Concussion induced Depersonalisation
 

In my searching for an answer and some form of security that I will get better I thought it won't be a bad idea to share my story and see if anyone can relate, has experienced it, or can provide any guidance.


The Accident:

Just over 4 months ago I came off my mountain bike and fell around 2 meter (head to ground), taking the full impact on my head, breaking my helmet, and going unconscious for between 30 seconds and 1 minute.

There was no broken bones and the only source of blood was from surface wounds caused by my sunglasses digging into my skin.

I had a few hours of amnesia and was taken to hospital from the scene where scans were done and I was kept for a couple of days.


A Few Days After:

Over this period I was in a dream like state which reduced significantly over the days that followed and I returned to work on reduced duties after 5 days.

The condition I was in felt much like a drunk / high sensation minus the buzz - a detachment from reality. This faded over the weeks but not completely. The feeling is a dreamy element to my conscious state. A feeling of not being entirely present. This effects short term memory and ability to think in detail without some time to sit down and think the problem through. I've associated this with what’s termed "brain fog" in many discussions but I'm not entirely sure if it is the same thing. Depersonalisation is another term which roughly fits my feeling.

I'm an engineer and found myself mentally drained very quickly. I found it difficult to remember, retain, basically difficulty doing anything complex. Tiredness was mental. I wasn't tired during the day but felt I needed to sleep earlier than usual, sleeping for 10 hours a night in general with no memory of dreams in the morning. It felt like extremely deep sleep. Tiredness increased the dreamy reality feeling.


1 Month After:

At this point in time I felt like my condition had stabilised overall. I had begun to remember dreams on waking but they always felt intense. The sense of not being entirely present remained.


2 Months After:

The neurologist determined at this stage I was on the path to recovery without any signs of permanent long term damage.


4 Months After:

Entering the fourth month since the accident I feel like my mental recovery has flat lined. The sense of a dreamy reality remained - not being entirely present in my conscious state. It doesn't feel like I'm dreaming, it just feels different to how I felt before. The terms I’ve found to best describe it is depersonalisation.


Future:

I hope that the depersonalisation is related to the effects of the concussion and will reduce over time. Obviously with no real information on this condition I’m unable to know for sure and in that lies a worry that I will need to live like this in the long term or that it will detreated and get worse, ultimately leading to a condition such as dementia.

mothbox,

Welcome to NeuroTalk.

The brain fog and depersonalization usually fades over time. Anti-inflammatory and brain health supplements can give your brain the best help to get better. Read the vitamins sticky. The anti-inflammatory action of Omega 3 fish oil and good concentrated curcumin extract plus the B12 and other Bs should help your brain.

Why were you kept in the hospital? What symptoms did you manifest?

An important part of your recovery is making sure your neck, specifically your upper neck has healed. The subtle neck injury that goes with a concussion can slow blood flow to the brain through the vertebral arteries. Some skilled but gentle physical therapy or upper cervical chiropractic or osteopathic therapy can help followed with good posture discipline, especially during sleep.

The intense dreams could be due to reduced blood flow. I had them from improper breathing. For a year or two, I dreaded going to sleep due to the intensity of my dreams. When I finally resolved my upper neck issue, things got better.

Much of your symptoms are likely sleep related. Non-restorative sleep can leave your brain in a fog. Sleeping longer than usual often means you brain is struggling to get quality sleep.

Do you feel sleepy during the day? Do you hit fatigue points where you have to stop for a while?

The Vitamin regimen in the Vitamins sticky at the top can take weeks of discipline to see a benefit. It is worth it. Finding the best sleep situation, posture and pre-sleep hygiene can be a challenge. I learned that when I fell asleep in a reclining chair, I got my best sleep with less stressful/ less intense dreams. My wife could tell because my face would be calm. The stressful dreams would cause a stern look on my face. She knew that if she saw me with the stern look on my face, my day would not be good.

It takes time to sort these issues out. Doctors are not usually much help. We have to do it on our own.

My best to you.

I second the upper cervical chiropractic - info @ Up C Spine

I went off my horse , hit head and was out for some amount of time..long ago @ age 15, no internet to learn about things then.. I was OK for the most part, but many years later I do think some upper cervical chiropractic back then would have headed off my chronic shoulder & hip & low back pain in middle age......
( if c1c2 become misaligned- the body will try to rebalance itself..)


If you can slow activities & mental activities down a bit, eat clean ( limit junk foods , alcohol, caffeine etc)...might get you past the plateau.

A really good chiro /PT can be very helpful, with soft tissue, alignment, muscle spasms, trigger points.

Thanks for the information and support.

The time in hospital was because I was brought in by ambulance. They did a CT scan and X rays to confirm there was no damage then I was kept in over a couple of days until the emergency team discharged me (about 24 hours, some of this is due to them being busy and me being in a ward at the opposite side of the hospital), then the neuro team needed to discharge me which was about 3 days from entry.

I had stitches and my jaw was swollen so they had me in for observation. They took it pretty seriously and were full of warnings when i discharged about making sure i come back for the MRI ans EEG and that I needed to take it easy.

I'm currently taking omega3 tablets and multi vitamins and trying to maintain a balanced diet with a good amount of water to make sure im not dehydrated.

I'm not doing much in the way of exercise. I have a route through a country park where i live which i used to do on bike - just tracks with some good uphill sections to get the heart going - but I've only been out on it once since. I need to get my heart going regularly because i feel the emotional benefits to it more so than the physical.

For the condition of my neck I'm not sure. X rays and a CT was done and i was in a neck brace from the scene of the accident until they had determined my neck was not broken.

My neck is something I'll read into. Physio is a big business here in Oz and a lot of my colleagues go for physio massages regularly relating to the various sports they do.

A multivitamin is not even getting started on brain nutrition. The RDA used to formulate multivitamins is designed to prevent malnutrition, not promote optimal health. The B-12 in a multi is probably 5 mcgs. 1000 mcgs would be a good start.

The subtle neck issue from a concussion is rarely imaged in a CT Scan or X-ray. It is just a strain and bruise to the ligaments and surface that causes inflammation. The inflammation is the problem. The neck brace and imaging was to check for spinal cord risk. It is just EMT and ER protocol.

It sounds like you have a good health plan and the hospital and doctors were eager to bill for services. An EEG would not be indicated without seizures. A follow up MRI would also not be indicated without severe symptoms. A CT Scan is usually a better scan for head injuries. A CT Scan at 72 hours post impact would be optimum if you had symptoms that indicated a problem.

Otherwise, they are just subjecting you to excessive radiation and expense.

Avoid physio that pursues range of motion. Your neck may be strained by pushing for range of motion. Most physios like to track progress by pushing range of motion. Gentle traction with mobilization is about all you want until your heal.

Where is Oz?

Oz is Australia.

There was a possibility that I had a seizure on impact. This was later determined to have been a tremor which was said to be totally normal when getting knocked unconscious in such a way. This was unfortunately miscommunicated somewhere and whilst I was suffering amnesure and totally spaced out it had been deemed that a seizure had occured pre-impact. It was my stupidity in tackling the jump which caused me to fall, nothing else.

So, I needed to wipe that up because it had resulted in some hefty conditions in my returning to work. Its since been shown im not epileptic and the scans provided some information such as possible inflimation and some slowing in that area which is all attributed to the fall and will subside.

Im not sure how much of the scans are standard practice and how many are the result of the fake seizure and how much was milking my insurance, but the results allowed the neurologist to clear me of epilepsy which I needed for work.

In terms of person preception of life I feel its more of an emotional battle with myself and thats what has led me to ask here.

I'll look through the thread of vitamins you suggested and see whats available to me.

I've found the information here to be a lot more helpful than I've had to date.

And vitamin B12 is best absorbed on an empty stomach.

I sustained a concussion and definitely had the depersonalization issues, where you are here, but you don't really feel like you're all here. Absolutely, I know what you are talking about. As my concussion healed, that aspect went away, for the most part. I still get dizziness or light headedness from time to time under certain conditions or what I am doing.

There is comfort in hearing that others have been through similar conditions and come out the other side. How long did this last for with you?

I started on B12 (1,000 mcgs) this morning so hopefully that will provide my brain with some additional nutrients to aid its recovery.

I experienced this on the early days of my recovery. Felt dazed, spaced out, and disconnected with reality: the feeling you get when you don't sleep the night before. It might have something to do with my vision as well, which is not healed yet.

It disappeared within 3 months. I took and am still taking a lot of supplements though.

My recovery wasn't typical, as I sustained pituitary gland damage from a whiplash sustained in a rear-end collision. As a result, I had hypopituitarism, along with a concussion. I produced very little growth hormone. I didn't know it at the time, nor was it diagnosed for two years post-accident, so the concussion only minimally healed for the first two years.

When I was placed on growth hormone therapy, I'd say it took about six months to a year for the depersonalization issues to go away. All said and done, I had depersonalization for I'd say 2.5-3 years. Without the hypopituitarism issue, it'd probably have been two years less.

Ive seen depersonalization resolve after testosterone replacement therapy. It can be caused by hormonal imbalances that are due to a concussions affect on the hypothalamus or pituitary. clearly, as identified in medical literature and studies, hormonal issues can cause psychiatric like symptoms.

The source of the depersonalisation (if it actually is that) could be one of a few things from what I have read:

1) hormonal imbalance
2) reduced blood flow to brain
3) temporary swelling due to concussion
4) brain damage

All of these, I assume, could cause a variation in the way in which particular brain waves are sent, travel, or read, which could be the source of this current feeling. I hope its the 3rd one and eventually subsides.

It's very difficult to get any clear answers as it's all done with external tests.

Upper cervical chiropractic or osteopathic therapy could be the way to go as a start and I'm currently looking into where to get this service locally.

I've started on B-12 supplements alongside omega-3 and multi-vitamins which will hopefully aid recovery. I will add additional supplements as necessary but am cautious about loading up in one go to ensure that there are no reactions.

The next stage would be to review the possibility of a hormonal imbalance as a result of the concussion - and how this could be assessed and treated if it was to be the source.

Entering month 5, my feeling is fairly consistent with the past month. The sense of “depersonalisation”, a distance from reality, still remains with no noticeable improvement. The feeling of a detachment from reality doesn’t appear to be effecting cognitive ability and overall I seem to be getting used to living with it.

I have had a couple of weeks of good amounts of energy throughout the day and evening which seem to correlate with reduced sleep despite me focusing on trying to increase sleep. My sleep posture, on my side, is a work in progress as I adjust pillow height with towels under a memory foam pillow to achieve the right height. Over the last week I have found that I’m waking up between sleep cycles and finding that I'm naturally waking before my alarm and needing less sleep than previously. This may be a cycle that I'm going through or it could be a sign that I am returning to my pre-concussion sleep requirement of around 7 to 7.5 hours per night.

My diet has been important to me, not just because of the concussion recovery but in general I recognise that when I’m outside of the home I can easily be let astray. I have been trying to improve my lunches with salads containing plenty of nuts, fish, vegetables, and peas. I find I can eat a lot without feeling lethargic afterwards and this provides me with energy for the rest of the day and is likely the link with my increased daily energy.

In conjunction with this diet improvement I am trying to drink 2 to 3 litres of water a day and have started carrying a water bottle with me as much as possible to provide a stimulus to drink. I’m probably about a month into it at the moment and have slackened off over the last week but am conscious of it and am picking it up again.

I’m trying to tie my supplements into my eating habits as well and have begun to string out the fish oil tablets over the day with my meals, totalling 1,000mg of DHA per day. I take a multi-vitamin with breakfast and try to ensure I don’t take it on an empty stomach because it makes a noticeable difference to my urine indicating I’m passing it relatively quickly when taken without food.

I’m about 3 weeks into taking vitamin B12 (1,000 mcgs) every morning on an empty stomach about 1 hour before breakfast. Initially there was a noticeable energy boost when taking this which would have been a placebo effect. I have noticed some increase in concentration ability over the day so I will continue with this into the future. Currently I’m taking 1,000mg of DHA (fish oil) and 1,000 mcgs B12 per day plus a multi-vitamin.

I very recently saw a chiropractor who has set me up with some exercise for posture overall and didn’t find anything concerning with my neck – my main concern had been C1-C2 following online research and forums. He will continue to work with me on my overall posture and this will also focus on my neck as part of this but at present there hasn’t been a specific issue found. I have no neck ache or pain.

I am now 15 months out and this aspect of the injury has not really improved much at all for me. I HATE it.

I completely understand what you guys are going through, and it is one of the most unsettling aspects of this whole thing. It reminds me of the old axiom "I think, therefor I am."

Well the sad fact now confronts me that because my thinker is diminished, my existence itself is diminished in that I feel less present, almost as though I exist less. The crispness of reality that I once took for granted seems gone for now. Reality is less sharp, less vivid, less convincing.

It is very similar to the effect of taking dissociative drugs. So I hypothesize that this aspect of the injury may be due to a reduction of glutamate neurotransmission, reflecting white matter damage in particular. This is based on my experience taking these drugs in the past where the same sort of feeling has occurred, but of course always resolving spontaneously. TBIs sadly do not.

I'm now 6 months after and don't feel any different to previous months in terms of depersonalisation.

My length of required sleep has returned to around 7-8 hours / night and I often wake up before my alarm and can carry out a full day at work without any major problems.

I found a stronger B-50 complex and have started on that with no negative side effects. My current supplement regime is:

• DHA (fish oil) – 2x360mg
• B50-Complex (Ultra B 150 Forte):
  • B1 - 150mg
  • B2 - 150mg
  • B3 - 150mg
  • B5 - 150mg
  • B6 - 150mg
  • B12 – 0.4mg
  • Folic Acid – 0.5mg
  • Biotin – 0.15mg
  • Choline Bitartrate – 75mg
  • Inositol – 75mg
• Activated Methyl B12 (mecobalamin) - 1mg
• Curcumin - 15,800mg with bioperine

I currently also take lecithin and a standard multi-vitamin which I plan on dropping back. I also hoped to drop back on the fish oil and replace it with an increase in oily fish in my diet but so far I haven't managed to increase it beyond about 2 meals per week so I'm sticking with the fish oil tablets.

I have begun to accept that my current feeling of depersonalisation is permanent brain damage. It doesn't get weaker or more intense, it doesn't alter based on what I've eaten or drunk. I hope that by accepting this that it will make it easier to accomodate it into my life long term, and if I turn out to be wrong and I recover totally then it's a bonus, rather than the other way around.

On the one hand, I think that's the right attitude. Recovery is never guaranteed. On the other hand, it's only been six months, and it's certainly very possible that you'll see ongoing improvement.

Where in Australia are you?
I'm in Brisbane. I've just suffered another concussion after having PCS for the last year. It's funny but I feel the depersonalisation you describe more with this latest concussion then the last. But I am hopeful because I got over it before so feel like I can again.
Find a good physio. A bit tough I know because there are so many of them but shop around a bit. If you don't have private health cover think about getting it. I was treated publicly for quite a while but didn't really improve until I started seeing a private physio. It was a bit tough financially but worth it.
Have you tried a psychologist? Another known symptom of PCS is depression and anxiety. I was referred to a neuropsychologist who specialises in people with chronic pain. I'm an engineer also so was sceptical at first, but it did help, especially when she explained that certain regions of the brain can become 'dormant' so to speak when we are in chronic pain such as those controlling emotions or those giving us our sense of being present.
Good luck.

I'm in Sydney at the moment.

I've started with a chiro due to reading through these forums and it's let me to go back about once a month just to work on overall posture and wellbeing. This was never something that was recommended by the hospital or neurologist.

I took the full energy of my body plus my bike into my head so I'm probably quite lucky I don't have any serious PCS. It's my assessment of the severity of that impact and the constant state of the depersonalisation which has let me to conclude that it's probably permanent damage, although obviously it turning out not to be would be absolutely fantastic. Until then though this acceptance has allowed me to be more positive about the situation.

I've always been an anxious person and this hasn't changed and haven't had any symptoms of depression or any of the other common PCS symptoms.

I've contemplated trying some meditation. Probably a good thing all round even without the concussion. Not trying to reach a higher plane or anything, just to clear my head and sit empty for a few minutes and gather my thoughts at the end of the day. Getting into a positive mindset about the situation and the future, regardless of how bad it could be, can only be a good thing.

Your depersonalization will go when you recover its not permanent.

You should be taking Vitamin D. There are two studies Im aware of that point to Vitamin D levels and improved sleep. They identify the range of 60 to 80 as the zone to strive for. According to the vitamin D council you can take up to 10,000 mg per day of vitamin d3. my son took 12,000 for a few weeks and then moved down to 8,000. Vitamin D is a hormone not a vitamin. Its very important in many aspects of human physiology and I believe can protect against concussions. There are studies out there on this you can google. also see this

A Concussion-Free Football Season: How one High School beat the odds - July 2�12 | Vitamin D Wiki

According to Dr Komer who helped my son recover from his concussion you should be taking 3,000 fish oil per day in addition to the Vitamin D.

Dr. Larry Komer, MD - Home | Facebook

I recommend you check him out on the web.