Saturday, January 30, 2022-This is a day to reflect on those lost to CTE, how to help those suffering with the disease, and most importantly how to stop the disease.
What is CTE?
CTE, Chronic Traumatic Encephalopathy, is a brain disease that is degenerative and progressive.
It occurs as a result of repetitive head impacts. CTE has been found in people with or without a history of concussions. Concussions may add to the likelihood of getting CTE, but the biggest factor seems to be the length of time exposed to sub concussive hits. CTE was originally only thought to exist with boxers, but it was later discovered in victims of physical abuse, head banging and poorly controlled epilepsy. Now it is being associated with athletes playing contact sports including American football, ice hockey, soccer, wrestling, extreme sports, as well as veterans and military personnel with a history of being exposed to repetitive hits from training or blasting. One of the largest concerns is the growing discovery of CTE in high school and college athletes and tragically athletes who only played sports at the youth level.
The brain of a person with CTE gradually deteriorates and tau proteins begin to become defective and interfere with neuron functioning. At the current time CTE can only be verified through a specific autopsy. But there is a growing consensus among researchers that see the possibility of a clinical diagnosis of CTE, or TES (Traumatic Encephalopathy Syndrome). The clinical presentation of CTE usually begins with a lack of behavioral control: explosivity, impulsivity, rage behaviors, paranoia, violence, and loss of control. In most cases mood behaviors such as depression and anxiety occur. Memory issues, executive functioning deficits, and attention problems have also been noted. Addictive behaviors and suicidal thinking are also associated with CTE. Since often times the onset of CTE symptoms occurs many years after the RHIs, it is imperative for doctors, family members, morticians, policing entities, and rehab facilities to look for the possibility of CTE through examination of the history of each individual.
Symptoms of CTE
Mood and behavior symptoms
Among individuals diagnosed with CTE, some report mood and behavior symptoms that can appear as early as the patient’s 20s. Common changes seen include:
- Impulse control problems
- Aggression
- Mood swings
- Depression
- Paranoia
- Anxiety
Cognitive symptoms
Most patients with CTE eventually experience progressive problems with thinking and memory, including:
- Short-term memory loss
- Confusion
- Impaired judgment
- Dementia
Cognitive symptoms tend to appear later in life, often in a patient’s 40s or 50s. Patients may exhibit one or both symptom clusters. In some cases, symptoms worsen with time (even if the patient suffers no additional head impacts). In other cases, symptoms may be stable for years before worsening.
Sleep symptoms
A 2020 study from the VA-BU-CLF Brain Bank suggested that problems with sleep, specifically symptoms associated with REM behavior disorder, may be related to CTE pathology.
Tips for Daily Living
Write things down: If you have concerns about your memory, writing things down can help you be more productive and maintain a sense of control over your life. Whether you keep a notebook, use voice memos or put in calendar reminders on your phone, a system can help.
Develop a routine: Creating structured environment, planning tasks to complete and goals to accomplish can help with creating a sense of stability. Whether it’s sleep, cooking breakfast, or going for a nature walk, approaching one task can make life more manageable.
Control impulsive behaviors: Studies show CTE can damage parts of the brain that regulate impulsive behaviors. Be cognizant of unhealthy habits like gambling, overspending money, using alcohol, drugs, or other addictive substances to cope with problems. Avoid these activities as needed or seek professional help.
Self-regulation: Managing emotion, anxiety, and stress is an important and learned skill. Practice relaxation techniques like deep breathing, meditation, or counting to 10 to help ensure your emotions don’t get the best of you. Seek professional help to find the right techniques for you.
Build a support system: Reaching out to people you trust can help get you through moments of stress. Friends, family, colleagues, a church community, a hobby or sport club, or a crisis hotline like the National Suicide Prevention Lifeline can all serve as sources of support. If you are concerned about your safety in a moment of crisis, you can make a safety plan to guide you through those especially difficult moments.
Live well with sleep, exercise, and nutrition
Sleep: Get good sleep. Your body needs a full night of rest every night to function at its best. Sleep disorders like sleep apnea can cause mental fogginess and headaches, and poor sleep can affect self-regulation and emotion. Be disciplined in your sleep habits, and, if necessary, seek professional help.
Watch Dr. Robert Stern, director of clinical research at the Boston University CTE Center, explain how getting adequate sleep can help the brain fight off the effects of CTE and other brain disorders:
Exercise: Don’t underestimate the benefits of regular exercise. Regular exercise can relieve stress, help with pain, and improve overall well-being. And remember, what is good for your heart is also good for the vascular system in your brain. Be sure to consult a doctor before beginning a program.
Nutrition: Maintaining a well-balanced diet can help you feel better and regulate energy levels. Consider consulting a dietitian.
Learn more about how diet and exercise can help you fight suspected CTE from Dr. Robert Stern:
Maintain hope
It is crucial that someone who is concerned they may be living with CTE remains hopeful. Hope and help are available and happening every day. Watch Dr. Robert Stern explain why CTE is not a death sentence, how those who are suffering can have hope that their symptoms can be treated, and why loved ones are so important in instilling that hope.
Seek out treatment and research
Treatment: Talk to your doctor. Since we cannot yet accurately diagnose CTE in living patients, there are few evidence-based treatment protocols. However, many specialists can treat a patient with suspected CTE by treating the symptoms you find most challenging.
Research: You can help accelerate research on CTE risk factors and pathways to effective treatments by enrolling in research studies.
Reach out for help in times of crisis
It is okay to feel anxious or worried if you believe you or a loved one may have CTE. But you don’t have to cope alone. If you are in emotional crisis or concerned about a loved one, call the National Suicide Prevention Lifeline at 1-800-273-8255 to connect with a trained counselor. It’s free, confidential, and available to everyone in the United States. You do not have to be suicidal to call.
If you are concerned that someone you care about may be in crisis, there are simple actions that you can take to help. The 5 #BeThe1To steps are a step-by-step guide to helping someone that may be suicidal.
Sources:
https://stopcte.org/whats-cte/
https://concussionfoundation.org/CTE-resources/what-is-CTE
