What could be the reasons that lead to the change in nervous system function described on the previous page?
The answer seems to be that there are many potential reasons why an individual can develop chronic symptoms after a head injury. These reasons can be divided up in to:
Predisposing Factors: things that happened before the symptoms started
Precipitating Factors: things that happened at the time the symptoms started
Perpetuating Factors: things that happened after the symptoms started
These factors can be:
Biological: for example, there probably is a genetic vulnerability to these symptoms;
Psychological: for example, when you worry that a headache might be due to brain damage it tends to make the headache worse;
Social: for example, if you experience a lack of support from your family, friends or colleagues, you will tend to feel worse.
This is called the “biopsychosocial model of illness”.
Below, this model is illustrated by a picture from Hou and colleagues.
As you can see, there are certain factors that can make you more vulnerable to developing symptoms (‘predisposing factors’). These might be experiences from the past or having certain expectations.
A head injury can trigger all sorts of symptoms, like headache, dizziness, fatigue and memory problems.
This in turn causes a range of thoughts (‘cognitions’), feelings (’emotions’), behaviours and reactions from others around you.
Having symptoms can be quite scary. You might feel worried and wonder what the long-term consequences are going to be. This can make you feel anxious. You might tend to avoid certain activities, because they make your symptoms worse. Even though this is very understandable, all of these things can actually maintain your symptoms.
The good news is, that you can actually influence these thoughts, feelings and behaviours. How you deal with your head injury and the symptoms that you have can make a big difference!
If you become convinced that the symptoms are due to brain damage, then that is likely to hamper your recovery. If you can become convinced that your symptoms are potentially reversible your rehabilitation will be easier.