Hi Don,

I suffered from lingering headaches (which my doctors called a good sign of healing), bad depression, and extremely disrupted sleep. These PCS symptoms lasted long after the cognitive stuff faded. I think cognitively I was 80% of the way back after 2 months. I could read, write etc. But those other lingering symptoms and an extreme problem of lack of concentration endured for around 12 months. I was fortunate to get into college early as that application was already in when I got hurt. I went from being at the top of my class to dropping all but 2 courses and graduating high school simply based on the generosity of my school administrators and teachers. My parents were great at fighting my battles, but there were times in classes I used to ace that I just wanted to cry.

I think the first thing to understand about recovery is that it will occur. It’s slow, tedious, and discouraging at times, but given sufficient time, rest, and patience you will get better.

PCS is one of the worst types of injuries someone can endure because it is so hard to measure and understand. Most people look fine. All physical injuries have likely healed. It’s bad for athletes because teammates really don’t get it. You look fine, you move fine, so why can’t you get back out there? Teachers, employers, etc are all the same story. Even doctors don’t get it. People think just because you look fine and don’t exhibit major psychological symptoms you’re healthy and should just “get over it.” If you had PTSD from combat you would wake up screaming, be incoherent at times or something like that and people would know there’s something wrong. PCS robs you of more of yourself than PTSD, but it’s less pronounced so people don’t understand what it’s like for you. Even a significant other at times may ask if you’re faking it. Doctors calling symptoms psychosomatic are horrible, but not much of a surprise.

So the first thing I would suggest is just accept the notion that people will not understand what you’re going through unless they’ve been there. Don’t expect much of anything, even from doctors. PCS takes a piece of you that’s far worse than losing a finger or hand. Where you once excelled you are often average or even unable to complete basic tasks. No one understands how frustrating that feels as there’s very little that can rob someone of their cognitive abilities and still leave them coherent and mostly there.

Besides the Nintendo DS thing, I would say to just be patient with yourself. It’s hard to do. You want everything back, headaches to stop etc. But over time they inevitably will. Every doctor and patient I talked to said the same thing: given the time and support you will get better. When you’re going through it and saddled with PCS depression it’s impossible to feel that way, but it’s the truth.

Get your sleep under control. Stop setting alarms totally. I’m not sure of your age or situation, but every doctor will tell you good deep REM sleep speeds recovery tremendously. It took me on average six or seven hours to fall asleep, even with the drugs. (I had insomnia long before and after the concussions, so my sleep wasn’t good to begin with.) Once you’re actually asleep you need to maximize the REM hours you get. For me they were occurring at 5am and later. I had an alarm set for school at 7am, so I really wasn’t maximizing my REM hours. My advice is if possible turn off the alarm. When I did that I found the pace of recovery, mood, and frequency of headaches all improved greatly.

Try not to get frustrated. It solves nothing, adds to depression, and slows healing. Schedule simple tasks into the day that you know you can complete well. Nintendo is exactly that. What’s nice about it is it tracks the progress and helps you overcome even the most stubborn PCS depression. But any simple hand eye cognitively stimulating but simple tasks will do.

Sorry this is getting a bit long. Hang in there. I’m happy to answer other questions, talk on the phone or whatever. To give you some hope I went from first in my high school class to barely graduating. I ended up going to Princeton, graduating, and I’m in money management today. Given time, patience, and sleep I’m confident you will recover.

David