The Hidden Battle: Mental Health and Post-Concussion Syndrome with Nate Pope

Welcome to Overcome - a Mental Health Podcast.

In this episode, we speak with Nate Pope. We discuss post-concussion syndrome and the effects it has on mental health as well as the steps to start healing. 

Nate Pope is a Neurological Occupational Therapist specializing in innovative brain recovery techniques. As one of the founders of NCX Brain Recovery, he's helped pioneer multi-sensory integration therapy for concussions, traumatic brain injuries, and post-concussion syndrome. With over 20 years of experience, Nate helps listeners understand cutting-edge approaches to brain health and rehabilitation, offering hope and practical insights for those affected by neurological challenges, especially those dealing with post-concussion syndrome.

Find out more about NCX Brain Recovery:

https://www.ncxbrainrecovery.com/

If you or someone you know is struggling with the effects of a concussion, traumatic brain injury, or post-concussion syndrome, NCX Brain Recovery offers hope through innovative, personalized treatments. Schedule a free consultation with one of our neuro-occupational therapists to take the first step towards better brain health. Visit our google calendar to book your free consultation today.

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Transcript

Travis White (00:01.466)
Hello and welcome to Overcome, mental health podcast, a place where you can freely share your stories. Tonight's guest is Nate Pope. I'm very excited to have Nate on tonight. He is on deals with the cutting edge of rehab from post concussion syndrome or mild traumatic brain injury. And I will let Nate go into a little bit more details about himself.

Nate Pope (00:27.694)
Okay. I like self-introducing sometimes because then I don't, you know, it doesn't get overdone. no, I feel like I just got fortunate to be thrown into this almost, you know, your paths don't always go where you think they'll go. And I just wanted to help people in the beginning and I didn't know how to do that the best. I eventually...

Travis White (00:35.149)
Hehehehe

Nate Pope (00:55.97)
my path led to helping people who have had a head injury and are suffering from the symptoms that did not resolve. In most cases, that's post-concussion syndrome is the official diagnosis. But a lot of mild traumatic brain injuries, basically the same thing as post-concussion syndrome. And just figured out that there was

There's almost always a path to recovery for these people if they do the right things. And that was exciting to see someone's quality of life that had suffered so much after their head injury regain that quality of life and have the symptoms dissipate and resolve and eventually go away. That was just...

It's kind of a therapist dream job really. And so I'm a neurological occupational therapist is what I am. I've worked in pediatrics for 22 years with kids of all sorts of disabilities, but a lot of them are brain related conditions. And then three and a half years ago, together with another therapist who's my brother.

Travis White (01:55.92)
Yeah.

Nate Pope (02:21.986)
We started the therapy side and we have a business partner as well that we're focused on concussion rehab. And that's because 11 and a half years ago, I started with another place that's a lead in the research, kind of pioneering the research for post-concussion syndrome and mild traumatic brain injury stuff.

Just had some awesome experiences there, but saw that maybe the therapy side could even be built on that. And so, super grateful for the beginnings and what led me in this direction with them. And then this last three and a half years has been just quite a ride and adventure and just love seeing people's lives change. So that's what brought me here. That's why I do what I do. And that's probably enough.

Travis White (03:18.064)
That's perfect. It's exciting. Well, can you, one of topics I wanted to get into, like right off is how concussions, the kind of the link to mental health there and what type of mental health issues that concussions can cause.

Nate Pope (03:18.262)
of an intro.

Nate Pope (03:34.446)
Mm-hmm.

Nate Pope (03:39.054)
Sure, sure, yeah, that's a great topic to start with. Boy, it's a little bit of a heavy topic sometimes too because the severe end of that could even be suicide. When the quality of life goes so low that you just can't see a way out and you...

You've hit your head, you've gone to every professional, most of them go through the medical, well, I hit my head, it's probably my brain, something's wrong, and they get an MRI and it says they're fine. 90 plus percent of the people who have hit their head have symptoms that don't resolve, have MRIs that say you're fine. And that is discouraging because they know they're not fine.

they've got symptoms, a myriad of symptoms, know, headaches and memory issues and dizziness, lightheadedness, blurry vision, word retrieval challenges, and then the whole emotional, mental, you know, the dysregulation stuff, which leads to anxiety, depression, irritability, apathy, just lack of motivation, and just feeling

maybe really over emotional, really emotional. Just all of those things are often, more often than not, part of post-concussion syndrome, which is what happens when you've hit your head and you have unresolved symptoms. The MRI is right. Your brain is healthy brain tissue. Where it's wrong is that you can have healthy brain tissue not working right.

Certain parts of your brain are not doing the job they were designed to do. They're knocked off line, so to speak, with that impact. And what happens is other parts recognize the urgency of needing to still function, and they can take over those jobs. And they compensate and do the job that they weren't designed to do. You can see this on functional MRIs, not a regular MRI. But can see the blood flow going...

Nate Pope (06:02.552)
to the wrong parts of the brain and not enough blood going to the parts that are designed to do those tasks. It's cool that our brain can compensate that way, but it's not cool when it doesn't reset. And in most concussions, about 70 to 75 % of those just resolve on their own without any extraordinary interventions even. People get concussions and mild TBIs.

quite frequently and recover without more than just a little bit of therapy. that's still a pretty big population, 30%, 25 to 30%. If you've had more than one concussion, of course, your chances go up, that percentage. So you're very likely, if you've had multiple concussions, that you have some symptoms that haven't fully resolved.

Travis White (06:42.0)
Yeah.

Travis White (06:49.646)
deserve. Yeah.

Nate Pope (07:00.562)
and you have a healthy brain in terms of healthy brain tissue just not doing its job right. I guess the big hope side of this is that because that's the case, you have healthy brain tissue and it's just some inactive areas of your brain and over other areas compensating for that and being overactive, that's totally resolvable. is therapy can.

reengage the areas that have disengaged and when that happens just symptoms start going away because The the thing that causes the symptoms is that the brain? Parts of that are just not doing what they're supposed to do and the parts that are taking over are not great at it They're they're they're compensating but they weren't designed for that and it's almost like an overheating engine because they just are working harder and

Travis White (07:47.29)
Mm-hmm.

Nate Pope (07:58.082)
So it's pretty exciting. Most of the symptoms are things that you can recover from, and we see it all the time.

Travis White (08:05.488)
Yeah, kind of a crazy story, but I had a nephew that or have have a nephew when he was, I think he was like 13 or 14 at the time. He actually got hit in the head with a baseball bat by accident. Somebody was just swinging it back. He ducked down and it clobbered him just right in the back of the head. And at that time, nothing happened. Like he went to the hospital and they got an MRI and

I, if I recall, if I'm recalling right, he, no signs of concussion. Like I don't know how he got so lucky. So what, go ahead.

Nate Pope (08:41.25)
Yeah, yeah, yeah, some, yeah, some just, yeah, it's kind of crazy because you can have something pretty minor turn into a concussion or something like that, not be a concussion.

Travis White (08:52.654)
Yeah. And now does it have to be like a certain part of the head that gets hit? No.

Nate Pope (08:58.606)
Nope, nope. Essentially it's an acceleration, deceleration injury where the brain is going a certain speed and stops so abruptly and you have movement inside the skull. And it's not even the pressure against the hard skull like we kind of thought too. It's more the stretching of neurons and the movement, certain parts of the brain are more dense or less dense.

And it just creates a little bit of a stretching and shearing force inside the brain. You'll have a lot of your symptoms are more related to the middle part of your brain. You're like, how did I injure the middle part of my brain? But it's because everything, when that brain is going a certain speed and then stops, you have some shearing and stretching forces of the neurons and then things you hope that they just reset and you get, you're fortunate to be one of those.

Travis White (09:42.874)
Mm-hmm.

Nate Pope (09:58.936)
that often, you know, about 25 to 30 % don't. And they're the ones left with symptoms. And then the brain is a creature of habit. Unfortunately, in this case, that means when it compensated, if it did it for long enough, it would stick. And unfortunately, a of people believe that the cocooning is what we call it, that going into a dark room doing nothing.

is the best thing to do for your brain. And they would do that for days and weeks and that is not what you want to do.

Travis White (10:36.388)
That's actually interesting because I'm one of those people. That's what I've always thought. That's what we've, I've been taught like my whole life.

Nate Pope (10:41.708)
Yeah, yeah, that's prevalent. Yeah. Yeah, it's

Travis White (10:46.577)
So what types of therapies and things are the best to do for this type of situation?

Nate Pope (10:52.526)
Yeah, so well, if we're talking about the acute stage, I just got a head injury and I have these symptoms. Really, there are some things that people should be doing so they avoid coming to us. And we tell them all the time. It's not a great marketing strategy actually, but we try to help people recover just by, if you can get blood to your brain via, you know, the most natural means is cardio. You can do

cardio, but it's got to be non-jarring cardio. Jogging is even too much bouncing. Walking is okay, but you can't really get a lot of cardio with walking unless you're one of those really good speed walkers. But like a stationary bike is acceptable because you're not bouncing. Swimming is a great way to get cardio. So if you can get cardio, blood to your brain. So this is, you can see very opposite, very different from sitting in a room doing nothing, a dark, quiet room.

Travis White (11:51.716)
Mm-hmm.

Nate Pope (11:51.918)
I'm doing nothing. Now the dark is a problem because that's you're eliminating visual stimulation. Quiet is a problem because you're eliminating auditory stimulation. If you're not with people, you're also not being verbal. So you're basically depriving yourself of visual, auditory, verbal, and vestibular proprioceptive. Those are like the movement centers. You're depriving yourself of all stimulation and hoping your brain will reset.

Travis White (11:57.072)
Mm-hmm.

Travis White (12:19.78)
Yeah.

Nate Pope (12:21.518)
Ha

Travis White (12:22.604)
And to me that saying going back to where you mentioned that, you know, concussions can cause depression and anxiety. If you're going into a room, there's no way that's going to be good for your, especially your depression. It's just going to make it worse.

Nate Pope (12:39.672)
Yeah, yeah, for sure. Yeah, you want a bunch of neurochemicals that are gonna, like dopamine among many others, that you're not gonna get by doing nothing sitting in a dark, quiet room. So you need oxygen via the cardio, because oxygen is something you want as part of many neurochemical things that we want to happen for.

brains to recover and reengage with a brain injury. So you want oxygen present and then, know, dopamine is another big one. But anyway, you deprive yourself of a lot of what you need when you do nothing and you don't and you're depriving yourself of a lot of stimulation. Now, that being said, there's a reason that that was recommended in the first place because

overstimulation if you jump back into work or school something pretty stressful and a lot of demands in all of those areas that's too much and that that can cause problems but because that was too much I think it turned into a blanket statement of avoid all of that and it's actually the exact stuff you need but in a very smaller more controlled dose you need to go like going for a walk in the park

while talking to someone. Might be one of your best ways to get the stimulation and you just would need the cardio to add to that. If you do like a stationary bike a couple times a day, get your heart rate up, get that cardio and then you go for a walk with someone outside where your visual processing and the challenge visually is a lot greater outside than inside. So if you can go out.

And if you're with someone and can engage in conversation, but more like not thought provoking deep thought stuff, this kind of casual small talk stuff, that would be a great way to reengage the brain and would actually lessen your chances by about 80 % of having prolonged symptoms. So if you do the right things in those first two to four weeks after a concussion, your likelihood of having

Nate Pope (15:01.55)
post-concussion syndrome or having prolonged symptoms is drastically reduced. So we try to help people with that part. We've just created an acute care program to help them through that. But a lot of people, and most of who we're dealing with, have the mental health stuff, depression, anxiety, the apathy, lack of motivation, irritability, all of that.

Those are the people who haven't caught it or figured it out for whatever reason in that first month. And the brain is a creature of habit. And so unfortunately now it's gonna keep doing that pattern. And it's not a healthy one, so.

Travis White (15:44.388)
Yeah. So like with post-concussion syndrome, like what are some of the signs to like kind of look for, like, you know, thinking like, you know, this, this might be what's going on.

Nate Pope (15:52.718)
Sure.

Nate Pope (15:56.876)
Yeah, yeah. So, I mean, the chronology of hitting your head and then having symptoms, that's the biggest telltale thing, you know, that they're probably connected. I hit my head, now I have symptoms, and they're not resolving. So that's the biggest thing, like, okay, it's been a month after I had a concussion or a mild TBI, and these symptoms haven't resolved all the way.

Travis White (16:07.866)
Mm-hmm.

Nate Pope (16:24.192)
or have gotten worse or just stayed the same, whatever it is, they're just still there. That's almost for sure post-concussion syndrome. So that's the biggest thing that can help someone know that that's what's probably going on. I hit my head, have symptoms, they haven't gotten better. It's been a month or more. The other thing that helps you know more, we have a symptoms checklist. There's about 40 different symptoms on there that we go through.

and we talk about severity of each of those 40 symptoms from a 0 to 6 severity. And the severity helps us know, but also how many of those you have that are kind of specific to post-concussion syndrome, like headaches, mental fatigue, brain fog, blurry vision that sometimes it's clear, sometimes it's blurry, usually for most people.

That's more of a brain thing than an eye thing. Word retrieval, it's hard, you you find yourself in conversation, it's just hard to engage like you used to. You can't come up with the words. Those kinds of things. You could have some more like physical symptoms like nausea, balance issues, lightheadedness. Light sensitivity and noise sensitivity are also very characteristic.

And then I mentioned all the emotional dysregulation, anxiety, depression, irritability, apathy or lack of motivation and just feeling less or feeling really emotional more than normal. But you might also have physical fatigue. Let's see, what are some others? Sleep. So if your sleep habits are messed up big time.

Travis White (17:57.508)
Mm-hmm.

Nate Pope (18:22.294)
in any way, can't fall asleep, can't stay asleep. When I wake up, I don't feel like I got good sleep. Like I'm drowsy during the day and I didn't used to be. Those are some signs. And then memory is a big one. Like walk into a room, I'm like, why did I, why am I here? What was I doing? Like.

You're forgetting stuff all the time, finding yourself having to write stuff down that you used to be able to remember, but now you're just relying on external ways of getting it down. So you're writing everything down and you have to try to be more organized that way. Lack of organization skills. There's more on the list, but that's some of the bigger ones.

Travis White (19:17.614)
So if you get like a start feeling like you have a concussion or whatever and it's like the beginning signs of it, like those people that are just starting to get it, like what do you tell those people to do? Is it still the cardio stuff or would you tell them something different? Like.

Nate Pope (19:37.634)
How long since their concussion are you talking?

Travis White (19:41.282)
say you know something just like I got hit in head by something like a couple hours ago and I'm starting to see these signs come up yeah yeah right away

Nate Pope (19:48.596)
yeah, so right away. Mm-hmm, yeah. Yeah, so if you're in that acute stage right away, like right after, you're okay to rest. Like you might have a huge headache, you know, that's sometimes, and that's normal. Don't like, you know, you don't want to panic. Now, if you have like seizures that come after you've been hit, you've got vomiting, uncontrolled vomiting.

Travis White (20:04.046)
Mm-hmm.

Nate Pope (20:19.162)
You've got, you're passing out frequently. Those are things you got to go to the emergency room for. Like those are like 911, like, or just go, you know, so I'll have somebody just take you there. Those are things you need medical attention for, because you may have a brain bleed. These are the people who get an MRI and they say, oh, there is something there, you know, a lot of times. And so you got to go get that stuff checked out. Those extreme symptoms.

Travis White (20:30.234)
Yeah.

Travis White (20:42.095)
Yeah.

Nate Pope (20:46.072)
But if you just have a headache, you're like, man, I got a headache and my vision's a little bit blurry. And like, I keep repeating myself. People tell me I'm saying the same thing over and over. Those are some of the more common things we would hear memories off. And sensitivity to light and sound, that's often part of it too. So if you get some of those right away and you've just had a concussion, and this is like within hours or days, like,

what you want to do within hours, like after. It's okay to rest a little bit. Don't go to sleep. That's not going to sleep, but take it easy. It would be nice to just go somewhere and chill. Just do the chill mode, not sleep mode, not engage in be active mode. Do not go back into the game. If you got, if you're an athlete and it was during the game, don't jump back in there. You know, pull yourself out. Hopefully your coach and trainers do, but.

Travis White (21:44.976)
Yeah. You stole my next question right out of my mouth. I was just going to ask like, is it okay to go to sleep? But you said it's not. So, cause I remember my nephew played football and he got a slight concussion. Is he the football or wrestling? And they said, don't let him go to sleep. Just watch him and make sure it's pretty quiet around where he's at. And just want to make sure that wasn't a myth.

Nate Pope (22:04.227)
Yep.

Yes, yeah, yeah, that is, nope, that is the right thing to do right after. But, you know, about 24 hours and beyond, that's when you're really wanting to start engaging. Because earlier they found is actually better to start getting that cardio. Then you may just do, you know, 10 minutes is what you can tolerate because your headache gets really bad or whatever. So there might be some...

symptoms exacerbation that happens, but you really want to get blood to the brain and doing the non-jarring cardio and then just continue doing mild stimulation, know, going for walks, talking with people. Just anything that you normally would do, you could do it in chill mode. You know, that would be maybe a a good easy way to think of it, but

Travis White (22:57.776)
and

Nate Pope (23:04.354)
And then just kind of see how things go. Hopefully, if you're in the acute stage and you're doing the cardio twice a day and you're doing chill mode, most of those reset and they don't have to worry about anything that I deal with. They don't have to come to us. And if they talk to us and then they say, hey, I'm all better, I'm like, great. I'm glad you don't have to come to us. But the ones who do, it's still pretty positive.

Travis White (23:28.59)
Yeah.

Nate Pope (23:33.548)
because a lot of them have been actually months or years of searching, usually. We're often, unfortunately, they find us too late. They've already had suffered for a long time, but not too late for recovery though. So the fortunate thing is, is hey, that's okay. You've been 20 years and you've got ingrained habits, but guess what? We have people that have been 40 years.

Travis White (23:47.077)
Yeah.

Nate Pope (24:01.774)
within CrayonHab that are recovering from this stuff. It'll take you a little longer than somewhat spend one year. Yeah.

Travis White (24:05.338)
That's, yeah, that's, that's insane. 40 years dealing with all this stuff. Like I, it took me about, I guess, 15 years to kind of, or at least 10 years to kind of get an official diagnosis of my neurological problems. So, so I can understand not necessarily the concussion side of it, but it's very relatable what you're saying. Like very relatable.

Nate Pope (24:24.494)
Mm-hmm.

Nate Pope (24:36.238)
Yeah, well, it's good to be a place of hope because honestly, most head injuries, the traditional approaches are an hour a week or a few hours here and there or whatever insurance and that is what insurance will pay for often, you know, and you want to change a brain pattern. know, brain, this is a very ingrained habit.

Travis White (25:04.624)
Mm-hmm.

Nate Pope (25:04.706)
These neural pathways are well established, compensatory neural pathways. They're compensating, not working the way they should, but they have been doing it for a while and they are very, like, it's pretty solid, you know, these pathways. And you want to change that in one hour a week. Like the brain, for that one hour, it's just going to compensate harder. It's not the areas that are already over engaged are just going to work harder.

to compensate harder, very rarely does a little bit here and there approach lead to recovery for post-concussion syndrome stuff. So most therapists and clinicians give up pretty early on, fix it. They very quickly jump in to deal with it approaches. And most of the therapies are just focused on, gosh, you're still light sensitive. Just wear sunglasses, that's your answer.

Oh yeah, headaches and anxiety and depression and ADHD. Oh, guess what? Medication is probably your best option. We're going to do meds for all of that and sleep too. Yeah, we'll just do sleep. And also maybe go to a psychologist, you know, and not that we work with them all the time. You have to have the right, you know, treatment if that's what you need. But if it is onset from a head injury,

Travis White (26:15.28)
Mm-hmm.

Travis White (26:30.064)
Mm-hmm.

Nate Pope (26:34.184)
and you didn't have these mental health issues prior to, you do not have the typical anxiety, depression stuff or ADHD. This is related to your brain not working right, areas that are inactive. This is fixable. This is stuff that we can reengage those areas and those symptoms should get better and we see it all the time.

Travis White (26:45.038)
Yeah.

Travis White (26:58.66)
Yeah, so pretty much when you get rid of the post-concussion symptoms, see that anxiety and depression start to go away for the most part. That's crazy.

Nate Pope (27:08.312)
yeah, yep, yep, yep. It is, it is. And that's what's so rewarding, because people are just miserable. They didn't ease into this either. It's like I was fine, and now I have anxiety and depression and all these things, after I hit my head. So their coping skills are really nonexistent, because they haven't had to deal with it.

Travis White (27:34.212)
Yeah.

Nate Pope (27:35.886)
And then one day, now they do, had, they were in a car accident or in a sports injury or slip and fall something. And now their life has changed and they don't know how to deal with it. There's zero coping. But what they really need is to have those areas re-engaged and fixed because when you address the post-concussion syndrome, you're going to address all of those symptoms and they just start going away. We track them. We do a very

Travis White (28:00.687)
Mm-hmm.

Nate Pope (28:05.368)
detailed tracking daily between eight and 10 times we're asking them about their most five, their five to 10 most prevalent symptoms and where they're at on a zero to six scale on each one of those, just to touch base. We do it real quick so it doesn't interrupt the therapy too bad, but we want to know what's going on. And 95 % of our patients in a two week program, because we do one or two week programs, have 75%.

self-reported reduction in symptoms, which is awesome. Yeah, and we have an eight week aftercare that begins after that. So the aftercare is meant to take care of that remaining, say 25 % that is there because when they're with us for those two weeks, it is like flipping switches, like, this symptoms gone and this symptoms better. It's awesome. And then we kind of...

Travis White (28:38.746)
That's really cool. That's really cool. Yeah.

Travis White (28:59.44)
Mm-hmm.

Nate Pope (29:04.738)
get to where we know what cards we've been dealt by the end of those two weeks. That's everything that's going to reset real quick. And now it's like a dial. And don't give up, because we want this 25. No one who recovers 75 % is like, whew, I'm good now. Thank you. They're more like, thank you so much. But is there possible that I can get the remaining? I want full recovery. And we do too. So we're like, yeah, it's just more like a dial now.

Travis White (29:15.898)
Yeah.

Nate Pope (29:34.732)
It's not like flipping switches. So we just, we give them a very detailed program tailored to their hobbies and their interests and their work and every school, whatever they've got going, we just make it work with their life. And they don't have to do a lot each day, but they do need to do a few things every day. And we follow them for eight weeks just to make sure that by the end of the eight weeks, they have habits and lifestyle changes that they've been able to make. They're doing brain healthy activities on a daily basis that

are just part of the stuff, hopefully, that they enjoy or would do anyways. And they're getting closer, if not meeting that 100 % recovery by the end of the eight weeks.

Travis White (30:16.804)
Yeah. And once you find that kind of the answer to whatever issue you're going through, whether mentally or physically, it's like you want to go the distance. You want to push yourself and be like, you know what? This is awesome. I'm so much better. Yeah. I love that.

Nate Pope (30:29.612)
Yeah, yeah, yeah, yeah, yeah, keep rolling. We feel that way, they feel that way. Yeah, it's fun.

Travis White (30:40.298)
speaking of brain activities, like what are, what are some like good, like basic brain activities just to like keep your brain healthy?

Nate Pope (30:49.934)
So, it's kind of funny because a lot of the therapies out there for years, and many are still, most still do this. If you go to physical therapy, you're gonna focus on, you know, balance and strength and range of motion and those sorts of things. If you go to vision therapy, you're gonna focus on the vision stuff, know, vision therapy. And if you go to speech therapy, you're gonna be, you know, talking and listening and.

them back and forth, but most of them don't incorporate the other things with their therapy. But most real life activities, so I'm like a pickleball lover. So let's say I'm out playing pickleball. I'm not having to engage visually and then move my body and then

call out to my partner that don't hit that it's out, out well, you know, I'm doing it all together at the same time, you know, and therapy should resemble that. That's what life, that's the demands we have in real life. Therapy should, is gonna be more effective if it is a whole brain kind of therapy. So everything we do in our clinic, almost everything, the entire time, and we do seven hours a day.

in clinic time for five days, Monday through Friday, and then two week program, another Monday through Friday. So you feel like you're living in the clinic a little bit, but it's awesome because there's a ton of results in that time. But almost every one of those activities is engaging the body movement and balance centers of the brain. So you're moving, you're doing something, you're on your feet doing something while there's a visual challenge that's.

Travis White (32:29.572)
here.

Nate Pope (32:45.006)
Maybe you're catching a ball that's being thrown to the opposite side of your body. You have to reach across and catch it. While we're probably engaged in conversation that's pretty thought provoking or challenging that way. You know, once you're to the post concussion stage post one month, it's no longer take it easy. Now it's like go crazy. You know, we're trying to reengage the brain and it's safe to do so now. And so we also start jogging.

where it will have like a curved or manual treadmill that you have to keep pace. There's no motor. You are the motor. But we have you looking sideways at targets and talking and engaging in conversation while you're looking in every direction. You're just doing so many things simultaneously. And when you engage the brain, multiple processing areas of the brain simultaneously, none of them can really compensate and cheat that well.

Travis White (33:33.648)
Mm-hmm.

Nate Pope (33:43.534)
Like you're breaking those patterns. It's hard to stay in a compensatory pattern when you do many hours in a row, many days in a row of engaging whole brain stuff. Because the brain has to figure out how to work together and integrate. And it tends to activate whatever's been inactive and then the stuff that's been overworking and compensating can calm down and doesn't have to do that anymore.

Travis White (33:46.192)
Mm-hmm.

Nate Pope (34:12.247)
can do its own job better and then those areas start integrating better and symptoms start going away. And that's kind of essentially what happens. So, but for most of us, like some brain healthy activities we could do, sorry, long answer to your question, but.

Travis White (34:27.716)
Nope, you're good. is all very interesting to me, so this is great.

Nate Pope (34:31.406)
Yeah, you should be doing something that if you can get your heart rate up a little, that's a bonus. Get some cardio because there's some great research on during cardio and the 30 minutes following, your brain is primed for neurodevelopment stuff like neuropathway development. And that's part of recovery as well, but it's also part of just new learning. If you're a student or whatever, know, do cardio right before you study. That's a great idea. anyways.

if you can get cardio as part of it and then do like what we call multi-sensory integration activity. That's multiple areas of the brain that are processing information and having to integrate it. So multi-sensory integration is what we do at our clinic. And you can find natural activities, but sometimes tweaking them a little bit. you know, if you're going for, let's say you're going for a walk.

Maybe you do some interval training and do a little bit of jogging to get that cardio too. But then you're walking, but you're maybe with somebody and you're like Sherlock Holmes on a little walk or a hike. Let's say you're going on a hike and you just have to visually take in every, don't go tunnel vision, go the opposite. Like I am Sherlock Holmes. I'm trying to take in everything I can visually.

and also everything auditory. I'm gonna listen. I'm gonna see and hear everything and try to like think about what I'm seeing and hearing while I'm walking. So I move my body, I'm on uneven terrain. So my brain, when you're on uneven terrain, your brain has to process where your feet are a lot more than when it's on flat. And so it's a very much more brain involved. You can go autopilot.

if you're on a sidewalk or pavement. But if you're on a trail, you know, or an uneven grass or something like that, then the brain has to be more engaged. And so if you're talking with someone while you're on uneven terrain and you're visually noticing everything, then you're going to be just naturally, it's not going to feel like therapy. But that kind of activity is engaging. Body vestibular.

Nate Pope (36:51.014)
Approprioceptive information, those are the balance centers, know, where my body is in space. They're going to be engaged at a high level when you're moving your body on uneven terrain. The visual part, if you're looking for the birds and the trees and you're thinking about them, like, I wonder what that bird or that dog is or that tree or whatever, you know, you're visually engaged or there's my neighbor, you know, what's he doing wearing that? That doesn't match his pants, you know, or I don't know. You're just thinking about what you're seeing, right? And then...

Travis White (37:18.48)
Yeah.

Nate Pope (37:19.862)
And then you're like talking awesome if you could talk with someone and go with someone. That's the ultimate because then you're also having to to listen to what they're saying. Think about what they're saying. Engage in conversation. That's a whole brain activity, but it's pretty natural and is very healthy as people get older. Like they can not only go on a walk, which we already know is really healthy. They can go on a walk with somebody and talk.

Travis White (37:46.608)
Mm-hmm.

Nate Pope (37:49.228)
Walk and talk and also try to notice everything and connect with the environment visually as you're going. Those are some simple things that people can do. There's a million other things, but you can take almost any sport. Like pickleball, for example, it's naturally going to challenge you plenty visually and with your body balance and movement, but it doesn't challenge you as much.

for the auditory verbal stuff, you know? So you have to change that a little bit. I gotta call things out for my partner. I gotta be more vocal player, you know? And I'm gonna call the score out after every score so that I'm working on my memory and I'm working on my verbal stuff. And so you can tweak almost anything though. If someone likes to go to the gym, you just say, okay, if that's your hobby, let's make it a brain healthy one.

Travis White (38:32.144)
Yeah.

Nate Pope (38:48.226)
Don't go tunnel vision anymore. Connect visually with what's going on and maybe go with somebody and talk and engage in conversation. If you can't go with someone, an audio book is better than music. Music is a great way to relax and reset your brain, but it's not the challenge part. An audio book is a lot more challenging. Or a podcast for that matter. I'll put a plug in for the podcast.

But listening to someone where you have to keep listening to engage is a lot more challenging. that's, you're not doing the verbal back and forth thing like you are when you're talking to somebody. But at least you're getting a lot of auditory. So you could be at the gym doing an audio book and being more visually engaged. And that would be your way of going to the gym that's brain healthy. Anyway.

I could go on and on, but I won't.

Travis White (39:48.568)
No, no, you're good. You're good. is, this is all just because like I said before, this is so relatable to like some things and symptoms that I went through, even though it wasn't like concussion related, just kind of neural neurological related in general. But so it's all like, I'm, I'm literally like eating it all up. Cause I really, it's just all been really interesting.

Nate Pope (40:02.051)
Yeah.

Nate Pope (40:08.595)
Good.

Travis White (40:16.366)
I think you've answered most of my questions. me just scroll down here and see. me just one second here.

Travis White (40:30.276)
I think you kind of touch base on this, but so if you have repeated, well, let me rephrase this. So you said like post concussion, like all the, if you take away like, or they go through this therapy and all the mental health symptoms that go away with it, is it possible for like repeat concussions to cause permanent mental health disorders?

Nate Pope (40:55.47)
Yes, but it's not as like like you hear about for example your professional football players CTE like there's there's different levels of concussion if you're getting you know 20 concussions in a day because you know impacts small little impacts like a lineman would

that plays in the NFL or something like that, or MMA stuff, or there's a few people out there that are getting a lot of head trauma that are in a different category of their own. And those are often the ones that end up with those permanent conditions, which you really can't tell without.

Travis White (41:48.954)
Mm-hmm.

Nate Pope (41:50.434)
without an autopsy that they had it. Although you can kind of guess they do because of all of the symptoms that they're having, but they're more extreme. As far as multiple concussions, I've had patients upwards of 20 concussions that have made full recoveries. What the research shows is that if you have reset

your brain, let's say you go through therapy and you've reset and you go through a period of time with no symptoms, your brain is almost like it hasn't had a concussion. And the next concussion is like starting afresh. What's harmful is when you have subsequent concussions and you're not recovering from the previous because then there's a cumulative effect and so your symptoms get worse and worse and your post-concussion syndrome gets worse.

and you're already in post-concussion syndrome and you're getting more concussions. And so if you have unresolved symptoms and issues and you want to continue playing your sport or doing your activity or whatever it is, you got to get those fixed. You need to do the right kind of therapy, which in my opinion is an intense approach, many hours in a row, many days in a row, doing the kinds of things we do in our clinic.

We do free consultation, so it's really like people just call and talk to us. We set up a consultation. We'll go into details of what they're experiencing. It's probably the easiest way for someone to get some valuable free information. There's zero pressure or obligation to come to us. We just like to educate at that point and so we can just help people know. But yeah, usually you don't have to...

Travis White (43:35.289)
Yeah.

Nate Pope (43:41.708)
worry too much like, man, I got permanent debt, you don't want cumulative issues. So you gotta get it treated. It will get worse and it will be a little bit harder to deal with. And a lot of the people who end up on the really bad side of that, you know, with either.

really poor quality of life in the end or suicide. They are ones that just didn't get it treated and just kept going and or didn't know how where to go or what to do. Unfortunately, they a lot of times have been in the system. That's what I would call it where they're getting the one hour a week and and it's just not doing doing it and they're they're using live with it approaches.

and not fix it approaches. And unfortunately, most head injury stuff, well, fortunately, most head injury stuff is healthy brain, not working right, we can fix that stuff. So you never wanna settle for live with it approaches until you've exhausted all of your fix it approaches, in my opinion. So.

Travis White (45:03.397)
Mm-hmm.

Good stuff. And I just have one last question here for you. What advice would you give to someone struggling with mental health issues after a concussion?

Nate Pope (45:12.376)
Yeah.

Nate Pope (45:19.0)
Sure. Well, and this maybe I should say as well, we've treated quite a few that haven't had concussions as well. So this advice could also go for some of them. Some people have had traumatic experiences that present similar to people who have had traumatic head injuries. And it's pretty interesting, but they will also have similar results.

from the same kinds of treatments. We don't know why. We've had people have, you know, we had several women have babies and all of a sudden they had symptoms, you know, or long COVID is another one of those things. And there's just a number of things or PTSD that led to all of these kind of PCS, post-concussion syndrome like symptoms.

So my advice to anyone who's dealing with those symptoms, whether you've had a head injury or whether you're just dealing with similar symptoms for post-concussion syndrome, is to get some professional help with a place that does an intense approach. It's hard to do it on your own. The stuff we make people do is not something that's very easy.

to do on your own and you just, you you need someone to guide you through it. If you push too hard, you have override of the brain, like you don't benefit, like it's almost like shut down. If you don't push enough, you're not bumping that threshold up and so you're not making any changes. So it's gotta be the just right challenge. And to provide the just right challenge,

over and over and over and get the repetition to break a habit, you probably need to go somewhere that does an intense approach. In my opinion, that's probably the best option. And yeah, come for a free consultation is a really great first place to start. Because we're happy to give any specific advice to your situation and give you ideas on what you can do on your own if even coming to us is not possible.

Nate Pope (47:44.558)
We just want to help people that are suffering and if some of them come to us then that's awesome, but if we help a bunch that don't that's also awesome.

Travis White (47:58.266)
Awesome. Well, where can people find you? Like, where can people find out more information?

Nate Pope (48:06.254)
Sure, just go to NCX Brain Recovery.

NCXbrainrecovery.com and that's our website and you can just access us that way. You can Google us. We're still a five-star rated place. You can read the reviews and such. So we're pretty happy to just set up a video conference if you live out of state or out of country. That's mostly what we do when someone doesn't live very close.

If you happen to be in Utah and kind of close by or want to fly over here, we do in-person consultations. Those are always nice. We love the in-person stuff, but we're pretty much set up for a lot of virtual. We'll have just about an hour that we can go through all of your history and what symptoms you're still struggling with.

try to figure out if what you have is likely something that we can help. It's all about the fit and we're pretty good at filtering that. That's why we still have pretty good ratings and a lot of successes is we only want to have people come to us if we're very confident we can help them. But the consultation is the best place to start with that.

Travis White (49:34.17)
Awesome. Any last words? Anything that you want to say that you weren't able to say?

Nate Pope (49:42.158)
No, most people have had hit their heads and a lot of people know someone else who's hit their head and there's a certain population of those that are still struggling. I would just say if anyone's listening, gosh, there's, I promise you there is hope for those people and they don't have to keep suffering.

I really want to reach out and help as many people as we can. I'm positive we can make a significant impact on those who have hit their head and their symptoms haven't gotten better. If you know anyone in that category, just send them our way and we'll do a consult.

Travis White (50:30.096)
Well, thank you, Nate. So thank you so much for being on the show today. I've really enjoyed this discussion and for thank you for all those that listened today and follow us on Instagram at overcome pod and share. Please, please push the like button and share all that you can.

Nate Pope (50:35.436)
You bet. Thanks, Travis.

Nate Pope (50:52.824)
Thanks Travis.

Travis White (50:53.294)
We'll see you next time.