Like any brain injury, the symptoms will vary in each person based on the areas of the brain, which have been affected, the severity and frequency of the damage, the age of the victim during impacts, and possibly genetic factors that can heal the brain in different ways. There is a lot we do not know about brain injuries but this website hopes to help you recognize possible symptoms of CTE in order to gain understanding. Below are the symptoms we noticed in Patrick in the order of their appearance to us.
- Quick temper, Physical Outbursts, Anger. This was the first brain trauma symptom that we noticed in Patrick. Previously he was very introspective, aimed to please and never bothered anyone. He loved being happy, cracking jokes and having fun. He loved his family and friends and was always defensive of any underdog. But suddenly, any minor offense would bring out his rage. The unexpected quick temper was very pronounced and led to his tendency to get into fights. This increased in frequency as he got older. In his late twenties he was diagnosed with “Explosive Disorder”. He tried very hard to control his quick anger, but it was very difficult. As he grew older he seemed angry with everyone most of the time.
- Impulsivity, Lack of Self-Control, Poor Judgment. Patrick loved to laugh and make people happy. He would do anything for you if you asked. Hopefully you did not ask for anything too silly because it would be done. His impulsiveness and poor judgment increased every year. There are many funny stories of things Patrick would do in college that no one else would dream of doing. If he got an idea in his head, many times the switch to a “reality check” did not occur. When the videographer from his sister’s wedding turned out to be a scam artist and did not provide the videos as promised, Patrick broke his door down to retrieve the tapes, never once thinking of the consequences. As he got older the lack of self-control led to purchasing items he did not need, gambling, and making crazy decisions.
- Reclusive. This was the CTE symptom that was very noticeable over the years. As a child he loved being underfoot and as he grew up he loved being on a team and being with friends and family. As his college years progressed, he grew more and more reclusive in his dorm room. As an adult he seemed to stay in his room all the time. He complained of having no life, but had a hard time venturing out.
- Addictive Behavior. Patrick won the DARE poster contest in grade school and felt very sorry for people addicted to drugs or alcohol. He disliked what his dad was doing to himself by smoking cigarettes. He was always level headed about being a good contributor to society. He liked to have a good time, but was usually smart about it. But this CTE symptom is a hard one to fight. As his impulsivity rose, so did the tendency to drink alcohol and smoke marijuana. When he broke his back at Dartmouth he became addicted to the painkiller, Percocet. This would be an addiction he would fight on and off for the remainder of his life. When he was able to stay off of the painkiller he always sought a different distraction, which many times involved on-line gambling. In his later years he claimed he needed to shut-off the “ugly thoughts” he was having. He was proud that he never became addicted to hard drugs. He felt that his addictions were something he needed to do to save his sanity. The last few years of his life he smoked cigarettes almost incessantly.
- Trouble Concentrating. This CTE symptom appeared gradually in his post high school years. As a high school student he was always a quick learner and excelled in school. But by his senior year at Dartmouth he was seeking help and was diagnosed with an “Audio Processing Disorder”. In his last semester he was allowed to record his professors’ notes and also allowed extra time for his tests. After he graduated he sought help froma doctor and was prescribed Adderall for possible “Attention Deficit Disorder.” When he took the medication he was almost too attentive. It was like watching the “Beautiful Mind” movie with attention to detail that was unreal. Without the medication he had a hard time staying on task or even reading.
- Memory Problems, Difficulty Keeping Track of Verbal Exchanges. This became more and more noticeable as his disease progressed. It caused him a lot of problems at home and at work. He would have a discussion with a task in mind and then would do the opposite of what was discussed. Then he would become angry when his actions were questioned because he felt he was trying to do what was agreed upon. He always felt he was trying to do what people wanted him to do but forgot what that was. In high school he bragged about being able to memorize whole sections of text. His last week of life he showed up for a meeting on the wrong day and lost three golf clubs playing golf with a friend and fretted over why it happened. He started to forget how to sign his name.
- Trouble Prioritizing, Hard to Get Going. As a young man Patrick was very focused and driven for success. The CTE Patrick wanted very much to be successful but was very easily distracted away from important tasks. He worked best when he had a list but, having never needed lists before, he felt pressured and insulted when a list was presented. He would have good ideas but was unable to get them on paper.
- Confabulation, Feeling Misunderstood. As Patrick struggled with CTE it was very common to hear him say that no one understood him. And he was right. No one knew what was going on, and sadly, he probably was scared about his life direction as well. He would sometimes rant about an occurrence in his life. If you agreed with him that it was a terrible thing he would be alright, even if it really was not that bad. If you tried to convince him it was not a big deal or that he maybe could have done something differently to have prevented the occurrence, it would send him into a fit of anger. Confabulation is a psychological term defined in Wikipedia as a memory disturbance, defined as the production of fabricated, distorted or misinterpreted memories about oneself or the world, without the conscious intention to deceive. His interpretation of events was always so different. He would become very hurt by events he perceived happening. One which others perceived very differently. Patrick always prided himself on being a very forthright and honest person and when people questioned what he believed to be very true, it was hurtful.
- Low Self-Esteem. Everything Patrick touched was easy for him. If he wanted to do something he would excel. And no one was more charming or persuasive than Patrick when he wanted something. Success was very simple and he was gifted with many talents, strengths, and handsome good looks. He had friends and family that loved him, financial means, and a fantastic son he adored. But as his disease progressed things became harder. Convincing people of things was almost impossible. In his mind, no one wanted to work, hire, or partner with him.
- Paranoia. Patrick was always proud of his family and roots. He did not mind being himself and maybe even played it to extremes. But as the CTE permeated his brain he became less self-confident and more and more paranoid about what people said and thought about him. He believed the whole Mon Valley and Pittsburgh area was aware of everything he did and his struggles.
- Anxiety, Disturbed Sleep. This was a complaint he made often in his later years dealing with the CTE symptoms. He felt he could not go to sleep. He said he felt anxious. He was prescribed Klonopin to help him and maybe it did a little. But it seemed like his last few years were anxiety ridden. He was awake at all hours of the night and would eventually sleep late the next day.
- Depression, Negativity. Patrick’s most charming gift was his ability to find the fun and humor in just about everything. Towards the end of his sadly short life, Patrick was very negative about the world and was very depressed about his life. No amount of encouragement helped. During his last few days he complained that he had no friends, yet there was standing room only at his funeral mass. In his mind everyone’s situation was better than his life.
- Lack of Empathy. When Patrick was a young man he cared about everyone and worried about every underdog. It was nothing for him to give away his new school clothes to a less fortunate classmate before the tags were even off. He championed anyone he felt was ignored or abused. But as his CTE progressed, he seemed to care less or maybe just did not see the plight or opinion of others. He became much more focused on his issues and no longer focused on the challenges of others.
- Ugly Thoughts, Verbal Outbursts. These were the most alarming CTE traits that appeared in his last few years with us. He complained that he needed to gamble online in order to stop the “ugly thoughts” he had in his mind. He said he thought of suicide. He would blurt out words at inappropriate times. He would talk to himself. He said no one beat himself up as much as he did. At times we thought he was surely crazy and then he could pull it all together and be as normal as ever. Doctors did not see this part of the disease because he controlled it well when in public. He was diagnosed as having Post Traumatic Stress Syndrome resulting from his father’s death and sister’s car accident. He said he knew those bad things were going to happen and more bad things were coming.
- Unexplained Localized Pain, Headaches. This symptom stumped all of us. One day he would wake up with intense back pain. The next week it might show up in his ankle. And headaches seemed to be an almost chronic on and off occurrence. This was hard for him since he wanted to stay away from painkillers and hard for us to believe because he couldn’t explain what happened to create this pain out of the blue. Even his doctors doubted him. Sadly we now know how his brain was playing tricks on him.
- Suicide. This was the CTE symptom we dreaded but really never thought would happen. We called his psychologist office and informed them of our fears. We begged Patrick to seek help elsewhere and we talked to medical professionals on our own. We read every book we could get our hands on dealing with Bipolar Disorder and Borderline Disorder and Schizophrenia. Nothing seemed to fit and there was no family history indicating a similar problem. We were watching a young man, once successful and strong, now having issues with every part of his life. We even sought the help of a therapist who was supposedly trained to deal with concussions and head injury. Unfortunately, little is known in the medical community about CTE. The doctor felt Patrick’s issues were not concussion related. Sadly, he was very wrong and we now know the suffering Patrick endured was due to CTE, which is currently only able to be diagnosed post-mortem. Hopefully, a diagnosis can be developed for the living person in the near future. Even more hopefully, a cure can be discovered.
We are providing this list to provide insight for anyone showing similar symptoms. In his short life Patrick tried so hard to be successful for his family, friends, and schools. But his hard work and punishing athletic endeavors created this hideous disease. There is also a list of other possible symptoms on the Possible CTE Symptoms page. Everyone is different.
Please also see the page, What People With CTE May Want to Hear, for lessons we learned the hard way and sadly, too late.
Patrick would have liked this song, it described his struggles.