Multiple Concussions or Anxiety
 

Hi everyone,

Apologies for the long post


Would love some expert input to the past three months! I've been diagnosed with anxiety/trauma and am actively working on it, but would appreciate some advice if the "bumps and bruises" I've experienced post initial concussion were real or not.


About me: 23M, very fit and used to exercise daily/run 40miles a week. Still trying to stay fit post-injury with stationary bikes and light weightlifting most days


Current Symptoms - Anxiety/PTSD, sore neck/tense shoulders, clogged ears (airplane ears), dull ache from initial concussion blunt trauma spot, occasional dizziness and vertigo when "agitated" or anxious


Timeline

Mid-January 2022 - Was bench pressing flat on a bench and the barbell dropped on my head. Clear concussion, symptoms were headaches, aversion to screens. Symptoms had resolved 90% by the end of two weeks. No other symptoms. Returned to light exercise 48 hours after injury, resumed normal exercise routine (stationary bike in lieu of running) a week after.


Early February 2022 - I had bought a new foam mattress (Casper Element, Full ~80lbs) and had it leaning against the wall while I was sitting next to it. The mattress crumpled and tipped over, bouncing off my head after falling a few feet. Initially I didn't think much of it since it was soft and bouncy, but new symptoms of anxiety and nausea kicked in. No headaches, no aversion to light - nausea was the main problem (Zofran helped a lot). Not sure if this was a new concussion, but this is where my anxiety started. My head became very sensitive to any bumps and bruises, where as prior to this incident (post initial concussion) I wasn't fearful of light bumps and bruises.


Late February 2022 - Was walking down a flight of stairs outdoors when a car honked at me. I stumbled and planted my right foot down a stair, jamming my heel. Immediately I felt it and my mind panicked. Immediate new symptoms were a renewed aversion to light, anxiety and fear. After this incident, my entire body became sensitive to bumps and bruises, bumpy car rides, hard steps from walking, etc.


While most of my physical symptoms have healed pretty well, my mental state continues to deteriorate. Any slight jostle or bump triggers my flight or fight mode, and while a few sessions of CBT have helped me reduce the length of my state of agitation, I'm still getting triggered as commonly as I was before. I'm fearful of taking any hard steps - I can feel the bumps of driving over a pothole, and my head is incredibly sensitive to any contact. After agitation, I often get a dull headache at the portion of the head where the barbell slammed into my skull, slight vertigo, and of course - anxiety.


For example, I dropped my head a few inches into a firm pillow last night and panicked. I've taken to dropping an egg to mimic these bumps, arguing to the rational brain that if an egg doesn't crack, my head should be fine.


My question to you all is two-fold:

1. Out of those two additional incidents post-initial concussion, do you think any of the other two were real concussions, or just my anxiety/brain freaking out? My PCP doesn't think so while my psychiatrist (versed in military PTSD) thinks the mattress incident was a second concussion and the source of all my current psychological problems.


2. What do you recommend to desensitize my brain? CBT hasn't worked as well as I hoped, and supplements to reduce inflammation haven't made a noticeable difference.

1. No. They were not even subconcussive impacts. You triggered into an anxiety reaction. You are not thinking logically. Your brain is playing old memories and making you think they are real.

2. You might benefit from an SSRI to help you not have anxiety reactions. Talk to your therapist.

I have seen many on NT in the past 10 years who could not overcome these issues until they finally gave their mind a break with an SSRI or SNRI medication. I hate meds but know they are the only solution for some and temporary use can be justified.

Your workout routine suggests you are tightly wound. This is the primary pre-existing condition for the Concussion Anxiety Disorder you are manifesting. 80% of people with prolonged symptoms had a prior OCD, anxiety, or depression struggle.

Your exercising was your self-medicating for your mental struggles. It can work well until you make it worse with a real concussion. Then, you need help.

I hope you can find the help you need.

Over the last decade, I have answered these illogical "Did landing hard on my pillow cause a concussion?" too many times. Then, I was answering the same question while my wife was recovering from cancer surgery. I decided NO MORE.
Life hands us real struggles but some choose to make illogical events into struggles.

Everybody gets one chance with me.

I wish you the best as you look for help. Don't let anybody tell you these head contacts were damaging. They were not.

That makes sense
 

Thank you Mark for your feedback - I totally agree that anxiety/PTSD is the root cause for the vast majority of my problems. Upon further reflection, you were spot-on about anxiety in my past. I've always been more prone to stress and irrational fears, especially about health, even though I didn't realize it

Aside from SSRIs, do you have any other recommendations or experience with how folks resolved their anxiety/PTSD with concussions? I tried Lexapro briefly, but the side effects were too rough to continue - definitely worth trying another SSRI to see if my body reacts a little better to different medication. I do have an emergency stash of low-dosage Klonopin prescribed to me, but I prefer less addictive and and a more healthy long-term solution. I've heard EMDR, biofeedback, and exposure therapy (sports psychology) are also effective.

As a side question - my "head/neck" is still very sensitive to jostling - even walking roughly sends a "bumpy" sensation to my brain. This happens even when I'm less anxious or on Klonopin, which leads me to believe there may be something that hasn't healed yet physically. In your experience, can a subtle upper neck injury be the source of this sensitivity to bumpy walks/roads? I do notice my perceived bumpiness and dizziness increases on weeks where my neck hurts.

I would avoid pharmaceutical drugs like antidepressants or antinausea pills because they don't help the brain heal. If you look at the most severe PCS cases, they usually have two things in common - multiple head hits and antidepressants.

I think Inflammation is the more likely culprit and treatment should focus on that. The brain's inflammatory system is on high alert after a concussion and a secondary impact, even a minor impact, can trigger an over-active inflammatory response and it's that inflammation that causes the symptoms.

A lot of the foods we eat, especially refined carbohydrates and processed vegetable oils, cause inflammation which will exacerbate your sensitivities. So you should adopt a low carb high fat / ketogenic / sugar free / wheat free / organic diet to help keep the inflammation down as part of your treatment.

• Stop eating sugar and refined carbohydrates (fructose, wheat, white flour) because they cause inflammation, lack nutrition, and are acidic.
• Replace wheat with whole grains such as Quinoa flour, Almond flour, or Chickpea flour.
• Avoid processed vegetable oils such as Canola oil as they can cause oxidation and inflammation which is destructive.
• Cook with healthy saturated fats such as Coconut oil, Olive oil, butter, or animal fats instead, and eat lots of it.
• Processed foods often contain the bad ingredients and added sugars so they should be avoided.

Anxiety is linked to brain inflammation, and so is PTSD. Diet can be and should be used as part of the treatment. The goal is to give the body optimal nutrition and optimal conditions so the brain can heal itself.

Then your brain needs to learn to stop over-reacting to the jolts. Try a Gradual Exposure strategy. Do just enough activity to cause mild discomfort but not so much to cause major symptoms. Rest and recover, then repeat.

When you do experience severe symptoms from minor bumps, take a double dose of Omega-3 DHA and Curcumin immediately after the incident. Both are anti-inflammatory and neuro-protective so they will protect your brain from possible injury.

Save the Klonopin for rescue situations. I had it for rescue in the early years.

You should try the vitamin regimen listed in the stickies. Consider adding 5-HTP and L-Theanine.

I was on paroxetine for 14 years to reduce the looping in my thoughts. Not OCD but an OCD like looping of mundane things like words to a song, spelling a word, repeating a car license plate. The side-effects were getting old. My doctor helped me transition off it to L-Tryptophan and 5-HTP and L-Theanine. I am doing great on 5-HTP and L-Theanine. Both are Over the Counter. 200 mgs a day of each.

Worth a try IF you are not taking meds.

Do you find that your emotions are unstable? In addition to anxiety, do you feel increased irritability and fly off the handle easily? I find my mood is very adversely triggered by even minor stress. I'd like to know what you are experiencing in this regard.

I am easily triggered so I have learned to recognize those triggers and make an effort to remove myself from those environments if at all possible.

We need to learn how to pick our challenges each day.

I do much better with this risk of being triggered not that I am off the SSRI and using 5-HTP and L-Theanine instead.

I also MUST focus on getting proper quality sleep. Quantity sleep is useless for preparing me for a good day.

Welcome bluesinthenight. :Tip-Hat: