, or give you an easy way to document your baby’s behaviors and needs. Online resources and support groups can provide a wealth of knowledge when you need advice. These technologies can help free up some “cognitive space” in an overwhelmed brain and reduce memory challenges. Joining a group of parents with babies around the same age will provide not only problem-solving ideas for your baby, but can also provide a much needed social community to support a parent struggling with PCS challenges.

Depression in new parents with PCS

About a third of TBI survivors will experience feelings of depression.2 These feelings can be exasperated in a new, overwhelmed, exhausted parent. An estimated 1 in 9 women experience post-partum depression in the weeks and months following childbirth, which can be complicated by depression to TBI or PCS.3 Depression in people with TBI is often treated with a combination of medicinal and psychotherapeutic interventions.4 If you are experiencing feelings of depression, it is critical that you talk to your doctor so that you can find a treatment that is suitable and manageable.

Take care of your child by taking care of yourself

As a new parent, it is easy to become wrapped up in the needs of your child, but it’s important to remember that the best thing you can do for your baby is to take care of yourself. This is true for all new parents, but particularly for parents with PCS. Research suggests that self-care techniques such as mindfulness-based stress reduction (MBSR) are both emotionally and functionally therapeutic because they allow the person time to regroup and regain focus.5 For parents with PCS, allowing yourself this time may mean trading feeding schedules with your partner so that you can get more sleep, or finding time to do things that keep you relaxed and help you maintain focus. Asking for support from family and friends can also decrease some of the mental and physical strains associated with caring for an infant.

TBI and PCS is hard on both parents

While the parent with PCS is learning how to manage their symptoms while also taking care of an infant, their partner may be struggling mentally and emotionally as well. The partner may be picking up extra childcare duties, and as a result they may feel resentment towards their partner. They may note that their partner with PCS is having trouble bonding with their baby, and this can generate further resentment. Spouses of TBI survivors report feeling higher levels of anxiety and depression, and these feelings can be exacerbated in the context of parenting.6 As co-partner of a TBI survivor, ensure that you are allowing time for own self-care, recognize when you feel overwhelmed, and reach out early for support from your family or physician.

References

  1. Ryan, L. M., & Warden, D. L. (2003). Post concussion syndrome. International review of psychiatry, 15(4), 310-316.
  2. Jorge, R. E., Robinson, R. G., Moser, D., Tateno, A., Crespo-Facorro, B., & Arndt, S. (2004). Major depression following traumatic brain injury. Archives of general psychiatry, 61(1), 42-50.
  3. Alderfer, B. S., Arciniegas, D. B., & Silver, J. M. (2005). Treatment of depression following traumatic brain injury. The Journal of head trauma rehabilitation, 20(6), 544-562.
  4. https://www.cdc.gov/reproductivehealth/depression/index.htm
  5. Azulay, J., Smart, C. M., Mott, T., & Cicerone, K. D. (2013). A pilot study examining the effect of mindfulness-based stress reduction on symptoms of chronic mild traumatic brain injury/postconcussive syndrome. The Journal of head trauma rehabilitation, 28(4), 323-331.
  6. Doyle, S. T., Perrin, P. B., Díaz Sosa, D. M., Espinosa Jove, I. G., Lee, G. K., & Arango-Lasprilla, J. C. (2013). Connecting family needs and TBI caregiver mental health in Mexico City, Mexico. Brain injury, 27(12), 1441-1449.
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