repeated suffocation could lead to a brain injury.
They can, it's called hypoxic brain injury. This is the kind of brain injury that usually leaves people "brain dead" or PVS, or minimally conscious. So it can be very severe.
But when we think of "injury" hypoxia isn't as intuitive, but it still "counts." It's sort of the same thing as whether or not saturating your brain in poisonous chemicals at age 8 is enough to cause "brain injury." If not injury, then certainly there are changes in the way that the brain activates, the areas that light up during tasks, and areas that should be lighting up but are much darker, or areas that shouldn't be involved at all which
are involved.
So, like, is a child with a congenital lack of activation in the medial prefrontal cortex, "brain injured?" Neurodivergent? There's nothing wrong with them and they are just "bad people?" We would probably not consign them to the same realm as a TBI patient who throws an object or screams in anger - the MPFC deactivated child would instead be consigned as "fully cognizant" of their actions and "non-personality disordered."
But yet the clinical relevance remains - there is a distinction and that has real-world impacts on their behavior. (Interestingly enough, the overlap of how ADHD brains process oxytocin and dopamine shouldn't be ignored, either.) So how much of this is "brain injury" versus neurodivergence versus "neural activation discrepancy" or post-concussion syndrome, blast/shock injuries, intermittent explosive disorder, fetal-alcohol syndrome, drug addiction...
For ex I just learned recently that high doses (well beyond therapeutic) of the medication I actually take to regulate my sensory input (dextromethorphan, the active ingredient in newly-approved Auvelity) is associated with structural changes of the occipital lobe. (Olney's lesions were never, ever proven to occur in humans, but these results are more concrete.) So not only do I have a CVI from physical damage (force, mass and velocity) but there is the potential that these symptoms are made worse by my excessive use of this substance in childhood.
Is that a TBI? TBI-adjacent? Compounding damage?
As we
think about what a brain injury is? That is, being caused by physical forces acting in nature? No, since the equation of force and velocity is not present in the same manner (that is, you are not having your head smashed in). But like, you can get brain injury from surgery. You can get brain injury from drug overdose. (Most of that again is hTBI). And you can definitely get it from being deprived of oxygen. The reason I bring all this other stuff up is because it's fairly ubiquitous that PTSD and TBI go together, but what is less commonly discussed is the intersection of neurodivergence and PTSD relative to attachment and goal/reward-seeking.
(So ex: we know that PTSD has higher rates of substance abuse - is that because of an existential cause, like "their pain is so great they must use substances to cope"
or is it relative to the changes in the structures of how they process dopamine and oxytocin, which are regulatory chemicals in sensory input && human bonding? Or, more likely: both. -> worth noting I have both SUD, ADHD, TBI, RAD and PTSD. So uhhhhh
my brain? Be borked.
So how much is one thing impacted by the other? Who rightly knows.)
