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By On June 5th, 2018

Domestic violence survivors face the real concussion crisis

War veterans. Football players. Victims of domestic abuse. All of these are among the most vulnerable to repeated head trauma that can have lifelong implications, but only one continues to suffer in silence.

While the NFL and Department of Defense have been forced to publicly reckon with their roles in placing people at risk for brain injury, holding the perpetrators of domestic abuse responsible for the injuries they’ve caused can be much more complicated. According to neurologist Glynnis Zieman, many don’t even realize they have brain trauma.

Zieman works with survivors of domestic abuse every day at her practice, where she runs the first program dedicated to treating TBI in survivors of domestic violence. Initially, she says, most come to her seeking help for physical symptoms, like headaches, exhaustion, dizziness, or problems sleeping. However, Zieman’s research has shown that these symptoms are almost always signs of more serious issues like post-traumatic stress disorder and traumatic brain injuries.

While there are numerous factors that could prevent survivors of domestic abuse from recognizing the signs of brain trauma – such as lack of public awareness efforts – Zieman suggests the biggest issues stem from how the health care system handles victims of domestic violence.

For starters, approximately 70% of people treated in the ER for abuse are never actually identified as victims of domestic abuse. Many are also afraid to tell health professionals about their abuse out of shame and fear of retribution from their abusive spouse.

“They have been labeled for so long with all these horrible things,” Zieman told NPR.

A 2016 review of Zieman’s program found that less than one-fifth had been treated by a physician for their injuries. However, her clinic determined that 88% had experienced more than one head injury from abuse.

Further, survivors of domestic abuse face more severe and more repeated injuries than the typical athlete or veteran.

“About 81 percent of our patients had so many hits to the head, they lost count, which, you compare that to athletes, is astronomical,” Zieman explained.

This high number of brain injuries in quick succession make treatment more complex and can cause more severe, long-lasting symptoms or disability.

“One single athletic concussion is hard enough to treat, but these patients are beyond that,” Zieman said. “Unlike athletes, they do not have the luxury, if you will, of recovering after an injury before they are injured again.”

While most estimates suggest approximately 10 million people are affected by domestic violence every year, the number is likely higher when considering the chance of underreporting.

Because of the lack of research and poor understanding around brain injuries from domestic violence, Zieman says the medical community is still in the early stages of truly uncovering the effects of repetitive head trauma, but she says her clinic aims to help expand our understanding of TBI the best way she knows how – treating survivors of domestic abuse.

“I feel that we can make the biggest difference for these patients,” she says.

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