Invisible Disabilities

Uncovering Invisible Disability: Acquired Brain Injury (ABI)

What is an Invisible Disability? ‘Invisible Disability’ is an umbrella term encompassing disabilities that are not visibly apparent. This includes chronic physical, behavioral, cognitive, and neurological conditions that significantly impair a person’s day-to-day life (1). The impairments resulting from an Acquired Brain Injury (ABI) are an example of an invisible disability, as they may not be visibly represented through any physical markers such as walkers, or wheelchairs. Often, ABI symptoms include issues with memory, concentration, problem-solving, language, and more. These symptoms can pose challenges to a survivor’s daily life; however, since they are not apparent on the outside, misunderstandings, judgments or false perceptions can often be placed on those living with invisible disabilities. For this reason, it is important to understand and raise awareness for ABI as an invisible disability, and work to overcome its associated stigma and stereotypical ideals of what disability means. 

What is an ABI? An Acquired Brain Injury is the umbrella term for all brain injuries post-natal, and refers to any type of brain damage that is not hereditary, congenital, degenerative, or induced by birth trauma (2). It can include damage sustained by infection, disease, lack of oxygen or a blow to the head. 

This includes the subset of Traumatic Brain Injury (TBI), (3), which includes injury due to physical trauma such as a car accident, fall or sports related injury. When there is a hard blow to the head, the brain slams against the skull which leads to bruising, swelling, bleeding, or concussion. As well, a TBI may be due to medical issues, like the onset of a brain tumor or brain hemorrhage. The severity of the injury can range from a temporary loss of consciousness to a coma causing lifelong effect to an individual’s ability to function. 

Non-Traumatic Brain Injury (nTBI) is also considered an ABI, and includes damage to the brain caused by internal factors such as anoxia (lack of oxygen to the brain), meningitis, encephalitis, stroke, or other non-hereditary neurodegenerative diseases. 

The effects of an ABI vary from person to person, and range from mild to severe. The prognosis (direction/likely course that a medical condition will take) and long-term effects of an ABI are thus difficult to predict. Common symptoms include increased fatigue (mental and physical), reduced speed of processing, planning and problem solving. Changes to behaviour, personality, physical and sensory abilities, or thinking and learning are also possible.

The Impact of Stigma on Individuals with ABI: The stigma faced by ABI survivors is due largely in part to ABI being an invisible disability. Since it is not possible to gauge the severity of an ABI upon first glance, people may not respond appropriately to a person living with an ABI.

With a lack of knowledge and awareness,  people may refuse to acknowledge the severity of impact caused by an ABI, and consequently not provide ABI survivors with the appropriate support, empathy, and accommodation they require to positively participate in society (4). If a survivor’s experience is invalidated in this way, many harmful effects may ensue. For instance, a survivor may be reluctant to seek help or treatment, in fear of not being accepted and understood for what they have gone through and how that affects their needs now (5). As well, stigma in the form of negative attitudes and a lack of understanding by family, friends, or even acquaintances may lead to social isolation, feelings of shame and hopelessness, and an overall decline in mental health (4). 

Stereotypes and misconceptions about ABI survivors may also induce discrimination and stigma. This can look like considering a survivor of ABI to be less qualified for a job, less capable of performing in a sports team, or unable to perform up to par with other students, because of their disability. Treating ABI survivors as less than in this way is harmful to their self-perception and can ultimately damage their self-esteem (5).  This treatment can be discouraging, and can deter an ABI survivor from working towards their aspirations and living a fulfilled life.

Supporting Those with ABI

Whether you want to make a positive impact in the life of an ABI survivor in your community, or advocate for and raise awareness of ABI as an invisible disability, there are steps you can take to show your support (6):

• You can start by learning more about ABI through articles, community associations, or other resources online. 
• Be an advocate for the ABI community, stand up against misinformation, misconceptions, and stereotypes surrounding ABI when you encounter them. 
• Most importantly, you can also work to understand how your own behavior and biases may be reinforcing stigma and stereotypes placed on the ABI community. 
• Finally, you can show up for the community through fundraising or donating to ABI initiatives, or volunteering for your local Brain Injury Association. 

References

1. Lorenz Laura S. LS. Visual metaphors of living with brain injury: exploring and communicating lived experience with an invisible injury. http://dx.doi.org/101080/1472586X2010523273 [Internet]. 2010 Dec [cited 2022 Mar 18];25(3):210–23. Available from: https://www.tandfonline.com/doi/abs/10.1080/1472586X.2010.523273 

2. Definition – ABI [Internet]. [cited 2022 Mar 18]. Available from: https://abinetwork.ca/individuals-families/about-brain-injury/definition/ 

3. Greenwald BD, Burnett DM, Miller MA. Congenital and acquired brain injury. 1. Brain injury: epidemiology and pathophysiology. Archives of Physical Medicine and Rehabilitation [Internet]. 2003 Mar 1 [cited 2022 Mar 18];84(3 Suppl 1):S3-7. Available from: https://europepmc.org/article/med/12708551 

4. McClure J. The Role of Causal Attributions in Public Misconceptions About Brain Injury. Rehabilitation Psychology [Internet]. 2011 May [cited 2022 Mar 18];56(2):85–93. 

5. Hagger BF, Riley GA. The social consequences of stigma-related self-concealment after acquired brain injury. Neuropsychological Rehabilitation. 2019 Aug 9;29(7):1129–48.

6. Venville A, Mealings M, Ennals P, Oates J, Fossey E, Douglas J, et al. Supporting Students with Invisible Disabilities: A Scoping Review of Postsecondary Education for Students with Mental Illness or an Acquired Brain Injury. http://dx.doi.org/101080/1034912X20161153050 [Internet]. 2016 Nov 1 [cited 2022 Mar 18];63(6):571–92.