People are hurt in lots of different ways and it’s impossible to list all of them. It can be hard to get medical care after a brain injury, so brain injuries often go unidentified and unaddressed. Sometimes if your brain has been hurt, even a “minor” assault (such as being slapped across the face) can exacerbate a previous injury and make it worse.

Some common causes of brain injuries related to violence include:

• A blow to your face or head, like being punched
• Being headbutted
• Being hit in the head with something
• Having your head slammed against the wall or the floor
• Falling and banging your head
• You are shaken severely
• Someone did something that made you pass out, lose consciousness, or have trouble breathing.

A traumatic brain injury happens when there is a change to how your brain normally works due to a bump, blow, or jolt to your head. Head injuries are also a result of the brain not getting the oxygen or blood it needs, like when someone strangles or chokes you or does something that restricts or disrupts your breathing. Because your brain plays a role in everything your body does, it can have a huge impact on your life for a long time. Concussions can occur from even a minor bump, and you don’t need to be knocked out to experience a concussion.

Just like broken arms, brains need time to heal. After your head has been hurt, it might feel like your brain isn’t working right or that it’s hard to do things like you used to. This is normal when a brain has been hurt.

You don’t need to have any bruises, swelling, or obvious signs of damage for your brain to be hurt.

Traumatic brain injuries can also be caused by other things not related to violence, such as vehicle crashes, sports accidents, or any type of slipping or falling when someone hits their head.

Anything that happens to you that makes it hard to breathe can hurt your brain. Our brains weigh about 2% of our body but use 20% of our oxygen and need a constant flow of oxygen to function. When our brain is deprived of oxygen, it causes damage very quickly and kills brain cells, so the brain doesn’t work how it should. It does not take a lot of pressure to restrict oxygen to our brain and you can lose consciousness within seconds. Some of the ways in which the brain can’t get oxygen are when someone:

• Put their hands or something else around your neck or throat by choking or strangling you
• Sat on your chest
• Put their hand or something else over your mouth so you can’t breathe, and you feel suffocated
• Put you in a chokehold
• Choked or strangled you during sex—which can cause long-lasting brain damage

People who choke or strangle are dangerous and put you at higher risk of being killed.

People who choke or strangle their partner are around seven times more likely to kill you. Strangulation is the ultimate act of power and control and is terrifying to experience. When people strangle their partners, it’s often a sign that the violence is getting worse and more severe. Being choked or strangled has significant short-term and long-term health consequences for both your physical and mental health. Reach out to a domestic violence program that can help plan for your safety and review other issues that increase your risk for lethal violence.

Problems with your physical or mental health, emotions, and thinking could be signs or symptoms of an unidentified brain injury.

A symptom is something you feel, that others might not notice unless you tell them. A sign is something others are able to see—that you may notice or not. Many signs and symptoms of brain injury overlap with other conditions—including traumatic stress, which always accompanies brain injuries from violence. It’s important to talk to a doctor to better determine the role your head trauma might play in the signs and symptoms listed below, including but not limited to:

Physical problems: Headaches, sleeping problems, sensitivity to light or noise, vision problems, dizziness, balance problems, fatigue, seizures.

Emotional problems: Worries and fears, panic attacks, flashbacks, sadness, depression, hopelessness, anger or rage, irritability, inability to control emotions, going from 0 to 100 very quickly.

Thinking problems: Remembering things, multi-tasking, paying attention or focusing, problem-solving, getting things started, figuring out what to do next, organizing things, controlling emotions or reactions.

Brain injury can impact you for a long time and make normal daily activities challenging, as well as cause other significant problems.

One of the difficult realities of brain injuries is that the impact of them often does not show up immediately after you are hurt, and can continue to manifest weeks, months, or even years after a brain injury. Some of the longer-term changes can include:

• Changes in personality
• Problems with maintaining employment due to cognitive challenges
• Persistent health problems that often are hard to identify a cause or reason for
• Consistent problems with thinking tasks such as memory, organization, prioritizing things, multitasking
• Functional limitations that prevent you from living your life how you want to, like fatigue, sleep issues, worsened mental health, or inability to manage your complex life
• Challenges doing something that you used to be able to do well

While tests such as MRI or CT scans can sometimes show evidence of a brain injury, there is no imaging test that can always show evidence of brain injury.

There is no medical imaging test that can always accurately diagnose a brain injury. Often the damage to the brain happens to brain cells, which don’t show up on imaging exams. Sometimes brain injuries that occur from severe blunt force trauma, such as in a car accident, do show up. Most brain injury diagnoses, including diagnoses for concussions, are clinical diagnoses, which means that a doctor determines whether a concussion occurred as opposed to having some type of test (like a blood test, Covid test, or x-ray for a broken bone).

Remember that only a qualified medical professional will be able to diagnose a brain injury. A good place to start is to begin writing down observations and what types of problems you are having, how frequently they are happening, and how it’s impacting your life. Consider asking others who you know and trust if they have noticed any changes—because sometimes others notice things we don’t. Writing down this information and then sharing it with a doctor, therapist, or another person who is helping you is a good step.

Brain injuries can get better, and there is a lot you can do so brain injuries are less disruptive to your life. You can live a good life, even with a brain injury.

It’s hard to address something that hasn’t been identified, so acknowledging that your brain may have been hurt is a significant first step. Many survivors find it empowering and relieving to know that some of their challenges and limitations could be related to something that someone else did to them, as opposed to something that is their fault. Many survivors state this helps them understand their limitations differently and that education and information about brain injury helped them realize they weren’t crazy or stupid.

Brain injury might continue to impact your life for a long time and even forever. But just like any other health condition, knowing how it impacts you can only help you to manage it better and make it less disruptive in your life. You CAN go on to live a fulfilling life where you are treated with the love and respect you deserve and take this knowledge of how domestic violence has impacted you into your future. No one can rewrite the past, but we all can help write a better future.

Manage by:

• Use organizational tools, planners, or apps to keep important dates and information, including to-do lists, calendars, and important numbers.
• Set a central location to always put important things, such as phones, keys, wallets, and glasses.
• Follow a routine and come up with associations, such as always taking medication with breakfast, or always checking appliances before bed.
• Use a timer or alarm to help you get started and work on something for a set time
• Take frequent breaks, especially if you feel frustrated

Manage by:

• Use earplugs, headphones, and sunglasses, or adjust lighting as possible
• Adjust text size and volume settings on your technology
• Consider contacting an eye doctor if vision issues persist
• Reduce your screen time
• Take frequent breaks
• Work where it is quiet with minimal distractions

Manage by:

• Ask people to speak slowly
• Re-read/review the information multiple times
• Have shorter meetings, activities, or conversations
• When problem-solving, write down several ideas and talk them over with someone you trust
• Break down large tasks into smaller steps.
• Focus on one thing at a time