How concussions can impact memory and energy

Concussions are the most mild—and common—form of traumatic brain injury (TBI). TBI happens when brain function changes, usually caused by some type of hit, shake, or jolt to the head, or by a penetrating object such as a bullet or stab wound. The severity of TBI depends on the amount of brain tissue injured and ranges from mild to severe. Impairment can include physical (such as headaches, balance), sensory (vision, hearing), cognitive (thinking, memory), and emotional (depression, personality) issues.

For many people who get a concussion, impacts on memory and energy levels are a source of worry and frustration. Learn more about the impacts of concussion on thinking and energy-–and some ways you might help recovery.

Am I at risk for concussions?

Military Service Members are at greater risk than their civilian counterparts for concussions and more severe forms of TBI. Concussions make up more than 80% of TBIs reported by Warfighters. Between 2000 and 2019, more than 410,000 Military Service Members sustained some form of TBI. In theater, blasts account for most TBIs. Each injury is unique, and each person’s road to recovery is different.

How concussions can impact memory

Concussions often impact memory, especially short-term memory. Think of long-term memory and short-term memory as “holding bins” for information. Your long-term memory can hold information from several days to decades. Your short-term memory retains information for just a few seconds. Short-term memory is closely associated with working memory (your ability to process information) and sustained attention (your ability to maintain focus).

When memory problems strike, short-term memory, working memory, and sustained attention tend to suffer before long-term memory does. You remember events that took place longer ago than newer events because your mind has “rehearsed” the older event repeatedly, essentially embedding it in your brain through repetition. By comparison, your mind hasn’t yet “learned” the newer event. For example, you might recall every detail of combat stories but have difficulty remembering what you ate for lunch. In this case, brain connections that rehearsed the combat story have become solidified, while connections responsible for learning this new information haven’t formed yet.

Depending on the location and severity of the injury, your brain might work differently than it did in the past. This could happen because brain cells that used to “communicate” with each other easily are now being rerouted. Short-term memory, working memory, and sustained attention also can be affected by factors such as stress, distraction, poor sleep, depression, and anxiety. The cause isn’t always obvious. Your doctor can help sort it out; answer questions about your condition, treatment, and prognosis; and refer you to a neuropsychologist for further evaluation.

How concussions can impact your energy

Fatigue is a frequent, significant, and debilitating condition for those who have been diagnosed with a concussion or more severe form of TBI. Some patients have described fatigue as an “overwhelming lack of energy” or “mush brain.” Or you might feel as if you “hit a wall,” or you’re “out of gas,” where even basic activities are hard to do.

Nearly 70% of those living with a concussion or more severe form of TBI experience physical, mental, or psychological fatigue. When your brain is injured you need more energy for even simple tasks. The healing process to recover from a concussion itself demands extra energy too. Sleep problems, stress, and depression associated with any form of TBI also can make fatigue worse. Psychological and physical fatigue can feel frustrating and hard to overcome, but knowing it’s a normal part of recovery can help you be kinder to yourself.

Tips to help recovery from a concussion

  1. Get medical help. 

The most important thing you can do if you suspect you or someone you care about has a concussion is to see a medical professional as soon as possible. This might seem like an obvious first step but many Warfighters resist disclosing symptoms because they feel they should “suck it up and drive on,” they’re worried they might be letting their battle buddies down, or they fear they’ll be seen as weak. The most common symptom of concussion is a headache or a feeling of pressure in your head. Other symptoms to watch for include dizziness, sleep disturbances, fatigue, attention and memory problems, irritability, and changes in vision, balance, and mood. Symptoms can be subtle and occur immediately or begin a few days later. If you’re unsure, it’s best to err on the side of seeing a doctor. 

  1. Use a Total Force Fitness approach to your health. 

Most concussion recovery methods involve good health behaviors you should already be doing. Prioritize quality sleep, manage stress levels, and eat healthy—especially foods high in omega-3 fatty acids that help reduce inflammation and help brain cell health. Rest is important after suffering a concussion, but after about 2–3 days you may consider if it is time to begin exercising again. Make sure you speak to your health care professional to determine when it’s all right to start and what exercises are appropriate for your current condition. Also make sure you don’t put yourself at risk for further impacts to the head. Regular exercise is important for your brain health and can help boost energy and improve your quality of sleep at night.

  1. Manage tasks and time strategically.

As you’re progressing, try to start your day by doing the most important and hardest things first, when you’re less likely to feel fatigued. Try making to-do lists to help separate tasks that must be done soon from those that can wait until later. Pace yourself and take frequent breaks. Plan your day for success by balancing work with periods of rest. Also, learn your triggers and stop activity before you reach your limit. It is important to set realistic expectations with SMART goals to help break tougher tasks into smaller, manageable “chunks.” Take time to celebrate small wins!


Additional ideas to help recovery

Music therapy for concussions

Music therapy is proven to help some patients with brain and psychological injuries such as TBI. A trained music therapist can use music to activate injured areas of the brain involved in the control of movement, cognition, speech, and emotions. Research supports how and why music therapy works, but it also can be understood intuitively. Music evokes emotions and influences mood, whether happy or sad, relaxed or pumped. Music also inspires movement: Think how a good beat can induce foot tapping or dancing. Injured nerve pathways actually can be stimulated by music. Music also can be used to stimulate speech and facilitate cognitive function.

Gaming for concussions 

Computer programs—such as those that have been used to train pilots, surgeons, and drivers—also can help supplement cognitive rehab after TBI. “Exercising” your brain with computer programs and other brain games also can help slow cognitive decline.

For example, stimulating cognitive activities such as reading or learning a new language can lower the risk of developing early dementia. Brain games such as crossword puzzles, sudoku, Scrabble®, etc., can help curb cognitive decline associated with TBI too. Other brain fitness strategies include video games that can improve your brain performance. Some programs can target specific brain functions such as memory and attention, while others “cross-train” your entire brain to help different functions. For best results, cognitive exercises should be challenging, novel, and engaging, but not frustrating.


Most Military Service Members who get a concussion return to full duty within 7–10 days. But repeated concussions, considered more intense forms of TBI, can require ongoing care and rehabilitation, both to aid in recovery and manage outcomes. Brain health is key to optimal performance, especially for those diagnosed with concussions or more severe TBI’s. It’s important to stay socially and physically active, eat a healthy diet, and get enough quality sleep to promote brain health. Omega-3 supplements are also worth exploring with your doctor. Visit HPRC’s Mental Health web page for additional information and resources.


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References

Bell, K. R. (2019). Fatigue and traumatic brain injury. Retrieved 19 February 2020 from https://msktc.org/tbi/factsheets/fatigue-and-traumatic-brain-injury

Defense and Veterans Brain Injury Center. (2019). DOD Worldwide Numbers for TBI, 2019. Retrieved 19 February 2020 from https://dvbic.dcoe.mil/dod-worldwide-numbers-tbi

Gupta, A., Summerville, G., & Senter, C. (2019). Treatment of acute sports-related concussion. Current Reviews in Musculoskeletal Medicine, 12(2), 117–123. doi:10.1007/s12178-019-09545-7

Kohl, A. D., Wylie, G. R., Genova, H. M., Hillary, F. G., & DeLuca, J. (2009). The neural correlates of cognitive fatigue in traumatic brain injury using functional MRI. Brain Injury, 23(5), 420–432. doi:10.1080/02699050902788519

Register-Mihalik, J. K., Cameron, K. L., Kay, M. C., Kerr, Z. Y., Peck, K. Y., Houston, M. N., . . . Marshall, S. W. (2019). Determinants of intention to disclose concussion symptoms in a population of U.S. military cadets. Journal of Science and Medicine in Sport, 22(5), 509–515. doi:10.1016/j.jsams.2018.11.003

Shapi’i, A., Mat Zin, N. A., & Elaklouk, A. M. (2015). A game system for cognitive rehabilitation. BioMed Research International, 2015, 1–7. doi:10.1155/2015/493562

Silverberg, N. D., & Iverson, G. L. (2013). Is rest after concussion “the best medicine?”. Journal of Head Trauma Rehabilitation, 28(4), 250–259. doi:10.1097/HTR.0b013e31825ad658

Sullivan, K. W., Solomon, N. P., Pramuka, M., Quinn, J. E., Teixeira, K. A., & French, L. M. (2015). Computer-based cognitive rehabilitation research in a military treatment facility: Recruitment, compliance, and lessons learned. Work, 50(1), 131–142. doi:10.3233/wor-141986

Ziino, C., & Ponsford, J. (2006). Vigilance and fatigue following traumatic brain injury. Journal of the International Neuropsychological Society, 12(1), 100–110. doi:10.1017/s1355617706060139