Are all my symptoms psychological at this point?
 

I suffered a concussion about 6 months ago, and have been experiencing PCS symptoms ever since, primarily headaches and some cognitive difficulties.

I have been making steady progress, and my symptoms have been gradually subsiding, although I still seem to have a certain way left to go.

I have seen a neurologist, and she assured me that after 6 months, she was certain that my symptoms were no longer related to physical injury, but were psychological at this point, a mild form of PTSD. She recommended a psychologist and encouraged me to push my limits more. She also said that once I overcame the injury, I would not see any cognitive/IQ deficit or lingering symptoms.

This is great news to me, as I was very worried about residual cognitive effects and physical damage. I wanted to ask if this was a common pattern of recovery, and if there's any chance that some it what I'm experiencing could still be physical?

The Cat

Welcome to NeuroTalk.

The doc may be right but there is no evidence to say she is. Nobody can set a timeline to recovery from a concussion. Those that do are not fully informed.

What cognitive deficits are you experiencing ?

Do you experience any anxiety symptoms or responses to triggers ?

Hi Mark, thanks for your reply!

I've experienced primarily short-term memory problems and problems with 'deep' (?) reasoning, things like visualizing images, seeing a few moves ahead in chess, etc--and feeling like there's a sense that I'm less smart than I used to be, although it's hard to exactly pinpoint. The memory problems, and everything else to be honest, seem to be improving with time; 1 month after injury, I couldn't read more than a page without headache and a certain degree of dyslexia setting in!

There is also quasi-permanent headache and ringing ears which worsen as I do mentally intense tasks or go for a drive.

To your second question, I was extremely worried about recovering all my mental faculties, perhaps obsessively so. I have actually noticed a decrease in physical symptoms following my meeting with the neurologist, and I do feel calmer.

Do you have any experience with this kind of thing? I've seen in some of your other posts you mention it's good to avoid stress following concussion; is that permanent advice or only during the recovery period?

Thanks!

Mental stress is never good, even for healthy brains. The science shows that multitasking is detrimental to even healthy brains.

I doubt you have less intelligence. More likely you just need to learn new ways to access that intelligence. Many intelligent people have never had to focus hard to complete a task so they have never learn what it takes to focus. By giving yourself a chance to focus, you will be able to access your intelligence.

A key part of any brain injury or stress is quite simple. As we do tasks over and over, our brain learns shortcuts. The square of 4 is 16. Simple short cut. The long way would be to stop and think, The square of 4 is the same as 4 x 4. What is 4 x 4 ? If you give yourself a break and slow down to think, you may over time progress through this as:

First try,
What is the square of 4 ?
The square of any number is that number times itself.
The square of 4 is 4 times 4.
4 times 4 is 16.

A later try,
What is the square of 4 ?

The square of 4 is 4 times 4.
4 times 4 is 16.
The square of 4 is 16.

After even more repetitions,
What is the square of 4 ?

4 times 4 is 16.

Finally,
What is the square of 4 ?

16.

This same process happens with developing muscle memory (typing), walking up stairs (first you look at the stairs then later you don't need to)
driving
and many thought processes.

In chess, the way each individual piece can move is memorized (diagonal, straight one space, straight until a piece is encountered, 2 forward 1 to the side, etc.) But a skilled chess player never even thinks about how a piece can move. It just becomes intrinsic to the piece.

So, give yourself a break and time to relearn the many shortcuts and you will start improving. Getting frustrated will only make things worse.

I have lost and regained these skills multiple times. My personal challenge was mental math and trying to beat the cash register in the days before bar codes when items had price tags. I'd suffer another concussion and lose this skill then practice and get it back.

The tinnitus may never go away or may come and go. The only solution is to learn to ignore it. There is no treatment.

Stress makes cognitive effort like trying to untangle a string. The more you pull, the tighter the tangles. But, shake the string loose and the tangles will be much easier to untangle.

Short term memory is often a result of focus. Example. Learning somebody's name. A common problem at a new introduction is simple. We are distracted by thinking of our own name that we want to tell the other person so we do not fully hear their name. If we stop thinking of our name and focus on hearing their name, we will do much better.

Is this making sense ?

It sounds like you are telling me that for a period after concussion, familiar tasks need to be relearned. The best thing to do is not push it too hard and try to make some progress at a reasonable pace? I'm starting university in 1 year, so I will no doubt have learned these lessons by then!

I can relate to what you said (although of course, I imagine to a much lesser extent) about things getting 'tighter' the more you push them; it was difficult to 'let go' in the beginning, but I think I may have finally learned the importance of this.

Thanks very much for taking the time to answer, it's very helpful to hear from someone who has been through the whole process, as I've found as I personally progress through it, many of my initial reactions/preoccupations were not what would lead to the best progression.

I would just also like to ask you, when you say "new ways to access that intelligence", will that ultimately entail really truly regaining my full prior mental capacities? I really don't mean to say this in a pretentious way at all, but I was objectively quite gifted in that regard, and this is something that has caused me a lot of worry as I will soon be entering a very challenging program at university.

Thank you for your help.

I suggest you not plan on regaining your full capability and learn a less intense life. Not because of any projection that you won't, but because most of the high performing, high intelligence people I have observed end up burning out, either emotionally, relationally, or otherwise. It also sets one up for hard falls every time there is a hick-up in achievement.

Most people I know or have known who build their lives around high achievement and intellect end up becoming jerks or at the minimum, dysfunctional in some areas of their life. Many have developed bi-polar struggles.

You will likely experience some roller coaster rides down the road as stress impacts people with a concussion history much more than than it does the rest of the population. The down cycles can make life miserable as the search for blame impacts those around us.

There is a rule about carrying a heavy load. Never carry a heavy load in such a way that if a single part of the load carrying system fails, the whole load is dropped. If it takes 3 to carry a load, use 4. If 1 fails, the other 3 can still carry the load.

If you have to perform at 98% all the time and 90% causes a failure, you are dooming yourself for a rocky ride. With PCS, we should plan to have those down cycles even when we are recovered.

Thank you for all your advice, Mark; I will remember it. I think I understand what you mean about not worrying too much about regaining intelligence not because of any chance that I won't, but because it's not a healthy thing to do in any event. I will try to moderate my activities for a good while until I feel much healthier.

Thank you again!